Turkiye Klinikleri Journal of Pediatrics

.: ORIGINAL RESEARCH
Çölyak Hastalığı Olan Çocuklarda Beslenme Durumu ve Mikro Besin Yetersizliklerinin Değerlendirilmesi
Evaluation of Micronutrient Deficiencies and Growth in Children with Celiac Disease
Suna SELBUZa
aSağlık Bilimleri Üniversitesi Keçiören Eğitim ve Araştırma Hastanesi, Çocuk Gastroenteroloji, Hepatoloji ve Beslenmesi Kliniği, Ankara, TÜRKİYE
Turkiye Klinikleri J Pediatr. 2021;30(1):48-55
doi: 10.5336/pediatr.2020-77962
Article Language: TR
Full Text
ÖZET
 Amaç: Gelişme geriliği ve mikro besin eksiklikleri çölyak hastalığı (ÇH)nın iyi bilinen komplikasyonlarıdır. Bu araştırmada, birincil olarak çölyak tanısı ile izlenen hastaların besleme ve büyüme durumlarının değerlendirmesi ve sağlıklı çocuklarla karşılaştırılması, ikincil olarak çölyak hastalarında diyete uyumun besleme ve büyüme durumuna etkisinin incelemesi amaçlanmıştır. Gereç ve Yöntemler: Çalışma, Haziran 2017 ve Aralık 2019 tarihleri arasında yapıldı. Hastalar, yeni tanılı ve takipli çölyak hastaları olarak 2 gruba ayrıldı. Takipli çölyak hastaları en az 1 yıldır izlemde olan hastalardan seçildi ve glutensiz diyet uyumuna göre 2 gruba ayrıldı. Hastaların sosyodemografik, antropometrik özellikleri ve laboratuvar değerleri kaydedildi. Büyüme geriliği (BG), yaşa göre boy z (YBZ) skorunun <-2 olması, beslenme yetersizliği, yaşa göre vücut ağırlığı z (YVZ) skorunun <-2 olması, kronik malnütrisyon beden kitle indeksi z (BKİZ) skorunun <-2 olması ve obezite BKİZ >+2 olması olarak tanımlandı. Bulgular: Çalışmaya, 70 çölyak hastası ve 57 sağlıklı çocuk alındı. Çölyak hastalarında yetersiz beslenme, BG ve kronik malnütrisyon prevalansı sırasıyla %24,3, %17,1 ve %14,3'tü. Çölyak grubunun ortalama YVZ, YBZ ve BKİZ skorları sırasıyla -1,2, -0,92 ve -1,0'dı ve kontrol grubununkinden anlamlı olarak düşük saptanırken, diyet uyumu iyi olan hastalarda bu farkın kısmen kapandığı gözlendi. Çölyak hastalarında D vitamini, çinko, demir ve A vitamini eksiklikleri en sık görülen mikro besin eksiklikleriydi Sonuç: Çalışmamız, tanı anında ÇH'nin yaygın bir şekilde gelişme geriliği ile birlikte görülmesine rağmen bu çalışmaya dâhil edilen hastaların büyük bir kısmında gelişme geriliği gözlemlenmediğini, hastaların bir kısmında diyet uyumunun iyi olmasına rağmen gelişme geriliğinin ve yetersiz beslenmenin devam ettiğini ve yeni tanı alan ve takipli çölyak hastalarında mikro besin eksikliklerinin görülme sıklığının yüksek olduğunu ortaya koymuştur.

Anahtar Kelimeler: Çölyak hastalığı; büyüme; vitaminler; mineraller
ABSTRACT
 Objective: Growth retardation and micronutrient deficiencies are well-known complications of celiac disease (CD). In this study, it was aimed primarily to evaluate the nutritional and growth status of patients with celiac disease and to compare them with healthy children, and secondarily to examine the effect of dietary compliance on feeding and growth status in these patients. Material and Methods: The study was conducted between June 2017 and December 2019. Celiac patients were grouped as newly diagnosed and follow-up. Follow up children with celiac disease were chosen from at least one-year disease follow-up and grouped into two according to their compliance to glutenfree diet. The patients' sociodemographic and anthropometric features and laboratory values were recorded. Growth retardation was considered if height-for-age z-scores (HAZ) were below -2; undernutrition if weightfor-age z-scores were below -2, severe malnutrition if weight-for-age zscores (WAZ) were below -2 and obesity was considered if body mass index z scores (BMIZ) were above +2. Results: Seventy celiac patients and 57 healthy children were included in the study. The prevalence of malnutrition, growth retardation and chronic malnutrition in celiac patients was 24.3%, 17.1% and 14.3%, respectively. The mean YVZ, YBZ and BMI scores of the celiac group were -1.2, -0.92 and -1.0, respectively, and were significantly lower than those of the control group, while this difference was partially closed in patients with good dietary compliance. Vitamin D, zinc, iron and vitamin A deficiencies were the most common micronutrient deficiencies in patients with celiac disease. Conclusion: Our study revealed that although growth retardation can be seen in patients with celiac disease at diagnosis, there was no growth retardation in most of the our patients, catch up growth did not occur in some patients with CD, and the frequency of micronutrient deficiencies were high in both newly diagnosed and followed-up celiac patients.

Keywords: Celiac disease; growth; vitamins; minerals
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5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com