Esra TUNÇER, Alev KESER, Emine Nüket ÜNSAL, Sevinç ODABAŞI GÜNEŞ, Onur AKIN

Fazla Kilolu ve Obeziteli Çocuklarda D Vitamini Düzeyi ile İnsülin Direnci Arasındaki Korelasyonunun Değerlendirilmesi

Amaç: Bu çalışmada fazla kilo ve obezitesi olan çocuklarda D vitamini düzeyleri ile insülin direnci parametreleri arasındaki ilişkinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya 6-17 yaş aralığında, %64,4% (n=112) kız ve %35,6 (n=62) erkek, toplam 174 çocuk dahil edilmiştir. Katılımcılar, Dünya Sağlık Örgütü beden kitle indeksi (BKİ) sınıflaması kriterlerine göre normal (%29,9; n=52), fazla kilolu (%23,6; n=41) ve obezite (%46,5; n=81) olmak üzere üç gruba ayrılmıştır. Katılımcıların insülin direnci durumları, insülin direncinin homeostatik model değerlendirmesi (homeostatic model assessment of insulin resistance, HOMA-IR), açlık glikozunun insüline oranı (fasting glucose to insulin ratio, FGIR) ve kantitatif insülin duyarlılığı kontrol indeksi (quantitative insulin sensitivity check index, QUICKI) ile değerlendirilmiştir. Bulgular: HOMA-IR, fazla kilolu (2,2±1,0) ve normal kilolu (1,5±1,0) gruplara göre obezite grubunda (3,2±2,1) yüksek bulunmuştur (p<0,001). Fazla kilolu (0,34±0,03) ve obezite (0,33±0,03) gruplarının QUICKI değerlerinin normal kilolu (0,37±0,03) gruptan daha düşük olduğu görülmüştür (p<0,001). FGIR, normal kilolu grupta (16,8±10,4), fazla kilolu (10,6±6,0) ve obezite (8,5±5,5) gruplarına göre daha yüksek saptanmıştır (p<0,001). Çocuk ve adölesanların ortalama serum 25-hidroksivitamin D [25(OH)D] düzeyi 19,6±10,7 ng/mL olup, gruplar arasında istatistiksel olarak anlamlı bir farklılık bulunmamıştır (p=0,153). Serum 25(OH)D ile HOMA-IR değerleri arasında anlamlı, zayıf negatif (r=-0,170; p=0,025) bir korelasyon bulunmuştur. Buna ek olarak, serum 25(OH)D düzeyi ile QUICKI ve FGIR değerleri arasında zayıf pozitif istatistiksel olarak anlamlı (sırasıyla, r=0,173; p=0,022 ve r=0,173, p=0,023) bir korelasyon bulunmuştur. Sonuç: D vitamini düzeyleri insülin direnci parametrelerini etkileyebilir.

Anahtar Kelimeler:

insülin direnci, pediatrik obezite, D vitamini

Evaluation of the Correlation Between Vitamin D Level and Insulin Resistance in Children with Overweight and Obesity

Aim: This study aimed to evaluate the relationship between vitamin D levels and insulin resistance parameters in children with overweight and obesity. Material and Methods: A total of 174 children, 64.4% (n=112) female, and 35.6% (n=62) male, aged between 6-17 years were included in the study. The participants were divided into three groups as normal (29.9%, n=52), overweight (23.6%, n=41), and obesity (46.5%, n=81) based on the criteria of the World Health Organization body mass index (BMI) classification. The insulin resistance status of the participants was evaluated by homeostatic model assessment of insulin resistance (HOMA-IR), fasting glucose to insulin ratio (FGIR), and quantitative insulin sensitivity check index (QUICKI). Results: HOMA-IR was found higher in the obesity group (3.2±2.1) compared to the overweight (2.2±1.0) and the normal weight (1.5±1.0) groups (p<0.001). It was observed that QUICKI values of the overweight (0.34±0.03) and the obesity (0.33±0.03) groups were lower than the normal weight (0.37±0.03) group (p<0.001). FGIR was noticed as higher in the normal weight (16.8±10.4) group compared to the overweight (10.6±6.0) and the obesity (8.5±5.5) groups (p<0.001). The mean serum 25-hydroxyvitamin D [25(OH)D] levels of the children and adolescents were 19.6±10.7 ng/mL, and no statistically significant difference was found between the groups (p=0.153). A significant weak negative correlation between serum 25(OH)D and HOMA-IR values was found (r=-0.170, p=0.025). Additionally, a weak positive statistically significant correlation was found between serum 25(OH)D level and QUICKI and FGIR values (r=0.173, p=0.022, and r=0.173, p=0.023, respectively). Conclusion: Vitamin D levels can affect insulin resistance parameters.

Keywords:

insulin resistance, pediatric obesity, vitamin D,

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