Romatizmal Kapak Hastalığında Serum Eser Elementlerinin Değerlendirilmesi

Yıl 2016, Cilt: 13 Sayı: 1, 74 - 79, 28.04.2016

Eyyup Tusun Abdulselam İlter Feyzullah Beşli Ahmet Çelik

Öz

Amaç
Bu çalışmanın amacı romatizmal kapak hastalığı (RKH) olan bireylerde serum eser elementleri düzeyinin
değerlendirilmesidir.
Materyal ve Metod
Bu çalışmaya, kardiyoloji polikliniğine başvuran hastalar arasından RKH mevcut olup fonksiyonel
kapasitesi sınıf 1 olan ardışık 30 (15 Erkek ve ort yaş: 34,0±9,3 yıl) hasta dâhil edildi. Yapılan kardiyak
değerlendirme sonucunda patoloji saptanmayan, benzer demografik özelliklere sahip ardışık 30 (9 Erkek ve
ortalama yaş:37,4±5,9 yıl ) sağlıklı birey kontrol grubu olarak alındı. Serum Çinko (Zn) düzeyi alev
fotometresinde, Selenyum (Se) düzeyi atomik absorbsiyon spektrofotometresinde ve Demir (Fe) düzeyi ise
spektrofotometrik olarak ölçüldü.
Sonuçlar
Yaş ve cinsiyet, gruplar arasında benzerdi (p>0,05). Boy, vücut ağırlığı, serum Fe, Se ve Zn düzeyleri hasta
grubunda kontrol grubuna göre daha düşüktü (tüm p değerleri <0,05). Yapılan korelasyon analizinde, serum
Fe düzeyi ile, yaş, vücut ağırlığı, serum Se ve Zn düzeyi arasında pozitif ilişki saptandı (p<0,05). Serum Se
düzeyi, boy, serum Fe ve Zn düzeyi ile; serum Zn düzeyi ise boy, vücut ağırlığı, serum Fe ve Se düzeyleri ile
pozitif korele idi. (tüm p değerleri <0,05). Çok değişkenli logistik regresyon analizi bu değişkenlerden
sadece serum demir seviyesinin RKH varlığının bağımsız belirleyicisi olduğunu gösterdi (beta
değeri=0,500, p<0,05).
Tartışma
Çalışmamızda, RKH olanlarda, serum eser elementlerinin kontrol grubuna göre daha düşük olduğu
bulunmuştur. Serum eser elementlerindeki bu düşüklük, RKH olanlardaki uygunsuz immün yanıt ile ilişkili
olabilir. Ancak eser element seviyelerinin RKH'larında düşük olmasının sebep mi sonuç mu olduğu kesin
olarak bilinmektedir. Ayrıca, eser elementleri yerine koymanın hastalık ilerleyişine etkisini inceleyen
çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

Romatizmal kapak hastalığı, Eser elementler, Selenyum, Demir, Çinko

The Evaluation Of Trace Elements In Rheumatic Valvular Disease

Öz

Aim
The aim of this study was to investigate trace elements in patients with rheumatic valvular disease
Material and Method
A total of 30 consequently (15 male and age: 34.0 ±9.3 years) patients with rheumatic valvular disease and
functional capacity class 1 according to NYHA (RVD) who admitted to our cardiology department were
enrolled in this sturdy. 30 randomly age/sex matched subjects with no cardiovascular or systemic disease
were recruited as control group. Serum levels of trace elements including selenium (Se) zinc (Zn) and iron
(Fe) were measured.
Results
The age and sex were comparable between two groups (p>0.05). Height, weight, serum levels of Fe, Se and
Zn were lower in patients with RVD compared to control group (all p values <0.05). In correlation analysis,
serum Fe levels were positively correlated with age, weight, and serum Se and Zn levels (all p values <0.05).
Serum Se levels were positively correlated with height, serum Fe and Zn levels, while serum Zn levels were
positively correlated with height, weight, and serum Fe and Se levels (all p values <0.05). Multivariable
regression analyses showed that serum Fe levels were the only independent predictor of RVD (beta
value=0,500, p<0.05).
Conclusion
In this study, we yield that serum levels of Fe, Se and Zn were significantly lower in patients with RVD. These
results may be associated with inappropriate immune response in this population. However, it is not clear
whether this is a cause or a result of rheumatic heart disease. Additionally, further studies which investigating
the effect of replacement of trace elements in rheumatic valvular disease are needed.

Anahtar Kelimeler

rheumatic valvular disease, trace elements, Selenium, iron, zinc

Kaynakça

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