Turkiye Klinikleri Journal of Pediatrics

.: ORIGINAL RESEARCH
Farklı Sosyoekonomik Düzeydeki Ergenlerde Santral Obezitenin Bel/Boy Oranı ile Değerlendirilmesi
The Evaluation of Central Obesity in Teenagers from Different Socio-Economic Levels with the Waist/Height Ratio
Mukaddes DEMİR ACARa, Meral BAYATb, Osman DEMİRc, Betül ÇİÇEKd, Emine ERDEMb
aHemşirelik Bölümü, Tokat Gaziosmanpaşa Üniversitesi Sağlık Bilimleri Fakültesi, Tokat, TÜRKİYE
bHemşirelik Bölümü, Erciyes Üniversitesi Sağlık Bilimleri Fakültesi, Kayseri, TÜRKİYE
cBiyoistatistik AD, Tokat Gaziosmanpaşa Üniversitesi Tıp Fakültesi, Tokat, TÜRKİYE
dBeslenme ve Diyetetik Bölümü, Erciyes Üniversitesi Sağlık Bilimleri Fakültesi, Kayseri, TÜRKİYE
Turkiye Klinikleri J Pediatr. 2019;28(2):55-62
doi: 10.5336/pediatr.2018-63401
Article Language: TR
Full Text
ÖZET
 Amaç: Bu araştırma ile sosyoekonomik düzeyin obezite ve santral obeziteye etkisini incelemektir. Bu çalışmada, Türkiye'de bir il merkezinde üç farklı sosyoekonomik yerleşim bölgesinde yer alan okullarda altı, yedi ve sekizinci sınıflarda öğrenim gören ergenlerde beden kitle indeksi (BKİ) ile obezite ve bel/boy oranı ile santral obezite prevalasının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışma, 2012-2013 eğitim-öğretim yılında 1.713 öğrenci ile yapılmıştır. Tokat il merkezinde düşük, orta ve yüksek sosyoekonomik bölgelerde bulunan ilköğretim okulları gruplandırılarak, basit rasgele örnekleme yöntemi ile altı okul örneklem grubuna seçilmiştir. Altı okulun altı, yedi ve sekizinci sınıflarındaki tüm öğrenciler araştırma kapsamına alınmıştır. Boy uzunluğu, vücut ağırlığı ve bel çevresi ölçümleri araştırmacı tarafından öğrencilerin kendi sınıflarında yapılmıştır. Bel/boy oranı 0,5 ve üzerinde ise santral obezite olarak değerlendirilmiştir. Veriler bilgisayar ortamında değerlendirilmiştir. Bulgular: Çalışma kapsamına alınan tüm ergenlerin; yaş ortalaması 12,54±0,92 yıl olup, %33,8'i altıncı sınıfta, %35,8'i yedinci sınıfta, %30,4'ü sekizinci sınıfta öğrenim görmektedir ve %48,5'i kız, %51,5'i erkektir. Çalışma kapsamına alınan tüm ergenlerin BKİ'ye göre %9,3'ü zayıf, %62,5'i normal, %21,7'si hafif şişman, %6,5'i ise obezdir. Hafif şişmanlık, obezite, santral obezite ve 95 persentilden yüksek bel çevresine sahip olma prevalansının, okulun sosyoekonomik düzey artışına paralel olarak arttığı belirlenmiştir. Benzer olarak; vücut ağırlığı, BKİ, bel çevresi ve bel/boy oranı ortalamalarının okulun sosyoekonomik düzey artışına paralel olarak anlamlı artış gösterdiği bulunmuştur. Çalışma kapsamına alınan tüm ergenlerin %19,7'sinde santral obezite belirlenmiştir ve BKİ'ye göre obez ergenlerin %92,8, hafif şişmanların %55,1 ve normal ergenlerin %2.8'inde santral obezite belirlenmiştir. Ayrıca; kız ergenlerin %15,6'sında, erkeklerin %23,6'sında santral obezite olduğu ve aralarındaki farkın anlamlı olduğu bulunmuştur. Sonuç: Obezite ve santral obezitenin belirlenmesi için okullarda ergenlerin BKİ'lerinin yanında bel/boy oranı bakımından da değerlendirilmesi ve özellikle orta ve yüksek sosyoekonomik düzey okullarda artış gösteren obeziteye yönelik koruyucu, eğitici ve tedavi edici okul merkezli hizmetlerin artırılması önerilmektedir.

Anahtar Kelimeler: Ergenlik; okul sağlık hizmetleri; sosyoekonomik düzey; obezite; santral obezite; bel/boy oranı
ABSTRACT
 Objective: The purpose of the present study was to examine the effects of socio-economic status on obesity and central obesity. For this purpose, the body mass index (BMI), obesity and waist/height rates were evaluated in terms of central obesity prevalence in teenagers who were studying at 6th, 7th and 8th grades in schools located in three different socio-economic areas a city center in Turkey. Material and Methods: The study was conducted on a total of 1.713 students in 2012-2013 academic year. The Primary Schools in the city center of Tokat were grouped according to low, middle and high socio-economic levels; and a total of 6 schools were selected with the Simple Random Sampling Method. All the students in the 6th, 7th and 8th grades of these 6 Primary Schools were included in the present study. The height, body weight and waist circumference measurements were carried out by the researcher herself in the own classrooms of the students. If the waist/height ratio was at or above 0.5, the participant was evaluated as having central obesity. The data that were obtained were evaluated in the computer medium. Results: For all the teenagers, who were included in the study, the mean age value was 12.54±0.92; 33.8% of them were in the 6th grade; 35.8% were in the 7th grade; 30.4% were in the 8th grade; 48.5% were female and 51.5% were male. In terms of the BMI of the teenagers, who were included in the present study, 9.3% were weak, 62.5% were normal, 21.7% were slightly obese, and 6.5% were obese. It was determined that the prevalence of being slightly obese, obese, central obese, and having waist circumferences above 95 percentile increased paralel to the increase in the socio-economic level of the school. Similarly, it was also determined that the body weight, BMI, waist circumference and waist/height ratio increased at a significant level parallel to the increase in the socioeconomic level of the schools. Central obesity was determined in 19.7% of the participants who were included in the study. According to the BMI values, it was also determined that 92.8% of the obese teenagers, 55.1% of the slightly fat teenagers, and 2.8% of the normal teenagers had central obesity. In addition, it was also determined that 15.6% of the female teenagers and 23.6% of the male teenagers had central obesity, and the difference between them was significant. Conclusion: For the purpose of determining the obesity and central obesity rates, it is recommended that teenagers are evaluated in terms of BMI values and also in terms of waist/height ratios; and it is also recommended that preventive, educative and remedial school-centered services are increased especially against obesity, which is increasing in middle and high socio-economic level schools.

Keywords: Teenagers; school health services; socio-economic levels; obesity; central obesity; waist/height ratio
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