Research Outputs
Permanent URI for this communityhttps://hdl.handle.net/20.500.14288/2
Browse
7 results
Search Results
Publication Metadata only Anthropometric indicators and diabetes incidence: results from a national cohort study, Turkey(Oxford University Press (OUP), 2021) Alpay, E. Emli; Ünal, Belgin; Ergör, Gül; Horasan, Gönül Dinç; Sözmen, Kaan; Ekinci, Banu; N/A; Sakarya, Sibel; Faculty Member; School of Medicine; 172028Background: Anthropometric indicators such as Body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), and Body Shape Index (ABSI) are used globally to evaluate the risk of type 2 diabetes (T2DM). Our study aimed to investigate associations between different anthropometric indicators and the risk of T2DM using data from a national cohort. Methods: The data on anthropometric measures and other risk factors of diabetes were obtained from Turkey Chronic Diseases and Risk Factors Survey in 2011 (n = 18,477). Disease information for the years 2012-2017 of the cohort has been reached through electronic health records and DM was ascertained by standard ICD-10 Codes. Four logistic regression models were generated based on different groups of confounders: unmodifiable risk factors, behavioral risk factors, comorbidities and socioeconomic variables. Categorical BMI, WC, WHR, WHtR, and ABSI values were used and adjusted RRs (95% CIs) of measurements were computed for men and women separately. Results: Median follow-up year (IQR) was 6,46 (0,06). Between 2012 and 2017, 540 people were diagnosed with new diabetes. All anthropometric measurements except ABSI were associated with T2DM risk in all models. Among the anthropometric measures, BMI showed the strongest effect on incident diabetes, both in men (BMI ≥30; RRadj: 3.06, 95% CI 1.93-4.86) and women (BMI ≥30; RRadj: 2.58; 95%CI 1.73-3.85) in model 4 (adjusting for all confounding factors). WHtR provided the second strongest association with a RRadj of 2.57 in men (95% CI 1.78-3.71) and 2.55 in women (95%CI 1.87-3.47). Conclusions: Independent of other risk factors, individuals with high BMI, WHR, WHtR and WC are at higher risk of developing T2DM. Public health strategies aimed at prevention of weight gain and obesity will probably be the most effective way to struggle with diabetes.Publication Metadata only Cut-off values for anthropometric indices in predicting morbidity and mortality in Turkey: a cohort(Oxford University Press (OUP), 2021) Erkoyun, Erdem; Eren, E. Boncukçu; Ünal, Belgin; Sözmen, Kaan; Horasan, Gönül Dinç; Ekinci, Banu; Ergör, Gül; N/A; Sakarya, Sibel; Faculty Member; School of Medicine; 172028Background: Anthropometric measurements are associated with cardiovascular outcomes and mortality and the association varies by community. This study aims to estimate the incidence of cardiovascular outcomes and all cause mortality and determines their association with the anthropometric measurements. Methods: The data from Turkey Chronic Diseases and Risk Factors Survey were used for the cohort which recruited two 15 years and older adults from each family physicians' list in 2011 in Turkey using simple random sampling (n = 18,477). Family physicians collected the medical history and performed anthropometric measurements. Initially healthy participants for cardiovascular morbidity (coronary heart disease (ICD-10 codes I20.0-I25.0) and stroke (ICD-10 codes I60.0-I69.0) and all participants for all-cause and cardiovascular mortality were followed-up through electronic health records by 2017. Area under the curves (AUCs) were estimated and the adiposity risk was defined as cut-off points determined using Youden Index. The sample was stratified by age-groups (<65, ≥65). Poisson and Cox models were fitted for morbidity and mortality outcomes, respectively. Results: Over six years of follow-up, 5.7% of 15,877 and 1.3% of 16,062 participants developed CHD and stroke respectively. In total, 664 all-cause deaths (4.0%) were observed with 155 caused by CVDs (0.9%). A body shape index (i.e. 0.658 for all-cause mortality among younger men), waist-to-height ratio (i.e. 0.743 for CHD incidence among younger women), and BMI had higher AUCs for the outcomes. Higher anthropometric measurement groups had almost always higher CHD incidence risk in all groups but lower all-cause mortality in older men. Higher body-mass index was associated with lower mortality in younger men. Conclusions: This cohort study in Turkey showed that having higher anthropometric measurements is mostly associated with higher CHD incidence and mostly lower mortality among older men. This association deserves further studies.Publication Metadata only Educational level inequalities in cardiovascular outcomes and all-cause mortality in turkey: a cohort(Oxford University Press (OUP), 2021) Erkoyun, Erdem; Ünal, Belgin; Sözmen, Kaan; Horasan, Gönül Dinç; Ekinci, Banu; Ergör, Gül; N/A; Sakarya, Sibel; Faculty Member; School of Medicine; 172028Background: Recent decades witnessed an increase in the burden of non-communicable diseases including adverse cardiovascular outcomes in low- and middle income countries and the burden was not equal across socioeconomic strata. This study aimed to define educational level inequalities in cardiovascular outcomes and all-cause mortality in a six-years cohort in Turkey. Methods: Non-communicable Diseases and Risk Factors Cohort randomly sampled two adults (>14) from each of the registered family physicians in Turkey in July 2011 (n = 18,477). The family physicians collected demographic data. Incident coronary heart disease (CHD), cardiovascular and all-cause deaths were obtained from electronic health records in the end of 2017. Ridit score transformation was applied to the educational level by gender (illiterate, primary school, secondary school, high school or higher) and then Relative Index of Inequalities by educational level were estimated using Poisson Regression for morbidity and Cox Regression for mortality. Results: There were 17,847 participants in CHD and 18,461 in the mortality cohort. During six-years 1,026 cases were diagnosed with CHD, 185 cardiovascular and 769 all-cause deaths occurred respectively. The inequalities were not significant for all outcomes however Relative Index of Inequalities were close to be significant for CHD incidence among men and all-cause mortality among women (0.721 (0.507 to 1.025) and 1.721 (0.969 to 3.057), respectively). Conclusions: This is the first-ever cohort in Turkey with the aim to define educational level inequalities in cardiovascular outcomes and all-cause mortality. The inequalities may not have been observed due to the low number of outcomes.Publication Metadata only Health-related qol and fatality in chd patients: findings from a national cohort study, turkey(Oxford University Press (OUP), 2021) Alpay, E. Emli; Dinç, Gönül; Ergör, Gül; Sözmen, Kaan; Ekinci, Banu; Ünal, Belgin; N/A; Sakarya, Sibel; Faculty Member; School of Medicine; 172028Background: Although strong association between self-reported health and coronary heart disease (CHD) exists, health related quality of life (HRQOL) has not been conceptualized as a predictor for fatality in CHD patients. We investigated whether HRQOL may predict the risk of death in six years in CHD patients. Methods: There were overall, 614 of CHD cases in the national representative Chronic Diseases and Risk Factors Survey in Turkey, 2011. Baseline self-reported health data on EuroQol- 5 Dimension (EQ-5D) and a Visual Analog Scale (VAS) were used from the same survey. The cases were followed-up for all-cause and CHD specific fatality (ICD-10 diagnostic codes: I20- I25) through electronic health records by 2017. Kaplan Meier and Cox regression models were used for data analysis. Age and sex adjusted HRs [aHR 95% CIs] were estimated for having some or extreme problems in EQ5D domains and VAS. Results: Median follow-up years (IQR) was 6.46 (6.39-6.47). The number of deaths from all causes and CHD were 103 and 26, respectively. Age and sex adjusted HRs for all causes fatality were statistically significant for some or extreme problems in usual activities [2.48 (95%CI 1.60-3.83)], in pain/comfort [2.28 (95% CI 1.44-3.62)], in self-care [2.25 (95% CI 1.46-3.46)] and in mobility [1.85 (95% CI 1.16-2.96)]. Age and sex adjusted HRs for CHD specific fatality were statistically significant for some or extreme problems in self-care [3.45 (95% CI 1.48-8.07)] and pain/comfort [3.07(95% CI 1.19-7.93)]. VAS was negatively associated with overall fatality. Conclusions: In CHD cases, poor self reported health might be a good indicator for overall and CHD specific fatality in 6 years. Especially having some or extreme problems in selfcare and pain/comfort are closely related with overall fatality as well as CHD specific fatality.Publication Metadata only Health-related quality of life and perceived health status of Turkish population(Springer, 2019) Horasan, Gönül Dinç; Selçuk, Kevser Tarı; Sözmen, Kaan; Ergör, Gül; Yardım, Nazan; Sarıoğlu, Gülay; Soylu, Meltem; Keskinkılıç, Bekir; Buzgan, Turan; Hülür, Ünal; Ekinci, Halil; Ekinci, Banu; Ünal, Belgin; N/A; Sakarya, Sibel; Faculty Member; School of Medicine; 172028Purpose: This study was conducted to assess the health-related quality of life (HRQOL) and perceived health status of the Turkish population. Methods: The data came from a nationwide survey, which was conducted by Ministry of Health on prevalence and risk factors for chronic diseases in Turkey, with a representative random sample of 18,477 people aged >= 15 years from Turkey. Each family physician invited two individuals selected from their registered population to the Family Health Center, conducted the survey by face to face interviews using an electronic form. HRQOL was determined using EQ-5D-3L scale. Results: In Turkish population, each four women out of 10, two men out of 10 have problems in pain/discomfort and anxiety/depression dimensions of the scale; three women out of 10, one man out of 10 have some or severe problems in mobility. Proportion of people without health problems (health state 11,111) were 64,1% in men, 40,7% in women. The mean VAS score for males was 71.50.2 (95% CI 70.9-72.1), 66.4 +/- 0.2 (95% CI 65.8-66.9) for females (p < 0.05).The most important determinants of having a problem in any of the five dimensions are age, gender, education, diabetes mellitus, coronary heart disease, stroke, alzheimer, cancer, renal failure. The OR of having some or severe problems in any dimensions was 4.6 (95% CI 38-5.4) for over 65-74 and 7.5 (95% CI 5.8-9.6) for over 75 compared to 15-24 age group. Conclusions: The perceived health level and HRQOL is worse in women, in older age groups, in people from lower socioeconomical status.Publication Metadata only Noncommunicable disease incidences in 2012-2017, Turkey(Oxford University Press (OUP), 2021) Ergör, Gül; Sözmen, Kaan; Horasan, Gönül Dinç; Ekinci, Banu; Arıkan, Ayşe; Sis, Seçil; Ünal, Belgin; N/A; Sakarya, Sibel; Faculty Member; School of Medicine; 172028Background: Globally, 88% of deaths are caused by noncommunicable diseases (NCD) and they are increasing in our country as in many parts of the world. Effective control, prevention and treatment of NCD, can begin from knowing the disease incidence by age, sex and regions. Methods: This study aimed to determine the incidence of chronic diseases (coronary heart disease, stroke, diabetes, hypertension and cancer) by record linkage of the data from the Turkey Chronic Diseases and Risk Factors Prevalence Study 2011 (TCD-RFS) with health service databases, which are Family Medicine Information System, Medulla- E-Pulse and Death Notification System. The cohort (18.477 people above age 15) from TCD-RFS is followed up to determine the incidence of coronary heart disease, hypertension, diabetes, stroke and cancer, from the electronic health record systems for the period between 2012 and 2017 (6 years). Cumulative incidences were calculated, age and sex standardized incidences were given with 95% CI. Results: The age and sex standardized cumulative incidences are, 5939 (95% CI 5933-5945) for CHD 1378 (95%CI:1369-1388) for stroke, 2254 (95% CI 2 253 -2 255) for cancer, 4200 (95% CI 4194-4204) for diabetes and 20788 (95% CI 1369-1388) for hypertension (per 100,000). The annual incidences are approximately 990 for CHD, 229 for stroke, 375 for cancer, 700 for diabetes and 3464 for hypertension (per 100,000). CHD and cancer incidences are higher in men, while diabetes, hypertension and stroke incidences are higher in women. Conclusions: Regardless of the difficulties in comparing incidence of NCD with other countries, we think our results show that hypertension, diabetes, stroke and CHD have higher incidence than Western European countries. We also showed that these metrics can be obtained through data linkage of National Health Records for the first time in Turkey.Publication Metadata only Response to a letter to the editor regarding "connectors as a risk factor for blood-associated infections (3-way stopcock and needleless connector): a randomized-experimental study"(Mosby-Elsevier, 2020) Guven, Betul; Ocakci; Kaya, Nurten; N/A; Şengül, Tuba; Ocakçı, Ayşe Ferda; Faculty Member; Faculty Member; School of Nursing; School of Nursing; 59230; 1729In our study, “Results of this study found no significant difference between rates of colonization in NCs and TWSs,” this sentence was perceived as a contradiction. This contradiction was explained in the letter by Devrim. In our study, as indicated by Devrim, there was a difference in the rate of colonization in needleless connectors (NC) and 3-way stopcock (TWS) attached to peripheral venous catheters, but no statistically significant difference was found in the rate of colonization in central and port catheters. This is stated in the abstract section with the following sentence: “When the results of colonization for patients using TWS and NC were compared, the peripheral venous catheters (using a TWS) resulted in a significantly higher increase in reproduction than patients using NC (P ≤ .01) and no significant difference in the level of colonization in other types of connectors or catheters (P ˃ .05).” The results section is associated with the other data obtained; it has been emphasized that connectors attached to intravenous (IV) catheters are a risk factor for catheter-related bloodstream infections. In addition, it is necessary for a scientific research to reach a general conclusion by discussing the findings with other literature. Indeed, studies comparing the effect of periferal intravenous catheter- integrated NC and TWS on the causing of infection are very limited, and available studies2,3 state that there is no difference between the 2 types of connectors. In addition, the number of injections, duration of use of the device, and microbial contamination rate were not confounders in both studies. In our study, the procedure for obtaining the culture from the connectors was carried out with attention, and this was stated in the study. Standard maintenance of catheters and connectors are summarized in Table 1. This table could not be shown in the study due to the publication standards of the Journal, but the process was summarized. In addition, clinical examinations of the patients were made in terms of signs of infection and body temperature measurements, and laboratory findings (C-reactive protein and blood leukocyte levels) were evaluated.