Turkiye Klinikleri Journal of Health Sciences

.: ORIGINAL RESEARCH
Akut ve Subklinik Benign Paroksismal Pozisyonel Vertigo Hastalarında D Vitamini ve B12 Eksikliği: Bir Retrospektif Çalışma
Vitamin D and B12 Deficiency in Patients with Acute and Subclinical Benign Paroxysmal Positional Vertigo: A Retrospective Study
Büşra ALTINa, Görkem ERTUĞRULa
aHacettepe Üniversitesi Sağlık Bilimleri Fakültesi, Odyoloji Bölümü, Ankara, Türkiye
Turkiye Klinikleri J Health Sci. 2023;8(1):95-100
doi: 10.5336/healthsci.2022-93538
Article Language: TR
Full Text
ÖZET
Amaç: Benign paroksismal pozisyonel vertigo (BPPV), en sık görülen vertigo ve dizziness nedenidir. Bu retrospektif çalışmanın amacı, akut ve subklinik benign paroksismal pozisyonel vertigo (BPPV) hastalarında D ve B12 vitamini eksikliğinin görülme oranının ve bu eksikliklerin BPPV rekürrensi ile ilişkisinin araştırılmasıdır. Gereç ve Yöntemler: Çalışma kapsamında 38'i erkek, 93'ü kadın toplam 131 BPPV hastasının verileri retrospektif olarak taranmış ve D ve B12 vitamini eksikliğinin görülme oranı araştırılmıştır. Çalışmaya verisi dâhil edilen bireylerin yaş ortalaması 52,89±15,37 (minimum-maksimum: 16- 83 yaş) yıl olarak belirlenmiştir. Hastaların 64'ü (%48,9) akut BPPV, 67'si (%51,1) subklinik BPPV tanısı almıştır. Bulgular: Akut BPPV'lerin %43,8'inde ve subklinik BPPV'lerin %28,4'ünde olmak üzere tüm BPPV hastalarının %35,9'unda D vitamini eksikliği bulunmaktadır. D vitamini eksikliği görülme oranı açısından akut ve subklinik BPPV arasında istatistiksel olarak anlamlı ilişki bulunmamıştır (p=0,40). D vitamini eksikliği olan BPPV hastalarında, BPPV ataklarının en fazla ilk 1 yıl içerisinde tekrarladığı görülmüştür (p=0,01). B12 vitamini eksikliği görülme oranı açısından akut ve subklinik BPPV arasında istatistiksel olarak anlamlı ilişki bulunmamıştır (p=0,07). Benzer şekilde, B12 eksikliği ve BPPV rekürrensi arasında istatistiksel olarak anlamlı bir ilişki bulunmamıştır (p=0,08). Sonuç: Bu çalışmada, D vitamini eksikliği bulunan hastalarda BPPV ataklarının sıklıkla ilk 1 yıl içerisinde tekrarladığı bulunmuştur. Bu bulgular ışığında, BPPV hastalarında D vitamini eksikliğinin sorgulanmasının, hastalığın seyrinin belirlenmesinde klinisyenlere önemli bilgiler sağlayacağı düşünülmektedir.

Anahtar Kelimeler: Vertigo; benign paroksismal pozisyonel vertigo; rekürrens; eksiklik; D vitamini eksikliği
ABSTRACT
Objective: Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo and dizziness. The aim of this retrospective study is to investigate the rate of benign paroxysmal positional vertigo (BPPV) vitamin D and B12 deficiency in acute and subclinical BPPV patients and relationship between the deficiency and recurrence. Material and Methods: The data of 131 BPPV patients, 38 male and 93 female, were examined retrospectively and the rate of vitamin D and B12 deficiency were analyzed. The mean age of the individuals was 52.89±15.37 (minimum-maximum: 16-83 years) years. It was determined that 64 (48.9%) patients had acute BPPV and 67 (51.1%) had subclinical BPPV. Results: Vitamin D deficiency was detected in 35.9% of all BPPV patients, including 43.8% of acute BPPV and 28.4% of subclinical BPPV. There was no statistically significant relationship between acute and subclinical BPPV in terms of the rate of vitamin D deficiency (p=0.40). In BPPV patients with vitamin D deficiency, it was observed that BPPV attacks mostly recurred within the first year (p=0.01). There was no statistically significant relationship between acute and subclinical BPPV in terms of the incidence of vitamin B12 deficiency (p=0.07). Similarly, no statistically significant correlation was found between B12 deficiency and BPPV recurrence (p=0.08). Conclusion: In this study, it was found that BPPV attacks frequently recurred in the first year in patients with vitamin D deficiency. In the light of these findings, it is thought that evaluating vitamin D deficiency in BPPV patients will provide clinicians with important information in determining the process of the disease.

Keywords: Vertigo; benign paroxysmal positional vertigo; recurrence; deficiency; vitamin D deficiency
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