title: Dynamics in Cardiometabolic Risk among Turkish Adults: Similarities to that in Iranians?
abstract: Based on 20 years experiences of follow-up of the Turkish Adult Risk Factor (TARF) study, this review summarizes the distribution of risk factors among Turks which is dominated by components of the metabolic syndrome (MetS), especially abdominal obesity and atherogenic dyslipidemia. The adoption of a 95 cm cutoff for male abdominal circumference was crucial in the understanding of cardiometabolic risk factors. The prevalence of MetS, type-2 diabetes and coronary heart disease (CHD) are high, alike in Iranians. The TARF study demonstrated that low-grade systemic inflammation and oxidative stress are major determinants of cardiometabolic risk in the population at large, and involves the female sex to a greater extent than the male. As a result, impaired anti-inflammatory and atheroprotective function developed in middle-aged and elderly obese individuals emerging as dysfunction of apolipoprotein A-I and HDL particles. This dysfunction is currently a major driver cardiometabolic risk in Turkish adults leading to substantial excess diabetes and CHD. Separate algorithms for diabetes and CHD were derived that improved the risk prediction of these diseases.The author strongly suspects that such dynamics in the development of diabetes and CHD exist in Western adults prone to impaired glucose tolerance, and evidence is accumulating regarding general Iranian adults. These issues posing a vast threat on public cardiometabolic health will have to be recognized with the purpose of not delaying implementation of measures for the modification of cardiometabolic risk, especially in women.
authors: Emeritus Professor, Cardiology Department, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey. Email: alt_onat@yahoo.com.tr.
authors: Altan
authors: A
authors: Onat
references: Nutr Metab Cardiovasc Dis. 2012 Aug;22(8):643-50
references: 21315565
references: Int J Cardiol. 2010 Jun 25;142(1):72-9
references: 19171400
references: J Endocrinol Invest. 2011 Sep;34(8):580-6
references: 21042044
references: Metabolism. 2005 Jun;54(6):800-8
references: 15931618
references: Clin Chim Acta. 2008 Nov;397(1-2):42-7
references: 18691566
references: Int J Cardiol. 2009 Jun 26;135(2):211-7
references: 18582961
references: Diabetes Res Clin Pract. 2010 Mar;87(3):342-7
references: 20004035
references: Lipids Health Dis. 2010 Jan 23;9:6
references: 20096127
references: Metabolism. 2008 Feb;57(2):207-14
references: 18191050
references: Eur Heart J. 2009 May;30(9):1022-4
references: 19422082
references: Diabetes Res Clin Pract. 2011 Feb;91(2):220-5
references: 21208678
references: Nutrition. 2010 Apr;26(4):382-9
references: 19632090
references: Metabolism. 2011 Apr;60(4):499-512
references: 20580781
references: Atherosclerosis. 2009 Mar;203(1):311-9
references: 18692848
references: Arterioscler Thromb Vasc Biol. 2004 Feb;24(2):e13-8
references: 14766739
references: Lancet. 2005 Sep 24-30;366(9491):1059-62
references: 16182882
references: Metabolism. 2009 Oct;58(10):1393-9
references: 19570555
references: Diabet Med. 2009 Oct;26(10):981-8
references: 19900229
references: Atherosclerosis. 2001 May;156(1):1-10
references: 11368991
references: J Endocrinol Invest. 2009 Oct;32(9):724-30
references: 19574728
references: Metabolism. 2010 May;59(5):628-34
references: 19913840
references: J Lipid Res. 1995 Apr;36(4):839-59
references: 7616127
references: Clin Chem. 2007 Mar;53(3):456-64
references: 17259238
references: Atherosclerosis. 2007 Aug;193(2):380-8
references: 16926017
references: Diabetes Care. 2003 Nov;26(11):3160-7
references: 14578255
references: Atherosclerosis. 2007 Mar;191(1):182-90
references: 16678831
references: Nutrition. 2010 Oct;26(10):975-80
references: 20116212
references: Anadolu Kardiyol Derg. 2006 Dec;6(4):314-21
references: 17162275
references: Ann Nutr Metab. 2010;57(2):77-84
references: 20733290