Obez Çocuklarda D Vitamini Düzeylerinin İnsülin Direnci ve Hepatosteatoz ile İlişkisi

Amaç: Son zamanlarda yaygınlaşan obezite sorunu ile birlikte çocuklarda, D vitamini eksikliğinin de daha sık olduğusaptanmıştır. Çalışmada obez çocuklarda, insülin direnci ve hepatosteatoz ile D vitamini arasındaki ilişki değerlendirilmiştir.Gereç ve Yöntemler: Sağlık Bilimleri Üniversitesi Ankara Çocuk Sağlığı ve Hastalıkları Hematoloji Onkoloji Eğitim veAraştırma Hastanesi, Çocuk Endokrinoloji Polikliniği’ne başvuran yaşları 3-18 arası hastaların tıbbi kayıtları geriye dönükolarak incelenmiştir. Yaş ve cinsiyete göre vücut kitle indeksi (VKİ) 95 persentil üzerinde olan çocuk ve adölesan olgularçalışmaya dahil edildi. Serum 25(OH) vitamin D düzeylerine göre; 25 (OH) vitamin D konsantrasyonu < 12 ng/ml (< 30nmol/L) altında olması eksiklik, 12–20 ng/ml (30–50 nmol/L) arasında olması yetersizlik ve > 20 ng/ml (>50 nmol/L)olması yeterlilik olarak sınıflandırıldı.Bulgular: Çalışmada 212’si (%59.6) kız olmak üzere toplam 356 hastanın dosya kaydı verilerine ulaşıldı. Hastaların yaşortalamaları 12.3±3.26 yıl (3.11-18.0), VKİ SDS ortalaması 2.47±0.69 (1.66-8.32)’di. Hastaların serum 25 (OH) vitaminD düzeyleri ortalaması 12.54±5.23 ng/ml, HOMA-IR ortalaması 3.45±2.31 (0.44-18.9)’du. D vitamini eksikliği kızlarda(%55.2), erkeklere göre (%38.9) daha sık görülmekteydi (p=0.003). D vitamini eksikliği insülin direnci olanlarda (%58.4),insülin direnci olmayan gruba göre (%43.3) daha sık görülmekteydi (p=0.007).Sonuç: Çalışma özellikle, insülin direnci ve/veya hepatosteatozu olan obez hastalarda anlamlı derecede düşük D vitamini seviyeleri olduğunu göstermiştir. Elde ettiğimiz sonuçların doğrulanması için ileriye yönelik, geniş serili ve uzun dönemçalışmalara ihtiyaç vardır.

The Relation of Vitamin D Levels to Insulin Resistance and Hepatosteatosis in Obese Children

Objective: It has recently been revealed that vitamin D deficiency is becoming more common in children together with the widespread problem of obesity. The aim of this study was to evaluate the relationship between insulin resistance and hepatosteatosis and vitamin D in obese children. Material and Methods: The medical records of patients aged 3-18 years who presented to the Pediatric Endocrinology Clinic of the Department of Health Sciences University, Ankara Children’s Health and Diseases Hematology Oncology Training and Research Hospital were evaluated retrospectively. Children and adolescents with a body mass index (BMI) greater than the 95th percentile by age and sex were included in the study. Vitamin D deficiency was defined as a serum 25-hydroxy-vitamin D (25-(OH)D) level below 50 nmol/L). Results: A total of 356 patients, including 212 (59.6%) girls, were reached in the study. The mean age of the patients was 12.3 ± 3.26 years (3.11-18.0) and the mean BMI SDS was 2.47 ± 0.69 (1.66-8.32). The mean 25 (OH) vitamin D level was 12.54 ± 5.23 ng/ml and the mean HOMA-IR was 3.45 ± 2.31 (0.44-18.9). Vitamin D deficiency was more frequent in females (55.2%) than in males (38.9%) (p = 0.003). Vitamin D deficiency was more frequent in patients with insulin resistance (58.4%) than in patients without insulin resistance (43.3%) (p = 0.007). Conclusion: This study has shown in particular that significantly low vitamin D levels are present in obese patients with insulin resistance and/or hepatosteatosis. There is a need for forward-looking, large-scale and long-term studies to verify our results.

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