Zeynep Hülya DURMAZ, Aslıhan Dilara DEMİR, Meral TİRYAKİ, Namık DELİBAŞ

AMASYA BÖLGESİNDE HASTANEYE BAŞVURAN BİREYLERDE VİTAMİN D DÜZEYLERİ

ÖZET Amaç: Hastanemize başvuran bireylerde vitamin D seviyesinin değerlendirilmesi. Gereç ve Yöntem: Amasya Üniversitesi Sabuncuoğlu Şerefeddin Eğitim ve Araştırma Hastanesi hasta veri- tabanı aracılığıyla 2013-2014 ocak tarihleri arasında hastanemiz polikliniklerine başvuran ve vitamin D bakılan hastalar çalışmaya alındı. 49 erkek 160 kadın olmak üzere toplam 209 hasta çalışmaya alındı. Çalışmaya dahil edilen hastaların karaciğer enzimleri ve kan kreatini normaldi. Sonuçlar istatistiksel olarak değerlendirildi. Bulgular: Yaş grupları arasında yapılan karşılaştırmada medyan vitamin D düzeyleri yönünden istatistiksel olarak anlamlı fark görülmedi. Erkeklere göre kadınların medyan vitamin D düzeyi karşılaştırıldığında istatis- tiksel olarak anlamlı bir şekilde düşüktü. Genel muayene ve osteoporoz nedeniyle başvuran hastalarla kar- şılaştırıldığında diyabetes mellitus (DM) nedeniyle başvuranların vitamin D düzeyi daha düşüktü. Erkekler ve kadınlar içerisinde yaş grupları arasında medyan vitamin D düzeyleri yönünden istatistiksel olarak anlamlı fark görülmedi. 0-18 yaş grubu ve 65 yaş üstü bireylerde kadın ve erkekler arasında Vitamin D düzeyleri istatistiksel olarak benzerdi. 19-40 yaş ve 41-64 yaş grubu içerisinde erkeklere göre kadınların medyan vitamin D düzeyi istatistiksel anlamlı olarak daha düşüktü. Başvuru nedenlerine göre tüm yaş grupları arasında medyan vitamin D düzeyleri yönünden istatistiksel olarak anlamlı fark görülmedi. Sonuç: Optimal Vitamin D seviyesi göz önüne alındığında çalışmaya aldığımız tüm gruplarda optimal vitamin D seviyesinin ilimizde düşük olduğunu gördük. Hasta sayısı daha fazla olan çalışmaların yapılması bu konunun aydınlatılması açısından faydalı olacağına inanıyoruz.

Vitamine D Levels of Individuals in Amasya Region

Objective: Purpose of this work is to evaluate vitamine D level in blood of individuals referred to the Amasya University, Sabuncuoğlu Serefeddin Research Hospital. Material and Methods: Patients who had referred to the policlinics of Amasya Univ. Sabuncuoglu Serefeddin Hospital in the period of January 2013-to-January 2014, were selected as subject of this study. Hospital data base of total 209 people, comprised of 49 male and 160 female patients, are studied for variations in vitamine D levels. Liver enzymes and kreatins were found normal. Proper statistics applied to the results for better interpretation. Results: No statistical meaningful correlation or covariation are found in median vitamin-D level of different age groups. Median vitamine D levels of men when compared with median Vitamin-D level of women came up with lower values. Patients referred with diabetes mellitus (DM) showed lower vitamin-D levels, with respect to VD-levels of patients referred general examination and osteoporosis. Any difference between median vitamin-D levels of male and female patients are not observed. Vitamin-D levels of males and females of ages between 0-18 years and those above 65 years, showed similar statistical characteristics. On the other hand, in regarding with patients of ages between 19-40 years and 41-64 years, median VD levels of women was lower than median VD levels of men. Based on the referring purposes, there has been no statistically meaningful difference found in mVD levels, amoung all age groups. Conclusion: As the conclusion, in regarding with the optimum level of Vitamin-D, it is found that Vitamin D optimum level is low in all patients involved in this research from the region of Amasya and neighbouring area, It is suggested to carry out further researches on higher number of patients, will provide successful results in better understanding the subject.

PDF

___

1. Friedman, T.C. and K.C. Norris. The role of vitamin D in mild to moderate chronic kidney disease. Trends Endocrinol Metab, 2002. 13(5): p. 189-94 2. Bikle DD. Whats new in vitamin-D: 2006-2007. CurrOpin Rheumatol 2007; 19(4): 383-388. 3. Brannon PM, Yetley EA, Bailey RL, Picciano MF. Overview of the conference Vitamin D and Healthin the 21st Century: an Update. Am J Clin Nutr2008;88(S1):483S90S 4. Kulie T, Groff A, Redmer J, Hounshell J, Schrager S. Vitamin D: an evidence-based review. J Am Board Fam Med. 2010;23(1):138 5. Sözen T. D hormonu: Guncel gelişlmeler Hacettepe Tıp Dergisi 2011; 42(1):14-27 6. Bischoff-Ferrari HA, Dawson-Hughes B, Willett WC, et al. Effect of vitamin D on falls: a metaanalysis. JAMA 2004;291(5):1999 2006. 7. Farahati Jamshid, at all.Ethnicity, Clothing Style And Body Mass Index Are Significant Predictors Of Vitamin D Insufficiency In Germany.Endocr Pract. 2014;1(1):1-18 8.Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr 2004;80(9):1678-88. 9. Bouillon, R., Carmeliet, G. Daci, E. Segaert, S. Verstuyf, A. Vitamin D metabolism and action. Osteoporos Int, 1998; 8 (2):S13-9. 10. Holick MF. Vitamin D deficiency. N Engl J Med 2007;357(3):266-81.7 11. Dawson-Hughes B, Heaney RP, Holick MF, Lips P, Meunier PJ, Vieth R. Estimates of optimal vitamin D status. Osteoporos Int 2005;16(8):713-6. 12. İyidir ÖT, Altınova AE. Vitamin D ve Diabetes Mellitus Türk Jem 2012; 16(1): 89-94 13. Wu S, Sun J. Vitamin D, vitamin D receptor, and macroautophagy in inflammation and infection. Discov Med 2011;11(4):325-35. 14. Alemzadeh R, Wyatt D.T. Diabetes Mellitus. In: Behrman R.E, Kliegman R.M, Jenson H.B (eds). Nelson Textbook of Pediatrics. 17 edition. Pennsylvania: Elsevier Saunders; 2004. p.1947-72. 15. Sloka S, Grant M, Newhook L. The geospatial relation between UV solar radiation and type 1 diabetes in Newfoundland. Acta Diabetol 2009; 4(3):58-72. 16. Mathieu C, van Etten E, Decallonne B, et al. Vitamin D and 1,25-dihydroxyvitamin D3 as modulators in the immunesystem. J Steroid Biochem Mol Bio 2004;8990:449 52. 17. Danescu LG, Levy S, Levy J. Vitamin D and diabetes mellitus. Endocrine 2009;35(1):117. 18. Guo J, Xiao Z, Xue X, et al. 25-Hydroxyvitamin D is closely related with the function of the pancreatic islet β cells Med Sci. 2013;29(3):809-13. 19. Scragg R, Sowers M, Bell C: Serum 25-hydroxyvitamin D, diabetes, and ethnicity in the Third National Health and Nutrition Examination Survey. Diabetes Care 2004;27(12):28132818, 20. 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(8):820825 21. Mathieu C, Gysemans C, Giulietti A, Bouillo R. Vitamin D and diabetes. Diabetologia 2005; 48(9): 12471257 22. Alhamad HK, Nadukkandiyil N, El-Menyar et al. Vitamin D deficiency among the elderly: insights from Qatar. Curr Med Res Opin Epub 2014 Mar 13.. 2014;30(6):1189-96. 23. Bajaj S, Singh RP, Dwivedi NC, et al. Vitamin D levels and microvascular complications in type 2 diabetes. Endocrinol Metab. 2014;18(4):537-41. 24. Lenchik, L. and Sartoris, D.J. Orthopedic aspects of metabolic bone disease Orthopedic Clinics of North America 1998; 29(2): 103-34 25. Cranney A, Weiler HA, ODonnell S, Puil L. Summary of evidence-based review on vitamin D efficacy and safety in relation to bone health. Am J Clin Nutr 2008;88(5):513S9S 26. Melhius H, Snellman G, Gedeborg R, et al. Plasma 25 Oh hydroxyvitmin D levels and fracture risk in a community- based cohort of elderly men in Sweden. J Clin Endocrinol Metab 2010; 95(20):2637-45. 27. Broe KE, Chen TC, Weinberg J, et al. A higher dose of vitamin D reduces the risk of falls in nursing home residents: a randomized multiple-dose study. J Am Geriatr Soc 2007;55(3):234 9. 28. Wagner CL, Greer FR, American Academy of Pediatrics Section on Breastfeeding, American Academy of Pediatrics Committee on Nutrition. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics 2008;122(6):1142 52