Archives of the Turkish Society of Cardiology
Clustering of risk factors for abdominal obesity in Turkish adults and its demographic distribution [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2005; 33(4): 195-203

Clustering of risk factors for abdominal obesity in Turkish adults and its demographic distribution

Altan Onat1, Hüseyin Uyarel2, Ahmet Karabulut2, Sinan Albayrak3, Yüksel Doğan4, Günay Can5, Gülay Hergenç6, Vedat Sansoy77

We investigated the distribution of abdominal obesity among Turkish adults, according to age groups and geographic regions, and the prevalence and type of its clustering with traditional risk factors including high total and low HDL cholesterol levels, smoking, hypertension, and diabetes.
The study included a cohort of 3267 individuals (1607 men, 1660 women; mean age 52±12 years) whose waist circumferences were measured at least one time in the past three surveys of the Turkish Adult Risk Factor Study from 2000 to 2004. Cardiovascular disease was diagnosed on the basis of the presence of angina history, the Minnesota coding of resting electrocardiograms, and a history of stroke. Criteria of the NCEP ATP III guidelines proposed for metabolic syndrome were adopted for defining abdominal obesity and hypertension.
Out of every four adults aged 50 years or above, one man and three women had abdominal obesity. The prevalence of abdominal obesity did not exhibit marked changes among geographic regions. Coexistence of 3-5 risk factors in subjects with abdominal obesity showed a significantly higher proportion than other clusters of risk factors (p<0.001). All of the six risk factors studied exhibited significant and independent associations with abdominal obesity in women, whereas in men, only smoking, low HDL-C levels, and hypertension were independent factors. In contradistinction to men, there was an over three-fold adjusted likelihood of diabetes to accompany abdominal obesity in women, with hypercholesterolemia significantly clustering with both. While abdominal obesity conferred an increased likelihood of coronary heart disease through mediation of five risk factors in women, it was found as a residual independent component in men.
According to the NCEP ATP III criteria, abdominal obesity is three times more prevalent among Turkish women than in men. The female-specific combination of abdominal obesity, diabetes, and hypercholesterolemia may partly contribute to the comparatively high risk for cardiovascular disease in Turkish women. This study needs a re-evaluation of the role of abdominal obesity in Turkish men with a threshold of ?96 cm, which was previously proposed by the authors.

Keywords: Abdomen; coronary disease; diabetes mellitus; female; hypercholesterolemia; hypertension; lipoproteins, HDL cholesterol; obesity; risk factors

How to cite this article
Altan Onat, Hüseyin Uyarel, Ahmet Karabulut, Sinan Albayrak, Yüksel Doğan, Günay Can, Gülay Hergenç, Vedat Sansoy7. Clustering of risk factors for abdominal obesity in Turkish adults and its demographic distribution. Turk Kardiyol Dern Ars. 2005; 33(4): 195-203
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