Obez çocuklarda serum fibroblast büyüme faktörü-23 düzeylerinin biyokimyasal ve hormonal parametrelerle ilişkisi
Küçük Resim Yok
Tarih
2018
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Obezitenin insülin direnci, prediyabet ve dislipidemi gibi metabolik sorunlara yol açtığı bilinmektedir. Bununla beraber, obezitenin serum fibroblast büyüme faktörü-23 (FGF-23) düzeylerine etkisi henüz açıklığa kavuşmamış bir konudur. Amacımız; obez çocuk ve adölesanlarda serum FGF-23 düzeylerini ölçmek ve FGF-23'ün insülin direnci, prediyabet, dislipidemi ve diğer metabolik sendrom parametreleriyle ilişkisini ortaya koymaktır. Materyal ve Metot: Çalışmamızın hasta grubunu obez olan 5-17 yaş (n=46) çocuk ve adölesanlar, kontrol grubunu aynı yaş aralığındaki sağlıklı çocuk ve adölesanlar (n=46) oluşturdu. Her iki grupta serumda FGF-23, ?-klotho, Ca, P, PTH, ALP, 1,25(OH)2D3, açlık glikozu, insülin, C-peptit, sT3, sT4, TSH düzeyleri ölçüldü, HOMA-IR (Homeostasis model assessment of insulin resistance) değerleri hesaplandı. Obez gruba oral glikoz tolerans testi (OGTT) uygulandı, HbA1c ve serum total kolesterol, HDL-kolesterol, LDL-kolesterol, trigliserit düzeyleri ölçüldü, DEXA (Dual enerji X-ışını absorbsiyometri) yapılarak Z-skor değerleri hesaplandı. Bulgular: Obez grupta, serumda; ?-klotho, fibroblast büyüme faktörü-23, 1,25(OH)2D3 düzeyleri anlamlı olarak düşük (p<0,05), açlık insülin, açlık kan glikozu, C-peptit, HOMA-IR , alkalen fosfataz, sT3 düzeyleri ise anlamlı olarak yüksek ölçüldü (p<0,05). Obez grupta FGF-23 ile ?-klotho arasında anlamlı pozitif korelasyon (p<0,05), hem FGF-23 hem de ?-klotho ile sT3 arasında anlamlı negatif korelasyon saptandı (p<0,05). Obez ve bozulmuş glikoz toleransı (BGT) olan alt grupta FGF-23, ?-klotho, 1,25(OH)2D3 düzeyleri, BGT olmayan alt gruba göre, anlamlı olarak yüksek ölçüldü (p<0,05). BGT olmayan alt grupta FGF-23 ile C-peptit arasında (p<0,05) ve ?-klotho ile trigliserit arasında negatif korelasyon (p=0,052) saptandı. Aynı alt grupta HDL-kolesterol ile ?-klotho (p=0,058) ve FGF-23 ile HDL-kolesterol arasında pozitif korelasyon (p<0,05) saptandı. Sonuç: Obezitedeki hiperinsülineminin ve/veya obez grupta 1,25(OH)2D3 seviyelerini düşük tespit etmiş olmamızın FGF-23'ü suprese etmiş olabileceğini düşünmekteyiz. Anahtar Kelimeler: Obezite, VKİ, FGF-23, ?-klotho, 1,25(OH)2D3, insülin, C-peptit, sT3, HOMA-IR , bozulmuş glikoz toleransı, prediyabet
Aim: Obesity is known to cause metabolic disturbances such as insulin resistance, prediabetes and dyslipidemia. In addition, the effects of obesity to serum FGF-23 levels have not yet been clarified. Our aims are to measure serum FGF-23 levels in obese children and adolescents; and to reveal the association of FGF-23 with insulin resistance, prediabetes, dyslipidemia and other metabolic syndrome parameters. Material and Method: The patient group included children with obesity aged 5-17 years (n=46) and the control group included healthy children in the same age range (n=46). FGF-23, ?-klotho, Ca, P, PTH, ALP, 1,25(OH)2D3, fasting glucose, insulin, C-peptide, fT3, fT4 and TSH levels were measured in serum and HOMA-IR ( Homeostasis model assessment of insulin resistance) values were calculated in two groups. Oral glucose tolerance test (OGTT) was performed, HbA1c, serum total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglyceride levels were measured, and Z-scores were calculated via DEXA (Dual energy X-ray absorbtiometry) in obese group. Results: FGF-23, ?-klotho, 1,25(OH)2D3 levels were significantly lower and fasting insulin, fasting glucose, C-peptide, HOMA-IR , and ALP levels were significantly higher in the obese group (p<0.05). Among the obese group, a statistically significant positive correlation was revealed between FGF-23 and ?-klotho (p<0.05), both FGF-23 and ?-klotho revealed a significant negative correlation between fT3 at p<0.05. FGF-23, ?-klotho, 1,25(OH)2D3 levels were significantly higher in the obese subgroup with impaired glucose tolerance (IGT) (p<0.05). Negative correlations were found between FGF-23 and C-peptide, between ?-klotho and triglycerides in the obese subgroup without IGT (p<0.05). Positive correlations were detected between HDL-cholesterol and ?-klotho (p=0.058), between FGF-23 and HDL-cholesterol (p<0.05) in the same subgroup. Conclusion: We believe that hiperinsulinemia in obesity and/or lower 1,25(OH)2D3 levels may lead to low levels of FGF-23 in the obese group. Key Words: Obesity, BMI, FGF-23, ?-klotho, 1,25(OH)2D3, insulin, C-peptide, free T3, HOMA-IR , impaired glucose tolerance, prediabetes
Aim: Obesity is known to cause metabolic disturbances such as insulin resistance, prediabetes and dyslipidemia. In addition, the effects of obesity to serum FGF-23 levels have not yet been clarified. Our aims are to measure serum FGF-23 levels in obese children and adolescents; and to reveal the association of FGF-23 with insulin resistance, prediabetes, dyslipidemia and other metabolic syndrome parameters. Material and Method: The patient group included children with obesity aged 5-17 years (n=46) and the control group included healthy children in the same age range (n=46). FGF-23, ?-klotho, Ca, P, PTH, ALP, 1,25(OH)2D3, fasting glucose, insulin, C-peptide, fT3, fT4 and TSH levels were measured in serum and HOMA-IR ( Homeostasis model assessment of insulin resistance) values were calculated in two groups. Oral glucose tolerance test (OGTT) was performed, HbA1c, serum total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglyceride levels were measured, and Z-scores were calculated via DEXA (Dual energy X-ray absorbtiometry) in obese group. Results: FGF-23, ?-klotho, 1,25(OH)2D3 levels were significantly lower and fasting insulin, fasting glucose, C-peptide, HOMA-IR , and ALP levels were significantly higher in the obese group (p<0.05). Among the obese group, a statistically significant positive correlation was revealed between FGF-23 and ?-klotho (p<0.05), both FGF-23 and ?-klotho revealed a significant negative correlation between fT3 at p<0.05. FGF-23, ?-klotho, 1,25(OH)2D3 levels were significantly higher in the obese subgroup with impaired glucose tolerance (IGT) (p<0.05). Negative correlations were found between FGF-23 and C-peptide, between ?-klotho and triglycerides in the obese subgroup without IGT (p<0.05). Positive correlations were detected between HDL-cholesterol and ?-klotho (p=0.058), between FGF-23 and HDL-cholesterol (p<0.05) in the same subgroup. Conclusion: We believe that hiperinsulinemia in obesity and/or lower 1,25(OH)2D3 levels may lead to low levels of FGF-23 in the obese group. Key Words: Obesity, BMI, FGF-23, ?-klotho, 1,25(OH)2D3, insulin, C-peptide, free T3, HOMA-IR , impaired glucose tolerance, prediabetes
Açıklama
Anahtar Kelimeler
Çocuk Sağlığı ve Hastalıkları, Child Health and Diseases
