Ataklarla Seyreden Multipl Skleroz Hastalarında Yorgunluk, Depresyon Ve Beslenme Durumu Arasındaki İlişkinin İncelenmesi

Yıl 2024, , 33 - 43, 19.02.2024

Elif Gökçe İnbaşı , Nural Erzurum Alim , Mehmet Fatih Yetkin

https://doi.org/10.33715/inonusaglik.1379379

Öz

Bu çalışma ataklarla seyreden Multipl Skleroz (MS) hastalarının beslenme, depresyon ve yorgunluk durumlarını değerlendirmeyi amaçlamıştır. Çalışma, 30 MS hastası (Hasta Grubu: HG) ve benzer özelliklerdeki 30 sağlıklı gönüllüden oluşan kontrol grubu (Kontrol Grubu: KG) üzerinde gerçekleştirilmiştir. MS’liler arasında depresyon ve yorgunluk arasındaki ilişkinin pozitif yönlü olduğu bulunmuştur (p<0.05). HG'dekilerin Yorgunluk Şiddeti Ölçeği (YŞÖ) ortalama puanı 5.65±1.57 iken, KG'dekilerin 3.10±0.97’dir. Hastaların yorgunluk düzeyi kontrollere göre anlamlıdır (p<0.05). HG'dekilerin B12 vitamini alımı ile YŞÖ ve Beck Depresyon Ölçeği (BDÖ) puanları açısından negatif yönlü ilişki bulunmuştur (p<0.05). Çalışma MS hastalarının yorgunluk ve depresyon durumlarının beslenme alışkanlıkları ile yakından ilişkili olduğunu göstermiştir. Düşük serum B12 seviyeleri yorgunluk ve depresyon riskini artırabileceğinden B12 vitamini alımına dikkat edilmelidir. MS hastalarının yaşam kalitesini artırmak için beslenmeleri yakından takip edilmeli, ihtiyaçlarına uygun, dengeli ve sağlıklı bir beslenme planı uygulanmalıdır.

Anahtar Kelimeler

Beslenme, Depresyon, Multipl Skleroz, Yorgunluk

INVESTIGATION OF THE RELATIONSHIP BETWEEN FATIGUE, DEPRESSION AND NUTRITIONAL STATUS IN PATIENTS WITH RELAPSING REMITTING MULTIPLE SCLEROSIS

Öz

This study aimed to evaluate the nutritional status, depression and fatigue status of patients with Relapsing Remitting Multiple Sclerosis (RRMS). The study was carried out on 30 MS patients (Patient Group: PG) and a control group consisting of 30 healthy volunteers with similar characteristics (Control Group: CG). It was found that the relationship between depression and fatigue among MS patients was positive (p<0.05). The mean score of the Fatigue Severity Scale (FSS) was 5.65±1.57 in PG patients and 3.10±0.97 in CG patients. The fatigue level of the patients was significantly higher than that of the controls (p<0.05). A negative correlation was found between vitamin B12 intake and the scores of the FSS and Beck Depression Inventory (BDI) in patients with PG (p<0.05). The study showed that fatigue and depression in MS patients were closely related their dietary habits. Since low serum B12 levels may increase the risk of fatigue and depression, attention should be paid to vitamin B12 intake. In order to improve the quality of life of MS patients, their nutrition should be closely monitored and a balanced and healthy nutrition plan appropriate to their needs should be implemented.

Anahtar Kelimeler

Depression, Fatigue, Multiple Sclerosis, Nutrition

Kaynakça

• Armutlu, K., Korkmaz, N. C., Keser, I., Sumbuloglu, V., Akbiyik, D. I., Guney, Z., & Karabudak, R. (2007). The validity and reliability of the Fatigue Severity Scale in Turkish multiple sclerosis patients. International Journal of Rehabilitation Research, 30(1), 81-85. doi: 10.1097/MRR.0b013e3280146ec4
• Beck, A. T., Ward, C., Mendelson, M., Mock, J., & Erbaugh, J. J. A. G. P. (1961). Beck depression inventory (BDI). Arch Gen Psychiatry, 4(6), 561-571. doi: 10.1001/archpsyc.1961.01710120031004.
• Browne, P., Chandraratna, D., Angood, C., Tremlett, H., Baker, C., Taylor, B. V., & Thompson, A. J. (2014). Atlas of multiple sclerosis 2013: a growing global problem with widespread inequity. Neurology, 83(11), 1022-1024. doi:10.1212/WNL.0000000000000768
• Compston, A., Winedl, H., & Kieseier, B. C. (2008). Coles. Multiple sclerosis. Lancet, 372, 1502-1517. Confavreux, C., & Vukusic, S. (2006). Natural history of multiple sclerosis: a unifying concept. Brain, 129(3), 606-616. doi:10.1093/brain/awl007
• Dendrou, C. A., Fugger, L., & Friese, M. A. (2015). Immunopathology of multiple sclerosis. Nature Reviews Immunology, 15(9), 545-558. doi:10.1038/nri3871
• Erdhardt DJ. Beslenme Bilgi Sistemi (BeBİS) 7.1. 2010.
• Feinstein, A., Magalhaes, S., Richard, J. F., Audet, B., & Moore, C. (2014). The link between multiple sclerosis and depression. Nature Reviews Neurology, 10(9), 507-517. doi:10.1038/nrneurol.2014.139
• Garg N, & Smith TW. An update on immunopathogenesis, diagnosis, and treatment of multiple sclerosis. Brain Behav 2015; 5(9): e00362. doi: 10.1002/brb3.362. doi:10.1002/brb3.362
• Golden, L. C., & Voskuhl, R. (2017). The importance of studying sex differences in disease: The example of multiple sclerosis. Journal of Neuroscience Research, 95(1-2), 633-643. doi:10.1002/jnr.23955
• Hedström, A. K., Olsson, T., & Alfredsson, L. (2012). High body mass index before age 20 is associated with increased risk for multiple sclerosis in both men and women. Multiple Sclerosis Journal, 18(9), 1334-1336. https://doi.org/10.1177/1352458512436596
• Hisli, N. (1989). Beck Depresyon Envanterinin üniversite öğrencileri için geçerliği, güvenirliği. Psikoloji Dergisi, 7(23), 3-13.
• Kankaya, H., Dogru, B. V., Yildirim, Y., & Fadiloglu, Ç. (2016). Multipl Skleroz’lu hastaların günlük yaşam aktivite düzeyleri ile bakım verenlerin gösterdiği tepkiler arasındaki ilişkinin incelenmesi. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, 5(1), 33-49.
• Klineova, S., & Lublin, F. D. (2018). Clinical course of multiple sclerosis. Cold Spring Harbor perspectives in medicine, 8(9), a028928. doi:10.1101/cshperspect.a028928
• Kobelt G, Thompson A, Berg J, Gannedahl M, Eriksson J. New insights into the burden and costs of multiple sclerosis in Europe. Mult Scler 2017; 23(8): 1123-1136. doi: 10.1177/1352458517694432
• Krupp, L. B., LaRocca, N. G., Muir-Nash, J., & Steinberg, A. D. (1989). The fatigue severity scale: application to patients with multiple sclerosis and systemic lupus erythematosus. Archives of Neurology, 46(10), 1121-1123. doi: 10.1001/archneur.1989.00520460115022
• Manjaly, Z. M., Harrison, N. A., Critchley, H. D., Do, C. T., Stefanics, G., Wenderoth, N., & Stephan, K. E. (2019). Pathophysiological and cognitive mechanisms of fatigue in multiple sclerosis. Journal of Neurology, Neurosurgery & Psychiatry, 90(6), 642-651. doi:10.1136/jnnp-2018-320050
• Manousaki, D., Dudding, T., Haworth, S., Hsu, Y. H., Liu, C. T., Medina-Gómez, C. & Richards, J. B. (2017). Low-frequency synonymous coding variation in CYP2R1 has large effects on vitamin D levels and risk of multiple sclerosis. The American Journal of Human Genetics, 101(2), 227-238. doi: 10.1016/j.ajhg.2017.06.014. Epub 2017 Jul 27
• Mirza, M. (2002). The etiology and the epidemiology of multiple sclerosis. Erciyes Medical Journal, 24(1): 40-47.
• Munger, K. L., Chitnis, T., & Ascherio, A. (2009). Body size and risk of MS in two cohorts of US women. Neurology, 73(19), 1543-1550. doi:10.1212/wnl.0b013e3181c0d6e0
• Najafi, M. R., Shaygannajad, V., Mirpourian, M., & Gholamrezaei, A. (2012). Vitamin B12 deficiency and multiple sclerosis; is there any association?. International Journal of Preventive Medicine, 3(4), 286.
• Oksenberg, J. R., Baranzini, S. E., Sawcer, S., & Hauser, S. L. (2008). The genetics of multiple sclerosis: SNPs to pathways to pathogenesis. Nature Reviews Genetics, 9(7), 516-526. doi:10.1038/nrg2395
• Onat, Ş. Ş., Delialioğlu, S. Ü., & Ozel, S. (2015). Multipl Sklerozda Depresyon, Fonksiyonel Durum ve Yaşam Kalitesi İlişkisi: Bir Rehabilitasyon Merkezi Deneyimi. Journal of Physical Medicine & Rehabilitation Sciences, 18(3).
• Orton, S. M., Herrera, B. M., Yee, I. M., Valdar, W., Ramagopalan, S. V., Sadovnick, A. D., & Ebers, G. C. (2006). Sex ratio of multiple sclerosis in Canada: a longitudinal study. The Lancet Neurology, 5(11), 932-936. doi:10.1016/s1474-4422(06)70581-6
• Ozakbas, S., Turkoglu, R., Tamam, Y., Terzi, M., Taskapilioglu, O., Yucesan, C., & Turkes, N. (2018). Prevalence of and risk factors for cognitive impairment in patients with relapsing-remitting multiple sclerosis: multi-center, controlled trial. Multiple Sclerosis and Related Disorders, 22, 70-76. doi:10.1016/j.msard.2018.03.009
• Thompson, A. J., Banwell, B. L., Barkhof, F., Carroll, W. M., Coetzee, T., Comi, G., ... & Cohen, J. A. (2018). Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. The Lancet Neurology, 17(2), 162-173. doi:10.1016/s1474-4422(17)30470-2
• Türk Nöroloji Derneği (TND). (2020). Multipl Skleroz Tanı Ve Tedavi Kılavuzu. In 10 September 2023 retrieved from https://www.noroloji.org.tr/TNDData/Uploads/files/MS_tan%C4%B1%20ve%20teda vi%202018.pdf
• World Health Organization (WHO). (2011) Waist circumference and waist-hip ratio: report of a WHO expert consultation, Geneva, 8-11 December 2008. In 16 December 2023 retrieved from https://iris.who.int/bitstream/handle/10665/44583/?sequence=1
• Wollin, J., Bennie, M., Leech, C., Windsor, C., & Spencer, N. (2005). Multiple sclerosis and continence issues: an exploratory study. British Journal of Nursing, 14(8), 439-446. doi:10.12968/bjon.2005.14.8.1792