Obezite ve D vitamini

Abstract

Obezite; Dünya Sağlık Örgütü tarafından “Sağlığı riske edecek şekilde aşırı yağ birikimi” olarak tanımlanmaktadır. Birçok metabolik olayda rol alan yağ doku sadece bir depo organı değil, 250’den fazla farklı peptid/proteini sekrete edebilen endokrin bir organdır. Vitamin D bir prohormondur ve insanda 7-dehidrokolesterolden sentez edilebilir. Takiben karaciğer ve böbrekte hidroksilaz enzimleri ile aktif hormon olan kalsitriole (1,25(OH)₂D₃) dönüştürülür. Dolaşımdaki 1,25(OH)₂D₃ hücre çekirdeğine ulaşır ve vitamin D reseptörüne bağlanıp, genetik düzenlenmeye neden olur. İlgili genlere etki ederek Ca ve P metabolizmalarının düzenlerken, diğer taraftan, hücre döngüleri veya bağışıklık mekanizmaları, kas kasılmaları, sinir uyarı iletimleri gibi birçok fizyolojik olayı da yönlendirilmektedir. D vitamini eksikliği küresel bir salgın olarak kabul edilmektedir. Ülkemizde de eksiklik ve yetersizliğinin yüksek oranlarda olduğu tespit edilmiştir. Eksikliği nedenleri arasında; yetersiz güneş ışığı maruziyeti, nutrisyonel eksiklik, emilimi engelleyen hastalıklar, ilaçlar, karaciğer ve böbrek hastalıkları, metabolik eksiklikler sayılabilir. D vitamini eksikliğinin için tek başına rikets, osteomalazi gibi hastalıkların patogenezinde rol oynadığı bilinmekle birlikte, diyabet, metabolik sendrom, multipl skleroz, romatoid artrit, sistemik lupus eritematozus, epilepsi, polikistik over ve kanser gibi hastalıklarda da rol alabileceği değerlendirilmektedir. Günümüzde HPLC, ECL ve LC‑MS/MS yöntemleri ile 25(OH)D₃ ve 1,25(OH)₂D düzeylerinin ölçümü gerçekleştirilebilmektedir. Ancak düzeyi değerlendirmek için, 25(OH)D düzeylerine bakılması önerilmektedir. 25(OH)D₃ ölçümünde yöntemler arası farklılıklar ve kalibratörlerde standardizasyon yokluğu laboratuvarlar arası farklılıklara yol açmaktadır. 25(OH)D₃‘ün analitik, biyolojik ve mevsimsel değişkenliği de ölçüm belirsizliğine katkıda bulunmaktadır. Vitamin D ile obezite arasında, sebep-sonuç ilişkisini araştıran ileriye dönük randomize kontrollü çalışmalara ihtiyaç bulunmakla birlikte, ölçüm metodları arasındaki farklılıkların kaldırılması, referans metodların kullanılması ve standardizasyonun sağlanması önemli görülmektedir.

Anahtar Kelimeler: D vitamini, obezite, vitamin D eksikliği

Keywords

• D vitamini, obezite, vitamin D eksikliği

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