Obez Bireylerde İnsülin Direncine Bağlı D Vitamini Düzeyleri

Yıl 2020, Cilt: 2 Sayı: 1, 17 - 21, 12.05.2020

Fatih Kar , Muhammed Ertalş Hüseyin Tuna Kubilay Şimşek Nihat Eray Gülümsek Sema Uslu

https://izlik.org/JA83ZB42NG

Öz

Glukoz, insülin ve HOMA-IR değerleri belli olan obez tanısı almış hastalarda yaşa, cinsiyete ve insülin direncine göre D vitamini seviyeleri arasındaki ilişkiyi incelemektir. 01.01.2010- 01.04.2019 yılları arasında Eskişehir Osmangazi Üniversitesi Tıp Fakültesi Araştırma Hastane’sine başvuru yapmış obez tanısı alan hastaların ölçülmüş glukoz, insülin parametreleri ve D vitamini seviyeleri retrospektif olarak elde edilmiştir. Belirtilen kriterleri içeren hastaların insülin ve glukoz değerleri kullanılarak, HOMA-IR (Glukoz*İnsülin/405) değerleri belirlenmiştir. HOMA-IR ≥ 2.5 olanların insülin direnci olduğu kabul edildi. 169 hastada insulin direnci olduğu tespit edilirken, 80 hastada ise insülin direnci yoktu. İnsülin direnci olmayanlar grup I, insülin direnci olanlar ise grup II olarak tanımlandı. D vitamini seviyelerinin insülin direnci ile arasındaki korelasyon incelendiğinde istatistiksel olarak anlamlı bir fark gözlenmedi (p>0.05). Grup II’de D vitamini düzeyleri Grup I’e göre düşük olmasına rağmen istatistiksel olarak anlamlı bir fark gözlenmedi (p>0.05). Obez kişiler üzerinde yapılan çalışmamızda glukoz değerleri ile yaş, insülin ve HOMA-IR değerleri arasında istatistiksel bir anlamlılık saptanıp, 25-OH D değerleri ile HOMA-IR arasında istatistiksel bir anlamlılık saptanmadı. Bu konu hakkında daha fazla çalışmaya ihtiyaç duyulmaktadır.

Anahtar Kelimeler

obezite , HOMA-IR , glukoz

Vitamin D Levels Due to İnsulin Resistance in Obese Subjects

https://izlik.org/JA83ZB42NG

Öz

The aim of this study is to investigate the relationship between vitamin D levels according to age, gender and insulin resistance in obese patients with defined glucose, insulin and HOMA-IR values. Measured glucose, insulin parameters and vitamin D levels of obese patients who applied to Eskişehir Osmangazi University Faculty of Medicine Research Hospital between 01.01.2010 and 01.04.2019 were obtained retrospectively. HOMA-IR (Glucose * Insulin / 405) values were determined using insulin and glucose values of the patients who met the specified criteria. In this study, the data of 249 patients with obese diagnosis were obtained. These patients were divided into two groups according to insulin resistance. Patients with HOMA-IR ≥ 2.5 were considered to have insulin resistance. Insulin resistance was found in 169 patients, whereas 80 patients had no insulin resistance. Those without insulin resistance were defined as group I and those with insulin resistance were defined as group II. When the correlation between vitamin D levels and insulin resistance was examined, no statistically significant difference was observed (p> 0.05). Although vitamin D levels were lower in Group II compared to Group I, no statistically significant difference was observed (p>0.05). In our study on obese subjects, a statistically significant difference was found between glucose values and age, insulin and HOMA-IR values, and no statistically significant difference was found between 25-OH D values and HOMA-IR. Further studies are needed on this subject. 

Anahtar Kelimeler

Obezite , HOMA-IR , glukoz

Kaynakça

• 1. Ng M, Fleming T, Robinson M et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014; 384: 766-81.
• 2. World Health Organization (WHO). Obesity and overweight. February 16, 2018. http://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight. [Last Accessed November 2018].
• 3. World Health Organization (WHO). Prevalence of obesity among adults. http:// www.who.int/gho/ncd/risk_factors/overweight_obesity/obesity_adults/en. [Last Accessed November 2018].
• 4. Branca F, Nikogosia H, Lobstein T. (eds) The Challenge of Obesity in the WHO European Region and the Strategies for Response. Summary. World Health Organization, 2007
• 5. El-Sayed Moustafa JS, Froguel P. From obesity genetics to the future of personalized obesity therapy. Nat Rev Endocrinol. 2013; 9: 402–13.
• 6. Oliveira JL, et al. Fenótipo Cintura Hipertrigliceridêmica e Risco Cardiometabólico em Indivíduos Dislipidêmicos. Rev Bras Cardiol. 2014;27: 395–402.
• 7. Yao Y, et al. A meta-analysis of the relationship between vitamin D deficiency and obesity. Int J Clin Exp Med. 2015; 8: 14977–84.
• 8. Vanlint S. Vitamin D and obesity. Nutrients 2013; 5: 949–56.
• 9. Turner AG, Anderson PH and Morris HA. Vitamin D and bone health. Scand J Clin Lab Invest Suppl 2012; 243: 65-72.
• 10. Holick MF. Vitamin D deficiency. N Engl J Med 2007; 357: 266-81
• 11. Gonzalez-Molero I, Rojo-Martinez G, Morcillo S et al. Hypovitaminosis D and incidence of obesity: a prospective study. Eur J Clin Nutr 2013; 67: 680-2.
• 12. Creo AL, Rosen JS, Ariza AJ et al. Vitamin D levels, insulin resistance, and cardiovascular risks in very young obese children. J Pediatr Endocrinol Metab 2013; 26: 97-104.
• 13. Caron-Jobin M, et al. Elevated serum 25(OH)D concentrations, vitamin D, and calcium intakes are associated with reduced adipocyte size in women. Obesity. 2011; 19: 1335–41.
• 14. Karatas S, et al. Vitamin D levels in overweight/obese adults with and without metabolic syndrome. J Endocrinol Metab. 2013; 3: 47–56.
• 15. Ruiz FS, et al. Associação entre Deficiência de Vitamina D, Adiposidade e Exposição Solar em Participantes do Sistema de Hipertensão Arterial e Diabetes Melito. Ciên Biol Saúde. 2014; 35: 103–14.
• 16. Giudice EMD, et al. Bioavailable vitamin D in obese children: the role of insulin resistance. J Clin Endocrinol Metab. 2015; 100: 3949–55.
• 17. Saneei P, Salehi-Abargouei A and Esmaillzadeh A. Serum 25-hydroxy vitamin D levels in relation to body mass index: a systematic review and meta-analysis. Obes Rev 2013; 14: 393-404.
• 18. DOS SANTOS, Loanne Rocha, et al. Role of vitamin D in insulin resistance in obese individuals. Nutrire, 2017, 42.1: 17.
• 19. Lima EV, et al. Influência da Hipovitaminose D no Diabetes Mellitus Tipo 2. Rev Bras Med. 2013; 70 : 217–21.
• 20. Clemente-Postigo M, et al. Serum 25-hydroxyvitamin D and adipose tissue vitamin D receptor gene expression: relationship with obesity and type 2 diabetes. J Clin Endocrinol Metab. 2015; 100: 591–5.
• 21. Ferreira TS, et al. Vitamin D Deficiency is Associated With Insulin Resistance Independente of Intracelular Calcium, Dietary Calcium and Sérum Levels of Parathormone, Calcitriol and Calcium in Premenopausal Women. Nutr Hosp. 2015; 31: 1491–8.