Obezite Polikliniğine Başvuran Hastalarda Hematoljik ve Biyokimyasal Parametrelerle Kardiyovasküler Risk Skorlarının Karşılaştırılması

Year 2022, , 544 - 550, 20.10.2022

Nursel Kaya , Zerrin Gamsızkan , Mehmet Ali Sungur

https://doi.org/10.18521/ktd.1111994

Abstract

Amaç: Bu çalışmada, obezite polikliniğine başvuran hastalarda; hematolojik ve biyokimyasal parametreler ile kardiyovasküler risk skorlamasının karşılaştırmalı değerlendirilmesi amaçlanmıştır.
Yöntem: Tanımlayıcı-kesitsel olarak planlanan bu araştırmada, Düzce Üniversitesi Araştırma ve Uygulama Hastanesinin Obezite Polikliniğine 2017-2018 yılları arasında başvuran hastaların, dosya verileri retrospektif olarak değerlendirildi. Hastaların yaş, cinsiyet, sigara kullanımları, DM tanılarının varlığı, BKİ değerleri kaydedildi; kardiyovasküler risk faktörleri Avrupa ve Türkiye Kardiyoloji Dernekleri risk skorlamasına göre değerlendirildi.
Bulgular: Çalışmaya %75,1’i kadın, %24,9’u erkek, 631 katılımcı dahil edilmiştir. Yaş ortalaması 38,9±12,1 (min=21-maks=65) olarak bulunmuştur. Hastaların %19,2’sinin sigara kullandığı, %4,6’sında DM ve %36,9’unda insülin direnci olduğu görülmüştür. Katılımcıların %3,3’ü zayıf, %7,3’ü normal kilolu, %22,5’i fazla kilolu ve %66,9’u obezdir. Türkiye Kardiyoloji Derneği risk skorlamasına göre hastaların %51,4’i düşük , %20,5’i orta ve %28,1’i yüksek risklidir. Avrupa Kardiyoloji Derneği risk skorlamasına göre ise hastaların %83,5’i düşük, %10,9’u orta ve %5,5’i yüksek risklidir. Her iki risk skorlamasına göre risk grupları arasında yaş, cinsiyet, beden kitle indeksi ve DM varlığı açısından anlamlı farklılık görüldü (p<0,001). Türkiye Kardiyoloji Derneği risk skorlamasına göre; yüksek risk grubunda olanların daha düşük trombosit/lenfosit oranına ve daha yüksek total kolesterol/HDL oranına sahip olduğu görüldü. Her iki skorda da kardiyovasküler risk ile RDW, MPV, lökosit sayısı, nötrofil/lenfosit oranı değerlerinde ilişki saptanmadı.
Sonuç: Birinci basamak sağlık hizmetlerine obezite danışmanlığı için başvuran hastalara risk değerlendirmesi yapılması önemlidir. Yapılan kardiyovasküler risk değerlendirmesi ile bazı önlemlerin erkenden alınması sağlanabilir. Riskin erken saptanması amacıyla klinisyenlerin kolay ulaşabilecekleri parametreleri ortaya çıkaracak daha çok çalışmaya ihtiyaç vardır.

Keywords

Obezite, BKI, NLR, PLR, Kardiyovasküler risk skorları, hematolojik parametreler

Comparison of Hematological and Biochemical Parameters and Cardiovascular Risk Scores in Patients Applying to the Obesity Outpatient Clinic

Abstract

Objective: The aim of this study was to compare hematological and biochemical parameters and cardiovascular risk scoring in patients admitted to the obesity outpatient clinic.
Method: In this descriptive cross-sectional study, data of the patients who admitted to the Obesity Outpatient Clinic of Duzce University Research and Application Hospital between 2017 and 2018 were evaluated retrospectively. Age, gender, smoking status, presence of Diabetes Mellitus (DM), and body mass index (BMI) were recorded and the cardiovascular risk of the patients was calculated by using the scoring system of the European Society of Cardiology (ESC) and Turkish Society of Cardiology (TSC).
Results: A total of 631 participants were included in the study. The mean age was 38.9±12.1 (min=21, max=65) and 75.1% of the patients were female and 24.9% were male. It was observed that 19.2% of the patients were smokers, 4.6% had DM and 36.9% had insulin resistance. When the patients were evaluated according to the BMI scores, it was found that 3.3% of them were underweight, 7.3% were normal weight, 22.5% were overweight and 66.9% were obese. According to TSC risk scoring system, 51.4% of the patients were in low risk, 20.5% were in medium risk and 28.1% were in high risk category. According to the ESC risk scoring system, 83.5% of the patients were in low risk, 10.9% were in medium risk and 5.5% were in high risk category. According to both risk scoring systems, there were significant differences between the risk groups in terms of age, gender, BMI, and presence of DM (p<0.001). When evaluated according to the TSC risk score, it was seen that the patients in the high-risk category had a lower platelet/lymphocyte ratio and a higher total cholesterol/HDL ratio. According to both risk scoring systems, no correlation was found between cardiovascular risk and RDW, MPV, leukocyte count, and NLR(Neutrophil-Lymphocyte ratio).
Conclusion: Conducting a cardiovascular risk assessment for patients who admit to primary health care services for obesity counseling is important. A cardiovascular risk assessment conducted at admission may help some precautions to be taken earlier. There is a need for more studies to determine easily accessible parameters that can predict cardiovascular risk.

Keywords

Obesity, BMI, NLR, PLR, Cardiovasculer risk scores, hematologic parameters

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