Araştırma Makalesi
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Evaluation of Nutritional Status of Children with Thalassemia

Yıl 2023, , 272 - 279, 30.10.2023
https://doi.org/10.17942/sted.1284869

Öz

Objective: The research was carried out to examine the nutritional status of children with thalassemia diagnosis between the ages of 2-17.
Method: The study was conducted with 23 children diagnosed with thalassemia, aged 2-17, who met the inclusion criteria and volunteered among 86 thalassemia patients. The data were collected face to face with a questionnaire consisting of children's sociodemographic characteristics, nutritional habits, anthropometric measurements, biochemical findings, and food consumption record questions. The data obtained from the research were evaluated using the SPSS 26,0 package program and using appropriate statistical tests.
Results: The 65,2% of the participants were girls and 34,8% were boys, with a mean age of 10.3±5.2 years. All of the children (100,0%) participating in the study had low hemoglobin and hematocrit levels and high ferritin levels. It was determined that 52.2% of the children with thalassemia used nutritional supplements and the three most used nutritional supplements were vitamin D (52,2%), folic acid (26,1%) and zinc (21,7%). Approximately half of the girls with thalassemia had insufficient energy (43.5%) and calcium (53,3%) intakes; boys were found to had insufficient energy (50,0%), folate (50,0%), vitamin C (37,5%), calcium (37,5%) and magnesium (37,5%) intakes. It was determined that 30% of the children aged between 2-10 years had insufficient folate intake and 40,0% of them had insufficient calcium intake. Besides, 53,8% of the children aged between 11-17 years had insufficient intake of vitamin C and calcium, and 38,5% of them had insufficient intake of zinc.
Conclusion: It is detected that children with thalassemia receive insufficient macro and micronutrients. The present study found out that children with thalassemia need nutritional monitoring to determine that they are at risk for nutritional deficiency. Further studies should focus directly on the impact of diet quality and nutritional status on health outcomes in Turkish children with thalassemia in a larger sample.

Kaynakça

  • Vichinsky EP. Changing patterns of thalassemia worldwide. Annals of the New York Academy of Sciences. 2005;1054(1):18-24.
  • Sönmez Ç, Öztürk-Kaymak A, Güntaş G. Halk sağlığı problemi olan talasemilerde laboratuvar. Türk Hijyen ve Deneysel Biyoloji Dergisi, 2014;71(4):221-228.
  • Canatan D, Kose MR, Ustundag M, Haznedaroglu D, Ozbas S. Hemoglobinopathy control program in Turkey. Community Genetics. 2006;9(2):124-126.
  • M, Turhan E, Babaoğlu AB. Beta Thalassemia trait in Turkey and The Middle East: A meta-analysis of prevalence. Acta Medica Mediterranean. 2018;34:1731.
  • Aydınok Y, Oymak Y, Atabay B, Aydoğan G, Yeşilipek A, Ünal S, Karakaş Z. A national registry of thalassemia in Turkey: demographic and disease characteristics of patients, achievements, and challenges in prevention. Turkish Journal of Hematology. 2018;35(1):12-18.
  • Saxena A. Growth retardation in thalassemia major patients. International Journal of Human Genetics. 2003;3(4):237-46.
  • Fung EB, Xu Y, Trachtenberg F, Odame I, Kwiatkowski JL, Neufeld EJ, Thompson AA, Boudreaux J, Quinn CT, Vichinsky EP, Thalassemia Clinical Research Network. Inadequate dietary intake in patients with thalassemia. Journal of the Academy of Nutrition and Dietetics. 2012;112(7):980-90.
  • Fung EB. Nutritional deficiencies in patients with thalassemia. Annals of the New York Academy of Sciences. 2010;1202(1):188-96.
  • Goldberg EK, Neogi S, Lal A, Higa A, Fung E. Nutritional deficiencies are common in patients with transfusion-dependent thalassemia and associated with iron overload. Journal of Food and Nutrition Research (Newark, Del.). 2018;6(10):674.
  • Claster S, Wood JC, Noetzli L, Carson SM, Hofstra TC, Khanna R, Coates TD. Nutritional deficiencies in iron overloaded patients with hemoglobinopathies. American Journal of Hematology. 2009;84(6):344-8.
  • Fahim FM, Saad K, Askar EA, Eldin EN, Thabet AF. Growth parameters and vitamin D status in children with thalassemia major in upper Egypt. International Journal of Hematology-oncology and Stem Cell Research. 2013;7(4):10.
  • Sreenivasan P, Mahtani AU, Ravi M D, Gowda K. Impact of diet counseling in thalassemic children and its response on nutritional status. Int J Health Allied Sci 2017;6:26-9
  • World Health Organization (WHO), WHO AnthroPlus for Personal Computers Manual Software for assessing growth of the world's children and adolescents 2009. Available at: https://cdn.who.int/media/docs/default-source/child-growth/growth-reference-5-19-years/who-anthroplus-manual.pdf. Accessed March 10, 2023.
  • Rakıcıoğlu, Neslişah Et Al. Yemek ve Besin Fotoğraf Kataloğu Ölçü ve Miktarlar. Ata Ofset Matbaacılık, 2010.
  • Aksoydan E, Soylu M, Ağagündüz D, Ceylan Dİ. Türkiye Beslenme Rehberi (TÜBER) 2022 (pp.211-218), Ankara: T.C. Sağlık Bakanlığı Yayın No : 1031.
  • Usman SY, Rahmat SA, Vetinly V, Kurniawan F. Dietary intake, Nutritional status, and quality of life in patients with thalassemia major. Althea Medical Journal. 2022;30;9(2):86-92.
  • Moiz B, Habib A, Sawani S, Raheem A, Hasan B, Gangwani M. Anthropometric measurements in children having transfusion-dependent beta thalassemia. Hematology. 2018;23(4):248-52.
  • Sheikh MA, Shakir MU, Shah M. The assessment of nutritional status of children with beta thalassemia major with body mass index. Pak J Med Health Sci. 2017;11:262-5.
  • Salih KM, Al-Mosawy WF. Evaluation some consequences of thalassemia major in splenectomized and non-splenectomized Iraqi patients. Int J Pharm Pharmceut Sci, 2013;5(4):385-388.
  • Pemde HK, Chandra J, Gupta D, Singh V, Sharma R, Dutta AK. Physical growth in children with transfusion-dependent thalassemia. Pediatric Health, Medicine and Therapeutics. 2011;2:13.
  • Mirhosseini NZ, Shahar S, Ghayour-Mobarhan M, Kamaruddin NA, Banihashem A, Yusoff NA, Esmaili HA, Tavallaei S. Factors affecting nutritional status among pediatric patients with transfusion-dependent beta thalassemia. Mediterranean Journal of Nutrition and Metabolism. 2013;6(1):45-51.
  • Mehrvar A, Azarkeivan A, Faranoush M, Mehrvar N, Saberinedjad J, Ghorbani R, Vossough P. Endocrinopathies in patients with transfusion-dependent ß-thalassemia. Pediatric Hematology and Oncology. 2008;25(3):187-94.
  • Abdalla MY, Fawzi M, Al-Maloul SR, El-Banna N, Tayyem RF, Ahmad IM. Increased oxidative stress and iron overload in Jordanian β-thalassemic children. Hemoglobin. 2011;35(1):67-79.
  • Panigrahi I, Agarwal S. Thromboembolic complications in β-thalassemia: Beyond the horizon. Thrombosis Research. 2007;120(6):783-9.
  • Qureshi TZ, Anwar M, Ahmed S, Khan DA, Saleem M. Serum ferritin levels in carriers of β-thalassaemia trait. Acta Haematologica. 1995;94(1):7-9.
  • Ayyash H, Sirdah M. Hematological and biochemical evaluation of β-thalassemia major (βTM) patients in Gaza Strip: A cross-sectional study. International Journal of Health Sciences. 2018;12(6):18.
  • Karakul A. Nutrition management in children with thalassemia In: Chernopolski PM, ed. Advances in Health Sciences Research. 1st ed. Sofia: St. Kliment Ohridski University Press;2020. p.33-40.
  • Ayukarningsih Y, Amalia J, Nurfarhah G. Thalassemia and nutritional status in children. Journal of Health and Dental Sciences. 2022;2(1):39-52.
  • d'Arqom A, G Putri M, Savitri Y, Rahul Alfaidin AM. Vitamin and mineral supplementation for β-thalassemia during COVID-19 pandemic. Future Science OA. 2020;6(9):FSO628.
  • Behera S, Dixit S, Bulliyya G, Kar SK. Fat-soluble antioxidant vitamins, iron overload and chronic malnutrition in β-thalassemia major. The Indian Journal of Pediatrics. 2014;81:270-4.
  • Abbassy HA, Elwafa RA, Omar OM. Bone mineral density and vitamin D receptor genetic variants in Egyptian children with beta thalassemia major on vitamin D supplementation. Mediterranean Journal of Hematology and Infectious Diseases. 2019;11(1):1-11.
  • Karunaratna AM, Ranasingha JG, Mudiyanse RM. Zinc status in beta thalassemia major patients. Biological Trace Element Research. 2018;184:1-6.
  • Fung EB. The importance of nutrition for health in patients with transfusion‐dependent thalassemia. Annals of the New York Academy of Sciences. 2016;1368(1):40-8.

Talasemi Hastası Çocukların Beslenme Durumunun Değerlendirilmesi

Yıl 2023, , 272 - 279, 30.10.2023
https://doi.org/10.17942/sted.1284869

Öz

Amaç: Araştırma 2-17 yaş arası talasemi tanılı çocukların beslenme durumunu incelemek amacıyla yapılmıştır.
Yöntem: Araştırma, 86 talasemi hastasından dahil edilme kriterlerini karşılayan ve gönüllü olan 2-17 yaş arası, talasemi tanısı alan 23 çocuk ile yürütülmüştür. Veriler çocukların sosyodemografik özellikleri, beslenme alışkanlıkları, antropometrik ölçümleri, biyokimyasal bulguları ve besin tüketim kaydı sorularından oluşan anket formu ile yüz yüze toplanmıştır. Araştırmadan elde edilen veriler SPSS 25,0 paket programı kullanılarak uygun istatistiki testler kullanılarak değerlendirilmiştir.
Bulgular: Katılımcıların %65,2’si kız ve %34,8’i erkek olup, ortalama yaş 10,3±5,2 yıl olarak saptanmıştır. Çalışmaya katılan çocukların tamamının (%100,0) hemoglobin ve hematokrit düzeyleri düşük, ferritin düzeyleri yüksekti. Talasemi hastası çocukların %52,2’si besin desteği kullandığını ve en çok kullandıkları üç besin desteğinin D vitamini (%52,2), folik asit (%26,1) ve çinko (%21,7) olduğu belirlenmiştir. Talasemi hastası kız çocuklarının yaklaşık yarısının enerji (%43,5) ve kalsiyum (%53,3) alımlarının yetersiz olduğu; erkek çocukların enerji (%50,0), folat, (%50,0), C vitamini (%37,5), kalsiyum (%37,5) ve magnezyum (%37,5) alımlarının yetersiz olduğu saptanmıştır. İki-10 yaş aralığındaki çocukların %30,0’unun folat, %40’ının kalsiyum alımlarının yetersiz olduğu saptanmıştır. Bunun yanı sıra, 11-17 yaş aralığındaki çocukların %53,8’inin C vitamini ve kalsiyum, %38,5’inin çinko alımlarının yetersiz olduğu saptanmıştır.
Sonuç: Talasemi hastası çocukların makro ve mikro besin ögelerini yetersiz aldığı saptanmıştır. Bu çalışma talasemi tanılı çocukların beslenme yetersizliği açısından risk altında olduğunu saptamak için beslenme izlemine ihtiyaçları olduğunu belirlemiştir. Gelecekteki çalışmalar, Türk talasemi hastası çocuklarda daha geniş örneklemde diyet kalitesi ve beslenme durumunun sağlık sonuçları üzerindeki etkisine doğrudan odaklanmalıdır.

Kaynakça

  • Vichinsky EP. Changing patterns of thalassemia worldwide. Annals of the New York Academy of Sciences. 2005;1054(1):18-24.
  • Sönmez Ç, Öztürk-Kaymak A, Güntaş G. Halk sağlığı problemi olan talasemilerde laboratuvar. Türk Hijyen ve Deneysel Biyoloji Dergisi, 2014;71(4):221-228.
  • Canatan D, Kose MR, Ustundag M, Haznedaroglu D, Ozbas S. Hemoglobinopathy control program in Turkey. Community Genetics. 2006;9(2):124-126.
  • M, Turhan E, Babaoğlu AB. Beta Thalassemia trait in Turkey and The Middle East: A meta-analysis of prevalence. Acta Medica Mediterranean. 2018;34:1731.
  • Aydınok Y, Oymak Y, Atabay B, Aydoğan G, Yeşilipek A, Ünal S, Karakaş Z. A national registry of thalassemia in Turkey: demographic and disease characteristics of patients, achievements, and challenges in prevention. Turkish Journal of Hematology. 2018;35(1):12-18.
  • Saxena A. Growth retardation in thalassemia major patients. International Journal of Human Genetics. 2003;3(4):237-46.
  • Fung EB, Xu Y, Trachtenberg F, Odame I, Kwiatkowski JL, Neufeld EJ, Thompson AA, Boudreaux J, Quinn CT, Vichinsky EP, Thalassemia Clinical Research Network. Inadequate dietary intake in patients with thalassemia. Journal of the Academy of Nutrition and Dietetics. 2012;112(7):980-90.
  • Fung EB. Nutritional deficiencies in patients with thalassemia. Annals of the New York Academy of Sciences. 2010;1202(1):188-96.
  • Goldberg EK, Neogi S, Lal A, Higa A, Fung E. Nutritional deficiencies are common in patients with transfusion-dependent thalassemia and associated with iron overload. Journal of Food and Nutrition Research (Newark, Del.). 2018;6(10):674.
  • Claster S, Wood JC, Noetzli L, Carson SM, Hofstra TC, Khanna R, Coates TD. Nutritional deficiencies in iron overloaded patients with hemoglobinopathies. American Journal of Hematology. 2009;84(6):344-8.
  • Fahim FM, Saad K, Askar EA, Eldin EN, Thabet AF. Growth parameters and vitamin D status in children with thalassemia major in upper Egypt. International Journal of Hematology-oncology and Stem Cell Research. 2013;7(4):10.
  • Sreenivasan P, Mahtani AU, Ravi M D, Gowda K. Impact of diet counseling in thalassemic children and its response on nutritional status. Int J Health Allied Sci 2017;6:26-9
  • World Health Organization (WHO), WHO AnthroPlus for Personal Computers Manual Software for assessing growth of the world's children and adolescents 2009. Available at: https://cdn.who.int/media/docs/default-source/child-growth/growth-reference-5-19-years/who-anthroplus-manual.pdf. Accessed March 10, 2023.
  • Rakıcıoğlu, Neslişah Et Al. Yemek ve Besin Fotoğraf Kataloğu Ölçü ve Miktarlar. Ata Ofset Matbaacılık, 2010.
  • Aksoydan E, Soylu M, Ağagündüz D, Ceylan Dİ. Türkiye Beslenme Rehberi (TÜBER) 2022 (pp.211-218), Ankara: T.C. Sağlık Bakanlığı Yayın No : 1031.
  • Usman SY, Rahmat SA, Vetinly V, Kurniawan F. Dietary intake, Nutritional status, and quality of life in patients with thalassemia major. Althea Medical Journal. 2022;30;9(2):86-92.
  • Moiz B, Habib A, Sawani S, Raheem A, Hasan B, Gangwani M. Anthropometric measurements in children having transfusion-dependent beta thalassemia. Hematology. 2018;23(4):248-52.
  • Sheikh MA, Shakir MU, Shah M. The assessment of nutritional status of children with beta thalassemia major with body mass index. Pak J Med Health Sci. 2017;11:262-5.
  • Salih KM, Al-Mosawy WF. Evaluation some consequences of thalassemia major in splenectomized and non-splenectomized Iraqi patients. Int J Pharm Pharmceut Sci, 2013;5(4):385-388.
  • Pemde HK, Chandra J, Gupta D, Singh V, Sharma R, Dutta AK. Physical growth in children with transfusion-dependent thalassemia. Pediatric Health, Medicine and Therapeutics. 2011;2:13.
  • Mirhosseini NZ, Shahar S, Ghayour-Mobarhan M, Kamaruddin NA, Banihashem A, Yusoff NA, Esmaili HA, Tavallaei S. Factors affecting nutritional status among pediatric patients with transfusion-dependent beta thalassemia. Mediterranean Journal of Nutrition and Metabolism. 2013;6(1):45-51.
  • Mehrvar A, Azarkeivan A, Faranoush M, Mehrvar N, Saberinedjad J, Ghorbani R, Vossough P. Endocrinopathies in patients with transfusion-dependent ß-thalassemia. Pediatric Hematology and Oncology. 2008;25(3):187-94.
  • Abdalla MY, Fawzi M, Al-Maloul SR, El-Banna N, Tayyem RF, Ahmad IM. Increased oxidative stress and iron overload in Jordanian β-thalassemic children. Hemoglobin. 2011;35(1):67-79.
  • Panigrahi I, Agarwal S. Thromboembolic complications in β-thalassemia: Beyond the horizon. Thrombosis Research. 2007;120(6):783-9.
  • Qureshi TZ, Anwar M, Ahmed S, Khan DA, Saleem M. Serum ferritin levels in carriers of β-thalassaemia trait. Acta Haematologica. 1995;94(1):7-9.
  • Ayyash H, Sirdah M. Hematological and biochemical evaluation of β-thalassemia major (βTM) patients in Gaza Strip: A cross-sectional study. International Journal of Health Sciences. 2018;12(6):18.
  • Karakul A. Nutrition management in children with thalassemia In: Chernopolski PM, ed. Advances in Health Sciences Research. 1st ed. Sofia: St. Kliment Ohridski University Press;2020. p.33-40.
  • Ayukarningsih Y, Amalia J, Nurfarhah G. Thalassemia and nutritional status in children. Journal of Health and Dental Sciences. 2022;2(1):39-52.
  • d'Arqom A, G Putri M, Savitri Y, Rahul Alfaidin AM. Vitamin and mineral supplementation for β-thalassemia during COVID-19 pandemic. Future Science OA. 2020;6(9):FSO628.
  • Behera S, Dixit S, Bulliyya G, Kar SK. Fat-soluble antioxidant vitamins, iron overload and chronic malnutrition in β-thalassemia major. The Indian Journal of Pediatrics. 2014;81:270-4.
  • Abbassy HA, Elwafa RA, Omar OM. Bone mineral density and vitamin D receptor genetic variants in Egyptian children with beta thalassemia major on vitamin D supplementation. Mediterranean Journal of Hematology and Infectious Diseases. 2019;11(1):1-11.
  • Karunaratna AM, Ranasingha JG, Mudiyanse RM. Zinc status in beta thalassemia major patients. Biological Trace Element Research. 2018;184:1-6.
  • Fung EB. The importance of nutrition for health in patients with transfusion‐dependent thalassemia. Annals of the New York Academy of Sciences. 2016;1368(1):40-8.
Toplam 33 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makalesi
Yazarlar

Nazlı Nur Aslan Çin 0000-0002-4458-8817

Nevra Koç 0000-0002-4358-4443

Yayımlanma Tarihi 30 Ekim 2023
Yayımlandığı Sayı Yıl 2023

Kaynak Göster

Vancouver Aslan Çin NN, Koç N. Talasemi Hastası Çocukların Beslenme Durumunun Değerlendirilmesi. STED. 2023;32(4):272-9.