Obezite polikliniğine başvuran hastaların değerlendirilmesi
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Dosyalar
Tarih
2021
Yazarlar
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Cilt Başlığı
Yayıncı
Düzce Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada obezite polikliniğe başvuran hastaların biyokimyasal özelliklerinin, eşlik eden hastalık ve kullandıkları ilaçların yaş, cinsiyet ve VKİ ile ilişkisini inceledik. Hastaların poliklinik takipleri süresince kilo değişim durumunu ve tedavi başarısını tespit etmeyi amaçladık. Yöntem: Bu retrospektif çalışmaya Düzce Üniversitesi Tıp Fakültesi Aile Hekimliği Anabilim Dalı Obezite Polikliniği'ne Ocak 2018-Aralık 2018 tarihleri arasında başvuran hastalar dahil edildi. Hastaların sosyodemografik özellikleri, antropometrik ölçümleri, poliklinik başvuru sayıları ve laboratuvar sonuçları dosyalardan taranarak veriler elde edildi. Hastalar vücut kitle indeksi değerlerine göre 4 gruba ayrıldı. Hastaların ilk kontrol ve son kontrolleri arasındaki kilo değişim yüzdeleri hesaplandı ve %5 ve üzeri kilo kaybı olanlar başarılı kabul edildi. Hastaların kilo verme başarısı ve etkileyen faktörler incelendi. Bulgular: Çalışmaya %85,7 (n= 498) kadın, %14,3 (n=83) erkek olan ve çalışma kriterlerine uyan 581 hasta dahil edildi. Cinsiyet dışında yaş grupları, medeni durum, eğitim düzeyi, çocuk sayısı ve mesleklere göre VKİ grupları arasında anlamlı düzeyde fark vardı (her biri için p<0,001). 18-29 yaş grubunda preobez bireylerin oranı diğer gruplara göre anlamlı daha yüksekti. Evlilerde preobez bireylerin oranı diğer gruplara göre anlamlı daha düşükken bekarlarda anlamlı daha yüksekti. Eğitim düzeyine göre ilkokul mezunlarında morbid obez grup, üniversite mezunlarında ise preobez grup diğer gruplara göre anlamlı yüksekti. Preobez gruptaki bireylerin çocuk sayısı diğer VKİ grupları içinde en düşüktü (her biri p<0,05). Kadınlarda TSH ve HDL medyan değeri erkeklerden anlamlı daha yüksekti. Erkeklerde ise hemoglobin, demir, Ferritin, trigliserit medyan değeri kadınlardan anlamlı olarak daha yüksek bulundu (her biri p<0,05). Çalışmamızda obezite derecesinin artmasıyla olguların açlık plazma glukozu, insülin, insülin direnci, trigliserit düzeylerinde anlamlı artış olduğu görüldü (her biri için p<0,001). Çalışmamızda kilo verme yüzdesi ortalama %5,6, en düşük %-8,8 en yüksek %31,2 idi. Kilo kaybı %5 ve üzeri olan başarılı grup hasta oranı %50,6 iken erkeklerde kilo verme başarı oranı (%65,1), kadınlardakinden (%48,2) anlamlı düzeyde daha yüksekti (p<0,05) Cinsiyet dışında yaş grubu, meslek ve VKİ gruplarına göre kilo verme başarı durumu oranları arasında anlamlı düzeyde fark yoktu (her biri p>0,05). Poliklinik takip sayısı arttıkça kilo verme yüzdesi de artmaktaydı (p<0,001). Sonuç: Çalışma sonuçlarımıza göre Obezite Polikliniğimize başvuran hastaların %50,6'ı yaşam tarzı değişikliği, diyet ve egzersiz önerileri ile takipleri süresince en az %5 ve üzeri kilo vermiştir. Kilo verme oranı poliklinik takip sayısı arttıkça artmıştır. Obezitenin tedavisinin başarılı olmasında düzenli kontroller önemli bir etkendir. Birinci basamağın görevlerinden olan koruyucu hekimlik adına normal kilolu bireylere obezite ve sağlıklı yaşam ile ilgili danışmanlık hizmeti verilerek kilo almalarının önüne geçilmeli, preobez ve obez kişilerin takibinde ise danışmanlık hizmeti verilmeli, gerektiğinde medikal tedavi desteği verilerek kilonun azaltılması sağlanmalıdır.
Aim: In this study, we examined the relationship between biochemical characteristics, comorbid diseases and the drugs they use, with age, gender and VKİ of patients who applied to the obesity outpatient clinic. We aimed to determine the weight change status and treatment success of the patients during their outpatient follow-up. Method: Patients who applied to Duzce University Faculty of Medicine, Department of Family Medicine, Obesity Polyclinic between January 2018 and December 2018 were included in this retrospective study. Data were obtained by scanning the sociodemographic characteristics, anthropometric measurements, number of outpatient clinic applications and laboratory results of the patients from the files. The patients were divided into 4 groups according to their body mass index values. The weight change percentages between the first and last controls of the patients were calculated, and those with 5% or more weight loss were considered successful. The weight loss success of the patients and the affecting factors were examined. Results: A total of 581 patients, 85.7% (n= 498) female and 14.3% (n=83) male, who met the study criteria were included in the study. Apart from gender, there were significant differences between BMI groups according to age groups, marital status, education level, number of children and occupations (p<0.001 for each). The rate of preobese in the 18-29 age group was significantly higher than the other groups. While the rate of preobese was significantly lower in married compared to other groups, it was significantly higher in singles. According to education level, morbidly obese group in primary school graduates and preobese group in university graduates were significantly higher than other groups. The number of children in the preobese group was the lowest among the other BMI groups (each p<0.05). The median value of TSH and HDL in women was significantly higher than in men. Hemoglobin, iron, ferritin and triglyceride median values were found to be significantly higher in males than females (each p<0.05). In our study, it was observed that there was a significant increase in fasting plasma glucose, insulin, insulin resistance and triglyceride levels of the cases with the increase in the degree of obesity (p<0.001 for each). In our study, the mean weight loss percentage was 5.6%, the lowest-8.8% and the highest 31.2%. While the rate of successful group patients with 5% or more weight loss was 50.6%, weight loss success rate in men (65.1%) was significantly higher than in women (48.2%) (p<0.05). There was no significant difference in weight loss success rates according to gender, occupation and BMI groups (each p>0.05). As the number of outpatient follow-ups increased, the percentage of weight loss also increased (p<0.001). Conclusion: According to our study results, 50.6% of the patients who applied to our Obesity Outpatient Clinic lost at least 5% or more weight during their follow-up with lifestyle changes, diet and exercise recommendations. As the number of outpatient follow-ups increased, the rate of weight loss also increased. Regular check-ups are an important factor in the successful treatment of obesity. In the name of preventive medicine, which is one of the duties of primary health care services, weight gain should be prevented by providing counseling services to individuals with normal weight on obesity and healthy life.
Aim: In this study, we examined the relationship between biochemical characteristics, comorbid diseases and the drugs they use, with age, gender and VKİ of patients who applied to the obesity outpatient clinic. We aimed to determine the weight change status and treatment success of the patients during their outpatient follow-up. Method: Patients who applied to Duzce University Faculty of Medicine, Department of Family Medicine, Obesity Polyclinic between January 2018 and December 2018 were included in this retrospective study. Data were obtained by scanning the sociodemographic characteristics, anthropometric measurements, number of outpatient clinic applications and laboratory results of the patients from the files. The patients were divided into 4 groups according to their body mass index values. The weight change percentages between the first and last controls of the patients were calculated, and those with 5% or more weight loss were considered successful. The weight loss success of the patients and the affecting factors were examined. Results: A total of 581 patients, 85.7% (n= 498) female and 14.3% (n=83) male, who met the study criteria were included in the study. Apart from gender, there were significant differences between BMI groups according to age groups, marital status, education level, number of children and occupations (p<0.001 for each). The rate of preobese in the 18-29 age group was significantly higher than the other groups. While the rate of preobese was significantly lower in married compared to other groups, it was significantly higher in singles. According to education level, morbidly obese group in primary school graduates and preobese group in university graduates were significantly higher than other groups. The number of children in the preobese group was the lowest among the other BMI groups (each p<0.05). The median value of TSH and HDL in women was significantly higher than in men. Hemoglobin, iron, ferritin and triglyceride median values were found to be significantly higher in males than females (each p<0.05). In our study, it was observed that there was a significant increase in fasting plasma glucose, insulin, insulin resistance and triglyceride levels of the cases with the increase in the degree of obesity (p<0.001 for each). In our study, the mean weight loss percentage was 5.6%, the lowest-8.8% and the highest 31.2%. While the rate of successful group patients with 5% or more weight loss was 50.6%, weight loss success rate in men (65.1%) was significantly higher than in women (48.2%) (p<0.05). There was no significant difference in weight loss success rates according to gender, occupation and BMI groups (each p>0.05). As the number of outpatient follow-ups increased, the percentage of weight loss also increased (p<0.001). Conclusion: According to our study results, 50.6% of the patients who applied to our Obesity Outpatient Clinic lost at least 5% or more weight during their follow-up with lifestyle changes, diet and exercise recommendations. As the number of outpatient follow-ups increased, the rate of weight loss also increased. Regular check-ups are an important factor in the successful treatment of obesity. In the name of preventive medicine, which is one of the duties of primary health care services, weight gain should be prevented by providing counseling services to individuals with normal weight on obesity and healthy life.
Açıklama
Anahtar Kelimeler
Aile Hekimliği, Family Medicine, obezite, VKİ, kilo verme yüzdesi, takip, Obesity, BMI, weight loss percentage, follow-up
