Karaciğer hastalarında (siroz veya hepatit) homosistein ve selenyum düzeyleri
Yükleniyor...
Tarih
2006
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Türk Gastroenteroloji Vakfı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş ve amaç: Homosisteinin sentezinde ve metabolizmas›nda karaciğer önemli bir rol oynar. Karaciğer hasar› oluştuğunda homosisteinin
metabolizmas›nda önemli değişiklikler meydana gelmektedir. Selenyum
düzeyinin karaciğer hasar›nda düştüğü rapor edilmektedir. Yine selenyum eksikliğinde karaciğerde önemli değişikliklerin olduğu ifade edilmekte ve patogenezdeki rolü araşt›r›lmaktad›r. Çal›şmam›zda karaciğer
hasar›nda homosistein ve selenyum düzeylerinde meydana gelen değişiklikleri ve bu değişikliklere etki edebilecek faktörleri incelemeyi amaçlad›k. Gereç ve yöntem: Çal›şmaya 22 kronik hepatitli (E: 12, K: 10;
yaş ortalamalar›: 43,90±15,02), 28 sirozlu (E: 25, K: 3; yaş ortalamalar›:
42,50±16,00) hasta ile, 20 sağl›kl› kontrol grubu (E: 12, K: 8; yaş ortalamalar›: 36.65±8.29) dahil edildi. Etyolojik dağ›l›m: 36’s› Hepatit B virusu, 7’si Hepatit C virusu, 3’ü Hepatit B virusu + Hepatit D virusu, 1’i
Wilson hastas›yd›. Üç olgu kriptojenik sirozluydu. High Performance Liquide Chromotography (HPLC) cihaz›nda floresan dedektörle homosistein; atomik absorbsyon cihaz›nda grafit modunda selenyum; Abotte Aeroset otoanalizor cihaz›nda fotometrik yöntemle ALT, AST, GGT, albumin düzeyleri; Roche E170 modüler analitik sistem ile, kemiluminesans
metodu kullan›larak B12 ve folat düzeyleri çal›ş›ld›. Metilen tetrahidrofolat redüktaz (MTHFR) geni ise, hastalardan al›nan tam kan örneklerinden elde edilen DNA’lar kullan›larak incelendi. Bulgular: Her 3 grubun
yaşlar› aras›nda fark saptanmad›. Hem kronik hepatit hem de siroz grubundaki homosistein düzeylerinin kontrol grubundan istatistiksel olarak
daha yüksek olduğu saptand› (p=0.001). Kronik hepatit grubu ile siroz
grubunun homosistein düzeyleri aras›nda fark saptanmad›. Öte yandan,
kronik hepatit ile kontrol grubu aras›nda vitamin B12 düzeyi aç›s›ndan
fark yoktu. Siroz grubunda vitamin B12 düzeyinin kontrol grubundan istatistiksel olarak daha yüksek olduğu izlendi. Folat düzeyi bak›m›ndan
gruplar aras›nda fark saptanmad›. MTHFR gen mutasyonu bak›m›ndan
da hasta ve kontrol gruplar› aras›nda fark saptanmad›. Her iki hastal›k
grubundaki selenyum düzeyinin kontrol grubundan daha düşük olduğu
görüldü (p=0.001). Sonuç: Sonuçlar›m›z göstermektedir ki sirozlu ve
kronik hepatitli hastalarda gözlenen hiperhomosisteinemi folat, vitamin
B12 eksikliği ve MTHFR gen mutasyonu ile ilgili değildir. Homosistein
metabolizmas›nda görev alan diğer enzimlerin rollerinin olabileceği anlaş›lmaktad›r. Kronik hepatit ve sirozlularda belirgin selenyum eksikliğinin varl›ğ› dikkat çekicidir.
Background/aim: The liver has a crucial role in homocysteine synthesis and metabolism. Important changes in homocysteine metabolism occur when hepatic deficiency exists. Selenium levels have also been reported as being decreased in liver damage. Furthermore, many changes take place in the liver when selenium deficiency occurs, and the role in pathogenesis is being investigated. We aimed to search the changes in homocysteine and selenium levels in liver damage and determine the probable influencing factors. Materials and methods: Twenty-two chronic hepatitis (m:11, f:11, average age: 43.90±15.02), 28 cirrhotic patients (m:25, f:3, average age: 42.50±16.00) and 20 healthy subjects (m:12, f:8, average age: 36.65±8.29) were included in the study. Etiology was hepatitis B in 36, hepatitis C in 7, hepatitis B + D in 3 and Wilson disease in 1 patient. Three patients had cryptogenic cirrhosis. Homocysteine level was measured by fluorescent detector using high performance liquid chromatography (HPLC); selenium level in graphite mode by atomic absorption; AST, ALT, GGT and albumin by Abotte Aeroset autoanalyzer with photometric method; and vitamin B12 and folate levels by ELECYSIS E170 using chemiluminescence method; methylene tetrahydrofolate reductase (MTHFR) gene analysis in DNA of whole blood samples was done. Results: There was no significant difference between the three groups with respect to age. Both chronic hepatitis and cirrhotic groups had higher homocysteine levels than those of the control group (p=0.001). There was no difference in homocysteine levels between chronic hepatitis and cirrhotic groups. On the other hand, there was no difference between chronic hepatitis and control groups with respect to vitamin B12 levels. Vitamin B12 level was higher in the cirrhotic group than in controls and the difference was statistically significant. There was no difference between any of the groups in respect to folate levels. MTHFR gene mutation was similar in both patient and control groups. Selenium level was found to be lower in both patient groups than in the control group (p=0.001). Conclusion: Our results showed that hyperhomocysteinemia in chronic hepatitis and cirrhosis is not related to deficiency in folate and vitamin B12 and MTHFR gene mutation. It is seen that other enzymes involved in homocysteine metabolism might play a part in this process. It is noteworthy that selenium deficiency exists in both chronic hepatitis and liver cirrhosis.
Background/aim: The liver has a crucial role in homocysteine synthesis and metabolism. Important changes in homocysteine metabolism occur when hepatic deficiency exists. Selenium levels have also been reported as being decreased in liver damage. Furthermore, many changes take place in the liver when selenium deficiency occurs, and the role in pathogenesis is being investigated. We aimed to search the changes in homocysteine and selenium levels in liver damage and determine the probable influencing factors. Materials and methods: Twenty-two chronic hepatitis (m:11, f:11, average age: 43.90±15.02), 28 cirrhotic patients (m:25, f:3, average age: 42.50±16.00) and 20 healthy subjects (m:12, f:8, average age: 36.65±8.29) were included in the study. Etiology was hepatitis B in 36, hepatitis C in 7, hepatitis B + D in 3 and Wilson disease in 1 patient. Three patients had cryptogenic cirrhosis. Homocysteine level was measured by fluorescent detector using high performance liquid chromatography (HPLC); selenium level in graphite mode by atomic absorption; AST, ALT, GGT and albumin by Abotte Aeroset autoanalyzer with photometric method; and vitamin B12 and folate levels by ELECYSIS E170 using chemiluminescence method; methylene tetrahydrofolate reductase (MTHFR) gene analysis in DNA of whole blood samples was done. Results: There was no significant difference between the three groups with respect to age. Both chronic hepatitis and cirrhotic groups had higher homocysteine levels than those of the control group (p=0.001). There was no difference in homocysteine levels between chronic hepatitis and cirrhotic groups. On the other hand, there was no difference between chronic hepatitis and control groups with respect to vitamin B12 levels. Vitamin B12 level was higher in the cirrhotic group than in controls and the difference was statistically significant. There was no difference between any of the groups in respect to folate levels. MTHFR gene mutation was similar in both patient and control groups. Selenium level was found to be lower in both patient groups than in the control group (p=0.001). Conclusion: Our results showed that hyperhomocysteinemia in chronic hepatitis and cirrhosis is not related to deficiency in folate and vitamin B12 and MTHFR gene mutation. It is seen that other enzymes involved in homocysteine metabolism might play a part in this process. It is noteworthy that selenium deficiency exists in both chronic hepatitis and liver cirrhosis.
Açıklama
Anahtar Kelimeler
Kronik hepatit, Siroz, Homosistein, Selenyum, Chronic hepatitis, Cirrhosis, Homocysteine, Selenium
Kaynak
Akademik Gastroenteroloji Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
5
Sayı
1
Künye
Canoruç, N., Canoruç, F., Aslan, Ç., Yılmaz, Ş., Turgut, C., Dursun, M. ve diğerleri. (2006). Karaciğer hastalarında (siroz veya hepatit) homosistein ve selenyum düzeyleri. Akademik Gastroenteroloji Dergisi, 5(1), 26-30.
