KH2014 Suositus KH2014 Suositus

Tulosta

Diabetesta sairastavien naisten VTI-alttiuden syyt

Lisätietoa aiheesta
27.6.2006
Työryhmä

Syyt diabetesta sairastavien naisten lisääntyneeseen VTI-alttiuteen ovat osittain epäselvät.

Useissa tutkimuksissa potilaan ikä, diabeteksen kesto ja mikrovaskulaarikomplikaatioiden esiintyminen korreloivat bakteriuriaan «Zhanel GG, Nicolle LE, Harding GKM, and the Manitoba Diabetic Urinary Infection Study Group. Prevalence of asymptomatic bacteriuria and associated host factors in women with diabetes mellitus. Clin In»1, «Hoepelman AI, Meiland R, Geerlings SE. Pathogenesis and management of bacterial urinary tract infections in adult patients with diabetes mellitus. Int J Antimicr Agents 2003; 22:S35-S43»2 tai VTI-alttiuteen « Geerlings SE, Stolk RP, Camps MJ ym. Asymptomatic becteriuria may be considered a complication in women with diabetes. Diabetes Care 2000;23:744-9»3, «Zhanel GG, Harding GK, Nicolle LE. Asymptomatic bacteriuria in patient with diabetes mellitus. Rev Infect Dis 1991;3:150-4»4. Vaikka mikrovaskulaarikomplikaatioiden kehittyminen liittyy nimenomaan huonoon verensokeritasapainoon «The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes m»5 «The Diabetes Control and Complications Trial Research Group.The relationship of glycemic exposure (HbA1c) to the risk of development and progression of retinopathy in the Diabetes Control and Complica»6 «Stratton IM, Adler AI, Neil HA ym. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35). BMJ 2000;321:405-12»7, bakteriurian ei kuitenkaan ole todettu olevan tilastollisesti yhteydessä tutkimushetkellä todettuun glukosuriaan, hyperglykemiaan tai GHbA1c-tasoon «Zhanel GG, Nicolle LE, Harding GKM, and the Manitoba Diabetic Urinary Infection Study Group. Prevalence of asymptomatic bacteriuria and associated host factors in women with diabetes mellitus. Clin In»1, «Zhanel GG, Harding GK, Nicolle LE. Asymptomatic bacteriuria in patient with diabetes mellitus. Rev Infect Dis 1991;3:150-4»4, « Geerlings SE, Stolk RP, Camps MJ ym. Risk factors for symptomatic urinary tract infection in woman with diabetes. Diabetes care 2000;23:1737-41»8, «Boyko EJ, Fihn SD, Scholes D ym. Diabetes and the risk of acute urinary tract infection among postmenopausal women. Diabetes Care 2002;25:1778-83»9, «Boyko EJ, Fihn SD, Scholes D, Abreham L, Monsey B. Risk of urinary tract infection and asymptomatic bacteriuria among diabetic and nondiabetic postmenopausal women. Am J Epidemiol 2005;161:557-64»10.

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 Kissel KC, Van Kats-Rinaud HJ ym. Granulocyte function in women with diabetes and asymptomatic bacteriuria. Diabetes Care 1997;20:392-5»11, «Geerlings SE, Meiland R, Hoepelman AI. Pathogenesis of bacteriuria in women with diabetes mellitus. Int J Antimicrobial Agents 2002;19:539-45»12. Glukosuria parantaa E. coli -bakteerien kasvua in vitro «Geerlings SE, Meiland R, Hoepelman AI. Pathogenesis of bacteriuria in women with diabetes mellitus. Int J Antimicrobial Agents 2002;19:539-45»12. Lisäksi 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 of type 1-fimbriated Escherichia coli to uroepithelial cells. More in diabetic women than in control subjects. Diabetes Care 2002;25:1405-9»13.

Kirjallisuutta

  1. Zhanel GG, Nicolle LE, Harding GKM, and the Manitoba Diabetic Urinary Infection Study Group. Prevalence of asymptomatic bacteriuria and associated host factors in women with diabetes mellitus. Clin Infect Dis 1995;21:316-22
  2. Hoepelman AI, Meiland R, Geerlings SE. Pathogenesis and management of bacterial urinary tract infections in adult patients with diabetes mellitus. Int J Antimicr Agents 2003; 22:S35-S43
  3. Geerlings SE, Stolk RP, Camps MJ ym. Asymptomatic becteriuria may be considered a complication in women with diabetes. Diabetes Care 2000;23:744-9
  4. Zhanel GG, Harding GK, Nicolle LE. Asymptomatic bacteriuria in patient with diabetes mellitus. Rev Infect Dis 1991;3:150-4
  5. The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993;329:977-86
  6. The Diabetes Control and Complications Trial Research Group.The relationship of glycemic exposure (HbA1c) to the risk of development and progression of retinopathy in the Diabetes Control and Complication Trial. Diabetes 1995;44:968-83
  7. Stratton IM, Adler AI, Neil HA ym. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35). BMJ 2000;321:405-12
  8. Geerlings SE, Stolk RP, Camps MJ ym. Risk factors for symptomatic urinary tract infection in woman with diabetes. Diabetes care 2000;23:1737-41
  9. Boyko EJ, Fihn SD, Scholes D ym. Diabetes and the risk of acute urinary tract infection among postmenopausal women. Diabetes Care 2002;25:1778-83
  10. Boyko EJ, Fihn SD, Scholes D, Abreham L, Monsey B. Risk of urinary tract infection and asymptomatic bacteriuria among diabetic and nondiabetic postmenopausal women. Am J Epidemiol 2005;161:557-64
  11. Balasoiu D, Van Kissel KC, Van Kats-Rinaud HJ ym. Granulocyte function in women with diabetes and asymptomatic bacteriuria. Diabetes Care 1997;20:392-5
  12. Geerlings SE, Meiland R, Hoepelman AI. Pathogenesis of bacteriuria in women with diabetes mellitus. Int J Antimicrobial Agents 2002;19:539-45
  13. Geerlings SE, Meiland R, van Lith EC ym. Adherence of type 1-fimbriated Escherichia coli to uroepithelial cells. More in diabetic women than in control subjects. Diabetes Care 2002;25:1405-9
Käypä hoito -suositukset ovat riippumattomia, tutkimusnäyttöön perustuvia kansallisia hoitosuosituksia. Lue lisää
LINKKIEN TYYPIT JA VÄRIKOODIT
Kirjallisuusviite
Kuva
Linkki toiselle sivustolle
Lisätietoa
Näytönastekatsaus
PDF-tiedosto
PubMed-abstrakti
Taulukko