Browsing by Author "Dogan, Yuksel"

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Diverging Sex-Specific Long-Term Effects of Cigarette Smoking on Fasting Insulin and Glucose Levels in Non-Diabetic People
(Pergamon-elsevier Science Ltd, 2012) Onat, Altan; Can, Gunay; Cicek, Gokhan; Dogan, Yuksel; Kaya, Hasan; Gumrukcuoglu, Hasan Ali; Yuksel, Husniye
Objectives: We determined in non-diabetic persons the associations of current smoking with future glucose and insulin concentrations. Design and methods: Middle-aged non-diabetic adults (n = 1071) were studied in whom these values were measured at baseline and 5.2-years later. Results: Age-adjusted fasting insulin concentrations in 137 smoking men remained lower than never smokers at both surveys. While age-adjusted fasting glucose values in male never smokers declined at follow-up (p = 0.037), they rose in male smokers. In 94 female smokers, age-adjusted fasting insulin values marginally declined, and fasting glucose was reduced (by 0.09 mmol/L., p = 0.055) during follow-up. In contrast in never-smoking women, insulin and glucose concentrations rose (p < 0.001 in both). Age-adjusted insulin levels in former smokers exhibited similar trends as never smokers. Trends were essentially unchanged when adjustment included body mass index. Current male smokers demonstrated evidence of reduced insulin sensitivity, female smokers of improved one, as assessed by QUICKI. Conclusion: Smoking among Turks induces at long-term lower fasting insulin levels which represent improved insulin sensitivity in women, yet a reduced one in men. (C) 2011 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.
Obstructive Sleep Apnea Syndrome Is Associated With Metabolic Syndrome Rather Than Insulin Resistance
(Springer Heidelberg, 2007) Onat, Altan; Hergenc, Gulay; Uyarel, Huseyin; Yazici, Mehmet; Tuncer, Mustafa; Dogan, Yuksel; Rasche, Kurt
The aim of this study was to investigate crosssectionally the prevalence and covariates of obstructive sleep apnea syndrome (OSAS) and its relationship to metabolic syndrome (MS), insulin resistance (IR), and coronary heart disease (CHD) in a population sample of 1,946 men and women representative of Turkish adults. OSAS was identified when habitual snoring and episodes of apnea were combined with another relevant symptom. MS was diagnosed based on modified criteria of the Adult Treatment Panel III and IR by homeostatic model assessment (HOMA). OSAS was identified in 61 men (6.4%) and 58 women (5.8%), at a similar prevalence, after adjusting for covariates. Among individuals with OSAS, significantly higher odds ratios (ORs), adjusted for age, body mass index (BMI), and waist girth, were observed for MS, hypertension, and prevalent CHD, but not for HOMA or menopause. Significantly higher C-reactive protein existed only in women with OSAS who were also more frequent smokers. In logistic regression models, waist circumference, but not BMI nor hypertension, was significantly associated with OSAS among men. In women, by contrast, current cigarette smoking and hypertension were the significant independent covariates. Regression models controlling for sex, age, and smoking revealed that MS (and not IR per se) was associated significantly with OSAS (OR 1.94) in nondiabetic individuals. To conclude, abdominal rather than overall obesity in men and smoking among women are significant independent determinants of OSAS in Turkish adults. OSAS is associated with MS rather than IR per se. Relatively high prevalence of OSAS is observed in Turkish women in whom it is significantly associated with CHD.
The Turkish Adult Risk Factor Survey 2009: Similar Cardiovascular Mortality in Rural and Urban Areas
(Turkish Soc Cardiology, 2010) Onat, Altan; Ugur, Murat; Cicek, Gokhan; Ayhan, Erkan; Dogan, Yuksel; Kaya, Hasan; Can, Gunay
Objectives: We analyzed the 2009 survey of the Turkish Adult Risk Factor (TARF) Study to assess the distribution of all-cause and cardiovascular mortality in urban and rural areas and gender-specific coronary mortality in the age-range of 45 to 74 years. Study Design: The Marmara and Central Anatolian regions have been surveyed every odd year in the TARF Study. In 2009, 1,655 participants were surveyed. Information on the mode of death was obtained from first-degree relatives and/or health personnel of local heath office; 960 participants underwent physical examination and ECG recording, and 572 subjects were evaluated on the basis of information obtained regarding health status. Results: In the survey, 23 men and 20 women were ascertained to have died. Twenty-one deaths were attributed to coronary disease and four deaths to cerebrovascular events. Assessment of the entire cohort in the age range of 45-74 years after a 19-year follow-up disclosed a high coronary mortality with 7.5 per 1000 person-years in men and 3.9 in women. In a Cox regression analysis comprising 405 deaths (235 cardiovascular) and over 24,000 person-year follow-up, age- adjusted cardiovascular mortality was similar in rural and urban participants. All- cause mortality was higher in females living in urban areas than those living in rural areas (HR 1.41; 95% CI 1.02-1.96). Conclusion: Cardiovascular mortality both in absolute terms and as a share of overall mortality persists to be high among Turkish adults, with similar rates in urban and rural areas. Age-adjusted all-cause mortality rate is higher among urban versus rural women.