Çocukluk Çağı Obezitesinin Koroidal Yapılar Üzerine Etkisinin Değerlendirilmesi

Year 2024, , 6 - 12, 29.04.2024

Serdar Bilici , Tuba Gültekin Erol , Esra Bilici , Sılay Cantürk Uğurbaş , Suat Hayri Uğurbaş

https://doi.org/10.25048/tudod.1400388

Abstract

Amaç: Çocukluk çağı obezitesinin koroidal yapılar üzerindeki etkilerini spektral domain optik koherens tomografi ile değerlendirmek.
Gereç ve Yöntemler: Çalışmaya her gruptan (sağlıklı, fazla kilolu, obez ve morbid-obez) 20’ şer toplamda 80 çocuk dahil edildi.
Olguların insülin direnci, dislipidemi ve metabolik sendrom gibi komorbiditelerinin varlığı kaydedildi. Olguların optik koherens
tomografi görüntülerinden elde edilen subfoveal koroid kalınlığı (SFKK) ve koroid vaskülarite indeksi (KVİ) değerleri karşılaştırıldı.
Bulgular: Gruplar yaş ve aksiyel uzunluk ortalamaları açısından benzer bulundu (sırasıyla p=0,504 ve p=0,805). Sağlıklı, fazla kilolu,
obez ve morbid-obez çocuklarda medyan (min-maks) SFKK sırasıyla 398,5 (319,0-453,5) μm, 299,0 (274,7-387,0) μm, 295,5 (257,0-
385,0) μm ve 304,5 (272,2-386,0) μm idi. Fazla kilolu ve obez çocuklarda SFKK sağlıklı çocuklara göre daha inceydi (p=0,032). Ancak obezite şiddeti ile SFKK istatistiksel olarak ilişkili bulunmadı (p=0,722). Gruplar arasında KVİ, toplam koroid alanı, luminal alan ve
stromal alan açısından anlamlı fark yoktu (sırasıyla p=0,710, p=0,452, p=0,221 ve p=0,863). Dislipidemisi olan obez çocuklarda SFKK,
dislipidemisi olmayanlara göre daha düşük bulundu (292,0(166-431) μm vs 348,0(173-491) μm, p=0,003). Eşlik eden insülin direnci ve
metabolik sendrom varlığının ise SFKK üzerine etkisi gözlenmedi (p=0,336 ve p=0,211, sırasıyla).
Sonuç: Çocukluk çağı obezitesi ve eşlik eden dislipidemi varlığı, KVİ' de herhangi bir anlamlı değişiklik yapmadan SFKK'de azalmaya
yol açmaktadır. Ancak obezite şiddeti ve eşlik eden insülin direnci veya metabolik sendroma sahip olmanın SFKK veya KVİ üzerinde
etkisi gözlenmemiştir. SFKK parametresinde incelme görülmesi çocukluk çağı obezitesi ve dislipidemi varlığına bağlı mikrovasküler
bozukluklar ile ilişkili olabilir.

Keywords

Çocukluk çağı obezitesi, koroid vaskülarite endeksi, subfoveal koroid kalınlığı, optik koherens tomografi

Evaluating the Effect of Childhood Obesity on Choroidal Structures

Abstract

Aim: To evaluate the effect of childhood obesity on choroidal structures with spectral-domain optical coherence tomography (SD-OCT).
Material and Methods: A total of 80 children (20 children per each group; healthy, overweight, obese, and morbid-obese) were included
in the study. Accompanying comorbidities such as insulin resistance, dyslipidemia, and metabolic syndrome were recorded. The
subfoveal choroidal thickness (SFCT) and choroidal vascularity index (CVI) measurements were obtained from SD-OCT images and
compared between groups.
Results: No notable differences were found between groups regarding the means of age and axial length (p=0.504, and p=0.805,
respectively). The SFCT medians (min-max) of healthy, overweight, obese, and morbid-obese children were 398.5 (319.0-453.5) μm,
299.0 (274.7-387.0) μm, 295.5 (257.0-385.0) μm, and 304.5 (272.2-386.0) μm respectively. Overweight and obese children had thinner
choroid than non-obese healthy children (p=0.032). Besides, no significant correlation was observed between the severity of obesity and
SFCT (p=0.722). In terms of CVI, total choroidal area, luminal area, and stromal area; no significant differences were found between
groups (p=0.710, p=0.452, p=0.221, and p=0.863, respectively). Obese children with dyslipidemia had thinner SFCT than those not have
dyslipidemia (292.0 (166-431)μm vs 348.0(173-491)μm, p=0.003), while insulin resistance and metabolic syndrome had no effect on
SFCT (p=0.336, and p=0.211, respectively).
Conclusion: Childhood obesity and accompanying dyslipidemia led to a decrease in SFCT without any significant change in the CVI.
However, the severity of obesity and having insulin resistance or metabolic syndrome had no effect on either SFCT or CVI. The thinning
in the SFCT may be related to microvascular disorders due to childhood obesity and dyslipidemia

Keywords

Childhood obesity, choroidal vascularity index, subfoveal choroidal thickness, optical coherence tomography

Ethical Statement

This study was approved by Zonguldak Bülent Ecevit University Ethics Committee (2022/06-09).

Supporting Institution

No financial support was received.

Thanks

Special thanks to Dr. Esra Gultekin for the statistical analysis.

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