Bir prospektif kohort çalışmasının temel verileri: Kapadokya kohort çalışması, Türkiye

Year 2018, , 190 - 203, 24.12.2018

Serhat Unal Sibel Ascioglu Ahmet Demirkazik İhsan Ertenli Erdal Eskioglu Kerim Guler Sedat Kiraz Mert Ozbakkaloglu Birol Ozer Tufan Tukek Mine Durusu Tanriover Eda Akyar Pelin Cagatay Yunus Erdem

https://doi.org/10.20518/tjph.500196

Cited By: 1

Abstract

Amaç: Bu
çalışmada, Türkiye'nin Kapadokya bölgesinde başlatılan geniş bir prospektif
kohort çalışmasının temel verilerinden kronik hastalıkların ve davranışsal risk
faktörlerinin prevalansını belirlemek amaçlanmıştır. Yöntem: Çalışma popülasyonu Kapadokya bölgesinin iki ilçesi
Gülşehir ve Avanos'ta ikamet eden yetişkin gönüllülerden oluşuyordu. Toplum
temelli olarak planlanan bu müdahale çalışmasında Gülşehir “müdahale”, Avanos
“kontrol” ilçesi olarak seçildi. Çalışma 2013 yılında başlatıldı ve en az 10
yıl devam etmesi planlandı. Her iki ilçede de çalışma ofisleri kuruldu ve eğitimli personeller
tarafından ev ve iş yeri ziyaretleri ile elektronik anketler uygulandı ve fizik
muayeneler yapıldı. Bulgular: Toplamda 10.992 kişi kaydedilddahil edildi. Türkiye'nin
erişkin nüfusu ile karşılaştırıldığında, çalışma kohortunda yaş ortalaması
(44.5±17.4 yıla karşılık 31.9±21.2 yıl) ve kadın oranı (%56.5’e karşılık %51.2)
daha yüksekti ancak üniversite mezunlarının oranı (%17.1'e karşılık %32.2) daha
düşüktü. Kadınlarda erkeklere kıyasla obezite (%39.0’a karşılık %20.8) ve
yüksek riskli bel çevresi (%16.8’e karşılık %30.7) oranı daha yüksekti. Obezite
ayrıca her iki ilçede de kadınlar arasında çok yaygın bir risk faktörüydü
(Avanos'ta %36.9 ve Gülşehir'de %41.5). Fiziksel aktivite seviyeleri düşüktü;
en genç yaş grubunda bile (18-34 yaş) sadece kadınların %6'sı ve erkeklerin
%8'i “aktif” veya “çok aktif” idi. Sigara içme oranı erkeklerde kadınlara göre
daha yüksekti (%46.9 karşılık %13.8). Hipertansiyon, diabetes mellitus ve
romatolojik hastalıkların prevalansı kadınlarda erkeklere göre daha yüksekti
(her biri için p <0.0001); ancak kardiyovasküler hastalıklar ve kronik
obstrüktif akciğer hastalığı için anlamlı fark saptanmadı. Her iki ilçede de
hipertansiyon en sık bildirilen kronik hastalık iken, bunu Diabetes Mellitus,
hiperlipidemi ve kardiyovasküler hastalıklar izliyordu. Sonuçlar: Başlangıç veriler, Türkiye'nin Kapadokya bölgesinde
modifiye edilebilir yaşam tarzı risk faktörlerinin yüksek prevalansını
göstermiş ve etkili toplum tabanlı müdahalelere duyulan ihtiyacı ortaya
çıkarmıştır.

Keywords

Kohort çalışmaları, müdahale çalışması, kronik hastalıklar, risk faktörleri

Baseline data of a prospective cohort study: Cappadocia cohort study, Turkey

Abstract

Aims: This study aimed to determine the prevalence of chronic diseases and
behavioural risk factors from the baseline data of a large prospective cohort
study initiated in the Cappadocia region of Turkey. Method: The study population consisted of adult volunteers who resided in two
towns, Gulsehir and Avanos, of the Cappadocia region.  For the planned
community-based intervention trials, Gulsehir served as the “intervention” town
and Avanos was the “control” town. The study was initiated in 2013 and was
planned to be continued for a minimum of 10 years. Study offices were
established in both towns and trained personnel conducted electronic questionnaires and physical
examinations by visiting households and working places. Results: In total, 10,992
individuals were enrolled. Compared to Turkey’s adult population, the mean age
(44.5±17.4 years vs. 31.9±21.2 years) and the female proportion (56.5% vs.
51.2%) were higher but the proportion of university graduates (17.1% vs. 32.2%)
was lower in the study cohort. The rates of females having obesity (39.0% vs.
20.8%) and high-risk waist circumference (61.8% vs. 30.7%) were higher than males.
Obesity was also a very prevalent risk factor among females in both towns
(36.9% in Avanos and 41.5% in Gulsehir). Physical activity levels were low;
only 6% of females and 8% of males were “active” or “very active” even at the
youngest age group (18-34 years). The rate of smoking was higher in males than
in females (46.9% vs. 13.8%). The prevalence of hypertension, diabetes
mellitus, and rheumatologic diseases were higher in females than in males
(p<0.0001 for each); however, no significant differences were obtained for
cardiovascular diseases and chronic obstructive pulmonary disease. In both
towns, hypertension was the most commonly reported chronic disease followed by
DM, hyperlipidaemia, and cardiovascular diseases. Conclusions: Baseline data revealed
a high prevalence of modifiable lifestyle risk factors in the Cappadocia region
of Turkey and elucidated the need for effective community-based interventions.

Keywords

Cohort studies, intervention study, chronic diseases, risk factors

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