Turkish Adult Research Articles

Gender-modulated risk of coronary heart disease, diabetes and coronary mortality among Turks for three major risk factors, and residual adiposity risk.

BackgroundWe determined the proportion of the effects of body mass index (BMI) or its categories on cardiometabolic outcomes mediated through systolic blood pressure (SBP), total cholesterol and fasting glucose.MethodsCox regression analyses were performed for incident outcomes among Turkish Adult Risk Factor study participants in whom the three mediators had been determined (n = 2158, age 48.5 ± 11 years). Over a mean 10.2-years’ follow-up, new coronary heart disease (CHD) developed in 406, diabetes in 284 individuals, and 149 CHD deaths occurred.ResultsHazard ratios (HR) of BMI for incident diabetes were no more than marginally attenuated by the 3 mediators including glucose, irrespective of gender. Compared to “normal-weight”, sex- and age-adjusted RRs for incident CHD of overweight and obesity were 1.40 and 2.24 (95 % CI 1.68; 2.99), respectively, in gender combined. Only three-tenths of the excess risk was retained by BMI in men, six-tenths in women. No mediation of glycemia was discerned in males, in contrast to greatest mediation in females. HR of age-adjusted continuous BMI was a significant but modest contributor to CHD mortality in each gender. While the BMI risk of CHD death was abolished by mediation of SBP in men, HR strengthened to over two-fold in women through mediation of fasting glucose.ConclusionsMediation of adiposity by 3 traditional factors exhibited among Turkish adults strong gender dependence regarding its magnitude for CHD risk and the mediation by individual risk factors. Retention of the large part of risk for diabetes in each sex and for CHD in women likely reflects underlying autoimmune activation.Electronic supplementary materialThe online version of this article (doi:10.1186/s12902-016-0134-6) contains supplementary material, which is available to authorized users.

Risk of obesity and metabolic syndrome associated with FTO gene variants discloses clinically relevant gender difference among Turks.

Gene variations in the fat mass- and obesity-associated gene (FTO) have shown controversial associations with obesity and metabolic syndrome (MetS) in several populations. We explored the association of FTO gene with obesity, MetS, and insulin-related parameters separately in men and women. Two SNPs in the FTO, gene rs9939609 and rs1421085, were genotyped by the Taqman System in 1967 adults (mean age of the whole group 50.1±12.0; 48.4% male). A random sample of the Turkish Adult Risk Factor cohort was cross-sectionally analyzed. Both SNPs exhibited strong linkage disequilibrium (r(2)=0.85) and minor alleles were associated with risk of obesity in women and of MetS in men. Carriers of the rs1421085 C-allele exhibited higher body mass index (BMI) in each gender. Adjusted fasting insulin and HOMA index were significantly higher in C-allele carriers in men alone. Logistic regression analysis demonstrated significantly increased likelihood for obesity in female C-risk allele carriers (OR 1.61; 95% CI 1.19-2.18), after adjustment for age, smoking status, alcohol usage, physical activity grade and presence of diabetes mellitus. Male C-allele carriers were at increased risk for MetS (OR 1.44; 95% CI 1.07-1.95), adjusted for age, smoking status, alcohol consumption, and physical activity. Further adjustment for BMI attenuated the MetS risk, indicating interaction between C-allele, gender and BMI. The FTO gene in Turkish adults contributes independently to obesity in women and-by interacting with BMI-to MetS and insulin resistance in men.

The Impact of Low Socio-economic Status on the Degree of Motivation and Autonomous Behaviors of Turkish Adult Students

Low socio-economic status, poverty, or social-economic gap may have undesirable effects on the emotional state of individuals at any age during education process and may be the grounds of negative ...

Twenty-five years of the TARF study: The 2015 survey, and temporal trends in mortality and loss to follow-up.

The aims of the present study were to examine, first, overall mortality in the Turkish Adult Risk Factor (TARF) 2015 survey, and second, distribution of cumulative mortality and temporal losses to follow-up in the 7 geographic regions of Turkey over 25 years. Information on mode of death was obtained from first-degree relatives and/or primary health center personnel. Information regarding survivors was based on history, examination of the cardiovascular system, and Minnesota coding of electrocardiograms. Of the 1304 participants to be screened, 58 were lost to follow-up, 787 were examined, and 39 participants had died. In 420 subjects, verbal reporting alone was used to determine health status. Deaths were attributed to coronary heart disease in 16 subjects, and cerebrovascular event and cancer in 8 cases each. However, evidence suggested underlying autoimmune activation in 85% of cases. Cumulative 25-year assessment of the entire cohort, comprising 863 deaths over a mean follow-up of 20.5 years, corresponded to a rate of 11.4 per 1000 person-years. A significantly lower mortality rate was found in the Southeast. The 1992 participants lost to follow-up represented a rate of 22.5 per 1000 person-years. The generally high overall mortality in Turkey is similar among geographic regions, with the exception of a lower rate in Southeastern Anatolia. One of every 45 surviving participants is lost to follow-up each year.

Türk Erişkin Popülasyonunda Keratokonus Progresyonu

Türk Erişkin Popülasyonunda Keratokonus Progresyonu

Turkish Adult Risk Factor survey 2014: Overall mortality and coronary disease incidence in Turkey's geographic regions

This study aimed to examine the overall and coronary mortality in the 2014 Turkish Adult Risk Factor Study survey, and the distribution of cumulative mortality and incident coronary heart disease (CHD) across 7 geographic regions. Information on mode of death was appropriately obtained. Information collected from survivors was based on history, examination of the cardiovascular system and the Minnesota coding of electrocardiograms. Cox regression analyses were performed. Of the 1.323 participants to be surveyed, 87 were lost to follow-up, 753 examined, and 35 ascertained as deceased. In 448 subjects, verbal information alone was obtained regarding health status. Nineteen deaths were of coronary and cerebrovascular origin. Cumulative 24-year assessment of the entire cohort in the age bracket 45-74 years disclosed high coronary mortality, at 7.3 per 1000 person-years in men and 3.8 in women, and recorded a limited decline of 18% since the year 2000. Age-adjusted Cox regression analysis, comprising 614 deaths and 482 incident CHD over a follow-up of 9.6 years, revealed higher mortality rates in the Mediterranean region and in men in the Black Sea and Marmara regions. The age-adjusted CHD incidence was significantly higher in males of the Mediterranean and females of the Southeast regions. An estimated 400-420.000 incident CHD cases develop currently each year in Turkey. The generally high age-adjusted overall mortality in Turkey displays significant differences across geographic regions. Age-adjusted CHD incidence is not regressing sufficiently, and is especially high among men of the Mediterranean and women of the Southeast regions.

Second Language Acquisition of Syntactic Movement in English by Turkish Adult Learners

Second Language Acquisition of Syntactic Movement in English by Turkish Adult Learners

The Role of Magical Thinking, Religiosity and Thought-Control Strategies in Obsessive-Compulsive Symptoms in a Turkish Adult Sample

Background: It has been suggested that magical thinking is related to both obsessions and compulsions in obsessive-compulsive disorder (OCD). Recent studies have indicated the significant relationship between level of religiosity and beliefs about the importance and need to control unwanted thoughts in OCD. People also use diverse strategies to control their unwanted thoughts. Aims: The present study aimed to examine the interrelationships between magical thinking and worry and punishment as thought-control strategies in mediating the relationship between religiosity and obsessive-compulsive (OC) symptoms in a Turkish sample. Methods: The sample of the present study was comprised of 179 non-clinical, community-based participants who completed measures of OC symptoms (measured with the Obsessive Compulsive Inventory — Revised), magical thinking (measured with the Magical Ideation Scale), religiosity, and thought-control strategies (measured with the Thought Control Questionnaire). Results: Both worry and punishment as thought-control strategies and magical thinking mediated the links between religiosity and OC symptoms. Furthermore, the relationship between religiosity and OC symptoms was mediated by magical thinking through punishment and worry. Conclusions: Findings pointing out the mediating role of magical thinking through punishment and worry in the relationship between religiosity and OC symptoms are novel and need to be replicated in future studies.

Absenteeism and Delay to Work Due to Sleep Disorders in the Turkish Adult Population: A Questionnaire Based National Survey

Absenteeism and Delay to Work Due to Sleep Disorders in the Turkish Adult Population: A Questionnaire Based National Survey

Prevalence of sleep disorders in the Turkish adult population epidemiology of sleep study

Sleep disorders constitute an important public health problem. Prevalence of sleep disorders in Turkish adult population was investigated in a nationwide representative sample of 5021 Turkish adults (2598 women and 2423 men, response rate: 91%) by an interviewer-administered questionnaire. Insomnia was defined by the DSM-IV criteria, habitual snoring and risk for sleep-related breathing disorders (SDB) by the Berlin questionnaire, excessive daytime sleepiness (EDS) by the Epworth sleepiness scale score, and restless legs syndrome (RLS) by the complaints according to the International Restless Legs Syndrome Study Group criteria. Mean age of the participants was 40.7 ± 15.1 (range 18 to 90) years. Prevalence rates (men/women) were insomnia 15.3% (10.5%/20.2%; P < 0.001), high probability of SDB 13.7% (11.1%/20.2%; P < 0.001), EDS 5.4% (5.0%/5.7%; P: 0.09), RLS 5.2% (3.0%/7.3%; P < 0.001). Aging and female gender were associated with higher prevalence of sleep disorders except for habitual snoring. Prevalence rates of the sleep disorders among Turkish adults based on the widely used questionnaires were close to the lower end of the previous estimates reported from different parts of the world. These findings would help for the assessment of the health burden of sleep disorders and addressing the risk groups for planning and implementation of health care.

Prevalence of insomnia and its clinical correlates in a general population in Turkey.

The prevalence of insomnia is influenced by environmental factors. This study aimed to investigate the prevalence of insomnia and its sociodemographic and clinical correlates in a general population-based survey in Turkey. This population-based study included 4758 subjects among 5021 who participated in the Turkish Adult Population Epidemiology of Sleep Disorders study. Questionnaire items evaluating insomnia were adapted from the International Classification of Sleep Disorders II and the DSM-IV-TR. Subjects with restless legs syndrome were excluded. Insomnia was found to be associated with older age (18-24 years, 9.8%; 25-44 years, 11.7%; 45-64 years, 13.8%; 65 years or older, 13.9%), lower income level (<500 USD, 16.5%), time spent watching TV (6-8 h or more, 18.4%), tea consumption in the evening (≥6 glasses, 14.5%) and smoking status (current and ex-smoker, both 14.2%) in multiple logistic regression analysis. In respect to other medical disorders, insomnia was significantly associated with the presence of hypertension, diabetes and heart diseases after the adjustment for relevant risk factors for each disease, across all age and sex groups. Insomnia is a major health problem in our population, affecting subjects in the working age group and those of lower socioeconomic status. It should especially be screened in patients with chronic diseases. A relatively low proportion of insomnia diagnosed as a sleep disorder suggests that this condition and its clinical correlates are possibly under-recognized.

HDL-C levels in newly diagnosed type 2 diabetes in Turkey

In this study, we aimed to investigate whether HDL-C levels of non-diabetic and type 2 diabetic Turks are as low as those of non-diabetic Turks reported in Turkish Heart Study (THS) and Turkish Adult Risk Factor Sudy (TEKHARF).

Wohlfahrtia magnifica’dan Kaynaklanan Gingival Miyaz Olgusu

Myiasis is an infestation of living or dead tissue of humans and animals by diptera larvae. Gingival myiasis is a rare pathology and is mainly associated with poor oral hygiene, alcoholism, senility, suppurative lesions, mouth breathing, mental retardation and hemiplegia. Myiasis is most common during summer since the fly population increases during this season. Mostly it occurs in farmers and people who live in tropical climates. Gingival myiasis in humans in Turkey is limited to only a few cases. According to our literature research, this is the first case of gingival myiasis produced by larvae of Wohlfahrtia magnifica in a Turkish adult. According to our best knowledge, it is also the first gingival myiasis case that one of the causative larva had grown to the adult stage in Turkey. A 43 years old male patient who perceived the presence of live maggots in his mouth was referred to our clinic. Clinical findings of gingival myiasis were observed. The patient had no history of systemic disease but oral hygiene was poor. Clinical and radiographic examination indicated that he had chronic periodontitis. Before the dental treatment seven larvae and during the scalling five larvae were elevated from the gingival sulcus. The body of the larvae composed of 12 segments and they were 8-10 mm in length. One of the larvae which was sent to the microbiology laboratory were placed into sheep liver to resume life and the other larvae were placed into 70% alcohol solution. After 9-10 days, the larva which was placed in the liver became pupa. Approximately 15 days later, the pupa became an adult fly. The larvae were identified as the second stage larvae of Wohlfahrtia magnifica. Treatment consisted of removal of the maggots from the gingival sulcus, followed by scaling and oral hygiene instruction. Non-surgical periodontal treatment was applied and the patient was followed-up for 3 months. After non-surgical periodontal treatment, patient didn't accept the flap operation. The most important point for the prevention of gingival myiasis is to establish a good oral hygiene, together with the elimination of environmental factors which support the proliferation of the flies.

Facial soft tissue thickness database for craniofacial reconstruction in the Turkish adult population

320 Turkish adults (160 men, 160 women) who had undergone brain CT in the radiology clinic and showed no sign of maxillofacial pathology were analyzed in order to create a facial soft-tissue thickness database of the Turkish adult population. The soft-tissue thicknesses were measured at 31 landmarks, 10 midline and 21 bilateral anatomical landmarks. Average thickness values for each landmark as well as the standard deviation and range classified according to gender and age are reported.The differences of these mean values related to age and sexes were calculated. The values were then statistically compared to the findings of the European and Korean adults.Overall, the soft-tissue thickness measurements obtained in this study can be used as a database for the forensic craniofacial reconstruction of Turkish adult faces.

Normal thyroid-stimulating hormone levels, autoimmune activation, and coronary heart disease risk.

Whether 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±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±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.

Enhanced Proinflammatory State and Autoimmune Activation: a Breakthrough to Understanding Chronic Diseases

Insight is provided herein into the novel mechanisms of cardiometabolic risk. Previous reports, including the epidemiological work of the Turkish Adult Risk Factor study, indicated that proinflammatory state and oxidative stress are crucial for evaluating cardiometabolic risk. Autoimmune pathways in the course of oxidative stress are major determinants of cardiorenal and metabolic risk. The latter encompasses metabolic syndrome, type 2 diabetes, coronary heart disease, and chronic kidney disease (CKD). Along with platelet-activating factor acetylhydrolase, creatinine, thyroid stimulating hormone, acylation-stimulating protein, asymmetric dimethylarginine, and serum lipoprotein[Lp](a) are triggers of systemic low-grade inflammation and enhanced autoimmune reactions. Related studies are analyzed in the current review. Lp(a) plays a crucial role by taking part in the immune activation, thereby accelerating the course of diabetes, CKD, and other chronic disorders. Populations prone to impaired glucose tolerance, and particularly peri- and postmenopausal women, are at high risk of developing related vascular complications.

Psychometric Properties of the Turkish Child and Adult Form of “Reading the Mind in the Eyes Test”

The purpose of this study is to examine psychometric properties of “Reading the Mind in the Eyes Test” for both children and adult forms. Adult study group consists of 268 participants between the age of 18 - 60 (59.7% female, 40.03% male). Children study group consists of 202 normally developed children and 33 children with autism between the ages of 6 to 16. In the study, 42.1% of children participants (N = 99) were female and 57.9% were male (N = 136). According to results, both forms have adequate internal consistency reliability (Cronbach Alpha value for adult form is 0.71 and for children form is 0.72). In children form, construct validity was examined in terms of age, gender and diagnosis and differentiation of this group were determined. Adults form is determined as a reliable and valid form for high school graduated individuals.

Turkish Adult Risk Factor survey 2013: rapid rise in the prevalence of diabetes

To analyze (1) the sex-specific and age-bracket defined 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. Information on the mode of death was obtained from first-degree relatives and/or health personnel of local heath office. Information collected in survivors was based on history, physical examination of the cardiovascular system and Minnesota coding of resting electrocardiograms. Diabetes was defined by criteria of the American Diabetes Association without the use of glycated hemoglobin. 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 45-74 years disclosed coronary mortality to be 7.5/1000 person-years 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 finding 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. 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.

Gender specific association of ABCA1 gene R219K variant in coronary disease risk through interactions with serum triglyceride elevation in Turkish adults

ATP binding cassette transporter A1 (ABCA1) controls the reverse cholesterol transport. Some ABCA1 variants are correlated with serum high-density lipoprotein cholesterol (HDL-C) and other lipid concentrations. We aimed to explore the relationship of ABCA1 gene with both the lipid profile and coronary heart disease (CHD) risk. Selected 627 individuals of the Turkish Adult Risk Factor Study were genotyped for ABCA1 R219K polymorphism using PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism) method. Student's t-test, one-way ANOVA, Chi-square test, linear and logistic regression was used for statistical analysis. We demonstrated a gender-specific effect of the R219K polymorphism on plasma lipids and CHD. In men, while homozygosity of the K allele was associated with increased plasma low-density lipoprotein cholesterol (LDL-C) (p<0.05) and total cholesterol concentrations (p<0.05), carriage of this allele was associated with higher HDL-C concentrations (p<0.05) after adjustment for associated risk factors, but not with CHD. In women, however, without being related to HDL-C levels, each 219K allele was associated with 10% higher triglycerides (TG) concentrations (p<0.05). R219K heterozygosity in women independently doubled (95% CI 1.00; 3.80) the odds ratio for CHD risk in regression models, after adjustment for several variables. Interaction of TG elevation (>140 mg/dL) with CHD was demonstrated in female 219RK genotype carriers. R219 allele of the ABCA1 gene independently confers CHD risk in heterozygote Turkish women, not via reduced HDL-C, but interacting with elevated TG expressed by the 219K allele, but not in men.

Psychometric Properties of Adult Inventory of Procrastination in a Turkish Sample

The present study assessed the psychometric properties of the Adult Inventory of Procrastination for Turkish adults. The Adult Inventory of Procrastination (AIP), General Procrastination Scale (GP), and Decisional Procrastination Scale were administered to 423 Turkish adults (183 women, 240 men; Mage = 38.7, SD = 8.24) working in the governmental institutions in Turkey. The results of the confirmatory factor analysis yielded fit index values demonstrating viability of univariate factor solution as in the original. Findings also revealed that, as predicted, the AIP score was strongly correlated with GP score (r = .66). Overall, results provided evidence for the factor validity and reliability of the Turkish version of the scale for use in Turkish adult populations.