Turkish Adult Research Articles

The serious adjustment bias and competing outcomes in hypertriglyceridemic waist phenotype

The newly published article by Hadaegh's group [1] points to paradoxical aspects regarding the pathogenesis of cardiovascular disease (CVD), yet without optimal evaluation and interpretation. Utilizing a large sample of the Tehran Lipid and Glucose study cohort, authors investigated the predictive value of hypertriglyceridemic waist (HtgW) for CVD and mortality. Authors concluded that, after adjustment for potential confounders, though inwomen incident CVD risk was significantly increased all-cause mortality was inversely associated with HtgW in each gender and CVD mortality in men. HtgW is a crucially important distinct phenotype leading to excess cardiometabolic risk. It is a state of enhanced subclinical inflammation and autoimmune activation in either gender [2]. Sexand age-adjusted differences of this phenotype in the Turkish Adult Risk Factor study participants bystratifying into the categories of “healthy”, onlyabdominal obesity, hypertriglyceridemia (N1.7 mmol/L) aloneandHtgWemergedas follows. Compared with the “healthy” category, HtgW had significantly higher bloodpressure (BP), total, low-density lipoprotein andnon-highdensity lipoprotein(HDL)-cholesterol, apolipoprotein B, glucose, Creactive protein and complement C3 (a marker of autoimmunity) concentrations, and lowerHDL-cholesterol levels andprevalence ineach sex of current smoking. Individuals with HtgW further displayed lower circulating Lp(a), adiponectin, and sex hormone-binding globulin (SHBG). Collectively, these aspects strongly support the notion that HtgW phenotype is driven by oxidized phospholipids, particularly concentrated on Lp(a) particles which also become gradually oxidized, resulting in damaged epitopes that render themnot being captured fully by the immunoassay. The consequence is on one hand an “apparently” low Lp(a) level, on the other higher apoB-containing lipoproteins, because apoB itself, not damaged in the pro-inflammatory milieu, is assayed adequately. Protective plasma proteins such as apoA-I, HDL, adiponectin and SHBG combat the slow process of subclinical inflammation and autoimmune activation but, eventually, may each be converted pro-inflammatory during the stage of HtgW (as yet unpublished findings). In people with this phenotype, adjusting for total and HDLcholesterol, BP, and CRP has inherent bias [3] because HtgW represents enhanced pro-inflammatory state with elevated apoB, and resultant elevated BP. As regards adjusting for smoking status, this is a fallacy by causal relationship, because non-smoking in many ethnicities contributes to drive pro-inflammatory state, and current smoking induces avoidance of abdominal obesity [4,5] and may inhibit the autoimmune process [2,6]. A second important factor that deforms the paradoxical assessment is that HtgW phenotype leads not only to cardiovascular disease and death from it but also to other diseases, such as chronic kidney disease [7], diabetes mellitus [8] and presumably also to certain types of cancer, so that overall mortality is influenced by competing causes. Adjustment for conventional cardiovascular risk factors reduces the attributable part for cardiovascular mortality without substantially modifying mortality due to other causes. Inappropriate evaluation of the huge clinical significance of HtgW maymislead to imperfect guidelines anderraticmedical practice.Hence, the clinical significance of HtgWshouldbeput into proper context in the future by further related research across various ethnicities and appropriate assessment.

Predictors of Quality of Life in Turkish Adult Primary Care Patients

This study determines perceived self-efficacy, personal characteristics and quality of life among Turkish adult primary care patients. The research used descriptive cross-sectional design. The sample group had moderate perceived self-efficacy and was mostly satisfied with quality of life. These findings help health professionals to improve quality of life in healthy adults.

Relationship Between the Levels of Normal Conus Medullaris and Body Mass Index in the Turkish Adult Population

Objectives:To establish the normal range of the conus medullaris (CM) in large Turkish adult population and to correlate this position with body mass index and sex.Methods:T2-weighted midline, sagittal and axial spin echo magnetic resonance imaging studies of 1236 patients were assessed to identify

The Turkish Version of the Meaning in Life Questionnaire: Assessing the Measurement Invariance Across Turkish and American Adult Samples

The purpose of this study was to adapt the Meaning in Life Questionnaire (MLQ) developed by Steger, Frazier, Oishi, and Kaler (2006) into Turkish and examine the measurement and structural invariance of this scale across Turkish (N = 815) and U.S. (N = 207) samples. Our findings indicated that the hypothesized 2-factor model of the MLQ fit the data well for both Turkish and U.S. samples. Results also provided support for the full metric invariance, partial scalar invariance, and partial invariance of residual variances of the MLQ across the 2 samples (i.e., Turkish and U.S.). Supporting the structural invariance, we found that factor variances and covariances were equivalent across the 2 groups. Internal consistency reliability analyses revealed a Cronbach's alpha value of .88 for the MLQ Presence scale and .90 for the Search scale. Our findings also provided preliminary support for the convergent validity of the Turkish version of the MLQ (MLQ–TR). Contrary to findings in other collectivist cultures, the relationship between Search and Presence was negative in Turkish culture. These results support the psychometric properties of the MLQ–TR and its partial equivalence to the original U.S. version.

Waist Circumference Cutoff Points to Predict Obesity, Metabolic Syndrome, and Cardiovascular Risk in Turkish Adults

Objective. The waist circumference (WC) cutoff levels defined for the Caucasian people may not be representative for different ethnic groups. We determined sex specific WC cutoff points to predict obesity, metabolic syndrome, and cardiovascular risk in Turkish adults. Design and Methods. The demographic characteristics of 1898 adult males and 2308 nonpregnant females from 24 provinces of 7 different regions of Turkey (mean age 47 ± 14 yrs) were evaluated. Results. The WC levels of 90 cm and 100 cm define overweight and obese males while the levels of 80 cm and 90 cm define overweight and obese females. With these cutoff values, 239 additional males (12.6%) are diagnosed as overweight and 148 additional males (7.8%) as obese. Instead, 120 females (5.1%) are free of being labeled as obese. Conclusions. This is the first nationwide study to show the action levels of WC for overweight and obese Turkish adults. The ideal cutoff levels of WC to predict metabolic syndrome are 90 cm and 80 cm for Turkish adult men and women, respectively. These values are easy to implement and suggested to be used by the physicians dealing with cardiometabolic disorders in Turkey.

Turkish Adult Risk Factor Study survey 2012: overall and coronary mortality and trends in the prevalence of metabolic syndrome

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 prevalence of metabolic syndrome (MetS) and its distribution across seven geographic regions. 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. 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 Southeast Anatolia, while the prevalence declined in the Marmara region and persisted to be lowest in the Aegean region. 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.

Coronary Disease Risk Curve of Serum Creatinine Is Linear in Turkish Men, U-Shaped in Women

ObjectivesThe highest levels of glomerular filtration rate are associated with increased coronary heart disease (CHD) risk, an issue we investigated in separate sexes in a population prone to metabolic syndrome.Research...

TARF Survey 2011: mortality and performance in the long-term follow-up

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. 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. 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. 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.

Apparent Sex-Specific Divergence of Acylation Stimulating Protein Levels With Respect to Metabolic Parameters of Pathogenetic and Clinical Relevance

Background: Acylation stimulating protein (ASP) is an adipose tissue-derived hormone that regulates triglyceride (TG) synthesis and glucose transport. Associations of ASP and / or its precursor complement C3 have been demonstrated with obesity, insulin resistance, diabetes, and cardiovascular diseases. We determined fasting serum ASP in a Turkish adult population sample and assessed relationships with cardiometabolic risk factors. Methods: Cross-sectional population-based study recruiting 224 men and women from the Turkish Adult Risk Factor (TARF) study. Results: Geometric Mean ASP levels (median) in women (271 nmol / L) tended to be lower than men (305 nmol / L) (P = 0.059), and this was also true in most subgroups with vs . without cardiometabolic disorders. Interestingly, correlations of ASP diverged in direction across genders with TG, glucose, height, age and other risk variables. Conclusion: Gender divergence is an aspect of this Turkish population that has been noted for various lipid parameters (HDL, Lp(a)), association of cardiometabolic risk with smoking and alcohol intake and the response of the pro-inflammatory state to adiposity. This is consistent in the present study, where metabolic states correlate with ASP, but are divergent between genders. doi:10.4021/jem58w

Apparent Sex-Specific Divergence of Acylation Stimulating Protein Levels With Respect to Metabolic Parameters of Pathogenetic and Clinical Relevance

Background: Acylation stimulating protein (ASP) is an adipose tissue-derived hormone that regulates triglyceride (TG) synthesis and glucose transport. Associations of ASP and / or its precursor complement C3 have been demonstrated with obesity, insulin resistance, diabetes, and cardiovascular diseases. We determined fasting serum ASP in a Turkish adult population sample and assessed relationships with cardiometabolic risk factors. Methods: Cross-sectional population-based study recruiting 224 men and women from the Turkish Adult Risk Factor (TARF) study. Results: Geometric Mean ASP levels (median) in women (271 nmol / L) tended to be lower than men (305 nmol / L) (P = 0.059), and this was also true in most subgroups with vs . without cardiometabolic disorders. Interestingly, correlations of ASP diverged in direction across genders with TG, glucose, height, age and other risk variables. Conclusion: Gender divergence is an aspect of this Turkish population that has been noted for various lipid parameters (HDL, Lp(a)), association of cardiometabolic risk with smoking and alcohol intake and the response of the pro-inflammatory state to adiposity. This is consistent in the present study, where metabolic states correlate with ASP, but are divergent between genders. J Endocrinol Metab. 2012;2(1):1-10 doi: https://doi.org/10.4021/jem58w

Regional distribution of all-cause mortality and coronary disease incidence in Turkey: findings of Turkish Adult Risk Factor survey 2010

We analyzed the distribution of cumulative all-cause and cardiovascular mortality and incident coronary heart disease (CHD) across the seven geographic regions of Turkey and presented overall and coronary mortality findings of the 2010 survey of the Turkish Adult Risk Factor Study. A total of 1406 participants were surveyed. Information on the mode of death was obtained from first-degree relatives and/or health personnel of local heath offices. Information on survivors was obtained from history, physical examination, and 12-lead electrocardiography. Of the surveyed participants, 686 were examined; information on health status was obtained in 577 subjects, and 32 participants (14 women, 18 men; mean age 72.3±15.6 years) were ascertained to have died. The total duration of follow-up was 2,520 person-years. Nineteen deaths were of coronary (n=16) or cerebrovascular (n=3) origin. Cumulative 20-year assessment of the entire cohort for the age bracket of 45-74 years disclosed a high coronary mortality rate, being 7.4 and 4.1 per 1000 person-years in men and women, respectively, and representing a limited decline after year 2000. Age-adjusted Cox regression analysis comprising 433 deaths and 506 incident CHD cases over a 7.3-year follow-up showed similar mortality rates across the regions, and a significantly high CHD incidence in males of the Black Sea and Marmara regions and in females of the Southeast Anatolia. Currently, 480,000 incident CHD cases are estimated yearly in Turkey. The high age-adjusted overall mortality in Turkey shows nonsignificant differences across geographic regions, whereas the age-adjusted CHD incidence is high in the Black Sea and Marmara regions.

Prevalence of Metabolic Syndrome in Patients with Rheumatoid Arthritis

It was stated that the control group enrolled in the study contained subjects who did not have inflammatory bowel disease. This is a poor description that fails to reflect the characteristics of the control group and doesn’t clarify whether this population has other diseases or not. The authors have reported the prevalence of metabolic syndrome to be 16% in the control group with an average age of 49.8 years and gender distribution of 85.1% women. However, these findings do not match the data obtained from two large-scale epidemiological studies conducted in our country. The prevalence of metabolic syndrome among adult patients has been reported in two studies and the results are 37.1% in the TEKHARF study (Turkish Adult Risk Factor Survey) (in male patients 31.2%, in female patients 42.8%)[2] and 33.9% in the METSAR study (Metabolic Syndrome Prevalence Survey in Turkey) (in male patients 28%, in female patients 39.6%). The prevalence of metabolic syndrome is known to increase with age and to be higher in women.[3] Consequently, it is obvious that the evaluation of the study should be radically changed to reflect that the prevalence of metabolic syndrome in patients with rheumatoid arthritis is much lower than that of the overall population! In the article, a correlation was reported between the use of corticosteroids and fasting blood glucose level, but it wasn’t clarified whether or not there was a difference between corticosteroid use and triglycerides. Increased blood glucose is among the metabolic effects of corticosteroids while the most important dyslipidemic effect of corticosteroids is the heightened level of triglycerides.[4,5] It is possible to attribute the increased level of triglycerides to steroids used by 54.9% of the patients. Therefore, we believe that comparing a group of patients using corticosteroids to healthy individuals who do not use corticosteroids and attributing the findings like high levels of triglyceride and blood pressure (which are well-known side effects of steroids) to the disease or the degree of activity of the disease can be misleading.

The APOE −219G/T and +113G/C polymorphisms affect insulin resistance among Turks

The −219G/T (rs405509) and +113G/C (rs440446) polymorphisms within the regulatory region of the apolipoprotein E ( APOE) gene have been related to the transcriptional activity of the gene. We examined the effect of the stated polymorphisms and their construct haplotypes with the APOE ɛ2/ ɛ3/ ɛ4 polymorphism on lipid levels and insulin resistance in the Turkish Adult Risk Factor Study. Randomly selected 1774 adults (mean age, 55.0 ± 11.7 years; 51.2% women) participating in the population-based Turkish Adult Risk Factor Study were cross-sectionally analyzed for the −219G/T, +113G/C, and ɛ2/ ɛ3/ ɛ4 polymorphisms as well as their haplotypes. Insulin resistance was defined as the 70th percentile in the sample (>2.51) of the homeostatic model assessment (HOMA). The frequencies of the −219T and +113C alleles were 0.477 and 0.423, respectively; and those of haplotype 1 (GG ɛ3) and haplotype 2 (TC ɛ3) were 44.1% and 41.9%, respectively. The −219G/T and +113G/C genotypes (both P < .04) and diplotypes of haplotype 2 (TC ɛ3) ( P < .014) were inversely related to serum fasting insulin and the HOMA index, even after controlling for 8 relevant covariates, but not to serum lipids. Within the APOE3 group, haplotype 2 (TC−/TC+) heterozygotes had an odds ratio of 0.66 (95% confidence interval, 0.42-0.99) for HOMA of insulin resistance after adjusting for 8 covariates. APOE promoter polymorphisms and their diplotypes are independently related with serum fasting insulin levels and HOMA index among Turks.

Association of C-reactive protein (CRP) gene allelic variants with serum CRP levels and hypertension in Turkish adults

Objective Serum C-reactive protein (CRP) is an independent risk factor for cardiovascular disease and metabolic syndrome (MetS). The aim of this study was to analyze the CRP gene allelic variations in the Turkish adult risk factor (TARF) study and relate them with serum CRP levels as well as MetS and its components. Methods We analyzed CRP gene polymorphisms (−286C > T > A [rs3091244], +1444C > T [rs1130864], +1059G > C [rs1800947], and +1846G > A [rs1205]) as well as their haplotypes, in addition to measuring CRP levels ( n = 1138) and collecting risk factor data from 1987 adults (mean age 54.3 ± 11.9 years, 51.3% women) participating in the TARF Study. MetS was defined by using the criteria of the National Cholesterol Education Program modified for pre-diabetes and in men for abdominal obesity. Results After adjustment for the major cardiovascular risk factors, four CRP SNPs (−286C > T > A, +1059G > C, +1444C > T, and +1846G > A) were significantly associated with serum CRP levels in women ( p < 0.05), whereas the −286C > T > A and +1444C > T polymorphisms were associated with CRP levels in men ( p < 0.05). The haplotype analyses revealed four common CRP haplotypes. The haplotype 1 (CGCA) in women and the haplotype 3 (TGTG) in men were associated with serum CRP levels and hypertension ( p < 0.05). However, no haplotype association was observed for MetS or its components. Conclusion CRP gene allelic variation is associated with serum CRP levels as well as hypertension in Turkish adults.

Comparison Between Turkish Cardiovascular Risk Platform and United States National Cholesterol Education Program Adult Treatment Panel III Definitions of the Metabolic Syndrome in Turkish Adults

The Turkish Cardiovascular Risk Platform (TCRP) calls for the diagnosis of the metabolic syndrome (MS) if insulin resistance, impaired fasting glucose, impaired glucose tolerance, or diabetes mellitus and >or=2 other established criteria are present. TCRP defines insulin resistance as a homeostasis model assessment >2.7. The aim of this cross-sectional study was to compare TCRP guidelines with the United States National Cholesterol Education Program Adult Treatment Panel III (NCEP) definition of MS in Turkish adults (N=1690). The age- and sex-adjusted prevalence of MS was 25% with the TCRP and 40% for the NCEP definition. Patients with MS identified by the NCEP definition but not by the TCRP definition had lower body mass index and less insulin resistance, but had a similarly adverse cardiovascular risk factor profile to those with TCRP-identified MS, with high blood pressure, waist circumference, triglycerides, and total cholesterol/high-density lipoprotein cholesterol ratio. Other national health organizations should avoid using homeostasis model assessment as a prerequisite for diagnosing MS. Modification of the NCEP definition would be more appropriate for ethnic groups with different body sizes.

Exophthalmometry Values of Turkish Adult Population and the Effect of Age, Sex, Refractive Status, and Hertel Base Values on Hertel Readings

To establish normal exophthalmometry values in the adult Turkish population, and the impact of age, gender, interpupillary distance, Hertel base selection, and refractive status on globe position. Exophthalmometry measurements and refractive status of 2477 subjects were conducted in one tertiary and five primary health care centers. Change of globe position by age, intersex differences in terms of globe position, correlations of Hertel base with exophthalmometry results, and interpupillary distance (IPD) were evaluated. Multiple linear regression analysis was performed to test determination effect of each variable on final Hertel reading. Median Hertel reading was 13 mm, and 95% of the population had an upper limit of 17 mm for both eyes. There was a negative correlation between spherical equivalent of refractive status and exophthalmometry results and a weak positive correlation between IPD and exophthalmometry result. Mean Hertel value was found to decrease significantly after the third decade. Hertel base value was found to have moderate linear correlation with Hertel results. A weak correlation was detected with Hertel base/IPD ratio with final Hertel results. Multiple linear regression analysis was performed and only 13% and 20% of change in Hertel values bilaterally were found to be determined by other variables (age, IPD, refractive status, and Hertel base value) for females and males. Normative dataset for exophthalmometry results of the Turkish population is established to be used in clinical practice and research. Only 13% to 20% of change in Hertel values was detected to be determined by age, IPD and Hertel base values.

Gender-modulated impact of apolipoprotein A5 gene (APOA5) −1131T&gt;C and c.56C&gt;G polymorphisms on lipids, dyslipidemia and metabolic syndrome in Turkish adults

Apolipoprotein A5 (APOA5) gene polymorphisms are usually associated with plasma triglyceride levels. We evaluated the relationship of the APOA5 -1131T>C and c.56C>G polymorphisms [single nucleotide polymorphism (SNP)] with serum lipids, dyslipidemia [low high-density lipoprotein (HDL)/high triglyceride] and the risk for metabolic syndrome (MS) in the Turkish Adult Risk Factor study. We genotyped SNPs using the Taqman allelic discrimination assays in 1564 Turkish adults (51.4% female, mean age 54.1+/-11.6 years). MS and dyslipidemia were defined using the criteria of the National Cholesterol Education Program. For both SNPs, rare allele carriers had significantly higher fasting triglyceride levels in both genders, except the c.56G allele in men. The -1131C allele was associated with lower HDL cholesterol (HDL-C) levels in women. In relation to dyslipidemia, the c.56C>G and haplotype 1 had significant gender-genotype interactions (p<0.05). Otherwise, both SNPs were significantly associated with dyslipidemia after adjustment for risk factors in women. After similar adjustment, non-carriers of the haplotype 1 (odds ratio=4.1, p=0.003) increased the MS risk in women. However, no significant associations emerged between SNPs and HDL-C, dyslipidemia or MS in a similar analysis in men. Excess risk for low HDL-C, dyslipidemia and MS is associated with the rare alleles of the APOA5 SNPs and non-carriers of common haplotype in women.

Low levels of high density lipoprotein cholesterol in Turkish children: an important risk factor.

In Turkish adults, the incidence of coronary artery disease (CAD) has been found to be high. However, no detailed lipid, or lipoprotein data of children are available from Turkey. The present study was designed to define the borderline lipid and lipoprotein levels of sera in 397 healthy children (aged 5-14 years; 206 boys and 191 girls). Mean levels of total cholesterol (TC), triglyceride (TG), high- and low-density lipoprotein cholesterol (HDL-C and LDL-C, respectively) were found to be 150, 79, 46.7, and 87.6 mg/dL, respectively, for boys, and 152, 77.5, 46.3 and 90.5 mg/dL, respectively, for girls. Lipids and lipoproteins did not show any significant correlation with age and body mass index (BMI), except for TG in boys in whom TG levels were positively correlated with age and BMI. There were no significant differences in lipid and lipoprotein levels between boys and girls. As in the Turkish adult population, serum HDL-C levels of Turkish children were profoundly low on international comparison. Twenty-three (53%) of 43 children with low HDL-C level (< or = 35 mg/dL) had abnormal ratios of TC/HDL-C (> or = 5) and/or LDL-C/HDL-C (> or = 4.5), whereas only 13 (3.7%) of the remaining 354 children with a HDL-C level less than 35 mg/dL had abnormal ratios of TC/HDL-C (> or = 5) and/or LDL-C/HDL-C (> or = 4.5). The low levels of HDL-C in Turkish children may be associated with the high incidence of CAD in the Turkish adult population.

The S447X variant of lipoprotein lipase gene is associated with metabolic syndrome and lipid levels among Turks

BackgroundWe evaluated the relationship of the lipoprotein lipase (LPL) S447X variant with serum lipid levels and the metabolic syndrome (MS) in the Turkish Adult Risk Factor (TARF) study. This is the first study examining this LPL variant in the Turkish population. MethodsThe sample comprised 1586 Turkish adults. Genotyping was performed using the Taqman allelic discrimination assay. ResultsThe X447 allele frequency was 0.11 (95% CI: 0.10–0.12). X447 allele carriers had significantly higher levels of HDL-C, LDL-C and total cholesterol; and lower fasting glucose, when compared with the SS genotype in females. In men, no significant association with any parameters was seen. The genotypic impact of the S447X variant on lipid levels appears to be modulated by environmental factors, such as cigarette smoking in women. Logistic regression analysis demonstrated a significantly reduced likelihood for metabolic syndrome in female X447 allele carriers (p=0.04), after adjustment for age, cigarette smoking, alcohol usage and physical activity grade. ConclusionsIn especially Turkish women, compared to non-carriers, carriers of the LPL X447 allele have higher levels of HDL-C, LDL-C and total cholesterol, and show a degree of protection against developing the metabolic syndrome.

Prevalence Study of Signs and Symptoms of Temporomandibular Disorders in a Turkish Population

The aim of this study was to evaluate the prevalence of signs and symptoms of temporomandibular disorders (TMD) in a population of 792 Turkish adults ranging in age from 15- to 72-years-old. Subjects were examined objectively and subjectively for signs and symptoms of TMD through the distribution of frequency of the data obtained from a questionnaire and a physical examination using a similar methodology of previous studies. This study determined the prevalence of signs and symptoms of TMDs in subjects from male and female subgroups in a Turkish adult population. Both signs and symptoms of TMDs were generally more prevalent in females than in males. The prevalence of signs and symptoms were generally greater than in previous studies of other populations.