{"id":20835,"date":"2024-06-14T09:07:56","date_gmt":"2024-06-14T09:07:56","guid":{"rendered":"https:\/\/www.tuat.org\/?p=20835"},"modified":"2024-10-07T09:54:54","modified_gmt":"2024-10-07T09:54:54","slug":"uzm-dr-elif-tugce-sahin-sincan-training-and-research-hospital","status":"publish","type":"post","link":"https:\/\/www.tuat.org\/en\/uzm-dr-elif-tugce-sahin-sincan-training-and-research-hospital\/","title":{"rendered":"Functional Medicine Series: The Power of Zinc and Its Role in Our Health"},"content":{"rendered":"\t\t
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FONKS\u0130YONEL TIP YAZI D\u0130Z\u0130S\u0130;
\u00c7\u0130NKO \u0130LE \u0130LG\u0130L\u0130 NELER B\u0130L\u0130YORUZ…<\/h2>

Havalar bu kadar so\u011fumu\u015fken, \u00dcSYE\u2019ler AGE\u2019ler havada u\u00e7u\u015furken, kendimizi ve ailemizi korumak i\u00e7in destek olarak ne alal\u0131m diye d\u00fc\u015f\u00fcn\u00fcrken bir de yo\u011fun bir acilde \u00e7al\u0131\u015f\u0131yorsak ve ye\u015fil alanda hasta bak\u0131yorsak akl\u0131m\u0131za gelen bir elementten bahsedelim istedim. \u00c7inko..
Subklinik \u00e7inko eksikli\u011finin ishal ve \u00fcst solunum yolu enfeksiyonlar\u0131n\u0131n g\u00f6r\u00fclme s\u0131kl\u0131\u011f\u0131n\u0131, morbiditesini ve mortalitesini \u00f6nemli \u00f6l\u00e7\u00fcde art\u0131rabilece\u011fi olas\u0131l\u0131\u011f\u0131 hekimler aras\u0131nda b\u00fcy\u00fck ilgi uyand\u0131rd\u0131. \u00c7inko eksikli\u011fi d\u00fcnya \u00e7ap\u0131nda en \u00f6nemli mikro besin eksikliklerinden biridir. Bir \u00e7ok \u00e7al\u0131\u015fma, y\u00fcksek riskli pop\u00fclasyonlarda \u00c7inko takviyesinin sa\u011fl\u0131k a\u00e7\u0131s\u0131ndan \u00f6nemli faydalar sa\u011flayabilece\u011fini g\u00f6stermi\u015ftir.
\u00c7inko nedir?
\u00c7inko (Zn), do\u011fada genellikle iki de\u011ferlikli halde bulunan bir ge\u00e7i\u015f metalidir. V\u00fccutta y\u00fczlerce enzimin \u00fcretimi i\u00e7in gerekli oldu\u011fundan \u00f6nemli bir mineral olarak kabul edilir. \u00c7inko eksikli\u011fi veya a\u015f\u0131r\u0131 emilimi, \u00e7inko homeostazisini bozar ve b\u00fcy\u00fcmeyi, morfogenezi ve ba\u011f\u0131\u015f\u0131kl\u0131k tepkisinin yan\u0131 s\u0131ra n\u00f6rosens\u00f6r ve endokrin fonksiyonlar\u0131n\u0131 da etkiler. Ya\u015fam i\u00e7in gerekli olan h\u00fccresel s\u00fcre\u00e7leri ve biyolojik tepkileri s\u00fcrd\u00fcrmek i\u00e7in \u00e7inko d\u00fczeylerinin uygun \u015fekilde ayarlanmas\u0131 gerekir.
Diyette \u00e7inko kaynaklar\u0131 nelerdir?
\u00c7inkonun birincil beslenme kaynaklar\u0131 et ve kabuklu deniz \u00fcr\u00fcnleri gibi hayvansal \u00fcr\u00fcnleri ve mercimek, f\u0131nd\u0131k, nohut, kaju f\u0131st\u0131\u011f\u0131 ve kabak \u00e7ekirde\u011fi gibi bitkisel \u00fcr\u00fcnleri i\u00e7erir. Bitkisel \u00fcr\u00fcnler aras\u0131nda, zenginle\u015ftirilmi\u015f t\u00fcketime haz\u0131r tah\u0131llar (\u00f6rne\u011fin Bat\u0131 diyetinde kahvalt\u0131l\u0131k gevrek gibi g\u0131da \u00fcr\u00fcnleri) en yayg\u0131n \u00e7inko kayna\u011f\u0131d\u0131r. Tipik bir karma diyette yeterli miktarda \u00e7inko kayna\u011f\u0131 mevcuttur. Lakto-ovo-vejetaryenler yeterli seviyelere ula\u015fmak i\u00e7in daha fazla g\u00fc\u00e7lendirilmi\u015f tah\u0131llara veya baklagillere, s\u00fcte, yumurtaya, kuruyemi\u015flere ihtiya\u00e7 duyarlar. Bitkisel kaynaklar\u0131n , \u00e7inko olu\u015fturan \u00e7\u00f6z\u00fcnmeyen komplekslere ba\u011flanan ve b\u00f6ylece \u00e7inkonun emilimini engelleyen fitik asitin varl\u0131\u011f\u0131ndan dolay\u0131 daha az biyoyararlan\u0131ml\u0131 oldu\u011fu d\u00fc\u015f\u00fcn\u00fclmektedir.
Yeti\u015fkinlerin yakla\u015f\u0131k y\u00fczde 45’i yetersiz \u00e7inko al\u0131m\u0131na sahip olabilir.
Diyet referans al\u0131m\u0131: \u00c7inko i\u00e7in \u00f6nerilen diyet referans al\u0131m\u0131, ya\u015fa ve cinsiyete g\u00f6re de\u011fi\u015fir; erken \u00e7ocukluk d\u00f6neminde 3 mg\/g\u00fcn’den yeti\u015fkin kad\u0131nlarda 8 mg\/g\u00fcn’e ve yeti\u015fkin erkeklerde 11 mg\/g\u00fcn’e y\u00fckselir. Hamilelik ve emzirme d\u00f6neminde gereksinimler daha y\u00fcksektir
\u00c7inko metabolizmas\u0131
Yeti\u015fkinlerde toplam v\u00fccut \u00e7inkosu ortalama 1,5 ila 2,5 gramd\u0131r. Toplam v\u00fccut \u00e7inkosunun b\u00fcy\u00fck bir k\u0131sm\u0131 (y\u00fczde 60\u2019\u0131) kemik ve kas havuzundad\u0131r. \u00c7inko ince ba\u011f\u0131rsak boyunca aktif olarak emilir. Esas olarak duodenum ve jejunumda ve daha az oranda ileum ve kal\u0131n ba\u011f\u0131rsakta emilir. Sindirim s\u0131ras\u0131nda diyetteki \u00e7inko sal\u0131n\u0131r ve amino asitler, fosfatlar, organik asitler ve histidinler gibi farkl\u0131 ligandlarla kompleksler olu\u015fturur. \u00c7inko-ligand kompleksleri daha sonra hem aktif hem de pasif bir s\u00fcre\u00e7le ba\u011f\u0131rsak mukozas\u0131ndan emilir. Emilimden sonra portal dola\u015f\u0131m \u00e7inkoyu karaci\u011fere ta\u015f\u0131r.
\u00c7inko alb\u00fcmine ba\u011fl\u0131 olarak ta\u015f\u0131n\u0131r. Periferik dokular, \u00f6zellikle kemik ve kas taraf\u0131ndan ve metalotiyonein olarak depolanabilece\u011fi karaci\u011fer taraf\u0131ndan al\u0131n\u0131r.
\u00c7inko at\u0131l\u0131m\u0131n\u0131n ana yolu gastrointestinal sistemdir. Dola\u015f\u0131mdaki \u00e7inkonun y\u00fczde 10 kadar\u0131 da idrar yoluyla at\u0131l\u0131r.
Toplam v\u00fccut \u00e7inko i\u00e7eri\u011finin <%0,2’sini temsil eden plazma \u00e7inko, \u00e7inko durumunun en s\u0131k \u00f6l\u00e7\u00fclen biyobelirtecidir. Ancak plazma \u00e7inko konsantrasyonunun enfeksiyon, inflamasyon, stres veya travma gibi \u00e7inko durumu veya diyetle \u00e7inko al\u0131m\u0131yla ilgisi olmayan fakt\u00f6rlere yan\u0131t olarak d\u00fc\u015febilece\u011fi bilinmelidir. Tersine, a\u00e7l\u0131k s\u0131ras\u0131ndaki doku katabolizmas\u0131 \u00e7inkonun dola\u015f\u0131ma sal\u0131nmas\u0131na neden olarak dola\u015f\u0131mdaki \u00e7inko seviyelerinde ge\u00e7ici bir art\u0131\u015fa neden olabilir.
D\u00fc\u015f\u00fck plazma \u00e7inkosu genel olarak <60 mikrogram\/dL (<9,2 mikromol\/L) olarak tan\u0131mlanm\u0131\u015ft\u0131r.
Hangi durumlarda \u00e7inko seviyeleri azal\u0131r?
Malabsorbsiyon sendromu, karaci\u011fer hastal\u0131\u011f\u0131nda muhtemelen hipoalb\u00fcminemiye ba\u011fl\u0131 olarak, kronik b\u00f6brek hastal\u0131\u011f\u0131nda idrarla at\u0131l\u0131m\u0131n art\u0131\u015f\u0131na ba\u011fl\u0131 olarak, orak h\u00fccre hastal\u0131\u011f\u0131 ve di\u011fer kronik hastal\u0131klar\u0131 olan hastalarda \u00e7inko eksikli\u011fi riski y\u00fcksektir. Fitatlarla ve y\u00fcksek lifli diyetle beslenenlerde ise zay\u0131f \u00e7inko emilimi \u00e7inko eksikli\u011fine neden olabilir.
\u00c7inko eksikli\u011fi, kardiyovask\u00fcler hastal\u0131klar, tip 2 diyabet, b\u00fcy\u00fcme gerili\u011fi, bili\u015fsel bozukluk, bula\u015f\u0131c\u0131 hastal\u0131klar, erkek hipogonadizmi, cilt de\u011fi\u015fiklikleri, yara iyile\u015fmesinde gecikme ve benzeri gibi \u00e7e\u015fitli hastal\u0131k durumlar\u0131n\u0131n daha y\u00fcksek riskiyle ili\u015fkilidir. Buna kar\u015f\u0131l\u0131k, yeterli \u00e7inko t\u00fcketimi kronik metabolik hastal\u0131\u011f\u0131, diyabeti ve kardiyovask\u00fcler hastal\u0131klar\u0131 olan ki\u015filere fayda sa\u011flayabilir. Bu nedenle insan sa\u011fl\u0131\u011f\u0131n\u0131 korumak i\u00e7in diyetle yeterli \u00e7inko al\u0131m\u0131 gereklidir.
\u00c7inko eksikli\u011fi klinik bulgular\u0131
Hafif \u00e7inko eksikli\u011finde, ba\u011f\u0131\u015f\u0131kl\u0131k sisteminin zay\u0131flamas\u0131, tat ve kokunun bozulmas\u0131, gece k\u00f6rl\u00fc\u011f\u00fcn\u00fcn ba\u015flamas\u0131, spermatogenezin azalmas\u0131 ve sedef hastal\u0131\u011f\u0131 benzeri dermatit gibi klinik bulgular g\u00f6r\u00fclmektedir.
\u015eiddetli \u00e7inko eksikli\u011finde, dermatit (tipik olarak perioral ve perianal b\u00f6lgelerde veya uzuvlar\u0131n ekstans\u00f6r y\u00fczeylerinde eritemat\u00f6z, pullu, vezik\u00fclob\u00fcll\u00f6z veya p\u00fcst\u00fcler lezyonlar), ciddi derecede bask\u0131lanm\u0131\u015f ba\u011f\u0131\u015f\u0131kl\u0131k fonksiyonu, s\u0131k enfeksiyonlar, ishal ve alopesi gibi klinik bulgular g\u00f6r\u00fclmektedir.
Akrodermatitis enteropatika: \u00c7inko emiliminin bozuldu\u011fu otozomal resesif bir hastal\u0131kt\u0131r. Bozuklu\u011fa, \u00e7inko ta\u015f\u0131nmas\u0131nda rol oynayan bir proteini kodlayan SLC39A4 genindeki varyantlar neden olur. Hastal\u0131k \u015fiddetli \u00e7inko eksikli\u011finin belirti ve semptomlar\u0131 ile karakterizedir. A\u011f\u0131zdan \u00e7inko takviyesi (30 ila 45 mg\/g\u00fcn) semptomlar\u0131n h\u0131zla ortadan kalkmas\u0131n\u0131 sa\u011flar. Tedavinin ya\u015fam boyu s\u00fcrd\u00fcr\u00fclmesi gerekir.
Tedavi
Yetersiz oral al\u0131mdan kaynaklanan \u00e7inko eksikli\u011fi i\u00e7in, tipik bir oral replasman dozu 1 ila 2 mg\/kg\/g\u00fcn elemental \u00e7inkodur. Akrodermatitis enteropatika i\u00e7in yakla\u015f\u0131k 3 mg\/kg\/g\u00fcn elemental \u00e7inko gibi daha y\u00fcksek replasman dozlar\u0131 \u00f6nerilir.
6 ay-5 ya\u015f aras\u0131 akut ishali olan \u00e7ocuklar i\u00e7in D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc 14 g\u00fcn boyunca 10 mg\/g\u00fcn \u00e7inko takviyesi \u00f6nermektedir.
\u00c7inko toksisitesi
\u00c7inko takviyesi ile \u00e7ok az toksisite meydana gelir. \u00d6nerilen g\u00fcnl\u00fck al\u0131m\u0131n 10 kat\u0131na kadar yutulmas\u0131 hi\u00e7bir belirti olu\u015fturmaz. Y\u00fcksek dozda \u00e7inkonun kronik al\u0131m\u0131 bak\u0131r eksikli\u011fi ile ili\u015fkili olabilir \u00e7\u00fcnk\u00fc \u00e7inko, bak\u0131r\u0131n ba\u011f\u0131rsaktan emilimini engeller.
1 ila 2 g \u00e7inko s\u00fclfat\u0131n akut al\u0131m\u0131, gastrointestinal sistemin tahri\u015fi ve korozyonu ile ili\u015fkili bulant\u0131 ve kusmaya neden olur. Y\u00fcksek dozlarda \u00e7inko bile\u015fikleri ayn\u0131 zamanda t\u00fcb\u00fcler nekroz veya interstisyel nefritin neden oldu\u011fu akut b\u00f6brek yetmezli\u011fine de neden olabilir.<\/p>

REFERANSLAR
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World Health Organization. The treatment of diarrhoea, a manual for physicians and other senior health workers. 4th revision. WHO\/FCH\/CAH\/05.1. Geneva: World Health Organization, 2005. https:\/\/apps.who.int\/iris\/handle\/10665\/43209 (Accessed on June 16, 2023).<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t\n

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    FUNCTIONAL MEDICINE ARTICLE SERIES; WHAT DO WE KNOW ABOUT ZINC… With the weather getting this cold, URTIs and AGE are spreading rapidly, and while thinking about what supplements to take to protect ourselves and our families, if we also work in a busy emergency room and take care of patients in the green zone, I […]<\/p>\n","protected":false},"author":3,"featured_media":22185,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[115],"tags":[],"class_list":["post-20835","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articles"],"_links":{"self":[{"href":"https:\/\/www.tuat.org\/en\/wp-json\/wp\/v2\/posts\/20835","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.tuat.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.tuat.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.tuat.org\/en\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.tuat.org\/en\/wp-json\/wp\/v2\/comments?post=20835"}],"version-history":[{"count":0,"href":"https:\/\/www.tuat.org\/en\/wp-json\/wp\/v2\/posts\/20835\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.tuat.org\/en\/wp-json\/wp\/v2\/media\/22185"}],"wp:attachment":[{"href":"https:\/\/www.tuat.org\/en\/wp-json\/wp\/v2\/media?parent=20835"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.tuat.org\/en\/wp-json\/wp\/v2\/categories?post=20835"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.tuat.org\/en\/wp-json\/wp\/v2\/tags?post=20835"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}