GÜLİN ÖZTÜRK ÖZKAN, Gülgün ERSOY, Akın DAYAN

Enerji ve Besin Ögeleri Alımının İnsülin Direnci ve İnflamasyon Bulguları Üzerine Etkileri

Amaç: Bu araştırma, insülin direnci hastalarının enerji ve besin ögeleri alımlarının insülin ve inflamasyon bulguları üzerine etkisini saptamak amacıyla yapılmıştır. Bireyler ve Yöntem: Araştırma,30-50 yaşları arasında, ilk defa insülin direnci teşhisi konulan, Beden Kütle İndeksi (BKİ) 30-40 kg/m2 arasında olan ve hiperlipidemi dışında başka bir hastalığı bulunmayan 53 kadın hastanın katılımıyla yapılmıştır. Araştırmaya katılan hastaların bir günü hafta sonu olmak üzere 3 günlük besin tüketim kayıtları alınmıştır. Bunun yanında hastaların açlık ve tokluk glukoz, açlık ve tokluk insülin, total kolesterol, trigliserit, HDL-kolesterol, LDL-kolesterol, VLDL-kolesterol değerlerine bakılmış, HOMA-IR hesaplanmıştır. Ayrıca hastaların CRP, TNF-?, IL-1 ve IL-6 düzeylerine bakılmıştır. Bulgular: Hastaların diyetle aldıkları karbonhidrattan gelen enerji oranının (%46.5±10.4) önerilen düzeyin altında, yağ oranının (%39.3±8.9) önerilen düzeyin üzerinde olduğu belirlenmiştir. Diyetle alınan yağ miktarının (66.7±24.2 g) önerilen düzeyin çok az üzerinde olduğu bulunmuştur. Çoklu doymamış yağ asitleri oranı (%8.9±4.4), tiamin (0.6±0.2 mg), niasin (0.9±0.4 mg), folik asit (238.8±84.6 µg), kalsiyum (577.9±263.3 mg), magnezyum (222.1±94.6 mg) ve çinko (8.1±3.6 mg) alımının önerilen düzeyin altında olduğu saptanmıştır. Doymuş yağ asitleri (24.9±10.9 g) ve C vitamini (107.0±75.6 mg) miktarlarının önerilen düzeyin çok az üzerinde olduğu bulunmuştur. Enerjinin doymuş yağ (%15.1±5.9) ve tekli doymamış yağ (%13.4±4.8), asitlerinden sağlanan oranının, A vitamini (1098.9±1041.1 µg) ve fosfor (933.1±410.2 mg) miktarlarının önerilen düzeyin üzerinde olduğu belirlenmiştir. Hastaların tükettikleri karbonhidrat miktarı ile TNF-? arasında pozitif yönlü zayıf bir ilişki olduğu saptanmıştır (p=0.043, r=0.416). Diyetin karbonhidrat yüzdesi ile CRP (p=0.007, r=0.366) ve TNF-? arasında pozitif yönlü zayıf (p=0.033, r=0.437) ilişki olduğu görülmüştür. Yağ yüzdesi ile CRP arasında negatif yönlü zayıf (p=0.018, r=-0.325), TNF-? ile arasında negatif yönlü orta derecede (p=0.000, r=-0.665) bir ilişki olduğu belirlenmiştir. Alınan tiamin (p=0.014, r=0.493), potasyum (p=0.030, r=0.443) ve fosfor (p=0.027, r=0.451) miktarı ile TNF-? arasında pozitif yönlü zayıf bir ilişki olduğu saptanmıştır. Buna ek olarak alınan demir miktarı ile TNF-? arasında da pozitif yönlü orta düzeyde ilişki olduğu belirlenmiştir (p=0.004, r=0.563). Tartışma: İnsülin direnci hastalarının enerji ve besin ögeleri alımlarının insülin direnci ve inflamasyon bulguları üzerine etkisi net bir şekilde saptanamamıştır. Bunun nedeni örnek sayısının azlığı olabilir. Bu konuda daha fazla araştırma yapılmasına gerek vardır

Effects of Energy and Nutrients Intakes on Insulin Resistance and Inflammation Markers

Aim: This study aimed to determine the relationship between energy and nutrients intake of patients with insulin resistance parameters and inflammation markers. Subjects and Method: This study was conducted with participation of 53 female patients aged between 30 and 50 years, were diagnosed with insulin resistance for the first time, had a body mass index of 30-40 kg/m2, had no disease other than hyperlipidemia, in order to determine the presence of inflammation in the patients with insulin resistance. Three-day (including one weekend day) food consumption records of the patientss has been collected. Fasting and postprandial glucose, fasting and postprandial insulin, total cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol, VLDL-cholesterol values of patients were examined, and HOMA-IR values were calculated. Also CRP, TNF-α, IL-1β, and IL-6 levels of patients were examined. Results: The ratio of energy from carbohydrates (46.5%±10.4) and the ratio of polyunsaturated fatty acids (8.9%±4.4) and thiamin (0.6±0.2 mg), niacin (0.9±0.4 mg), folic acid (238.8±84.6 µg), calcium (577.9±263.3 mg), magnesium (222.1±94.6 mg) and zinc (8.1±3.6 mg) intake of patients were below the recommended levels. The ratio of fat from energy (39.3%±8.9), saturated fatty acids (15.1%±5.9) and monounsaturated fatty acids (13.4%±4.8), saturated fatty acids (24.9±10.9 g), vitamin C (107.0±75.6 mg), vitamin A (1098.9±1041.1 µg) and phosphorus (933.1±410.2 mg) intakes were above the recommended levels. There was a positive weak correlation between carbohydrate intake of patients and TNF-α (p=0.043; r=0.416) and between the ratio of carbohydrate and CRP (p=0.007; r=0.366) and TNF-α (p=0.033; r=0.437). There was a negative weak correlation between the ratio of fat percentage and CRP (p=0.018; r=-0.325). There was a negative medium correlation between the ratio of fat percentage and TNF-α (p=0.000; r=-0.665). There was a positive weak correlation between thiamin (p=0.014; r=0.493), potassium (p=0.030; r=0.443) and phosphorus (p=0.027; r=0.451) intakes and TNF-α. In addition, there was a positive medium correlation between iron intake and TNF-α (p=0.004; r=0.563). Conclusion: The relationships between energy and nutrients intake of patients with insulin resistance and insulin resistance and inflammation markers could not be clearly established, may be depending on small sample size. Further research is needed in this regard

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