Obez çocuk ve adolesanlarda artmış demir eksikliği riski ve insülin direnci ile ilişkisi

Year 2019, Volume: 24 Issue: 3, 183 - 188, 24.10.2019

Fatma Dursun

Abstract

Amaç: Çocuklarda
obezite prevelansı giderek artmaktadır. Obez çocuk ve adolesanlarda demir,
çinko, vitamin A ve vitamin E düzeylerinin düşük olduğunu gösteren çalışmalar
mevcuttur, fakat vitamin ve mineral eksikliği ile enflamasyon, insülin direnci
ilişkisini gösteren yeterli veri yoktur. Bu kesitsel çalışmanın amacı, obez ve
obez olmayan çocuklarda vitamin ve mineral düzeylerinin vücut kitle indeksi,
lipid profili, insülin direnci ve enflamasyon ile ilişkisini irdelemektir.

Gereç ve Yöntemler: Çalışmaya
yaşları 10-18 arasında olan, 77 obez ve 34sağlıklı çocuk alındı. Hastalardan
alınan kanda şu parametreler değerlendirildi; demir, total demir bağlama
kapasitesi (TDBK), vitamin A, vitamin E, 
çinko, lipid profili, high-sensitive C-reactive protein (hsCRP), glukoz
ve insülin. Transferrin saturasyon indeksi (TSI) demir/ TDBKx 100 ile
hesaplandı. İnsülin direnci (İD)
tanısı için homeostasis model of assessment-insulin resistance (HOMA-IR) kullanıldı.

Bulgular:  Obez çocuklarda demir ve TSI düzeyleri
kontrol grubundan anlamlı derecede daha düşüktü (p=0,02, p=0,00, sırasıyla). Serum vitamin E, vitamin
A ve çinko düzeyleri obezlerde kontrol grubuna göre daha düşük olmakla birlikte
anlamlı düzeyde değildi (p>0, 05). Her iki grubun folat, vitamin B12,
hemoglobin ve hematokrit düzeyleri benzerdi. İD olan grupta demir ve TSI daha
düşüktü (p=0, 01; p=0, 01).  Ayrıca demir
ve TSI, HOMA-IR (r=-0, 40, p=0, 00 ve r=-0, 38; p=0, 00, sırasıyla) ve hsCRP
(r=-0, 286, p=0, 004 ve r=-0, 282, p=0, 005, sırasıyla) ile negatif
ilişkiliydi.

Sonuç: Obez çocuklarda serum demiri ve TSI daha düşüktür.
Ve her ikisinin de obezlerdeki kronik enflamasyon ve insulin direnci ile
ilişkili olduğu gösterilmiştir. Bu nedenle obez çocuk ve adolesanlar vitamin ve
mineral eksiklikleri özellikle de demir eksikliği açısından araştırılmalıdır. 

Keywords

Obezite, çocuklar, vitamin ve mineral eksikliği, demir eksikliği

Obez çocuk ve adolesanlarda artmış demir eksikliği riski ve insülin direnci ile ilişkisi

Abstract

Aim: The
prevalence of obesity in children is on the incline globally. Obese children and adolescents have been
found to have low concentrations of iron, zinc, vitamin A and vitamin E. The
relationshipbetween micronutrient status and comorbidities, such as chronic
inflammation and insulin resistance (IR) is unclear in obese children and
adolescents.The aim of this cross-sectional study was to evaluate the
relationship of micronutrient status with body mass index, lipid profile, IR
and inflammation in pediatric obese and nonobese subjects.

Materials
and Methods: The
study included 77 obese and 34 healthy children 10 to 18 years of
age. Serum levels of the following parameters were studied: ironlevels, total
iron-binding capacity (TIBC), vitamin A, vitamin E, zinc, lipids,
high-sensitive C-reactive protein (hsCRP), glucose and insulin. Transferrin saturation
index (TSI) was calculated by the formula: iron/ TIBC x 100. The
diagnosis of insulin resistance (IR) was defined by homeostasis
model of assessment-insulin resistance (HOMA-IR).

Results: The
obese children had significantly lowerserum iron levels and TSI than the controls (p=0.02, p=0.00, respectively). Serum vitamin E,
vitamin A and zinc levels were lower in obese children but these differences did
not reach a significant level (p>0.05). The two groups were similar in terms
of folate, vitamin B12 and hemoglobin levels. The presence of IR was
significantly associated with decreased serum iron and TSI levels (p=0.01; p=0. 01).Moreover, iron and TSIwere inversely
correlated with HOMA-IR, (r=-0.40, p=0.00 and r=-0.38; p=0.00, respectively) and
hsCRP (r=-0.286,p=0.004 and r=-0.282, p=0.005, respectively).

Conclusion:
Obese children have decreased levels of iron
and TSI, both of which are also associated with inflammation and IR, suggesting
that obese children should
be closely monitored in terms of micronutrients deficiency. 

Keywords

Obesity, children, micronutrient deficiency, iron deficiency

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