Obez Çocuklarda Artmış Demir Eksikliği Riski ve İnsülin Direnci ile İlişkisi

Amaç: Bu kesitsel çalışmada obez ve obez olmayan çocuklarda vitamin ve mineral düzeylerinin vücut kitle indeksi, lipit profili, insülin direnci (İD) ve enflamasyon ile ilişkisini incelemekamaçlanmıştır.Gereç ve Yöntemler: Çalışmaya 10–18 yaş aralığında 77 obez ve 34 sağlıklı çocuk alındı. Alınankan örneklerinde demir, total demir bağlama kapasitesi (TDBK), vitamin A, vitamin E, çinko, lipitprofili, high-sensitive C-reactive protein (hsCRP), glikoz ve insülin ölçümleri yapıldı. Transferrinsatürasyon indeksi (TSİ), demir / TDBK x 100 formülüyle hesaplandı. İD tanısı için homeostasismodel of assessment-insulin resistance (HOMA-IR) kullanıldı.Bulgular: Kontrol grubuna kıyasla obez çocuklarda demir ve TSİ düzeyleri anlamlı şekilde dahadüşüktü (sırasıyla p=0,02; p=0,00). Serum vitamin E, vitamin A ve çinko düzeyleri obezlerdeistatistiksel olarak anlamlı olmayan şekilde daha düşüktü (p>0,05). Her iki grubun folat, vitamin B12, hemoglobin ve hematokrit düzeyleri benzerdi. İD’li grupta demir ve TSİ anlamlı şekildedaha düşüktü (iki karşılaştırma için de p=0,01). Ayrıca demir ve TSİ parametreleri, HOMA-IR(sırasıyla r=-0,40; p=0,00 ve r=-0,38; p=0,00) ve hsCRP (sırasıyla r=-0,286; p=0,004 ve r=-0,282; p=0,005) ile negatif ilişkiliydi.Tartışma ve Sonuç: Obez çocuklarda serum demir düzeyi ve TSİ daha düşüktür ki bunların herikisinin de obezitede kronik enflamasyon ve İD ile ilişkili olduğu gösterilmiştir. Bu nedenle obezçocuk ve adölesanlar başta demir eksikliği olmak üzere vitamin ve mineral eksikliği bakımındanyakından izlenmelidir.

Increased Risk of Iron Deficiency and Its Relationship with Insulin Resistance in Obese Children

Aim: This cross-sectional study aimed to evaluate the relationship of micronutrient status with body mass index, lipid profile, insulin resistance (IR) and inflammation in obese and nonobese children. Materials and Methods: The study included 77 obese and 34 healthy children aged between 10 and 18 years. Levels of iron, total iron-binding capacity (TIBC), vitamin A, vitamin E, zinc, lipids, high-sensitive C-reactive protein (hsCRP), glucose, and insulin were measured in the collected blood samples. Transferrin saturation index (TSI) was calculated by the formula iron / TIBC x 100. For the IR diagnosis the homeostasis model of assessment-insulin resistance (HOMA-IR) was used. Results: Compared to the control group, the obese children had significantly lower levels of serum iron and TSI (p=0.02, p=0.00, respectively). The serum vitamin E, vitamin A, and zinc levels were statistically insignificantly lower in the obese group (p>0.05). The two groups exhibited similar levels of folate, vitamin B12, and hemoglobin. The serum iron levels and TSI were significantly lower in the IR group (p=0.01, for both comparison). Moreover, the parameters of iron and TSI were inversely correlated with HOMA-IR, (r=-0.40, p=0.00; r=-0.38, p=0.00, respectively) and hsCRP (r=-0.286, p=0.004; r=-0.282, p=0.005, respectively). Discussion and Conclusion: Obese children have lower levels of serum iron and TSI, both of which were shown to be linked with inflammation and IR in obesity. Accordingly, obese children and adolescents should be closely monitored for micronutrient deficiencies, particularly iron deficiency.

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