Niasin Dislipidemi Riskini Azaltmada Potansiyel Bir Ajan Mıdır?

Öz

Tüm dünyada prevalansı ve mortalite oranı en yüksek, bulaşıcı olmayan hastalıkların başında kardiyovasküler hastalıklar gelmektedir. Bu hastalıkların gelişiminde değiştirilebilir ve değiştirilemez olarak sınıflandırılan bazı risk faktörleri önemli bir rol oynamaktadır. Değiştirilebilir risk faktörleri özellikle kardiyovasküler hastalıkların zeminini oluşturan dislipidemi ile yakından ilişkilidir. Dislipidemi; yüksek triaçilgliserol (TAG) ve serbest yağ asitleri, azalmış yüksek yoğunluklu lipoprotein (HDL-High density lipoprotein) düzeyi ve fonksiyonu, artmış düşük yoğunluklu lipoprotein (LDL-Low density lipoprotein) düzeyi ve apolipoprotein B (Apo B) üretimi ile karakterizedir. Dislipidemi ile beslenme ve fiziksel aktivite alışkanlıkları arasında önemli bir ilişki olduğu bilinmektedir. Özellikle Batı tarzı beslenme alışkanlıkları yerine Akdeniz diyeti ve Akdeniz tipi yaşam tarzının benimsenmesi ile birlikte dislipidemi riskinde önemli bir azalma olabileceği düşünülmektedir. Diğer yandan, niasin gibi bazı mikro besin öğelerinin besin desteği olarak kullanımının dislipidemi riskini potansiyel olarak azalttığı görülmüştür. B grubu, suda çözünen bir vitamin olan niasinin potansiyel olarak TAG, serbest yağ asitleri, Apo B, çok düşük yoğunluklu lipoprotein (VLDL-Very low density lipoprotein) ve LDL düzeylerini azaltırken, HDL ve apolipoprotein A (Apo A) düzeylerini arttırabildiği bilinmektedir. Bu potansiyel etkileri dolayısı ile niasin, dislipidemi riskinin azaltılmasında ve tedavisinde farmakolojik bir ajan olarak görev almaktadır. Ancak potansiyel etkilerin görülmesi adına, önerilen üst alım düzeyinin (35 mg/gün) oldukça üzerinde (1-3 g) niasin tedavisi uygulanmakta, bu durum ‘niasin flush’ semptomunu tetikleyebilmektedir. Ek olarak, yüksek miktarda niasin alımının uzun vadede insan sağlığı üzerindeki olumsuz etkilerini inceleyen araştırmalara ihtiyaç olduğu düşünülmektedir. Bu derleme yazıda niasinin dislipidemi üzerindeki potansiyel etkileri literatürde yer alan güncel bilgiler ve araştırma sonuçları doğrultusunda incelenmiştir.

Anahtar Kelimeler

• Niasin
• dislipidemi
• kardiyovasküler hastalıklar

Is Niacine a Potential Agent to Decrease Dyslipidemia Risk?

Abstract

Cardiovascular diseases are the most common non-communicable diseases with the highest prevalence and mortality rate in the all around the world. There are some risk factors -such as modifiable and non-modifiable- which are effective on the development of these diseases. Modifiable risk factors are closely related to dyslipidemia, which forms the basis of cardiovascular diseases. Dyslipidemia is characterized by high triacylglycerol (TAG) and free fatty acids, decreased high density lipoprotein (HDL) level and function, increased low density lipoprotein (LDL) level and apolipoprotein B (Apo B) production. There is a relation between dyslipidemia with nutritional and physical activity behaviors. In particular, adherence to the Mediterranean diet and lifestyle behaviors instead of the Western diet can potentially decrease dyslipidemia risk. On the other hand, some of micronutrients such as niacin can potentially decrease dyslipidemia risk as a nutritional supplement. Niacin -which is a water-soluble, B group vitamin- can potentially decrease TAG, free fatty acids, Apo B, very low density lipoprotein (VLDL) and LDL levels and increase HDL and apolipoprotein A (Apo A) levels in plasma. Due to these potential beneficial effects, niacin acts a pharmacological agent to decrease both of dyslipidemia risk and symptoms. However, niacin is used more than tolerable upper intake level (35 mg/day) to show these potential effects (1-3 g). This situation may cause to ‘niacin flush’ symptom. In addition, there is a need for the studies which aim to determine the negative effects of high dose niacin intake on human’s health in long-term. In this review article, potential effects of the niacin on dyslipidemia are examined within the current literature.

Keywords

• Niacin
• dyslipidemia
• cardiovascular diseases

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