Abdullah YAZAR, Fatma ŞAMLIOĞLU, Fatih AKIN, Şükrü ARSLAN

İnfantlarda Görülen Kalsiyum Yüksekliğinin D Vitamini ile İlişkisi

ÖZ Amaç: Kalsiyum yüksekliği saptanan infantlarda hiperkalsemi etiyolojisinde D vitaminin rolünün araştırmak ve D vitamini düzeyine etki eden faktörlerin belirlenmesidir. Gereç ve Yöntemler: Çalışmamız Ocak-Aralık 2012 tarihleri arasında Konya Eğitim ve Araştırma Hastanesi Çocuk Sağlığı ve Hastalıkları Kliniği’nde yatan kalsiyum yüksekliği (≥10mg/dl) bulunan 53 infantta gerçekleştirildi. İnfantlar Grup I (1- 6 ay) ve Grup II (7-12 ay) olmak üzere iki gruba ayrıldı. Çalışmaya alınan tüm bebeklerde başvuruda ve D vitamin kesildikten bir ay sonra serum kalsiyum, fosfor, alkalenfosfataz (ALP), parathormon (PTH), 25(OH)D3 ve spot idrarda kalsiyum, kreatinin(ca/cr) düzeyleri çalışıldı. Bulgular: Hastaların 44’ü (%83) erkek, 9 ‘u (%17) kız idi ve yaş ortalaması 5,11±2,48 aydı. Sadece anne sütü alan bebeklerde serum 25(OH)D3 düzeyi (41,48 ng/ml)ek gıda alanlara göre daha yüksek saptandı. 400 IU/gün D vitamini preperatı kullanan 45 infant ile farklı doz (800-1200 IU/gün) kullanan 8 infant arasında kalsiyum, fosfor, ALP, PTH ve 25(OH)D3 düzeyleri arasında anlamlı fark yoktu( p≥0,05). Hastaların D vitamini kesildikten sonraki kontrollerinde 25(OH)D3 düzeyinde düşüş sağlanırken kalsiyum seviyesi aynı düzeyde seyretti. Ancak D vitamini düşüklüğü olduğu dönemde PTH ve fosfor artışı saptandı. ALP değerleri değişmedi. Hastaların başvuru anında ve kontrollerinde hiperkalsiüri tespit edilmedi. Sonuç Kalsiyum yüksekliği sıklıkla rutin biyokimya tetkiklerinde tesadüfen fark edilen, yaygın olmayan bir elektrolit bozukluğudur. Sebeplerinden biri de D vitamini kullanımı olmakla beraber, çalışmamızda 1200 IU/gün ve altındaki vitamini alımının hiperkalsemi ve hiperkalsiüri ile ilişkisinin olmadığı gösterildi. Anahtar Kelimeler: D vitamini, infant, kalsiyum The Relationship of Hypercalcemia and Vitamin D in Infants ABSTRACT Objective: To investigate the role of vitamin D in the etiology of hypercalcemia in infants with calcium elevation and to determine the factors affecting vitamin D levels. Material and Methods: Our study was carried out in 53 infants with high calcium levels (≥10 mg / dl) who were hospitalized in the pediatrics clinic of Konya Training and Research Hospital between in a one year period. The patients were divided into two groups as Group I (1- 6 months-old) and Group II (7-12 months-old). Serum levels of calcium, phosphorus, alkalenephosphatase (ALP), parathormone (PTH), 25 (OH) D3 and spot urine calcium and creatinine (ca / cr) levels were studied in all infants on admission and one month after vitamin D supplementation was stopped. Results: 44 (83%) of the patients were male and 9 (17%) were female and the mean age was 5,11 ± 2,48 months. Serum 25 (OH) D3 levels (41.48 ng / ml) were significantly higher in infants who received only breast milk. There were no significant differences between 45 infants who received 400 IU / day vitamin D and 8 infants using different doses (800-1200 IU / day) in terms of calcium, phosphorus, ALP, PTH and 25 (OH) D3 levels (p≥0.05). 25 (OH) D3 levels were decreased and calcium levels remained the same after vitamin D supplementation was stopped. However, there was an increase in PTH and phosphorus levels in the period when vitamin D levels were low. ALP levels did not change. Hypercalciuria was not detected at the time of admission and the follow-up period of the patients. Conclusion: Calcium is a non-widespread electrolyte disorder, which is coincidentally detected during routine biochemical analysis. Although one of the reasons was the use of vitamin D, it was shown in our study that vitamin D intake of 1200 IU / day and below did not correlate with hypercalcaemia and hypercalciuria. Keywords: vitamine D, infant, calcium 0000-0003-0733-3943

Anahtar Kelimeler:

D vitamini; infant; kalsiyum

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