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dc.contributor.advisorBilgiç, Pelin
dc.contributor.authorÖteleş, Sümeyra
dc.date.accessioned2024-02-14T08:06:27Z
dc.date.issued2024-02-02
dc.date.submitted2024-01-08
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dc.identifier.urihttps://www.openaccess.hacettepe.edu.tr/xmlui/submit?workspaceID=51257
dc.identifier.urihttps://hdl.handle.net/11655/34658
dc.description.abstractObesity is one of the most common comorbidities in Psoriatic Arthritis (PsA), an inflammatory arthritis, and is associated with high disease activity, low quality of life, and unfavorable treatment processes. This study aimed to investigate the effect of diet and cognitive exercise therapy approach (BETY) intervention on disease activity and quality of life in overweight/obese PsA patients. The study included 70 obese/slightly obese patients aged 20-65, who were diagnosed with PsA according to CASPAR (Psoriatic Arthritis Classification Criteria) criteria and applied to Hacettepe University Department of Internal Medicine, Department of Rheumatology between 2021-2022. The patients were randomly divided into three groups (diet, n=23; diet+BETY, n=23; control, n=24) and followed for 12 weeks. While patients in the diet group were applied only to a diet program, patients in the diet+BETY group were applied to a diet program together with a biopsychosocial-based exercise (BETY) program. Disease activity assessments, anthropometric measurements, food consumption records, quality of life scale, and BETY-Biopsychosocial Questionnaire (BETY-BQ) scores were recorded and compared at baseline (week 0) and week twelve. Correlation and logistic regression analyses were used to examine the effects of interventions on disease activity scores. The study was completed with 48 patients. A significant decrease in body weight was observed in the diet+BETY (-6.2±1.3 kg, p<0.001) and diet (-6.6±2.6 kg, p<0.001) groups compared to the baseline. After 12 weeks, the Disease Activity for Psoriatic Arthritis (DAPSA) score significantly decreased in both intervention groups (diet+BETY: -10.7±8.1, p<0.001; diet: -7.6±6.7, p<0.001). Regardless of interventions, weight loss (≥5%) increased the chance of achieving Minimal Disease Activity (MDA) (OR: 6.51, 95% CI: 1.09-38.90). These results showed that weight loss and a biopsychosocial-based exercise intervention, alone or in combination, improved PsA symptoms. Multidisciplinary approaches for obese PsA patients may improve the management of the disease and increase the chances of achieving remission.tr_TR
dc.language.isoturtr_TR
dc.publisherSağlık Bilimleri Enstitüsütr_TR
dc.rightsinfo:eu-repo/semantics/openAccesstr_TR
dc.subjectpsoriyatik artrittr_TR
dc.subjectobezitetr_TR
dc.subjecthastalık aktivitesitr_TR
dc.subjectağırlık kaybıtr_TR
dc.subjectdiyettr_TR
dc.subjectbiyopsikososyal egzersiztr_TR
dc.titleHafif Şişman/Obez Psoriyatik Artrit Hastalarında Vücut Ağırlık Yönetimi ve Bilişsel Egzersiz Terapi Yaklaşımının İyileşme Özelliklerine Etkisinin Araştırılmasıtr_TR
dc.typeinfo:eu-repo/semantics/doctoralThesistr_TR
dc.description.ozetObezite inflamatuar bir artrit olan Psoriyatik Artrit (PsA)’te en sık görülen komorbiditelerden biri olup yüksek hastalık aktivitesi, düşük yaşam kalitesi ve olumsuz tedavi süreci ile ilişkilendirilmektedir. Bu araştırmada hafif şişman/obez PsA hastalarında diyet ve bilişsel egzersiz terapi yaklaşımı (BETY) müdahalesinin hastalık aktivitesi ve yaşam kalitesi üzerine etkisinin araştırılması amaçlanmıştır. Araştırmaya Hacettepe Üniversitesi İç hastalıkları Ana Bilim Dalı, Romatoloji Bilim Dalına 2021-2022 yılları arasında başvuran CASPAR (Psoriyatik Artrit Sınıflandırma Kriterleri) kriterlerine göre PsA tanısı almış, 20-65 yaşlar arası 70 obez/hafif şişman hasta dâhil edilmiştir. Hastalar rastgele üç gruba (diyet, n=23; diyet+BETY, n=23; kontrol, n=24) ayrılmış ve 12 hafta takip edilmiştir. Diyet grubundaki hastalara sadece diyet programı uygulanırken, diyet+BETY grubundaki hastalara BETY programıyla birlikte diyet programı uygulanmıştır. Kontrol grubu hastalarına ise herhangi bir müdahale uygulanmamıştır ancak genel sağlıklı beslenme önerileri sözel olarak bildirilmiştir. Tüm hastaların başlangıç (0. hafta) ve 12. hafta hastalık aktivite değerlendirmeleri, antropometrik ölçümler, besin tüketim kayıtları, yaşam kalitesi ölçeği ve BETY-Biyopsikososyal Ölçeği (BETY-BQ) puanları kaydedilerek karşılaştırılmıştır. Müdahalelerin hastalık aktivite skorları üzerindeki etkilerini incelemek için korelasyon ve lojistik regresyon analizleri kullanılmıştır. Araştırma ‘diyet’ grubu (n=19), ‘diyet+BETY’ grubu (n=11) ve ‘kontrol’ grubu (n=18) olmak üzere toplam 48 hasta ile tamamlanmıştır. Diyet+BETY (-6.2±1.3 kg, p<0.001) ve diyet (-6.6±2.6 kg, p<0.001) gruplarında başlangıca göre vücut ağırlığında anlamlı azalma görülmüştür. On iki haftanın sonunda Psoriyatik Artrit Hastalık Aktivitesi (DAPSA) skoru her iki müdahale grubunda da (diyet+BETY:-10.7±8.1, p<0.001; diyet: -7.6±6.7, p<0.001) anlamlı düzeyde azalmıştır. Müdahalelerden bağımsız olarak vücut ağırlığı kaybı (≥%5) Minimal Hastalık Aktivitesi (MDA)’ne ulaşma şansını artırmıştır (OR: 6.51, %95 GA: 1.09-38.90). Elde edilen bu sonuçlar ağırlık kaybı ve biyopsikososyal temelli bir egzersiz müdahalesinin tek başına veya birlikte PsA semptomlarını iyileştirdiğini göstermiştir. Dolayısıyla obez PsA hastalarına yönelik multidisipliner yaklaşımlar hastalığın yönetimini iyileştirebilir ve remisyona ulaşma şansını arttırabilir.tr_TR
dc.contributor.departmentBeslenme ve Diyetetiktr_TR
dc.embargo.terms6 aytr_TR
dc.embargo.lift2024-08-18T08:06:27Z
dc.fundingYoktr_TR


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