Erişkin astımında vitamin D düzeyleri ve astım kontrolüne etkisi
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Dosyalar
Tarih
2016
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
AMAÇ: Bu çalışmada; D vitamini düşük olan hastalarda astım kontrolünün daha güç olabileceği hipotezinden yola çıkılarak; Vitamin D ile erişkin astımı arasındaki ilişkiyi kendi hasta grubumuzda araştırmak, serum vitamin D düzeyleri ile astım şiddeti arasındaki ilişkiyi ve vitamin D eksikliğinin astım kontrolüne etkisini değerlendirmek amaçlanmıştır. GEREÇ VE YÖNTEM: Kliniğimiz astım polikliniğinde düzenli olarak izlenen kayıtlı astım olgularının verileri, vitamin D düzeyleri ile kontrol durumu arasındaki ilişkiyi saptamak amacıyla retrospektif olarak değerlendirilmiş, eksiklikler prospektif olarak tamamlanmaya çalışılmıştır. Kontrol grubu olarak da göğüs hastalıklarına başvurusu olan ve tetkikleri yapılan, ancak anlamlı solunumsal patoloji saptanmayan erişkin olguların verileri alınmıştır. Astım grubunda; astım dışı hastalığın olmaması, D vitamini düzeyini etkileyecek ilaç kullanımı veya hastalıkların bulunmaması, VKİ≥35 olması dikkate alınmıştır. D vitamini için 25(OH)D değerleri kullanılmıştır. Serum 25(OH)D düzeyinin >30 ng/ml olmasını yeterli D vitamini düzeyi, 20-30 ng/ml arasında olmasını D vitamini yetersizliği, <20 ng/ml olmasını D vitamini eksikliği ve <10 ng/ml olması ciddi D vitamini eksikliği olarak kabul edilmiştir. BULGULAR: Çalışmamızda Ege Üniversitesi Tıp Fakültesi Göğüs Hastalıkları Polikliniklerine Mayıs 2014 – Mayıs 2016 tarihleri arasında başvuran hastalardan herhangi bir nedenle D vitamini bakılan 329 hasta dosyası taranmıştır. 25 atak döneminde ve 77 stabil döemde toplam 102 astım tanısı olan hasta ve benzer özelliklere sahip 62 sağlıklı yetişkinin verileri kontrol grubu olarak alınmıştır. Kontrol grubu ve astım grubu D vitamin düzeyleri arasında anlamlı fark gözlenmedi ( p=0.047). Stabil dönem astım hastaları (43.93±24.06 ng/ml) ile atak grubu astım hastalarının(29.96±18.96 ng/ml) D vitamini düzeyi karşılaştırıldığında atak grubunda D vitamini düzeyinin daha düşük olduğu görüldü (p=0.07). Astım hastalarında D vitamini eksikliği olan grup ile D vitamini eksikliği olmayan grup karşılaştırıldığı zaman, D vitamini eksikliği olan grubun VKİ'nin daha yüksek olduğu izlenmiştir (30.54±4.91 kg/m2, 28.31±5.38 kg/m2; p=0.035). D vitamini düzeyi ile FEV1 değeri arasında doğrusal bir ilişki saptanmış, bu ilişkinin, VKİ ve diğer değiştirici faktörlerden bağımsız olduğu görülmüştür (p<0.001). Astım kontrol anketine göre kontrol altında olmayan hastalarda D vitamini değeri daha düşük bulunmuştur (47.76±24.11, 30.55±19.03; p<0.001). SONUÇ Çalışmamızda astımlı hasta grubu ile sağlıklı grup arasında D vitamini düzeyi açısından anlamlı fark saptanmamış, stabil astımlı hastalar ile atak dönemindeki astımlı hastalar arasındaki fark anlamlı bulunmuştur. Ayrıca, D vitamini düzeyi düşük olan hastaların solunum fonksiyon testi değerlerinin de düşük olduğu gözlenmiştir. Kontrol altında olmayan astımlı hastalarda kontrolü güçleştiren nedenlerden biri olarak D vitamini düzeylerinin dikkate alınması gerekliliği sonucuna varılmış, D vitamini düzeyi düşük olan astım hastalarında astım kontrolünün daha zor olduğu görüşü desteklenmiştir.
OBJECTIVE: The aim of this study was to investigate the relationship between vitamin D and adult asthma in our patient group, the relationship between serum vitamin D levels and severity of asthma and the effect of vitamin D deficiency on asthma control. MATERIAL AND METHOD: We retrospectively evaluated the relationship between level of vitamin D and control status in patients with asthma who were followed up regularly in Ege University Faculty of Medicine Chest Diseases Policlinic in asthma clinic and the deficiencies were tried to be completed prospectively. The data of adult cases who were applied for thoracic diseases in the clinic and were not detected significant respiratory pathology were taken as a control group. In the asthma group, non-asthmatic disease, using drug to affect the vitamin D level, absence of illness and BMI≥35 was considered. 25(OH)D values for vitamin D were used. Serum 25-30 (OH) D level> 30 ng/mL is accepted adequately vitamin D level, between 20-30 ng/mL is accepted Vitamin D inadequency, <20 ng/mL is D vitamin deficiency and <10 ng/mL is severe D vitamin deficiency. RESULTS: Total of 329 patients' level of vitamin D were screened from patients who applied to the Ege University Faculty of Medicine Chest Diseases Polyclinics between May 2014 and May 2016. A total of 102 asthmatic patients whose of 25 are episodes and 77 patients are stable periods and 62 healthy adults with similar characteristics as the control group were evaluated. There was no significant difference between vitamin D levels of asthmatic group and control group (p=0.047). When the level of vitamin D were compared between asthmatic patients with asthma (43.93±24.06 ng/ml) and asthmatic patients with exacerbation (29.96±18.96 ng/ml), it was observed that the level of vitamin D of the exacerbated patients were lower (p=0.07). When the group with vitamin D deficiency was compared with the group without vitamin D deficiency in asthmatic patients, it was observed that the group with vitamin D deficiency was higher in BMI (30.54±4.91 kg/m2, 28.31±5.38 kg/m2);(p=0.035). There was a linear relationship between level of vitamin D and FEV1 level, which was found to be independent of BMI and other modifying factors (p<0.001). According to the asthma control questionnaire, level of vitamin D was found to be lower in patients not under control (47.76±24.11, 30.55±19.03, p<0.001). CONCLUSION: There was no significant difference in level of vitamin D between our asthmatic patient group and healthy group, and the difference between stable asthmatic patients and asthmatic patients was found to be significant in this study. It was also observed that both pulmonary function test values of patients and level of vitamin D were low. One of the reasons for controlling patients in uncontrolled asthmatics is the need to consider level of vitamin D, which is supported by the view that asthmatic patients with low level of vitamin D are more difficult to control.
OBJECTIVE: The aim of this study was to investigate the relationship between vitamin D and adult asthma in our patient group, the relationship between serum vitamin D levels and severity of asthma and the effect of vitamin D deficiency on asthma control. MATERIAL AND METHOD: We retrospectively evaluated the relationship between level of vitamin D and control status in patients with asthma who were followed up regularly in Ege University Faculty of Medicine Chest Diseases Policlinic in asthma clinic and the deficiencies were tried to be completed prospectively. The data of adult cases who were applied for thoracic diseases in the clinic and were not detected significant respiratory pathology were taken as a control group. In the asthma group, non-asthmatic disease, using drug to affect the vitamin D level, absence of illness and BMI≥35 was considered. 25(OH)D values for vitamin D were used. Serum 25-30 (OH) D level> 30 ng/mL is accepted adequately vitamin D level, between 20-30 ng/mL is accepted Vitamin D inadequency, <20 ng/mL is D vitamin deficiency and <10 ng/mL is severe D vitamin deficiency. RESULTS: Total of 329 patients' level of vitamin D were screened from patients who applied to the Ege University Faculty of Medicine Chest Diseases Polyclinics between May 2014 and May 2016. A total of 102 asthmatic patients whose of 25 are episodes and 77 patients are stable periods and 62 healthy adults with similar characteristics as the control group were evaluated. There was no significant difference between vitamin D levels of asthmatic group and control group (p=0.047). When the level of vitamin D were compared between asthmatic patients with asthma (43.93±24.06 ng/ml) and asthmatic patients with exacerbation (29.96±18.96 ng/ml), it was observed that the level of vitamin D of the exacerbated patients were lower (p=0.07). When the group with vitamin D deficiency was compared with the group without vitamin D deficiency in asthmatic patients, it was observed that the group with vitamin D deficiency was higher in BMI (30.54±4.91 kg/m2, 28.31±5.38 kg/m2);(p=0.035). There was a linear relationship between level of vitamin D and FEV1 level, which was found to be independent of BMI and other modifying factors (p<0.001). According to the asthma control questionnaire, level of vitamin D was found to be lower in patients not under control (47.76±24.11, 30.55±19.03, p<0.001). CONCLUSION: There was no significant difference in level of vitamin D between our asthmatic patient group and healthy group, and the difference between stable asthmatic patients and asthmatic patients was found to be significant in this study. It was also observed that both pulmonary function test values of patients and level of vitamin D were low. One of the reasons for controlling patients in uncontrolled asthmatics is the need to consider level of vitamin D, which is supported by the view that asthmatic patients with low level of vitamin D are more difficult to control.
Açıklama
Anahtar Kelimeler
Astım, D Vitamini, Astım Atak, Astım Kontrol, Asthma, Vitamin D, Asthma Exacerbation, Asthma Control
