Mehmet Tahir ESKİ, Kuddusi TEBERİK, Taha SEZER, İlknur ARSLANOĞLU

Obez Çocuklarda ve Sağlıklı Kontrol Grubunda Ön Segment Parametrelerinin Karşılaştırılması

Amaç Obez çocuklarda ön segment parametrelerinin değerlendirilmesi Gereç ve yöntemler: 55 obez ve 30 kontrol grubu çocuk denek katıldı. Tüm katılımcılar ve kontrol grubu incelendi ve antropometrik ölçümler yapıldı. Açlık kan şekeri (AKŞ), trigliserit(TG), toplam kolesterol (TC), yüksek yoğunluklu lipoprotein-kolesterol (HDL-K), düşük yoğunluklu lipoprotein-kolesterol (LDL-K) ve insülin değerleri ölçümleri yapıldı. . İnsülin direncinin (HOMA‑IR) homeostaz modeli değerlendirmesi hesaplandı. Her katılımcıya detaylı bir göz muayenesi yapıldı ve Göz içi basıncı(GİB), Santral kornea kalınlığı (SKK), Ön kamara derinliği (ÖKD) ve Lens kalınlığı (LK) ölçüldü. Bulgular: Grupların cinsiyet dağılımı benzerdi (p=0,893). SKK ve LT ortalaması obez grupta anlamlı olarak daha yüksekti (572.9 ± 14.5'e karşılık 559.5 ± 10.1 µm, p=0.001; 3.6 ± 0.14'e karşı 3.48 ± 0.25 mm, p=0.007). Obez ve kontrol grupları arasında diğer parametreler açısından anlamlı fark bulunmadı. BMI ve WC, LT kontrol grupları ile anlamlı bir negatif korelasyona sahipti. Obez grup, GİB ile TG arasında anlamlı bir pozitif korelasyon (r=0.276, p=0.042) ve HDL-C ile anlamlı bir negatif korelasyon gösterdi (r=-0.273, p=0.043). Kontrol grubunda GİB ile VKİ (r=0.389, p=0.034), WC (r=0.497, p=0.005), HOMA-IR (r=0.384, p=0.036), İnsülin arasında anlamlı pozitif ilişki vardı. (r=0.407, p=0.026) ve TC ile anlamlı bir negatif korelasyon (r=-0.511, p=0.004). Kontrol grubunda AKD ile LDL-K arasında anlamlı pozitif korelasyon (r=0.371, p=0.043) ve HOMA-IR arasında anlamlı derecede negatif korelasyon saptandı (r=-0.682, p=0.000). Sonuç: Obez grup, kontrol gruplarına göre daha yüksek SKK ve LT'ye sahipti.

Anahtar Kelimeler:

Obez çocuklar, Kornea kalınlığı, Ön kamara derinliği, Lens kalınlığı, Göz içi basıncı

Comparison of Anterior Segment Parameters in Obese Children And Healthy Control Group

Objective:: To evaluate anterior segment parameters in obese children Material and methods: 55 obese and 30 control group children subjects participated. All participants and the control group were examined and anthropometric measurements were made. The measurements of fasting blood glucose(FBG), triglyceride(TG), total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), and insulin values were performed. The homeostasis model assessment of insulin resistance (HOMA‑IR) was calculated. Each participant underwent a detailed ophthalmic examination and IOP, CCT, ACD and LT were measured. Results: The gender distribution of the groups was similar (p=0.893). The mean of CCT and LT were significantly higher in the obese group (572.9 ± 14.5 vs. 559.5 ± 10.1 µm, p=0.001; 3.6 ± 0.14 vs. 3.48 ± 0.25 mm, p=0.007) . No significant difference was found between the obese and control groups in terms of other parameters. BMI and WC had a significant negative correlation with LT control groups. The obese group showed a significant positive correlation between IOP and TG (r=0.276, p=0.042), and a significant negative correlation with HDL-C (r=-0.273, p=0.043). In the control group, there was a significant positive correlation between IOP and BMI (r=0.389, p=0.034), WC (r=0.497, p=0.005), HOMA-IR (r=0.384, p=0.036), Insulin (r=0.407, p=0.026), and a significant negative correlation with TC (r=-0.511, p=0.004). A significantly positive correlation between ACD and LDL-C (r=0.371, p=0.043) and a significantly negative correlation between HOMA-IR in the control group were detected (r=-0.682, p=0.000). Conclusion: The obese group had higher CCT and LT than the control groups.

Keywords:

Obese children, Corneal thickness, Anterior chamber depth, Lens thickness, Intra ocular pressure,

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1. Bessesen DH. Update on obesity. J Clin Endocrinol Metab. 2008;93(6):2027-34.
2. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA. 2014;311(8):806-14.
3. Dietz WH. Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics. 1998;101(3 Pt 2):518-25.
4. Bergman B, Nilsson-Ehle H, Sjöstrand J. Ocular changes, risk markers for eye disorders and effects of cataract surgery in elderly people: a study of an urban Swedish population followed from 70 to 97 years of age. Acta Ophthalmol Scand. 2004;82(2):166-74.
5. Koçak N, Arslan N, Karti O, Tokgoz Y, Ozturk T, Gunenç U, et al. Evaluation of the intraocular pressure in obese adolescents - Minerva Pediatrica 2015 October;67(5):413-18.
6. Cheung N, Wong TY. Obesity and Eye Diseases. Surv Ophthalmol. 2007 Mar;52(2):180–95.
7. Teberik K, Eski MT, Doğan S, Pehlivan M, Kaya M. Ocular abnormalities in morbid obesity. Arq Bras Oftalmol. 2019;82(1):6-11.
8. Muir KW, Jin J, Freedman SF. Central corneal thickness and its relationship to intraocular pressure in children. Ophthalmology. 2004 Dec 1;111(12):2220–23. 9. Lurbe E, Agabiti-Rosei E, Cruickshank JK, Dominiczak A, Erdine S, Hirth A, et al. 2016 European Society of Hypertension guidelines for the management of high blood pressure in children and adolescents. J Hypertens. 2016;34(10):1887–920.
10. Akinci A, Cetinkaya E, Aycan Z, Oner O. Relationship between intraocular pressure and obesity in children. J Glaucoma. 2007 Oct;16(7):627–30. 11. Baran R, Baran S, Toraman N, Filiz S, Demirbilek H. Evaluation of intraocular pressure and retinal nerve fiber layer, retinal ganglion cell, central macular thickness, and choroidal thickness using optical coherence tomography in obese children and healthy controls. Niger J Clin Pract. 2019 Apr 1;22(4):539–45.
12. Pekel E, Altıncık SA, Pekel G. Inner retinal thickness and optic disc measurements in obese children and adolescents. Arq Bras Oftalmol. 2020 Sep 1;83(5):383–88.
13. Halpern DL, Grosskreutz CL. Glaucomatous optic neuropathy: mechanisms of disease. Ophthalmol Clin North Am. 2002;15(1):61–68.
14. Budak BA, Kıvanç SA, Başkaya K, Baykara M YA. Evaluation of Occupational Closed Globe Eye Injuries. Ann Clin Anal Med. 2015;06(Suppl-3).
15. Hennis A, Wu SY, Nemesure B, Leske MC. Hypertension, diabetes, and longitudinal changes in intraocular pressure. Ophthalmology. 2003 May 1;110(5):908–14.
16. Wu SY, Leske MC. Associations with intraocular pressure in the Barbados Eye Study. Arch Ophthalmol. 1997;115(12):1572–6.
17. Park SS, Lee EH, Jargal G, Paek D, Cho S Il. The distribution of intraocular pressure and its association with metabolic syndrome in a community. J Prev Med Public Health. 2010 Mar;43(2):125–30.
18. Mori K, Ando F, Nomura H, Sato Y, Shimokata H. Relationship between intraocular pressure and obesity in Japan. Int J Epidemiol. 2000;29(4):661–6.
19. Cohen E, Kramer M, Shochat T, Goldberg E, Garty M, Krause I. Relationship Between Body Mass Index and Intraocular Pressure in Men and Women: A Population-based Study. J Glaucoma. 2016;25(5):e509–13.
20. Gunes A, Uzun F, Karaca EE, Kalaycı M. Evaluation of Anterior Segment Parameters in Obesity. Korean J Ophthalmol. 2015 Aug 1;29(4):220–5.
21. Can ME, Kızıltoprak H, Buluş AD, Özkoyuncu D, Koç M, Yıldız ZÖ. Corneal Biomechanical Properties in Childhood Obesity. J Pediatr Ophthalmol Strabismus. 2020 Apr 1;57(2):103–7.
22. Acer S, Agladioglu SY, Pekel G, Özhan B, Çetin EN, Yagci R, et al. Density of the crystalline lens in obese and nonobese children. J AAPOS Off Publ Am Assoc Pediatr Ophthalmol Strabismus. 2016 Feb 1;20(1):54–7.
23. Weintraub JM, Willett WC, Rosner B, Colditz GA, Seddon JM, Hankinson SE. A prospective study of the relationship between body mass index and cataract extraction among US women and men. Int J Obes. 2002 Dec 1;26(12):1588–95.
24. Panon N, Luangsawang K, Rugaber C, Tongchit T, Thongsepee N, Cheaha D, et al. Correlation between body mass index and ocular parameters. Clin Ophthalmol. 2019;13:763.
25. Okosun IS, Cooper RS, Rotimi CN, Osotimehin B, Forrester T. Association of waist circumference with risk of hypertension and type 2 diabetes in Nigerians, Jamaicans, and African-Americans. Diabetes Care. 1998;21(11):1836–42.
26. Özen B, Öztürk H, Çatlı G, Dündar B. An Assessment of Retinal Nerve Fiber Layer Thickness in Non-Diabetic Obese Children and Adolescents. J Clin Res Pediatr Endocrinol. 2018;10(1):13–8.

ISSN: 1309-3878
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 2009
Yayıncı: Düzce Üniversitesi Tıp Fakültesi Aile Hekimliği AD adına Yrd.Doç.Dr.Cemil Işık Sönmez