D vitamini metabolik sendrom bileşenlerini etkiler mi?

Öz

Metabolik sendrom tüm dünyada giderek yaygınlaşan kardiyometabolik komplikasyonları ile yüksek morbidite ve mortaliteye sahip önemli bir halk sağlığı sorunudur. Kalıtımla gelen bazı özellikler dışında hareketsiz yaşam tarzı, yanlış beslenme alışkanlıkları gibi çevresel etmenler metabolik sendrom için risk faktörü oluşturmaktadır. Metabolik sendromun önemli komponentleri; dislipidemi HDL düzeyi düşüklüğü, artmış trigiserid düzeyi , hiperglisemi, yüksek kan basıncı ve abdominal obezitedir. Metabolik sendromu oluşturan beş ana komponent dışında temelinde insülin direncinin rol oynadığı düşünülen birçok klinik tabloda bu sendromun klinik yansımaları olarak kabul edilmektedir. Metabolik sendromun klinik yansımaları; diyabet, esansiyel hipertansiyon, visseral obezite, kardiyovasküler rahatsızlıklar, insülin direnci, osteoporoz, polikistik over sendromu, dislipidemi, hiperkoagulabilite, hiperürisemi, kemik mineral yoğunluğu, yağlı karaciğer ve uyku apnesidir. Son yıllarda D vitamininin, şişmanlık ve insülin direncinin neden olduğu hastalıkların oluşumunu önlediği, eksikliğinin ise bu hastalıkların ortaya çıkmasını kolaylaştırdığı ileri sürülmektedir. D vitamini yetersizliği gelişmiş ve gelişmekte olan ülkelerde prevalansı giderek artan bir halk sağlığı sorunudur. D vitamini yağda eriyebilen bir vitamin olmasına karşın, vücutta sentez edilen ve sentezlendiği yerin dışında farklı bölgelerde etki göstermesi nedeniyle günümüzde bir hormon olarak ta tanımlanmaktadır. Kalsiyum dengesi üzerine bilinen olumlu etkilerinin yanı sıra, endokrin sistemle ilgili fizyolojik işlevlere de sahiptir. Vitamin D düzeyini gösteren en iyi gösterge serum 25 OH D düzeyidir. D vitamini alımı ve 25 OH D düzeyinin obezite, metabolik sendrom ve diyabetle ilişkili olduğu bildirilmektedir. Vitamin D ile ilişkisi en çok araştırılan hastalıklar; kardiyovasküler hastalıklar, böbrek hastalıkları, diyabet, obezite, metabolik sendromdur. Bu derlemede D vitaminin metabolik sendrom bileşenlerinden insülin direnci, diyabet, obezite, hipertansiyon, dislipidemi, kardiyovasküler hastalıklar, yağlı karaciğer hastalığı, polikistik over sendromu ve kemik mineral yoğunluğu üzerine etkilerinin değerlendirilmesi amaçlanmıştır

Anahtar Kelimeler

• Metabolik sendrom, D vitamini, diyabet, obezite, dislipidemi

Does vitamin D affects components of the metabolic syndrome?

Öz

Metabolic syndrome is a major public health problem which has become increasingly common worlwide with cardiometabolic complications and have high morbidity and mortality. In addition to some genetical features, environmental factors such sedentary lifestyle, improper eating habits constitutes a risk factor for metabolic syndrome. Important components of the metabolic syndrome are dyslipidemia low HDL levels, high triglycerides level , hyperglycemia, elevated blood pressure and abdominal obesity. Forming metabolic syndrome of other than the five main components, insulin resistance on the basis thought to play a role in several clinical implications of this syndrome is considered. Clinical implications of the metabolic syndrome are; diabetes, essential hypertension, visceral obesity, cardiovascular disorders, insulin resistance, osteoporosis, polycystic ovary syndrome, dyslipidemia, bone mineral density, fatty liver disease and sleep apnea. In recent years, it is suggested that vitamin D prevents the occurrence of diseases caused by obesity and insulin resistance and the lack of it facilitates occurence of these diseases. Vitamin D deficiency is a public health problem with a growing prevalence in developed and developing countries. Vitamin D is a fat-soluble vitamin, but it is synthesized in the body and affect also other regions it is expressed in the body. Because of this it is described as a hormone in the present day. As well as its known positive effects on calcium balance, it has also physiological functions related the endocrine system. The best indicator showing gösteren en iyi gösterge serum 25 OH D düzeyidir. D vitamini alımı ve 25 OH D düzeyinin obezite, metabolik sendrom ve diyabetle ilişkili olduğu bildirilmektedir. Vitamin D ile ilişkisi en çok araştırılan hastalıklar; kardiyovasküler hastalıklar, böbrek hastalıkları, diyabet, obezite, metabolik sendromdur. Bu derlemede D vitaminin metabolik sendrom bileşenlerinden insülin direnci, diyabet, obezite, hipertansiyon, dislipidemi, kardiyovasküler hastalıklar, yağlı karaciğer hastalığı, polikistik over sendromu ve kemik mineral yoğunluğu üzerine etkilerinin değerlendirilmesi amaçlanmıştır

Anahtar Kelimeler

• Metabolic syndrome, vitamin D, diabetes, obesity, dyslipidemia

Kaynakça

1. 1. Reaven GM. Role of insulin resistance in human disease. Diabetes, 1988; 37(12): 1595-607.
2. 2. Cameron A. The metabolic syndrome validity and utility of clinical definitions for cardiovascular disease and diabetes risk prediction. Maturitas, 2010; 65(2): 117-21.
3. 3. Muszkat P, Camargo MB, Griz LH, Lazaretti-Castro M. Evidence-based non-skeletal actions of vitamin D. Arq Bras Endocrinol Metabol, 2010; 54(2): 110-7.
4. 4. Özkan B, Döneray H. D vitamininin iskelet sistemi dışı etkileri. Çocuk Sagligi Hast Derg , 2011; 54(2): 99-119.
5. 5. Chung JY, Hong SH. Vitamin D status and its association with cardiometabolic risk factors in Korean adults based on a 2008-2010 Korean National Health and Nutrition Examination Survey. Nutr Res Pract, 2013; 7(6): 495-2.
6. 6. Song Y, Wang L, Pittas AG, Del Gobbo LC, Zhang C, Manson JE, Hu FB. Blood 25-hydroxy vitamin D levels and incident type 2 diabetes: a metaanalysis of prospective studies. Diabetes Care, 2013; 36(5): 1422-8.
7. 7. Ceballos LT. Síndrome metabólico en la infancia. An Pediatr (Barc), 2007; 66(2): 159-66.
8. 8. Arslan M, Atmaca A, Ayvaz G, Başkal N, Beyhan Z, Bolu E, ve ark. Metabolik Sendrom Kılavuzu. Türkiye Endokrinoloji ve Metabolizma Derneği, 2009.

9. 9. Babgy, S. Obesity-initiated metabolic syndrome and the kidney: a recipe for chronic kidney disease. J Am Soc Nephrol, 2004; 15(11): 2775-91.
10. 10. Metabolik Sendrom Derneği Türkiye Sağlık Çalışması PURE TÜRKİYE; Prospective Urban Epidemiological Study, 2010.
11. 11. Cinaz P, Aycan S. Gazi Üniversitesi/Sağlık Bakanlığı (GÜ/SB) Türkiye’de 6-17 Aylık Çocuklarda ve Annelerinde Hemoglobin Ferritin, D Vitamini Düzeyi ve Demir Eksikliği Anemisi Durum Belirleme. Yürütülen Programların Değerlendirilmesi Araştırması. Gazi Üniversitesi Tıp Fakültesi, Ankara, 2011.
12. 12. Sözen T, Yavuz Gogas D, Atmaca A. Metabolik Kemik Hastalıkları Tanı ve Tedavi Kılavuzu, ISBN:978-605- 4011-14-8, Türkiye Endokrinoloji ve Metabolizma Derneği,1. Baskı, İstanbul, Galenos Yayınevi, 2012
13. 13. Chon SJ, Yun BH, Jung YS, Cho SY, Choi YS, Kim SY, et al. Association between vitamin D status and risk of metabolic syndrome among Korean postmenopausal women. PLoS One, 2014; 9(2).
14. 14. Gupta N, Shah P, Nayyar S, Misra A. Childhood obesity and the metabolic syndrome in developing countries. Indian J Pediatr, 2013; 80(1): 28-37.
15. 15. Cheng KH, Huang SP, Huang CN, Lee YC, Chu CS, Lai WT, et al. The impact of estradiol and 1,25(OH)2D3 on metabolic syndrome in middle-aged Taiwanese males. PLoS One, 2013; 8 (3).
16. 16. Kayaniyil S, Harris SB, Retnakaran R, Vieth R, Knight JA, Gerstein HC, et al. Prospective association of 25(OH)D with metabolic syndrome. Clin Endocrinol, 2014; 80(4): 502-7.
17. 17. Mitri J, Nelson J, Ruthazer R, Garganta C, Nathan DM, Hu FB, et al. Plasma 25-hydroxyvitamin D and risk of metabolic syndrome: an ancillary analysis in the Diabetes Prevention Program. Eur J Clin Nutr, 2014; 68(3): 376-83.
18. 18. Schuch NJ, Garcia VC, Vívolo SR, Martini LA. Relationship between Vitamin D Receptor gene polymorphisms and the components of metabolic syndrome. Nutr J, 2013; 12: 96.
19. 19. Khan H, Kunutsor S, Franco OH, Chowdhury R. Vitamin D, type 2 diabetes and other metabolic outcomes: a systematic review and meta-analysis of prospective studies. Proc Nutr Soc, 2013; 72: 89-97.
20. 20. Holick MF. Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis. Am J Clin Nutr, 2004; 79(3): 362-71.
21. 21. Ryu YS, Coutu JP, Rosas HD, Salat DH. Effects of insulin resistance on white matter microstructure in middle-aged and older adults. Neurology, 2014; 82(21): 1862-70.
22. 22. Chiu KC, Chu A, Go VL, Saad MF. Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction. Am J Clin Nutr, 2004; 79(5): 820-5.
23. 23. Nada AM. Correlation between vitamin D3 and fasting plasma glucose, A1C and serum lipids in non-diabetic subjects. Z.U.M.J, 2013; 19(4).
24. 24. Alkharfy KM, Al-Daghri NM, Yakout SM, Ahmed M. Calcitriol attenuates weight-related systemic inflammation and ultrastructural changes in the liver in a rodent model. Basic Clin Pharmacol Toxicol, 2013; 112(1): 42-9.
25. 25. Kelishadi R, Salek S, Salek M, Hashemipour M, Movahedian M. Effects of vitamin D supplementation on insulin resistance and cardiometabolic risk factors in children with metabolic syndrome: a triple-masked controlled trial. J Pediatr (Rio J), 2014; 90(1): 28-34.
26. 26. Sharifi F, Mousanavisab N, Mellati AA. Defining a cutoff point for vitamin D deficiency based on insulin resistance in children. Diabetes Metab Syndr, 2013; 7(4): 210-3.
27. 27. Agarwal N, Mithal A, Kaur P, Dhingra V, Godbole MM, Shukla M, et al. Vitamin D and insulin resistance in postmenopausal Indian women. Indian J Endocrinol Metab, 2014; 18(1): 89-93.
28. 28. Talaei A, Mohamadi M, Adgi Z. The effect of vitamin D on insulin resistance in patients with type 2 diabetes. Diabetol Metab Syndr, 2013; 5(1): 8.
29. 29. Breslavsky A, Frand J, Matas Z, Boaz M, Barnea Z, Shargorodsky M. Effect of high doses of vitamin D on arterial properties, adiponectin, leptin and glucose homeostasis in type 2 diabetic patients. Clin Nutr, 2013; 32(6): 970-5.
30. 30. Rosen CJ, Adams JS, Bikle DD, Black DM, Demay MB, Manson JE, et al. The nonskeletal effects of vitamin D: an Endocrine Society scientific statement. Endocr Rev, 2012; 33(3): 456-92.
31. 31. Kostoglou-Athanassiou I, Athanassiou P, Gkountouvas A, Kaldrymides P. Vitamin D and glycemic control in diabetes mellitus type 2. Ther Adv Endocrinol Metab, 2013; 4(4): 122-8.
32. 32. Al-Daghri NM, Al-Attas OS, Alkharfy KM, Khan N, Mohammed AK, Vinodson B, et al. Association of VDR-gene variants with factors related to the metabolic syndrome, type 2 diabetes and vitamin D deficiency. Gene, 2014; 542(2): 129-33.
33. 33. Afzal S, Bojesen SE, Nordestgaard BG. Low 25-hydroxyvitamin D and risk of type 2 diabetes: a prospective cohort study and meta analysis. Clin Chem, 2013; 59(2): 381–91.
34. 34. Al-Shoumer KA, Al-Asoosi AA, Ali AH, Nair VS. Does insulin resistance in type 2 diabetes alter vitamin D status? Prim Care Diabetes, 2013; 7(4): 283-7.
35. 35. Shenoy V, Datta P, Prabhu K, Singh K. Association between vitamin D, fasting blood glucose, HbA1c and fasting lipid profile in euglycemic individuals. J Research Diabet, 2014. Article ID: 929743.
36. 36. Belenchia AM, Tosh AK, Hillman LS, Peterson CA. Correcting vitamin D insufficiency improves insulin sensitivity in obese adolescents: a randomized controlled trial. Am J Clin Nutr, 2013; 97(4): 774-81.
37. 37. Soskić S, Stokić E, Isenović ER. The relationship between vitamin D and obesity. Curr Med Res Opin, 2014; 30(6): 1197-9.
38. 38. Bhatt SP, Misra A, Sharma M, Guleria R, Pandey RM, Luthra K, et al. Vitamin D insufficiency is associated with abdominal obesity in urban Asian Indians without diabetes in North India. Diabetes Technol Ther, 2014; 16(6): 392-7.
39. 39. Barchetta I, De Bernardinis M, Capoccia D, Baroni MG, Fontana M, Fraioli A ,et al. Hypovitaminosis D is independently associated with metabolic syndrome in obese patients. PLoS One, 2013; 8(7): e68689
40. 40. Pathak K, Soares MJ, Calton EK, Zhao Y, Hallett J. Vitamin D supplementation and body weight status: a systematic review and meta-analysis of randomized controlled trials. Obes Rev, 2014; 15(6): 528-37.
41. 41. Zemel MB, Shi H, Greer B, Dirienzo D, Zemel PC. Regulation of adiposity by dietary calcium. FASEB J, 2000; 14(9): 1132-38.
42. 42. Dolinsky DH, Armstrong S, Mangarelli C, Kemper AR. The association between vitamin D and cardiometabolic risk factors in children: a systematic review. Clin Pediatr (Phila), 2013; 52: 210-23.
43. 43. Grundy SM. Hypertriglyceridemia, insulin resistance, and the metabolic syndrome. Am J Cardiol, 1999; 83(9): 25-9.
44. 44. Kim M, Na W, Sohn C. Correlation between vitamin D and cardiovascular disease predictors in overweight and obese Koreans. J Clin Biochem Nutr, 2013; 52(2): 167-71.
45. 45. Kashi Z, Saeedian Fs, Akha O, Gorgi Ma, Emadi Sf, Zakeri H. Vitamin D deficiency prevalence in summer compared to winter in a city with high humidity and a sultry climate. Endocrinol Pol, 2011; 62(3): 249-51.
46. 46. Conceic¸ão-Machado ME, Silva LR, Santana ML, Pinto EJ, SilvaRde C, Moraes LT, et al. Hypertriglyceridemic waist phenotype: association with metabolic abnormalities in adolescents. J Pediatr (Rio J), 2013; 89(1): 56-63.
47. 47. Miñambres I, Sánchez-Quesada JL, SánchezHernández J, Rodríguez J, de Leiva A, Pérez A. Vitamin D concentrations in familial combined hyperlipidemia: effects of lipid lowering treatment. Diabetol Metab Syndr, 2014; 6(1): 7.
48. 48. Creo AL, Rosen JS, Ariza AJ, Hidaka KM, Binns HJ. Vitamin D levels, insulin resistance, and cardiovascular risks in very young obese children. J Pediatr Endocrinol Metab, 2013; 26(1-2): 97-104.
49. 49. Kelishadi R, Ardalan G, Motlagh ME, Shariatinejad K, Heshmat R, Poursafa P, et al. National report on the association of serum vitamin D with cardiometabolic risk factors in the pediatric population of the Middle East and North Africa (MENA): the CASPIAN-III Study. Nutrition. 2014; 30(1): 33-8.
50. 50. Chen WR, Qian YA, Chen YD, Shi Y, Yin da W, Wang H, et al. The Effects of Low vitamin D on coronary artery disease. Heart Lung Circ, 2014; 23(4): 314-9.
51. 51. Kara M, Erdal M. Sıklığı Artan Bir halk Sağlığı Sorunu: Non-Alkolik Yağlı Karaciğer Hastalığı. TAF Prev Med Bull, 2014; 13(1): 65-76.
52. 52. Dasarathy J, Periyalwar P, Allampati S, Bhinder V, Hawkins C, Brandt P, et al. Hypovitaminosis D is associated with increased whole body fat mass and greater severity of non-alcoholic fatty liver disease. Liver Int, 2013; 34(6): 118-27.
53. 53. Rhee EJ, Kim MK, Park SE, Park CY, Baek KH, Lee WY, et al. High serum vitamin D levels reduce the risk for nonalcoholic fatty liver disease in healthy men independent of metabolic syndrome. Endocr J, 2013; 60(6): 743-52.
54. 54. El-Shal AS, Shalaby SM, Aly NM, Rashad NM, Abdelaziz AM. Genetic variation in the vitamin D receptor gene and vitamin D serum levels in Egyptian women with polycystic ovary syndrome. Mol Biol Rep, 2013; 40(11): 6063-73.
55. 55. Bagheri M, Abdi Rad I, Hosseini JN, Nanbakhsh F. Vitamin D receptor taqI gene variant in exon 9 and polycystic ovary syndrome risk. Int J Fertil Steril, 2013; 7(2): 116-21.
56. 56. Güdücü N, Görmüş U, Kutay SS, Kavak ZN, Dünder I. 25-Hydroxyvitamin D levels are related to hyperinsulinemia in polycystic ovary syndrome. Gynecol Endocrinol, 2014; 30(8): 557-60.
57. 57. Raja-Khan N, Shah J, Stetter CM, Lott ME, Kunselman AR, Dodson WC, et al. High-dose vitamin D supplementation and measures of insulin sensitivity in polycystic ovary syndrome: a randomized, controlled pilot trial. Fertil Steril, 2014; 101(6): 1740-6.
58. 58. Sun M, Cao M, Fu Q, Zhu Z, Meng C, Mao J, et al. Association of calcaneal quantitative ultrasound parameters with metabolic syndrome in middleaged and elderly Chinese: a large population-based cross-sectional study. BMC Endocr Disord, 2014; 14: 14.
59. 59. da Rocha AK, Bos AJ, Carmenaz G, Machado DC. Bone mineral density, metabolic syndrome, and vitamin D in indigenous from south of Brazil. Arch Osteoporos, 2013; 8(1-2): 134.