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Öğe Apparently low serum asymmetric dimethylarginine is associated with fasting glucose and tends toward association with type-2 diabetes(Turkish Soc Cardiology, 2014) Onat, Altan; Koroglu, Bayram; Can, Gunay; Karagoz, Ahmet; Yuksel, Murat; Aydin, MesutObjective: We investigated the association of serum asymmetric dimethylarginine (ADMA) with metabolic syndrome (MetS), type-2 diabetes and coronary heart disease (CHD) in the general population. Methods: Cross-sectional and, at 2000 person-years' follow-up, prospective analysis. Adults with measured serum ADMA level (n=848) were analyzed using tertiles or dichotomized values. ADMA concentrations were measured by a validated commercial ELISA kit. Results: Dichotomized subjects of combined sexes with low (<= 0.68 mu ol/L) ADMA values had significantly higher fasting glucose, total cholesterol, apolipoprotein B and lower diastolic blood pressure. In linear regression analyses comprising age, smoking, triglyceride, HDL-cholesterol, C-reactive protein and waist circumference as well, creatinine was significantly and independently associated with ADMA, further in women glucose (inversely). In logistic regression analyses uniformly adjusted for age, smoking status and waist girth, prevalent MetS tended to positive independent association with ADMA tertiles only in men. Combined prevalent and incident diabetes weakly tended to be associated with the lowest (vs mid-and highest) ADMA tertiles in combined gender; and prevalent and incident CHD was not associated with ADMA tertiles in either sex. Conclusion: Apparently low circulating ADMA is independently associated with fasting glucose and tends to be so with type-2 diabetes. The lack of anticipated positive associations of ADMA with cardiometabolic disorders is likely due to autoimmune responses operating against serum ADMA under oxidative stress, rendering partial failure in immunoassay.Öğe Apparently “low” serum asymmetric dimethylarginine is associated with fasting glucose and tends toward association with type-2 diabetes(2014) Can, Günay; Onat, Altan; Aydın, Mesut; Karagöz, Ahmet; Köroğlu, Bayram; Yüksel, MuratObjective: We investigated the association of serum asymmetric dimethylarginine (ADMA) with metabolic syndrome (MetS), type-2 diabetes and coronary heart disease (CHD) in the general population. Methods: Cross-sectional and, at 2000 person-years’ follow-up, prospective analysis. Adults with measured serum ADMA level (n=848) were analyzed using tertiles or dichotomized values. ADMA concentrations were measured by a validated commercial ELISA kit. Results: Dichotomized subjects of combined sexes with low (≤0.68 μmol/L) ADMA values had significantly higher fasting glucose, total cholesterol, apolipoprotein B and lower diastolic blood pressure. In linear regression analyses comprising age, smoking, triglyceride, HDL-cholesterol, C-reactive protein and waist circumference as well, creatinine was significantly and independently associated with ADMA, further in women glucose (inversely). In logistic regression analyses uniformly adjusted for age, smoking status and waist girth, prevalent MetS tended to positive independent association with ADMA tertiles only in men. Combined prevalent and incident diabetes weakly tended to be associated with the low- est (vs mid- and highest) ADMA tertiles in combined gender; and prevalent and incident CHD was not associated with ADMA tertiles in either sex. Conclusion: Apparently “low” circulating ADMA is independently associated with fasting glucose and tends to be so with type-2 diabetes. The lack of anticipated positive associations of ADMA with cardiometabolic disorders is likely due to autoimmune responses operating against serum ADMA under oxidative stress, rendering partial failure in immunoassay.Öğe Distinction of hypertriglyceridemic waist phenotype from simple abdominal obesity: interaction with sex hormone-binding globulin levels to confer high coronary risk(Taylor & Francis Ltd, 2017) Karagoz, Ahmet; Onat, Altan; Aydin, Mesut; Can, Gunay; Simsek, Baris; Yuksel, MuratObjective: The associations of total testosterone (TT) and sex hormone-binding globulin (SHBG) with the hypertriglyceridemic waist (HtgW) phenotype and coronary heart disease (CHD) risk have scarcely been examined. We explored such cardiometabolic risk mediations in middle-aged adults. Methods: Participants (n = 1924) in a population-based study were studied by forming categories consisting of abdominal obesity, hypertriglyceridemia, both (HtgW), or none ('healthy'). Cardiometabolic risk was prospectively analyzed (mean follow-up 5.7 years). Results: With reference to the healthy group, SHBG values in HtgW were significantly lower, alike serum HDL-cholesterol. ApolipoproteinB-containing lipoproteins, fasting glucose and complement C3 levels, inverse to lipoprotein[Lp](a) especially in female participants with HtgW phenotype compared with those in the 'healthy' category, suggested the operation of aggregation to Lp(a). Multivariable Cox regression analysis in a model comprising age, waist circumference and systolic blood pressure showed significant protection by SHBG against incident diabetes which tended to be so with TT in men. Sex hormones were not associated with risk of incident CHD or MetS. In another multivariable model, compared to the ` healthy' and the hypertriglyceridemia categories, dichotomized high and, in females, low SHBG values within the HtgW category, positively predicted CHD at significant over 2-fold relative risks. Conclusion: HtgW phenotype distinguishes itself from the (virtually neutral) simple abdominal obesity in independently conferring high CHD risk when elevated or reduced SHBG levels interact. Underlying operation of Lp(a) aggregation is suggested.Öğe Elevated serum uric acid in nondiabetic people mark pro-inflammatory state and HDL dysfunction and independently predicts coronary disease(Springer London Ltd, 2013) Onat, Altan; Can, Gunay; Ornek, Ender; Altay, Servet; Yuksel, Murat; Ademoglu, EvinWe explored the association of serum uric acid (UA) concentrations with pro-inflammatory state and high-density lipoprotein (HDL) dysfunction. UA tertiles in tracked 1,508 nondiabetic participants were analyzed cross-sectionally for associations with inflammation biomarkers and protective proteins over a mean follow-up of 4.9 years for incident coronary heart disease (CHD) using Cox proportional hazards regression. In the absence of metabolic syndrome (MetS), UA tertiles significantly distinguished, in each sex, increasing categories of three MetS components (inflammation/oxidation markers, apolipoprotein (apo)B) and (inversely) current smoking (but not protective proteins such as HDL, apoA-I, and adiponectin). Distinctions attenuated in the presence of MetS. Linear regression model revealed fasting triglycerides (1.86 mg/dl variance), male sex, and gamma-glutamyl transferase and age as covariates of UA levels in women. In Cox analysis, incident CHD (n = 137) was predicted by mid and upper UA tertile in men alone at significant hazard ratios of 2.7, additively to conventional risk factors. Elevated serum UA levels, linked to triglycerides, mark in nondiabetic people pro-inflammatory state, and, notably, HDL dysfunction. CHD risk is independently predicted by elevated UA levels in nondiabetic men and is modulated by MetS and gender.Öğe Fasting, non-fasting glucose and HDL dysfunction in risk of pre-diabetes, diabetes, and coronary disease in non-diabetic adults(Springer-Verlag Italia Srl, 2013) Onat, Altan; Can, Gunay; Cicek, Gokhan; Ayhan, Erkan; Dogan, Yuksel; Kaya, HasanWe determined in non-diabetic persons the risk of fasting and non-fasting glucose levels for pre-diabetes, diabetes, and coronary heart disease (CHD), including the roles of serum C-reactive protein (CRP) and HDL cholesterol, and delineated risk profiles of the pre-diabetic states. Over 7A1/4A years, 2,619 middle-aged Turkish adults free of diabetes and CHD were studied prospectively. Using different serum glucose categories including impaired fasting glucose (IFG, 6.1-6.97 mmol/L) and impaired glucose tolerance (IGT), outcomes were analyzed by Cox regression. IFG was identified at baseline in 112 and IGT in 33 participants. Metabolic syndrome components distinguished individuals with IFG from those with normoglycemia. Participants with IGT tended to differ from adults in normal postprandial glucose categories in regard to high levels of triglycerides, apoA-I, and CRP. Diabetes risk, adjusted for sex, age, waist circumference, CRP, and HDL cholesterol, commenced at a fasting 5.6-6.1 mmol/L threshold, was fourfold at levels 6.1-6.97 mmol/L. Optimal glucose values regarding CHD risk were 5.0-6.1 mmol/L. Fasting and postprandial glucose values were not related to CHD risk in men; IGT alone predicted risk in women (HR 3.74 [1.16;12.0]), independent of age, systolic blood pressure, non-HDL cholesterol, waist circumference, smoking status, and CRP. HDL cholesterol was unrelated to the development of IFG, IGT, and diabetes, while CRP elevation independently predicted the development of diabetes. IGT independently predicts CHD risk, especially in women. HDL dysfunction associated with low-grade inflammation is a co-determinant of pre-diabetic states and their progression to diabetes.Öğe High adiponectin levels fail to protect against the risk of hypertension and, in women, against coronary disease: involvement in autoimmunity?(Baishideng Publishing Group Inc, 2013) Onat, Altan; Aydin, Mesut; Can, Gunay; Koroglu, Bayram; Karagoz, Ahmet; Altay, ServetAIM: To investigate whether serum adiponectin protects against cardiometabolic risk in a population sample with prevailing metabolic syndrome. METHODS: Middle-aged adults representative of a general population with baseline circulating adiponectin measurements (n = 1224) were analyzed prospectively at a mean of 3.8 years' follow-up, using continuous values or sex-specific tertiles. Total adiponectin was assayed by an ELISA kit. Type-2 diabetes was identified by criteria of the American Diabetes Association. Hypertension was defined as a blood pressure >= 140 mmHg and/or >= 90 mmHg and/or use of antihypertensive medication. Outcomes were predicted using Cox proportional hazards regression analysis in models that were controlled for potential confounders. RESULTS: In models of multiple linear regression, sex hormone-binding globulin, fasting insulin (inverse) and, in men, age were significant independent covariates of serum adiponectin which further tended in women to be positively associated with serum creatinine. Cox regression analyses for incident coronary heart disease (CHD), adjusted for sex, age, non-HDL cholesterol, waist circumference and C-reactive protein, revealed significant inverse association with adiponectin tertiles in men but not women (HR = 0.66; 95% CI: 0.32-1.38 for highest tertile). Cox regression for type-2 diabetes in a similar model (wherein glucose replaced non-HDL cholesterol), adiponectin tertiles appeared to protect in each gender. HR for incident hypertension roughly displayed unity in each of the adiponectin tertiles (P -trend = 0.67). CONCLUSION: High adiponectin levels failed to protect against the development of hypertension and, in women, against CHD, presumably paralleling impairment in renal function as well. Involvement of adiponectin in autoimmune complex with loss of antioxidative- antiatherogenic properties may be underlying. (C) 2013 Baishideng. All rights reserved.Öğe Impaired fasting glucose: Pro-diabetic, atheroprotective and modified by metabolic syndrome(Baishideng Publishing Group Inc, 2013) Onat, Altan; Aydin, Mesut; Can, Gunay; Cakmak, H. Altug; Koroglu, Bayram; Kaya, Aysem; Ademoglu, EvinAIM: To investigate whether impaired fasting glucose (IFG) confers cardiovascular risk. METHODS: A non-diabetic population-based sample representative of middle-aged and elderly Turks was studied at 8.5 years' follow-up for incident diabetes and coronary heart disease (CHD). Metabolic syndrome (MetS) was defined by ATP-III criteria modified for male abdominal obesity, and IFG and type 2 diabetes were identified by criteria of the American Diabetes Association. Stratification by presence of MetS was used. Outcomes were predicted providing estimates for hazard ratio (HR) obtained by use of Cox proportional hazards regression analysis in models that controlled for potential confounders. RESULTS: In 3181 adults (aged 52 +/- 11.5 years at baseline), analysis stratified by MetS, gender and IFG status distinguished normoglycemic subjects by a hypertriglyceridemic waist phenotype consisting of significantly higher waist circumference, fasting triglyceride and lower high-density lipoprotein-cholesterol, regardless of gender and MetS. Additionally, lipoprotein (Lp) (a) tended to be lower in (especially female) participants with MetS. Multivariable linear regression in a subset of the sample demonstrated decreased Lp (a) levels to be associated with increased fasting glucose and insulin concentrations, again particularly in women. In Cox regression analysis, compared with normoglycemia, baseline IFG adjusted for major confounders significantly predicted incident diabetes at a 3-fold HR in men and only women with MetS. Cox models for developing CHD in 339 individuals, adjusted for conventional risk factors, revealed that IFG status protected against CHD risk [HR = 0.37 (95% CI: 0.14-0.998)] in subjects free of MetS, a protection that attenuated partly in male and fully in female participants with MetS. CONCLUSION: IFG status in non-diabetic people without MetS displays reduced future CHD risk, yet is modulated by MetS, likely due to autoimmune activation linked to serum Lp (a). (C) 2013 Baishideng. All rights reserved.Öğe Lipoprotein(a)-activated immunity, insulin resistance and new-onset diabetes(Taylor & Francis Ltd, 2017) Kaya, Aysem; Onat, Altan; Yuksel, Husniye; Can, Gunay; Yuksel, Murat; Ademoglu, EvinObjectives: Some evidence suggests that serum lipoprotein[Lp](a) may be inversely linked to type-2 diabetes. We aimed to determine in nondiabetic people the relationship of serum [Lp](a) with insulin resistance and new-onset diabetes (NOD). Materials and methods: Population-based middle-aged adults (n = 1685) were categorized by fasting glucose and stratified to gender, having excluded prevalent diabetic subjects. NOD (n = 90) occurred over a median 5 years' follow-up. Results: Subjects that subsequently developed NOD, derived both from the normoglycemia and impaired fasting glucose (IFG) groups,were distinguished, among others, primarily by significantly elevated serum gamma glutamyltransferase, reduced Lp(a) (by 31%) and, compared to IFG, by low total cholesterol levels. Partial correlation of Lp(a) with homeostatic model assessment (HOMA) was inverse in normoglycemic men; such correlation, neutral in normoglycemic women, proved inverse in IFG (r = -0.17). Circulating Lp(a) in individuals with paired measures increased significantly (1.55-fold) in the period from baseline up to NOD. Multivariable-adjusted logistic regression analysis for NOD in combined sexes indicated independent and additive prediction by serum Lp(a), albeit inverse in direction (RR 0.84, [95%CI 0.72; 0.97]). Conclusion: Lp(a) is significantly reduced in the period preceding NOD and is inversely associated with HOMA index, observations consistent with underlying autoimmune activation.Öğe Low acylation stimulating protein levels are associated with cardiometabolic disorders-secondary to autoimmune activation?(Turkish Soc Cardiology, 2017) Onat, Altan; Altay, Servet; Yuksel, Murat; Karadeniz, Yusuf; Can, Gunay; Yuksel, Husniye; Ademoglu, EvinObjective: We investigated the possible association of serum acylation stimulating protein (ASP) with cardiometabolic disorders and the evidence of autoimmune activation. Methods: Population-based randomly selected 1024 participants were cross-sectionally and prospectively analyzed. ASP concentrations were measured with a validated ELISA kit. Correlations were sought separately in subjects with no cardiometabolic disorders (n=427) designated as healthy. Results: ASP was positively correlated with total testosterone and inversely correlated with platelet activating factor (PAF), PAF-acetylhydrolase (AH), in each gender, and positively correlated in healthy men with lipoprotein [Lp](a) and apolipoprotein B. Correlations of ASP with PAF values =22 nmol/L were abolished, contrasted to a strongly inverse one in subjects with PAF Conclusion: Findings can be explained by the notion of operation of immune responses against both ASP and oxidized PAF-like lipids of Lp(a) to yield for reduced values and increased likelihood of cardiometabolic disorders.Öğe Normal thyroid-stimulating hormone levels, autoimmune activation, and coronary heart disease risk(Springer, 2015) Onat, Altan; Aydin, Mesut; Can, Gunay; Celik, Etem; Altay, Servet; Karagoz, Ahmet; Ademoglu, EvinWhether euthyroid status affects cardiovascular disease risk is unclear. We aimed to investigate whether serum thyroid-stimulating hormone (TSH) levels within the normal range are related to the risk of coronary heart disease (CHD). In participants of the Turkish Adult Risk Factor Study (mean age 52.7 +/- A 11.5), in whom TSH was measured in the 2004/05 survey, cross-sectional and longitudinal analyses were performed. Subjects with TSH concentrations < 0.3 and > 4.2 mIU/L were excluded to ensure euthyroid status leaving 956 individuals as the study sample. Mean follow-up was 4.81 +/- A 1.3 years. Men had 18 % lower (p < 0.001) geometric mean TSH levels (1.10 mIU/L) than women (1.35 mIU/L). Correlations of TSH with risk variables were notably virtually absent except weakly positive ones in men with age and systolic blood pressure (SBP). The age-adjusted TSH mid-tertile in men was associated with lowest lipoprotein [Lp](a), apoB, and total cholesterol values. Incident CHD was predicted in Cox regression analyses in men [HR of 2.45 (95 %CI 1.05; 5.74] and in combined sexes by the lowest compared with the highest TSH tertile, after adjustment for age, smoking status, SBP, and LDL-cholesterol. Analysis for combined prevalent and incident CHD stratified by metabolic syndrome (MetS) confirmed the independent association with the lowest TSH tertile in men, specifically in men without MetS. TSH levels within normal range, low due to partial assay failure, may manifest as independent predictors of incident CHD, particularly in middle-aged men. Autoimmune responses involving serum Lp(a) under oxidative stress might be implicated mechanistically.Öğe Serum total and high-density lipoprotein phospholipids: Independent predictive value for cardiometabolic risk(Churchill Livingstone, 2014) Onat, Altan; Cakmak, H. Altug; Can, Gunay; Yuksel, Murat; Koroglu, Bayram; Yuksel, HusniyeObjective: Given that serum phospholipids (PL) may serve as inflammation mediators, we studied whether they predicted metabolic syndrome (MetS), type-2 diabetes or coronary heart disease (CHD) risk in people prone to enhanced low-grade inflammation. Methods: We analyzed unselected middle-aged Turkish adults with available serum total (n = 852) and HDL-PL (n = 428) measurements and follow-up (mean 6.6 years) by Cox or logistic regression, after exclusion of prevalent cases of outcome disorder. The enzymatic method used measured total content of phosphatidylcholine, sphingomyelin and lyso-phosphatidylcholine. Results: Most lipid and non-lipid variables were significantly different in the upper two compared with the lowest total PL tertile, whereby apolipoprotein (apo)A-I and HDL-cholesterol were higher (not lower). ApoA-I. HDL-cholesterol and uric acid were uniformly positive independent linear covariates of total and HDL PI, apoA-I even in participants without MetS. After adjustment for sex, age, waist circumference. HDL-cholesterol and systolic blood pressure, logistic regression for incident MetS disclosed a 3-fold risk (RR [95% CI 1.28; 6.81]) in the upper HDL-pl tertile. In Cox regression models, while the combined two higher HDL-pl tertiles significantly protected against CHD risk in males (HR 0.29 [95% CI 0.10; 0.89]), they weakly tended to impart risk in females: upper two total PL tertiles tended to increased risk of diabetes and CHD. Conclusion: Excess total PL may mediate inflammatory properties to apoA-I. HDL and uric acid. Excess HDL-pl independently predict risk for MetS in each gender, but are protective against CHD risk in men, possibly because oxidized PL content mediated by total PL is sex-dependent, as reviewed elsewhere. (C) 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.Öğe TARF Survey 2011: mortality and performance in the long-term follow-up(Turkish Soc Cardiology, 2012) Onat, Altan; Aydin, Mesut; Koroglu, Bayram; Ornek, Ender; Altay, Servet; Celik, Ethem; Karagoz, AhmetObjectives: We analyzed all-cause and coronary mortality data of the Turkish Adult Risk Factor Study cohort in Marmara and Central Anatolia regions, surveyed in 2011, and overall performance of long-term (21 years) follow-up of participants. Study design: A total of 1,588 participants with an age range of 45 to 74 years were surveyed. Information on the mode of death was obtained from first-degree relatives and/or personnel of local health offices. Information on survivors was obtained from history, physical examination, and 12-lead electrocardiograms. Loss to follow-up was defined as the lack of physical examination for at least eight years. Results: Of the surveyed participants, 854 were examined, information on health status was obtained in 606 subjects, 46 individuals (28 men, 18 women) were ascertained to have died, and 82 subjects were lost to follow-up. A total of 2,800 person-years were added to follow-up. Nineteen deaths were attributed to coronary heart disease (CHD) and five deaths to cerebrovascular events. Overall mortality was estimated as 10.9 per 1000 person-years. In the age bracket of 45-74 years, overall annual all-cause mortality and CHD mortality were 12.8 and 5.5 per mille, respectively. Based on the total loss to follow-up (31.2%) during the past two decades, an annual loss to follow-up may be derived as 19.3 for every 1000 participants. This loss was nearly twice as high in participants living in big cities compared to those in smaller towns and rural areas. Conclusion: A trend to slight reduction in coronary mortality, though not in overall mortality, before the age 75 years is noted in Turks. Annual loss to follow-up amounts to 2% of the participants.Öğe TEKHARF 2011 taraması: Ölümler ve uzun vadeli takipte performans(2012) Köroğlu, Bayram; Çelik, Ethem; Onat, Altan; Aydın, Mesut; Karagöz, Ahmet; Örnek, Ender; Altay, ServetAmaç: Türk Erişkinlerinde Kalp Hastalıkları ve Risk Faktörleri (TEKHARF) Çalışmasının Marmara ve İç Anadolu bölgelerine ilişkin 2011 taramasında kaydedilen tümnedenli ve koroner kökenli ölüm verileri ile 21 yıllık uzun vadeli takip performansı değerlendirildi. Çalışma planı: Taramada izlenen örneklem sayısı 1588 kişi, taranan kişilerde yaş aralığı 45-74 idi. Ölüm konusunda birinci derece akraba ve/veya aile sağlık merkezi personelinden bilgi alındı; yaşayanlarda bilgi edinmekten başka, fizik muayene ve 12-derivasyonlu EKG kaydı yapıldı. Katılımcının takipten kaybı, en az sekiz yıl süreyle muayene edilmemiş olma durumu olarak tanımlandı. Bulgular: T aranan ö rneklemden 8 54 k işi m uayene edildi, 606 kişinin sağlık durumu hakkında bilgi edinildi ve 46 kişinin (28 erkek, 18 kadın) öldüğü belirlendi. Seksen iki kişi takipten kayıp kabul edildi. İzlemeye 2800 kişi-yılı eklenmiş oldu. Ölümlerin 19u koroner hastalığa, beşi serebrovasküler olaya bağlandı. Şimdiye dek tüm nedenli ölümler geneli 1000 kişi-yılında 10.9 bulundu. Anılan yaş kesiminde toplam yıllık mortalite binde 12.8, koroner kalp hastalığı ölüm prevalansı binde 5.5 düzeyindeydi. Tarama başlangıcından itibaren toplam takip kaybının %31.2 olması sonucu, izlenen her 1000 kişiden yılda 19.3ünün kayıp hanesine geçtiği ifade edilebilir. Bu kayıp, küçük şehir ve köylerde oturan katılımcılara kıyasla, büyük şehirlerde neredeyse iki kat yüksekti. Sonuç: Yetmiş beş yaşından önce tüm nedenli ölümlerin değilse de, koroner kökenli ölümlerin sıklığı hafifçe gerileme eğilimindedir. Tarama katılımcılarının her yıl %2si takipten uzaklaşmaktadır.Öğe TEKHARF 2012: Genel ve koroner mortalite ile metabolik sendrom prevalansı eğilimleri(2013) Çakmak, H. Altuğ; Aydın, Mesut; Yüksel, Murat; Onat, Altan; Gümrükçüoğlu, H. Ali; Köroğlu, Bayram; Karagöz, AhmetAmaç: Türk Erişkinlerinde Kalp Hastalıkları ve Risk Faktörleri (TEKHARF) çalışmasının 1) 2012 kohortu taramasına ilişkin ve birikimli ölüm ile koroner mortalite verilerinin; 2) metabolik sendrom (MetS) prevalansında bölgelerdeki ve son onyıldaki değişimlerin açıklanması.Çalışma planı: Ölüm konusunda birinci derece akraba ve/veya sağlık ocağı personelinden bilgi alındı. Yaşayanlarda bilgi edinmekten başka, kardiyovasküler sistemin fizik muayenesi ve dinlenme elektrokardiyogramların Minnesota kodlamasına dayandırıldı.Bulgular: Taranacak 1527 kişilik örneklemden 796sı muayene edildi, 502 kişinin sağlık durumu hakkında bilgi edinildi ve 56 katılımcının öldüğü belirlendi. Ölümlerin 30u koroner kalp hastalığı ve serebrovasküler olaya bağlandı. Tüm kohortun 22 yıllık takibinde 45-74 yaş kesimindeki koroner kalp hastalığı kökenli ölümler erkeklerde bin kişi-yılında 7.6, kadınlarda 3.8 düzeyinde bulundu. İki dönemde muayene edilen ve başlangıçta ortanca yaşı 46 olan aynı 1754 kişinin verilerine göre, MetS prevalansının son 12 yıl içerisinde bir yıl yaşlanma başına %1.3 oranında arttığı belirlendi. Analizler, sıklığı en fazla olan Güneydoğu Anadolu bölgesi ile birlikte Akdeniz bölgesinde prevalansın arttığını, Marmara bölgesinde gerilediğini, Ege bölgesinde göreli seyrekliğinin sürdüğünü işaret etti.Sonuç: Kırk yaş ve üzerindeki Türk erişkinlerde %53 olan MetS sıklığı, coğrafi bölgeler arasında önemli farklılıklar göstermekte, iki güney bölgemizde yüksek, Ege bölgesinde ise düşüktür.Öğe TEKHARF 2013 taraması ve diyabet prevalansında hızlı artış(2014) Onat, Altan; Can, Günay; Karagöz, Ahmet; Çakır, Hakan; Yüksel, Murat; Karadeniz, Yusuf; Dönmez, İbrahimAmaç: TEKHARF Çalışmasının 2013 takip taramasında saptanan 1) cinsiyete özgü ve belirli yaş kesimindeki genel mortalite ve koroner mortalitesinin analizi ve 2) ülke çapında tip-2 diyabet prevalansının son 12 yıldaki değişiminin açık- lanması. Çalışma planı: Ölüm konusunda birinci derece akraba ve/ veya sağlık ocağı personelinden bilgi alındı. Yaşayanlarda bilgi edinmekten başka, kardiyovasküler sistem fizik muaye- nesi ve dinlenme EKG kaydı yapıldı. Diyabet varlığı Ameri- kan Diyabet Birliği ölçütlerine dayandırıldı. Bulgular: İzlenecek 1370 kişilik örneklemden 768i incelen- di, 452 kişi hakkında bilgi edinildi ve 29 erkek ile 18 kadının öldüğü belirlendi. Ölenlerden 22si koroner kalp hastalığı (KKH) kökenli sayıldı. Tüm kohortun 23 yıllık takibinde 45-74 yaş kesiminde genel mortalite bin kişi-yılında erkekte16.8, kadınlarda 9.9 oranındaydı. KKH kökenli ölümler erkeklerde bin kişi-yılında 7.5, kadınlarda 3.74 düzeyinde (Avrupa ül- kelerine göre yüksek seviyede) bulundu. Diyabet genel pre- valansı 1998i izleyen 12 yıl içerisinde, yaklaşık 2600 kişide yaşın kontrol edilmesi durumunda %80 oranında yükseldi. Yıllık %5 artışa denk düşen bu gelişme ileri derece kaygı vericidir. Sonuç: Yetişkinlerimizde genel mortalite ve koroner morta- litesi yüksek düzeylerini sürdürmektedir. Daha düşündürücü saptama, nüfus artışı ve yaştan arındırılan tip-2 diyabet sık- lığının kabul edilmeyecek hızda yükselmesi olup yeni önlem- lere ihtiyaç göstermesidir.Öğe Turkish Adult Risk Factor Study survey 2012: overall and coronary mortality and trends in the prevalence of metabolic syndrome(Turkish Soc Cardiology, 2013) Onat, Altan; Yuksel, Murat; Koroglu, Bayram; Gumrukcuoglu, H. Ali; Aydin, Mesut; Cakmak, H. Altug; Karagoz, AhmetObjectives: We aimed to analyze 1) overall and coronary mortality findings in the Turkish Adult Risk Factor (TARF) study survey 2012 and 2) the temporal trends in the prevalence of metabolic syndrome (MetS) and its distribution across seven geographic regions. Study design: Information on the mode of death was obtained from first-degree relatives and/ or health personnel of a local health office. Information collected in survivors was based on history, physical examination of the cardiovascular system and Minnesota coding of resting electrocardiograms. Results: Of 1527 participants to be surveyed, 796 were examined. Information was obtained on the health status in 502 subjects, and death was ascertained in 56 participants. Thirty deaths were attributed to coronary and cerebrovascular disease. Cumulative 22-year evaluation of participants in the age bracket 45-74 years revealed coronary mortality to be high, with 7.6 per 1000 person-years in men and 3.8 in women. Data used from 1754 identical subjects (median age 46 years initially), and examined in two periods 12 years apart, indicated an increase in the prevalence of MetS by 1.3% per aging of 1 year. Analysis across geographic regions showed a rise in the prevalence in the Mediterranean region, already having highest prevalence along with thr Southeast Anatolia, while the prevalence declined in the Marmara region and persisted to be thr lowest in the Aegean region. Conclusion: The prevalence of MetS in Turkish adults aged 40 years or over, currently standing at 53%, shows significant differences across geographic regions, being highest in the two southern regions and lowest in the Aegean region.Öğe Turkish Adult Risk Factor survey 2013: rapid rise in the prevalence of diabetes(Turkish Soc Cardiology, 2014) Onat, Altan; Cakir, Hakan; Karadeniz, Yusuf; Domez, Ibrahim; Karagoz, Ahmet; Yuksel, Murat; Can, GunayObjectives: To analyze (1) the sex-specific and age-bracket defned all-cause and coronary mortality in the 23-years' follow-up of the Turkish Adult Risk Factor Study, and (2) to determine the nation-wide prevalence of Type-2 diabetes and its recent trend. Study design: Information on the mode of death was obtained from frst-degree relatives and/or health personnel of local heath offce. Information collected from survivors was based on history, physical examination of the cardiovascular system and Minnesota coding of resting electrocardiograms. Diabetes was defned by criteria of the American Diabetes Association without the use of glycated hemoglobin. Results: Of the 1370 participants to be surveyed, 768 were examined, in 452 subjects information was gathered, and 29 men, 18 women were ascertained to have died. Cumulative assessment of the entire cohort in the age bracket of 45-74 years disclosed coronary mortality to be 7.5/1000 personyears in men and 3.74 in women, persisting to be high among the European countries. The recent decline observed in overall mortality seemed to halt as well. Of greatest concern was the fnding in the past 12 years that the rate of rise in the age-controlled prevalence of Type-2 diabetes was as high as 5% annually. Conclusion: Overall and coronary mortality in Turkish adults continue to be high, while an elicited annual increase of 5% in the age-controlled prevalence of diabetes is virtually alarming and requires new public health policies.
