Akut Miyokard İnfarktüsü Geçiren Bireylerin Beslenme Durumu ile Serum Nesfatin-1 Düzeyi Arasındaki İlişkinin Değerlendirilmesi

Abstract

Kuyumcu, A., Evaluation of the Relationship Between Nutritional Status and Serum Nesfatin-1 Level in Individuals with Acute Myocardial Infarction. Hacettepe University, Institute of Health Sciences, Programme of Nutrition and Dietetic, PhD Thesis. Ankara, 2018. Cardiovascular diseases (CVD) is one of the most important causes of disease and mortality on the world and in our country. Acute myocardial infarction (AMI) constitutes the most important part of these coronary events. The Mediterranean diet provides a significant reduction in the incidence of myocardial infarction and stroke, as well as a reduction in mortality due to cardiovascular diseases. Nesfatin-1, an anorexigenic peptide, has effects on nutrient uptake, body weight and adipose tissue beside its potent cardiovascular effects are very limited. This study was conducted to investigate the possible relationship between CVD, Mediterranean diet, anthropometric measurements, dietary composition and serum nesfatin-1 level. The sample of the study consisted of a total of 100 patients (51 male, 49 female) between at the age of 45 and 80, who underwent urgent coronary angiography due to AMI in the department of cardiology in the Turkiye Yuksek Ihtisas Education and Research Hospital. Coronary angiography results were graded by SYNTAX score. According to the SYNTAX score, they were classified into the first group (without CAD, n:33), the second group (mild CAD, n:33) and the third group (severe CAD, n:34). The general characteristics, nutrition intake status and physical activity levels of the individuals were questioned using questionnaire and serum nesfatin-1 level analysis were done and some biochemical findings and anthropometric measurements were taken. The content of the diet was determined by using the 'Mediterranean Diet Compliance Scale'. The difference in neck circumference was found to be statistically significant (p<0.001), but there was no statistically significant difference in BMI and waist circumference in both genders (p>0,05). Nesfatin-1 levels were 293.9± 207.9 pg/ml in the without CAD group, 110.5±37.95 pg/ml in the patients with mild CAD and 35.3±27.58 pg/ml in the patients with severe CAD (p<0.001). There is a strong and negative correlation between the SYNTAX score and nesfatin-1 levels (r=-0.642, p<0.001). Threshold of serum nesfatin-1 level was 74.75 pg/ml for the risk of severe CAD. Serum nesfatin-1 level were found to be negatively correlated with neck circumference, waist circumference, CRP, oily seeds, offal, white bread and positively correlated with fish, grain bread, vegetable consumption and Mediterranean diet score (p<0.001). As a result, in patients with AMI, SYNTAX score was inversely correlated with serum nesfatin level and Mediterranean diet score and linearly correlated with neck circumference. It is evident that the protective effect of Mediterranean diet against coronary artery disease was detected in our study. The generalization of the Mediterranean diet as a health policy will be an important contribution to our country's economy and public health. This study, which is one of the limited studies investigating the relationship between nesfatin-1 and acute myocardial infarction, will be helpful in understanding the pathophysiology of myocardial infarction and may shed light on new research.