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Amaç: Çölyak hastalığında kalsiyum ve D vitamini eksikliğine bağlı metabolik kemik hastalığı en sık ekstraintestinal semptomlardan biridir. Bu çalışmada, çölyak hastalığı olan çocuklarda tanı esnasında kemik mineral yoğunluğunun değerlendirilmesi ve kemik mineral metabolizmasıyla ilişkili faktörlerin değerlendirilmesi amaçlandı. Gereç ve Yöntemler: Çalışmaya hastanemiz çocuk gastroenteroloji bölümünde Aralık 2015-Aralık 2019 tarihleri arasında çölyak hastalığı tanısı alan 43 çocuk hasta alındı. Retrospektif olarak hastaların klinik, antropometrik, patolojik ve laboratuar özellikleri [kalsiyum, fosfor, alkalenfosfataz (ALP), parathormon (PTH), 25-OH vitamin D düzeyleri] incelendi. Tanıda Dual Energy X-Ray Absorptiometry (DEXA) yöntemi ile ölçülmüş olan lumbal (L1-L4) kemik mineral yoğunluğu düzeyleri değerlendirilerek kronolojik yaşa ve boy yaşına göre Z-skorları hesaplandı. Bulgular: Ortalama yaşları 9,9±4,8 (2,5-17,7) yıl olan 43 hastanın (34 kız/9 erkek) verileri değerlendirildi. %30,2’si (n=13) 0-6 yaş, %30,2’si (n=13) 7-11 yaş aralığında ve % 39,5’i (n=17) 11 yaş üzerindeydi. Yaşa göre KMY Z-skoru -0,83±1,1 (-3,6-1,6), boy yaşına göre KMY Z-skoru -0,18±1,1 (-3,6-1,8) saptandı. Hastaların %51,2’sinde (n=22) yaşa göre KMY Z-skoru>-1, %34,9’unda (n=15) -1 ve -2 arasında ve %14’ünde (n=6) <-2 saptandı. Yaşa göre KMY Z-skorunun<-2 olma oranı 11 yaştan büyük çocuklarda anlamı olarak yüksekti (p<0,001). Hastaların KMY Z-skorları ile serum D vitamini, kalsiyum, fosfor, ALP ve PTH düzeyleri arasında ilişki saptanmadı (p>0,050). Sonuç: Çölyak hastalarında tanı yaşının gecikmesi kemik mineral yoğunluğunu olumsuz etkilemektedir. Erken yaşta tanı konulması kemik mineral kaybını engeller ve osteopeni/osteoporoz gelişmiş olan hastalarda tedavi olanağı sağlayarak morbiditeyi azaltır.
Purpose: Metabolic bone disease associated with a deficiency of calcium and vitamin D in cranberry disease is one of the many extra-intestinal symptoms. This study was aimed at assessing the bone mineral intensity during diagnosis in children with dirt disease and assessing the factors associated with bone mineral metabolism. Tools and Methods: Study at our hospital’s children’s gastroenterology department was taken to 43 children who were diagnosed with malaria between December 2015-December 2019. The clinical, anthropometric, pathological and laboratory characteristics of patients were studied retrospectively [calcium, phosphorus, alkaline phosphatase (ALP), parathormone (PTH), 25-OH vitamin D levels]. In the diagnosis, the lumbal (L1-L4) bone mineral intensity levels, which were measured by the Dual Energy X-Ray Absorptiometry (DEXA) method, were assessed and Z scores were calculated according to chronological age and age. Results: Data of 43 patients (34 girls/9 men) with an average age of 9.9±4.8 (2,5-17.7) years were evaluated. 30.2 percent (n=13) were 0-6 years old, 30.2 percent (n=13) were 7-11 years old and 39.5 percent (n=17) were over 11 years old. By age, KMY Z score was -0,83±1,1 (-3,6-1,6), and by age, KMY Z score was -0,18±1,1 (-3,6-1,8). In 51.2 percent of patients (n=22) the KMY Z score was identified according to age>-1, in 34.9 percent (n=15) between -1 and -2 and in 14 percent (n=6) <-2. According to age, the rate of KMY Z-score<-2 was significantly higher in children over the age of 11 (p<0,001). There is no relationship between patients’ KMY Z scores and serum vitamin D, calcium, phosphorus, ALP and PTH levels (p>0,050). The result: the delay in diagnosis age in malaria patients has a negative impact on the bone mineral intensity. Early diagnosis prevents bone mineral loss and reduces morbidity by providing treatment in patients with osteopenia/osteoporosis.
Aim:Metabolic bone disorders due to calsium and vitamin D deficiency are one of the most frequent extraintestinal symptoms in Celiac disease. In this study it is aimed to evaluate bone mineral density in patients with Celiac disease during diagnose and evaluate the factors related to bone mineral metabolism. Material and Methods: The study included 43 children diagnosed as Celiac disease between December 2015 and December 2019. Clinical, anthropometric, patological and laboratory (calsiyum, phosphor, alkalenphosphataz (ALP), parathormon (PTH), 25 OH vitamin D levels) properties of patients were detected retrospectively. Lumbal (L1-L4) bone mineral density levels measured via DEXA (Dual Energy X-Ray Absorptiometry) were evaluated and Z scores due to cronological age and height age were calculated. Results: Mean age of 43 patients (34 girl/9 boys) was 9.9±4.8 (2.5-17.7) years. 30.2% (n=13) was 0-6 years old, 30.2% (n=13) was 7-11 years and 39.5% (n=17) was over 11 years. BMD Z score due to chronological age was -0.83±1.1 (-3.6-1.6) and -0.18±1.1 (-3.6-1.8) due to height age. BMD Z scores due to chronological age was >-1 in 51.2% of the patients (n=22), between -1 and -2 in 34.9% (n=15) and <-2 in 14% (n=6). BMD Z scores due to chronological age < -2 in over 11 age was statistically high (p<0.001). No relation between BMD Z scores and plasma vitamin D, Ca, P, ALP and PTH levels (p>0.050). Conclusion: Delayed diagnose ages effects bone mineral density negatively in Celiac disease. Diagnose in early ages decreases bone mineral leak and decreases morbidity in patients with osteopeni and osteoporosis via treatment posibilities.
Field : Sağlık Bilimleri
Journal Type : Uluslararası
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