Ankara Med J. 2021; 21(1): 57-71 | DOI: 10.5505/amj.2021.57767

Fazla kilolu ve obez adölesanlarda metabolik sendrom sýklýðý ile kardiyovasküler risk faktörlerinin deðerlendirilmesi

Yaðmur Gökseven¹, Guzin Zeren Ozturk^2
1Hassa Devlet Hastanesi, Aile Hekimliði, Hatay
²Saðlýk Bilimleri Üniversitesi, Þiþli Hamidiye Etfal Eðitim ve Araþtýrma Hastanesi, Aile Hekimliði Kliniði, Ýstanbul

GÝRÝÞ ve AMAÇ: 5-19 yaþ arasý 340 milyonun üzerinde fazla kilolu veya obez olduðu bildirilmiþtir. Çocukluk çaðý ve adölesan dönemde baþlayan obezite, metabolik sendrom ve kardiyovasküler hastalýklara zemin hazýrlamakta, aterosklerotik sürecin hýzlanmasýna neden olmaktadýr. Çalýþmamýzýn amacý aþýrý kilolu ve obez adölesanlarda kardiyovasküler hastalýklar için risk faktörlerini ve metabolik sendrom sýklýðýný deðerlendirmektir.
YÖNTEM ve GEREÇLER: Çalýþma popülasyonu 11-18 yaþ arasý fazla kilolu ve obez adölesanlardan oluþmaktadýr. Katýlýmcýlarýn antropometrik ölçümleri ve kan örneklerini aldýktan sonra REGODCI puanlama sistemine göre kardiyovasküler riskleri ve Uluslararasý Diyabet Federasyonu'na göre metabolik sendrom prevalanslarý incelenmiþtir.
BULGULAR: Çalýþmaya 150 fazla kilolu ve obez adölesan dahil edildi. Katýlýmcýlarýn 115’i (%76,70) obez idi; %22'sinde (n=33) Metabolik sendrom (MetS); %46,60'ýnda (n=80) kardiyometabolik risk (KMR) varlýðý saptandý. MetS tanýsý alan katýlýmcýlarýn vücut kitle indeksleri (VKÝ), sistolik kan basýncý, TG-HDL oranlarý arasýnda istatistiksel olarak anlamlý fark saptandý (sýrasýyla p = 0,040, p= 0,012 ve p <0,001). KMR varlýðý ile katýlýmcýlarýn VKÝ, TG-HDL oranlarý, bel- kalça çevresi oranlarý arasýnda istatiksel anlamlý bir iliþki saptandý (sýrasýyla p=0,001, p = 0,001 ve p= 0,034). ROC analizine göre MetS için eðri altýndaki alan 0,826, kesme deðeri 2,59; %72 duyarlýlýk ve %72 özgüllük ile bulundu; KMR varlýðý için eðri altýnda kalan alan 0,652; kesim deðeri 2,06; %65 duyarlýlýk ve %63 özgüllük ile bulundu.
TARTIÞMA ve SONUÇ: Obezite hem MetS hem de KMR için baðýmsýz bir risk faktörüdür ve tanýdan hemen sonra tedavi edilmelidir. Fazla kilolu ve obez adölesanlarda TG/HDL oraný MetS (2,59 üzeri) ve CMR (2,06 üzeri) için prediktör faktör olarak kullanýlabilir.

Anahtar Kelimeler: Adölesan, kardiyometabolik risk, metabolik sendrom, obezite.

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Evaluation of risk factors for cardiovascular diseases and prevalence of metabolic syndrome in overweight and obese adolescents

Yaðmur Gökseven¹, Guzin Zeren Ozturk^2
1Hassa State Hospital, Family Medicine, Hatay, Turkey
²Health Sciences University, Sisli Hamidiye Etfal Training and Research Hospital, Family Medicine Clinics, Istanbul, Turkey

INTRODUCTION: It is reported that there are more than 340 million people who are either overweight or obese aged between 5-19. Obesity starting in childhood and adolescence leads up to metabolic syndrome, cardiovascular diseases and hastens the atherosclerotic process. The aim of our study is to evaluate risk factors for cardiovascular diseases and the prevalence of metabolic syndrome in overweight and obese adolescents.
METHODS: The study population comprised overweight and obese adolescents aged 11–18 years. After taking all anthropometric measurements and blood samples; cardiovascular risk according to the REGODCI scoring system and prevalence of metabolic syndrome according to the International Diabetes Federation were examined.
RESULTS: 150 overweight and obese adolescents were included. 115 (76.70%) subjects were determined as obese. MetS was seen in 22% (n=33); cardiometabolic risk (CMR) was seen in 46.60% (n=80) of the participants. A statistically significant difference between systolic blood pressure, TG/HDL, and BMI of participants diagnosed with MetS was detected (p = 0.040, p= 0.012, p < 0.001, respectively). A significant correlation was found between CMR and participants’ BMI, TG/HDL, waist-hip ratio (p = 0.001, p = 0.001, p= 0.034, respectively). According to the ROC analysis for MetS, the area under the curve was 0.826, the cutoff value was 2.59 with 72% sensitivity and 72% specificity; and for the CMR the area under the curve was 0.652, the cutoff value was 2.06 with 65% sensitivity and 63% specificity.
DISCUSSION AND CONCLUSION: Obesity is an independent risk factor for both MetS and CMR, and it should be treated immediately after diagnosis. TG/HDL ratio may use as a predictor factor for MetS (over 2.59) and for CMR (over 2.06) in overweight and obese adolescents.

Keywords: Adolescent, cardiometabolic risks, metabolic syndrome, obesity.

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