Talasemi Major Hastalarında D Vitamini ile Sol Ventrikül Fonksiyonu Arasındaki İlişki

Öz

Amaç: Talasemi Major (TM) hastalarında D vitamini düzeylerinin (VDL) sol ventriküler fonksiyon (LVF) ile ilişkisini değerlendirmeyi amaçladık. Materyal ve Metod: 1 Haziran 2022 ve 1 Haziran 2023 tarihleri arasında Adana Tıp Fakültesi, Sağlık Bilimleri Üniversitesi, Adana Şehir Eğitim ve Araştırma Hastanesi'nde (AŞEAH) pediatrik hematoloji onkoloji kliniğine başvuran TM'li hastalar çalışmaya alınmıştır. Rutin tetkikleri yapılarak, 25-Hidroksivitamin D (25(OH)D) düzeyleri, ferritin değerleri, Ekokardiyografi (EKHO) Ejeksiyon Fraksiyonu (EF), Fraksiyonel Kısalma (FS) verileri hasta kayıtlarından elde edildi. Bulgular: Çalışmaya 89 TM hastası dahil edildi. Kadın oranı %46,1 (n=41), %53,9'u erkek (n=48) idi. Vakaların yaşları bir ile yirmi dört yaş arasında değişiyordu ve ortalama on yaş idi. Vakaların 84'ü 0-18 yaş arasında (%94,4), 5'i (%5,6) 18 yaş üzerindeydi. Medyan ferritin düzeyi 1497 µg/L (68-11354), VDL 18 µg/L (3-52), EF 66 (37-77) ve FS 36 (21-67) olarak belirlendi. Anlamlı bir ters korelasyon TM hastala-rında ferritin düzeyleri ile VDL bulundu. (p=0,026, r=-0,235). TM hastalarında VDL, EF ve FS düzeyleri arasında korelasyon saptanmadı (p=0,684, r_0,44; p=0,082, r=0,185). Sonuç: TM tanısı alan hastalarda demir yükü ile VDL arasında ters ilişki gözlendi. Kardiyak disfonksiyon demir birikiminin bir sonucu olmasına rağmen, bu çalışma düşük VDL'li hastalarda anlamlı kalp bozuk-luğunu ortaya koymamıştır. Mevcut veriler bu eksikliğin kardiyak sistolik fonksiyonlar üzerindeki doğ-rudan etkilerini desteklememektedir. Bu bulgular Talasemi Major hastalarında D vitamini durumunun izlenmesinin ve demir yükünün kontrol edilmesinin önemini vurgulamaktadır.

Anahtar Kelimeler

• Transfüzyon bağımlı talasemi
• d vitamini
• kalp yetmezliği

Proje Numarası

2639/08.06.2023

The Relationship Between Vitamin D and Left Ventricular Function in Thalassemia Major Patients

Öz

Background: Our goal was to evaluate a correlation vitamin D levels(VDL) with left ventricular function (LVF) in Thalassemia Major (TM) patients. Materials and Methods: Patients with TM who presented to the PHOC at Adana Faculty of Medicine, Health Sciences University, Adana City Training and Research Hospital(ACTRH) during June 1, 2022 and June 1, 2023, were eligible for the study. Routine investigations were performed, and data on 25-Hydroxyvitamin D (25(OH)D) levels, ferritin values, Echocardiography (ECHO) Ejection Fraction (EF), and Fractional Shortening (FS) were obtained from patient records . Results: The study included 89 patients of TM. The female ratio was 46.1% (n=41), while 53.9% were male (n=48). The cases ranged in age from one to twenty-four years, with a median of ten. Out of the cases, 84 were between the ages of 0 and 18 (94.4%), with 5 over the age of 18 (5.6%). The median ferritin level was 1497 µg/L (68-11354), VDL was 18 µg/L (3-52), EF was 66 (37-77), and FS was 36 (21-67). A significant inverse correlation was found in VDL with ferritin levels in TM patients. (p=0.026, r=-0.235). No correlation was found between VDL, EF, and FS levels in TM patients (p=0.684, r_0.44; p=0.082, r=0.185). Conclusions: An inverse relationship was observed between iron burden and VDL in patients diagno-sed with TM. Although cardiac dysfunction is a consequence of iron accumulation, this study did not reveal significant cardiac impairment in patients with low VDL. Available data do not support the direct effects of this deficiency on cardiac systolic functions. These findings highlight the importance of monitoring vitamin D status and controlling iron load in Thalassemia major patients.

Anahtar Kelimeler

• vitamin D
• thalassemia major
• heart failure

Proje Numarası

2639/08.06.2023

Etik Beyan

ADANA ŞEHİR EĞİTİM VE ARAŞTIRMA HASTANES ETİK KURULUNDA GÖRÜŞÜLDÜ VE ÇALIŞMA KABUL EDİLDİ.

Kaynakça

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