Kadınlarda ağırlık döngüsünün metabolik etkilerinin belirlenmesi

Bu çalışma, kadınlarda ağırlık döngüsü sıklığı ve şiddetinin belirlenerek metabolik etkilerinin değerlendirilmesi amacıyla, Mayıs 2016-Eylül 2016 tarihleri arasında Başkent Üniversitesi Hastanesi Ümitköy Polikliniği Endokrin Bölümü’ne başvuran, 25–45 yaş arasındaki 60 kadın birey üzerinde yürütülmüştür. Bireylerin kişisel özellikleri, genel ve beslenme alışkanlıkları, duygu durumları ile ağırlık değişimlerine ilişkin bilgileri saptamak için bir anket formu uygulanmıştır. Bireylerin beslenme durumları besin tüketim sıklığı ile saptanmıştır. Ağırlık değişimleri sonucunda, son 10 yıl içerisinde 2 kezden fazla 5 kg ve üzerinde ağırlık kaybı yaşayıp sonrasında tekrar geri kazanma ağırlık döngüsü olarak tanımlanmıştır. Çalışmaya katılan bireyler ağırlık döngüsü yaşayanlar (vaka grubu, n=20) ve ağırlık döngüsü yaşamayanlar (kontrol grubu, n=40) olmak üzere iki gruba ayrılmıştır. Vaka grubundaki bireylerin 6’sının (%30.0) hafif derecede ve 14’ünün (%70.0) ciddi derecede döngüye girdiği belirlenmiştir. Vaka ve kontrol grupları arasında vücut ağırlığı, beden kütle indeksi, bel çevresi, kalça çevresi, bel/kalça oranı, toplam vücut yağı, yağ dokusu kütlesi, yağsız doku kütlesi ve toplam vücut su kütlesi açısından istatistiksel olarak önemli fark bulunurken (p0.05). Gruplar arasında serum glukoz, total kolesterol, LDL-kolesterol, trigliserit, AST, ALT ve ürik asit değerleri açısından istatistiksel anlamlı bir ilişki saptanırken (p0.05). Ağırlık döngü dereceleri ve döngü sayısı ile biyokimyasal parametreler arasında istatistiksel açıdan önemli bir fark belirlenmemiştir (p>0.05). Beck depresyon ölçeğine göre gruplar arasında istatistiksel açıdan önemli bir ilişki saptanmış (p0.05). Gruplar arasında, günlük enerji, protein, bitkisel protein, yağ, karbonhidrat posa alım ortalaması açısından önemli bir fark saptanmıştır (p0.05). Sonuç olarak, ağırlık döngüsünün antropometrik ölçümler, biyokimyasal parametreler, beslenme ve duygu durumları üzerinde önemli bir etkisinin olduğu belirlenmiş, ancak döngü derecesinin etkinliği tam olarak saptanmamıştır. This study was conducted on 60 female subjects aged 25 – 45 years, who applied to Başkent University Hospital Ümitköy Policlinic Department of Endocrinology between May 2016 and September 2016 for the purpose of determining the frequency and severity of weight cycling in women and their metabolic effetcs. A questionnaire form was used to determine individual characteristics, general and nutritional habits, psychological status and information on weight changes. Nutritional status of the individuals was determined by the frequency of food consumption. As a result of weight changes, weight cycling have been defined intentionally lost two or more times at least 5 kg during the past 10 years and regained the weight. The subjects were divided into groups: those who have weight cycling (the case group, n=20) and do not have weight cycling (the control group, n=40). Of the individuals in the case group, 6 (30.0%) were mild cycler and 14 (70.0%) were severe cycler identified. Between the case and control groups, body weight, body mass index, waist circumference, hip circumference, waist / hip ratio, total body fat, fat mass, fat free mass and total body water mass were statistically significant (p0.05). Between the case and control groups, serum glucose, total cholesterol, LDL-cholesterol, triglyceride, AST, ALT and uric acid levels a statistically significant relations (p0.05). No statistically significant difference was found when the relationship between weight cycling leveles and cycle numbers wew correlated with biochemical parametres (p>0.05). There was a statistically significant relationship between the Beck depression scale and the groups (p0.05). There was a significant between the groups in terms of daily mean energy, protein, fat, carbohydrate, vegetable protein and pulp intake (p0.05). As a result, weight cycle were determined to have a significant effect on anthropometric measurements, biochemical parameters, nutrition and psychological status, but the efficacy of weight cycling levels and numbers was no found

The influence of bias in randomized controlled trials on rehabilitation intervention effect estimates: what we have learned from meta-epidemiological studies

This study aimed to synthesize evidence from studies that addressed the influence of bias domains in randomized controlled trials on rehabilitation intervention effect estimates and discuss how these findings can maximize the trustworthiness of an RCT in rehabilitation. We screened studies about the influence of bias on rehabilitation intervention effect estimates published until June 2023. The characteristics and results of the included studies were categorized based on methodological characteristics and summarized narratively. We included seven studies with data on 227,806 RCT participants. Our findings showed that rehabilitation intervention effect estimates are likely exaggerated in trials with inadequate/unclear sequence generation and allocation concealment when using continuous outcomes. The influence of blinding was inconsistent and different from the rest of medical science, as meta-epidemiological studies showed overestimation, underestimation, or neutral associations for different types of blinding on rehabilitation treatment effect estimates. Still, it showed a more consistent pattern when looking at patient-reported outcomes. The impact of attrition bias and intention to treat has been analyzed only in two studies with inconsistent results. The risk of reporting bias seems to be associated with overestimation of treatment effects. Bias domains can influence rehabilitation treatment effects in different directions. The evidence is mixed and inconclusive due to the poor methodological quality of RCTs and the limited number and quality of studies looking at the influence of bias and treatment effects in rehabilitation. Further studies about the influence of bias in RCTs on rehabilitation intervention effect estimates are needed