Araştırma Makalesi
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Determination of Etiology and Risk Factors in Patients Applying to Our Outpatient Clinic for Weight Loss

Yıl 2024, Cilt: 46 Sayı: 3, 198 - 204, 30.09.2024

Ayşe Münevver Mühürdaroğlu , İbrahim Akdağ , Mercan Taştemur

https://doi.org/10.7197/cmj.1539734

Öz

Archive information of 100 patients who applied to Ankara University Health Sciences University Dışkapı Yıldırım Beyazıt Training and Research Hospital Internal Diseases Polyclinic between 01 December 2016 and 01 June 2017 with a desire to lose weight was examined. Patients who were excluded from exclusion criteria and whose BMI was m2 25 kg / m2 were included in the study. Age, gender, curriculum vitae, blood pressure, anthropometric measurements and laboratory data recorded in patient files were used in the routine functioning of the Internal Diseases Polyclinic. Measurements and blood tests were done in the morning hours after at least 8 hours of fasting. The data of the study were analyzed using Statistical Package for the Social Sciences (SPSS) statistical package program.
Size E: 178.00 (165-186), K: 161.00 (150-185) (p <0.001) and body weight E: 100.00 (76-134), K: 87.00 (66-140 ) (p <0.001). Waist / hip circumference ratio was E: 0.88 ± 0.09, K: 0.83 ± 0.06 (p = 0.02). TPG K: 94.00 (61-218), E: 101.00 (70-219) (p = 0.05). HDL E: 41.00 (28-141), K: 48.00 (31-78) (p = <0.01). Vitamin B12 K: 215.00 (97-1500), E: 188.00 (107-394) (p: 0.04).
HOMA IR Overweight: 1.57 (0. 5-5.7), Stage 1 Obese: 2.19 (0.55-20.20), Stage 2 Obese: 2.80 (1.09- 12. 7), Stage 3 Obese: 3.06 (0.42-6.2 ) (p: 0.002).
Waist circumference; overweight: 89.86 ± 10.71, Stage 1: 95.30 ± 16.51, Stage 2: 104.52 ± 9.04, Stage 3 obese: 114.88 ± 11.75 (p <0.001). Hip circumference; overweight: 107.0 (97-125), Stage 1: 114.0 (96-134), Stage 2: 125.0 (101-140), Stage 3: 130.0 (111-150) (

As a result of our study, as the BMI increases in accordance with the literature, APG, HOMA-IR, insulin, hip circumference, waist / hip ratio, LDL, platelet count, folate levels increase. We also found that vitamin D levels decreased as BMI increased. We have seen that the highest awareness rate is in the overweight group. In addition to these results, we encountered new questions that should be answered such as the dose and necessity of vitamin D replacement in obese patients, and preventing unnecessary tests such as anti tpo and anti tg. We have seen that new studies are needed in different areas on a larger scale.

Anahtar Kelimeler

Obesity body mass index vitamin D HOMA-IR hip circumference fasting plasma glucose LDL insulin waist / hip circumference

Kaynakça

  • 1. Okka B, Durduran Y. Obesity in the Ancient Greek and Byzantine Periods. Turkiye Klinikleri J Med Ethics . 2013;21(3):111-117.
  • 2. WHO Consultation on Obesity, World Health Organization, Programme of Nutrition, Family and Reproductive Health. Obesity : Preventing and Managing the Global Epidemic : Report of a WHO Consultation on Obesity.; 1997. Accessed July 25, 2024. https://iris.who.int/handle/10665/63854
  • 3. World Health Organization. Obesity. Accessed July 25, 2024. https://www.who.int/health-topics/obesity#tab=tab_1
  • 4. Gergerlioğlu U. Evaluation of Obesity Taxes in the Context of Some OECD Countries. Journal of Economic and Social Research. 2016;12(2):149-166.
  • 5. Turkish Society of Cardiology. Coronary Heart Disease Prevention and Treatment Guidelines; 2002.
  • 6. Haslam DW, James WPT. Obesity. Lancet. 2005;366(9492):1197-1209. doi:10.1016/S0140-6736(05)67483-1
  • 7. TEMD Obesity LMHÇG. Obesity Diagnosis and Treatment Guideline. 8th ed.; 2019.
  • 8. Jensen MD, Ryan DH, Apovian CM, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation. 2014;129(25 Suppl 2):S102-38. doi:10.1161/01.cir.0000437739.71477.ee
  • 9. Prospective Studies Collaboration, Whitlock G, Lewington S, et al. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet. 2009;373(9669):1083-1096. doi:10.1016/S0140-6736(09)60318-4
  • 10. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000;894:i-xii, 1-253.
  • 11. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults--The Evidence Report. National Institutes of Health. Obes Res. 1998;6 Suppl 2:51S-209S.
  • 12. Bulur Ş, Çeçen S, Eren F. Anthropometric and Biochemical Characteristics of Individuals Applying to the Department of Sports Physiology with Overweight Complaint. Journal of ADU Faculty of Medicine. 2014;15(1):29-35.
  • 13. Akbas F, Usta Atmaca H, Karadas E, Yildiz I, Okten IN. Evaluation of Data from the Obesity Outpatient Clinic at the End of the Second Year as a Newly Formed Unit in Istanbul Training and Research Hospital. Istanbul Medical Journal. 2013;14(4):253-256. doi:10.5152/imj.2013.69672
  • 14. Turkey Health Survey; 2022. Accessed July 27, 2024. https://data.tuik.gov.tr/Bulten/Index?p=Turkiye-Saglik-Arastirmasi-2022-49747
  • 15. Saygın M, Öztürk Ö, Akbulut S, Kılınç F, Saygın RR. Prevalence of obesity in patients applying to the diet outpatient clinic of Süleyman Demirel University Faculty of Medicine Hospital. SDU Medical Faculty Derg . 2015;22(3):53-59.
  • 16. Altun B, Arici M, Nergizoglu G, et al. Prevalence, awareness, treatment and control of hypertension in Turkey (the PatenT study) in 2003. J Hypertens. 2005;23(10):1817-1823. doi:10.1097/01.hjh.0000176789.89505.59
  • 17. GBD 2015 Obesity Collaborators, Afshin A, Forouzanfar MH, et al. Health Effects of Overweight and Obesity in 195 Countries over 25 Years. N Engl J Med. 2017;377(1):13-27. doi:10.1056/NEJMoa1614362
  • 18. Forman JP, Stampfer MJ, Curhan GC. Diet and lifestyle risk factors associated with incident hypertension in women. JAMA. 2009;302(4):401-411. doi:10.1001/jama.2009.1060
  • 19. Huang Z, Willett WC, Manson JE, et al. Body weight, weight change, and risk for hypertension in women. Ann Intern Med. 1998;128(2):81-88. doi:10.7326/0003-4819-128-2-199801150-00001
  • 20. Menke A, Rust KF, Fradkin J, Cheng YJ, Cowie CC. Associations between trends in race/ethnicity, aging, and body mass index with diabetes prevalence in the United States: a series of cross-sectional studies. Ann Intern Med. 2014;161(5):328-335. doi:10.7326/M14-0286
  • 21. Uusitupa M, Khan TA, Viguiliouk E, et al. Prevention of Type 2 Diabetes by Lifestyle Changes: A Systematic Review and Meta-Analysis. Nutrients. 2019;11(11). doi:10.3390/nu11112611
  • 22. Bogers RP, Bemelmans WJE, Hoogenveen RT, et al. Association of overweight with increased risk of coronary heart disease partly independent of blood pressure and cholesterol levels: a meta-analysis of 21 cohort studies including more than 300 000 persons. Arch Intern Med. 2007;167(16):1720-1728. doi:10.1001/archinte.167.16.1720
  • 23. Bays HE, Kirkpatrick C, Maki KC, et al. Obesity, dyslipidemia, and cardiovascular disease: A joint expert review from the Obesity Medicine Association and the National Lipid Association 2024. Obesity Pillars. 2024;10:100108. doi:10.1016/j.obpill.2024.100108
  • 24. Uysal A. Investigation of the Correlation Between Obesity and Liver Function Tests in Obese Cases. Specialization Thesis. Taksim Training and Research Hospital; 2005.
  • 25. Fishbein MH, Miner M, Mogren C, Chalekson J. The Spectrum of Fatty Liver in Obese Children and The Relationship of Serum Aminotransferases to Severity of Steatosis. J Pediatr Gastroenterol Nutr. 2003;36(1):54-61. doi:10.1097/00005176-200301000-00012
  • 26. Salvaggio A, Periti M, Miano L, Tavanelli M, Marzorati D. Body mass index and liver enzyme activity in serum. Clin Chem. 1991;37(5):720-723.
  • 27. Wang Y, Chen X, Song Y, Caballero B, Cheskin LJ. Association between obesity and kidney disease: A systematic review and meta-analysis. Kidney Int. 2008;73(1):19-33. doi:10.1038/sj.ki.5002586
  • 28. Gómez-Ambrosi J, González-Crespo I, Catalán V, et al. Clinical usefulness of abdominal bioimpedance (ViScan) in the determination of visceral fat and its application in the diagnosis and management of obesity and its comorbidities. Clinical Nutrition. 2018;37(2):580-589. doi:10.1016/j.clnu.2017.01.010
  • 29. Shen W wen, Chen H mei, Chen H, Xu F, Li L shi, Liu Z hong. Obesity-related glomerulopathy: body mass index and proteinuria. Clin J Am Soc Nephrol. 2010;5(8):1401-1409. doi:10.2215/CJN.01370210
  • 30. Walsh JS, Evans AL, Bowles S, et al. Free 25-hydroxyvitamin D is low in obesity, but there are no adverse associations with bone health. Am J Clin Nutr. 2016;103(6):1465-1471. doi:10.3945/ajcn.115.120139
  • 31. Walsh JS, Bowles S, Evans AL. Vitamin D in obesity. Curr Opin Endocrinol Diabetes Obes. 2017;24(6):389-394. doi:10.1097/MED.0000000000000371

Polikliniğimize Kilo Vermek İçin Başvuran Hastalarda Etiyoloji ve Risk Faktörlerinin Belirllenmesi

Yıl 2024, Cilt: 46 Sayı: 3, 198 - 204, 30.09.2024

Ayşe Münevver Mühürdaroğlu , İbrahim Akdağ , Mercan Taştemur

https://doi.org/10.7197/cmj.1539734

Öz

Çalışmada Ankara İli Sağlık Bilimleri Üniversitesi Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi İç Hastalıkları Polikliniği’ne 01 Aralık 2016- 01 Haziran 2017 tarihleri arasında kilo verme isteğiyle başvurmuş 100 hastanın arşiv bilgileri incelenmiştir. Dışlanma kriterleri dışında kalan ve VKİ ≥ 25 kg/m2 olan hastalar çalışmaya alınmıştır. İç Hastalıkları Polikliniği’ nin rutin işleyişinde hasta dosyalarına kaydedilen yaş, cinsiyet, özgeçmiş, kan basıncı, antropometrik ölçümlerve laboratuvar verileri kullanılmıştır. Ölçüm ve kan tetkikleri en az 8 saatlik açlık sonrası sabah saatlerinde yapılmıştır. Araştırmanın verileri Statistical Package for the Social Sciences (SPSS) istatistik paket programı kullanılarak analiz edildi.
Boy E: 178,00(165-186),K: 161,00(150-185) (p<0,001) ve vücut ağırlığı E: 100,00(76-134) , K: 87,00(66-140) (p<0,001) . Bel/kalça çevresi oranı E: 0,88±0,09 , K: 0,83±0,06 bulundu (p=0,02). TPG K:94,00(61-218), E:101,00(70-219) (p=0,05) . HDL E: 41,00(28-141) , K: 48,00(31-78) (p=<0,01). Vitamin B12 K: 215,00(97-1500) , E: 188,00(107-394) (p:0,04) .
HOMA IR açısında Fazla Kilolu: 1.57 (0. 5-5. 7), Evre 1 Obez: 2.19 (0.55-20.20) , Evre 2 Obez: 2.80 (1.09- 12. 7) , Evre 3 Obez: 3.06 (0.42-6.2) (p:0.002) .
Bel çevresi; fazla kilolu: 89,86±10,71, Evre 1: 95,30±16,51, Evre 2: 104,52±9,04 , Evre 3 obez : 114,88±11,75 ( p<0,001). Kalça çevresi; fazla kilolu: 107,0(97-125), Evre 1: 114,0(96-134), Evre 2: 125,0(101-140) ,Evre 3: 130,0(111-150) ( Evre 1: 88,0(75-159), Evre 2: 88,0(75-159), Evre 3: 94,0(83-134), Evre 4: 116,0(94-140) (p<0,01). LDL fazla kilolu: 114,17±29,82, Evre 1: 130,58±34,80, Evre 2: 137,34±29,31, Evre 3: 119,22±22,98 (p:0,04). İnsülin fazla kilolu: 7,8(0,57-25,4), Evre 1: 9,90(3,1-82,1), Evre 2: 13,07(4,11-53,2), Evre 3: 11,2(2,24-29,3) (p:0,00). APG; fazla kilolu: 86,0(61-133), Evre 1: 90,00(72-155) , Evre 2: 92,00(71-136) , Evre 3: 97,00(76-115) (p:0,04)
Çalışmamızın neticesinde literatürle uyumlu olarak VKİ arttıkça APG, HOMA-IR, insülin, kalça çevresi, bel/kalça oranı, LDL, platelet sayısı, folat düzeyleri artmaktadır. D vitamini düzeylerinin de yine VKİ arttıkça azaldığını saptadık. En yüksek farkındalık oranının da fazla kilolu grupta olduğunu gördük. Bu sonuçlara ek olarak obez hastalarda D vitamini replasmanı dozu ve gerekliliği, anti tpo, anti tg gibi gereksiz tetkiklerin önüne geçilmesi gibi cevaplanması gereken yeni sorularla karşılaştık. Konu ile ilgili daha büyük ölçekli farklı alanlarda yeni çalışmalara ihtiyaç olduğunu gördük.

Anahtar Kelimeler

Obezite vücut kitle indeksi D vitamini HOMA-IR kalça çevresi açlık plazma glikozu LDL insülin bel / kalça çevresi.

Kaynakça

  • 1. Okka B, Durduran Y. Obesity in the Ancient Greek and Byzantine Periods. Turkiye Klinikleri J Med Ethics . 2013;21(3):111-117.
  • 2. WHO Consultation on Obesity, World Health Organization, Programme of Nutrition, Family and Reproductive Health. Obesity : Preventing and Managing the Global Epidemic : Report of a WHO Consultation on Obesity.; 1997. Accessed July 25, 2024. https://iris.who.int/handle/10665/63854
  • 3. World Health Organization. Obesity. Accessed July 25, 2024. https://www.who.int/health-topics/obesity#tab=tab_1
  • 4. Gergerlioğlu U. Evaluation of Obesity Taxes in the Context of Some OECD Countries. Journal of Economic and Social Research. 2016;12(2):149-166.
  • 5. Turkish Society of Cardiology. Coronary Heart Disease Prevention and Treatment Guidelines; 2002.
  • 6. Haslam DW, James WPT. Obesity. Lancet. 2005;366(9492):1197-1209. doi:10.1016/S0140-6736(05)67483-1
  • 7. TEMD Obesity LMHÇG. Obesity Diagnosis and Treatment Guideline. 8th ed.; 2019.
  • 8. Jensen MD, Ryan DH, Apovian CM, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation. 2014;129(25 Suppl 2):S102-38. doi:10.1161/01.cir.0000437739.71477.ee
  • 9. Prospective Studies Collaboration, Whitlock G, Lewington S, et al. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet. 2009;373(9669):1083-1096. doi:10.1016/S0140-6736(09)60318-4
  • 10. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000;894:i-xii, 1-253.
  • 11. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults--The Evidence Report. National Institutes of Health. Obes Res. 1998;6 Suppl 2:51S-209S.
  • 12. Bulur Ş, Çeçen S, Eren F. Anthropometric and Biochemical Characteristics of Individuals Applying to the Department of Sports Physiology with Overweight Complaint. Journal of ADU Faculty of Medicine. 2014;15(1):29-35.
  • 13. Akbas F, Usta Atmaca H, Karadas E, Yildiz I, Okten IN. Evaluation of Data from the Obesity Outpatient Clinic at the End of the Second Year as a Newly Formed Unit in Istanbul Training and Research Hospital. Istanbul Medical Journal. 2013;14(4):253-256. doi:10.5152/imj.2013.69672
  • 14. Turkey Health Survey; 2022. Accessed July 27, 2024. https://data.tuik.gov.tr/Bulten/Index?p=Turkiye-Saglik-Arastirmasi-2022-49747
  • 15. Saygın M, Öztürk Ö, Akbulut S, Kılınç F, Saygın RR. Prevalence of obesity in patients applying to the diet outpatient clinic of Süleyman Demirel University Faculty of Medicine Hospital. SDU Medical Faculty Derg . 2015;22(3):53-59.
  • 16. Altun B, Arici M, Nergizoglu G, et al. Prevalence, awareness, treatment and control of hypertension in Turkey (the PatenT study) in 2003. J Hypertens. 2005;23(10):1817-1823. doi:10.1097/01.hjh.0000176789.89505.59
  • 17. GBD 2015 Obesity Collaborators, Afshin A, Forouzanfar MH, et al. Health Effects of Overweight and Obesity in 195 Countries over 25 Years. N Engl J Med. 2017;377(1):13-27. doi:10.1056/NEJMoa1614362
  • 18. Forman JP, Stampfer MJ, Curhan GC. Diet and lifestyle risk factors associated with incident hypertension in women. JAMA. 2009;302(4):401-411. doi:10.1001/jama.2009.1060
  • 19. Huang Z, Willett WC, Manson JE, et al. Body weight, weight change, and risk for hypertension in women. Ann Intern Med. 1998;128(2):81-88. doi:10.7326/0003-4819-128-2-199801150-00001
  • 20. Menke A, Rust KF, Fradkin J, Cheng YJ, Cowie CC. Associations between trends in race/ethnicity, aging, and body mass index with diabetes prevalence in the United States: a series of cross-sectional studies. Ann Intern Med. 2014;161(5):328-335. doi:10.7326/M14-0286
  • 21. Uusitupa M, Khan TA, Viguiliouk E, et al. Prevention of Type 2 Diabetes by Lifestyle Changes: A Systematic Review and Meta-Analysis. Nutrients. 2019;11(11). doi:10.3390/nu11112611
  • 22. Bogers RP, Bemelmans WJE, Hoogenveen RT, et al. Association of overweight with increased risk of coronary heart disease partly independent of blood pressure and cholesterol levels: a meta-analysis of 21 cohort studies including more than 300 000 persons. Arch Intern Med. 2007;167(16):1720-1728. doi:10.1001/archinte.167.16.1720
  • 23. Bays HE, Kirkpatrick C, Maki KC, et al. Obesity, dyslipidemia, and cardiovascular disease: A joint expert review from the Obesity Medicine Association and the National Lipid Association 2024. Obesity Pillars. 2024;10:100108. doi:10.1016/j.obpill.2024.100108
  • 24. Uysal A. Investigation of the Correlation Between Obesity and Liver Function Tests in Obese Cases. Specialization Thesis. Taksim Training and Research Hospital; 2005.
  • 25. Fishbein MH, Miner M, Mogren C, Chalekson J. The Spectrum of Fatty Liver in Obese Children and The Relationship of Serum Aminotransferases to Severity of Steatosis. J Pediatr Gastroenterol Nutr. 2003;36(1):54-61. doi:10.1097/00005176-200301000-00012
  • 26. Salvaggio A, Periti M, Miano L, Tavanelli M, Marzorati D. Body mass index and liver enzyme activity in serum. Clin Chem. 1991;37(5):720-723.
  • 27. Wang Y, Chen X, Song Y, Caballero B, Cheskin LJ. Association between obesity and kidney disease: A systematic review and meta-analysis. Kidney Int. 2008;73(1):19-33. doi:10.1038/sj.ki.5002586
  • 28. Gómez-Ambrosi J, González-Crespo I, Catalán V, et al. Clinical usefulness of abdominal bioimpedance (ViScan) in the determination of visceral fat and its application in the diagnosis and management of obesity and its comorbidities. Clinical Nutrition. 2018;37(2):580-589. doi:10.1016/j.clnu.2017.01.010
  • 29. Shen W wen, Chen H mei, Chen H, Xu F, Li L shi, Liu Z hong. Obesity-related glomerulopathy: body mass index and proteinuria. Clin J Am Soc Nephrol. 2010;5(8):1401-1409. doi:10.2215/CJN.01370210
  • 30. Walsh JS, Evans AL, Bowles S, et al. Free 25-hydroxyvitamin D is low in obesity, but there are no adverse associations with bone health. Am J Clin Nutr. 2016;103(6):1465-1471. doi:10.3945/ajcn.115.120139
  • 31. Walsh JS, Bowles S, Evans AL. Vitamin D in obesity. Curr Opin Endocrinol Diabetes Obes. 2017;24(6):389-394. doi:10.1097/MED.0000000000000371
Toplam 31 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Tıp Eğitimi
Bölüm Araştırma Makalesi
Yazarlar

Ayşe Münevver Mühürdaroğlu 0009-0007-8255-1832

İbrahim Akdağ 0000-0003-3388-2989

Mercan Taştemur 0000-0003-0320-4095

Yayımlanma Tarihi 30 Eylül 2024
Gönderilme Tarihi 28 Ağustos 2024
Kabul Tarihi 29 Eylül 2024
Yayımlandığı Sayı Yıl 2024Cilt: 46 Sayı: 3

Kaynak Göster

AMA Mühürdaroğlu AM, Akdağ İ, Taştemur M. Determination of Etiology and Risk Factors in Patients Applying to Our Outpatient Clinic for Weight Loss. CMJ. Eylül 2024;46(3):198-204. doi:10.7197/cmj.1539734
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