GKD Anest Yoð Bak Dern Derg. 2019; 25(1): 61-67 | DOI: 10.5222/GKDAD.2019.97659

The Relationship Between Taurin, Glycated Hemoglobýn And C- Reactive Protein In Diabetic Patients With Heart Surgery

Saliha Aksun¹, Banu Sarer Yürekli², Köksal Dönmez³, Habib Cakir³, Senem Girgin⁴, Ertan Damar⁵, Mert Kestelli³, Murat Aksun⁴, Ýsmail Yürekli^3
1Department Of Medical Biochemistry, Izmir Katip Celebi University, Faculty Of Medicine, Izmir, Turkey,
²Department Of Endocrinology, Ege University, Faculty Of Medicine, Izmir, Turkey,
³Department Of Cardiovascular Surgery, Izmir Katip Celebi University Atatürk Education And Research Hospital, Izmir, Turkey,
⁴Department Of Anesthesiology And Reanimation, Izmir Katip Celebi University Faculty Of Medicine, Izmir, Turkey,
⁵Private Ege City Hospital, Izmir, Turkey

INTRODUCTION: Taurine is an amino acid synthesized in the liver through methionine and cysteine sulfinic acid, is not used in protein synthesis. Its antiinflammatory and hypoglycemic effects were shown. In this study the postoperative level of taurine and its effects on inflammation were evaluated.
METHODS: Thirty-four patients with heart surgery were included in the study. Plasma taurine, C-reactive protein (Crp), HbA1c levels were measured in the blood taken on the third postoperative day. All patients included in the study were divided into two groups according to Group 1: HbA1c levels of 6 or less(with good glycemic control) and Group 2: HbA1c levels of 6 patients with diabetes(poor glycemic control).The dose of methyl prednisolone given during the operation was recorded retrospectively.
Normal adult serum taurine concentration ranges between 45-130 micromol/L.


RESULTS: Normal plasma taurine levels were detected in only eight out of 34 patients and taurine levels were lower in the other patients. The mean taurine level was 34.30±34.81 micromol/L.The amount of methylprednisolone given to patients with HbA1c≤%6,0 (group1) was found to be significantly higher than that of methylprednisolone given to patients with HbA1c>6.0% (group 2)(p <0.05).
There were no difference in Crp levels between the groups (group1;15,22±4,15 and group2;14,2±4,87mg/dl,p>0,05). Blood glucose and taurine values were not significantly different between the groups(p> 0.05).

DISCUSSION AND CONCLUSION: Twenty-six cases had a low taurine plasma level. The fact that Crp was not significantly different between the groups indicated that inflammation could be controlled equally in both groups. In Group2, equal antiinflammatory control with group 1 could be achieved and the methyl-prednisolone level given in this group was significantly lower (for group2; 8.36±1.04, for group1 9.78±1.68 mg/kg,p<0.006). Plasma taurine aminoacid, which is found to be higher in Group2, may be thought to have contributed to the antiinflammatory effect. Further studies including the preoperative taurine levels should be planned.

Keywords: Taurine aminoacide, Cardiac surgery, Antiinflamatuar effect, Nutritional support

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Kardiyak Cerrahi Uygulanan Diabetik Hastalarda Taurin, Glikolize Hemoglobin ve C-Reaktif Protein Ýliþkisi

Saliha Aksun¹, Banu Sarer Yürekli², Köksal Dönmez³, Habib Cakir³, Senem Girgin⁴, Ertan Damar⁵, Mert Kestelli³, Murat Aksun⁴, Ýsmail Yürekli^3
1Ýzmir Katip Çelebi Üniversitesi Týp Fakültesi, Týbbi Biyokimya Anabilim Dalý, Ýzmir
²Ege Üniversitesi Týp Fakültesi, Endokrinoloji Bilim Dalý, Ýzmir
³Ýzmir Katip Çelebi Üniversitesi Atatürk Eðitim ve Araþtýrma Hastanesi, Kalp ve Damar Cerrahi Kliniði, Ýzmir
⁴Ýzmir Katip Çelebi Üniversitesi Týp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalý, Ýzmir
⁵Özel Ege Þehir Hastanesi, Ýzmir

GÝRÝÞ ve AMAÇ: Taurin, protein sentezinde kullanýlmayan, methionin ve sistein sülfinik asit üzerinden karaciðerde sentezlenen bir aminoasittir. Antiinflamatuar ve hipoglisemik etkileri gösterilmiþtir. Bu çalýþmada taurinin postoperatif düzeyi ve inflamasyona etkileri deðerlendirilmiþtir.
YÖNTEM ve GEREÇLER: Kalp cerrahisine alýnan 34 hasta çalýþmaya dahil olmuþtur. Operasyon sonrasý üçüncü günde alýnan kanda plazma taurin, C reaktif protein (Crp), HbA1c düzeyleri ölçülmüþtür. Çalýþmaya katýlan tüm hastalar, Grup 1: HbA1c düzeylerine göre 6 ve daha düþük (glisemik kontrolü iyi olan) diyabetli hastalar ve Grup 2: HbA1c düzeyi 6’dan yüksek (glisemik kontrolü kötü olan) diyabetli hastalar olarak iki gruba ayýrýlmýþtýr.
Operasyon sýrasýnda verilen metil prednizolon dozu retrospektif olarak kaydedilmiþtir. Normal yetiþkin plazma taurin referans aralýðý 45-130 mikromol/L olarak alýnmýþtýr.


BULGULAR: 34 hastanýn sadece sekizinde normal plazma taurin düzeyleri saptanmýþ, diðer hastalarýn plazma taurin düzeyleri ise düþük bulunmuþtur. Ortalama taurin düzeyi 34,30±34,81 mikromol/L’dir. Grup 1’de verilmiþ olan metilprednizolon miktarý, grup 2’de verilen metil prednizolon düzeyinden anlamlý olarak yüksek bulunmuþtur (p<0,05).
Gruplar arasýnda Crp düzeylerinde fark saptanmamýþtýr (grup1;15,22±4,15 ve grup 2; 14,2±4,87 mg/dl,p>0,05). Kan þekeri ve taurin deðerlerinde de gruplar arasýnda anlamlý fark bulunmamýþtýr(p>0,05).

TARTIÞMA ve SONUÇ: Yirmi altý olgunun taurin plazma düzeyi düþüktür. Crp’nin gruplar arasýnda anlamlý olarak farklý bulunmamýþ olmasý inflamasyonun her iki grupta eþit seviyelerde kontrol edilebildiðine iþaret etmektedir. Grup2’de, grup 1 ile eþit antiinflamatuar kontrolün saðlanabildiði ve bu grupta verilen metil prednizolon düzeyinin anlamlý olarak daha düþük olduðu (grup 2 için; 8,36±1,04, grup 1 için 9,78±1,68 mg/kg,p<0,006) görülmüþtür. Bu durumda grup 2’de daha yüksek olarak bulunan plazma taurin aminoasitinin antiinflamatuvar etkiye katkýda bulunmuþ olabileceði düþünülebilir. Preoperatif taurin düzeylerini gösteren çalýþmalar planlanmalýdýr.

Anahtar Kelimeler: Taurin aminoasidi, Kardiyak cerrahi, Antiinflamatuar etki, Gýda desteði

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