Juvenil Sistemik Lupus Eritematozus Hastalarının Beslenme Durumları İle Kardiyovasküler Risk Faktörleri ve Serum Adipokin Düzeyleri Arasındaki İlişkinin Değerlendirilmesi

Abstract

In systemic lupus erythematosus (SLE), nutritional therapy has a great importance in the prevention and treatment of complications such as atherosclerosis, dyslipidemia, diabetes, metabolic syndrome and obesity. The aim of this study was to determine the relationship between nutritional status with dietary patterns and cardiovascular risk factors with serum adipokine (leptin, adiponectin) levels in adolescents with SLE. A total of 48 adolescents 24 adolescents with SLE (cases) and 24 healthy adolescents (control) were enrolled in the study in Rheumatology Unit of Hacettepe University Ihsan Dogramaci Children's Hospital. A questionnaire was applied to evaluate the general characteristics, health status, food consumption frequency and anthropometric measurements of the individuals and blood samples were taken for serum adipokine levels and other biochemical findings (blood lipid profile, vitamin D, vitamin B12, B6 and homocysteine). KIDMED quality index was applied. SLE patients were followed up for 12 weeks in order to evaluate the effectiveness of nutrition education given to patients at the beginning of the study. Waist circumference, body mass index (BMI), body fat ratio (%) and waist/height ratio of SLE patients were significantly higher than the control group (p <0.05). A linear correlation was found between the disease activity index (SLEDAI) and body weight, BMI, body fat ratio and waist circumference (p <0.05).There was no statistically significant difference between the two groups in terms of energy and macro nutrient intake (p> 0.05). On the other hand, carbohydrate and fat energy ratios of the individuals in the case group were found to be significantly higher than the control group (p <0.05). Vitamin D deficiency ((30ng / dL) was determined in 95.8% of the adolescents in both groups and no significant difference was found between the groups (p> 0.05). The HDL levels of the adolescents in the case group (50.3 ± 13.2 mg / dL) were significantly lower than the control group (58.6 ± 10.9 mg / dL) and the total cholestereol / HDL ratio was higher (case: 3.2 ± 0.8, control: 2.7 ± 0.5) (p <0.05). When adipokine levels compared, leptin levels of the case group were found to be significantly higher than the control group (case: 166.34 ± 167.4 pg / mL, control: 52.8 ± 59.4pg / mL) (p <0.05). Serum leptin levels were linearly correlated with serum triglycerides (r = 0.535), LDL (r = 0.324) and total cholesterol (r = 0.349) levels (p <0.05). In the second phase of the study, which evaluated the effectiveness of nutritional education, there was a statistically significant (p <0.05) increase in BMI although total fat, saturated fat and sodium intake decreased (p <0.05), fiber, vitamin C, potassium, magnesium, phosphorus and folate intake was found to be increased (p <0.05). Statistically insignificant increase in diet quality index (KIDMED) scores (baseline: 4.7 ± 2.3, 12 weeks later: 5.5 ± 2.4) was detected (p> 0.05). There was no difference in blood lipid levels, but there was an increase in serum leptin levels. As a result of this study, it was shown that nutritional status and diet patterns of SLE adolescents had a significant relationship between cardiovascular risk factors. Nutritional therapy and education are important in the prevention and treatment of complications such as atherosclerosis, dyslipidemia, metabolic syndrome and obesity in SLE patients.