Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Metformin İntoleransı Olan Tip 2 Diyabet Hastalarında Helicobacter Pylori Sıklığı
Helicobacter Pylori Incidence in Diabetic Patients With Metformin Intolerance
Gökhan PUŞUROĞLUa, Hatice BEYAZAL POLATa, Teslime AYAZa
aİç Hastalıkları AD, Recep Tayyip Erdoğan Üniversitesi Tıp Fakültesi, Rize, TÜRKİYE
Turkiye Klinikleri J Med Sci. 2019;39(2):165-9
doi: 10.5336/medsci.2018-63195
Article Language: TR
Full Text
ÖZET
 Amaç: Diyabet hastalarının tedavilerinde çok sık ve etkili olarak kullanılan metforminin bazı hasta grubunda tolere edilemediği, tedaviye uyum sağlayamadığı da gözlenmektedir. Dünya nüfusunun yaklaşık %50'sini etkileyen Helicobacter pylori (H. pylori) enfeksiyonu ile yapılan çalışmalarda diyabetik hastalarla H. pylori prevalansı arasında kontrol gruplarına göre çoğunlukla artış saptanmış olmasına rağmen, normal ya da düşük olduğunu gösteren çalışmalar da mevcuttur. Bu çalışmada diyabetik hastalarda metformin intoleransı ile H. pylori enfeksiyonu varlığı arasındaki ilişkinin incelenmesi amaçlanmıştır. Gereç ve Yöntemler: Ağustos 2014-Ağustos 2018 yılları arasında Recep Tayyip Erdoğan Üniversitesi Tıp Fakültesi Hastanesi Gastroenteroloji polikliniği Endoskopi Ünitesine başvuran ve üst gastrointestinal endoskopisi yapılan hastaların kayıtları retrospektif olarak değerlendirilmiştir. Metformin intoleransı olan 49 hasta, vaka grubu ve metformin intoleransı olmayan 50 hasta kontrol grubu olarak alınmıştır. Hastaların demografik özellikleri, üst gastrointestinal endoskopi raporları ve endoskopik biyopsi sonuçları değerlendirilmiştir. Tüm veriler bilgisayar ortamına aktarılmış olup, istatistiksel analizler SPSS 22,0 paket programı kullanılarak yapılmıştır. p değerinin 0,05'den küçük olması istatistiksel olarak anlamlı kabul edilmiştir. Bulgular: Araştırma kapsamında incelenen vaka grubunun yaş ortalaması 54,6±10,5 yıl olup %79,6'sı kadın, kontrol grubundaki hastaların ise yaş ortalaması 58,6±9,4 yıl olup %68,0'ı kadın olarak tespit edilmiştir. Endoskopik biyopsi sonucu H. pylori (-) ve (+) olarak gruplandığında vaka grubundaki hastaların %73,5'inde H. pylori (+) iken kontrol grubunun %50,0'ında (+) olarak tespit edilmiştir. Araştırmaya dahil edilen 99 hastanın tamamında ise; %61,6'sında (n=61) H. pylori (+) saptanmıştır. Sonuç: Bu çalışmanın sonucunda tüm hastalarda bulunan H. pylori pozitifliği Türkiye'de yapılmış olan çalışmalar ile uyumlu olarak bulunmuştur. Ayrıca bu çalışmada metformin intoleransı olan hastalarda H. pylori pozitifliği oranı metformin intoleransı olmayan hastalara göre yüksek tespit edilmiştir. Metformin intoleransı olan diyabetik hastalarda H. pylori eradikasyonu sonrasında metformin kullanımı açısından bir şans olabilir.

Anahtar Kelimeler: Diabetes mellitus; Helicobacter pylori; metformin
ABSTRACT
 Objective: It is observed that the metformin used frequently and efficiently in the treatment of diabetes patients can not be tolerated in some patient groups, and does not adapt therapy. Studies with Helicobacter pylori (H. pylori) infection that affects about 50% of the world's population, have been shown to be normal or low, although there is a significant increase in the prevalence of the H. pylori with diabetic patients. The aim of this study was to examine the relationship between metformin intolerance and presence of H. pylori infection in diabetic patients. Material and Methods: Between August 2014-August 2018 years, admitted to Recep Tayyip Erdoğan University Faculty of Medicine Hospital Gastroenterology Polyclinic Endoscopy Unit and retrospectively evaluated patients with upper gastrointestinal endoscopy. A total of 49 patients with metformin intolerance were taken as control group of 50 patients with no group and metformin intolerance. Demographic characteristics, upper gastrointestinal endoscopy reports and endoscopic biopsy results were evaluated. All data was transferred to the computer environment and statistical analyzes were made using the SPSS 22.0 package program. The p value less than 0.05 is statistically significant. Results: The mean age of the study group was 54.6±10.5 years and 79.6% were female and mean age was 58.6 ±9.4 years, and 68.0% were women. As a result of endoscopic biopsy H. pylori (-) and (+), 73.5% of the cases were determined as H. pylori (+) at 50.0% (+). In all of the 99 patients included in the study, H. pylori (+) was found in 61.6% (n=61). Conclusion: As a result of this study, the H. pylori positivity of all patients was consistent with studies in Turkey. In addition, H. pylori positivity rate in patients with metformin intolerance was higher in patients with metformin intolerance. Diabetic patients with metformin intolerance may have a chance to use metformin after H. pylori eradication.

Keywords: Diabetes mellitus; Helicobacter pylori; metformin
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