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Dahiliye Polikliniğine Başvuran Hastalarda Diyabetes Mellitüs ve Vitamin D Eksikliğinin Değerlendirilmesi

Yıl 2023, , 25 - 32, 24.02.2023
https://doi.org/10.33716/bmedj.1240748

Öz

Giriş: D vitamini (vit-D) eksikliği kalp hastalıkları, kanser, inflamatuvar barsak hastalıkları, diyabet, romatolojik hastalıklar gibi otoimmün hastalıkların gelişiminde de rol aldığı tespit edilmiştir. Ayrıca ottoimmün hastalıklardan olan vitamin B12 (vit-B12) eksikliği, vit-D eksikliğinde görülebilmektdir. Bunların yanı sıra vit-D insülin sekresyonun da ve insülinin hedef hücrelerde duyarlılığının artırılmasında da önemli bir role sahip olup, yapılan çalışmalarda diyabetes mellitüsün (DM) başlangıç aşamasında vit-D eksikliği gözlenmiştir. Bu nedenle bu çalışmamızda dahiliye polikliniğine başvuran hastalarda vit-D, DM, vit-B12 ve ferritin arasındaki ilişkiyi değerlendirmeyi hedefledik. Materyal-Metod: 18 yaş ve üzeri erişkin, 01 Haziran 2021 ile 31 Aralık 2021 tarihleri arasında Mersin Şehir Eğitim ve Araştırma Hastanesi dahiliye polikliniğine başvuran hastaların verileri retrospektif olarak değerlendirildi. Bulgular: Hastaların 476 (%95.2)’sinde vitamin D seviyesi 30 ng/ml altında, 20 (%4.0) B12 vitamin seviyesi 200 pg/ml altında, 319 (63.8) ferritin seviyesi 20 ng/ml altında tespit edildi. Kadın cinsiyet (p<0.01), ileri yaş (p<0.01) DM olanlarda; DM olmayan grupta ferritin düşüklüğü (p=0.01) anlamlı tespit edilmiştir. Sonuç-Öneriler: Vit-D eksikliği DM ve vit-B12 eksikliği gibi bir çok hastalığın oluşumu sürecinde önemli bir rol oynamaktadır. İnflamatuvar bir marker olan ferritinde bir çok hastalık ile ilişkisi gösterilmiştir. Biz bu çalışmamızda DM ile ileri yaş ve kadın cinsiyet, DM olmayanlarda ferritin düşüklüğü anlamlı olup, vit-D eksikliğini yüksek oranda tespit ettik. Bu hastalıkların erken dönemde tespit edilebilmesi, komplikasyonların önlenebilmesi veya vitamin eksikliği tedavileri ile hastalıkların önlemebilmesi için daha uzun dönem , tedavi sonrası takipleri de içeren çalışmalara ihtiyaç vardır.

Destekleyen Kurum

YOKTUR

Proje Numarası

YOKTUR

Kaynakça

  • Iqbal K, Islam N, Mehboobali N, Asghar A, Iqbal SP, Iqbal MP. Relationship of sociodemographic factors with serum levels of vitamin D in a healthy population of Pakistan, Pak J Pharma Scie. 2019; 32(1):29-34.
  • Holick MF. Vitamin D deficiency, N Engl J Med. 2007; 357:266–81.
  • Bikle D. Nonclassic actions of vitamin D, J Clin Endocrinol Metab. 2009 Jan; 94 ((1)):26– 34.
  • Dilas LT, Icin T, Paro JN, Bajkin I. Autoimmune thyroid disease and other nonendocrineautoimmune diseases, Med Pregl. 2011 Mar-Apr; 64 ((3-4)):183–7.
  • Giustina, A., & Bilezikian, J. P. (2018). Vitamin D in clinical medicine.,Karger Medical and Scientific Publishers.
  • Berridge MJ. Vitamin D deficiency and Diabetes, Biochem J 2017;474:1321-32.
  • Norman AW, Frankel JB, Heldt AM, Grodsky GM. Vitamin D deficiency inhibits pancreatic secretion of insulin, Science. 1980, 209:823-5
  • Mitri, J., Dawson-Hughes, B., Hu, F. B., & Pittas, A. G. Effects of vitamin D and calcium supplementation on pancreatic β cell function, insulin sensitivity, and glycemia in adults at high risk of diabetes: the Calcium and Vitamin D for Diabetes Mellitus (CaDDM) randomized controlled trial, The American journal of clinical nutrition, 94(2), 486-494.
  • Rajpathak S, Ma J, Manson J, Willett WC, Hu FB. Iron intake and the risk of type 2 diabetes in women:a prospective cohort study, Diabetes Care. 2006;29:1370–1376. doi:10.2337/dc06-0119.
  • Wacker M, Holick MF. Vitamin D-Effects on Skeletal and Extraskeletal Health and the Need for Supplementation, Nutrients 2013;5:111-48.
  • Dharmarajan TS, Adiga GU, Norkus EP. Vitamin B12 deficiency. recognizing subtle symptoms in older adults, Geriatrics March 2003; 58 (3): 30-8
  • Akman M, Budak Ş, and Kendir M. "Genel Dahiliye Polikliniğine Başvuran Hastalarda Obezite Sikliği Ve İlişkili Sağlik Problemleri," Marmara Medical Journal 17.3 (2004): 113- 120.
  • Özer Z. Bahçecioğlu Turan G, and Bakır E. "Dahiliye Polikliniğine Başvuran Hastaların Geleneksel ve Tamamlayıcı Tıbba Karşı Tutumları ve Etkileyen Faktörler," Sağlık Profesyonelleri Araştırma Dergisi 2.3: 102-112.
  • IDF Diabetes Atlas Fifth Edition, Brussels,2011,IDF.
  • Satman İ, Yılmaz T, Sengül A et al. Population-Based Study of Diabetes and Risk Characteristics in Turkey: Result of Turkish Diabetes Epidemiyology Study (TURDEP), Diabetes Care 2002; 25: 1551-1556.
  • Yasir M. "Vitamin D deficiency and diseases: a review from Pakistan." Authorea Preprints (2020).
  • Mehboobali N, Iqbal SP, Iqbal MP. High prevalence of vitamin D deficiency and insufficiency in a low income peri-urban community in Karachi. J Pak Med Assoc 2015;65:946-49.
  • Khushdil A, Ullah S, Ali S, Khan I, Awan T. Hypovitaminosis D in healthy students of a medical college, Khyber Med Univ J 2015;7:162-4.
  • Batieha A, Khader Y, Jaddou H, Hyassat D, Batieha Z, Khateeb M, et al. Vitamin D status in Jordan: Dress style and gender discrepancies, Ann Nutr Metab 2011;58:10-8.
  • Jumaa AM, Khalaf MA, Hassan HY: Determination of vitamin D concentration in diabetic and non diabetic men and its correlation with age, Indian J Forensic Med Toxicol. 2021, 15:1853-8.
  • Sacerdote A, Dave P, Lokshin V, Bahtiyar G: Type 2 diabetes mellitus, insulin resistance, and vitamin D, Curr Diab Rep. 2019, 19:101.
  • Elimam H, Abdulla AM, Taha IM. Inflammatory markers and control of type 2 diabetes mellitus, Diabetes Metab Syndr. 2019;13(1):800–804.
  • Sheu, W. H. H., Chen, Y. T., Lee, W. J., Wang, C. W., & Lin, L. Y. (2003). A relationship between serum ferritin and the insulin resistance syndrome is present in non‐diabetic women but not in non‐diabetic men.,Clinical endocrinology, 58(3), 380-385.
  • Kaplanoğlu, E., Özbalcı, D., Alanoğlu, E. G., & Gürdal, O. Isparta’da Erişkinlerde Demir Eksikliği Anemisi Prevalansı Ve Etyolojik Faktörlerin Değerlendirilmesi.,Sdü Tıp Fakültesi Dergisi, 28(1), 57-65.
  • Neal, E. S., Kumar, V., Borges, K., & Cuffe, J. S. (2023). Vitamin B12 deficiency induces glucose intolerance, delays peak insulin levels and promotes ketogenesis in female rats, Journal of Endocrinology, 256(2).

An Investigation of Diabetes Mellitus and Vitamin D Deficiency in Patients Presented to Internal Medicine Outpatient Clinic

Yıl 2023, , 25 - 32, 24.02.2023
https://doi.org/10.33716/bmedj.1240748

Öz

Introduction: Vitamin D deficiency plays a role also in the occurrence of autoimmune diseases, including heart disease, cancer, inflammatory bowel diseases, diabetes, and rheumatological diseases. In addition, vitamin B12 deficiency, one of the autoimmune diseases, can also be seen in cases of Vitamin D deficiency. Furthermore, Vitamin D is also associated with insulin secretion and increased insulin sensitivity in target cells, and relevant studies reported Vitamin D deficiency at the initial stage of diabetes mellitus (DM). Accordingly, the present study aimed to investigate the relationship between Vitamin D, DM, Vitamin B12, and ferritin in patients presented to the internal medicine outpatient clinic. Materials and Methods: The data from adults aged 18 years and over, who presented to the Internal Medicine Outpatient Clinic of the Mersin City Training and Research Hospital between 01 June 2021 and 31 December 2021 were retrospectively investigated. Results: 476 (95.2%) patients had vitamin D levels below 30 ng/ml, 20 (4.0%) had vitamin B12 levels below 200 pg/ml, and 319 (63.8%) patients had ferritin levels below 20 ng/ml. There was a significant decrease in ferritin in female gender (p<0.01), advanced age patients with DM (p<0.01), and patients without DM (p=0.01). Conclusion and Recommendations: Vitamin D deficiency plays an important role in the occurrence of many diseases, including DM and Vitamin B12 deficiency. Ferritin, an inflammatory marker, has been shown to be associated with a number of diseases. As a result of the present study, there was a significant decrease in ferritin in advanced age patients with DM, female sex, and patients without DM, and a higher rate of Vitamin D deficiency. Further long-terms studies including post-treatment follow-up periods are required to diagnose the above diseases in an earlier period, prevent complications, and prevent diseases by means of vitamin deficiency treatments

Proje Numarası

YOKTUR

Kaynakça

  • Iqbal K, Islam N, Mehboobali N, Asghar A, Iqbal SP, Iqbal MP. Relationship of sociodemographic factors with serum levels of vitamin D in a healthy population of Pakistan, Pak J Pharma Scie. 2019; 32(1):29-34.
  • Holick MF. Vitamin D deficiency, N Engl J Med. 2007; 357:266–81.
  • Bikle D. Nonclassic actions of vitamin D, J Clin Endocrinol Metab. 2009 Jan; 94 ((1)):26– 34.
  • Dilas LT, Icin T, Paro JN, Bajkin I. Autoimmune thyroid disease and other nonendocrineautoimmune diseases, Med Pregl. 2011 Mar-Apr; 64 ((3-4)):183–7.
  • Giustina, A., & Bilezikian, J. P. (2018). Vitamin D in clinical medicine.,Karger Medical and Scientific Publishers.
  • Berridge MJ. Vitamin D deficiency and Diabetes, Biochem J 2017;474:1321-32.
  • Norman AW, Frankel JB, Heldt AM, Grodsky GM. Vitamin D deficiency inhibits pancreatic secretion of insulin, Science. 1980, 209:823-5
  • Mitri, J., Dawson-Hughes, B., Hu, F. B., & Pittas, A. G. Effects of vitamin D and calcium supplementation on pancreatic β cell function, insulin sensitivity, and glycemia in adults at high risk of diabetes: the Calcium and Vitamin D for Diabetes Mellitus (CaDDM) randomized controlled trial, The American journal of clinical nutrition, 94(2), 486-494.
  • Rajpathak S, Ma J, Manson J, Willett WC, Hu FB. Iron intake and the risk of type 2 diabetes in women:a prospective cohort study, Diabetes Care. 2006;29:1370–1376. doi:10.2337/dc06-0119.
  • Wacker M, Holick MF. Vitamin D-Effects on Skeletal and Extraskeletal Health and the Need for Supplementation, Nutrients 2013;5:111-48.
  • Dharmarajan TS, Adiga GU, Norkus EP. Vitamin B12 deficiency. recognizing subtle symptoms in older adults, Geriatrics March 2003; 58 (3): 30-8
  • Akman M, Budak Ş, and Kendir M. "Genel Dahiliye Polikliniğine Başvuran Hastalarda Obezite Sikliği Ve İlişkili Sağlik Problemleri," Marmara Medical Journal 17.3 (2004): 113- 120.
  • Özer Z. Bahçecioğlu Turan G, and Bakır E. "Dahiliye Polikliniğine Başvuran Hastaların Geleneksel ve Tamamlayıcı Tıbba Karşı Tutumları ve Etkileyen Faktörler," Sağlık Profesyonelleri Araştırma Dergisi 2.3: 102-112.
  • IDF Diabetes Atlas Fifth Edition, Brussels,2011,IDF.
  • Satman İ, Yılmaz T, Sengül A et al. Population-Based Study of Diabetes and Risk Characteristics in Turkey: Result of Turkish Diabetes Epidemiyology Study (TURDEP), Diabetes Care 2002; 25: 1551-1556.
  • Yasir M. "Vitamin D deficiency and diseases: a review from Pakistan." Authorea Preprints (2020).
  • Mehboobali N, Iqbal SP, Iqbal MP. High prevalence of vitamin D deficiency and insufficiency in a low income peri-urban community in Karachi. J Pak Med Assoc 2015;65:946-49.
  • Khushdil A, Ullah S, Ali S, Khan I, Awan T. Hypovitaminosis D in healthy students of a medical college, Khyber Med Univ J 2015;7:162-4.
  • Batieha A, Khader Y, Jaddou H, Hyassat D, Batieha Z, Khateeb M, et al. Vitamin D status in Jordan: Dress style and gender discrepancies, Ann Nutr Metab 2011;58:10-8.
  • Jumaa AM, Khalaf MA, Hassan HY: Determination of vitamin D concentration in diabetic and non diabetic men and its correlation with age, Indian J Forensic Med Toxicol. 2021, 15:1853-8.
  • Sacerdote A, Dave P, Lokshin V, Bahtiyar G: Type 2 diabetes mellitus, insulin resistance, and vitamin D, Curr Diab Rep. 2019, 19:101.
  • Elimam H, Abdulla AM, Taha IM. Inflammatory markers and control of type 2 diabetes mellitus, Diabetes Metab Syndr. 2019;13(1):800–804.
  • Sheu, W. H. H., Chen, Y. T., Lee, W. J., Wang, C. W., & Lin, L. Y. (2003). A relationship between serum ferritin and the insulin resistance syndrome is present in non‐diabetic women but not in non‐diabetic men.,Clinical endocrinology, 58(3), 380-385.
  • Kaplanoğlu, E., Özbalcı, D., Alanoğlu, E. G., & Gürdal, O. Isparta’da Erişkinlerde Demir Eksikliği Anemisi Prevalansı Ve Etyolojik Faktörlerin Değerlendirilmesi.,Sdü Tıp Fakültesi Dergisi, 28(1), 57-65.
  • Neal, E. S., Kumar, V., Borges, K., & Cuffe, J. S. (2023). Vitamin B12 deficiency induces glucose intolerance, delays peak insulin levels and promotes ketogenesis in female rats, Journal of Endocrinology, 256(2).
Toplam 25 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm ARAŞTIRMA MAKALESİ
Yazarlar

Deniz Gezer 0000-0002-9036-0135

Seval Müzeyyen Ecin 0000-0002-7701-7826

Proje Numarası YOKTUR
Yayımlanma Tarihi 24 Şubat 2023
Yayımlandığı Sayı Yıl 2023

Kaynak Göster

APA Gezer, D., & Ecin, S. M. (2023). An Investigation of Diabetes Mellitus and Vitamin D Deficiency in Patients Presented to Internal Medicine Outpatient Clinic. Balıkesir Medical Journal, 7(1), 25-32. https://doi.org/10.33716/bmedj.1240748