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    The Prevalence of Insulin Resistance in the Turkish Population: A Study Conducted with 3331 Participants
    (Kare Publ, 2017) Kaya, Ahmet; Turan, Elif; Uyar, Mehmet; Bayram, Fahri; Turan, Yasar
    Objectives: The aim of this study was to apply the homeostasis model assessment of insulin resistance (HOMA-IR) and examine the relationships between age, sex, and body mass index (BMI) and the prevalence of diabetes mellitus (DM) and insulin resistance (IR) in the Turkish population of different regions of the country. Methods: This was a cross-sectional, observational study designed in the framework of a multicenter study to analyze the Turkish prevalence of insulin resistance. The study sample consisted of volunteers from the 7 different regions of Turkey. Weight, height, and waist circumference were measured. BMI, blood pressure, fasting blood glucose, and fasting blood insulin levels were calculated. IR was determined using the HOMA-IR. Results: The prevalence of DM, impaired fasting glucose, and IR was 11.1%, 21.3%, and 26.2%, respectively, in all 7 regions of Turkey. IR was detected in 28.9% of women and 25.1% of men.The difference between men and women was significant (p=0.04). The prevalence of IR in postmenopausal women (30.8%) was higher than premenopausal women (25.1%) (p<0.04). A comparison of age groups revealed that the prevalence of IR among those aged 50 to 59 (33.8%; p<0.001) was higher than in the other age groups. IR was also more prevalent in those with a BMI >25 kg/m2, those with hypertension, and those living in city centers (p<0.05). Conclusion:The high prevalence of IR and DM in Turkey is an important public health problem. This study provides a large-sample representative study of the Turkish population. The prevalence of IR was highly correlated with central obesity, hypertension, and a more sedentary lifestyle, such as is often seen in city centers. There is an urgent need to institute more aggressive, nationwide public health measures and screening programs regarding obesity.
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    The Prevalence of Insulin Resistance in the Turkish Population: A Study Conducted with 3331 Participants
    (Kare Publ, 2017) Kaya, Ahmet; Turan, Elif; Uyar, Mehmet; Bayram, Fahri; Turan, Yasar
    Objectives: The aim of this study was to apply the homeostasis model assessment of insulin resistance (HOMA-IR) and examine the relationships between age, sex, and body mass index (BMI) and the prevalence of diabetes mellitus (DM) and insulin resistance (IR) in the Turkish population of different regions of the country. Methods: This was a cross-sectional, observational study designed in the framework of a multicenter study to analyze the Turkish prevalence of insulin resistance. The study sample consisted of volunteers from the 7 different regions of Turkey. Weight, height, and waist circumference were measured. BMI, blood pressure, fasting blood glucose, and fasting blood insulin levels were calculated. IR was determined using the HOMA-IR. Results: The prevalence of DM, impaired fasting glucose, and IR was 11.1%, 21.3%, and 26.2%, respectively, in all 7 regions of Turkey. IR was detected in 28.9% of women and 25.1% of men.The difference between men and women was significant (p=0.04). The prevalence of IR in postmenopausal women (30.8%) was higher than premenopausal women (25.1%) (p<0.04). A comparison of age groups revealed that the prevalence of IR among those aged 50 to 59 (33.8%; p<0.001) was higher than in the other age groups. IR was also more prevalent in those with a BMI >25 kg/m2, those with hypertension, and those living in city centers (p<0.05). Conclusion:The high prevalence of IR and DM in Turkey is an important public health problem. This study provides a large-sample representative study of the Turkish population. The prevalence of IR was highly correlated with central obesity, hypertension, and a more sedentary lifestyle, such as is often seen in city centers. There is an urgent need to institute more aggressive, nationwide public health measures and screening programs regarding obesity.
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    Turkish nationwide survEy of glycemic and other Metabolic parameters of patients with Diabetes mellitus (TEMD study)
    (Elsevier Ireland Ltd, 2018) Sonmez, Alper; Haymana, Cem; Bayram, Fahri; Salman, Serpil; Dizdar, Oguzhan Sitki; Gurkan, Eren; Carlioglu, Ayse Kargili
    Aims: Turkey has the highest prevalence of diabetes in Europe. It is therefore essential to know the overall cardiovascular risk and reveal the predictors of metabolic control in Turkish adults with diabetes mellitus. Methods: A nationwide, multicenter survey consecutively enrolled patients who were under follow up for at least a year. Optimal control was defined as HbA1c <7%, home arterial blood pressure (ABP) <135/85 mmHg, or LDL-C <100 mg/dL. Achieving all parameters indicated triple metabolic control. Results: HbA1c levels of patients (n = 5211) were 8.6 +/- 1.9% (71 +/- 22 mmol/mol) and 7.7 +/- 1.7% (61 +/- 19 mmol/mol), in Type 1 and Type 2 diabetes, respectively. Glycemic control was achieved in 15.3% and 40.2%, and triple metabolic control was achieved in 5.5% and 10.1%, respectively. Only 1.5% of patients met all the criteria of being non-obese, nonsmoker, exercising, and under triple metabolic control. Low education level was a significant predictor of poor glycemic control in both groups. Conclusions: Few patients with Type 2, and even fewer with Type 1 diabetes have optimal metabolic control in Turkey. TEMD study will provide evidence-based information to policy makers to focus more on the quality and sustainability of diabetes care in order to reduce the national burden of the disease. (C) 2018 Elsevier B.V. All rights reserved.
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    Waist Circumference Cutoff Points to Predict Obesity, Metabolic Syndrome, and Cardiovascular Risk in Turkish Adults
    (Hindawi Ltd, 2013) Sonmez, Alper; Bayram, Fahri; Barcin, Cem; Ozsan, Muge; Kaya, Ahmet; Gedik, Vedia
    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.