Diabetesta sairastavien VTI-alttiuden syyt
Lisätietoa aiheesta
Maarit Wuorela
18.6.2019
- Syyt diabetesta sairastavien lisääntyneeseen VTI-alttiuteen ovat osittain epäselvät.
- Useissa tutkimuksissa naissukupuoli, potilaan ikä, diabeteksen kesto ja mikrovaskulaarikomplikaatioiden
esiintyminen, muu sairastavuus ja aikaisemmat VTI:t korreloivat bakteriuriaan «Zhanel GG, Nicolle LE, Harding GK. Prevalence of a...»1, «Hoepelman AI, Meiland R, Geerlings SE. Pathogenesi...»2 tai VTI-alttiuteen «Geerlings SE, Stolk RP, Camps MJ ym. Asymptomatic ...»3, «Zhanel GG, Harding GK, Nicolle LE. Asymptomatic ba...»4, «Wilke T, Boettger B, Berg B ym. Epidemiology of ur...»17.
- Vaikka mikrovaskulaarikomplikaatioiden kehittyminen liittyy nimenomaan huonoon verensokeritasapainoon
«The effect of intensive treatment of diabetes on t...»5, «The relationship of glycemic exposure (HbA1c) to t...»6, «Stratton IM, Adler AI, Neil HA ym. Association of ...»7, bakteriurian ei kuitenkaan ole todettu olevan tilastollisesti merkittävästi yhteydessä
tutkimushetkellä todettuun glukosuriaan tai hyperglykemiaan.
- Tutkimustulokset GHbA1c-tason vaikutuksesta VTI-alttiuteen ovat ristiriitaiset «Zhanel GG, Nicolle LE, Harding GK. Prevalence of a...»1, «Zhanel GG, Harding GK, Nicolle LE. Asymptomatic ba...»4 , «Geerlings SE, Stolk RP, Camps MJ ym. Risk factors ...»8, «Boyko EJ, Fihn SD, Scholes D ym. Diabetes and the ...»9, «Boyko EJ, Fihn SD, Scholes D ym. Risk of urinary t...»10, «Hine JL, de Lusignan S, Burleigh D ym. Association...»14, «Amos TB, Montejano L, Juneau P ym. Healthcare cost...»18.
- Glukosurian on todettu parantavan E. coli -bakteerien kasvua in vitro «Geerlings SE, Meiland R, Hoepelman AI. Pathogenesi...»12.
- Tutkimustulokset glukosuriaa aiheuttavien SGLT2:n estäjien yhteydestä VTI-alttiuteen
ovat ristiriitaiset «Li D, Wang T, Shen S ym. Urinary tract and genital...»16.
- Paikallisilla immunologisilla tekijöillä voi olla vaikutusta VTI-alttiuteen. Diabetesta
sairastavien naisten virtsan leukosyyttimäärät ja virtsan IL-6- ja IL-8-pitoisuudet
ovat pienempiä kuin terveiden «Balasoiu D, van Kessel KC, van Kats-Renaud HJ ym. ...»11, «Geerlings SE, Meiland R, Hoepelman AI. Pathogenesi...»12..
- E. coli -bakteerit, joilla on tyypin 1 fimbrioita, tarttuvat kaksi kertaa paremmin diabetesta
sairastavien naisten uroepiteelisoluihin kuin kontrollipotilaiden soluihin «Geerlings SE, Meiland R, van Lith EC ym. Adherence...»13.
Kirjallisuutta
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Artikkelin tunnus: nix00494 (000.494)
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