Türkiye'de Antropometrik Ölçüm Yöntemlerinin Kardiyovasküler Hastalık Riski İle İlişkisi

Amaç: Bu çalışmanın amacı antropometrik ölçütlerin ko- roner kalp hastalığı (KKH) ya da KKH’ya 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 KKH’a 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 BKİ’ye 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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  • 1. Obesity and overweight. Secondary obesity and overweight [http://www.who.int/mediacentre/factsheets/fs311/en/] 2. Klein S, Allison DB, Heymsfield SB, et al. Waist circumfer- ence and cardiometabolic risk: a consensus statement from Shaping America’s Health: Association for Weight Manage- ment and Obesity Prevention; NAASO, The Obesity Soci- ety; the American Society for Nutrition; and the American Diabetes Association. Am J Clin Nutr 2007;85:1197-1202. 3. Stevens GA, Singh GM, Lu Y, et al. National, regional, and global trends in adult overweight and obesity prevalences. Popul Health Metr 2012;10:22. 4. Satman I, Omer B, Tutuncu Y et al. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol 2013;28:169-180. 5. Nelson MR. Management of high blood pressure in those without overt cardiovascular disease utilizing absolute risk scores. Int J Hypertension 2011;21:235-340. 6. Conroy RM, Pyorala K, Fitzgerald AP, et al. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 2003, 24:987-1003. 7. Ashwell M, Gunn P, Gibson S. Waist-to-height ratio is a bet- ter screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis. Obes Rev 2012;13:275-286. 8. Bergman RN, Stefanovski D, Buchanan TA, et al. A bet- ter index of body adiposity. Obesity (Silver Spring) 2011;19:1083-1089. 9. Krakauer NY, Krakauer JC. A new body shape index predicts mortality hazard independently of body mass index. PLoS One. 2012;7:e39504. 10. Meseri R, Ucku R, Unal B. Waist:height ratio: a superior index in estimating cardiovascular risks in Turkish adults. Public Health Nutr 2014;17:2246-2252. 11. Türkiye Kronik Hastalıklar ve Risk Faktörleri Sıklığı Çalışması, Sağlık Bakanlığı, Ankara 2013;909 12. Mancia G, De Backer G, Dominiczak A, et al. 2007 Guide- lines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2007;25:1105-1187. 13. Wilson PW, D’Agostino RB, Levy D, et al. Prediction of coronary heart disease using risk factor categories. Circula- tion. 1998;97:1837-1847. 14. Freedman DS, Ogden CL, Goodman AB, et al. Skinfolds and coronary heart disease risk factors are more strongly associated with BMI than with the body adiposity index. Obesity (Silver Spring) 2013;21:E64-70. 15. Balkau B, Deanfield JE, Després J-P, et al. International Day for the Evaluation of Abdominal Obesity (IDEA): a study of waist circumference, cardiovascular disease, and diabetes mellitus in 168,000 primary care patients in 63 countries. Circulation 2007;116:1942-1951. 16. Winter Y, Rohrmann S, Linseisen J, et al. Contribution of obesity and abdominal fat mass to risk of stroke and tran- sient ischemic attacks. Stroke. 2008;39:3145-3151. 17. Taylor AE, Ebrahim S, Ben-Shlomo Y, et al. Comparison of the associations of body mass index and measures of central adiposity and fat mass with coronary heart disease, diabetes, and all-cause mortality: a study using data from 4 UK cohorts. Am J Clin Nutr 2010;91:547-556. 18. Lapidus L, Bengtsson C, Larsson B, et al. Distribution of adipose tissue and risk of cardiovascular disease and death: a 12 year follow up of participants in the population study of women in Gothenburg, Sweden. Br Med J (Clin Res Ed) 1984;289:1257-1261. 19. Pischon T, Boeing H, Hoffmann K, et al. General and ab- dominal adiposity and risk of death in Europe. N Engl J Med 2008;359:2105-2120.
Dicle Tıp Dergisi-Cover
  • ISSN: 1300-2945
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1963
  • Yayıncı: Cahfer GÜLOĞLU
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