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    The Risk Factor Survey of 2003 in Western Turkey Indicates Trend to Declining Coronary Mortality and Urban Overall Mortality
    (2003) Onat, Altan; Yazici, Mehmet; Sari, Ibrahim; Türkmen, Serdar; Uzunlar, Bülent; Uyarel, Hüseyin; Özmay, Mehmet
    With the aim of assessing, among others, the coronary morbidity and mortality in the past 27-month period, the last survey of the Turkish Adult Risk Factor Study was conducted in August, 2003 in the Marmara and Central Anatolian regions. Epidemiological methods applied were as previously described. In a total of 1560 individuals of the cohort, 1028 men and women were examined. Furthermore, information was obtained in 422 persons, and death was ascertained in 18 men and 13 women. Eleven new deaths of coronary origin were diagnosed at a follow-up over 2965 person-years. Estimated annual all-cause mortality amounted to 10.5 per mille, coronary mortality to 3.7 per mille. In the age-bracket 45-74 years, total mortality was 13.4 and coronary mortality 4. 2 per mille. A total of 28 cases of new fatal and nonfatal coronary heart disease (CHD) corresponded to an annual rate of 10.6 per mille. Furthermore, randomly selected 200 men and women aged 38 to 69 years from 11 communities were newly recruited in the survey's cohort for future follow-up. Though no evidence for a reduction existed in overall new CHD events, coronary and overall mortality tended to decline (to 5 and 12 per 1000 person-years, respectively) since year 2000; the decline in overall mortality appeared to take place in urban areas.
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    Serum total and high-density lipoprotein phospholipid levels in a population-based study and relationship to risk of metabolic syndrome and coronary disease
    (Sage Publications Inc, 2008) Hergenc, Gulay; Onat, Altan; Sari, Ibrahim; Yazici, Mehmet; Eryonucu, Beyhan; Can, Gunay
    The aim of study was to investigate the role of serum total (TPL) and high-density lipoprotein phospholipids (HDL-pl) as a risk factor in coronary heart disease (CHD) and metabolic syndrome (MS). In a random sample, total and HDL-pI were measured in 1088 and 642 adults from Turkey, respectively, who have a high prevalence of MS; this was done with an enzymatic method that measures total phosphatidylcholine, sphingomyelin, and lysophosphatidylcholine. Serum TPL and HDL-pl levels were significantly higher in women (TPL, 2.8 mmol/L; HDL-pl, 1.21 mmol/L) than in men. Strong correlations existed between serum TPL levels and non-HDL cholesterol (HDL-C), triglycerides, apolipoprotein (apo) B, complement C3, and gamma-glutamyltransferase. Non-HDL-C, HDL triglyceride, and apo A-I were strongly correlated with HDL-pl. Linear regression analyses revealed HDL-C, apo B, triglycerides, diabetes, and female gender as independent significant determinants of TPL levels in adults. HDL-C and impaired glucose regulation were sole significant variables, together contributing one-quarter of serum HDL-pl. Individuals with MS or diabetes had significantly higher TPL concentrations. The gender- and age-adjusted odds ratio (OR) of TPL for MS was 1.73 (95% confidence interval, 1.35-2.21), whereas the multiadjusted OR of HDL-pl per 1 SD increment corresponded to a significantly reduced independent MS likelihood by 26% in women (and 18% in the entire group). The multiadjusted OR of HDL-pl for CHD in men and women combined was 0.32 (P =.057) corresponding to a reduced CHD likelihood by 32% per I SD increment of HDL-pl. Plasma TPL levels point to an adverse relationship to MS, whereas their role in CHD risk needs further investigation. HDL-pls, in contrast, mark substantial protection from MS as well as from CHD.