ISSN: 1305-385X
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Abdominal Obesity,ınsulin Resistance And Dyslipidemia ın Turkish Men And Women
Dr. Altan ONATa
aİ.Ü. Cerrahpaşa Tıp Fakültesi Emekli Öğretim Üyesi, İSTANBUL
In this review focusing on dyslipidemia of the insulin resistance (IR) type in Turkish adults, the prevalence and features of abdominal obesity and IR and their effects on dyslipidemia have been summarized, based on data of the Turkish Adult Risk Factor Study. As cutpoints for abdominal obesity, it was proposed to adopt a waist circumference of ≥95 cm in men, ≥ 91 cm in women. At a given waist circumference in men, the lower the body mass index, the more likely is the association of a greater visceral adipose tissue area. Independent association exists between visceral adipose tissue area and apolipoprotein B and (inversely) HDL-cholesterol in men, and with HDL-cholesterol in women. In Turkish adults with normal glucose regulation, 2 and 1 of every 10 adults harbor the metabolic syndrome (MS) alone, or IR alone, respectively. Atherogenic dyslipidemia in this population is less affected by IR, as contrasted by aspects of visceral adiposity unrelated to IR. In diabetic men serum triglycerides are significantly, but only moderately elevated, and HDL-cholesterol levels are not diminished. In centrally obese women with diabetes, the prevalence of hypercholesterolemia is 1.5-fold as in men. Hypertriglyceridemia in Turkish men is a significant predictor of cardiovascular risk (at a relative risk 2.28), independent of traditional risk factors including HDL-cholesterol concentrations. HDL-cholesterol levels were found to decline in current smokers by a mean 3 mg/dl, independent of multiple confounders. Dyslipidemic hypertension, estimated to prevail in over 5 million Turkish adults, confers a 1.5-fold greater coronary risk than the remaining simple hypertensives, and confers alone half of all the population-attributable risk imparted by MS. To conclude, central obesity and IR which together represent among Turks the lion’s share for cardiovascular risk, lead tightly to atherogenic dyslipidemia.Keywords: Abdominal obesity, atherogenic dyslipidemia, cardiovascular disease risk, HDL-cholesterol, insulin resistance, Turkish adultsTurkiye Klinikleri J Int Med Sci 2006, 2(7):30-38
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