Ankilozan spondilitli hastalarda d vitamini düzeyinin hastalık aktivitesi ve inflamatuar parametreler üzerine etkisi
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Dosyalar
Tarih
2014-08-25
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Cilt Başlığı
Yayıncı
Selçuk Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Vitamin D kalsiyum, fosfor ve kemik metabolizmasında önemli rol oynayan bir vitamindir. İn vitro çalışmalar D vitamininin T hücre proliferasyonunu inhibe ettiğini, Th1 sitokinlerinden IL-2, IFN-γ, TNF-α salınımını azalttığı gösterilmiştir. İn vivo çalışmalar, vitamin D desteğinin kemirgenlerde inflamatuar artrit gelişimini ve progresyonunu önlediğini göstermiştir. Literatürde vitamin D düzeyi ile AS'de hastalık aktivitesini araştıran çalışmalar bulunmaktadır. AS'de vitamin D düzeyi ile inflamatuar parametreler olan, IL-1, IL-6, ADMA, SDMA, arginin, sitrülin arasındaki ilişkiyi araştıran çalışma bulunmamaktadır. Bu çalışmada AS'li hastalarda D vitamini düzeyi ile hastalık aktivitesi ve inflamatuar parametreler arasındaki ilişkiyi ortaya koymak amaçlanmıştır. Çalışmamız, bu ilişkiyi ortaya koyan literatürdeki ilk çalışma olma özelliğine sahiptir. Çalışmamıza vitamin D düzeyi <20 ng/ml, yaş ortalaması 39.91±10.28 yıl (18-65 yaş arası), hastalık süresi 5.58±7.26 yıl (0-35 yıl) olan, anti-TNF-α tedavi almayan 48 kadın, 34 erkek toplam 82 AS hastası alındı. Vitamin D değeri <20 ng/ml ve ≥20 ng/ml iken BASDAI, BASFI, sedimantasyon, CRP, kalsiyum, fosfor, albumin, ALP, PTH, TSH, TNF-α, IL-1, IL-6, ADMA, SDMA, LNMMA, arginin, arginin/ADMA oranı ve sitrülin düzeylerine bakıldı. Vitamin D düzeyi artınca albümin düzeyinin arttığı, parathormon, IL-1 ( 4.86±9.7 ve 3.17±4.05, p<0.001) IL-6 (7.17±14.19 ve 4.75±2.15, p=0.009) , ADMA (0.8±0.21 ve 0.49±0.16, p<0.001) , SDMA (0.93±0.26 ve 0.49±0.20, p<0.001) , LNMMA (0.08±0.02 ve 0.06±0.02, p<0.001), arginin (385.83±106.43 ve 269.22±79.08, p<0.001) ve sitrülin (91.14±34.34 ve 75.3±23.52, p<0.001) düzeyinin azaldığı görüldü. Arginin/ADMA düzeyinde ise artış görüldü. BASDAI, BASFI ve ESR'de düşme görüldü, fakat istatistiksel olarak anlamlı değildi. Sonuç olarak vitamin D düzeyi düşük olan AS hastalarında vitamin D düzeyi yükseldiğinde inflamatuar parametrelerden IL-1, IL-6, ADMA, SDMA, LNMMA, arginin ve sitrülinde düşme, arginin/ADMA oranında artış görülmektedir.
Vitamin D plays an important role in bone metabolism, calcium and phosphorus. Invitro studies showed that vitamin D inhibits T cell proliferation, reduces TNF-α oscillation from Th-1 cytokin IL-2, IFN-ɣ. Invivo studies showed that Vitamin D support prevents development and progression of inflammatory arthritis in rodents. In literature there is no study to investigate the disease activity and inflammatory parameters such as IL-1, IL-6, ADMA, SDMA, arginine, sitruline and arginine/ADMA ratio when the vitamin D level is low (<20 ng/mL) and high (≥20 ng/mL) in patients with AS. In this study, we aimed to determine the relationship between vitamin D level and disease activity and inflammatory parameters in patients with AS. Our study have the property of being the first in literature that reveals the relationship. 48 women, 34 men, in total 82 AS patient who did not take anti-TNF treatment, at <20 ng/ml vitamin D level, at avarage of age 39.91 ± 10.28 years (between the age 18 and 65), with 5.58 ± 7.26 years (0-35 year) disease duration, has been taken to our study. BASDAI, BASFI, sedimentation, CRP, calcium, phosphorus, albumin, ALP, PTH, TSH, TNF-α, IL-1, IL-6, ADMA, SDMA, LNMMA, arginine, arginine/ADMA ratio and sitruline levels were analyzed when vitamin D level is <20 ng/ml and ≥ 20 ng/ml. It has been seen that when vitamin D level rises, albumin levels rises also, and levels of parathormon, IL-1 (4.86 ± 9.7 and 3.17±4.05, p<0.001) IL-6 (7.17±14.19 and 4.75±2.15, p=0.009) , ADMA (0.8±0.21 and 0.49±0.16, p<0.001), SDMA (0.93±0.26 and 0.49±0.20, p0.001), LNMMA (0.08±0.02 and 0.06±0.02, p<0.001), arginine (385.83 ± 106.43 and 269.22±79.08, p<0.001) and sitruline (91,14±34,34 and 75,3±23,52, p<0,001) reduces. In the levels of arginine/ADMA raise has been seen (498.72±136.51 and 576.74±170.76, p<0.001) . In BASDAI, BASFI and ESR descent has been seen but it was statistically meaningless. Consequently, in patients with AS, who has low level of vitamin D, in inflammatory parameters such as IL-1, IL-6, ADMA, SDMA, LNMMA, arginine and sitruline descent, in arginine/ADMA raise has been seen as the level of vitamin D rises.
Vitamin D plays an important role in bone metabolism, calcium and phosphorus. Invitro studies showed that vitamin D inhibits T cell proliferation, reduces TNF-α oscillation from Th-1 cytokin IL-2, IFN-ɣ. Invivo studies showed that Vitamin D support prevents development and progression of inflammatory arthritis in rodents. In literature there is no study to investigate the disease activity and inflammatory parameters such as IL-1, IL-6, ADMA, SDMA, arginine, sitruline and arginine/ADMA ratio when the vitamin D level is low (<20 ng/mL) and high (≥20 ng/mL) in patients with AS. In this study, we aimed to determine the relationship between vitamin D level and disease activity and inflammatory parameters in patients with AS. Our study have the property of being the first in literature that reveals the relationship. 48 women, 34 men, in total 82 AS patient who did not take anti-TNF treatment, at <20 ng/ml vitamin D level, at avarage of age 39.91 ± 10.28 years (between the age 18 and 65), with 5.58 ± 7.26 years (0-35 year) disease duration, has been taken to our study. BASDAI, BASFI, sedimentation, CRP, calcium, phosphorus, albumin, ALP, PTH, TSH, TNF-α, IL-1, IL-6, ADMA, SDMA, LNMMA, arginine, arginine/ADMA ratio and sitruline levels were analyzed when vitamin D level is <20 ng/ml and ≥ 20 ng/ml. It has been seen that when vitamin D level rises, albumin levels rises also, and levels of parathormon, IL-1 (4.86 ± 9.7 and 3.17±4.05, p<0.001) IL-6 (7.17±14.19 and 4.75±2.15, p=0.009) , ADMA (0.8±0.21 and 0.49±0.16, p<0.001), SDMA (0.93±0.26 and 0.49±0.20, p0.001), LNMMA (0.08±0.02 and 0.06±0.02, p<0.001), arginine (385.83 ± 106.43 and 269.22±79.08, p<0.001) and sitruline (91,14±34,34 and 75,3±23,52, p<0,001) reduces. In the levels of arginine/ADMA raise has been seen (498.72±136.51 and 576.74±170.76, p<0.001) . In BASDAI, BASFI and ESR descent has been seen but it was statistically meaningless. Consequently, in patients with AS, who has low level of vitamin D, in inflammatory parameters such as IL-1, IL-6, ADMA, SDMA, LNMMA, arginine and sitruline descent, in arginine/ADMA raise has been seen as the level of vitamin D rises.
Açıklama
Anahtar Kelimeler
ADMA, Ankilozan spondilit, Arginin/ADMA, İnterlökin 1, İnterlökin 6, Vitamin D, Arginine/ADMA, Interleukin 1, Interleukin 6
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Eşmen, S. E. (2014). Ankilozan spondilitli hastalarda d vitamini düzeyinin hastalık aktivitesi ve inflamatuar parametreler üzerine etkisi. Selçuk Üniversitesi, Yayımlanmış uzmanlık tezi, Konya.
