Demir Eksikliği Anemisinde Tedavinin Kilo Alımına Etkisi ve Ghrelin ve Hepsidin Düzeyleri ile İlişkisi

Abstract

Amaç: Demir eksikliği anemisi (DEA)’nde iştahsızlık ve tedavi sırasında kilo alımı sık yakınmalar olsa da bu konuda erişkinlerde yapılmış çok az çalışma mevcuttur. Bu çalışmada, DEA’da iştah ile ilgili hormanlardan biri olan ghrelin ve demir metabolizmasının temel düzenleyicilerinden biri olan hepsidin seviyelerinin belirlenmesi ile tedavinin kilo alımına ve bu hormonların düzeylerine etkisinin incelenmesi amaçlandı. Gereç ve Yöntemler: Çalışmaya DEA tanılı 87 erişkin hasta ve 50 sağlıklı gönüllüden oluşan kontrol grubu dahil edildi. Hasta ve kontrol grubunda tedavi öncesi antropometrik ölçümler yapılarak kan örnekleri alındı ve tedavi sonrasında DEA grubunda tekrarlandı. Bulgular: Gruplar arasında kilo, vücut kitle indeksi (VKİ), bel-kalça oranı açısından anlamlı fark yoktu ancak hasta grubunda tedavi sonrasında kilo ve VKİ’de anlamlı artış saptandı (her iki p<0,001). Hasta grubunun tedavi öncesi hepsidin ve ghrelin seviyesi kontrol grubuna göre anlamlı olarak daha düşüktü (sırasıyla p<0,001 ve p=0,026) ve tedavi sonrası hepsidin seviyeleri anlamlı olarak arttı (p<0,001). Tedavi sonrası ghrelin artışı istatistiksel olarak anlamlı değildi ancak hem kilo (r=0,254; p=0,018) hem de VKİ (r=0,231; p=0,031) artışı ile pozitif yönde zayıf korelasyon gösteriyordu. Hepsidin düzeylerinin kilo ve VKİ değişimleri ile korelasyonu saptanmadı. Sonuç: Bu bulgular erişkinlerde DEA’da ghrelin ve hepsidinin düşük olduğunu ve tedavi ile hastalarda objektif bir kilo ve VKİ artışı olduğunu ortaya koydu. Hepsidin tedavi ile artış göstermekle beraber kilo alımı ile korele değildi, ghrelin zayıf korelasyon göstermekteydi.

Keywords

• Demir eksikliği anemisi
• iştah
• kilo alımı
• ghrelin
• hepsidin

The Effect of Treatment on Weight Gain in Iron Deficiency Anemia and Its Association with Ghrelin and Hepcidin Levels

Abstract

Aim: Although loss of appetite in iron deficiency anemia (IDA) and weight gain during treatment are common complaints, there are very few studies in adults. This study aimed to determine the levels of ghrelin, one of the appetite-related hormones, and hepcidin, one of the main regulators of iron metabolism, in IDA, and to examine the effects of treatment on weight gain and the levels of these hormones. Material and Methods: Eighty-seven adult patients with IDA and a control group of 50 healthy volunteers were included in the study. Anthropometric measurements and blood samples were obtained from the patient and control groups before treatment, and repeated after treatment in the IDA group. Results: No significant difference was found in terms of weight, body mass index (BMI), and waist-to-hip ratio between groups but there was a significant increase in weight and BMI, in the patient group after treatment (both p<0.001). Pre-treatment hepcidin and ghrelin levels of the patient group were significantly lower than the control group (p<0.001, and p=0.026, respectively), and hepcidin levels increased significantly after treatment (p<0.001). The increase in ghrelin was not statistically significant but showed a positive weak correlation with both weight (r=0.254, p=0.018) and BMI (r=0.231, p=0.031) increase. Hepcidin levels were not correlated with weight and BMI changes. Conclusion: These findings revealed low levels of ghrelin and hepcidin in adults with IDA and an increase in weight and BMI with treatment. Hepcidin increased with treatment but was not correlated with weight gain, ghrelin was weakly correlated.

Keywords

• İron deficiency anemia
• appetite
• weight gain
• ghrelin
• hepcidin

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