ÖZET

Amaç:

Postmenopozal kadınlarda kemik mineral yoğunluğunun (KMY) nutrisyonel durum ve serum bakır (Cu), çinko (Zn), selenyum (Se) ve manganez (Mn) seviyeleri ile olan ilişkisi tam olarak aydınlatılamamıştır. Bu nedenle postmenopozal kadınların KMY değerlerine göre nutrisyonel durumunu objektif bir indeks ile değerlendirerek Cu, Zn, Se ve Mn ile arasında bir ilişki olup olmadığını incelemeyi amaçladık.

Gereç ve Yöntem:

Çalışmada postmenopozal olan 105 kadın üç gruba ayrıldı; kontroller (kontrol grup, n=30, T-skoru >-1,0), osteopenik hastalar (osteopenik grup, n=30, T-skoru >-2,5) ve osteoporotik hastalar (osteoporotik grup, n=45, T-score ≤-2,5). Hastaların nutrisyonel durumlarının belirlenmesinde serum albümin ve total lenfosit sayısını içeren prognostik nutrisyonel indeks (PNI) kullanıldı. Cu, Zn, Se ve Mn eser elementlerinin serum seviyeleri belirlendi. KMY ile PNI ve eser elementlerin serum seviyeleri arasındaki ilişki incelendi.

Bulgular:

Katılımcıların ortalama yaş ve vücut kitle indeksi (VKİ) tüm gruplarda benzerdi. [Kontrol grubu (yaş, 63,4±5,2 yıl; VKİ, 33,7±5,6 kg/m²); osteopeni grubu (yaş, 64,6±5,3 yıl; VKİ, 33,5±5,9 kg/m²) ve osteoporozis grubu (yaş, 65,8±5 yıl; VKİ, 30,9±7,2 kg/m²)]. Osteoporoz grubunda; PNI, albümin, serum Cu ve Zn seviyelerinin kontrol grubuna göre anlamlı şekilde daha düşük olduğu (p<0,05) ve lomber total KMY değerleri ile PNI, albümin ve serum Mn seviyesi arasında pozitif zayıf bir korelasyon olduğu bulundu (p<0,05). Ayrıca osteoporoz grubunda PNI ile serum Zn seviyesi arasında pozitif orta düzeyde bir korelasyon olduğu tespit edildi (p=0,045, r=0,063).

Sonuç:

Postmenopozal osteoporoz hastalarında özellikle düşük serum albümin düzeyi ve/veya düşük PNI değeri lomber bölgedeki total KMY’yi olumsuz yönde etkileyebilir. Ayrıca düşük PNI değeri olan osteoporoz hastalarında Zn takviyesinin yapılması potansiyel ek bir tedavi stratejisi olabilir. Bununla birlikte Cu ve Mn bileşiklerinin takviyesi mevcut tedavilere ek olarak fayda sağlayabilir.

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Postmenapozal Kadınlarda Kemik Mineral Yoğunluğunun Prognostik Nutrisyonel İndeks ve Eser Elementler ile Olan İlişkisi

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