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

Year 2018, , 190 - 203, 24.12.2018
https://doi.org/10.20518/tjph.500196

Abstract



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.





References

  • 1. World Health Organization (WHO). Noncommunicable diseases, Available at: http://who.int/mediacentre/factsheets/fs355/en/ Accessed January 24, 2015. 2. GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015;385(9963):117-171. 3. Turkish Statistical Institute. Adrese Dayalı Nüfus Kayıt Sistemi Sonuçları, 2014. Available at: http://www.tuik.gov.tr/PreHaberBultenleri.do?id=18616 Accessed February 11, 2015. 4. Sengul S, Erdem Y, Akpolat T, et al. Controlling hypertension in Turkey: not a hopeless dream. Kidney Int Suppl 2013;3(4):326-31. 5. Kilic B, Kalaca S, Unal B, Phillimore P, Zaman S. Health policy analysis for prevention and control of cardiovascular diseases and diabetes mellitus in Turkey. Int J Public Health 2015;60 Suppl 1:47-53. 6. Akgün S, Rao C, Yardim N, et al. Estimating mortality and causes of death in Turkey: methods, results and policy implications. Eur J Public Health 2007;17(6):593-9. 7. Satman I, Omer B, Tutuncu Y, et al. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol 2013;28(2):169-180. 8. Erdem Y, Arici M, Altun B, et al. The relationship between hypertension and salt intake in Turkish population: SALTURK study. Blood Press 2010;19(5):313-8. 9. The Republic of Turkey Ministry of Health. Global Adult Tobacco Survey Turkey Report. Available at: http://www.who.int/tobacco/surveillance/en_tfi_gats_turkey_2009.pdf?ua=1 Accessed February 11, 2015. 10. Aygul N, Ozdemir K, Abaci A, et al. Comparison of traditional risk factors, angiographic findings, and in-hospital mortality between smoking and nonsmoking Turkish men and women with acute myocardial infarction. Clin Cardiol 2010;33(6):E49-54. 11. Ministry of Health of the Republic of Turkey. Health Transformation Program, Ankara, Turkey, 2003. Available at: http://www.saglik.gov.tr/TR/belge/1-2906/ saglikta-donusum-programi.html Accessed June 22, 2018. 12. Phillimore P, Zaman S, Ahmad B, et al. Health system challenges of cardiovascular disease and diabetes in four Eastern Mediterranean countries. Glob Public Health 2013;8(8):875-89. 13. Fathima FN, Joshi R, Agrawal T, et al. Rationale and design of the Primary pREvention strategies at the community level to Promote Adherence of treatments to pREvent cardiovascular diseases trial number (CTRI/2012/09/002981). Am Heart J 2013;166(1):4-12. 14. Puska P. From Framingham to North Karelia: from descriptive epidemiology to public health action. Prog Cardiovasc Dis 2010;53(1):15-20. 15. Farquhar JW, Fortmann SP, Maccoby N, et al. The Stanford Five-City Project: design and methods. Am J Epidemiol 1985;122(2):323-34. 16. Keys A. Seven Countries: A Multivariate Analysis of Death and Coronary Heart Disease. Cambridge: Harvard University Press, 1980. 17. Weinehall L, Hellsten G, Boman K, Hallmans G. Prevention of cardiovascular disease in Sweden: the Norsjo community intervention programme--motives, methods and intervention components. Scand J Public Health Suppl 2001;56:13-20. 18. Puska P. The North Karelia Project: nearly 20 years of successful prevention of CVD in Finland. Hygie 1992;11(1):33-5. 19. Jeffery RW. Community programs for obesity prevention: the Minnesota Heart Health Program. Obes Res 1995;3 Suppl 2:283-8. 20. Faich GA, Ellis S, Belloni JS, Fishbein HA. The Rhode Island Diabetes Intervention Program. R I Med J 1979;62(6):229-32. 21. Kamath DY, Xavier D, Gupta R, et al. Rationale and design of a randomized controlled trial evaluating community health worker-based interventions for the secondary prevention of acute coronary syndromes in India (SPREAD). Am Heart J 2014;168(5):690-7. 22. Turkish Statistical Institute. Seçilmiş Göstergelerle Nevşehir 2013. Available at: http://www.tuik.gov.tr/ilGostergeleri/iller/NEVSEHIR.pdf Accessed June 21, 2018 23. Centers for Disease Control and Prevention (CDC). State-specific secondhand smoke exposure and current cigarette smoking among adults - United States, 2008. MMWR Morb Mortal Wkly Rep 2009;58(44):1232-5. 24. Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute scientific statement: Executive Summary. Crit Pathw Cardiol 2005;4(4):198-203. 25. Johansson G, Westerterp KR. Assessment of the physical activity level with two questions: validation with doubly labeled water. Int J Obes (Lond) 2008;32(6):1031-3. 26. Turkish Statistical Institute (TURKSTAT). Address Based Population Registration System Results, Available at: http://www.turkstat.gov.tr/Kitap.do?metod=KitapDetay&KT_ID=11&KITAP_ID=139 27. Hacettepe University Institute of Population Studies, T.R. Ministry of Development and TÜBİTAK. 2013 Turkey Demographic and Health Survey. Available at: http://www.hips.hacettepe.edu.tr/eng/TDHS_2013_main.report.pdf 28. Ministry of Labour and Social Security. Net minimum wage by years. Available at: https://www.csgb.gov.tr/en/Contents/Istatistikler/AsgariUcret Accessed June 22, 2018 29. World Health Organization (WHO). Noncommunicable Diseases (NCD) Country Profiles. Available at: http://www.who.int/nmh/countries/tur_en.pdf Accessed 2015 30. Altun B, Arici M, Nergizoğlu G, et al. Prevalence, awareness, treatment and control of hypertension in Turkey (the PatenT study) in 2003. J Hypertens 2005;23(10):1817-2

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

Year 2018, , 190 - 203, 24.12.2018
https://doi.org/10.20518/tjph.500196

Abstract

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.


References

  • 1. World Health Organization (WHO). Noncommunicable diseases, Available at: http://who.int/mediacentre/factsheets/fs355/en/ Accessed January 24, 2015. 2. GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015;385(9963):117-171. 3. Turkish Statistical Institute. Adrese Dayalı Nüfus Kayıt Sistemi Sonuçları, 2014. Available at: http://www.tuik.gov.tr/PreHaberBultenleri.do?id=18616 Accessed February 11, 2015. 4. Sengul S, Erdem Y, Akpolat T, et al. Controlling hypertension in Turkey: not a hopeless dream. Kidney Int Suppl 2013;3(4):326-31. 5. Kilic B, Kalaca S, Unal B, Phillimore P, Zaman S. Health policy analysis for prevention and control of cardiovascular diseases and diabetes mellitus in Turkey. Int J Public Health 2015;60 Suppl 1:47-53. 6. Akgün S, Rao C, Yardim N, et al. Estimating mortality and causes of death in Turkey: methods, results and policy implications. Eur J Public Health 2007;17(6):593-9. 7. Satman I, Omer B, Tutuncu Y, et al. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol 2013;28(2):169-180. 8. Erdem Y, Arici M, Altun B, et al. The relationship between hypertension and salt intake in Turkish population: SALTURK study. Blood Press 2010;19(5):313-8. 9. The Republic of Turkey Ministry of Health. Global Adult Tobacco Survey Turkey Report. Available at: http://www.who.int/tobacco/surveillance/en_tfi_gats_turkey_2009.pdf?ua=1 Accessed February 11, 2015. 10. Aygul N, Ozdemir K, Abaci A, et al. Comparison of traditional risk factors, angiographic findings, and in-hospital mortality between smoking and nonsmoking Turkish men and women with acute myocardial infarction. Clin Cardiol 2010;33(6):E49-54. 11. Ministry of Health of the Republic of Turkey. Health Transformation Program, Ankara, Turkey, 2003. Available at: http://www.saglik.gov.tr/TR/belge/1-2906/ saglikta-donusum-programi.html Accessed June 22, 2018. 12. Phillimore P, Zaman S, Ahmad B, et al. Health system challenges of cardiovascular disease and diabetes in four Eastern Mediterranean countries. Glob Public Health 2013;8(8):875-89. 13. Fathima FN, Joshi R, Agrawal T, et al. Rationale and design of the Primary pREvention strategies at the community level to Promote Adherence of treatments to pREvent cardiovascular diseases trial number (CTRI/2012/09/002981). Am Heart J 2013;166(1):4-12. 14. Puska P. From Framingham to North Karelia: from descriptive epidemiology to public health action. Prog Cardiovasc Dis 2010;53(1):15-20. 15. Farquhar JW, Fortmann SP, Maccoby N, et al. The Stanford Five-City Project: design and methods. Am J Epidemiol 1985;122(2):323-34. 16. Keys A. Seven Countries: A Multivariate Analysis of Death and Coronary Heart Disease. Cambridge: Harvard University Press, 1980. 17. Weinehall L, Hellsten G, Boman K, Hallmans G. Prevention of cardiovascular disease in Sweden: the Norsjo community intervention programme--motives, methods and intervention components. Scand J Public Health Suppl 2001;56:13-20. 18. Puska P. The North Karelia Project: nearly 20 years of successful prevention of CVD in Finland. Hygie 1992;11(1):33-5. 19. Jeffery RW. Community programs for obesity prevention: the Minnesota Heart Health Program. Obes Res 1995;3 Suppl 2:283-8. 20. Faich GA, Ellis S, Belloni JS, Fishbein HA. The Rhode Island Diabetes Intervention Program. R I Med J 1979;62(6):229-32. 21. Kamath DY, Xavier D, Gupta R, et al. Rationale and design of a randomized controlled trial evaluating community health worker-based interventions for the secondary prevention of acute coronary syndromes in India (SPREAD). Am Heart J 2014;168(5):690-7. 22. Turkish Statistical Institute. Seçilmiş Göstergelerle Nevşehir 2013. Available at: http://www.tuik.gov.tr/ilGostergeleri/iller/NEVSEHIR.pdf Accessed June 21, 2018 23. Centers for Disease Control and Prevention (CDC). State-specific secondhand smoke exposure and current cigarette smoking among adults - United States, 2008. MMWR Morb Mortal Wkly Rep 2009;58(44):1232-5. 24. Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute scientific statement: Executive Summary. Crit Pathw Cardiol 2005;4(4):198-203. 25. Johansson G, Westerterp KR. Assessment of the physical activity level with two questions: validation with doubly labeled water. Int J Obes (Lond) 2008;32(6):1031-3. 26. Turkish Statistical Institute (TURKSTAT). Address Based Population Registration System Results, Available at: http://www.turkstat.gov.tr/Kitap.do?metod=KitapDetay&KT_ID=11&KITAP_ID=139 27. Hacettepe University Institute of Population Studies, T.R. Ministry of Development and TÜBİTAK. 2013 Turkey Demographic and Health Survey. Available at: http://www.hips.hacettepe.edu.tr/eng/TDHS_2013_main.report.pdf 28. Ministry of Labour and Social Security. Net minimum wage by years. Available at: https://www.csgb.gov.tr/en/Contents/Istatistikler/AsgariUcret Accessed June 22, 2018 29. World Health Organization (WHO). Noncommunicable Diseases (NCD) Country Profiles. Available at: http://www.who.int/nmh/countries/tur_en.pdf Accessed 2015 30. Altun B, Arici M, Nergizoğlu G, et al. Prevalence, awareness, treatment and control of hypertension in Turkey (the PatenT study) in 2003. J Hypertens 2005;23(10):1817-2
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Details

Primary Language English
Journal Section Original Research
Authors

Serhat Unal This is me

Sibel Ascioglu This is me

Ahmet Demirkazik This is me

İhsan Ertenli This is me

Erdal Eskioglu This is me

Kerim Guler This is me

Sedat Kiraz This is me

Mert Ozbakkaloglu This is me

Birol Ozer This is me

Tufan Tukek This is me

Mine Durusu Tanriover This is me

Eda Akyar This is me

Pelin Cagatay This is me

Yunus Erdem

Publication Date December 24, 2018
Submission Date December 12, 2017
Published in Issue Year 2018

Cite

APA Unal, S., Ascioglu, S., Demirkazik, A., Ertenli, İ., et al. (2018). Baseline data of a prospective cohort study: Cappadocia cohort study, Turkey. Turkish Journal of Public Health, 16(3), 190-203. https://doi.org/10.20518/tjph.500196
AMA Unal S, Ascioglu S, Demirkazik A, Ertenli İ, Eskioglu E, Guler K, Kiraz S, Ozbakkaloglu M, Ozer B, Tukek T, Tanriover MD, Akyar E, Cagatay P, Erdem Y. Baseline data of a prospective cohort study: Cappadocia cohort study, Turkey. TJPH. December 2018;16(3):190-203. doi:10.20518/tjph.500196
Chicago Unal, Serhat, Sibel Ascioglu, Ahmet Demirkazik, İhsan Ertenli, Erdal Eskioglu, Kerim Guler, Sedat Kiraz, Mert Ozbakkaloglu, Birol Ozer, Tufan Tukek, Mine Durusu Tanriover, Eda Akyar, Pelin Cagatay, and Yunus Erdem. “Baseline Data of a Prospective Cohort Study: Cappadocia Cohort Study, Turkey”. Turkish Journal of Public Health 16, no. 3 (December 2018): 190-203. https://doi.org/10.20518/tjph.500196.
EndNote Unal S, Ascioglu S, Demirkazik A, Ertenli İ, Eskioglu E, Guler K, Kiraz S, Ozbakkaloglu M, Ozer B, Tukek T, Tanriover MD, Akyar E, Cagatay P, Erdem Y (December 1, 2018) Baseline data of a prospective cohort study: Cappadocia cohort study, Turkey. Turkish Journal of Public Health 16 3 190–203.
IEEE S. Unal, “Baseline data of a prospective cohort study: Cappadocia cohort study, Turkey”, TJPH, vol. 16, no. 3, pp. 190–203, 2018, doi: 10.20518/tjph.500196.
ISNAD Unal, Serhat et al. “Baseline Data of a Prospective Cohort Study: Cappadocia Cohort Study, Turkey”. Turkish Journal of Public Health 16/3 (December 2018), 190-203. https://doi.org/10.20518/tjph.500196.
JAMA Unal S, Ascioglu S, Demirkazik A, Ertenli İ, Eskioglu E, Guler K, Kiraz S, Ozbakkaloglu M, Ozer B, Tukek T, Tanriover MD, Akyar E, Cagatay P, Erdem Y. Baseline data of a prospective cohort study: Cappadocia cohort study, Turkey. TJPH. 2018;16:190–203.
MLA Unal, Serhat et al. “Baseline Data of a Prospective Cohort Study: Cappadocia Cohort Study, Turkey”. Turkish Journal of Public Health, vol. 16, no. 3, 2018, pp. 190-03, doi:10.20518/tjph.500196.
Vancouver Unal S, Ascioglu S, Demirkazik A, Ertenli İ, Eskioglu E, Guler K, Kiraz S, Ozbakkaloglu M, Ozer B, Tukek T, Tanriover MD, Akyar E, Cagatay P, Erdem Y. Baseline data of a prospective cohort study: Cappadocia cohort study, Turkey. TJPH. 2018;16(3):190-203.

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