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dc.contributor.advisorAKYOL MUTLU, Aslı
dc.contributor.authorÖZTÜRK, Elif
dc.contributor.authorÖZTÜRK, Elif
dc.date.accessioned2019-01-07T13:58:31Z
dc.date.issued2019
dc.date.submitted2019-01-03
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dc.identifier.urihttp://hdl.handle.net/11655/5669
dc.description.abstractAluminium (Al) contamination of parenteral nutrition (PN) solutions has been known for over 30 years. Especially vascular intake of Al leads to accumulation in tissues. In addition, the nervous system, musculoskeletal, respiratory system, cardiovascular system, hepatobiliary system, endocrine system, reproductive system can affect these systems. The purpose of this study was to determine the Al concentration and macronutrient and energy content of PN solution used in Turkey. In this study, 8 all-in-one PN solutions which named PN1, PN2, PN3, PN4, PN5, PN6, PN7 and PN8 were examined. Aluminium concentration was analysed by high performance liquid chromatography. The protein content of solutions was measured by Kjehldahl method, oil content was anaysed by Soxhelet method and oil content was measured by aqueous extraction method. Moisture and ash determined. Carbohydrate composition is determined as the percentage (%) remaining from protein, oil, moisture and ash compositions. Energy value was measured with a bomb calorimeter. It has been found that mean Al concentration of glucose solutions of PN solutions was 16,36±8,31 µg/L, the mean Al concentration of amino acid solutions was 4,96±3,73 µg/L, the mean Al concentration of the lipid solution was 9,09±11,23 µg/L. The Al concentration of a PN5 glucose and PN2 lipid solution is above 25 µg/L, which the Food and Drug Administration (FDA) considers to be a limit. When the macronutrients were analysed, there was no significant difference in the PN1-7 solutions for protein amounts between the label information and the amounts determined by the analysis (p>0,05), whereas there was a significant difference in the PN8 solution (p<0.05). For the amount of fat, there was a significant difference in the PN1-8 solution according to the Soxhelet method (p<0.05). According to the method of aqueous hekzan extraction, there was a significant difference in PN2 and PN5-8 solutions (p<0,05), but there was no significant difference in PN1, PN3 and PN4 solutions (p>0.05). There is a significant difference in energy values for PN1-8 solutions compared to label information (p<0.05). In conclusion, it was not finded any studies to examine Al concentrations of all-in-one solutions with HPLC in the literature. In two of the analysed solutions, a higher concentration of Al was observed than the value accepted by the FDA. In addition, nutrients compared to the label information were 30.04% lower in energy, 50.98% lower in fat and 5.3% lower in protein.en
dc.description.tableofcontentsİÇİNDEKİLER Sayfa ONAY SAYFASI iii YAYIMLAMA VE FİKRİ MÜLKİYET HAKLARI BEYANI iv ETİK BEYAN SAYFASI v TEŞEKKÜR vi ÖZET vii ABSTRACT viii İÇİNDEKİLER ix SİMGELER VE KISALTMALAR xii ŞEKİLLER xiv TABLOLAR xv 1. GİRİŞ 1 1.1. Kuramsal Yaklaşım 1 1.2. Amaç ve Varsayım 2 2. GENEL BİLGİLER 3 2.1. Parenteral Nütrisyon 3 2.1.1. Parenteral Nütrisyonun Tarihçesi 4 2.1.2. Parenteral Nütrisyon Solüsyonlarında Enerji 5 2.1.3. Parenteral Nütrisyon Solüsyonlarında Karbonhidrat 6 2.1.4. Parenteral Nütrisyon Solüsyonlarında Protein 7 2.1.5. Parenteral Nütrisyon Solüsyonlarında Lipit 8 2.2. Alüminyum ve Kimyasal Özellikleri 9 2.3. Alüminyum Metabolizması 9 2.3.1. Alüminyumun Emilimi 9 2.3.2. Alüminyumun Doku Dağılımı 11 2.3.3. Alüminyumun Vücuttan Atılımı 11 2.4. Alüminyumun Vücut Sistemleri ve Sağlık Üzerine Etkileri 12 2.4.1. Alüminyumun Kas-İskelet Sistemine Etkisi 12 2.4.2. Alüminyumun Solunum Sistemine Etkisi 13 2.4.3. Alüminyumun Kardiovasküler Sisteme Etkisi 13 2.4.4. Alüminyumun Hepatobiliar Sisteme Etkisi 14 2.4.5. Alüminyumun Endokrin Sisteme Etkisi 15 2.4.6. Alüminyumun Kan ve Hematopoetik Sisteme Etkisi 15 2.4.7. Alüminyumun Üreme Sistemine Etkisi 15 2.4.8. Alüminyumun Sinir Sistemine Etkisi 16 2.4.9. Alüminyum ve Kanser 19 2.4.10. Alüminyumun ve Genotoksisite 20 2.5. Çevresel Alüminyum Maruziyeti 19 2.6. Oral Alüminyum Maruziyeti 20 2.6.1. Besinler ve İçecekler ile Alüminyum Maruziyeti 20 2.6.2. Besin Eklentileri ile Alüminyum Maruziyeti 25 2.6.3. Paketleme ve Kullanılan Malzeme ile Alüminyum Maruziyeti 29 2.6.4. Su ile Alüminyum Maruziyeti 28 2.6.5. Anne Sütü ve Formül Mamalar ile Alüminyum Maruziyeti 30 2.7. Parenteral Ürünlerle Alüminyum Maruziyeti 31 2.8. Alüminyum Tayininde Kullanılan Yöntemler 33 3. GEREÇ ve YÖNTEMLER 34 3.1. Materyal 34 3.2. Metot 39 3.2.1. Alüminyum Tayini 39 3.2.2. Yağ Tayini 49 3.2.3. Protein Tayini 48 3.2.4. Nem Tayini 50 3.2.5. Kül Tayini 50 3.2.6. Karbonhidrat Tayini 50 3.2.7. Enerji Tayini 50 3.3. Verilerin İstatiksel Değerlendirilmesi 50 4. BULGULAR 52 4.1. Parenteral Nütrisyon Solüsyonlarının Alüminyum Değerleri 52 4.2. Parenteral Nütrisyon Solüsyonlarının Yağ Miktarları 54 4.3. Parenteral Nütrisyon Solüsyonlarının Protein Miktarları 57 4.4. Parenteral Nütrisyon Solüsyonlarının Enerji Değerleri 58 4.5. Parenteral Nütrisyon Solüsyonlarının Kompozisyonu 59 5. TARTIŞMA 60 5.1. Parenteral Nütrisyon Solüsyonlarının Alüminyum İçerikleri 60 5.2. Parenteral Nütrisyon Solüsyonlarının Makro Besin Ögeleri 66 6. SONUÇ ve ÖNERİLER 68 6.1. Sonuç 68 6.2. Öneriler 74 7. KAYNAKLAR 76 8. EKLER Ek-1: Tez Çalışması Orijinallik Raporu 9. ÖZGEÇMİŞtr_TR
dc.language.isoturtr_TR
dc.publisherSağlık Bilimleri Enstitüsütr_TR
dc.rightsinfo:eu-repo/semantics/restrictedAccesstr_TR
dc.subjectalüminyumtr_TR
dc.subjectalüminyum konsantrasyonutr_TR
dc.subjectbesin ögesitr_TR
dc.subjectparenteral nütrisyontr_TR
dc.titleBazı Parenteral Nütrisyon Solüsyonlarının Makro Besin Ögesi ve Alüminyum İçeriğinin Belirlenmesitr_TR
dc.typeinfo:eu-repo/semantics/masterThesisen
dc.description.ozetParenteral nütrisyon (PN) solüsyonlarının alüminyum (Al) kontaminasyonu 30 yılı aşkın zamandır bilinmektedir. Al’nin özellikle damar yoluyla alımı dokularda birikime yol açmaktadır. Ayrıca sinir sistemi, kas ve iskelet sistemi, solunum sistemi, kardiovasküler sistem, hepatobiliyer sistem, endokrin sistem ve üreme sistemi gibi sistemlere etki edebilmektedir. Bu çalışmanın amacı Türkiye’de kullanılan PN solüsyonlarının Al konsantrasyonlarının yanısıra makro besin ögesi ve enerji değerlerinin belirlenmesidir. Çalışmada 8 adet PN1, PN2, PN3, PN4, PN5, PN6, PN7 ve PN8 isimleriyle kodlanan üç odalı PN solüsyonu incelenmiştir. Alüminyum konsantrasyonu, yüksek performanslı sıvı kromatografisi (YPSK) yöntemi ile analiz edilmiştir. Solüsyonların protein miktarı Kjehldahl yöntemi, yağ miktarı Soxhelet yöntemi ve sulu ekstraksiyon yöntemi ile yapılmıştır. Ayrıca solüsyonlaın nem ve kül tayini yapılmıştır. Karbonhidrat kompozisyonu yüzde (%) olarak belirlenmiştir. Enerji değeri bomba kalorimetre ile ölçülmüştür. PN solüsyonlarındaki glukoz solüsyonlarının ortalama Al konsantrasyonu 16,36±8,31 µg/L, amino asit solüsyonlarının ortalama Al konsantrasyonu 4,96±3,73 µg/L, lipit solüsyonunun ortalama Al konsantrasyonu 9,09±11,23 µg/L bulunmuştur. PN5 glukoz solüsyonunun ve PN2 lipit solüsyonunun Al konsantrasyonu Amerikan Gıda ve İlaç Dairesi (FDA) tarafından limit olarak kabul edilen 25 µg/L’nin üzerinde tespit edilmiştir. Makro besin ögeleri incelendiğinde solüsyonların etiket bilgisi ile analizle belirlenen miktarlar arasında protein miktarları için PN1-7 solüsyonlarında istatistiksel açıdan anlamlı bir fark yokken (p>0,05) PN8 solüsyonunda anlamlı derecede fark belirlenmiştir (p<0,05). Yağ miktarı için Soxhelet yöntemine göre PN1-8 solüsyonlarında istatiksel olarak anlamlı fark vardır (p<0,05). Yağ miktarı için sulu hekzan ekstraksiyonu yöntemine göre PN2 ve PN5-8 solüsyonlarında anlamlı fark varken PN1, PN3 ve PN4 solüsyonlarında anlamlı fark yoktur (p>0,05). Enerji değerleri PN1-8 solüsyonları için etiket bilgisiyle karşılaştırıldığında istatiksel açıdan anlamlı bir fark belirlenmiştir (p<0,05). Sonuç olarak, literatürde üç odalı kullanıma hazır PN solüsyonlarının Al konsantrasyonlarının YPSK ile incelendiği çalışmaya rastlanmamıştır. İncelenen solüsyonlardan ikisinde FDA’nın limit olarak kabul ettiği değerden daha yüksek miktarda Al konsantrasyonu belirlenmiştir. Ayrıca PN solüsyonlarının makro besin ögeleri incelendiğinde enerji değerinin etiket bilgisine göre %30,04, yağ miktarının %50,98, protein miktarının %5,23 daha düşük olduğu bulunmuştur.tr_TR
dc.contributor.departmentBeslenme ve Diyetetiktr_TR
dc.contributor.authorID225527tr_TR
dc.embargo.terms6 aytr_TR
dc.embargo.lift2019-07-12T13:58:31Z


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