Araştırma Makalesi
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Obezite ile Mücadelede Obezite Merkezleri; Antalya İli Örneği

Yıl 2021, Cilt: 15 Sayı: 1, 19 - 26, 09.03.2021
https://doi.org/10.21763/tjfmpc.791794

Öz

Amaç: Bu araştırmada Sağlık Bilimleri Üniversitesi Antalya Eğitim ve Araştırma Hastanesi bünyesinde yer alan obezite merkezimizde aldığımız sonuçlarla ilgili verilerimizi paylaşmayı hedefledik. Yöntem: Retrospektif, tanımlayıcı, kesitsel araştırmaya 1 Kasım 2018 ve 20 Mart 2020 tarihleri arasında Sağlık Bilimleri Üniversitesi Antalya Eğitim ve Araştırma Hastanesi Obezite Merkezinde takipli 281 obez hasta dahil edildi. Sağlıklı beslenme ve düzenli fiziksel aktiviteyi yaşam tarzı haline getirmenin hedeflendiği merkezimizden hizmet alan 281 hastanın ilk başvuru ve son kontrol antropometrik ölçümleri ile kontrol kan tetkikleri yapılan 106 hastanın başlangıç ve 6 veya 12. ay kontrollerinde (en son yapılan test ve eş zamanlı bakılan ölçümleri değerlendirmeye alınmıştır) bakılan açlık kan şekeri, glikozillenmiş hemoglobin, açlık insülini, insülin direnci, total kolesterol, düşük dansiteli lipoprotein kolesterol, yüksek dansiteli lipoprotein kolesterol ve trigliserit düzeyleri karşılaştırıldı. Bulgular: Çalışmaya dahil edilen hastaların 260’ı (%92,5) kadın, 21’i erkekti (%7,5); yaş ortalaması 52,05±9,52 (21-73) yıl idi. Ortalama takip süresi 161,1±82,97 (11-365) gün olarak hesaplandı. Çalışmaya dahil edilen tüm hastaların kilo ve vücut kitle indeksi ortancalarının sırasıyla 93,4 (68,5-152,6) kg’dan 83,7 (59,3-138) kg’a ve 36,9 (30-65,2) kg/m2’den 32,6 (24,68-58,9) kg/m2’ye düştüğü gözlendi (p<0,001). Benzer şekilde, hastaların bel ve kalça çevrelerinde de istatistiksel olarak anlamlı bir düşüş tespit edildi (p<0,001). Kontrol kan tetkikleri yapılmış olan 106 hastanın açlık kan şekeri, glikozillenmiş hemoglobin, açlık insülini, insulin direnci (p<0,001), sistolik kan basıncı (p=0,014) ve trigliserit (p=0,007) düzeylerinde anlamlı düşüş, yüksek dansiteli lipoprotein kolesterol düzeyinde ise anlamlı yükselme görüldü (p<0,001). Hastaların verdikleri kilo oranına göre vücut kitle indeksi (p<0,001), bel çevresi (p<0,001), kalça çevresi (p<0,001), bel/kalça oranının (p<0,001) yanısıra glikozillenmiş hemoglobin (p=0,043) düşüşünde de istatistiksel olarak anlamlı bir değişiklik olduğu gözlendi. Sonuç: Sadece doğru yaşam tarzı değişikliği ile sağlanan kilo kaybının kan basıncı, kan şekeri ve lipid parametreleri gibi endokrin ve metabolik belirteçler üzerine olumlu etkisi gözlenmektedir. Özellikle programa tam uyum sağlayabilen hastalarda obezite merkezleri sağlıklı, güvenilir, maliyet etkin ve sürdürülebilir bir tedavi olanağı sağlamaktadır.

Kaynakça

  • 1. Purnell JQ. Definitions, classification, and epidemiology of obesity. Feingold KRAnawaltBBoyceAChrousosGDunganKGrossmanAHershmanJMKaltsasGKochCKopp P, et al., eds. In: Endotext. South Dartmouth, MA: MDText.com Inc.; 2000. Available online: https://www.ncbi.nlm.nih.gov/books/NBK279167/ (accessed on 21 July 2020).
  • 2. WHO. Obesity and Overweight. Available online: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight(accessed on 21 July 2020).
  • 3. Ghoorah K, Campbell P, Kent A, Maznyczka A, Kunadian V. Obesity and cardiovascular outcomes: a review. Eur Heart J Acute CardiovascCare 2016;5(1):77-85.
  • 4. Eckel RH, Kahn SE, Ferrannini E, Goldfine AB, Nathan DM, Schwartz MW et al. Obesity and type 2 diabetes: What can be unified and what needs to be individualized?Diabetes Care 2011; 34(6): 1424-1430.
  • 5. Klein S, Sheard NF, Pi-Sunyer X, Daly A, Wylie-Rosett J, Kulkarni K, et al. Weight management through lifestyle modification for the prevention and management of type 2 diabetes: Rationale and Strategies: A statement of the American Diabetes Association, the North American Association for the Study of Obesity, and the American Society for Clinical Nutrition Obesity and Cancer Risk: Recent review and evidence. Diabetes Care 2004;27(8):2067-73
  • 6. Bassen-Enguist K, Chang M. Obesity and cancer risk: Recent review and evidence. CurrOncol Rep 2011;13(1):71-76.
  • 7. TEMD Obezite, Lipid Metabolizması, HipertansiyonÇalışmaGrubu. Obezitetanıvetedavikılavuzu 2019, 8. baskı. Ankara, TürkiyeEndokrinolojiveMetabolizmaDerneği, 2019. Available online: http://temd.org.tr/admin/uploads/tbl_kilavuz/ 20190506163904-2019tbl_kilavuz5ccdcb9e5d.pdf (accessed on 21 July 2020).
  • 8. 2018/29 sayılıobezitemerkezlerininaçılması, tesciledilmesi, çalışmausulveesaslarıhakkındagenelgesi Available online: https://shgm.saglik.gov.tr/TR, 50203/201829-sayili-obezite-merkezlerinin-acilmasi-tescil-edilmesi-calisma-usul-ve-esaslari-hakkinda-genelgesi.html (accessed on 21 July 2020).
  • 9. CDC. Defining adult overweight and obesity. Adult Body Mass Index (BMI), https://www.cdc.gov/obesity/adult/defining.html)
  • 10. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Teacher DF, Turner RC. Homeostasis model assessment: insulin resistance and b cell function from fasting plasma glucose and insulin concentration in man. Diabetologia 1985;28:412-429.
  • 11. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. ClinChem 1972; 18: 499-502.
  • 12. Yıldırım Dİ, Eryılmaz MA, Aydın M. Examination of patients’regularparticipiation at an obesity center with a retrospective evaluation of the effects of regular participation on patient mental status and blood parameters. ObesMetabSyndr 2020;30;29(2):150-157.
  • 13. Pasanisi F, Contaldo F, Simone G, Mancini M. Benefits of sustained moderate weight loss in obesity. NutrMetabCardiovasc Dis 2001;11:401-406.
  • 14. Wing RR, Lang W, Wadden TA, Safford M, Knowler WC, Bertoni AG, et al. Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with Type 2 diabetes. Diabetes care 2011;34(7):1481-1486.
  • 15. Heneghan HM, Meron-Eldar S, Brethauer SA, Schauer PS, Young JB. Effect of bariatric surgery on cardiovascular risk profile. Am J Cardiol 2011; 108(10):1499-507.
  • 16. Kocaöz S, Parlak Ö. The body weight, blood pressure, and biochemical parameters of the patients after obesity surgery. SN Comprehensive Clinical Medicine 2019;1:646-649.
  • 17. Son O, Erenoğlu Son N, Bilge U, Soğukpınar C, Yorulmaz G, Cileker M. Evaluation of patients who went under sleeve gastrectomy. Retrospective evaluation of 3 Groups of patients. Biomedical Research 2016;27(1):159-164.
  • 18. Domicnik-Karlowicz J, Rymarczyk Z, Dzikowska-Diduch O, Lisik W, Chmura A, Demkow U, Pruszczky P. Emerging markers of atherosclerosis before and after bariatric surgery.ObesSurg 2015;25:486-493.
  • 19. Ertugrul I, Kuzu F. The impact of bariatric surgery on hematological inflammatory parameters. Annals of Medical Research 2019;26(10):2250-2254.
  • 20. Ali KM, Wonnerth A, Huber K, Wojta J. Cardiovascular disease risk reduction by raising HDL-cholesterol-current therapies and future oppotunities. Br J Pharmacol 2012; 167(6): 1177–1194.
  • 21. Salvatore N. Low HDL-cholesterol concentrations cause atherosclerotic disease to develop. European Cardiology of Society. Available online:https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-7/Low-HDL-cholesterol-concentrations-cause-atherosclerotic-disease-to-develop#:~:text=Ample%20evidence%20supports%20the%20causal,traditional%20risk%20factors%20(7).(accessed on 21 July 2020).
  • 22. Hassan M, Philip P. CANHEART: Is HDL cholesterol a cardiovascular specific risk factor? Glob CardiolSciPract 2016; 2016(4):e201634.

The Role of Obesity Centers in the Fight Against Obesity: The Case of Antalya Province

Yıl 2021, Cilt: 15 Sayı: 1, 19 - 26, 09.03.2021
https://doi.org/10.21763/tjfmpc.791794

Öz

Aim: This study aimed to share data regarding the results obtained at the Obesity Center of Antalya Training and Research Hospital at the University of Health Sciences. Methods: This retrospective, descriptive and cross-sectional study included 281 obese patients who were followed up at the Obesity Center of Antalya Training and Research Hospital, the University of Health Sciences, between November 1st, 2018 and March 20th, 2020.First admission and last control anthropometric measurements of 281 patients and first follow-up and 6th or 12th months control blood tests of 106 patients (the last test and concurrent measurements were evaluated), during which fasting blood glucose, glycosylated hemoglobin, fasting insulin, insulin resistance, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and triglyceride levels were compared. Results: Of all the patients included in the study, 260 (92.5%) were female and 21 were male (7.5%). The mean age was 52.05 ± 9.52 (21-73) years. The mean follow-up period was estimated to be 161.1 ± 82.97 (11-365) days. Median weight and body mass index of all patients (281 patients) were found to have decreased from 93.4 (68.5-152.6) kg to 83.7 (59.3-138) kg, and from 36.9 (30-65.2) kg/m2 to 32.6 (24.68-58.9) kg/m2 (p<0.001), respectively. Similarly, a statistically significant decrease was observed in the waist and hip circumference of the patients (p <0.001). Apart from this, fasting blood glucose, glycosylated hemoglobin, fasting insulin, insulin resistance (p<0.001), systolic blood pressure (p=0.014), and triglyceride (p=0.007) levels of 106 patients who had control blood tests also showed a significant decrease, as opposed to a significant increase in high density lipoprotein cholesterol levels (p<0.001). Another statistical significance was the decrease in the body mass index (p<0.001), waist circumference (p <0.001), hip circumference (p <0.001), waist/hip ratio (p<0.001) as well as in the glycosylated hemoglobin (p=0.043) according to the weight loss ratio of the patients. Conclusion: Achieved only through adopting the right lifestyle, the positive effect of weight loss is observed on endocrine and metabolic markers such as blood pressure, blood sugar and lipid parameters. Obesity centers provide patients a healthy, reliable, cost-effective and sustainable treatment opportunity, especially for those who can fully comply with the program.

Kaynakça

  • 1. Purnell JQ. Definitions, classification, and epidemiology of obesity. Feingold KRAnawaltBBoyceAChrousosGDunganKGrossmanAHershmanJMKaltsasGKochCKopp P, et al., eds. In: Endotext. South Dartmouth, MA: MDText.com Inc.; 2000. Available online: https://www.ncbi.nlm.nih.gov/books/NBK279167/ (accessed on 21 July 2020).
  • 2. WHO. Obesity and Overweight. Available online: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight(accessed on 21 July 2020).
  • 3. Ghoorah K, Campbell P, Kent A, Maznyczka A, Kunadian V. Obesity and cardiovascular outcomes: a review. Eur Heart J Acute CardiovascCare 2016;5(1):77-85.
  • 4. Eckel RH, Kahn SE, Ferrannini E, Goldfine AB, Nathan DM, Schwartz MW et al. Obesity and type 2 diabetes: What can be unified and what needs to be individualized?Diabetes Care 2011; 34(6): 1424-1430.
  • 5. Klein S, Sheard NF, Pi-Sunyer X, Daly A, Wylie-Rosett J, Kulkarni K, et al. Weight management through lifestyle modification for the prevention and management of type 2 diabetes: Rationale and Strategies: A statement of the American Diabetes Association, the North American Association for the Study of Obesity, and the American Society for Clinical Nutrition Obesity and Cancer Risk: Recent review and evidence. Diabetes Care 2004;27(8):2067-73
  • 6. Bassen-Enguist K, Chang M. Obesity and cancer risk: Recent review and evidence. CurrOncol Rep 2011;13(1):71-76.
  • 7. TEMD Obezite, Lipid Metabolizması, HipertansiyonÇalışmaGrubu. Obezitetanıvetedavikılavuzu 2019, 8. baskı. Ankara, TürkiyeEndokrinolojiveMetabolizmaDerneği, 2019. Available online: http://temd.org.tr/admin/uploads/tbl_kilavuz/ 20190506163904-2019tbl_kilavuz5ccdcb9e5d.pdf (accessed on 21 July 2020).
  • 8. 2018/29 sayılıobezitemerkezlerininaçılması, tesciledilmesi, çalışmausulveesaslarıhakkındagenelgesi Available online: https://shgm.saglik.gov.tr/TR, 50203/201829-sayili-obezite-merkezlerinin-acilmasi-tescil-edilmesi-calisma-usul-ve-esaslari-hakkinda-genelgesi.html (accessed on 21 July 2020).
  • 9. CDC. Defining adult overweight and obesity. Adult Body Mass Index (BMI), https://www.cdc.gov/obesity/adult/defining.html)
  • 10. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Teacher DF, Turner RC. Homeostasis model assessment: insulin resistance and b cell function from fasting plasma glucose and insulin concentration in man. Diabetologia 1985;28:412-429.
  • 11. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. ClinChem 1972; 18: 499-502.
  • 12. Yıldırım Dİ, Eryılmaz MA, Aydın M. Examination of patients’regularparticipiation at an obesity center with a retrospective evaluation of the effects of regular participation on patient mental status and blood parameters. ObesMetabSyndr 2020;30;29(2):150-157.
  • 13. Pasanisi F, Contaldo F, Simone G, Mancini M. Benefits of sustained moderate weight loss in obesity. NutrMetabCardiovasc Dis 2001;11:401-406.
  • 14. Wing RR, Lang W, Wadden TA, Safford M, Knowler WC, Bertoni AG, et al. Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with Type 2 diabetes. Diabetes care 2011;34(7):1481-1486.
  • 15. Heneghan HM, Meron-Eldar S, Brethauer SA, Schauer PS, Young JB. Effect of bariatric surgery on cardiovascular risk profile. Am J Cardiol 2011; 108(10):1499-507.
  • 16. Kocaöz S, Parlak Ö. The body weight, blood pressure, and biochemical parameters of the patients after obesity surgery. SN Comprehensive Clinical Medicine 2019;1:646-649.
  • 17. Son O, Erenoğlu Son N, Bilge U, Soğukpınar C, Yorulmaz G, Cileker M. Evaluation of patients who went under sleeve gastrectomy. Retrospective evaluation of 3 Groups of patients. Biomedical Research 2016;27(1):159-164.
  • 18. Domicnik-Karlowicz J, Rymarczyk Z, Dzikowska-Diduch O, Lisik W, Chmura A, Demkow U, Pruszczky P. Emerging markers of atherosclerosis before and after bariatric surgery.ObesSurg 2015;25:486-493.
  • 19. Ertugrul I, Kuzu F. The impact of bariatric surgery on hematological inflammatory parameters. Annals of Medical Research 2019;26(10):2250-2254.
  • 20. Ali KM, Wonnerth A, Huber K, Wojta J. Cardiovascular disease risk reduction by raising HDL-cholesterol-current therapies and future oppotunities. Br J Pharmacol 2012; 167(6): 1177–1194.
  • 21. Salvatore N. Low HDL-cholesterol concentrations cause atherosclerotic disease to develop. European Cardiology of Society. Available online:https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-7/Low-HDL-cholesterol-concentrations-cause-atherosclerotic-disease-to-develop#:~:text=Ample%20evidence%20supports%20the%20causal,traditional%20risk%20factors%20(7).(accessed on 21 July 2020).
  • 22. Hassan M, Philip P. CANHEART: Is HDL cholesterol a cardiovascular specific risk factor? Glob CardiolSciPract 2016; 2016(4):e201634.
Toplam 22 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular İç Hastalıkları
Bölüm Orijinal Makaleler
Yazarlar

Remziye Nur Eke 0000-0002-2410-0802

Yayımlanma Tarihi 9 Mart 2021
Gönderilme Tarihi 8 Eylül 2020
Yayımlandığı Sayı Yıl 2021 Cilt: 15 Sayı: 1

Kaynak Göster

Vancouver Nur Eke R. The Role of Obesity Centers in the Fight Against Obesity: The Case of Antalya Province. TJFMPC. 2021;15(1):19-26.

Sağlığın ve birinci basamak bakımın anlaşılmasına ve geliştirilmesine katkıda bulunacak yeni bilgilere sahip yazarların İngilizce veya Türkçe makaleleri memnuniyetle karşılanmaktadır.