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A Onat

Publications and source records attributed to A Onat.

At least 19 recordsLinked to original sources
PubMed2004

Measures of abdominal obesity assessed for visceral adiposity and relation to coronary risk.

AIMS: We aimed to identify by computed tomography (CT) the best suited of three anthropometric indices that reflect the visceral adipose tissue (VAT), and to discern the relationship between VAT and certain atherogenic risk factors and coronary heart disease (CHD) diagnosis in a population sample which had a high (34%) prevalence of the metabolic syndrome (MS). METHODS: A single-scan CT was performed between the fourth and fifth lumbar vertebrae in 157 unselected men and women aged 34-69 y. Total adipose tissue area, abdominal VAT area and the abdominal sagittal diameter were determined. Diagnosis of CHD was based on clinical findings and Minnesota coding of resting electrocardiograms. RESULTS: Men had significantly higher VAT than women. Linear regression analysis for correlates of abdominal VAT area, in a model comprising age, sex, waist circumference, waist-to-hip ratio (WHR) and body mass index (BMI) identified waist circumference as the only independent variable (P<0.001). Waist circumference in men and BMI in women were the independently associated parameters of sagittal diameter (P<0.001). By stepwise linear regression, it was elicited that VAT area rose significantly by a mean of 6.8 cm2 in men and 3 cm2 in women for every 1 cm increment in waist circumference, independent of WHR. Age in women and (inversely) BMI in men were further independent variables, indicating in men that a lower BMI at a given waist girth suggests the existence of a higher VAT. Apo B and HDL-cholesterol (HDL-C) in men, and the latter in women were independently associated with VAT area in linear regression models that also comprised triglycerides, fasting insulin and C-reactive protein concentrations. In the study sample comprising 13 individuals with a CHD diagnosis, the age-adjusted odds ratio of cutpoints of VAT area > vs <140 cm2 in men and > vs <120 cm2 in women was 11.3 (95% CI (1.37, 93)). CONCLUSIONS: The best surrogate of visceral adiposity across a wide age range is waist circumference, in a population in which MS prevails. Apo B and HDL-C in men, and the latter in women were independently associated with VAT area, which proved to be closely related to CHD risk. A lower BMI at a given waist girth in men suggests the existence of a higher VAT.

Abdomen↗
PubMed2001

C-reactive protein and coronary heart disease in western Turkey.

C-reactive protein (CRP) has been recognized as a useful marker for coronary or cardiovascular risk in healthy subjects or patients with coronary heart disease (CHD) in industrialized societies. We assessed whether CRP could serve as a marker of prevalent CHD risk in a cross-sectional study of a population with low cholesterol levels (4.61 mmol/L in men and 4.82 mmol/L in women) but higher prevalence of other risk factors. In 1,046 participants of the Turkish Adult Risk Factor Survey in 2000, high-sensitivity CRP as well as other risk variables were evaluated, and CHD was diagnosed, based on clinical findings and Minnesota coding of electrocardiograms at rest. Almost an equal number of men and women > or = 30 years of age constituted the population sample of the western regions of Turkey. Geometric mean value of CRP was 1.9 mg/L (interquartile range 0.8 to 4.3), without revealing a significant difference in gender. CRP was correlated with many variables, notably those involving central obesity, fibrinogen, and apolipoprotein-B, but not with smoking status (regardless of age adjustment). In multiple regression models, blood fibrinogen, waist circumference, total cholesterol, and physical activity grade were independently associated with log CRP concentrations. Among many risk variables, CRP quartiles and systolic blood pressure were, besides age and gender, the only significant independent determinants of CHD. The age-adjusted odds ratio for CHD in the highest as opposed to the lowest quartile was 4.48 (p < 0.001). Even after adjustment for the 5 previously mentioned determinants of CRP, a 4.2-fold increased risk of CHD still persisted between the highest and lowest quartiles. Thus, the observed increased risk was not in large part due to the intermediary effects of fibrinogen, nor were some indicators of insulin resistance, but interaction appeared to be independent of these effects. Thus, CRP values serve as a marker of prevalent CHD risk in populations with low cholesterol levels. This association is independent of, or in addition to, the effects of conventional risk factors, suggesting that the contribution of chronic low-grade inflammation to the atherothrombotic process is present even in the setting of low cholesterol levels.

Adult↗
PubMed2001

Which fasting triglyceride levels best reflect coronary risk? Evidence from the Turkish Adult Risk Factor Study.

BACKGROUND: Association between raised low-density lipoprotein cholesterol (LDL-C) levels and high risk for coronary heart disease (CHD) is well established and taken into account in guidelines on coronary prevention. HYPOTHESIS: The relationship between risk for coronary heart disease (CHD) and the levels of fasting plasma triglycerides was studied in the cohort of the Turkish Adult Risk Factor Study, a representative random sample of an adult population. METHODS: In 829 men and 907 women aged > or =27 years (mean 48.5+/-11), plasma lipids and lipoproteins were measured by the enzymatic dry method in the postabsorptive state. A sample of values was validated in a reference laboratory. Apoliprotein (apo) A-I and B were measured by the turbidimetric immunoassay using commercial kits in part of the cohort. Blood pressure and anthropometric measurements were made. Criteria for the diagnosis of CHD were based on history, cardiovascular examination, and Minnesota coding of resting electrocardiograms. Coronary heart disease was diagnosed in about 7% of the subjects. Participants were divided into four categories depending on their triglyceride levels: I = < 100 mg/dl (282 men, 400 women), II = 100-139 mg/dl (204 men, 228 women), III = 140-212 mg/dl (188 men, 180 women), and IV = > or = 212 mg/dl (155 men, 99 women). RESULTS: After adjustment for age, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, smoking, and body mass index by logistic regression analysis, and after assigning the CHD risk of 1 to Category I, the relative risk for men and women combined rose to 1.42 in Category III (p<0.045) while it diminished to 0.94 in Category IV (p = 0.79). In women, the odds ratio (OR) rose gradually up to 1.78 (p< 0.025) in Category III, only to decline in Category IV. The OR in men was slightly, insignificantly, and equally elevated in Categories III and IV. Patients with CHD in Category III were not distinguished from those in Category IV by the studied risk parameters. It was suggested that high risk for CHD--particularly in subjects with slightly elevated or normal cholesterol levels-is often not reflected by extreme increases of fasting triglycerides but best by modest elevations (140-212 mg/dl), which serve better as a marker of triglyceride-rich lipoprotein particles. This knowledge may prove to be of value in population screening and individual risk assessment.

Adult↗
PubMed2001

Risk factors and cardiovascular disease in Turkey.

Cardiovascular risk factors as well as morbidity and mortality from coronary heart disease among Turkish adults are herein reviewed. Lipids and lipoproteins are in focus, but other relevant risk factors are also discussed. Turks have distinctively low levels of total and high-density lipoprotein (HDL)-cholesterol, associated with high levels of hepatic lipase and fasting triglycerides. In addition, physical inactivity is common in both genders; close to 60% of men have the smoking habit, while obesity is common among Turkish women leading to a high prevalence of hypertension and diabetes in them. These factors probably account for the unanticipated fact that Turkish adults have the pattern of causes of death similar to a developed population, although the process of industrialization is ongoing, the structure of its population is young and overall cholesterol levels are comparatively low. The age-standardized coronary heart disease death rate is estimated to rank among the highest in Europe. The leading independent predictors of coronary events and death [systolic blood pressure, total/HDL-cholesterol ratio, followed by diabetes and (central) obesity] are related to the metabolic syndrome, estimated to prevail in 3-4% of adults aged 30 or over, and to underlie one-eighth of cases of coronary disease. Since several adverse factors exhibit a rising trend, primary and secondary prevention of cardiovascular disease must assume a much higher priority in various issues in Turkey than it currently does.

Cardiovascular Diseases↗
PubMed1999

Waist circumference and waist-to-hip ratio in Turkish adults: interrelation with other risk factors and association with cardiovascular disease.

OBJECTIVE: To investigate the distribution of waist circumference (WC) and waist-to-hip ratio (WHR), their relationships with a number of established risk factors and their relevance to cardiovascular morbidity in a random sample of Turkish general adult population. DESIGN: Cross-sectional population-based study. SUBJECTS: The subjects comprised 958 men and 1014 women, aged 25-74 years. MEASUREMENTS: Waist circumference was measured midway between the lower rib and iliac crest while that of the hip at the level of trochanters. Mean of two blood pressure measurements was used for analysis. Plasma total cholesterol (Cho) and triglyceride (Trg) concentrations were measured by the enzymatic dry method with a Reflotron apparatus. RESULTS: Overall mean WC measured 93+/-12 cm in men, and 88.6+/-13 cm in women. Mean WHR was 0.919+/-0.077 and 0.823+/-0.074, respectively, and a rise by about 0.001 was associated with each year of age. In multiple regression analysis a model was utilized that included age, body mass index (BMI), systolic and diastolic blood pressure (BP), plasma total Cho and Trg and category of smoking. This revealed age, BMI, and Trg as independent determinants of WHR in both genders, and diastolic BP in women alone. Age, BMI, and diastolic BP proved to be independently associated with WC in both genders, while Cho did so in men alone, Trg and systolic BP in women alone. Partial correlation coefficients on univariate analysis between all four variables of blood pressure and plasma lipids and either WC or WHR, controlled for age, were highly significant though moderately weak in both genders. These were stronger in men than in women, and stronger with respect to WC than to WHR. Cigarette smoking men and women had significantly lower WC or WHR than nonsmokers and ex-smokers, though these associations did not prove to be independent. When the relevance of WC and WHR to CHD risk was tested in this cohort (for the age bracket 45-74 years) comprising 138 cases with a clinical diagnosis of CHD, only WHR in women proved to be significantly associated. Odds ratio for a value of >0.845 was 1.6. CONCLUSION: WC and WHR are strongly associated with BMI and age as well as with parameters reflecting insulin resistance such as diastolic blood pressure and plasma triglycerides. WHR was significantly associated with coronary heart disease in Turkish women.

Abdomen↗
PubMed1998

Systolic and diastolic blood pressure related to six other risk parameters in Turkish adults: strong correlation with relative weight.

This study aimed to investigate the relationship of systolic and diastolic blood pressure (BP) with a series of metabolic and nonmetabolic cardiovascular risk variables in a random sample of Turkish general adult population. Values of systolic and diastolic BP on the one hand and of six variables including body mass index (BMI), waist/hip ratio (W/H), grade of physical activity (PhA), plasma lipids and cigarette smoking from 1046 men and 1095 women aged 225 years were included in the analysis. Participants were classified into tertiles according to systolic and diastolic BP measurements, and were stratified in two age categories: 25-44 years (young) and 45-74 years (elderly). Plasma total cholesterol and triglyceride (Trg) concentrations were measured by the enzymatic method with the Reflotron apparatus. In multiple regression analysis, age proved the strongest independent determinant of BP. BMI was a strong independent marker of systolic and diastolic pressures in women, while in men the determinant value of the W/H was equivalent to BMI. For each increment of 1 kg/m2 of BMI was associated in men an increase of over 8 and 16 mmHg in diastolic and systolic pressure, respectively, regardless of age group. Corresponding figures in women were roughly 6 and 10 mmHg. Though plasma Trg were not independently associated with BP in either gender, the independent contribution of plasma cholesterol level in women to systolic and diastolic pressures was small but significant. BP was related to mean concentrations of plasma Trg in young adults only, total cholesterol levels were associated with diastolic pressure in young men only, whereas PhA grade was not associated with BP. These findings are consistent with the theory that, in the normal state, functions such as regulation of BP, body weight and lipid metabolism are closely linked to each other.

Adult↗
PubMed1997

Relatively high coronary death and event rates in Turkish women. Relation to three major risk factors in five-year follow-up of cohort.

The study describes rates of coronary heart disease death and nonfatal coronary events over five years in a cohort of random sample population and relates them to levels of three major risk factors. It is based on a longitudinal follow-up of survey conducted initially in 1990 in all geographic regions of Turkey. Two-thirds of the original cohort aged 20 years or over 2259 adults comprising 1146 women was followed up by physical examination and an ECG recording at rest. New coronary events were defined to include myocardial infarction and stable angina with or without associated myocardial ischemia developed during the follow-up period. Overall annual death rate was nine per 1000 adults. Coronary deaths numbered 55 (of which 26 were women) representing 4.1 per year and were found high in women. New coronary events were registered in 37 men and 32 women (annual rates 7.2 and 5.8 per 1000, respectively). Among male participants aged initially 40 years or over, high systolic blood pressure (> or = 130 mmHg) at baseline significantly predicted coronary death (age-adjusted risk ratio (RR) 3.3) while high cholesterol concentrations (> or = 5.2 mmol l-1) predicted new coronary events alone (RR almost 2). In women systolic pressure again strongly predicted coronary death (age-adjusted RR 3.9), whereas abnormal cholesterol levels discriminated for coronary death and new coronary events (RR around 2.3 for each). High diastolic pressure (> or = 85 mmHg) was of predictive value for the combined outcome of coronary death and events in women (RR 1.9) but not in men. Multivariate analysis by logistic regression identified systolic blood pressure in men as significant independent predictor of coronary death, while total cholesterol concentration in both genders and systolic blood pressure in men were independent predictors of the combined outcome of coronary death or nonfatal coronary events. It was concluded that known major risk factors act in similar magnitudes commensurate with the specific risk increments also in populations with essentially low cholesterol levels. The relatively high coronary morbidity and mortality in Turkish women approaching that in men may be accounted for by an inherent greater risk burden.

Adult↗
PubMed1995

[Not Available].

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History, 20th Century↗
PubMed1994

Relative risk of factors for coronary heart disease in population with low cholesterol levels.

We studied the odds ratios of seven leading risk variables in a population essentially having a 'low' cholesterol concentration. In a cross-sectional population-based study of 3689 Turkish adults 20 years of age or over, 90 men and 83 women were diagnosed to have definite or suspected coronary heart disease. The criteria were based on history, cardiovascular examination and on Minnesota coding of electrocardiograms. Potential risk factors studied were: plasma total cholesterol (> or = 240 mg/dl), fasting triglycerides (> or = 200 mg/dl), diabetes mellitus, hypertension (asystolic > or = 160 mmHg, diastolic > or = 95 mmHg, or both, or subjects reporting to take antihypertensive medication), smoking currently or in the past, obesity (body mass index > or = 30 kg/m2), and physical inactivity. Hypertension and lack of physical exercise constituted the most important risk factors in both sexes being valid for all age groups and having high attributable risks; odds ratios in men and women, respectively, were 3.16 and 2.6 for hypertension, and 2.16 and 3.49 for physical inactivity. Hypertriglyceridemia followed these factors in men with an odds ratio of 2.15. In women an additional significant factor was obesity (odds ratio 1.76), while diabetes and hypercholesterolemia revealed to be significant only in those aged 20-59 years, and smoking in women aged 30-59 years. Among men, smoking was a borderline significant risk factor for coronary disease, whereas hypercholesterolemia did not prove to be so. These findings, somewhat at variance with those of industrialized nations, may have significance for policy of cardiovascular disease prevention in third-world populations.

Activities of Daily Living↗
PubMed1994

Homozygous factor X deficiency associated with familial hypercholesterolemia, mitral valve prolapse, and hypertrophic cardiomyopathy.

The family investigated showed the presence of multiple genetic disorders among their members. The presumable defective genes were related to coagulation factor X, familial hypercholesterolemia, mitral valve prolapse, and hypertrophic cardiomyopathy. The parents were offspring of two siblings, and their children comprised a nonidentical twin. While the proband demonstrated factor X deficiency, obstructive hypertrophic cardiomyopathy, and primary hypercholesterolemia, her parents and her elder sister were considered heterozygous for factor X. In addition, her mother had elevated plasma cholesterol levels, and her father primary hypercholesterolemia as well as mitral valve prolapse. The twin sister, heterozygous for factor X deficiency, displayed mitral valve prolapse. The clustering of defective genes in this family was considered to represent 'coincidental' occurrences rather than being linked to each other.

Adolescent↗
PubMed1993

Prevalence of coronary heart disease in Turkish adults.

The prevalence of coronary heart disease was determined by a conducted survey in a random sample of 3689 subjects 20 years of age or older in 59 communities representing the Turkish adult population. Interview with a questionnaire, physical examination of the cardiovascular system and recording of a 12-lead ECG were performed. The latter was coded according to the Minnesota code. Expressed in age-adjusted rates (for 35-64 years), prevalence rates per 100 men were as follows: typical angina 3.7, atypical angina 0.9, electrocardiographic evidence of myocardial infarction and/or ischemia 3.7, any of the stated findings suggesting coronary heart disease 8. Women had a substantially higher rate of atypical angina, positive ECG findings and of any of the stated manifestations for coronary heart disease, whereas they had a significantly lower rate of Q/QS patterns as well as of a history of myocardial infarction. Based on a probability-related point score, age-adjusted clinical coronary heart disease was estimated to prevail in 5.8% of men and 5% of women (P > 0.4) in the sample of the Turkish population. The respective rates in urban residents was 6% and in rural resident 4.8%. Among participants diagnosed coronary heart disease, 63% presented the form of angina without infarction, 27% had evidence of myocardial infarction, 7% 'silent myocardial ischemia' and 3% cardiac failure alone.

Adult↗
PubMed1992

Plasma lipids and their interrelationship in Turkish adults.

STUDY OBJECTIVE: The aim was to describe the plasma total cholesterol and triglyceride profiles in a random sample of Turkish adults and analyse the effects of certain coronary risk factors on these levels. DESIGN: This was a cross sectional population based survey. SETTING: 59 communities scattered in all seven geographical regions of Turkey were surveyed in the summer of 1990. SUBJECTS: A random sample of 3689 men and women 20 years of age and over was studied. MEASUREMENTS AND MAIN RESULTS: Plasma total cholesterol, triglycerides, glucose (using Reflotron and with partial validation in reference laboratory), weight, height, and blood pressure were measured, and information on smoking, physical activity, and family income obtained. Hypercholesterolaemia (> or = 6.5 mmol/litre, 250 mg/dl) prevailed in 8.5%, and hypertriglyceridaemia (> 2.25 mmol/litre, 200 mg/dl) in 16.6% among men and women aged 40-59 years of age. Age adjusted total cholesterol values were 4.8 mmol/litre (185 mg/dl) in men and 5 mmol/litre (192 mg/dl) in women. A steep rise appeared in mean cholesterol levels between the ages of 20-29 and 40-49 years, in a ratio greater than the available data from some other populations indicated. Mean total cholesterol values increased substantially in both genders with diminishing grades of physical activity, rising serum triglyceride levels, in urban (opposed to rural) residents, in men with increasing income levels, and in the younger adults with rising body mass index. CONCLUSIONS: Turkish adults have comparatively low levels of total cholesterol and medium to moderately high levels of triglycerides. Lifestyle factors affect these levels in Turks as in other populations.

Adult↗
PubMed1991

Simulated myocardial infarction and slow atrial flutter due to cerebral embolism from a free left atrial thrombus.

The case of a 38-year-old female who suffered a cerebral embolism from a free left atrial thrombus is reported. The clinical picture, including serum enzyme elevations, was consistent with a nontransmural myocardial infarction. Atrial flutter exhibiting very slow (162/min) and tall waves was transiently recorded indicating development of an intra-atrial conduction disturbance.

Adult↗
PubMed1986

Familial sinus node disease and degenerative myopia--a new hereditary syndrome?

A family is reported in which the father and both offspring suffered from sick sinus syndrome (SSS) accompanied by degenerative myopia in the two elder of the three family members. In all three individuals, the basic manifestations of the SSS were total sinus arrest with secondary AV junctional rhythm at a normal rate. Only the 7-year-old boy also exhibited paroxysmal atrial flutter and ventricular asystole lasting up to almost 7 s. Since he had, furthermore, recently sustained a left hemiparesis, a ventricular demand pacemaker was implanted. Chronic atrial fibrillation was eventually established in the father in whom observations were available for 16 years. Myopia of -11 D and -4.5 D, respectively, existed in the father and his 14-year-old daughter. The familial association of this defect with SSS suggests a hitherto undescribed genetic syndrome, presumably with underlying autosomal dominant transmission of the two traits.

Adolescent↗
PubMed1984

Discrete subaortic stenosis as part of a short stature syndrome.

Observations in a family point to the existence of autosomal dominant inheritance for discrete subaortic stenosis (DSS), which made up part of a multisystem disorder. Both parents, offspring of two full siblings, had short stature, obstructive lung disease (OLD), hoarseness and upturned nose. The father alone had aortic stenosis and inguinal hernia. The six offspring, aged from 13 to 28 years, were followed up for up to 8 years. While one of them was virtually normal, and one had only minor abnormalities, four siblings displayed clinical signs of progressive aortic stenosis. Of the two eldest siblings who eventually died, necropsy in one showed a discrete subaortic stenosis, which was hemodynamically proven in one and surgically corrected in another sibling. Upturned nose was present in each examined member of the family, short stature and hoarseness in five of the siblings, DSS in four, OLD, inguinal hernia and congested episcleral veins in three, kyphoscoliosis in two, while epicanthus, strabismus, microphthalmos and widely spaced teeth were noted in the deceased female. The prevalence of some of these traits in roughly three-quarters of the sibship was consistent with an underlying single gene abnormality in affected heterozygous parents. We proposed that this constitutes a new syndrome.

Adolescent↗