Güney Türkiye'de Obezite ve İlişkili Metabolik Bozuklukların Kentsel-Kırsal Karşılaştırması

Giriş: Bir zamanlar yüksek gelirli ülkelerin sorunu olarak görülen obezitenin, özellikle kent yaşamının yoğun olduğu düşük ve orta gelirli ülkelerde sıklığı giderek artmaktadır. Bu çalışmanın amacı, Adana’nın kırsal ve kentsel bölgeleri arasında obezite ve buna bağlı metabolik hastalıkların dağılımını belirlemektir. Materyal ve Metod: Haziran-Eylül 2017 tarihleri arasında Pozantı Devlet Hastanesi İç Hastalıkları polikliniğine başvuran 545 ardışık hasta dahil edildi. Diyabet, hipertansiyon ve/veya hiperlipidemi tanılarının varlığı metabolik komorbid durum (MKD) olarak tanımlandı. Pozantı ilçesinde yaşayan bireyler yerli, Adana şehir merkezinde yaşayan bireyler ise yaylacı olarak tanımlandı. Bulgular: Katılımcıların 351 (%64,4)’i Pozantı, 194 (%35,6)’ü Adana kent merkezinden idi. Çalışma popülasyonunun ortanca vücut-kitle indeksi (VKİ) 29,1 (17,5-48,8) kg/m2 saptandı. Yaylacılarda, yerlilere göre istatistiksel olarak anlamlı olmayan VKİ yüksekliği saptandı (sırasıyla 28,7 kg/m2 vs. 29,6 kg/m2, p=0,078). MKD, yaylacılarda daha sık görülmüştür (%64,4 vs. %54,1, p=0,02). Tek değişkenli analizler sonucunda; yaylacılarda (p=0,02), yaş>65 (p=0,00), VKİ>25 kg/m2 (p=0,001), ürik asit > 7 mg/dl (p=0,001) olanlarda MKD daha sık görülmüştür. Çok değişkenli analizler sonucunda ise; VKİ>25 kg/m2, 65-79 yaş arasında olmak ve ürik asit düzeyi > 7 mg/dl bağımsız olarak MKD varlığı ile ilişkili saptandı. Sonuç: İç Hastalıkları polikliniğine başvuran hastalardan her üç kişiden birinde obezite, ve her iki kişiden birinde de metabolik komorbiditeler bulunmaktadır. Bölgemizdeki artan obezite ve ilişkili metabolik problemler, ulusal ölçekte acil önleyici müdahale gerekliliğini ortaya koymuştur.

Urban-Rural Comparison of Obesity and Related Metabolic Disorders in Southern Turkey

Introduction: Once considered a high-income country problem, obesity is now on the rise in low and middle-income countries, particularly inurban settings. The aim of this study is to estimate the distribution of obesity and related metabolic morbidities between rural and urbanregions of Adana. Materials and Methods: 545 consecutive patients, applied to Pozantı State Hospital Internal Medicine outpatient clinicbetween June-September 2017 were enrolled. Diabetes mellitus and/or hypertension and/or hyperlipidemia are defined as metaboliccomorbid condition (MCC). Participants living at Pozantı were named locals, and those living in Adana city center were named springers.Results: 351 (64.4%) participants were from Pozantı and 194 (35.6%) were from Adana city center. The median Body-mass index (BMI) ofthe study population was 29.1 (17.5-48.8) kg/m2. Springers had slightly higher, but statistically insignificant BMI compared to locals (28.7kg/m2 vs. 29.6 kg/m2 respectively, p=0.078). MCC was more frequent in springers (64.4% vs 54.1%, p= 0.02). Univariate analysis revealedthat; springers (p=0.02), age>65 (p=0.00), patients with BMI>25 kg/m2 (p=0.001) and uric acid>7 mg/dl (p=0.001) is associated with MCC.Multivariate analysis displayed the association of BMI>25 kg/m2, age between 65-79 and uric acid >7 mg/dl with MCC independently.Conclusion: Obesity exists approximately one in every three cases and metabolic morbidities are observed in nearly half of the patients whoapplied to internal medicine outpatient clinic. The growing burden of obesity and related metabolic disorders in our region points to urgentpreventive strategies on a national scale.

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