Obez çocuk ve adolesanlarda artmış demir eksikliği riski ve insülin direnci ile ilişkisi

Amaç: Çocuklarda obezite prevelansı giderek artmaktadır. Obez çocuk ve adolesanlarda demir, çinko, vitamin A ve vitamin E düzeylerinin düşük olduğunu gösteren çalışmalar mevcuttur, fakat vitamin ve mineral eksikliği ile enflamasyon, insülin direnci ilişkisini gösteren yeterli veri yoktur. Bu kesitsel çalışmanın amacı, obez ve obez olmayan çocuklarda vitamin ve mineral düzeylerinin vücut kitle indeksi, lipid profili, insülin direnci ve enflamasyon ile ilişkisini irdelemektir.Gereç ve Yöntemler: Çalışmaya yaşları 10-18 arasında olan, 77 obez ve 34sağlıklı çocuk alındı. Hastalardan alınan kanda şu parametreler değerlendirildi; demir, total demir bağlama kapasitesi (TDBK), vitamin A, vitamin E, çinko, lipid profili, high-sensitive C-reactive protein (hsCRP), glukoz ve insülin. Transferrin saturasyon indeksi (TSI) demir/ TDBKx 100 ile hesaplandı. İnsülin direnci (İD) tanısı için homeostasis model of assessment-insulin resistance (HOMA-IR) kullanıldı.Bulgular: Obez çocuklarda demir ve TSI düzeyleri kontrol grubundan anlamlı derecede daha düşüktü (p=0,02, p=0,00, sırasıyla). Serum vitamin E, vitamin A ve çinko düzeyleri obezlerde kontrol grubuna göre daha düşük olmakla birlikte anlamlı düzeyde değildi (p>0, 05). Her iki grubun folat, vitamin B12, hemoglobin ve hematokrit düzeyleri benzerdi. İD olan grupta demir ve TSI daha düşüktü (p=0, 01; p=0, 01). Ayrıca demir ve TSI, HOMA-IR (r=-0, 40, p=0, 00 ve r=-0, 38; p=0, 00, sırasıyla) ve hsCRP (r=-0, 286, p=0, 004 ve r=-0, 282, p=0, 005, sırasıyla) ile negatif ilişkiliydi. Sonuç: Obez çocuklarda serum demiri ve TSI daha düşüktür. Ve her ikisinin de obezlerdeki kronik enflamasyon ve insulin direnci ile ilişkili olduğu gösterilmiştir. Bu nedenle obez çocuk ve adolesanlar vitamin ve mineral eksiklikleri özellikle de demir eksikliği açısından araştırılmalıdır.

Anahtar Kelimeler:

Obezite, çocuklar, vitamin ve mineral eksikliği, demir eksikliği

Obez çocuk ve adolesanlarda artmış demir eksikliği riski ve insülin direnci ile ilişkisi

Aim: The prevalence of obesity in children is on the incline globally. Obese children and adolescents have been found to have low concentrations of iron, zinc, vitamin A and vitamin E. The relationshipbetween micronutrient status and comorbidities, such as chronic inflammation and insulin resistance (IR) is unclear in obese children and adolescents.The aim of this cross-sectional study was to evaluate the relationship of micronutrient status with body mass index, lipid profile, IR and inflammation in pediatric obese and nonobese subjects. Materials and Methods: The study included 77 obese and 34 healthy children 10 to 18 years of age. Serum levels of the following parameters were studied: ironlevels, total iron-binding capacity (TIBC), vitamin A, vitamin E, zinc, lipids, high-sensitive C-reactive protein (hsCRP), glucose and insulin. Transferrin saturation index (TSI) was calculated by the formula: iron/ TIBC x 100. The diagnosis of insulin resistance (IR) was defined by homeostasis model of assessment-insulin resistance (HOMA-IR). Results: The obese children had significantly lowerserum iron levels and TSI than the controls (p=0.02, p=0.00, respectively). Serum vitamin E, vitamin A and zinc levels were lower in obese children but these differences did not reach a significant level (p>0.05). The two groups were similar in terms of folate, vitamin B12 and hemoglobin levels. The presence of IR was significantly associated with decreased serum iron and TSI levels (p=0.01; p=0. 01).Moreover, iron and TSIwere inversely correlated with HOMA-IR, (r=-0.40, p=0.00 and r=-0.38; p=0.00, respectively) and hsCRP (r=-0.286,p=0.004 and r=-0.282, p=0.005, respectively). Conclusion: Obese children have decreased levels of iron and TSI, both of which are also associated with inflammation and IR, suggesting that obese children should be closely monitored in terms of micronutrients deficiency.

Keywords:

Obesity, children, micronutrient deficiency, iron deficiency,

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