Akdeniz Diyeti ve Karotis Arter Hastalığı Arasındaki İlişki.

Amaç: Akdeniz diyet tipi beslenmenin, kardiyovasküler olaylar ve aterosklerozu önlemede koruyucu rolleri olduğu bilinmektedir, fakat çalışmalar sınırlıdır. Bu çalışmanın amacı, karotis arter darlığı (KAD) ile Akdeniz diyet skoru arasındaki ilişkiyi değerlendirmektir. Yöntem: Hastalar, KAD >%60 olan (60 hasta),KAD <%60 olan (60 hasta) ve karotis aterosklereotik hastalığı bulunmayan (60 hasta) olarak üç gruba ayrılmıştır. Sonrasında, KAD olan hastalar, plak morfolojik özellikleri açısından kalsifikasyon görülen (67 hasta)ve görülmeyen(53 hasta) olmak üzere iki alt gruba ayrılmıştır. ‘Akdeniz Diyetine Uyum Ölçeği’ kullanılarak skorlama yöntemi(≤5, 6-9 ve ≥10 puan) ile diyet kalitesi belirlenmiş ve gruplar arasında karşılaştırılmıştır. Sonuç: Akdeniz diyet skoru, KAD<%60 olan hastalara göre aterosklerotik hastalığı bulunmayanlarda daha yüksek bulunmuştur (p<0,001). Ayrıca, KAD>60 olanlara göre KAD<60 olanlarda Akdeniz diyet skoru daha yüksektir (p<0,001). Akdeniz diyet skoru kalsifik aterosklerotik plağı olan hastalarda daha yüksek bulunmuştur (p<0,001). Tartışma: Akdeniz diyet tipi beslenmenin, karotis arter darlığı şiddeti üzerinde koruyucu rolü çalışmamızda açık olarak gözlenmiştir. Ayrıca serebrovasküler hastalıklarla yakın ilişkide olan non kalsifik karotis aterosklerozu üzerinde potansiyel engelleyici rolü gösterilmiştir. Akdeniz diyeti ile KAD arasındaki ilişkiyi inceleyen sınırlı sayıdaki çalışmalardan biri olan bu çalışma, karotis arter darlığı patofizyolojisinin anlaşılmasında fayda sağlayabilir.

Anahtar Kelimeler:

karotis arter hastalığı, Akdeniz diyet skoru, ateroskleroz

The relationship between Mediterranean diet and carotid artery disease.

Background: Mediterranean dietary nutrition is known to have protective roles in preventing cardiovascular events and atherosclerosis, but studies are limited. The aim of this study was to evaluate the relationship between carotid artery stenosis (KAD) and Mediterranean diet score.Methods: The patients were divided into three groups of patients with KAD> 60% (60 patients), KAD <60% (60 patients) and had no carotid atherosclerotic disease (60 patients). Afterwards, patients with KAD were divided into two subgroups, with calcific (67 patients) and non-calcific (53 patients) according to morphological characteristics of carotid atherosclerotic plaque. Diet quality was determined by scoring method (5, 6-9 and ≥10 points) ‘Mediterranean Diet Adaptation Scale’ and compared between groups.Results: Mediterranean diet score was higher in patients without atherosclerotic disease than patients with KAD <60% (p <0,001). In addition, Mediterranean diet score was higher in patients with KAD <60 than those with KAD >60 (p <0,001). Mediterranean diet score was higher in patients with calcific atherosclerotic plaque (p <0,001). Discussion: The protective role of Mediterranean diet on the severity of carotid artery stenosis was clearly observed in our study. In addition, its potential inhibitory role on non-calcific carotid atherosclerosis, which is closely related to cerebrovascular diseases, has been demonstrated. This study, which is one of the limited studies examining the relationship between Mediterranean diet and KAD, may be useful in understanding the pathophysiology of carotid artery stenosis.

Keywords:

carotid artery disease, Mediterranean diet score, atherosclerosis,

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1. Touboul PJ, Hernandez-Hernandez R, Kucukoglu S, Woo KS, Vicaut E, Labreuche J, et al. Carotid artery intima media thickness, plaque and Framingham cardiovascular score in Asia, Africa/Middle East and Latin America: the PARC-AALA study. The international journal of cardiovascular imaging. 2007;23(5):557-67.
2. Aboyans V, Ricco JB, Bartelink MEL, Bjorck M, Brodmann M, Cohnert T, et al. 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteriesEndorsed by: the European Stroke Organization (ESO)The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). Eur Heart J. 2017.
3. Franceschini N, Giambartolomei C, de Vries PS, Finan C, Bis JC, Huntley RP, et al. GWAS and colocalization analyses implicate carotid intima-media thickness and carotid plaque loci in cardiovascular outcomes. Nature communications. 2018;9(1):5141.
4. Cheng SF, Brown MM. Contemporary medical therapies of atherosclerotic carotid artery disease. Seminars in vascular surgery. 2017;30(1):8-16.
5. Gardener H, Wright CB, Cabral D, Scarmeas N, Gu Y, Cheung K, et al. Mediterranean diet and carotid atherosclerosis in the Northern Manhattan Study. Atherosclerosis. 2014;234(2):303-10.
6. Nettleton JA, Matijevic N, Follis JL, Folsom AR, Boerwinkle E. Associations between dietary patterns and flow cytometry-measured biomarkers of inflammation and cellular activation in the Atherosclerosis Risk in Communities (ARIC) Carotid Artery MRI Study. Atherosclerosis. 2010;212(1):260-7.
7. Buil-Cosiales P, Irimia P, Ros E, Riverol M, Gilabert R, Martinez-Vila E, et al. Dietary fibre intake is inversely associated with carotid intima-media thickness: a cross-sectional assessment in the PREDIMED study. European journal of clinical nutrition. 2009;63(10):1213-9.
8. Martínez-González MA, García-Arellano A, Toledo E, Salas-Salvadó J, Buil-Cosiales P, Corella D, et al. A 14-Item Mediterranean Diet Assessment Tool and Obesity Indexes among High-Risk Subjects: The PREDIMED Trial. PLoS ONE. 2012;7(8):e43134.
9. Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Atherosclerosis. 2016;252:2334.
10. Ferguson GG, Eliasziw M, Barr HW, Clagett GP, Barnes RW, Wallace MC, et al. The North American Symptomatic Carotid Endarterectomy Trial : surgical results in 1415 patients. Stroke. 1999;30(9):1751-8.
11. Rakıcıoğlu N, Tek N, Ayaz A, Pekcan GY. Besin Fotoğraf Katoloğu: Ölçü ve Miktarlar. Ankara; 2006.
12. Bach A, Serra-Majem L, Carrasco JL, Roman B, Ngo J, Bertomeu I, et al. The use of indexes evaluating the adherence to the Mediterranean diet in epidemiological studies: a review. Public health nutrition. 2006;9(1a):132-46.
13. YILMAZ A. Karotis Arter Stenozuna Bağlı İnmede Tıbbi Tedavi: Tıbbi Tedavi Sonrası, Ne Zaman Kimlere İnvaziv Girişimde Bulunalım? Turkiye Klinikleri Journal of Cardiovascular Surgery Special Topics. 2016;8(1):23-8.
14. Dernini S, Berry EM. Mediterranean Diet: From a Healthy Diet to a Sustainable Dietary Pattern. Frontiers in nutrition. 2015;2:15-.
15. GÖNDER M, AKBULUT G. Güncel Akdeniz Diyeti ve Potansiyel Sağlık Etkileri. Turkiye Klinikleri Journal of Health Sciences. 2017;2(2):110-20.
16. D’Alessandro A, De Pergola G. The Mediterranean Diet: its definition and evaluation of a priori dietary indexes in primary cardiovascular prevention. International journal of food sciences and nutrition. 2018:1-13.
17. van Lammeren GW, den Hartog AG, Pasterkamp G, Vink A, de Vries JP, Moll FL, et al. Asymptomatic carotid artery stenosis: identification of subgroups with different underlying plaque characteristics. European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery. 2012;43(6):632-6.