MELİH KAAN SÖZMEN, Belgin ÜNAL, Gül ERGÖR, SİBEL SAKARYA, Gönül DİNÇ, Nazan YARDIM, Bekir KESKİNKILIÇ

Türkiye'de Antropometrik Ölçüm Yöntemlerinin Kardiyovasküler Hastalık Riski İle İlişkisi

Amaç: Bu çalışmanın amacı antropometrik ölçütlerin ko- roner kalp hastalığı (KKH) ya da KKHya bağlı ölüm riskini öngörme güçlerini karşılaştırmaktır. Yöntemler: Bu çalışmada Sağlık Bakanlığı tarafından yü- rütülen ulusal temsiliyeti olan Kronik Hastalıklar ve Risk Faktörleri Sıklığı çalışmasının kesitsel verisi kullanılmış- tır. Beden kütle indeksi (BKİ), bel çevresi (BÇ), bel-kalça oranı (BKO), bel-boy oranı (BBO), beden adiposite indek- si ve beden şekli indeksi (BŞİ) incelenen antropometrik ölçümlerdir. Her bir birey için KKH gelişme ya da KKHa bağlı ölüm riski Framingham ve SCORE risk eşitlikleri kul- lanılarak hesaplanmıştır. Antropometrik ölçümlerin öngö- rü yeteneği ROC eğrileri ile değerlendirilmiştir. Bulgular: Her iki cinsiyette de yüksek KKH riski için sant- ral obezite ile ilişkili antropometrik ölçütlerin BKİye göre daha yüksek eğri altı alana (EAA) sahip olduğu saptan- mıştır. BŞİ, Framingham risk skoru (FRS) ile hesaplanan KKH ölümü (EAA: 0,61), SCORE ile elde edilen 10 yıllık KVH ölüm riski için (EAA: 0,63) en yüksek EAA değerle- rini sağlarken, kadınlarda BŞİ için en yüksek EAA değeri sadece SCORE risk eşik değeri için elde etmiştir (EAA: 0,71). Kadınlarda FRS ile hesaplanan KKH insidansı (EAA: 0,71) ve ölüm riski (EAA: 0,70) için en iyi gösterge- nin BBO olduğu bulunmuştur. Sonuç: BKİ gibi geleneksel antropometrik ölçümlerle karşılaştırıldığında BŞİ erkeklerde KKH gelişimi ve ölü- mü için yüksek riski belirlemede daha iyi bir göstergedir. Kadınlarda ise FRSye göre yüksek riski öngörmede BKO daha iyi iken, BŞİ, SCORE ile hesaplanan 10 yıllık KKH ölüm riskini öngörmede daha iyidir

Association of Anthropometric Measurement Methods with Cardiovascular Disease Risk in Turkey

Objective: The aim of this study is to compare the predic- tive power of anthropometric indices for risk of developing Coronary Heart Disease (CHD) or CHD death. Methods: We used cross-sectional data from nationally representative Chronic Diseases and Risk Factors Sur- vey conducted by the Ministry of Health in 2011. Body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist to height ratio (WHtR), body adiposity index (BAI) and A Body Shape Index (ABSI) formed the anthropometric measures. For each participant risk of de- veloping CHD or dying from CVDs were calculated based on Framingham and SCORE risk equations. Predictive ability of anthropometric measurements was assessed by receiver operating characteristic (ROC) curves. Results: Anthropometric measurements of central obe- sity recorded higher area under the ROC curve (AUC) values than BMI in both men and women. While ABSI had the highest AUC values for Framingham 10-year pre- dicted risk (FRS) for CHD death (AUC = 0.613), SCORE 10-year risk for CVD death (AUC = 0.633), in women AUC for ABSI was the highest for only SCORE risk threshold (AUC = 0.705). Among women, WHtR was found to be the best indicator for estimating CHD incidence (AUC = 0.706) and death from CVD (AUC = 0.696). Conclusion: Compared to traditional anthropometric measurements such as BMI, ABSI was a better indicator for given thresholds for estimating the risk of developing CHD and CVD death in men. Among women WHtR made better predictions for FRS thresholds, however, ABSI was better for predicting 10-year risk of CVD death calculated by SCORE risk equation.

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