Yıl: 2018 Cilt: 46 Sayı: 7 Sayfa Aralığı: 613 - 623 Metin Dili: İngilizce DOI: 10.5543/tkda.2018.32967 İndeks Tarihi: 05-08-2020

The Prospective Urban Rural Epidemiology (PURE) study: PURE Turkey

Öz:
Objective: The Prospective Urban Rural Epidemiology(PURE) study is a prospective cohort study that collectsdata on social, environmental, and individual risk factors andchronic diseases among residents of 25 countries in the rangeof 35 to 70 years of age, living in rural and urban areas. ThePURE study is directed by the Population Health Research Institute of McMaster University in Canada. In Turkey, the studyis conducted by the Metabolic Syndrome Society.Methods: In Turkey, the study is being conducted in 8 cities.The initial fieldwork began in 2008. Questionnaires werecompleted, and anthropometric measurements, blood andurine samples, handgrip strength evaluations, electrocardiogram readings, and spirometer and body compositionmeasurements were obtained. Each year, participants werefollowed up via telephone. Every third year, questionnaires,field measurements, and biological data sampling were repeated.Results: PURE Turkey has 4056 participants (female:60.7%, male: 39.3%; mean age: 50±9.1 years). Among them,43.9% had metabolic syndrome and 52.8% were obese. Theprevalence of hypertension was 41.1% and proportion ofcontrolled hypertension was 34%. A total of 2098 (51.7%)of the participants had a total cholesterol of ≥200 mg/dL orwere using a lipid lowering agent. In patients with diabetes,79.8% had low-density lipoprotein cholesterol levels ≥100mg/dL. Although a dramatic change was not observed inthose parameters in the follow-up years, the prevalence ofdiabetes mellitus increased from 13.7% in 2008 to 21% in2015. The baseline and follow-up data of the PURE studywere analyzed with the other countries participating in thestudy and reported for international publication.Conclusion: The PURE study is a large, ongoing, prospective epidemiological study that is investigating the “causes ofthe causes” of noncommunicable diseases in the world. In addition to revealing the health status of nations, the study alsohas the potential to affect health politics.
Anahtar Kelime:

The Prospective Urban Rural Epidemiology (PURE) çalışması: PURE Türkiye

Öz:
Amaç: The Prospective Urban Rural Epidemiology (PURE) çalışması sosyal, çevresel ve kişisel risk faktörleri ile kronik hastalıklar hakkında veri toplamayı amaçlayan, 35–70 yaş arası, şehirde ve kırsalda yaşayan 25 ülkeden katılımcıya sahip prospektif bir çalışmadır. Çalışma Kanada’da McMaster Üniversitesi Population Health and Research Institute tarafından yönetilmektedir. Türkiye’de ise çalışmayı Metabolik Sendrom Derneği yürütmektedir. Yöntemler: Çalışma için sekiz bölge seçildi. Saha çalışmaları 2008 yılında başlayan çalışmada antropometrik ölçümler, kan ve idrar örnekleri, el kavrama kuvveti, EKG, spirometre ve vücut kompozisyonu ölçümleri alındı. Katılım fazından sonra takip fazında her yıl katılımcılar telefon ile aranarak sağlık durumlarındaki yenilikleri analiz edecek soruları barındıran anketler yöneltildi. Üç yılda bir tekrar sahaya inilerek anketlere ek olarak başlangıçta yapılan antropometrik ölçümler, EKG, spirometre ve kan, idrar örnekleri tekrarlandı. Bulgular: PURE Türkiye 4056 (%60.7 kadın, %39.3 erkek, ortalama yaş: 50±9.1) katılımcı ile temsil edilmektedir. Katılımcıların %43.9’unda metabolik sendrom vardır, %52.8’i ise obezdir. Hipertansiyon prevelansı %41.1’dir ve kan basıncı kontrolü %34 hastada sağlanmıştır. Toplam 2098 (%51.7) katılımcının total kolesterolü ≥200 mg/dL’dir veya bir lipit düşürücü ilaç kullanmaktadır. Diyabetli hastalar arasında %79.8’inin LDL kolesterol seviyesi ≥100 mg/dL’dir. Yıllar içerisinde bu hastalıklara sahip hasta sayısında ciddi artış görülmemekle birlikte diyabet prevelansı 2008’de %13.7 iken 2015 yılında %21’e çıkmıştır. PURE çalışmasının başlangıç ve takip verileri tüm ülkelerle birlikle analiz edilmekte, uluslararası yayınlar olarak paylaşılmaktadır. Sonuç: Sonuç olarak PURE çalışması ülkemizde ve dünyada halen devam eden, prospektif, geniş katılımlı bir epidemiyolojik çalışmadır ve temel amacı kronik hastalıkların “sebeplerinin sebeplerini” bulmaktır. Ülkelerin sağlık durumlarını göz önüne koymanın yanı sıra sağlık politikalarına yön verme potansiyeli mevcuttur.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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  • 1. Teo K, Chow CK, Vaz M, Rangarajan S, Yusuf S; PURE Investigators-Writing Group. The Prospective Urban Rural Epidemiology (PURE) study: examining the impact of societal influences on chronic noncommunicable diseases in low-, middle-, and high-income countries. Am Heart J 2009;158:1– 7. [CrossRef]
  • 2. Onat A. Risk factors and cardiovascular disease in Turkey. Atherosclerosis 2001;156:1–10. [CrossRef]
  • 3. Gunes FE, Imeryuz N, Akalin A, Bekiroglu N, Alphan E, Oguz A, et al. Development and validation of a semi-quantitative food frequency questionnaire to assess dietary intake in Turkish adults. J Pak Med Assoc 2015;65:756–63.
  • 4. Yusuf S, Rangarajan S, Teo K, Islam S, Li W, Liu L, et al; PURE Investigators. Cardiovascular risk and events in 17 low-, middle-, and high-income countries. N Engl J Med 2014;371:818–27. [CrossRef]
  • 5. Chow CK, Teo KK, Rangarajan S, Islam S, Gupta R, Avezum A, et al; PURE (Prospective Urban Rural Epidemiology) Study investigators. Prevalence, awareness, treatment, and control of hypertension in rural and urban communities in high-, middle-, and low-income countries. JAMA 2013;310:959–68.
  • 6. Attaei MW, Khatib R, McKee M, Lear S, Dagenais G, Igumbor EU, et al; PURE study investigators. Availability and affordability of blood pressure-lowering medicines and the effect on blood pressure control in high-income, middle-income, and low-income countries: an analysis of the PURE study data. Lancet Public Health 2017;2:e411–9. [CrossRef]
  • 7. Khatib R, McKee M, Shannon H, Chow C, Rangarajan S, Teo K, et al; PURE study investigators. Availability and affordability of cardiovascular disease medicines and their effect on use in high-income, middle-income, and low-income countries: an analysis of the PURE study data. Lancet 2016;387:61–9.
  • 8. Murphy A, Palafox B, O’Donnell O, Stuckler D, Perel P, AlHabib KF, et al. Inequalities in the use of secondary prevention of cardiovascular disease by socioeconomic status: evidence from the PURE observational study. Lancet Glob Health 2018;6:e292–301. [CrossRef]
  • 9. Mente A, O’Donnell MJ, Rangarajan S, McQueen MJ, Poirier P, Wielgosz A, et al; PURE Investigators. Association of urinary sodium and potassium excretion with blood pressure. N Engl J Med 2014;371:601–11. [CrossRef]
  • 10. O’Donnell M, Mente A, Rangarajan S, McQueen MJ, Wang X, Liu L, et al; PURE Investigators. Urinary sodium and potassium excretion, mortality, and cardiovascular events. N Engl J Med 2014;371:612–23. [CrossRef]
  • 11. Yusuf S, Islam S, Chow CK, Rangarajan S, Dagenais G, Diaz R, et al; Prospective Urban Rural Epidemiology (PURE) Study Investigators. Use of secondary prevention drugs for cardiovascular disease in the community in high-income, middle-income, and low-income countries (the PURE Study): a prospective epidemiological survey. Lancet 2011;378:1231– 43. [CrossRef]
  • 12. Teo K, Lear S, Islam S, Mony P, Dehghan M, Li W,et al; PURE Investigators. Prevalence of a healthy lifestyle among individuals with cardiovascular disease in high-, middle- and low-income countries: The Prospective Urban Rural Epidemiology (PURE) study. JAMA 2013;309:1613–21. [CrossRef]
  • 13. Smyth A, Teo KK, Rangarajan S, O’Donnell M, Zhang X, Rana P, et al; PURE Investigators. Alcohol consumption and cardiovascular disease, cancer, injury, admission to hospital, and mortality: a prospective cohort study. Lancet 2015;386:1945–54. [CrossRef]
  • 14. Mente A, Dehghan M, Rangarajan S, McQueen M, Dagenais G, Wielgosz A, et al; Prospective Urban Rural Epidemiology (PURE) study investigators. Association of dietary nutrients with blood lipids and blood pressure in 18 countries: a crosssectional analysis from the PURE study. Lancet Diabetes Endocrinol 2017;5:774–87. [CrossRef]
  • 15. Dehghan M, Mente A, Zhang X, Swaminathan S, Li W, Mohan V, et al; Prospective Urban Rural Epidemiology (PURE) study investigators. Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study. Lancet 2017;390:2050–62. [CrossRef]
  • 16. Miller V, Mente A, Dehghan M, Rangarajan S, Zhang X, Swaminathan S, et al; Prospective Urban Rural Epidemiology (PURE) study investigators. Fruit, vegetable, and legume intake, and cardiovascular disease and deaths in 18 countries (PURE): a prospective cohort study. Lancet 2017;390:2037– 49. [CrossRef]
  • 17. Lear SA, Hu W, Rangarajan S, Gasevic D, Leong D, Iqbal R, et al. The effect of physical activity on mortality and cardiovascular disease in 130 000 people from 17 high-income, middle-income, and low-income countries: the PURE study. Lancet 2017;390:2643–54. [CrossRef]
  • 18. Leong DP, Teo KK, Rangarajan S, Lopez-Jaramillo P, Avezum A Jr, Orlandini A, et al; Prospective Urban Rural Epidemiology (PURE) Study investigators. Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study. Lancet 2015;386:266–73. [CrossRef]
APA Oguz A, Telci Caklili O, ÇALIK B, INVESTİGATORS P (2018). The Prospective Urban Rural Epidemiology (PURE) study: PURE Turkey. , 613 - 623. 10.5543/tkda.2018.32967
Chicago Oguz Aytekin,Telci Caklili Ozge,ÇALIK Burcu Tümerdem,INVESTİGATORS PURE The Prospective Urban Rural Epidemiology (PURE) study: PURE Turkey. (2018): 613 - 623. 10.5543/tkda.2018.32967
MLA Oguz Aytekin,Telci Caklili Ozge,ÇALIK Burcu Tümerdem,INVESTİGATORS PURE The Prospective Urban Rural Epidemiology (PURE) study: PURE Turkey. , 2018, ss.613 - 623. 10.5543/tkda.2018.32967
AMA Oguz A,Telci Caklili O,ÇALIK B,INVESTİGATORS P The Prospective Urban Rural Epidemiology (PURE) study: PURE Turkey. . 2018; 613 - 623. 10.5543/tkda.2018.32967
Vancouver Oguz A,Telci Caklili O,ÇALIK B,INVESTİGATORS P The Prospective Urban Rural Epidemiology (PURE) study: PURE Turkey. . 2018; 613 - 623. 10.5543/tkda.2018.32967
IEEE Oguz A,Telci Caklili O,ÇALIK B,INVESTİGATORS P "The Prospective Urban Rural Epidemiology (PURE) study: PURE Turkey." , ss.613 - 623, 2018. 10.5543/tkda.2018.32967
ISNAD Oguz, Aytekin vd. "The Prospective Urban Rural Epidemiology (PURE) study: PURE Turkey". (2018), 613-623. https://doi.org/10.5543/tkda.2018.32967
APA Oguz A, Telci Caklili O, ÇALIK B, INVESTİGATORS P (2018). The Prospective Urban Rural Epidemiology (PURE) study: PURE Turkey. Türk Kardiyoloji Derneği Arşivi, 46(7), 613 - 623. 10.5543/tkda.2018.32967
Chicago Oguz Aytekin,Telci Caklili Ozge,ÇALIK Burcu Tümerdem,INVESTİGATORS PURE The Prospective Urban Rural Epidemiology (PURE) study: PURE Turkey. Türk Kardiyoloji Derneği Arşivi 46, no.7 (2018): 613 - 623. 10.5543/tkda.2018.32967
MLA Oguz Aytekin,Telci Caklili Ozge,ÇALIK Burcu Tümerdem,INVESTİGATORS PURE The Prospective Urban Rural Epidemiology (PURE) study: PURE Turkey. Türk Kardiyoloji Derneği Arşivi, vol.46, no.7, 2018, ss.613 - 623. 10.5543/tkda.2018.32967
AMA Oguz A,Telci Caklili O,ÇALIK B,INVESTİGATORS P The Prospective Urban Rural Epidemiology (PURE) study: PURE Turkey. Türk Kardiyoloji Derneği Arşivi. 2018; 46(7): 613 - 623. 10.5543/tkda.2018.32967
Vancouver Oguz A,Telci Caklili O,ÇALIK B,INVESTİGATORS P The Prospective Urban Rural Epidemiology (PURE) study: PURE Turkey. Türk Kardiyoloji Derneği Arşivi. 2018; 46(7): 613 - 623. 10.5543/tkda.2018.32967
IEEE Oguz A,Telci Caklili O,ÇALIK B,INVESTİGATORS P "The Prospective Urban Rural Epidemiology (PURE) study: PURE Turkey." Türk Kardiyoloji Derneği Arşivi, 46, ss.613 - 623, 2018. 10.5543/tkda.2018.32967
ISNAD Oguz, Aytekin vd. "The Prospective Urban Rural Epidemiology (PURE) study: PURE Turkey". Türk Kardiyoloji Derneği Arşivi 46/7 (2018), 613-623. https://doi.org/10.5543/tkda.2018.32967