Obezite ile Mücadelede Obezite Merkezleri; Antalya İli Örneği

Amaç: Bu araştırmada Sağlık Bilimleri Üniversitesi Antalya Eğitim ve Araştırma Hastanesi bünyesinde yer alan obezite merkezimizde aldığımız sonuçlarla ilgili verilerimizi paylaşmayı hedefledik. Yöntem: Retrospektif, tanımlayıcı, kesitsel araştırmaya 1 Kasım 2018 ve 20 Mart 2020 tarihleri arasında Sağlık Bilimleri Üniversitesi Antalya Eğitim ve Araştırma Hastanesi Obezite Merkezinde takipli 281 obez hasta dahil edildi. Sağlıklı beslenme ve düzenli fiziksel aktiviteyi yaşam tarzı haline getirmenin hedeflendiği merkezimizden hizmet alan 281 hastanın ilk başvuru ve son kontrol antropometrik ölçümleri ile kontrol kan tetkikleri yapılan 106 hastanın başlangıç ve 6 veya 12. ay kontrollerinde (en son yapılan test ve eş zamanlı bakılan ölçümleri değerlendirmeye alınmıştır) bakılan açlık kan şekeri, glikozillenmiş hemoglobin, açlık insülini, insülin direnci, total kolesterol, düşük dansiteli lipoprotein kolesterol, yüksek dansiteli lipoprotein kolesterol ve trigliserit düzeyleri karşılaştırıldı. Bulgular: Çalışmaya dahil edilen hastaların 260’ı (%92,5) kadın, 21’i erkekti (%7,5); yaş ortalaması 52,05±9,52 (21-73) yıl idi. Ortalama takip süresi 161,1±82,97 (11-365) gün olarak hesaplandı. Çalışmaya dahil edilen tüm hastaların kilo ve vücut kitle indeksi ortancalarının sırasıyla 93,4 (68,5-152,6) kg’dan 83,7 (59,3-138) kg’a ve 36,9 (30-65,2) kg/m2’den 32,6 (24,68-58,9) kg/m2’ye düştüğü gözlendi (p<0,001). Benzer şekilde, hastaların bel ve kalça çevrelerinde de istatistiksel olarak anlamlı bir düşüş tespit edildi (p<0,001). Kontrol kan tetkikleri yapılmış olan 106 hastanın açlık kan şekeri, glikozillenmiş hemoglobin, açlık insülini, insulin direnci (p<0,001), sistolik kan basıncı (p=0,014) ve trigliserit (p=0,007) düzeylerinde anlamlı düşüş, yüksek dansiteli lipoprotein kolesterol düzeyinde ise anlamlı yükselme görüldü (p<0,001). Hastaların verdikleri kilo oranına göre vücut kitle indeksi (p<0,001), bel çevresi (p<0,001), kalça çevresi (p<0,001), bel/kalça oranının (p<0,001) yanısıra glikozillenmiş hemoglobin (p=0,043) düşüşünde de istatistiksel olarak anlamlı bir değişiklik olduğu gözlendi. Sonuç: Sadece doğru yaşam tarzı değişikliği ile sağlanan kilo kaybının kan basıncı, kan şekeri ve lipid parametreleri gibi endokrin ve metabolik belirteçler üzerine olumlu etkisi gözlenmektedir. Özellikle programa tam uyum sağlayabilen hastalarda obezite merkezleri sağlıklı, güvenilir, maliyet etkin ve sürdürülebilir bir tedavi olanağı sağlamaktadır.

Anahtar Kelimeler:

Obezite, obezite merkezi, kilo kaybı

The Role of Obesity Centers in the Fight Against Obesity: The Case of Antalya Province

Aim: This study aimed to share data regarding the results obtained at the Obesity Center of Antalya Training and Research Hospital at the University of Health Sciences. Methods: This retrospective, descriptive and cross-sectional study included 281 obese patients who were followed up at the Obesity Center of Antalya Training and Research Hospital, the University of Health Sciences, between November 1st, 2018 and March 20th, 2020.First admission and last control anthropometric measurements of 281 patients and first follow-up and 6th or 12th months control blood tests of 106 patients (the last test and concurrent measurements were evaluated), during which fasting blood glucose, glycosylated hemoglobin, fasting insulin, insulin resistance, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and triglyceride levels were compared. Results: Of all the patients included in the study, 260 (92.5%) were female and 21 were male (7.5%). The mean age was 52.05 ± 9.52 (21-73) years. The mean follow-up period was estimated to be 161.1 ± 82.97 (11-365) days. Median weight and body mass index of all patients (281 patients) were found to have decreased from 93.4 (68.5-152.6) kg to 83.7 (59.3-138) kg, and from 36.9 (30-65.2) kg/m2 to 32.6 (24.68-58.9) kg/m2 (p<0.001), respectively. Similarly, a statistically significant decrease was observed in the waist and hip circumference of the patients (p <0.001). Apart from this, fasting blood glucose, glycosylated hemoglobin, fasting insulin, insulin resistance (p<0.001), systolic blood pressure (p=0.014), and triglyceride (p=0.007) levels of 106 patients who had control blood tests also showed a significant decrease, as opposed to a significant increase in high density lipoprotein cholesterol levels (p<0.001). Another statistical significance was the decrease in the body mass index (p<0.001), waist circumference (p <0.001), hip circumference (p <0.001), waist/hip ratio (p<0.001) as well as in the glycosylated hemoglobin (p=0.043) according to the weight loss ratio of the patients. Conclusion: Achieved only through adopting the right lifestyle, the positive effect of weight loss is observed on endocrine and metabolic markers such as blood pressure, blood sugar and lipid parameters. Obesity centers provide patients a healthy, reliable, cost-effective and sustainable treatment opportunity, especially for those who can fully comply with the program.

Keywords:

Obesity, obesity center, weight loss,

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