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Yıl:2016; Cilt: 17; Sayı: 3>> Özet
TAM METİN
Anadolu Psikiyatri Dergisi; 2016;17(3):192-202
Tütün kullanım bozukluğu ile serum D vitamini düzeyi arasındaki ilişkinin değerlendirilmesi
T Şengezer, RN Yüksel, T Babacan, H Can, N Dilbaz
Numune Eğitim ve Araştırma Hastanesi, Ankara
Amaç: Son yıllarda, D vitamininin iskelet-kas sistemi ve endokrin sistem üzerindeki etkileri dışında nöroprotektif ve antioksidan etkileri olan bir steroid hormon olduğu üzerinde durulmakta ve metabolik hastalıklar, kanser hastalıkları, nöropsikiyatrik hastalıklar ile D vitamini arasındaki ilişki üzerinde çalışmalar yapılmaktadır. Tüm dünyada pandemik bir D vitamini eksikliğinden söz edilmektedir. Tütün kullanımı ile D vitamini arasında bir ilişki olduğu bildirilmiş olsa da, literatür sınırlıdır ve Türkiye’den tütün kullanımı ile D vitamini ilişkisi ile ilgili bir veri sunulmamıştır. Bu çalışmanın amacı, hastanemiz ‘Sigara Bırakma Birimi’ne başvuranların D vitamini düzeylerini değerlendirmek ve buna göre D vitamini düzeynin tütün kullanım bozukluğu ile ilişkisini araştırmaktır. Yöntem: Çalışmaya sigara bırakma birimine başvuran, 17-69 yaşları arasındaki 72 olgu alındı. Geriye dönük olarak hasta dosyalarında bulunan demografik veri formu, Fagerström Nikotin Bağımlılık Testi (FNBT), Beck Anksiyete Ölçeği (BAÖ), Beck Depresyon Ölçeği (BDÖ) formları incelendi, D vitamini düzeyleri kaydedildi. Parametrelerin normal dağılıma uyup uymadıkları Kolmogorov-Smirnov testi ile değerlendirildi. İstatistiksel analizde Mann-Whitney U testi, Kruskall-Wallis H testi, tek yönlü ANOVA kullanıldı. Sonuçlar p<0.05 anlamlılık düzeyinde değerlendirildi. Bulgular: Olguların yaş ortalaması 46.5±12.3 (17-69) yıl olup, 36’sı (%50) kadındı. Olguların ortalama sigara içme yılı 25.6±12.0 (1-50) yıl, başvuru sırasında kullandıkları günlük sigara adedi ortalama 21.1±9.7 (2-60) adet, FNBT puanı ortalaması 6.2±2.4 (1-10) idi. Cinsiyete göre D vitamini düzeyi açısından anlamlı bir farklılık saptandı. D vitamini düzeyi ile BDÖ puanı arasında düşük, ancak istatistiksel olarak anlamlı ve ters yönlü bir ilişki görüldü. Kaç yıldır sigara içildiği, boy, kilo, yaş, FNBT Puanı ve BAÖ puanı açısından değerlendirildiğinde, bu değişkenlerin D vitamini düzeyleriyle istatistiksel olarak anlamlı bir farklılık oluşturmadığı görüldü. Sonuç: Tütün kullanımı, düşük 25(OH)D düzeyi ile ilişkilidir. Henüz tütün kullanımı ve D vitamini eksikliği ile ilgili düzenekler aydınlatamamış olsa da, D vitamininin nöroprotektif, antioksidan etkileri göz önünde bulundurularak, tütün kullananların rutin muayenelerinde D vitamini düzeylerinin değerlendirilmesi, eksiklik varsa D vitamininin yerine konması ve gün ışığına maruziyetlerinin artırılması yararlı olacaktır.
Evaluation of the relationship between serum vitamin D levels and tobacco use disorder
Objective: In recent years; vitamin D, being a steroid hormone with neuroprotective and anti-oxidant effects apart from the effects on musculoskeletal system and endocrine system has been emphasized and studies on the relation of metabolic diseases, malignancies, neuropsychiatric diseases with vitamin D has been performed. A pandemic deficiency of vitamin D is mentioned all around the world. Although it has been reported that there is a relation between tobacco consumption and vitamin D; literature is limited and no data from Turkey regarding to the tobacco consumption and vitamin D has been reported. To evaluate vitamin D levels in individuals admitted to our hospital’s ‘smoking cessation unit’ and accordingly, to investigate the relation of vitamin D levels with tobacco dependence. Methods: Seventy-two cases between ages of 17-69 referring to smoking cessation unit were included in our study. Retrospectively, demographic data form the patients’ files, Fagerström Test for Nicotine Dependence (FTND), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI) forms were examined and levels of vitamin D were recorded. Whether the parameters conform the normal distribution or not is evaluated by Kolmogorov-Smirnov test. In statistical analyses; Mann-Whitney U test, Kruskall-Wallis H test, one way ANOVA were applied. p<0.05 level was accepted as statistically significant. Results: Mean age of the cases was 46.5±12.3 (17-69) years, 36 of them (50%) were female. The average years of smoking was 25.6±12.0 (1-50) years, average daily cigarette use at admission was 21.1±9.7 (2-60), average score of FTND was 6.2±2.4 (1-10). A statistical significance was determined among sex groups by means of vitamin D levels. A low but statistically significant and inverse relation has been observed between vitamin D levels and BDI score. Considering the year of smoking, height, weight, age, score of FTND and BAIQ; no statistical significance has been determined between these variables and vitamin D levels. Conclusion: Tobacco use has a relation with low levels of 25(OH)D. Although the mechanisms regarding to tobacco consumption and vitamin D deficiency are not enlightened yet; the evaluation of vitamin D levels in the routine examination of tobacco consumers, replacement of vitamin D if there is any deficiency and their exposure to daylight will be beneficial considering the neuroprotective and anti-oxidant effects of vitamin D.

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