Normal kilolu ve fazla kilolu kadınlarda vücut yağ oranının antropometrik ve metabolik parametrelerle ilişkisi; normal kilolu obezite kavramı
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Dosyalar
Tarih
2018
Yazarlar
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Cilt Başlığı
Yayıncı
Düzce Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
ÖZET Amaç: Obezite, vücutta yağ birikiminin aşırı düzeyde artmasıyla karakterize bir hastalık olarak tanımlanmakta ve pratikte tanısı beden kitle indeksiyle (BKİ) konulmaktadır. BKİ normal olup vücut yağ oranının (VYO) normalin üstünde bulunduğu durum "normal kilolu obezite(NKO)" olarak tanımlanmaktadır ve bu durumun metabolik parametreleri etkilediğine dair çalışmalar mevcuttur. Bu çalışma ile polikliniklerimize başvuran normal kilolu ve fazla kilolu kadınlarda VYO'nun antropometrik ve metabolik parametrelerle ilişkisini saptamaya ve NKO kavramını gündeme getirmeye çalıştık. Ayrıca önemine binaen NKO'lu hastaların atlanmaması, tedavilerinin düzenlenmesi ve geleceğe dair risklerinin hastalara aktarılmasını sağlayarak poliklinik pratiğinin bu konuda değişmesinin gerekliliğini vurgulamayı amaçladık. Yöntem: Çalışmamızda retrospektif olarak Ocak 2018 - Temmuz 2018 tarihleri arasında Düzce Üniversitesi Aile Hekimliği Anabilim Dalı polikliniklerine başvurmuş hastaların arşiv dosyaları incelenmiş ve dahil edilme kriterlerimize uyan 200 hasta çalışmaya alınmıştır. Hastalar BKİ ve VYO durumuna göre 50'şer kişilik 4 gruba ayrılmıştır: Normal kilolu ve normal VYO'ya (<%30) sahip olanlar (NKN); normal kilolu ve yüksek VYO'ya sahip olanlar; fazla kilolu ve normal VYO'ya sahip olanlar; fazla kilolu ve yüksek VYO'ya sahip olanlar. Çalışmada hastaların biyoelektrik impedans analizleriyle(BİA), antropometrik ve biyokimyasal parametreleri kullanılmıştır. Gruplar arasında bu parametrelerin değişimi ve birbirleri arasındaki korelasyon incelenmiştir. İstatistiksel değerlendirmeler için SPSS paket programı kullanılmıştır ve p<0,05 istatistiksel olarak anlamlı kabul edilmiştir. Bulgular: NKO grubunda NKN grubuna göre açlık kan şekeri, insülin, HOMA-IR, total kolesterol (TK), LDL, trigliserid (TG) ve TSH gibi önemli metabolik parametrelerin düzeyleri daha yüksektir. Ancak muhtemelen hasta sayısındaki azlık nedeniyle istatistiksel olarak anlamlı bulunmamıştır. NKO grubunda diğer gruplara göre ortalama LDL düzeyi pik yapmış ve istatistiksel olarak anlamlı derecede yüksek bulunmuştur. VYO; insülin, HOMA-IR, VYD, bel - kalça çevreleri ve bel/boy - kalça/boy oranlarıyla pozitif korelasyon göstermektedir. TK, TG, LDL ve HDL kolesterol seviyeleriyle ise anlamlı bir ilişkisi tespit edilmemiştir. Sonuç: VYO tespitinin obeziteyle mücadelede önemli bir yere sahiptir. Bu konuda pratik bir yöntem olan BİA öne çıkmakta ve önerilmektedir. Çalışmada elde ettiğimiz sonuçlar da göz önünde bulundurularak birinci basamakta, toplum taramalarında ve polikliniklerde hastaların obezite yönünden değerlendirilmesi sadece kilo – boy ölçümü yaparak değil ayrıntılı vücut komposizyonu tespitiyle yapılmalıdır.
ABSTRACT Aim: Although obesity is characterized by an excessive amount of body fat, it is commonly measured using body mass index (BMI). The term of "normal weight obesity (NWO)" was defined as the combination of BMI within the normal range and excess body fat (BF%). There are a lot of study that shows NWO affects biochemical parameters. In this study, we tried to examine the relationship between BF% and anthropometric and metabolic parameters and to revive the term of NWO. And also we aimed to change the polyclinic praxis by not missing out the NWO subjects, arranging treatment of this NWO group and remarking the risks about this situation. Method: In this study, we retrospectively reviewed the archive files of the patients who applied to the Department of Family Medicine at Düzce University between January 2018 and July 2018 and included 200 patients who met our inclusion criteria. Patients were divided into 4 groups according to BMI and BF% status: Normal weight – normal BF% (<%30) group (NWL); normal weight – excess BF% group; overweight – normal BF% group; overweight – excess BF% group. In the study, anthropometric and biochemical parameters were used with bioelectrical impedance analysis (BIA) of the patients. The change of these parameters between the groups and the correlation between each other were examined. SPSS package program was used for statistical evaluations and p <0.05 was considered statistically significant. Results: Serum levels of important biochemical parameters like fasting plasma glucose, insulin, HOMA-IR, total cholesterol (TC), LDL, triglyceride (TG) and TSH were higher in NWO subjects than NWL subjects. But these wasn't statically significant probably due to the small number of patients. The mean LDL levels was found to be higher in the NWO group compared to the other groups and it was found to be statistically significant. BF% was positively correlated to insulin, HOMA-IR, visceral fat rating, waist - hip circumferences, waist to height - hip to height ratios but there wasnt significant association between BF% and TC, TG, LDL, HDL levels. Conclusion: BF% detection has an important place in the fight against obesity. A practical method, BIA, stands out and is recommended. Considering the results obtained in the study, evaluation of patients in terms of obesity in primary care, community screening and polyclinics should be done not only by weight-height measurement but by detailed body composition determination.
ABSTRACT Aim: Although obesity is characterized by an excessive amount of body fat, it is commonly measured using body mass index (BMI). The term of "normal weight obesity (NWO)" was defined as the combination of BMI within the normal range and excess body fat (BF%). There are a lot of study that shows NWO affects biochemical parameters. In this study, we tried to examine the relationship between BF% and anthropometric and metabolic parameters and to revive the term of NWO. And also we aimed to change the polyclinic praxis by not missing out the NWO subjects, arranging treatment of this NWO group and remarking the risks about this situation. Method: In this study, we retrospectively reviewed the archive files of the patients who applied to the Department of Family Medicine at Düzce University between January 2018 and July 2018 and included 200 patients who met our inclusion criteria. Patients were divided into 4 groups according to BMI and BF% status: Normal weight – normal BF% (<%30) group (NWL); normal weight – excess BF% group; overweight – normal BF% group; overweight – excess BF% group. In the study, anthropometric and biochemical parameters were used with bioelectrical impedance analysis (BIA) of the patients. The change of these parameters between the groups and the correlation between each other were examined. SPSS package program was used for statistical evaluations and p <0.05 was considered statistically significant. Results: Serum levels of important biochemical parameters like fasting plasma glucose, insulin, HOMA-IR, total cholesterol (TC), LDL, triglyceride (TG) and TSH were higher in NWO subjects than NWL subjects. But these wasn't statically significant probably due to the small number of patients. The mean LDL levels was found to be higher in the NWO group compared to the other groups and it was found to be statistically significant. BF% was positively correlated to insulin, HOMA-IR, visceral fat rating, waist - hip circumferences, waist to height - hip to height ratios but there wasnt significant association between BF% and TC, TG, LDL, HDL levels. Conclusion: BF% detection has an important place in the fight against obesity. A practical method, BIA, stands out and is recommended. Considering the results obtained in the study, evaluation of patients in terms of obesity in primary care, community screening and polyclinics should be done not only by weight-height measurement but by detailed body composition determination.
Açıklama
YÖK Tez No: 520723
Anahtar Kelimeler
Aile Hekimliği, Family Medicine, Adipoz doku, Adipose tissue, Antropometri, Anthropometry, Elektriksel impedans, Electric impedance, Kadınlar, Women, Kilo alma, Weight gain, Obezite, Obesity, İnsülin direnci, Insulin resistance, Normal kilolu obezite, vücut yağ oranı, biyoelektrik impedans analizi, insülin direnci, antropometrik ölçümler, Normal weight obesity, body fat ratio, bioelectric impedance analysis, insülin resistance, anthropometric measurement
