Vücut yağ ölçütleri, dislipidemi, kan basıncı ve sigaranın etkisi açılarından Türk ve Alman erkek ve kadınlarının karşılaştırılması

Amaç: Alman ve Türk erişkinlerine ait birer kohortta obezite ölçütlerindeki farkları ve bunlarınilişkilerini araştırmak.Yöntem ve Gereç: Otuz ila 79 yaşlarındaki erkek ve kadınlar kesitsel biçimde incelendi.Karşılaştırmalarda yaş ayarlaması uygulandı.Bulgular: Alman kohortu 3055, Türk kohortu 2925 kişiden ibaretti. Türk kadınları, Almankadınlarına kıyasla anlamlı biçimde daha yüksek (abdominal) obezite ölçütlerine sahipken, belçevresi erkeklerde benzerdi. Kan basıncı (KB), total ve LDL-kolesterol ile apolipoprotein Bkonsatrasyonları Almanlarda anlamlı olarak daha yüksek iken, Türklerde açlık gliseridleri dahayüksek ve HD-kolesterol daha düşüktü. Almanlardan faklı olarak, Türk sigara içicilerindeiçmeyenlere kıyasla bel çevresi 3 cm, sistolik KB 4 mmHg daha düşüktü. Bel ve kalça çevrelerindekideğişiklikler Türklerde değil, ama Almanlarda beden kitle indeksinden bağımsız olarak LDLkolesterol yüksekliği ile ilişkiliydi. Sistolik KB’nin ana belirleyicileri olarak, cinsiyet farkına ilaveten,Almanlar ve Türk kadınlarında genel obezite fazlalığı, Türk erkeklerinde ise abdominal obezitebulundu. Aterojen dislipidemi Türk kadınlarında, Almanlar ve Türk erkeklerinden farklı olarak,anlamlı biçimde daha yüksek sistolik KB ile ilişkiliydi.Sonuç: Türk ve Alman yetişkinlerinde yağ dağılımı ve bunun ilişkileri, patogenetik farklılıklarıyansıtan önemli ayrımları sergilemektedir. Bunlar koruyucu önlem ve tedavide vurgu faklılıklarıgerektirebilir

Anahtar Kelimeler:

Dislipidemi, etnisite kan basıncı, metabolic sendrom, obezite, sigara içiciliği

Body fat, dyslipidemia, blood pressure and the effects of smoking in Germans and Turks

Aim: Determining the difference regarding obesity in German and Turkish adults. Materials and Methods: This study examined a cross-section of adults aged 30-79 years old. Age-adjustment was uniformly provided for comparisons. Results: Among 3055 Germans and 2925 Turks, Turkish women had significantly higher markers of (abdominal) obesity than German women, while waist circumference (WC) was similar among males. Blood pressure (BP), concentrations of total, LDL-cholesterol, and apolipoprotein B were significantly higher among Germans, whereas Turks had markedly higher fasting triglycerides and lower HDL-cholesterol. Unlike Germans, the current trend of smoking among Turks correlates with lower WC and lower systolic BP compared to non-smokers. Hip circumference was associated positively with atherogenic dyslipidemia more strongly among Germans than Turks. Changes in circumferences of waist and hip were significantly associated with elevated LDL-cholesterol, independent of BMI, in Germans, but not among Turks. Excess of overall obesity in Germans and Turkish females, and abdominal obesity among Turkish men, in addition to different sex, appeared to be major determinants of SBP. In contrast to Germans and Turkish males, atherogenic dyslipidemia was significantly associated with higher SBP in Turkish females. Conclusions: Distribution of adiposity, and its interrelationship in German and Turkish adults, reveals substantial disparity that reflects pathogenetic differences; this requires modified emphasis of preventive and therapeutic measures.

Keywords:

Blood pressure dyslipidemia, ethnicity, metabolic syndrome, obesity, smoking habit,

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Obesity. Preventing and managing the global epidemic: Report of a WHO consultation. World Health Organ Tech Rep Ser 2000; 894: i-xii, 1-253.
Onat A, Ceyhan K, Başar Ö, Erer B, Toprak S, Sansoy V. Metabolic syndrome: major impact on coronary risk in a population with low cholesterol levels – a prospective and cross- sectional evaluation. Atherosclerosis 2002; 165: 285-92.
HDL-cholesterol levels in Turkish and German individuals.
Onat A, Avcı GŞ, Şenocak M, Örnek E, Gözükara Y. Plasma lipids and their interrelation in Turkish adults. J Epidem Commun Health 1992; 46: 470-476.
World Health Organisation. Measuring obesity – classification and description of anthropometric data. Report on a WHO consultation on the epidemiology of obesity. Copenhagen: WHO Regional Office for Europe, 1987; [EUR/ICP/NUT 125, 0612v].
Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on detection, evaluation and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA 2001; 285: 2486- 2497.
Onat A, Avcı GŞ, Barlan MM, Uyarel H, Uzunlar B, Sansoy V. Measures of abdominal obesity assessed for visceral adiposity and relation to coronary risk. Int J Obes 2004; 28: 1018-25.
Han TS, Seidell JC, Currall JE, Morrison CE, Deurenberg P, Lean ME. The influences of height and age on waist circumference as an index of adiposity in adults. Int J Obes 1997; 21: 83-9.
Hsieh SD, Yoshinaga H. Abdominal fat distribution and coronary heart disease risk factors in men – waist-height ratio as a simple and useful predictor. Int J Obes 1995; 19: 585-9.
Panagiotakos DB, Pitsavos C, Yannakoulia M, Chrysohoou C, Stefanadis C. The implication of obesity and central fat on markers of chronic inflammation: the ATTICA study. Atherosclerosis 2005; 187: 308-15.
Teran-Garcia M, Després J-P, Couillard C, Tremblay A, Bouchard C. Effects of long-term overfeeding on plasma lipoprotein levels in identical twins. Atherosclerosis 2004; 173: 277-83.
Mahley RW, Palaoğlu E, Atak Z, Dawson-Pepin J, Langlois AM, Cheung V et al. Turkish Heart Study: lipids, lipoproteins, and apolipoproteins. J Lipid Res 1995; 36: 839-859.
Hodoglugil U, Tanyolac S, Williamson DW, Huang Y, Mahley RW. Apolipoprotein A-V: a potential modulator of plasma triglyceride levels in Turks. J Lipid Res. 2006; 47: 144-53.
Onat A, Ayhan E, Hergenç G, Can G, Barlan MM. Smoking inhibits visceral fat accumulation in Turkish females: Relation of visceral fat and body fat mass to atherogenic dyslipidemia, inflammatory markers, insulin resistance and blood pressure. Metabolism 2009; 58: 963-70.
Onat A, Hergenç G. Reduced asymmetric dimethylarginine (ADMA) levels mediate in the protection from metabolic syndrome by smoking. (Letter) Atherosclerosis 2008; 196: 479- 80.
Onat A, Can G, Hergenç G. Serum C-reactive protein is an independent risk factor predicting cardiometabolic risk. Metabolism 2008; 57: 207-14.
Xu F, Yin XM, Wang Y. The association between amounts of cigarettes smoked and overweight, central obesity among Chinese adults in Nanjing, China. Asia Pac J Clin Nutr 2007; 16: 240-7. Pisinger C, Jorgensen T. Waist circumference and weight following smoking cessation in a general population: the Inter99 study. Prev Med 2007; 44: 290-5.
Clouse WD, Yamaguchi H, Phillips MR, Hurt RD, Fitzpatrick LA, Moyer TP et al. Effects of transdermal nicotine treatment on structure and function of coronary artery bypass grafts. J Appl Physiol 2000; 89: 1213-23.
Seidell JC, Perusse L, Després JP, Bouchard C. Waist and hip circumferences have independent and opposite effects on cardiovascular disease risk factors: the Quebec Family Study. Am J Clin Nutr 2001; 74: 315-21.
Canoy D, Wareham N, Luben R, Welch A, Bingham S, Day N et al.. Serum lipid concentration in relation to anthropometric indices of central and peripheral fat distribution in 20,021 British men and women: Results from the EPIC-Norfolk population-based cohort study. Atherosclerosis 2006; 189: 420- 7.