Derya KARPUZ, Özlem TEZOL, Merve TÜRKEGÜN, Yusuf USTA

Çölyak hastalığı olan çocuklar ile sağlıklı yaşıtlarının erken ateroskleroz belirteçlerinin karşılaştırılması

Amaç: Bu çalışmada, pediatrik yaş grubundaki Çölyak hastalarının karotis intima-media kalınlığının (KİMK) ve epikardiyal yağ doku kalınlığının (EYDK) değerlendirilmesi amaçlandı. Gereç ve Yöntem: Bu kesitsel çalışmada, 5-18 yaş aralığındaki Çölyak hastaları (n=54) ve sağlıklı yaşıtları (n=54) yer aldı. En az son 12 aydır glutensiz diyet uygulayan hastalar dahil edildi. Antropometrik ve biyokimyasal ölçümler yapıldı. Ekokardiyografi ile ölçülen KİMK ve EYDK değerleri hasta ve kontrol grupları arasında karşılaştırıldı. Bulgular: Hasta ve kontrol gruplarında beden kitle indeksi (17,4±3,0’a karşı 18,4±3,1 kg/m2), kan basıncı (sistolik: 100 (85-120)’e karşı 100 (80-100); diastolik: 60 (40-90)’a karşı 70 (40-90) mmHg) ve lipid profili (total kolesterol: 144,6±30,2’ye karşı 150,8±22,6; trigliserid: 71,5 (27-178)’e karşı 92,5 (34-203) mg/dL) farklılık göstermedi. Hasta grubunda KİMK ve EYDK, kontrol grubuna göre istatistiksel anlamlılıkta daha yüksek saptandı (KİMK: 0,50±0,07 mm’ye karşı 0,45±0,04 mm; EYDK: 5,68±0,90 mm’ye karşı 4,22±0,76 mm). D vitamini yetersizliği riski hasta grubunda 2,68 kat yüksek bulundu (%95 Güven Aralığı = 1,19-6,03). Sonuç: Çölyak hastalığı olan çocukların sağlıklı yaşıtlarından daha yüksek KİMK ve EYDK değerlerine sahip olduğu görüldü. Ekokardiyografik KİMK ve/veya EYDK ölçümleri, Çölyak hastalığı olan çocuklarda subklinik aterosklerozu değerlendirmenin güvenilir ve basit bir yöntemi olabilir.

Anahtar Kelimeler:

ateroskleroz, karotis intima-media kalınlığı, Çölyak, çocuk, epikardiyal yağ doku kalınlığı

Comparison of early atherosclerosis markers in children with Celiac disease and their healthy peers

Purpose: We aimed to evaluate carotid intima-media thickness (cIMT) and epicardial adipose tissue thickness (EATT) concurrently as early atherosclerotic markers in pediatric patients with Celiac disease. Materials and Methods: Patients with Celiac disease (n=54) and healthy peers (n=54) aged 5-18 years were enrolled in this cross-sectional study. Patients who followed gluten free diet at least the past 12 months were included. Anthropometric and biochemical measurements were performed. cIMT and EATT were measured by echocardiography and compared between the patient and control groups. Results: Body mass index (17.4±3.0 vs. 18.4±3.1 kg/m2), blood pressure (systolic: 100 (85-120) vs. 100 (80-100) mmHg; diastolic: 60 (40-90) vs. 70 (40-90) mmHg), and lipid profile (total cholesterol: 144.6±30.2 vs. 150.8±22.6 mg/dL; triglycerides: 71.5 (27-178) vs. 92.5 (34-203) mg/dL) were not different between the patient and control groups, while there were significant differences in cIMT and EATT. The patient group had higher cIMT (0.50±0.07 vs. 0.45±0.04 mm) and EATT (5.68±0.90 vs. 4.22±0.76 mm) than the control group. The risk of vitamin D insufficiency was 2.68 times higher in the patient group (95% CI=1.19-6.03). Conclusions: Children with Celiac disease had higher cIMT and EATT than healthy peers. cIMT and/or EATT measurements by echocardiography may present as a reliable and easy method to investigate subclinical atherosclerosis in children with Celiac disease.

Keywords:

atherosclerosis, carotid intima media thickness, Celiac, children, epicardial adipose tissue thickness,

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