Diabetesta sairastavien VTI-alttiuden syyt
Lisätietoa aiheesta
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 asymptomatic bacteriuria and associated host factors in women with diabetes mellitus. The Manitoba Diabetic Urinary Infection Study Group. Clin Infect »1, «Hoepelman AI, Meiland R, Geerlings SE. Pathogenesis and management of bacterial urinary tract infections in adult patients with diabetes mellitus. Int J Antimicrob Agents 2003;22 Suppl 2:35-43 »2 tai VTI-alttiuteen «Geerlings SE, Stolk RP, Camps MJ ym. Asymptomatic bacteriuria may be considered a complication in women with diabetes. Diabetes Mellitus Women Asymptomatic Bacteriuria Utrecht Study Group. Diabetes Ca»3, «Zhanel GG, Harding GK, Nicolle LE. Asymptomatic bacteriuria in patients with diabetes mellitus. Rev Infect Dis 1991;13:150-4 »4, «Wilke T, Boettger B, Berg B ym. Epidemiology of urinary tract infections in type 2 diabetes mellitus patients: An analysis based on a large sample of 456,586 German T2DM patients. J Diabetes Complicat»17.
- Vaikka mikrovaskulaarikomplikaatioiden kehittyminen liittyy nimenomaan huonoon verensokeritasapainoon «The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. The Diabetes Control and Complications Trial Researc»5, «The relationship of glycemic exposure (HbA1c) to the risk of development and progression of retinopathy in the diabetes control and complications trial. Diabetes 1995;44:968-83 »6, «Stratton IM, Adler AI, Neil HA ym. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 2000;321:405-12 »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 asymptomatic bacteriuria and associated host factors in women with diabetes mellitus. The Manitoba Diabetic Urinary Infection Study Group. Clin Infect »1, «Zhanel GG, Harding GK, Nicolle LE. Asymptomatic bacteriuria in patients with diabetes mellitus. Rev Infect Dis 1991;13:150-4 »4 , «Geerlings SE, Stolk RP, Camps MJ ym. Risk factors for symptomatic urinary tract infection in women 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 ym. Risk of urinary tract infection and asymptomatic bacteriuria among diabetic and nondiabetic postmenopausal women. Am J Epidemiol 2005;161:557-64 »10, «Hine JL, de Lusignan S, Burleigh D ym. Association between glycaemic control and common infections in people with Type 2 diabetes: a cohort study. Diabet Med 2017;34:551-557 »14, «Amos TB, Montejano L, Juneau P ym. Healthcare costs of urinary tract infections and genital mycotic infections among patients with type 2 diabetes mellitus initiated on canagliflozin: a retrospective »18.
- Glukosurian on todettu parantavan E. coli -bakteerien kasvua in vitro «Geerlings SE, Meiland R, Hoepelman AI. Pathogenesis of bacteriuria in women with diabetes mellitus. Int J Antimicrob Agents 2002;19:539-45 »12.
- Tutkimustulokset glukosuriaa aiheuttavien SGLT2:n estäjien yhteydestä VTI-alttiuteen ovat ristiriitaiset «Li D, Wang T, Shen S ym. Urinary tract and genital infections in patients with type 2 diabetes treated with sodium-glucose co-transporter 2 inhibitors: A meta-analysis of randomized controlled trials.»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. 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 Antimicrob Agents 2002;19:539-45 »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 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
- Zhanel GG, Nicolle LE, Harding GK. Prevalence of asymptomatic bacteriuria and associated host factors in women with diabetes mellitus. The Manitoba Diabetic Urinary Infection Study Group. Clin Infect Dis 1995;21:316-22 «PMID: 8562738»PubMed
- Hoepelman AI, Meiland R, Geerlings SE. Pathogenesis and management of bacterial urinary tract infections in adult patients with diabetes mellitus. Int J Antimicrob Agents 2003;22 Suppl 2:35-43 «PMID: 14527769»PubMed
- Geerlings SE, Stolk RP, Camps MJ ym. Asymptomatic bacteriuria may be considered a complication in women with diabetes. Diabetes Mellitus Women Asymptomatic Bacteriuria Utrecht Study Group. Diabetes Care 2000;23:744-9 «PMID: 10840989»PubMed
- Zhanel GG, Harding GK, Nicolle LE. Asymptomatic bacteriuria in patients with diabetes mellitus. Rev Infect Dis 1991;13:150-4 «PMID: 2017615»PubMed
- The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. The Diabetes Control and Complications Trial Research Group. N Engl J Med 1993;329:977-86 «PMID: 8366922»PubMed
- The relationship of glycemic exposure (HbA1c) to the risk of development and progression of retinopathy in the diabetes control and complications trial. Diabetes 1995;44:968-83 «PMID: 7622004»PubMed
- Stratton IM, Adler AI, Neil HA ym. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 2000;321:405-12 «PMID: 10938048»PubMed
- Geerlings SE, Stolk RP, Camps MJ ym. Risk factors for symptomatic urinary tract infection in women with diabetes. Diabetes Care 2000;23:1737-41 «PMID: 11128343»PubMed
- 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 «PMID: 12351477»PubMed
- Boyko EJ, Fihn SD, Scholes D ym. Risk of urinary tract infection and asymptomatic bacteriuria among diabetic and nondiabetic postmenopausal women. Am J Epidemiol 2005;161:557-64 «PMID: 15746472»PubMed
- Balasoiu D, van Kessel KC, van Kats-Renaud HJ ym. Granulocyte function in women with diabetes and asymptomatic bacteriuria. Diabetes Care 1997;20:392-5 «PMID: 9051393»PubMed
- Geerlings SE, Meiland R, Hoepelman AI. Pathogenesis of bacteriuria in women with diabetes mellitus. Int J Antimicrob Agents 2002;19:539-45 «PMID: 12135845»PubMed
- 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 «PMID: 12145242»PubMed
- Hine JL, de Lusignan S, Burleigh D ym. Association between glycaemic control and common infections in people with Type 2 diabetes: a cohort study. Diabet Med 2017;34:551-557 «PMID: 27548909»PubMed
- Gadzhanova S, Pratt N, Roughead E. Use of SGLT2 inhibitors for diabetes and risk of infection: Analysis using general practice records from the NPS MedicineWise MedicineInsight program. Diabetes Res Clin Pract 2017;130:180-185 «PMID: 28646701»PubMed
- Li D, Wang T, Shen S ym. Urinary tract and genital infections in patients with type 2 diabetes treated with sodium-glucose co-transporter 2 inhibitors: A meta-analysis of randomized controlled trials. Diabetes Obes Metab 2017;19:348-355 «PMID: 27862830»PubMed
- Wilke T, Boettger B, Berg B ym. Epidemiology of urinary tract infections in type 2 diabetes mellitus patients: An analysis based on a large sample of 456,586 German T2DM patients. J Diabetes Complications 2015;29:1015-23 «PMID: 26476473»PubMed
- Amos TB, Montejano L, Juneau P ym. Healthcare costs of urinary tract infections and genital mycotic infections among patients with type 2 diabetes mellitus initiated on canagliflozin: a retrospective cohort study. J Med Econ 2017;20:303-313 «PMID: 27826987»PubMed
