Fizik aktivitenin Türk yetişkinlerini metabolik bozukluklardan koruduğuna ilişkin ileriye dönük kanıt
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Dosyalar
Tarih
2007
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Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Yeni gelişen koroner kalp hastalığı (KKH) ile belirli metabolik bozuklukları öngörmede fizik aktivite derecesinin rolü ve abdominal obezitenin olası aracılığı araştırıldı. Çalışma planı: TEKHARF çalışması 1997/98 ve 2002/03 taramalarında izlenen ve başlangıçta KKH tanısı bulunmayan, 28 yaş ve üzerindeki 3248 katılımcı (1601 erkek, 1647 kadın; ort. yaş 4812) sekiz yıl süresince ileriye dönük olarak incelendi. Fizik aktivite derecesi aktif ve oturgan biçiminde sınıflandırıldı. Metabolik sendrom (MetS) tanımında erkekte abdominal obezite için modifikasyonlu ATP-III ölçütlerine uyuldu. Ölümlü olmayan KKH tanısı öykü, kardiyovasküler sistemin fizik muayenesi ve dinlenme EKG’lerinin Minnesota kodlamasına dayandırıldı. Ortalama izleme süresi 6.8 yıldı. Bulgular: Yeni hipertansiyon, diyabet ve MetS gelişme oranları sırasıyla %39, %8.6 ve %25.4 bulundu. Cinsiyet, yaş ve bel çevresi için ayarlı fizik aktivite örnekleminde, aktif grubun oturgan gruba kıyasla nispi riskleri anlamlı biçimde düşük bulundu: Hipertansiyon için 0.76 (%95 GA 0.63; 0.91), diyabet için 0.66 (%95 GA 0.49; 0.89), MetS için 0.76 (%95 GA 0.60; 0.97). Fizik aktivitenin bu durumlardan koruması, bel çevresi ya da C-reaktif protein aracılığı dışında görüldü; çünkü, abdominal obezite riskinden koruması anlamlı düzeye ulaşmadı. Fiziksel aktivite derecesinin aterojen dislipidemi ile LDL-kolesterol yüksekliği ve KKH gelişme riskinde etkili olduğuna ilişkin kanıt ortaya çıkmadı. Egzersiz sayesinde erkeklerin diyabetten, kadınların hipertansiyondan anlamlı biçimde korunduğu görüldü. Metabolik bozukluklar bütününde ise, egzersizin sağladığı koruma iki cinste benzer bulundu. Sonuç: Cinsiyet ve yaş için ayarlanan fizik aktivite, Türk yetişkinlerini yeni gelişen hipertansiyon, diyabet ve MetS’den korumaktadır. Bu korumanın, abdominal obezite ve inflamasyon sürecinin dışında esas olarak kan basıncındaki iyileşme üzerinden gerçekleştiği düşünüldü.
Objectives: We investigated the role of physical activity levels in predicting incident coronary heart disease (CHD) and certain metabolic disorders and the possible mediation of abdominal obesity. Study design: A total of 3248 participants (1601 men, 1647 women; age 􀂕28 years; mean age 48±12 years) who were enrolled, without a previous diagnosis of CHD, into the Turkish Adult Risk Factor Survey in 1997/98 and 2002/03 were prospectively studied over an eight-year period. Physical activity levels of the participants were categorized as active or sedentary. Metabolic syndrome (MetS) was defined with the ATP-III criteria with modification for male abdominal obesity. Diagnosis of non-fatal CHD was based on history, physical examination, and the Minnesota coding of resting electrocardiograms. The mean follow-up was 6.8 years. Results: The rates of incident hypertension, diabetes, and MetS were 39%, 8.6%, and 25.4%, respectively. After adjustment for gender, age, and waist circumference, the relative risks (RR) calculated for hypertension (RR 0.76; 95% CI 0.63; 0.91), diabetes (RR 0.66; 95% CI 0.49; 0.89), and MetS (RR 0.76; 95% CI 0.60; 0.97) were significantly lower in the physically active group. Protection offered by physical activity was not mainly mediated by waist circumference or C-reactive protein, since protection from abdominal obesity risk did not reach significance. No influence of physical activity was observed on the risks for developing atherogenic dyslipidemia, elevated LDL-cholesterol, and CHD. Exercise significantly protected men from diabetes, and women from hypertension. Overall, protection from metabolic disorders was similar in both sexes. Conclusion: Physical activity, adjusted for gender and age, protects Turkish adults from incident hypertension, diabetes, and MetS. This protection is considered to operate mainly through improvements in blood pressure, beyond the mediation of abdominal obesity and low-grade inflammation.
Objectives: We investigated the role of physical activity levels in predicting incident coronary heart disease (CHD) and certain metabolic disorders and the possible mediation of abdominal obesity. Study design: A total of 3248 participants (1601 men, 1647 women; age 􀂕28 years; mean age 48±12 years) who were enrolled, without a previous diagnosis of CHD, into the Turkish Adult Risk Factor Survey in 1997/98 and 2002/03 were prospectively studied over an eight-year period. Physical activity levels of the participants were categorized as active or sedentary. Metabolic syndrome (MetS) was defined with the ATP-III criteria with modification for male abdominal obesity. Diagnosis of non-fatal CHD was based on history, physical examination, and the Minnesota coding of resting electrocardiograms. The mean follow-up was 6.8 years. Results: The rates of incident hypertension, diabetes, and MetS were 39%, 8.6%, and 25.4%, respectively. After adjustment for gender, age, and waist circumference, the relative risks (RR) calculated for hypertension (RR 0.76; 95% CI 0.63; 0.91), diabetes (RR 0.66; 95% CI 0.49; 0.89), and MetS (RR 0.76; 95% CI 0.60; 0.97) were significantly lower in the physically active group. Protection offered by physical activity was not mainly mediated by waist circumference or C-reactive protein, since protection from abdominal obesity risk did not reach significance. No influence of physical activity was observed on the risks for developing atherogenic dyslipidemia, elevated LDL-cholesterol, and CHD. Exercise significantly protected men from diabetes, and women from hypertension. Overall, protection from metabolic disorders was similar in both sexes. Conclusion: Physical activity, adjusted for gender and age, protects Turkish adults from incident hypertension, diabetes, and MetS. This protection is considered to operate mainly through improvements in blood pressure, beyond the mediation of abdominal obesity and low-grade inflammation.
Açıklama
Anahtar Kelimeler
Kalp ve Kalp Damar Sistemi
Kaynak
Türk Kardiyoloji Derneği Arşivi
WoS Q Değeri
Scopus Q Değeri
Cilt
35
Sayı
8
