Research Article
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Romatizmal Kapak Hastalığında Serum Eser Elementlerinin Değerlendirilmesi

Year 2016, Volume: 13 Issue: 1, 74 - 79, 28.04.2016

Abstract

Amaç
Bu çalışmanın amacı romatizmal kapak hastalığı (RKH) olan bireylerde serum eser elementleri düzeyinin
değerlendirilmesidir.
Materyal ve Metod
Bu çalışmaya, kardiyoloji polikliniğine başvuran hastalar arasından RKH mevcut olup fonksiyonel
kapasitesi sınıf 1 olan ardışık 30 (15 Erkek ve ort yaş: 34,0±9,3 yıl) hasta dâhil edildi. Yapılan kardiyak
değerlendirme sonucunda patoloji saptanmayan, benzer demografik özelliklere sahip ardışık 30 (9 Erkek ve
ortalama yaş:37,4±5,9 yıl ) sağlıklı birey kontrol grubu olarak alındı. Serum Çinko (Zn) düzeyi alev
fotometresinde, Selenyum (Se) düzeyi atomik absorbsiyon spektrofotometresinde ve Demir (Fe) düzeyi ise
spektrofotometrik olarak ölçüldü.
Sonuçlar
Yaş ve cinsiyet, gruplar arasında benzerdi (p>0,05). Boy, vücut ağırlığı, serum Fe, Se ve Zn düzeyleri hasta
grubunda kontrol grubuna göre daha düşüktü (tüm p değerleri <0,05). Yapılan korelasyon analizinde, serum
Fe düzeyi ile, yaş, vücut ağırlığı, serum Se ve Zn düzeyi arasında pozitif ilişki saptandı (p<0,05). Serum Se
düzeyi, boy, serum Fe ve Zn düzeyi ile; serum Zn düzeyi ise boy, vücut ağırlığı, serum Fe ve Se düzeyleri ile
pozitif korele idi. (tüm p değerleri <0,05). Çok değişkenli logistik regresyon analizi bu değişkenlerden
sadece serum demir seviyesinin RKH varlığının bağımsız belirleyicisi olduğunu gösterdi (beta
değeri=0,500, p<0,05).
Tartışma
Çalışmamızda, RKH olanlarda, serum eser elementlerinin kontrol grubuna göre daha düşük olduğu
bulunmuştur. Serum eser elementlerindeki bu düşüklük, RKH olanlardaki uygunsuz immün yanıt ile ilişkili
olabilir. Ancak eser element seviyelerinin RKH'larında düşük olmasının sebep mi sonuç mu olduğu kesin
olarak bilinmektedir. Ayrıca, eser elementleri yerine koymanın hastalık ilerleyişine etkisini inceleyen
çalışmalara ihtiyaç vardır.

References

  • 1 . h t t p : / / w w w . t k d - o n l i n e . o r g / UKSP/UKSP_Bolum02.pdf
  • 2. Cakır N, Pamuk ÖN, Derviş E, Imeryüz N, Uslu H, Benian Ö, Elelçi E, Erdem G, Sarvan FO, Senocak M. The prevalences of some rheumatic diseases in western Turkey: Havsa study. Rheumatol Int. 2012 Apr;32(4):895-908.
  • 3. Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Guyton RA, et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Thorac Cardiovasc Surg. 2014 Jul;148(1):e1-e132
  • 4. Namboodiri N, Remash K, Tharakan JA, Shajeem O, Nair K, Titus T, Ajitkumar VK, Sivasankaran S, Krishnamoorthy KM, Harikrishnan SP, Harikrishnan MS, Bijulal S. Natural history of aortic valve disease following intervention for rheumatic mitral valve disease. J Heart Valve Dis. 2009 Jan;18(1):61-7.
  • 5. Fairweather-Tait SJ, Bao Y, Broadley MR, Collings R, Ford D, Hesketh JE, Hurst R. Selenium in human health and disease. Antioxid Redox Signal. 2011 Apr 1;14(7):1337-83.
  • 6. Handelman GJ, Levin NW. Iron and anemia in human biology: a review of mechanisms. Heart Fail Rev. 2008 Dec;13(4):393-404.
  • 7. Prasad AS. Zinc in human health: effect of zinc on immune cells. Mol Med. 2008 May-Jun;14(5-6):353-7.
  • 8. Ganz T, Nemeth E. Iron homeostasis in host defence and inflammation. Nat Rev Immunol. 2015 Aug;15(8):500-10.
  • 9. Bonaventura P, Benedetti G, Albarède F, Miossec P. Zinc and its role in immunity and inflammation. Autoimmun Rev. 2015 Apr;14(4):277-85.
  • 10. Wong CP, Ho E. Zinc and its role in age-related inflammation and immune dysfunction. Mol Nutr Food Res. 2012 Jan;56(1):77-87.
  • 11. Huang Z, Rose AH, Hoffmann PR. The role of selenium in inflammation and immunity: from molecular mechanisms to therapeutic opportunities. Antioxid Redox Signal. 2012 Apr 1;16(7):705-43.
  • 12. Cunningham MW. Rheumatic fever, autoimmunity, and molecular mimicry: the streptococcal connection. Int Rev Immunol. 2014 Jul-Aug;33(4):314-29.
  • 13. Ramakrishnan U. Prevalence of micronutrient malnutrition worldwide. Nutr Rev. 2002 May;60(5 Pt 2):S46-52..
  • 14. Kosar F, Sahin I, Acikgöz N, Aksoy Y, Kucukbay Z, Cehreli S. Significance of serum trace element status in patients with rheumatic heart disease: a prospective study. Biol Trace Elem Res. 2005 Oct;107(1):1-10.
  • 15. Steinbrenner H, Al-Quraishy S, Dkhil MA, Wunderlich F, Sies H. Dietary selenium in adjuvant therapy of viral and bacterial infections. Adv Nutr. 2015 Jan 15;6(1):73-82.
  • 16. Bonaventura P, Benedetti G, Albarède F, Miossec P. Zinc and its role in immunity and inflammation. Autoimmun Rev. 2015 Apr;14(4):277-85.
  • 17. Formigari A, Irato P, Santon A. Zinc, antioxidant systems and metallothionein in metal mediated-apoptosis: biochemical and cytochemical aspects. Comp Biochem Physiol C Toxicol Pharmacol. 2007 Nov;146(4):443-59.
  • 18. Ganz T, Nemeth E. Iron homeostasis in host defence and inflammation. Nat Rev Immunol. 2015 Aug;15(8):500-10.
  • 19. Govindaraju V, Prabhudev N, Gurappa M, Jawali VS, Chandrasekhara PM, Manjunath CN. Zinc in rheumatic heart valves. J Assoc Physicians India. 1993 Oct;41(10):653-4.
  • 20. Durak I, Akyol O, Es MU, Canbolat O, Akpoyraz M. Element structure in stenotic mitral valves. Am J Cardiol. 1993 Feb 1;71(4):355.

The Evaluation Of Trace Elements In Rheumatic Valvular Disease

Year 2016, Volume: 13 Issue: 1, 74 - 79, 28.04.2016

Abstract

Aim
The aim of this study was to investigate trace elements in patients with rheumatic valvular disease
Material and Method
A total of 30 consequently (15 male and age: 34.0 ±9.3 years) patients with rheumatic valvular disease and
functional capacity class 1 according to NYHA (RVD) who admitted to our cardiology department were
enrolled in this sturdy. 30 randomly age/sex matched subjects with no cardiovascular or systemic disease
were recruited as control group. Serum levels of trace elements including selenium (Se) zinc (Zn) and iron
(Fe) were measured.
Results
The age and sex were comparable between two groups (p>0.05). Height, weight, serum levels of Fe, Se and
Zn were lower in patients with RVD compared to control group (all p values <0.05). In correlation analysis,
serum Fe levels were positively correlated with age, weight, and serum Se and Zn levels (all p values <0.05).
Serum Se levels were positively correlated with height, serum Fe and Zn levels, while serum Zn levels were
positively correlated with height, weight, and serum Fe and Se levels (all p values <0.05). Multivariable
regression analyses showed that serum Fe levels were the only independent predictor of RVD (beta
value=0,500, p<0.05).
Conclusion
In this study, we yield that serum levels of Fe, Se and Zn were significantly lower in patients with RVD. These
results may be associated with inappropriate immune response in this population. However, it is not clear
whether this is a cause or a result of rheumatic heart disease. Additionally, further studies which investigating
the effect of replacement of trace elements in rheumatic valvular disease are needed.

References

  • 1 . h t t p : / / w w w . t k d - o n l i n e . o r g / UKSP/UKSP_Bolum02.pdf
  • 2. Cakır N, Pamuk ÖN, Derviş E, Imeryüz N, Uslu H, Benian Ö, Elelçi E, Erdem G, Sarvan FO, Senocak M. The prevalences of some rheumatic diseases in western Turkey: Havsa study. Rheumatol Int. 2012 Apr;32(4):895-908.
  • 3. Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Guyton RA, et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Thorac Cardiovasc Surg. 2014 Jul;148(1):e1-e132
  • 4. Namboodiri N, Remash K, Tharakan JA, Shajeem O, Nair K, Titus T, Ajitkumar VK, Sivasankaran S, Krishnamoorthy KM, Harikrishnan SP, Harikrishnan MS, Bijulal S. Natural history of aortic valve disease following intervention for rheumatic mitral valve disease. J Heart Valve Dis. 2009 Jan;18(1):61-7.
  • 5. Fairweather-Tait SJ, Bao Y, Broadley MR, Collings R, Ford D, Hesketh JE, Hurst R. Selenium in human health and disease. Antioxid Redox Signal. 2011 Apr 1;14(7):1337-83.
  • 6. Handelman GJ, Levin NW. Iron and anemia in human biology: a review of mechanisms. Heart Fail Rev. 2008 Dec;13(4):393-404.
  • 7. Prasad AS. Zinc in human health: effect of zinc on immune cells. Mol Med. 2008 May-Jun;14(5-6):353-7.
  • 8. Ganz T, Nemeth E. Iron homeostasis in host defence and inflammation. Nat Rev Immunol. 2015 Aug;15(8):500-10.
  • 9. Bonaventura P, Benedetti G, Albarède F, Miossec P. Zinc and its role in immunity and inflammation. Autoimmun Rev. 2015 Apr;14(4):277-85.
  • 10. Wong CP, Ho E. Zinc and its role in age-related inflammation and immune dysfunction. Mol Nutr Food Res. 2012 Jan;56(1):77-87.
  • 11. Huang Z, Rose AH, Hoffmann PR. The role of selenium in inflammation and immunity: from molecular mechanisms to therapeutic opportunities. Antioxid Redox Signal. 2012 Apr 1;16(7):705-43.
  • 12. Cunningham MW. Rheumatic fever, autoimmunity, and molecular mimicry: the streptococcal connection. Int Rev Immunol. 2014 Jul-Aug;33(4):314-29.
  • 13. Ramakrishnan U. Prevalence of micronutrient malnutrition worldwide. Nutr Rev. 2002 May;60(5 Pt 2):S46-52..
  • 14. Kosar F, Sahin I, Acikgöz N, Aksoy Y, Kucukbay Z, Cehreli S. Significance of serum trace element status in patients with rheumatic heart disease: a prospective study. Biol Trace Elem Res. 2005 Oct;107(1):1-10.
  • 15. Steinbrenner H, Al-Quraishy S, Dkhil MA, Wunderlich F, Sies H. Dietary selenium in adjuvant therapy of viral and bacterial infections. Adv Nutr. 2015 Jan 15;6(1):73-82.
  • 16. Bonaventura P, Benedetti G, Albarède F, Miossec P. Zinc and its role in immunity and inflammation. Autoimmun Rev. 2015 Apr;14(4):277-85.
  • 17. Formigari A, Irato P, Santon A. Zinc, antioxidant systems and metallothionein in metal mediated-apoptosis: biochemical and cytochemical aspects. Comp Biochem Physiol C Toxicol Pharmacol. 2007 Nov;146(4):443-59.
  • 18. Ganz T, Nemeth E. Iron homeostasis in host defence and inflammation. Nat Rev Immunol. 2015 Aug;15(8):500-10.
  • 19. Govindaraju V, Prabhudev N, Gurappa M, Jawali VS, Chandrasekhara PM, Manjunath CN. Zinc in rheumatic heart valves. J Assoc Physicians India. 1993 Oct;41(10):653-4.
  • 20. Durak I, Akyol O, Es MU, Canbolat O, Akpoyraz M. Element structure in stenotic mitral valves. Am J Cardiol. 1993 Feb 1;71(4):355.
There are 20 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Eyyup Tusun

Abdulselam İlter

Feyzullah Beşli

Ahmet Çelik

Publication Date April 28, 2016
Submission Date January 26, 2016
Acceptance Date February 2, 2016
Published in Issue Year 2016 Volume: 13 Issue: 1

Cite

Vancouver Tusun E, İlter A, Beşli F, Çelik A. Romatizmal Kapak Hastalığında Serum Eser Elementlerinin Değerlendirilmesi. Harran Üniversitesi Tıp Fakültesi Dergisi. 2016;13(1):74-9.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty