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Öğe Turkish adult risk factor survey 2013: Rapid rise in the prevalence of diabetes(2014) Onat, Altan; Çakır, Hakan; Karadeniz, Yusuf; Dönmez, İbrahim; Karagöz, AhmetObjectives: To analyze (1) the sex-specific and age-brack- et defined all-cause and coronary mortality in the 23-years’ follow-up of the Turkish Adult Risk Factor Study, and (2) to determine the nation-wide prevalence of Type-2 diabetes and its recent trend. Study design: Information on the mode of death was ob- tained from first-degree relatives and/or health personnel of local heath office. Information collected in survivors was based on history, physical examination of the cardiovascular system and Minnesota coding of resting electrocardiograms. Diabetes was defined by criteria of the American Diabetes As- sociation without the use of glycated hemoglobin. Results: Of the 1370 participants to be surveyed, 768 were examined, in 452 subjects information was gathered, and 29 men, 18 women were ascertained to have died. Cumulative assessment of the entire cohort in the age bracket 45-74 years disclosed coronary mortality to be 7.5/1000 person- years in men and 3.74 in women, persisting to be high among the European countries. The recent decline observed in over- all mortality seemed to halt as well. Of greatest concern was the finding in the past 12 years that the rate of rise in the age-controlled prevalence of Type-2 diabetes was as high as 5% annually. Conclusion: Overall and coronary mortality in Turkish adults continue to be high, while an elicited annual increase of 5% in the age-controlled prevalence of diabetes is virtually alarming and requires new public health policies.Öğe Type-2 diabetes and coronary heart disease: Common physiopathology, viewed from autoimmunity(Expert Reviews Ltd., 2014) Onat, Altan; Dönmez, İbrahim; Karadeniz, Yusuf; Çakir, Hakan; Kaya, AyşemTwo highly prevalent diseases, Type-2 diabetes mellitus and coronary heart disease (CHD), share risk factors. Excess levels of LDL-cholesterol have been overemphasized to uniformly encompass the development of CHD, and the origin of insulin resistance underlying Type-2 diabetes has not been fully elucidated. Autoimmune response has been recognized to be responsible only of a small minority of diabetes. The increasing trend in the worldwide prevalence of diabetes and the risk factors for both diseases are reviewed, the independent mediation for CHD of (central) adiposity in both diseases and the 'hypertriglyceridemic waist' phenotype are outlined. Evidence is described that serum lipoprotein (Lp)(a) concentrations, not only in excess, but also in apparently 'reduced' levels, as a result of autoimmune response, underlie both disorders and are closely related to insulin resistance. © 2014 Informa UK, Ltd.