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Kronik hepatitli ve karaciğer sirozlu hastaların biyoelektrik impedans yöntemi ile değerlendirilmesi

Yıl 2018, Cilt: 17 Sayı: 3, 137 - 141, 29.12.2018
https://doi.org/10.17941/agd.498555

Öz

Giriş ve Amaç: Bu çalışmada, kronik hepatitli,
sirozlu ve sağlıklı bireyler arasında biyoelektriksel impedans analiz yöntemi
ile fark olup olmadığının araştırılması amaçlanmıştır. 
Gereç ve Yöntem: Çalışmaya Haziran 2012-2013 tarihleri arasında Harran Üniversitesi Tıp Fakültesi, Gastroenteroloji
polikliniğinde takip edilen 31 kronik hepatit B ve kronik hepatit C hastası, 35
karaciğer sirozu ve 38 sağlıklı erişkin alındı. Olgular kronik hepatit,
karaciğer sirozu ve sağlıklı kontrol olarak üç gruba ayrıldı. Olguların yaş,
cinsiyet, boy, kilo, hematokrit, sodyum, potasyum değerleri ve biyoelektriksel
impedans analiz ölçümü sonrası elde edilen değerler kaydedildi ve istatistiksel
analiz yapıldı. 
Bulgular: Siroz grubunun hematokrit ve
sodyum değeri anlamlı olarak düşüktü (p <0.05). Vücut kapasitans değeri
kronik hepatitli grupta ve siroz grubunda kontrol grubuna göre yüksekti (p <0.05).
Kronik hepatitli grupta rezistans kontrol grubuna göre düşüktü (p <0.05).
Vücut hücre kitlesi kronik hepatitli grupta kontrol grubuna göre yüksekti (p <0.05).
Kronik hepatitli grupta bazal metabolik hız kontrol grubuna göre yüksekti (p <0.05).
Kronik hepatitli grubun yağsız vücut kitlesi kontrol grubuna göre yüksekti (p <0.05).
Kronik hepatitli grubun intrasellüler sıvı ve total vücut suyu kontrol grubuna göre
yüksekti (p <0.05). Faz açısı kronik hepatitli grupta diğer gruplara göre
yüksek olsa da istatistiksel olarak anlamlı değildi (p >0.05). 
Sonuç: Biyoelektriksel
impedans analiz ile sirotik grupta, kontrol ve kronik hepatitli grupla
karşılaştırıldığında anlamlı bir değişiklik saptanmamasına rağmen kronik
hepatitli grupta saptanan değişiklikler biyoelektriksel impedans analiz açısından
ilerisi için ümit vericidir.

Kaynakça

  • 1. Harrison’s Principles of Internal Medicine 16th Edition 2005;1858-9.
  • 2. Memik F, Dolar E. Karaciğer sirozu. Tabak F, editör. Klinik Gastroenteroloji. I. Baskı, İstanbul; Nobel ve Güneş Tıp Kitapevleri. 2005;626-33.
  • 3. Tabak F, Yurdaydın C, Kaymakoğlu S, et al; Guidelines Study Group VH. Diagnosis, management and treatment of hepatitis B virus infection: Turkey 2017 Clinical Practice Guidelines. Turk J Gastroenterol 2017;28(Suppl 2):73-83.
  • 4. Idilman R, Baykam N, Kaymakoğlu S, et al; Guidelines Study Group VH. Turkey 2017 Clinical Practice Guidelines on recommendations for screening diagnosing and managing hepatitis C virus. Turk J Gastroenterol 2017 Dec;28(Suppl 2):90-93.
  • 5. Ökten A, Mungan Z, Çakaloğlu Y. Karaciğer sirozu: Gastroenterohepatoloji. Nobel Tıp Kitapevi 2001;449-50.
  • 6. Ökten A. Türkiye’de karaciğer sirozunun etiyolojisi. Hepatolojide Güncel Gelişmeler Sempozyumu Kitabı,1998; 67.
  • 7. Quer J, Esteban J. Epidemiology. In: Thomas HC, Lemon S, Zuckerman AJ (eds). Viral hepatitis. Massachusetts, USA. Third Edition. Blackwell Publishing, 2005;407-25.
  • 8. Bravo AA, Sheth SG, Chopra S. Liver biopsy. N Engl J Med 2001;344:495-500.
  • 9. Şahin M, Karayakar F, Erdogan KE, et al. Liver tissue trace element levels in HepB patients and the relationship of these elements with histological injury in the liver and with clinical parameters. J Trace Elem Med Biol 2018;45:70-77.
  • 10. Dienstag JL. The role of liver biopsy in chronic hepatitis C. Hepatology 2002;36(5 Suppl 1):S152-60.
  • 11. Bedossa P, Poynard T. An algorithm fort he grading of activity in chronic hepatitis C. The METAVİR Cooperative Study Group. Hepatology 1996;24:289-93.
  • 12. Silva AM, Matias CN, Nunes CL, et al. Lack of agreement of in vivo raw bioimpedance measurements obtained from two single and multi-frequency bioelectrical impedance devices. Eur J Clin Nutr 2018 Oct 22. [Epub ahead of print]
  • 13. Ruiz-Vargas A, Ivorra A, Arkwright JW. Design, Construction and Validation of an Electrical Impedance Probe with Contact Force and Temperature Sensors Suitable for in-vivo Measurements. Sci Rep 2018;8:14818.
  • 14. Kushner RF. Bioelectrical impedance analysis: a review of principles and applications. J Am Coll Nutr 1992;11:199-209.
  • 15. Baumgartner RN, Chumlea WC, Roche AF. Impedance for body composition. Exerc Sport Sci Rev 1990;18:193-224.
  • 16. Houtkopper LB, Lohman TG, Going SB, Howell WH. Why bioelectrical impedance analysis should be used for estimating adiposity. Am J Clin Nutr 1996;64(3 Suppl):436S-448S.
  • 17. Köksal İ, Yılmaz G, Parlak M, et al; Study Group TCHC. Diagnostic value of combined serum biomarkers for the evaluation of liver fibrosis in chronic hepatitis C infection: A multicenter, non interventional, observational study. Turk J Gastroenterol 2018;29:464-472.
  • 18. Kushner RF, Guidivaka R, Scholler DA. Clinical characteristics influencig bioelectrical impedance analysis measurements. Am J Clin Nutr 1996;64(3 Suppl):423S-427S.
  • 19. Kravetz D, Arderiu MT, Bosch J, et al. Increased plasma volume in two models of portal hypertension in the rat: Cirrhosis of the liver and partial portal vein ligation. Rev Esp Fisiol 1987;43:179-83.
  • 20. Guglielmi FW, Contento F, Laddaga L, et al. Bioelectric impedance analysis: experience with male patients with cirrhosis. Hepatology 1991;13:892-5.
  • 21. Cabré E, de León R, Planas R, et al. Reliability of bioelectric impedance analysis as a method of nutritional monitoring in cirrhosis with ascites. Gastroenterol Hepatol 1995;18:359-65.
  • 22. Runyon BA, Montano AA, Akriviadis EA, et al. The serum ascites albumin gradient is superior to the exudates-transudate concept in the differential diagnosis of ascites. Ann Int Med 1992;117:215-20.
  • 23. Kahraman A, Hilsenbeck J, Nyga M, et al. Bioelectrical impedance analysis in clinical practice: implications for hepatitis C therapy BIA and hepatitis C. Virol J 2010;7:191.
  • 24. Guida B, Laccetti R, Gerardi C, et al. Bioelectrical impedance analysis and agerelated differences of body composition in the elderly. Nutr Metab Cardiovasc Dis 2007;17:175-80.
  • 25. Barbosa-Silva MC, Barros AJ, Wang J, et al. Bioelectrical impedance analysis: population reference values for phase angle by age and sex. Am J Clin Nutr 2005;82:49-52.
  • 26. Selberg O, Selberg D. Norms and correlates of bioimpedance phase angle in healthy human subjects, hospitalized patients, and patients with liver cirrhosis. Eur J Appl Physiol 2002;86:509-16.
  • 27. Pirlich M, Schutz T, Spachos T, et al. Bioelectrical impedance analysis is a useful bedside technique to assess malnutrition in cirrhotic patients with and without ascites. Hepatology 2000;32:1208-15.

Evaluation of chronic hepatitis and cirrhotic patients with bioelectrical impedance analysis

Yıl 2018, Cilt: 17 Sayı: 3, 137 - 141, 29.12.2018
https://doi.org/10.17941/agd.498555

Öz

Background and Aims: The aim of this study
was to investigate whether there was a difference between chronic hepatitis
patients, cirrhotic patients, and healthy individuals with bioelectrical
impedance analysis method. Materials and
Methods:
Between June 2012 and June 2013, 31 chronic hepatitis B and C
patients, 35 cirrhotic patients who had been followed up in the Gastroenterology
outpatient clinic at Harran University Faculty of Medicine and 38 healthy
individuals were included in the study. Cases were divided into three groups as
chronic hepatitis, liver cirrhosis, and healthy controls. Each patient’s age,
sex, height, weight, hematocrit, sodium, potassium values, and values obtained
after bioelectrical impedance analysis measurements were recorded and a statistical
analysis was performed. Results: The
cirrhotic group’s hematocrit and blood sodium level were significantly lower (p < .05). The body capacitance value
in the chronic hepatitis and cirrhosis group was higher than that in the
control group (p < .05).
Resistance in the chronic hepatitis B group was lower than that in the control
group (p < .05). The body cell
mass value in the chronic hepatitis group was higher than that in the control
group (p < .05). The chronic
hepatitis group’s basal metabolic rate value was higher than that of the
control group (p < .05). The chronic
hepatitis group’s lean body mass value was higher than that of the control
group (p < .05). The chronic
hepatitis group’s intracellular water and total body water values were higher
than both of these were in the control group (p < .05). The phase angle was higher in the chronic hepatitis
group when compared with other groups, but was not statistically significant (p > .05). Conclusion: Although this study did not find significant changes
between cirrhotic patients, chronic hepatitis patients, and control groups with
bioelectrical impedance analysis, detecting any changes in patients with
chronic hepatitis is promising for the future regarding bioelectrical impedance
analysis.








Kaynakça

  • 1. Harrison’s Principles of Internal Medicine 16th Edition 2005;1858-9.
  • 2. Memik F, Dolar E. Karaciğer sirozu. Tabak F, editör. Klinik Gastroenteroloji. I. Baskı, İstanbul; Nobel ve Güneş Tıp Kitapevleri. 2005;626-33.
  • 3. Tabak F, Yurdaydın C, Kaymakoğlu S, et al; Guidelines Study Group VH. Diagnosis, management and treatment of hepatitis B virus infection: Turkey 2017 Clinical Practice Guidelines. Turk J Gastroenterol 2017;28(Suppl 2):73-83.
  • 4. Idilman R, Baykam N, Kaymakoğlu S, et al; Guidelines Study Group VH. Turkey 2017 Clinical Practice Guidelines on recommendations for screening diagnosing and managing hepatitis C virus. Turk J Gastroenterol 2017 Dec;28(Suppl 2):90-93.
  • 5. Ökten A, Mungan Z, Çakaloğlu Y. Karaciğer sirozu: Gastroenterohepatoloji. Nobel Tıp Kitapevi 2001;449-50.
  • 6. Ökten A. Türkiye’de karaciğer sirozunun etiyolojisi. Hepatolojide Güncel Gelişmeler Sempozyumu Kitabı,1998; 67.
  • 7. Quer J, Esteban J. Epidemiology. In: Thomas HC, Lemon S, Zuckerman AJ (eds). Viral hepatitis. Massachusetts, USA. Third Edition. Blackwell Publishing, 2005;407-25.
  • 8. Bravo AA, Sheth SG, Chopra S. Liver biopsy. N Engl J Med 2001;344:495-500.
  • 9. Şahin M, Karayakar F, Erdogan KE, et al. Liver tissue trace element levels in HepB patients and the relationship of these elements with histological injury in the liver and with clinical parameters. J Trace Elem Med Biol 2018;45:70-77.
  • 10. Dienstag JL. The role of liver biopsy in chronic hepatitis C. Hepatology 2002;36(5 Suppl 1):S152-60.
  • 11. Bedossa P, Poynard T. An algorithm fort he grading of activity in chronic hepatitis C. The METAVİR Cooperative Study Group. Hepatology 1996;24:289-93.
  • 12. Silva AM, Matias CN, Nunes CL, et al. Lack of agreement of in vivo raw bioimpedance measurements obtained from two single and multi-frequency bioelectrical impedance devices. Eur J Clin Nutr 2018 Oct 22. [Epub ahead of print]
  • 13. Ruiz-Vargas A, Ivorra A, Arkwright JW. Design, Construction and Validation of an Electrical Impedance Probe with Contact Force and Temperature Sensors Suitable for in-vivo Measurements. Sci Rep 2018;8:14818.
  • 14. Kushner RF. Bioelectrical impedance analysis: a review of principles and applications. J Am Coll Nutr 1992;11:199-209.
  • 15. Baumgartner RN, Chumlea WC, Roche AF. Impedance for body composition. Exerc Sport Sci Rev 1990;18:193-224.
  • 16. Houtkopper LB, Lohman TG, Going SB, Howell WH. Why bioelectrical impedance analysis should be used for estimating adiposity. Am J Clin Nutr 1996;64(3 Suppl):436S-448S.
  • 17. Köksal İ, Yılmaz G, Parlak M, et al; Study Group TCHC. Diagnostic value of combined serum biomarkers for the evaluation of liver fibrosis in chronic hepatitis C infection: A multicenter, non interventional, observational study. Turk J Gastroenterol 2018;29:464-472.
  • 18. Kushner RF, Guidivaka R, Scholler DA. Clinical characteristics influencig bioelectrical impedance analysis measurements. Am J Clin Nutr 1996;64(3 Suppl):423S-427S.
  • 19. Kravetz D, Arderiu MT, Bosch J, et al. Increased plasma volume in two models of portal hypertension in the rat: Cirrhosis of the liver and partial portal vein ligation. Rev Esp Fisiol 1987;43:179-83.
  • 20. Guglielmi FW, Contento F, Laddaga L, et al. Bioelectric impedance analysis: experience with male patients with cirrhosis. Hepatology 1991;13:892-5.
  • 21. Cabré E, de León R, Planas R, et al. Reliability of bioelectric impedance analysis as a method of nutritional monitoring in cirrhosis with ascites. Gastroenterol Hepatol 1995;18:359-65.
  • 22. Runyon BA, Montano AA, Akriviadis EA, et al. The serum ascites albumin gradient is superior to the exudates-transudate concept in the differential diagnosis of ascites. Ann Int Med 1992;117:215-20.
  • 23. Kahraman A, Hilsenbeck J, Nyga M, et al. Bioelectrical impedance analysis in clinical practice: implications for hepatitis C therapy BIA and hepatitis C. Virol J 2010;7:191.
  • 24. Guida B, Laccetti R, Gerardi C, et al. Bioelectrical impedance analysis and agerelated differences of body composition in the elderly. Nutr Metab Cardiovasc Dis 2007;17:175-80.
  • 25. Barbosa-Silva MC, Barros AJ, Wang J, et al. Bioelectrical impedance analysis: population reference values for phase angle by age and sex. Am J Clin Nutr 2005;82:49-52.
  • 26. Selberg O, Selberg D. Norms and correlates of bioimpedance phase angle in healthy human subjects, hospitalized patients, and patients with liver cirrhosis. Eur J Appl Physiol 2002;86:509-16.
  • 27. Pirlich M, Schutz T, Spachos T, et al. Bioelectrical impedance analysis is a useful bedside technique to assess malnutrition in cirrhotic patients with and without ascites. Hepatology 2000;32:1208-15.
Toplam 27 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Haşim Nar Bu kişi benim

İdris Kırhan 0000-0001-6606-6078

Hüseyin Taşkıran Bu kişi benim 0000-0002-1627-9507

Ahmet Uyanıkoğlu 0000-0003-4881-5244

Necati Yenice Bu kişi benim

Yayımlanma Tarihi 29 Aralık 2018
Yayımlandığı Sayı Yıl 2018 Cilt: 17 Sayı: 3

Kaynak Göster

APA Nar, H., Kırhan, İ., Taşkıran, H., Uyanıkoğlu, A., vd. (2018). Kronik hepatitli ve karaciğer sirozlu hastaların biyoelektrik impedans yöntemi ile değerlendirilmesi. Akademik Gastroenteroloji Dergisi, 17(3), 137-141. https://doi.org/10.17941/agd.498555

test-5