Zusammenfassung
Hintergrund: Der periphere Vasospasmus ist ein häufiges Symptom bei Normaldruckglaukompatienten. Wir untersuchten, ob der periphere Vasospasmus als ein Versuch, Wärmeverlust bei vermindertem Grundumsatz, zu verstehen ist. Patienten und Methoden: 20 gesunde, weibliche nicht rauchende Probandinnen wurden in diese Studie rekrutiert. Probandinnen wurden als vasospastisch (10 Probandinnen) eingeteilt, wenn sie eine eindeutige Anamnese von noch häufig kalten Händen hatten und als normale Probandinnen (10 Probanden), wenn eine solche Anamnese nicht vorhanden war. Die Probandenzahl wurde einer statistischen Wahrscheinlichkeit von 80 %, einen Unterschied von 20 % nachzuweisen, angepasst. Der Grundumsatz wurde durch indirekte Kaloriemetrie bestimmt und korrigiert für die fettfreie Masse, welche durch die bioelektrische Impendanzanalyse gemessen wurde. Ergebnisse: Der Grundumsatz war 1198 ± 155 kcal bei Vasospastikern und 1169 ± 122 kcal bei den Kontrollprobandinnen (Mann-Whitney-U-Test: p = 0,62). Die fettfreie Masse war 39,6 ± 3,3 kg bei Vasospastikern und 41,1 ± 2,3 kg bei Kontrollprobandinnen (Mann-Whitney-U-Test: p = 0,16). Der für die fettfreie Masse korrigierte Grundumsatz lag bei 30,2 ± 2,5 kcal/kg bei Vasospastikerinnen und 28,4 ± 2,3 kcal/kg bei Kontrollprobandinnen (Mann-Whitney-U-Test: p = 0,08). Schlussfolgerungen: Der periphere Vasospasmus scheint nicht eine sekundäre Antwort auf einen ungenügenden Grundumsatz darzustellen. Die Resultate dieser Studie deuten eher auf eine umgekehrte Tendenz hin, welche weiter untersucht werden sollte.
Abstract
Background: Peripheral vasospastic syndrome is frequently encountered in normal tension glaucoma patients. We tested the hypothesis as to whether peripheral vascular spastic tendency is due to an attempt to preserve body heat in subjects with reduced resting energy expenditure. Patients and Methods: Twenty healthy non-smoking female individuals were enrolled into the study. Subjects were classified as having vasospasm (10 subjects) if they related a clear history of frequent cold hands, and as normal subjects (10 subjects) if they denied such a history. Sample size calculation was based on a power of 80 % to find a difference of 20 %. Resting energy expenditure (REE) was assessed by indirect calorimetry and corrected for fat-free mass (FFM), which was assessed by bioelectric impedance analysis. Results: REE was 1198 ± 155 kilocalories (kcal) in vasospastics and 1169 ± 122 in controls (Mann-Whitney U-test: p = 0.62). FFM was 39.6 ± 3.3 kg in vasospastics and 41.1 ± 2.3 kg in controls (Mann-Whitney U-test: p = 0.16). REE adjusted for FFM was 30.2 ± 2.5 kcal/kg in vasospastics and 28.4 ± 2.3 kcal/kg in controls (Mann-Whitney U-test: p = 0.08). Conclusions: Peripheral vasospastic syndrome seems not to be a secondary response to insufficient resting energy expenditure. The results of the present study rather indicate an opposite tendency which deserves further investigation.
Schlüsselwörter
Kaloriemetrie - Mitochondrien - oxidativer Stress - vaskuläre Dysregulation - Vasospasmus
Key words
calorimetry - mitochondria - oxidative stress - vascular dysregulation - vasospasm
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Konstantin Gugleta, MD
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