S GÖKAY, Ü. TIRAŞ, E. ŞİMŞEK, U YASITLI, Y. DALLAR

Meningomiyeloselli hastalarda leptin ile vücut kitle indeksi arasındaki iliski

Amaç: Meningomiyeloselli hastaların plazma leptin düzeyini ve plazma leptin düzeyi ile vücut kitle indeksi arasında iliski olup olmadığını arastırmak amacıyla bu çalısma yapıldı. Yöntem ve Gereç: Çalısmaya 2008-2009 yılları arasında takip edilen, daha önceden tanı almıs 30 meningomiyeloselli hasta ve 30 sağlıklı birey kontrol grubu olarak alındı. Hastaların cinsiyet, yas, vücut ağırlığı, boy, vücut kitle indeksi, hidrosefali varlığı, yas ve cinsiyete göre vücut ağırlığı, boy ve vücut kitle indeksi persantilleri (yüzdeleri) kaydedildi. Hasta ve kontrol grubunda serum leptin düzeyi çalısıldı. Bulgular: Hastaların ortalama yası 42,1±27 ay iken, kontrol grubunun ortalama yası 44,8±25 ay idi. Hasta ve kontrol grubu arasında vücut kitle indeksinin >%95 olması açısından istatistiksel olarak anlamlı fark saptanmadı (p=0,052). Menigomiyeloselli hastalardan vücut kitle indeksi >%95 olanların ortanca leptin düzeyi 0,1 ng/ml (0,04-7,8), vücut kitle indeksi %95 olanların ortanca leptin düzeyi ile vücut kitle indeksi 0,05). Sonuç: Meningomiyeloselli hastalarda leptin düzeyinin vücut kitle indeksinden bağımsız olarak yüksek saptanması, hidrosefali dısındaki anatomik bozukluklar nedeniyle leptinin santral sinir sistemine geçisinde problem olabileceğini düsündürmektedir.

Leptin and body mass index correlation in patients with meningomyelocele

Aim: We aimed to determine the plasma leptin levels and the relationship between plasma leptin level and body mass index in patients with meningomyelocele. Material and Methods: Between the years 2008-2009, thirty patients who were previously diagnosed with meningomyelocele and 30 healty control group were enrolled for this study. The gender, age, weight, heigt, body mass index, presence of hydrocephalus, weight, heigt, body mass index percentiles according to age and gender were noted. Serum leptin levels were studied in both the patients and control group. Results: The mean age of patients was 42.1± 27 months and control group was 44.8±25 months. There was no significant difference between the patients and the control group in terms of body mass index which was >95% (p=0.052). The median leptin level was 0.1 ng/ml (0.04-7.8) in patients with a body mass index of >95%, 0.07 ng/ml (0.04-7.8) and in patients with body mass index of <95% and 0.04 ng/ml (0.04-0.8) in the control group. While there was no significant difference in leptin levels between the patients with body mass index >95% and <95% (p=0.055), leptin levels were determined significantly higher in all patients with any body mass index than in the control group (p<0.01). There was no relation between the precence of hydrocephalus and body mass index percentile. Leptin levels were not significantly different between the patients with or without hydrocephalus. Conclusion: Determination of higher leptin levels in meningomyelocele patients with any body mass index shows that anatomical abnormalities other than hydrocephalus may cause disorders in transport of leptin to the central nervous system.

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1. Baker S. Neural tube defects. In: Greenberg MS. Handbook of Neurosurgery. 3rd ed. Florida: Greenberg Graphics Inc; 1994. p.157-68.
2. Shaer CM, Chescheir N, Schulkin J. Myelomeningocele: A review of the epidemiology, genetics, risk factors for conception, prenatal diagnosis, and prognosis for affected individuals. Obstet Gynecol Surv 2007; 62: 471-9.
3. Roberts D, Shepherd RW, Shepherd K. Anthropometry and obesity in myelomeningocele. J Paediatr Child Health 1991; 27: 83- 90.
4. Rotenstein D, Adams M, Reigel DH. Adult stature and anthropomorphic measurements of patients with myelomeningocele. Eur J Pediatr 1995; 154: 398-402.
5. Wilding J, Widdowson P, Williams G. Neurobiology. Br Med Bull 1997; 53: 286-306.
6. Sahu A. Leptin signaling in the hypothalamus: Emphasis on energy homeostasis and leptin resistance. Front Neuroendocrinol 2003; 24: 225-53.
7. Perrone L, Del Gaizo D, Angelo E, Rea L, Di Manso G, Del Gado R. Endocrine studies in children with myelomeningocele. J Pediatr Endocrinol 1994; 7: 219-23.
8. Hochhaus F, Butenandt O, Schwarz HP, Ring-Mrozik E. Auxological and endocrinological evaluation of children with hydrocephalus and/or meningomyelocele. Eur J Pediatr 1997; 156: 597-601.
9. Gokcay G, Furman A, Neyzi O. Updated growth curves for Turkish children aged 15 days to 60 months. Child Care Health Dev 2008; 34: 454-63.
10. Bundak R, Furman A, Gunoz H, Darendeliler F, Bas F, Neyzi O. Body mass index references for Turkish children Acta Paediatr 2006; 95: 194-8.
11. Dietz WH, Robinson TN. Use of the body mass index (BMI) as a measure of overweight t in children and adolescents. J Pediatr 1998; 132: 191-3.
12. Van den Berg-Emons HJ, Bussmann JB, Meyerink HJ, Roebroeck ME, Stam HJ. Body fat, fitness and level of everyday physical activity in adolescents and young adults with meningomyelocele. J Rehabil Med 2003; 35: 271-5.
13. Fiore P, Picco P, Castagnola E, Palmieri A, Levato L, Gremmo M, et al. Nutritional survey of children and adolescents with myelomeningocele: overweight associated with reduced energy intake. Eur J Pediatr Surg 1998; 8: 34-6.
14. Shepherd K, Roberts D, Golding S, Thomas BJ, Shepherd RW. Body composition in myelomeningocele. Am J Clin Nutr 1991; 53: 1-6.
15. Considine RV, Sinha MK, Heiman ML, Kriauciunas A, Stephens TW, Nyce MR, et al. Serum immunreactive leptin concentrations in normal-weight and obese humans. N Engl J Med 1996; 334: 292-5.
16. Banks WA. Leptin transport across the blood brain barrier:Implication for the cause and treatment of obesity. Curr Pharm Des 2001; 7: 125-33.
17. Ergün A. Leptin (Ob Protein). Turkiye Klinikleri J Med Sci 1999;19:130-6.
18. Caro JF, Kolaczynski JW, Nyce MR, Ohannesian JP, Opentanova I, Goldman WH, et al. Decreased cerebrospinal-fluid/serum leptin ratio in obesity: a possible mechanism for leptin resistance. Lancet 1996; 348: 159–61.
19. Basbug M, Serin IS, Ozcelik B, Kula M, Basbug EM, Tutus A. Correlation of elevated leptin levels in amniotic fluid and maternal serum in neural tube defects. Obstet Gynecol 2003; 101: 523-8.