Dynamics in Cardiometabolic Risk among Turkish Adults: Similarities to that in Iranians?

Altan Onat



Based on observations of 20 years of follow-up of the Turkish Adult Risk Factor (TARF) study, this review summarizes the distribution of risk factors among Turks which is dominated by components of the metabolic syndrome (MetS), especially by abdominal obesity and atherogenic dyslipidemia. The adoption of a 95 cm cutoff for male abdominal obesity was crucial in the understanding of factors for cardiometabolic risk. The prevalence of MetS, type-2 diabetes and coronary heart disease (CHD) are high, alike in Iranians. The TARF study demonstrated that systemic low-grade inflammation and oxidative stress are a major determinant of cardiometabolic risk in the population at large, and involves the female sex to a greater extent than the male. As a result of this, impaired anti-inflammatory and atheroprotective function developed in large segments of middle-aged and elderly obese individuals emerging as dysfunction of apolipoprotein A-I and HDL particles. This dysfunction is currently a major driver cardiometabolic risk in Turkish adults leading to substantial excess diabetes and CHD. Separate algorithms for diabetes and CHD were derived that improved the risk prediction of these diseases.

The author strongly suspects that such dynamics in the development of diabetes and CHD exist in Western adults prone to impaired glucose tolerance, and evidence is accumulating also regarding general Iranian adults. These issues posing a vast threat on public cardiometabolic health will have to be recognized with the purpose of not delaying implementation of measures for the improvement in cardiometabolic risk, especially in women.

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