Vitamin B3 (Niasin)
Özet
Vitamin B3 alımında temel besin maddelerinin önde gelen kaynakları arasında maya, etler, özellikle de karaciğer gibi sakatatlar, tahıllar, baklagiller, alkali ile işlenmiş mısır (tortilla üretiminde gözlemlendiği gibi) ve tohumlar yer alır. Eksikliğinde mortaliteyle de ilişkili pellegra hastalığı görülür ve klasik triadı dermatit, demans ve diyare olarak tanımlanmıştır. Yüksek proteinli bir diyetle günlük niasin ihtiyacı karşılanabilmektedir. Yüksek dozda niasin, hiperlipidemi için etkili bir tedavi olarak tanımlanmıştır ve kardiyovasküler sağlığın iyileştirilmesine katkıda bulunmaktadır. Fakat terapötik dozlarda flushing, toksik dozlarda hepatit, trombositopeni, metabolik asidoz ve hipoglisemi gibi yan etkiler bildirilmiştir.
Leading sources of essential nutrients for vitamin B3 intake include yeast, meats, offal such as liver, grains, legumes, alkaline-treated corn (as observed in tortilla production), and seeds. Its deficiency causes pellagra disease, which is also associated with mortality, and its classic triad has been defined as dermatitis, dementia and diarrhea. Daily niacin needs can be met with a high-protein diet. High doses of niacin have been identified as an effective treatment for hyperlipidemia and contribute to improved cardiovascular health. However, side effects such as flushing at therapeutic doses and hepatitis, thrombocytopenia, metabolic acidosis and hypoglycemia at toxic doses have been reported.
Referanslar
PubChem. Niacinamide n.d. https://pubchem.ncbi.nlm.nih.gov/compound/936 (accessed January 22, 2025).
Combs Jr Gerald F, McClung JP. Chapter 12 - Niacin. In: Combs Jr Gerald F, McClung JP, editors. The Vitamins (Sixth Edition), Academic Press; 2022, p. 361–86. https://doi.org/10.1016/B978-0-323-90473-5.00029-X.
Kamanna VS, Kashyap ML. Mechanism of action of niacin. The American Journal of Cardiology 2008;101:S20–6. https://doi.org/10.1016/j.amjcard.2008.02.029.
Canner PL, Berge KG, Wenger NK, et al. Fifteen year mortality in Coronary Drug Project patients: long-term benefit with niacin. Journal of the American College of Cardiology 1986;8:1245–55. https://doi.org/10.1016/s0735-1097(86)80293-5.
The role of niacin in raising high-density lipoprotein cholesterol to reduce cardiovascular events in patients with atherosclerotic cardiovascular disease and optimally treated low-density lipoprotein cholesterol: Rationale and study design. The Atherothrombosis Intervention in Metabolic syndrome with low HDL/high triglycerides: Impact on Global Health outcomes (AIM-HIGH). American Heart Journal 2011;161:471-477.e2. https://doi.org/10.1016/j.ahj.2010.11.017.
G M, Sh D, P P. An Outbreak of Pellagra in the Kasese Catchment Area, Dowa, Malawi. The American Journal of Tropical Medicine and Hygiene 2017;96. https://doi.org/10.4269/ajtmh.16-0423.
Min S-W, Sohn PD, Cho S-H, et al. Sirtuins in neurodegenerative diseases: an update on potential mechanisms. Frontiers in Aging Neuroscience 2013;5:53. https://doi.org/10.3389/fnagi.2013.00053.
Wyness L. The role of red meat in the diet: nutrition and health benefits. Proceedings of the Nutrition Society 2016;75:227–32. https://doi.org/10.1017/S0029665115004267.
Fu L, Doreswamy V, Prakash R. The biochemical pathways of central nervous system neural degeneration in niacin deficiency. Neural Regeneration Research 2014;9:1509. https://doi.org/10.4103/1673-5374.139475.
Hill LJ, Williams AC. Meat Intake and the Dose of Vitamin B3 – Nicotinamide: Cause of the Causes of Disease Transitions, Health Divides, and Health Futures? Int J Tryptophan Res 2017;10. https://doi.org/10.1177/1178646917704662.
Boden WE, Sidhu MS, Toth PP. The therapeutic role of niacin in dyslipidemia management. J Cardiovasc Pharmacol Ther 2014;19:141–58. https://doi.org/10.1177/1074248413514481.
Tavintharan S, Kashyap ML. The benefits of niacin in atherosclerosis. Current Atherosclerosis Reports 2001;3:74–82. https://doi.org/10.1007/s11883-001-0014-y.
Gille A, Bodor ET, Ahmed K, et al. Nicotinic acid: pharmacological effects and mechanisms of action. Annu Rev Pharmacol Toxicol 2008;48:79–106. https://doi.org/10.1146/annurev.pharmtox.48.113006.094746.
Jin F-Y, Kamanna VS, Kashyap ML. Niacin decreases removal of high-density lipoprotein apolipoprotein AI but not cholesterol ester by Hep G2 cells: implication for reverse cholesterol transport. Arteriosclerosis, Thrombosis, and Vascular Biology 1997;17:2020–8. https://doi.org/10.1161/01.atv.17.10.2020.
Kirkland JB, Meyer-Ficca ML. Chapter Three - Niacin. In: Eskin NAM, editor. Advances in Food and Nutrition Research, vol. 83, Academic Press; 2018, p. 83–149. https://doi.org/10.1016/bs.afnr.2017.11.003.
Horwitt MK, Harper AE, Henderson LM. Niacin-tryptophan relationships for evaluating niacin equivalents. Am J Clin Nutr 1981;34:423–7. https://doi.org/10.1093/ajcn/34.3.423.
Daniels L, Gibson RS, Diana A, et al. Micronutrient intakes of lactating mothers and their association with breast milk concentrations and micronutrient adequacy of exclusively breastfed Indonesian infants 2019;110. https://doi.org/10.1093/ajcn/nqz047.
WHO. Vitamin and mineral requirements in human nutrition. 2nd ed. World Health Organization and Food and Agriculture Organization of the United Nations- Erişim tarihi:(01.01.2025) https://www.who.int/publications/i/item/9241546123; 2004.
Redzic S, Hashmi MF, Gupta V. Niacin Deficiency. StatPearls PMID: 32491660, Treasure Island (FL): StatPearls Publishing; 2024, p. http://www.ncbi.nlm.nih.gov/books/NBK557728/.
Seow HF, Bröer S, Bröer A, et al. Hartnup disorder is caused by mutations in the gene encoding the neutral amino acid transporter SLC6A19. Nat Genet 2004;36:1003–7. https://doi.org/10.1038/ng1406.
Prousky JE. Pellagra may be a rare secondary complication of anorexia nervosa: a systematic review of the literature. Altern Med Rev 2003;8:180–5. https://pubmed.ncbi.nlm.nih.gov/12777163/.
Grundy SM, Mok HY, Zech L, et al. Influence of nicotinic acid on metabolism of cholesterol and triglycerides in man. J Lipid Res 1981;22:24–36. https://www.jlr.org/article/S0022-2275(20)34737-4/pdf.
Probstfield JL, Hunninghake DB. Nicotinic acid as a lipoprotein-altering agent. Therapy directed by the primary physician. Arch Intern Med 1994;154:1557–9. https://doi.org/10.1001/archinte.1994.00420140015002.
Hathcock JN. Vitamins and minerals: efficacy and safety. Am J Clin Nutr 1997;66:427–37. https://doi.org/10.1093/ajcn/66.2.427.
Rader JI, Calvert RJ, Hathcock JN. Hepatic toxicity of unmodified and time-release preparations of niacin. Am J Med 1992;92:77–81. https://doi.org/10.1016/0002-9343(92)90018-7.
Marques C, Hadjab F, Porcello A, et al. Mechanistic Insights into the Multiple Functions of Niacinamide: Therapeutic Implications and Cosmeceutical Applications in Functional Skincare Products. Antioxidants (Basel) 2024;13:425. https://doi.org/10.3390/antiox13040425.
Combs, Jr. GF, McClung JP. Niacin. The Vitamins, Elsevier; 2022, p. 361–86. https://doi.org/10.1016/B978-0-323-90473-5.00029-X.
Ganji SH, Qin S, Zhang L, et al. Niacin inhibits vascular oxidative stress, redox-sensitive genes, and monocyte adhesion to human aortic endothelial cells. Atherosclerosis 2009;202:68–75. https://doi.org/10.1016/j.atherosclerosis.2008.04.044.
Prabhu D, Dawe RS, Mponda K. Pellagra a review exploring causes and mechanisms, including isoniazid-induced pellagra. Photodermatology, Photoimmunology & Photomedicine 2021;37:99–104. https://doi.org/10.1111/phpp.12659.
Gasperi V, Sibilano M, Savini I, et al. Niacin in the Central Nervous System: An Update of Biological Aspects and Clinical Applications. Int J Mol Sci 2019;20:974. https://doi.org/10.3390/ijms20040974.
Rawji KS, Young AMH, Ghosh T, et al. Niacin-mediated rejuvenation of macrophage/microglia enhances remyelination of the aging central nervous system. Acta Neuropathol 2020;139:893–909. https://doi.org/10.1007/s00401-020-02129-7.
Wakade C, Chong R, Seamon M, et al. Low-Dose Niacin Supplementation Improves Motor Function in US Veterans with Parkinson’s Disease: A Single-Center, Randomized, Placebo-Controlled Trial. Biomedicines 2021;9:1881. https://doi.org/10.3390/biomedicines9121881.
Williams PA, Harder JM, Foxworth NE, et al. Vitamin B3 modulates mitochondrial vulnerability and prevents glaucoma in aged mice. Science 2017;355:756–60. https://doi.org/10.1126/science.aal0092.
Conze D, Crespo-Barreto J, Kruger C. Safety assessment of nicotinamide riboside, a form of vitamin B3. Hum Exp Toxicol 2016;35:1149–60. https://doi.org/10.1177/0960327115626254.
Leung K, Quezada M, Chen Z, et al. Niacin‐Induced Anicteric Microvesicular Steatotic Acute Liver Failure. Hepatology Communications 2018;2:1293–8. https://doi.org/10.1002/hep4.1253.
Fayyaz B, Rehman HJ, Upreti S. Beating the urine drug test–a case report on niacin toxicity. Journal of Community Hospital Internal Medicine Perspectives 2018;8:73–5.
O’Connell C, Horwood K, Nadamuni M. Correction of refractory thrombocytopenia and anemia following withdrawal of extended release niacin. American J Hematol 2016;91. https://doi.org/10.1002/ajh.24371.