Bir prospektif kohort çalışmasının temel verileri: Kapadokya kohort çalışması, Türkiye

Amaç: Bu çalışmada, Türkiye'nin Kapadokya bölgesinde başlatılan geniş bir prospektif kohort çalışmasının temel verilerinden kronik hastalıkların ve davranışsal risk faktörlerinin prevalansını belirlemek amaçlanmıştır. Yöntem: Çalışma popülasyonu Kapadokya bölgesinin iki ilçesi Gülşehir ve Avanos'ta ikamet eden yetişkin gönüllülerden oluşuyordu. Toplum temelli olarak planlanan bu müdahale çalışmasında Gülşehir “müdahale”, Avanos “kontrol” ilçesi olarak seçildi. Çalışma 2013 yılında başlatıldı ve en az 10 yıl devam etmesi planlandı. Her iki ilçede de çalışma ofisleri kuruldu ve eğitimli personeller tarafından ev ve iş yeri ziyaretleri ile elektronik anketler uygulandı ve fizik muayeneler yapıldı. Bulgular: Toplamda 10.992 kişi kaydedilddahil edildi. Türkiye'nin erişkin nüfusu ile karşılaştırıldığında, çalışma kohortunda yaş ortalaması (44.5±17.4 yıla karşılık 31.9±21.2 yıl) ve kadın oranı (%56.5’e karşılık %51.2) daha yüksekti ancak üniversite mezunlarının oranı (%17.1'e karşılık %32.2) daha düşüktü. Kadınlarda erkeklere kıyasla obezite (%39.0’a karşılık %20.8) ve yüksek riskli bel çevresi (%16.8’e karşılık %30.7) oranı daha yüksekti. Obezite ayrıca her iki ilçede de kadınlar arasında çok yaygın bir risk faktörüydü (Avanos'ta %36.9 ve Gülşehir'de %41.5). Fiziksel aktivite seviyeleri düşüktü; en genç yaş grubunda bile (18-34 yaş) sadece kadınların %6'sı ve erkeklerin %8'i “aktif” veya “çok aktif” idi. Sigara içme oranı erkeklerde kadınlara göre daha yüksekti (%46.9 karşılık %13.8). Hipertansiyon, diabetes mellitus ve romatolojik hastalıkların prevalansı kadınlarda erkeklere göre daha yüksekti (her biri için p <0.0001); ancak kardiyovasküler hastalıklar ve kronik obstrüktif akciğer hastalığı için anlamlı fark saptanmadı. Her iki ilçede de hipertansiyon en sık bildirilen kronik hastalık iken, bunu Diabetes Mellitus, hiperlipidemi ve kardiyovasküler hastalıklar izliyordu. Sonuçlar: Başlangıç veriler, Türkiye'nin Kapadokya bölgesinde modifiye edilebilir yaşam tarzı risk faktörlerinin yüksek prevalansını göstermiş ve etkili toplum tabanlı müdahalelere duyulan ihtiyacı ortaya çıkarmıştır.

Baseline data of a prospective cohort study: Cappadocia cohort study, Turkey

Aims: This study aimed to determine the prevalence of chronic diseases and behavioural risk factors from the baseline data of a large prospective cohort study initiated in the Cappadocia region of Turkey. Method: The study population consisted of adult volunteers who resided in two towns, Gulsehir and Avanos, of the Cappadocia region.  For the planned community-based intervention trials, Gulsehir served as the “intervention” town and Avanos was the “control” town. The study was initiated in 2013 and was planned to be continued for a minimum of 10 years. Study offices were established in both towns and trained personnel conducted electronic questionnaires and physical examinations by visiting households and working places. Results: In total, 10,992 individuals were enrolled. Compared to Turkey’s adult population, the mean age (44.5±17.4 years vs. 31.9±21.2 years) and the female proportion (56.5% vs. 51.2%) were higher but the proportion of university graduates (17.1% vs. 32.2%) was lower in the study cohort. The rates of females having obesity (39.0% vs. 20.8%) and high-risk waist circumference (61.8% vs. 30.7%) were higher than males. Obesity was also a very prevalent risk factor among females in both towns (36.9% in Avanos and 41.5% in Gulsehir). Physical activity levels were low; only 6% of females and 8% of males were “active” or “very active” even at the youngest age group (18-34 years). The rate of smoking was higher in males than in females (46.9% vs. 13.8%). The prevalence of hypertension, diabetes mellitus, and rheumatologic diseases were higher in females than in males (p<0.0001 for each); however, no significant differences were obtained for cardiovascular diseases and chronic obstructive pulmonary disease. In both towns, hypertension was the most commonly reported chronic disease followed by DM, hyperlipidaemia, and cardiovascular diseases. Conclusions: Baseline data revealed a high prevalence of modifiable lifestyle risk factors in the Cappadocia region of Turkey and elucidated the need for effective community-based interventions.

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