EndoBridge Kurucu Ba\u015fkan\u0131 Prof. Dr. Okan B\u00fclent Y\u0131ld\u0131z, T\u00fcrkiye\u2019nin Avrupa\u2019da en \u015fi\u015fman \u00fclkeler s\u0131ralamas\u0131nda birinci s\u0131raya y\u00fckseldi\u011fini belirterek, “T\u00fcrkiye\u2019de eri\u015fkinlerde 3 ki\u015fiden biri obez, biri fazla kilolu, sadece biri normal kiloludur” dedi.<\/p>\n
EndoBridge y\u0131ll\u0131k toplant\u0131lar\u0131n\u0131n alt\u0131nc\u0131s\u0131, Amerikan Endokrin Derne\u011fi, Avrupa Endokrinoloji Derne\u011fi ve T\u00fcrkiye Endokrinoloji Derne\u011finin i\u015fbirli\u011finde Antalya\u2019n\u0131n Belek Turizm Merkezi\u2019ndeki bir otelde ger\u00e7ekle\u015ftirildi. Kongre kapsam\u0131nda d\u00fczenlenen bas\u0131n toplant\u0131s\u0131na EndoBridge Kurucu Ba\u015fkan\u0131 Prof. Dr. Okan B\u00fclent Y\u0131ld\u0131z, Endokrinoloji ve metabolizma Derne\u011fi Y\u00f6netim Kurulu \u00fcyesi Prof. Dr. F\u00fcsun Sayg\u0131l\u0131, Avrupa Endokrinoloji Derne\u011fi Ba\u015fkan\u0131 Prof. Dr. Aj Van Der Lely ve Amerikan Endokrin Derne\u011fi Ba\u015fkan\u0131 Prof. Dr. Susan Mandel kat\u0131ld\u0131.<\/p>\n
EndoBridge Kurucu Ba\u015fkan\u0131 Prof. Dr. Okan B\u00fclent Y\u0131ld\u0131z, sa\u011fl\u0131k alan\u0131nda d\u00fcnyada bir\u00e7ok ilke imza atan bu uluslararas\u0131 projenin 2018 y\u0131ll\u0131k toplant\u0131s\u0131n\u0131n 41 \u00fclkeden 578 kat\u0131l\u0131mc\u0131y\u0131 bulu\u015fturdu\u011funu ve bu y\u0131l en y\u00fcksek yabanc\u0131 delege ve en y\u00fcksek \u00fclke say\u0131s\u0131na ula\u015ft\u0131\u011f\u0131n\u0131 belirtti.<\/p>\n
“2 milyar ki\u015fi \u015fi\u015fman”<\/p>\n
Prof. Dr. Y\u0131ld\u0131z, programda diyabet, obezite, lipid bozukluklar\u0131, tiroid, kemik ve osteoporoz, hipofiz, b\u00f6brek\u00fcst\u00fc bezi, n\u00f6roendokrin t\u00fcm\u00f6rler, kad\u0131n ve erkek \u00fcreme endokrinolojisi dahil olmak \u00fczere endokrinolojinin t\u00fcm problemlerine g\u00fcncel yakla\u015f\u0131m kapsaml\u0131 bir \u015fekilde ele al\u0131nd\u0131\u011f\u0131n\u0131 bildirdi.1970\u2019li y\u0131llardan beri \u00e7ocuk ve eri\u015fkin obezitesi s\u0131kl\u0131\u011f\u0131n\u0131n \u00fc\u00e7 kat\u0131na \u00e7\u0131kt\u0131\u011f\u0131n\u0131 kaydeden Prof. Dr. Y\u0131ld\u0131z, g\u00fcn\u00fcm\u00fczde d\u00fcnyadaki fazla kilolu ve obez birey say\u0131s\u0131n\u0131n 2 milyar\u0131n \u00fczerinde oldu\u011funa dikkat \u00e7ekti.<\/p>\n
“3 ki\u015fiden biri obez”<\/p>\n
T\u00fcrkiye\u2019nin d\u00fcnyada en \u015fi\u015fman \u00fclkeler s\u0131ralamas\u0131nda birinci s\u0131raya y\u00fckseldi\u011fini belirten Prof. Dr. Y\u0131ld\u0131z, \u201cT\u00fcrkiye\u2019de eri\u015fkinlerde 3 ki\u015fiden biri obez, biri fazla kilolu, biri normal kiloludur. Obezite v\u00fccutta ya\u011f miktar\u0131n\u0131n artmas\u0131d\u0131r. Tan\u0131da en s\u0131k kullan\u0131lan kriter v\u00fccut kitle indeksi (VK\u0130)\u2019dir. VK\u0130, kilogram cinsinden a\u011f\u0131rl\u0131\u011f\u0131n metre cinsinden boyun karesine b\u00f6l\u00fcnmesi ile elde edilen rakamd\u0131r. VK\u0130\u2019nin 18.5 – 25 aras\u0131nda olmas\u0131 normal, 25-30 aras\u0131 fazla kiloluluk, 30\u2019un \u00fczerinde olmas\u0131 ise obezite olarak de\u011ferlendirilir. Ancak, bu kaba bir rakamd\u0131r ve v\u00fccuttaki ya\u011f miktar\u0131n\u0131 her zaman do\u011fru olarak yans\u0131tmaz, ya\u011f da\u011f\u0131l\u0131m\u0131 hakk\u0131nda fikir vermez, \u0131rk ve etnik gruplara g\u00f6re farkl\u0131l\u0131k g\u00f6sterir ve ileri ya\u015flarda yan\u0131lt\u0131c\u0131 olabilir. V\u00fccudunda ya\u011f fazlal\u0131\u011f\u0131 olan eri\u015fkinlerin yakla\u015f\u0131k yar\u0131s\u0131, \u00e7ocuk ve ergenlerin y\u00fczde 25-50\u2019si normal VK\u0130\u2019ne sahiptir. Klinik de\u011ferlendirmelerde v\u00fccut ya\u011f da\u011f\u0131l\u0131m\u0131 hakk\u0131nda da fikir sahibi olabilmek i\u00e7in bel \u00e7evresinin de \u00f6l\u00e7\u00fclmesi \u00f6nemlidir. Erkeklerde 94 santimetre, kad\u0131nlarda ise 80 cm \u00fczeri metabolik hastal\u0131k riskinin artt\u0131\u011f\u0131n\u0131 g\u00f6sterir” ifadelerine yer verdi.<\/p>\n
Prof. Dr. B\u00fclent Y\u0131ld\u0131z, obezite, diyabet, lipid ve kolesterol bozukluklar\u0131, k\u0131s\u0131rl\u0131k, kalp ve damar hastal\u0131klar\u0131, karaci\u011fer hastal\u0131klar\u0131, uyku apnesi, kanser, psikiyatrik hastal\u0131klar, eklem rahats\u0131zl\u0131klar\u0131 gibi bir\u00e7ok hastal\u0131\u011f\u0131n g\u00f6r\u00fclme s\u0131kl\u0131\u011f\u0131n\u0131, \u015fiddetini ve \u00f6l\u00fcm oranlar\u0131n\u0131 art\u0131rd\u0131\u011f\u0131n\u0131 kaydetti.<\/p>\n
“Obezite kronik bir hastal\u0131kt\u0131r”<\/p>\n
T\u00fcrkiye\u2019de obezitenin \u00f6nlenmesi ile t\u00fcm \u00f6l\u00fcmlerin erkeklerde y\u00fczde 11\u2019inin, kad\u0131nlarda y\u00fczde 16\u2019s\u0131n\u0131n \u00f6nlenebilmesinin m\u00fcmk\u00fcn oldu\u011funun alt\u0131n\u0131 \u00e7izen Prof. Dr. Y\u0131ld\u0131z, \u201cObezitenin \u00f6nlenmesi ve tedavi edilmesindeki ba\u015far\u0131s\u0131zl\u0131\u011f\u0131n en \u00f6nemli nedenlerinden biri, obezitenin ki\u015finin kontrol\u00fcnde bir ya\u015fam tarz\u0131 bi\u00e7imi sonucu olu\u015ftu\u011fu ve \u015fi\u015fman bireylerin kilo almalar\u0131ndan kendilerinin sorumlu oldu\u011fu d\u00fc\u015f\u00fcncesidir. Oysa obezite kompleks, ilerleyici ve tekrarlay\u0131c\u0131, kronik bir hastal\u0131kt\u0131r. Bireyin kendi kontrol\u00fcnde olmayan genetik, biyolojik, psikososyal ve \u00e7evresel pek \u00e7ok fakt\u00f6r de obezite geli\u015fiminde rol oynar. Metabolizma ve hormon dengemizden pazarlama g\u00fc\u00e7lerine kadar bir\u00e7ok etken, v\u00fccutta a\u015f\u0131r\u0131 ya\u011f birikimine e\u011filim ve duyarl\u0131l\u0131\u011f\u0131m\u0131z\u0131 belirler. Obeziteyi basit\u00e7e bir v\u00fccut a\u011f\u0131rl\u0131\u011f\u0131, imaj ya da irade problemi olarak tan\u0131mlamak yerine hastal\u0131\u011fa duyarl\u0131l\u0131\u011f\u0131 ve karma\u015f\u0131kl\u0131\u011f\u0131 dikkate alan insan odakl\u0131 ve d\u00f6rt boyutlu oldu\u011fu unutulmamal\u0131d\u0131r\u201d diye konu\u015ftu.<\/p>\n
“Hayati bir salg\u0131 bezi”<\/p>\n
T\u00fcrkiye Endokrinoloji ve Metabolizma Derne\u011fi Y\u00f6netim Kurulu \u00dcyesi Prof. Dr. F\u00fcsun Sayg\u0131l\u0131, hipofiz bezinin, beynin taban\u0131ndaki \u00e7anak bi\u00e7iminde kemik yap\u0131 i\u00e7inde yer alan ve v\u00fccuttaki bir\u00e7ok hormonun kontrol\u00fcn\u00fc sa\u011flayan hayati bir salg\u0131 bezi oldu\u011funu vurgulad\u0131. Hipofiz bezinin bir bezelye tanesi b\u00fcy\u00fckl\u00fc\u011f\u00fcnde olup, en \u00e7ok kanlanan organlardan oldu\u011funu belirten Prof. Dr. Sayg\u0131l\u0131, \u201cBu bezle ilgili hastal\u0131klar, bez hormonlar\u0131n\u0131n az ya da \u00e7ok salg\u0131lanmas\u0131, beze ait adenom denen -genellikle- iyi huylu t\u00fcm\u00f6rlerin geli\u015fimi sonucu ortaya \u00e7\u0131kar. Hipofiz hastal\u0131klar\u0131 deyince akla gelen bedenimizin orkestra \u015fefidir. Bu kongrede de oldu\u011fu gibi en ba\u015flarda yer al\u0131r. Hipofiz ad\u0131na 4 konferans verildi. Hipofiz endokrin organlar\u0131n\u0131 kontrol eder. Troid bezi b\u00fcy\u00fcd\u00fc\u011f\u00fcnde \u00fcrememizi sa\u011flayan metabolizmam\u0131z\u0131, b\u00f6brek \u00fcst\u00fc bezleri hep hipofiz bezinin sayesinde yapt\u0131klar\u0131n\u0131 yapmaya devam eder. Bu bezdeki bir tak\u0131m metolojiler biz tak\u0131m bozukluklar bu bezin adenomlar\u0131 denilen bir tak\u0131m t\u00fcm\u00f6rleri sonucu ortaya \u00e7\u0131kabilir. Suyu, tuzu, \u015fekeri elinde kontrol elinde tutan bir bezdir. Hipofiz bezi adenomlar\u0131, say\u0131lan hormonlar\u0131n bazen fazla salg\u0131lanmas\u0131na bazen de hi\u00e7 salg\u0131lanamamas\u0131na yol a\u00e7ar. Salg\u0131 eksiklikleri, bazen, acil ve hayati olabilir. Ayr\u0131ca hormon salg\u0131s\u0131ndan ba\u011f\u0131ms\u0131z, adenomlar\u0131n b\u00fcy\u00fcmesi, kom\u015fu yap\u0131lar\u0131 etkileyerek g\u00f6rme kayb\u0131na, \u00e7ift g\u00f6rmeye; ya da ba\u015f a\u011fr\u0131s\u0131, bulant\u0131-kusma gibi kafa i\u00e7i bas\u0131n\u00e7 art\u0131\u015f\u0131 belirtilerine yol a\u00e7ar. Hipofiz bezine ait hastal\u0131klar\u0131n tan\u0131, tedavi ve takibini endokrinoloji uzmanlar\u0131 yapar\u201d diye konu\u015ftu.<\/p>\n
\u201cTroid nod\u00fclleri”<\/p>\n
Amerikan Endokrin Derne\u011fi Ba\u015fkan\u0131 Prof. Dr. Susan Mandel, son on y\u0131lda t\u0131bbi g\u00f6r\u00fcnt\u00fclemenin giderek daha \u00e7ok kullan\u0131lmas\u0131yla birlikte tiroid nod\u00fcllerinde tan\u0131 say\u0131s\u0131 \u00e7ok b\u00fcy\u00fck oranda artt\u0131\u011f\u0131n\u0131 bildirdi. Tiroidin boyun a\u011fr\u0131s\u0131 veya kronik \u00f6ks\u00fcr\u00fck gibi di\u011fer t\u0131bbi durumlar\u0131n de\u011ferlendirilmesi amac\u0131yla yap\u0131lan boyun ve g\u00f6\u011f\u00fcs g\u00f6r\u00fcnt\u00fclemesinin bir par\u00e7as\u0131 olarak g\u00f6r\u00fcnt\u00fclendi\u011fini aktaran Prof. Dr. Mandel, \u201cTiroid nod\u00fcllerinin b\u00fcy\u00fck \u00e7o\u011funlu\u011fu benign nod\u00fcllerdir. Ancak bir tiroid nod\u00fcl\u00fc tespit edildi\u011finde hasta genellikle endi\u015feye kap\u0131l\u0131r ve bir kez daha de\u011ferlendirilmek \u00fczere ba\u015fka bir uzmana y\u00f6nlendirilir. Tiroidin ultrasonla g\u00f6r\u00fcnt\u00fclenmesi, kanser riskinin sa\u011fl\u0131kl\u0131 bir \u015fekilde de\u011ferlendirilmesini ve hem herhangi bir ek de\u011ferlendirmeye gerek bulunmayan hem de ince i\u011fne aspirasyon biyopsisi endike olan nod\u00fcllerin tespit edilmesini sa\u011flayabilmektedir. Dolay\u0131s\u0131yla tiroid ultrasonunun do\u011fru uygulanmas\u0131 ve yorumlanmas\u0131 kritik \u00f6nem ta\u015f\u0131r. Bir nod\u00fcl, biyopsi a\u00e7\u0131s\u0131ndan uygun olsa da sonu\u00e7 bazen belirsiz olabilir, yani benign veya kanser tan\u0131s\u0131 kesin olarak konamayabilir\u201d diye konu\u015ftu.<\/p>\n
\u201cTroid art\u0131\u015f\u0131\u201d<\/p>\n
Tiroid tan\u0131s\u0131n\u0131n t\u00fcm d\u00fcnyada g\u00f6r\u00fcnt\u00fcleme ve sa\u011fl\u0131k hizmetlerine eri\u015fimin artmas\u0131na ba\u011fl\u0131 olarak art\u0131\u015f g\u00f6sterdi\u011fini dile getiren Prof. Dr. Mandel, \u201cTiroid kanseri insanlar\u0131n y\u00fczde 20-25 \u2018inde var. 30 ya\u015f\u0131na geldi\u011finize y\u00fczde n\u00fcfusun 20-25\u2019de k\u00fc\u00e7\u00fck kanserler var. Bunlarla ya\u015fay\u0131p ba\u015fka \u015feylerden \u00f6l\u00fcyoruz. 15 y\u0131l \u00f6nce elle kontrol ediyorduk \u015fimdi, g\u00f6r\u00fcnt\u00fcleme \u00e7al\u0131\u015fmas\u0131yla belirleniyor. Baz\u0131 \u00fclkelerde d\u00fcnyada sa\u011fl\u0131\u011fa eri\u015fim olamad\u0131\u011f\u0131 i\u00e7in oran d\u00fc\u015f\u00fck. Daha fazla g\u00f6r\u00fcnt\u00fclemeye eri\u015fim artt\u0131k\u00e7a kanser insidans\u0131n\u0131n artt\u0131\u011f\u0131n\u0131 g\u00f6r\u00fcyoruz. Etnik anlamda \u00e7ok farkl\u0131l\u0131k belli de\u011fil\u201d dedi.<\/p>\n
“Beynin fonksiyonlar\u0131”<\/p>\n
Avrupa Endokrinoloji Derne\u011fi Ba\u015fkan\u0131 Prof. Dr. AJ Van Der Lely, metabolizman\u0131n kontrol\u00fc a\u00e7\u0131s\u0131nda beyinle ilgili \u00e7ok az \u015fey bildiklerini s\u00f6yledi. Beynin hastal\u0131klar\u0131 nas\u0131l etkiledi\u011fini yava\u015f yava\u015f \u00f6\u011frenmeye ba\u015flad\u0131klar\u0131n\u0131 kaydeden Prof.Dr. Lely, \u201cBeyin nas\u0131l ba\u011f\u0131rsakla ileti\u015fime ge\u00e7iyor, elimizde bir bilgi yok. Obez hastalar \u00e7ok daha fazla yiyorlar, zay\u0131f ki\u015fiye g\u00f6re bu do\u011fru de\u011fil. Beyin neden geri gidip neden orijinal kiloya d\u00f6nm\u00fcyor. Bu temel fakt\u00f6rleri tespit etmeye ba\u015flad\u0131k\u201d dedi.<\/p>\n
Lely, \u015f\u00f6yle konu\u015ftu:<\/p>\n
\u201cGhrelin (veya a\u00e7il ghrelin; AG) ve des-a\u00e7il ghrelin (DAG) peptidleri, \u00e7o\u011funlukla midede eksprese olan preproghrelin geni taraf\u0131ndan kodlan\u0131r. Hakk\u0131nda epeyce bilgi sahibi olunan obezite hormonu ghrelinle k\u0131yasland\u0131\u011f\u0131nda DAG \u00e7ok b\u00fcy\u00fck bir ilgi g\u00f6rmemi\u015ftir. DAG uzun zamand\u0131r AG\u2019nin inert bir bozunma \u00fcr\u00fcn\u00fc olarak de\u011ferlendirilmi\u015ftir. Bununla birlikte son d\u00f6nemde ula\u015f\u0131lan kan\u0131tlar, DAG\u2019nin ayr\u0131 bir hormon olarak davran\u0131\u015f sergiledi\u011fini g\u00f6stermektedir. DAG\u2019nin AG\u2019nin fonksiyonel bir inhibit\u00f6r\u00fc oldu\u011funu \u00f6ne s\u00fcren \u00e7al\u0131\u015fmalar\u0131n say\u0131s\u0131n\u0131n giderek artmas\u0131 da klinik a\u00e7\u0131dan potansiyel \u00f6nem ta\u015f\u0131maktad\u0131r. Dolay\u0131s\u0131yla DAG veya DAG analoglar\u0131; diyabet, obezite ve Prader Willi sendromu gibi metabolik bozukluklar\u0131n tedavisine y\u00f6nelik erken d\u00f6nem \u00e7al\u0131\u015fmalarda incelenmektedir.\u201d<\/p>\n
“Kanser ghrelin sistemi”<\/p>\n
Bug\u00fcnlerde kanser alan\u0131nda ghrelin sistemine daha b\u00fcy\u00fck bir ilgi g\u00f6sterildi\u011fini ifade eden Prof. Dr. Lely, \u201cLokal ve sistemik fakt\u00f6rlerin, \u00f6strojen resept\u00f6r\u00fc pozitif meme kanseri riski y\u00fcksek olan postmenopozal d\u00f6nemdeki obez kad\u0131nlarda meme kanseri h\u00fccrelerinin b\u00fcy\u00fcmesini te\u015fvik etti\u011fi kan\u0131tlanm\u0131\u015ft\u0131r. Aromataz enzimi taraf\u0131ndan memedeki ya\u011f dokusunda lokal olarak \u00fcretilen \u00f6strojenler, kanser h\u00fccrelerinin \u00e7o\u011falmas\u0131n\u0131 tetiklemede \u00f6nemli bir role sahiptir. Dola\u015f\u0131mdaki AG ve DAG d\u00fczeyleri obeziteyle hemen hemen her zaman ters orant\u0131l\u0131d\u0131r ve bu peptid hormonlar\u0131n\u0131n adipoz dokusundaki aromataz ekspresyonunu inhibe etti\u011fi k\u0131sa s\u00fcre \u00f6nce kan\u0131tlanm\u0131\u015ft\u0131r. Ayr\u0131ca bu peptid hormonlar\u0131n\u0131n baz\u0131 t\u00fcm\u00f6r h\u00fccreleri taraf\u0131ndan da \u00fcretildi\u011fi ve t\u00fcm\u00f6r b\u00fcy\u00fcmesini etkiledi\u011fi tespit edilmi\u015ftir. AG ve DAG\u2019nin enerji homeostaz\u0131 \u00fczerindeki etkileri de t\u00fcm\u00f6r geli\u015fimi ve b\u00fcy\u00fcmesini etkileyebilir. Son olarak DAG\u2019nin iskemide ve Duchenne m\u00fcsk\u00fcler distrofisinde kas h\u00fccrelerinin durumunu, diyabet hastalar\u0131nda ise kiloyu ve glisemik kontrol\u00fc iyile\u015ftirdi\u011fi tespit edilmi\u015ftir\u201d diye konu\u015ftu.<\/p>\n","protected":false},"excerpt":{"rendered":"
ENDOBR\u0130DGE KURUCU BA\u015eKANI PROF. DR. OKAN B\u00dcLENT YILDIZ, T\u00dcRK\u0130YE\u2019N\u0130N AVRUPA\u2019DA EN \u015e\u0130\u015eMAN \u00dcLKELER SIRALAMASINDA B\u0130R\u0130NC\u0130 SIRAYA Y\u00dcKSELD\u0130\u011e\u0130N\u0130 BEL\u0130RTEREK, \u201cT\u00dcRK\u0130YE\u2019DE ER\u0130\u015eK\u0130NLERDE 3 K\u0130\u015e\u0130DEN B\u0130R\u0130 OBEZ, B\u0130R\u0130 FAZLA K\u0130LOLU, SADECE B\u0130R\u0130 NORMAL K\u0130LOLUDUR” DED\u0130.<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[14,20],"tags":[13318,3486,13426,13425,51572,43386,20989,31087,12530],"class_list":["post-1354694","post","type-post","status-publish","format-standard","hentry","category-saglik","category-turkiye","tag-avrupada","tag-birinci","tag-dr","tag-prof","tag-sisman","tag-siralamasinda","tag-turkiye","tag-ulkeler","tag-yildiz"],"_links":{"self":[{"href":"https:\/\/www.erzhaber.com\/index.php?rest_route=\/wp\/v2\/posts\/1354694","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.erzhaber.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.erzhaber.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.erzhaber.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.erzhaber.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1354694"}],"version-history":[{"count":0,"href":"https:\/\/www.erzhaber.com\/index.php?rest_route=\/wp\/v2\/posts\/1354694\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.erzhaber.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1354694"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.erzhaber.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1354694"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.erzhaber.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1354694"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}