Hacer EROGLU ICLI, Arif Murat KAYTAZ, Emre AKKAYA, Evin ADEMOĞLU, Sema GENC

TÜRK ÇOCUKLARINDA YAŞ, CİNSİYET VE SOSYO-EKONOMİK DURUMUNUN SERUM DEMİR, VİTAMİN B-12 VE FOLİK ASİT KONSANTRASYONLARI ÜZERİNDEKİ ETKİLERİ: KESİTSEL BİR ÇALIŞMA

Amaç: Bu çalışmanın amacı, pediyatrik yaş gruplarında; yaş, cinsiyet ve sosyo-ekonomik durumun (SED) B12 vitamini, folik asit, demir ve ferritin konsantrasyonlarına etkisi, bu parametrelerin hemoglobin (Hb), hematokrit (Hct), ortalama eritrosit hacmi (MCV) , RDW gibi kan sayımı parametreleri arasındaki ilişkisinin saptanmasıdır. Gereç ve Yöntem: Çalışma 30504 venöz kan örneğinden oluştu (%54,5 kız, %45,5 erkek). Çalışma grupları; grup I: 1-6 yaş (n=3.870), grup II: 7-12 yaş (n=11.019), grup III: 13-18 yaş (n=15.615). Serum B12 vitamini, folik asit, ferritin, demir, demir bağlama kapasitesi (TDBK), Beckman Coulter’ın DXI 800 analizörü kullanılarak, tam kan sayımı Sysmex XE 2100 hematoloji cihazında çalışıldı. Bulgular: Kız ve erkek çocuklarının yaş grupları arasında Hb, Hct, MCV, RDW düzeyleri anlamlı olarak farklı bulundu (tüm parametreler için, p<0.001). Hb ve Hct düzeyleri 13-18 yaş grubu erkek çocuklarında en yüksek seviyede olup, aynı yaş grubundaki kız çocuklarına göre anlamlı olarak daha yüksekti (p<0.001). Demir eksikliği prevalansı, kız çocuklarda %12,3, erkek çocuklarda %4,2 idi. Serum folik asit ve B12 vitamin konsantrasyonlarında yaş grupları içerisinde yaşla azalma görüldü (sırasıyla r=-0,480, p<0,001; r=-0,377, p<0,001). Kız ve erkek çocuklarında, B12 vitamin eksikliği prevalansı sırasıyla %27,1 ve %28,3 iken, folik asit eksikliği prevalansı %6,0 ve %6,8 olarak bulundu. Demir, TDBK ve ferritin düzeylerinde yüksek ve orta SED arasında anlamlı farklılıklar görüldü (p<0,001, tüm parametreler için). Sonuç: Bu çalışmanın sonuçları, ferritin, B12 vitamini, folik asit düzeylerinin mental, emosyonal ve metabolik gelişimlerindeki rolleri nedeniyle çocukluk çağı ve ergenlikte izlenmesinin klinik uygulamaya katkıları açısından önem taşımaktadır. Ancak, bu nutrientleri ülke genelinde Türk çocuk ve ergenlerindeki temsil edebilecek daha geniş ve çok merkezli çalışmalara ihtiyaç vardır.

Anahtar Kelimeler:

B12 Vitamini, folik asit, demir eksikliği prevalansı, B12 vitamin eksikliği prevalansı, folik asit eksikliği prevalansı

THE IMPACT OF AGE, SEX, AND SOCIO-ECONOMIC STATUS ON SERUM VITAMIN B12, FOLATE CONCENTRATION AND IRON STATUS IN TURKISH CHILDREN: A CROSS-SECTIONAL STUDY

Objective: The aim of this study is to evaluate the effects of age, sex, and socio-economic status (SES) on concentrations of vitamin B12 (vit-B12), folate, iron, and ferritin through the pediatric age span, and to show the relationship of these nutrients with blood count parameters such as hemoglobin (Hb), hematocrit (Hct), mean corpuscular volume (MCV), and red cell distribution (RDW). Material and Method: The study comprised of 30,504 venous blood samples (54.5% of girls and 45.5% of boys). The study group was stratified; group I: 1-6 years (n=3,870), group II: 7-12 years (n=11,019), and group III: 13-18 years (n=15,615). Serum vit-B12, folate, ferritin, iron and total iron-binding capacity (TIBC) were measured using a Beckman Coulter DXI 800, and the blood count was analyzed using a Sysmex XE 2100 analyzer. Results: The Hb, Hct, MCV, and RDW levels were significantly different between the age groups of boys and girls (p<0.001, for all). Hb and Hct were the highest in boys aged 13-18 years, and higher than those of girls in the same age group (p<0.001). The MCV and RDW were also significantly different across the age groups (p<0.001). The iron deficiency prevalences were 12.3% and 4.2% for the girls and boys respectively. Serum folate and vit-B12 showed decrement with age across the age groups. The prevalences of vit-B12 deficiency were 27.1% and 28.3% and 6.0% and 6.8% for folate deficiency for girls and boys. Iron, TIBC ,and ferritin levels were significantly different between the high and medium SES. Conclusion: The results of this study are important in that the monitorization of ferritin, vit-B12, and folate levels greatly contribute to clinical practice because of the roles of vit-B12, folate, and iron in mental, emotional, and metabolic development. However, there is a need for larger and multicenter studies that can represent the nutrients of Turkish children and adolescents nationwide.

Keywords:

Serum vitamin B-12, folic acid, iron status, iron deficiency prevalence, B-12 and folate deficiency prevalence,

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