.: ORİJİNAL ARAŞTIRMA
Çocuklarda Eser Elementler ve Kronik Kabızlık Arasındaki İlişkinin Değerlendirilmesi-Vaka Kontrol Çalışması
Evaluation of the Relationship Between Trace Elements and Chronic Constipation in Children-Case Control Study
Turkiye Klinikleri J Pediatr. 2023;32(3):122-8
doi: 10.5336/pediatr.2023-97670
Makale Dili: TR
Tam Metin
Ücretsiz Erişim
ÖZET
Amaç: Kronik kabızlık çocukluk çağında en sık görülen hastalıklardan biridir ve çocuklardaki kabızlık vakalarının %95'i fonksiyoneldir. Bağırsak ekosistemindeki bozulmanın kabızlık ile yakından ilişkili olduğu gösterilmiştir. Bakır (Cu), çinko (Zn), krom (Cr) ve selenyum (Se) önemli eser elementlerdir, vücuttaki tüm sistemlerin normal işleyişinde önemli rol oynarlar ve bağırsak ekosistemi için çok önemlidirler. Bu çalışmanın amacı, çocuklarda kronik kabızlıkta eser elementlerin rolünü araştırmaktır. Gereç ve Yöntemler: Bu çalışma, Ocak-Ekim 2020 tarihleri arasında çocuk gastroenteroloji polikliniğinde Roma IV kriterlerine göre kronik kabızlık tanısı alan pediatrik hastalarda gerçekleştirildi. Kronik kabızlığı olan hastaların serum bakır, çinko, krom ve selenyum konsantrasyonları ölçüldü. Bulgular: Çalışma grubu kronik kabızlığı olan 61 (%59 kız, %41 erkek; yaş: 6,9±4,7 yıl) çocuk; kontrol grubu 30 (%60 kız, %40 erkek; yaş: 7,0±3,3 yıl) sağlıklı çocuktan oluşuyordu. Eser element düzeylerine göre gruplar arasında anlamlı farklılık yoktu (tüm analizler için p>0,05). Cu seviyeleri ile yaş arasında zayıf, negatif bir ilişki bulundu (r=-0,266, p=0,038). Se ile konstipasyon süresi arasında zayıf, pozitif bir ilişki bulundu (r=0,324, p=0,011). Cinsiyete göre eser element düzeyleri arasında anlamlı farklar bulunmadı (tüm analizler için p>0,05). Hastaların %23'ünde, kontrol grubunun %26,7'sinde malnütrisyon (hafif) saptandı (p=0,34). Hasta grubu içinde malnütrisyonu olan hastalarda, Se seviyesinin normal kiloda olanlara göre anlamlı yüksek olduğu saptandı (p=0,037). Hasta grubunda Zn ile ağırlık ve boy z skorları arasında negatif yönde zayıf bir korelasyon saptandı (r=-0,260, p=0,043, r=-0,317, p=0,013). Sonuç: Eser elementler, özellikle selenyum, çocuklarda kronik konstipasyon ve konstipasyon süresi ile ilişkili olabilir. Çocuklarda eser elementler ve kabızlık arasındaki ilişkiyi anlamak için daha kapsamlı prospektif çalışmalara ihtiyaç vardır.
Anahtar Kelimeler: Kronik konstipasyon; eser element; çocuk
Amaç: Kronik kabızlık çocukluk çağında en sık görülen hastalıklardan biridir ve çocuklardaki kabızlık vakalarının %95'i fonksiyoneldir. Bağırsak ekosistemindeki bozulmanın kabızlık ile yakından ilişkili olduğu gösterilmiştir. Bakır (Cu), çinko (Zn), krom (Cr) ve selenyum (Se) önemli eser elementlerdir, vücuttaki tüm sistemlerin normal işleyişinde önemli rol oynarlar ve bağırsak ekosistemi için çok önemlidirler. Bu çalışmanın amacı, çocuklarda kronik kabızlıkta eser elementlerin rolünü araştırmaktır. Gereç ve Yöntemler: Bu çalışma, Ocak-Ekim 2020 tarihleri arasında çocuk gastroenteroloji polikliniğinde Roma IV kriterlerine göre kronik kabızlık tanısı alan pediatrik hastalarda gerçekleştirildi. Kronik kabızlığı olan hastaların serum bakır, çinko, krom ve selenyum konsantrasyonları ölçüldü. Bulgular: Çalışma grubu kronik kabızlığı olan 61 (%59 kız, %41 erkek; yaş: 6,9±4,7 yıl) çocuk; kontrol grubu 30 (%60 kız, %40 erkek; yaş: 7,0±3,3 yıl) sağlıklı çocuktan oluşuyordu. Eser element düzeylerine göre gruplar arasında anlamlı farklılık yoktu (tüm analizler için p>0,05). Cu seviyeleri ile yaş arasında zayıf, negatif bir ilişki bulundu (r=-0,266, p=0,038). Se ile konstipasyon süresi arasında zayıf, pozitif bir ilişki bulundu (r=0,324, p=0,011). Cinsiyete göre eser element düzeyleri arasında anlamlı farklar bulunmadı (tüm analizler için p>0,05). Hastaların %23'ünde, kontrol grubunun %26,7'sinde malnütrisyon (hafif) saptandı (p=0,34). Hasta grubu içinde malnütrisyonu olan hastalarda, Se seviyesinin normal kiloda olanlara göre anlamlı yüksek olduğu saptandı (p=0,037). Hasta grubunda Zn ile ağırlık ve boy z skorları arasında negatif yönde zayıf bir korelasyon saptandı (r=-0,260, p=0,043, r=-0,317, p=0,013). Sonuç: Eser elementler, özellikle selenyum, çocuklarda kronik konstipasyon ve konstipasyon süresi ile ilişkili olabilir. Çocuklarda eser elementler ve kabızlık arasındaki ilişkiyi anlamak için daha kapsamlı prospektif çalışmalara ihtiyaç vardır.
Anahtar Kelimeler: Kronik konstipasyon; eser element; çocuk
ABSTRACT
Objective: Chronic constipation is one of the most common diseases in childhood and 95% of constipation cases in children are functional. It has been shown that disruption in the intestinal ecosystem is closely related to constipation. Copper (Cu), zinc (Zn), chromium (Cr) and selenium (Se) are important trace elements, they play an important role in the normal functioning of all systems in the body and are very important for the intestinal ecosystem. The aim of this study is to investigate the role of trace elements in chronic constipation in children. Material and Methods: This study was carried out in pediatric patients diagnosed with chronic constipation according to Rome IV criteria in the pediatric gastroenterology outpatient clinic between January and October 2020. Serum copper, zinc, chromium and selenium concentrations of patients with chronic constipation were measured. Results: The study group consisted of 61 children with chronic constipation (59% girls, 41% boys; age: 6.9±4.7 years); the control group consisted of 30 healthy children (60% girls, 40% boys; age: 7.0±3.3 years). There was not any significant differences between the groups according to trace element levels (for all analysis, p>0.05). A weak, negative correlation was found between Cu levels and age (r=-0.266, p=0.038). A weak, positive correlation was found between Se and duration of constipation (r=0.324, p=0.011). No significant differences were found between trace element levels by gender (for all analyses, p>0.05). Malnutrition (mild) was detected in 23% of the patients and 26.7% of the control group (p=0.34). In patients with malnutrition in the patient group, Se level was found to be significantly higher than those with normal weight (p=0.037). There was a weak negative correlation between Zn and weight and height z scores in the patient group (r=- 0.260, p=0.043, r=-0.317, p=0.013). Conclusion: Trace elements, especially Selenium, may be associated with chronic constipation and duration of constipation in children. More comprehensive prospective studies are needed to understand the relationship between trace elements and constipation in children.
Keywords: Chronic constipation; trace element; child
Objective: Chronic constipation is one of the most common diseases in childhood and 95% of constipation cases in children are functional. It has been shown that disruption in the intestinal ecosystem is closely related to constipation. Copper (Cu), zinc (Zn), chromium (Cr) and selenium (Se) are important trace elements, they play an important role in the normal functioning of all systems in the body and are very important for the intestinal ecosystem. The aim of this study is to investigate the role of trace elements in chronic constipation in children. Material and Methods: This study was carried out in pediatric patients diagnosed with chronic constipation according to Rome IV criteria in the pediatric gastroenterology outpatient clinic between January and October 2020. Serum copper, zinc, chromium and selenium concentrations of patients with chronic constipation were measured. Results: The study group consisted of 61 children with chronic constipation (59% girls, 41% boys; age: 6.9±4.7 years); the control group consisted of 30 healthy children (60% girls, 40% boys; age: 7.0±3.3 years). There was not any significant differences between the groups according to trace element levels (for all analysis, p>0.05). A weak, negative correlation was found between Cu levels and age (r=-0.266, p=0.038). A weak, positive correlation was found between Se and duration of constipation (r=0.324, p=0.011). No significant differences were found between trace element levels by gender (for all analyses, p>0.05). Malnutrition (mild) was detected in 23% of the patients and 26.7% of the control group (p=0.34). In patients with malnutrition in the patient group, Se level was found to be significantly higher than those with normal weight (p=0.037). There was a weak negative correlation between Zn and weight and height z scores in the patient group (r=- 0.260, p=0.043, r=-0.317, p=0.013). Conclusion: Trace elements, especially Selenium, may be associated with chronic constipation and duration of constipation in children. More comprehensive prospective studies are needed to understand the relationship between trace elements and constipation in children.
Keywords: Chronic constipation; trace element; child
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