Akne vulgarisin izotretinoin ile tedavisinde diyetin sistemik immün-inflamasyon indeksi üzerine etkinliğinin karşılaştırılması
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Tarih
2024
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Yayıncı
Necmettin Erbakan Üniversitesi, Sağlık Bilimleri Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Akne vulgaris oluşumunun sebum salgısı, hormon seviyeleri, bakteriyel enfeksiyon ve inflamatuar reaksiyonlar gibi faktörler ve bunlara ek olarak diyetle de ilişkili olduğu bilinmektedir. Akne vulgaris tedavisi için 1982'de onaylanan oral izotretinoin (13- cis -retinoik asit), dirençli patolojilerde kullanılan etkili bir tedavi olmaya devam etmektedir. İzotretinoin, inflamasyon dahil olmak üzere akne patogenezinin tüm aşamalarında etkili olan bir ilaçtır. Bu çalışmanın amacı akne vulgaris tedavisinde oral izotretinoin tedavisiyle süt ve süt ürünlerinden kısıtlı diyetin kan bulgularına ve sistemik immün-inflamasyon indeksi(SII) düzeyleri üzerine etkinliğinin değerlendirmesi ve karşılaştırılmasıdır. Mart- Temmuz 2023 tarihleri arasında Deri ve Zührevi hastalıklar anabilim dalına başvurmuş, çalışmaya gönüllü seçilmiş 18-65 yaş aralığında, 0,3 mg/kg oral izotretinoin tedavisi alan ve tedaviye en az 3 ay devam eden toplamda 60 akne vulgarisli hasta incelenmiştir. Bu hastaların 30'u sadece izotretinoin tedavisi alan ve 30'u da izotretinoin tedavisiyle birlikte süt ve süt ürünlerinden kısıtlı diyet uygulanan hasta grubu olarak ikiye ayrılmıştır. Bireylere genel bilgilerin, süt tüketim durumlarının, akneyi tetikleyecek besinlerin sorgulandığı anket yüz yüze görüşme tekniği ile uygulanmıştır. Hastalardan alınan tam kan ve biyokimyasal tetkik sonuçları başvuru anında, tedavinin 1.ayında ve tedavinin 3. ayında kayıt edilmiştir. Grupların alınan hemogram değerlerinden Sİİ(nötrofil x trombosit/lenfosit) değeri hesaplanmıştır. İki grupta da tedavinin 1.ayındaki ölçüm değerlerine bakıldığında ortalama TSH değerinde artış görülmüştür sadece izotretinoin grubunun diğer gruba göre artışındaki farklılık istatistiksel olarak anlamlı bulunmuştur(p <0,05). İki grubun tedavisinde 1 ay içerisinde LDL, total kolesterol, trigliserid artışları karşılaştırıldığında sadece izotretinoin tedavisi alan grubun değerlerindeki artış daha fazla olmuştur ve bu farklılıklar anlamlı bulunmuştur (p <0,05). Çalışmaya katılan akne vulgarisli hastalarda iki grubun da tedavisinin ilk 3 ayı içerisinde nötrofil, lenfosit, trombosit ölçümleri değerlendirildiğinde istatistiksel açıdan anlamlılık bulunmamıştır (p>0,05). Sadece izotretinoin tedavisi uygulanan grupta tedavi öncesine göre 1. ayın sonunda Sİİ' de düşüş gözlenmiş ancak istatistiksel açıdan anlamlılık bulunmamıştır (p>0,05). Akne vulgaris tedavisinde oral izotretinoin önemli olmakla birlikte süt ve süt ürünlerinden kısıtlı diyetin de etkili olabileceği gözlenmiştir.
The occurrence of acne vulgaris is known to be related to factors such as sebum secretion, hormone levels, bacterial infection and inflammatory reactions, as well as diet. Oral isotretinoin (13-cis-retinoic acid), approved in 1982 for the treatment of acne vulgaris, remains an effective treatment used in resistant pathologies. Isotretinoin is a drug that is effective in all stages of acne pathogenesis, including inflammation. The aim of this study was to evaluate and compare the efficacy of oral isotretinoin treatment with a dairy-restricted diet on blood findings and systemic immune-inflammation index (SII) levels in the treatment of acne vulgaris. A total of 60 acne vulgaris patients between the ages of 18-65, who were admitted to the Department of Dermatology and Venereology between March and July 2023, who received 0.3 mg/kg oral isotretinoin treatment and continued the treatment for at least 3 months, were voluntarily selected for the study. Of these patients, 30 were divided into two groups: 30 patients who received isotretinoin treatment alone and 30 patients who received isotretinoin treatment with a diet restricted from milk and dairy products. The questionnaire, in which general information, milk consumption status, and foods that may trigger acne were questioned, was administered by face-to-face interview technique. Complete blood and biochemical test results obtained from the patients were recorded at the time of admission, in the first month of treatment and in the third month of treatment. The SII (neutrophil x platelet/lymphocyte) value was calculated from the hemogram values of the groups. An increase in the mean TSH value was observed in both groups in the 1st month of treatment, but the difference in the increase in the isotretinoin group compared to the other group was found to be statistically significant (p<0.05). When the increases in LDL, total cholesterol, and triglyceride values were compared within 1 month in the treatment of the two groups, the increase in the values of the group receiving only isotretinoin treatment was higher and these differences were found to be significant (p<0.05). When neutrophil, lymphocyte and platelet measurements were evaluated in the first 3 months of treatment in both groups in patients with acne vulgaris, no statistical significance was found (p>0.05). In the group treated with isotretinoin only, a decrease in SII was observed at the end of the 1st month compared to the pre-treatment period, but statistical significance was not found (p>0.05). Although oral isotretinoin is important in the treatment of acne vulgaris, it has been observed that a diet restricted from milk and dairy products may also be effective.
The occurrence of acne vulgaris is known to be related to factors such as sebum secretion, hormone levels, bacterial infection and inflammatory reactions, as well as diet. Oral isotretinoin (13-cis-retinoic acid), approved in 1982 for the treatment of acne vulgaris, remains an effective treatment used in resistant pathologies. Isotretinoin is a drug that is effective in all stages of acne pathogenesis, including inflammation. The aim of this study was to evaluate and compare the efficacy of oral isotretinoin treatment with a dairy-restricted diet on blood findings and systemic immune-inflammation index (SII) levels in the treatment of acne vulgaris. A total of 60 acne vulgaris patients between the ages of 18-65, who were admitted to the Department of Dermatology and Venereology between March and July 2023, who received 0.3 mg/kg oral isotretinoin treatment and continued the treatment for at least 3 months, were voluntarily selected for the study. Of these patients, 30 were divided into two groups: 30 patients who received isotretinoin treatment alone and 30 patients who received isotretinoin treatment with a diet restricted from milk and dairy products. The questionnaire, in which general information, milk consumption status, and foods that may trigger acne were questioned, was administered by face-to-face interview technique. Complete blood and biochemical test results obtained from the patients were recorded at the time of admission, in the first month of treatment and in the third month of treatment. The SII (neutrophil x platelet/lymphocyte) value was calculated from the hemogram values of the groups. An increase in the mean TSH value was observed in both groups in the 1st month of treatment, but the difference in the increase in the isotretinoin group compared to the other group was found to be statistically significant (p<0.05). When the increases in LDL, total cholesterol, and triglyceride values were compared within 1 month in the treatment of the two groups, the increase in the values of the group receiving only isotretinoin treatment was higher and these differences were found to be significant (p<0.05). When neutrophil, lymphocyte and platelet measurements were evaluated in the first 3 months of treatment in both groups in patients with acne vulgaris, no statistical significance was found (p>0.05). In the group treated with isotretinoin only, a decrease in SII was observed at the end of the 1st month compared to the pre-treatment period, but statistical significance was not found (p>0.05). Although oral isotretinoin is important in the treatment of acne vulgaris, it has been observed that a diet restricted from milk and dairy products may also be effective.
Açıklama
Yüksek Lisans Tezi
Anahtar Kelimeler
Akne Vulgaris, İzotretinoin, Sistemik İmmün İnflamasyon, Süt, Acne Vulgaris, Milk, Isotretinoin, Systemic Immune Inflammation
Kaynak
WoS Q Değeri
Scopus Q Değeri
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Sayı
Künye
Güven, H. (2024). Akne vulgarisin izotretinoin ile tedavisinde diyetin sistemik immün-inflamasyon indeksi üzerine etkinliğinin karşılaştırılması. (Yayımlanmamış yüksek lisans tezi). Necmettin Erbakan Üniversitesi, Sağlık Bilimleri Enstitüsü Fizyoloji Anabilim Dalı, Konya.
