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Metabolik Sendromu Olan Hastalarda Visseral Yağlanma Oranı ve Boyun Çevresi Arasındaki İlişki

Yıl 2017, Cilt: 27 Sayı: 1, 15 - 22, 01.03.2017

Hakan Gülmez Altuğ Kut

Öz

Amaç: İnsanların yaşadığı çevre, davranışları ve yaşam tarzı, dramatik bir şekilde değişmektedir. Bu değişimlere bağlı olarak, obezite ve tip 2 diyabet sıklığında ciddi bir artış görülmektedir. Obezite ve diyabetin görülme sıklığındaki artışa paralel, her geçen gün daha fazla insanı etkilemekte olan ve multi faktöriyel risk etmenlerinin bir araya gelmesi sonucu oluşan metabolik sendrom, kardiyovasküler hastalık riskini de beraberinde getirdiği için 21. yüzyılın önemli sağlık sorunlarından biridir.Gereç ve Yöntem: Bu araştırmada, kilo yakınması ile başvuran hastalarda, boyun çevresi ölçümlerini bazı metabolik ve antropometrik ölçümlerle karşılaştırmayı ve özellikle metabolik sendromu olan hastalarda, visseral yağlanma oranları ile boyun çevresi ölçümleri arasındaki korelasyonu göstermeyi amaçladık. Araştırmamıza, 01.02.2009 – 01.02.2011 tarihleri arasında, Başkent Üniversitesi Ümitköy Semt Polikliniği, diyabet ve obezite polikliniğine, kilo yakınması ile başvuran 179 hasta alınmıştır. Bu çalışma retrospektif bir vaka – kontrol çalışmasıdır.Araştırmanın verileri, SPSS 16.0 versiyonu istatistik programına aktarılmış, veri kontrolü ve analizler bu programda yapılmıştır. Hipoteze yönelik analizlerde Pearson Ki-kare testi kullanılmış, verilerin anlamlılık düzeyleri Ki-kare testi ile saptanmıştır.Bulgular: Çalışmamıza alınan 179 hastadan % 77’si n=137 kadın, % 23’ü n=42 erkektir K:E oranı=3,26 . Hastalarımızın yaş ortalaması 37±13,15’dir. Hastalarımızdan 40’ına % 22,3 metabolik sendrom tanısı konmuştur. Metabolik sendromu olmayanların boyun çevresi ortalaması 35,15±3,48 cm, metabolik sendromu olanların ise 38,40±4,13 cm saptanmıştır. Metabolik sendromu olan hastalarda, boyun çevresi ile visseral yağlanma oranları arasında istatistiksel olarak anlamlı pozitif korelasyon gösterilmiştir r=0,71; p=0,01 .Sonuç: Çalışmamız, metabolik sendromda boyun çevresi ölçümünün, NCEP ATP III kriterlerinden biri olan bel çevresi ölçümü gibi değerli ve istatistiksel olarak anlamlı pozitif korelasyon gösteren bir ölçüm olduğunu ortaya koymuştur

Anahtar Kelimeler

Boyun Çevresi Visseral Yağlanma Antropometrik Metabolik Sendrom

Kaynakça

  • Reaven GM. Role of insulin resistance in human disease (syndrome X): an expanded definition. Annu Rev Med 1993;44:121-31.
  • Han TS, Williams K, Sattar N, Hunt KJ, Lean ME, Haff- ner SM. Analysis of Obesity and Hyperinsulinemia In The Development of Metabolic Syndrom: San Antonio Heart Study. Obes Res 2002; 10:923-31.
  • Kendall DM, Harmel AP. The Metabolic Syndrom, Type 2 Diabetes and Cardiovascular Disease: Understanding The Role of Insulin Resistance. Am J Manag Care 2002;8:S635- 53.
  • National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blo- od Cholesterol In Adults (Adult Tretment Panel III). JAMA 2001;285:2486-97.
  • Stabe C, Vasques AC, Lima MM, Tambascia MA, Pareja JC, Yamanaka A, Geloneze B. Neck Circumference as a Simple Tool for Identifying the Metabolic Syndrome and Insulin Resistance: Results from the Brazilian Metabolic Syndrome Study (BRAMS). Clin Endocrinol (Oxf) 2013;78:874-81.
  • Onat A, Hergenc¸ G, Yuksel H, Can G, Ayhan E, Kaya Z, Dursunoglu D. Neck circumference as a measure of central obesity: associations with metabolic syndrome and obstru- ctive sleep apnea syndrome beyond waist circumference. Clin Nutr 2009;28:46–51.
  • Yang GR, Yuan SY, Fu HJ, Wan G, Zhu LX, Bu XL, Zhang JD, Du XP, Li YL, Ji Y, Gu XN, Li Y; Beijing Community Di- abetes Study Group. Neck circumference positively related with central obesity, overweight, and metabolic syndrome in Chinese subjects with type 2 diabetes: Beijing Commu- nity Diabetes Study 4. Diabetes Care 2010;33:2465-7.
  • Bastard JP, Maachi M, Lagathu C, Kim MJ, Caron M, Vidal H, Capeau J, Feve B. Recent advances in the relationship between obesity, inflammation and insulin resistance. Eur Cytokine Netw 2006;17:4-12.
  • Galletti F, Barbato A, Versiero M, Iacone R, Russo O, Barba G, Siani A, Cappuccio FP, Farinaro E, della Valle E, Straz- zullo P. Circulating leptin levels predict the development of metabolic syndrome in middle-aged men: an 8 year fol- low-up study. J Hypert 2007;25:1671-7.
  • De Lorenzo A, Del Gobbo V, Premrov MG, Bigioni M, Gal- vano F, Di Renzo L. Normal-weight obese syndrome: early inflammation? Am J Clin Nutr 2007;85:40-5.
  • Poirier P, Ecke RH. Obesity and Cardiovascular Disease. Nutrition 2002;4:448–53.
  • Grundy SM, Brewer HB Jr, Cleeman JI, Smith SC Jr, Len- fant C. Definition of Metabolic Syndrom: Report of The National Heart, Lung and Blood Institute/American Heart Association Conference on Scientific Issues Related to De- finition. Circulation 2004;109:433-8.
  • Dehghan M, Merchant AT. Is bioelectrical impedance ac- curate for use in large epidemiological studies? Nutrition J 2008;7:26-32.
  • Ryo M, Maeda K, Onda T, Katashima M, Okumiya A, Nishida M, Yamaguchi T, Funahashi T, Matsuzawa Y, Na- kamura T, Shimomura I. A New Simple Method for the Measurement of Visceral Fat Accumulation by Bioelectrical Impedance. Diabetes Care 2005;28:451-3.
  • Klein S, Allison DB, Heymsfield SB, Kelley DE, Leibel RL, Nonas C, Kahn R. Waist circumference and cardiometa- bolic risk: a consensus statement from Shaping America’s Health: Association for Weight Management and Obesity Prevention; NAASO, The Obesity Society; the American Society for Nutrition; and the American Diabetes Associ- ation. Am J Clin Nutr 2007;85:1197–202.
  • Kyle UG, Bosaeus I, De Lorenzo AD, Deurenberg P, Elia M, Gómez JM, Heitmann BL, Kent-Smith L, Melchior JC, Pirlich M, Scharfetter H, Schols AM, Pichard C, Composi- tion of the ESPEN Working Group. Bioelectrical impedan- ce analysis - part I: review of principles and methods. Clin Nutr 2004;23:1226–43.
  • Thomas EL, Collins AL, McCarthy J, Fitzpatrick J, Durig- hel G, Goldstone AP, Bell JD. Estimation of abdominal fat compartments by bioelectrical impedance: the validity of the ViScan measurement system in comparison with MRI. Eur J Clin Nutr 2010;64:525-33.
  • Alberti KG, Zimmet PZ. Definition, diagnosis and classi- fication of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 1998;15:539- 53.
  • Zimmet P, Magliano D, Matsuzawa Y, Alberti G, Shaw J. The metabolic syndrome: A Global Public Health Problem and A New Definition. J Atheroscler Thromb 2005;12:295-300.
  • Rudy DR, Singh S, Barsano CP, Baba WI. Endocrinology. Rakel Textbook of Family Practice (Rakel RE, ed). Sixth edition. Newyork, W.B. Saunders Company. 1027-1106, 2002.
  • Alexander CM , Landsmann PB , Teutsch SM , Haffner SM. NCEP-defined Metabolic Syndrom, Diabetes and Prevalen- ce of Coronary Heart Disease Among NHANES III Parti- cipants Age 50 Years and Older. Diabetes 2003;52:1210-14.
  • Ford ES, Giles WH, Dietz WH. Prevalance of metabolic syndrome among US adults: findings from the third Na- tional Health and Nutrition Examination Survey. JAMA 2002;287:356-9.
  • Metabolik Sendrom Araştırma Grubu. METSAR sonuçları. XX. Ulusal Kardiyoloji Kongresi. Antalya, 2004.
  • Katzmarzyk PT, Janssen I, Ross R, Church TS, Blair SN. The Importance Of Waist Circumference İn The Definition Of Metabolic Syndrome. Diabetes Care 2006;29:404–9.
  • Araz F. Bilinen Hastalığı Olmayan ve Ultrasonografide No- nalkolik Yağlı Karaciğer Hastalığı Saptanan Erişkinlerde İnsülin Direnci ve Metabolik Sendrom Sıklığının Araştırıl- ması. Uzmanlık tezi, Çukurova Üniversitesi Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Adana, 2007.
  • Yorulmaz E. Nondiyabetik, Hipertansif Metabolik Send- romlu Hastalarda Serum Yüksek Duyarlılık C-Reaktif Pro- tein Düzeylerinin Hemodinamik ve Metabolik Parametre- lerle İlişkisi. Uzmanlık tezi, T.C. Sağlık Bakanlığı Göztepe Eğitim ve Araştırma Hastanesi. II. Dahiliye Kliniği, İstan- bul, 2006.
  • Wildman RP, Gu D, Reynolds K, Duan X, He J. Approp- riate body mass index and waist circumference cutoffs for categorization of overweight and central adiposity among Chinese adults. Am J Clin Nutr 2004;80:1129 –36.
  • WHO expert consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 2004;363:157–63.
  • Carr DB, Utzschneider KM, Hull RL, Kodama K, Retzlaff BM, Brunzell JD, Shofer JB, Fish BE, Knopp RH, Kahn SE. Intra-abdominal fat is a major determinant of the Na- tional Cholesterol Education Program Adult Treatment Panel III criteria for the metabolic syndrome. Diabetes 2004;53:2087-94.
  • Ribeiro-Filho FF, Faria AN, Azjen S, Zanella MT, Ferreira SRG. Methods of estimation of visceral fat: advantages of ultrasonography. Obes Res 2003;11:1488-94.
  • Lukaski HC. Methods for the assesment of human body composition: Traditional and new. Am J Clin Nutr 1987;46:537-556.
  • D. Berker, S. Koparal, S. Işık, L. Paşaoğlu, Y. Aydın, K. Erol, T. Delibaşı, S. Güler. Compatibility of different methods for the measurement of visceral fat in different body mass in- dex strata. Diagn Interv Radiol 2010; 16:99–105.
  • Wang X, Xue H, Kang W, Yu J, Jın Z. Correlation of Adipose Volume Parameters with Anthropometric Data in Severe Obese Patients. Acta Acad Med Sin 2011;33:277-80.
  • Kalkan İH, Savaş Ö, Yılmazer T, Suher M. A New Antropo- metric Measurement to Detect Glucose Metabolism Defect: Neck Circumference. Erişim: (http://www.medicalnetwork. com.tr /2009/konu.asp?goster=1&Metin=163 ) Erişim tari- hi: 6/4/2011.
  • Ferretti RL, Cintra IP, Passos MAZ, Ferrari GLM, Fisberg M. Elevated Neck Circumference and Associated Factors in Adolescents. BMC Public Health 2015;15:208.
  • Mazzuca E, Battaglia S, Marrone O, Marotta AM, Cast- rogiovanni A, Esquinas C, Barcelò A, Barbé F, Bonsignore MR. Gender-specific anthropometric markers of adiposity, metabolic syndrome and visceral adiposity index (VAI) in patients with obstructive sleep apnea. J Sleep Res 2014; 23:13-21.
  • Ben-Noun LL, Sohar E, Laor A. Neck circumference as a simple screening measure for identifying overweight and obese patients. Obes Res 2001;9:470-7.
  • Ben-Noun LL, Laor A. Relationship between changes in neck circumference and cardiovascular risk factors. Exp Clin Cardiol 2006;11:14-20.
  • Onat A. Türk Halkında Lipid, Lipoprotein ve Apolipopro- teinler. TEKHARF 2009 Türk Halkının Kusurlu Kalp Sağlı- ğı Sırrına Işık, Tıbba Önemli Katkı (Onat A ed.). İstanbul, Cortex İl. Hiz. 44-46. 2009.
  • Yang L, Samarasinghe YP, Kane P, Amiel SA, Aylwin SJ. Visceral adiposity is closely correlated with neck circum- ference and represents a significant indicator of insulin re- sistance in WHO grade III obesity. Clin Endocrinol (Oxf) 2010;73:197-200.
  • Preis SR, Massaro JM, Hoffmann U, D'Agostino RB Sr, Levy D, Robins SJ, Meigs JB, Vasan RS, O'Donnell CJ, Fox CS. Neck circumference as a novel measure of cardiometabo- lic risk: the Framingham Heart study. J Clin Endoc Metab 2010;95:3701-10.

Yıl 2017, Cilt: 27 Sayı: 1, 15 - 22, 01.03.2017

Hakan Gülmez Altuğ Kut

Öz

Objective: People’s environment, behavior and lifestyle are dramatically changing. Depending on these changes, there is a dramatic increase in obesity and type 2 diabetes. The metabolic syndrome is a combination of multi-factorial risk factors, which affects more people because of increased incidence of obesity and diabetes. The metabolic syndrome is one of the major health problems of the 21st century.Materials and Methods: In this retrospective case-control study, we aimed to compare neck circumference measurements with some of the metabolic and anthropometric measurements in patients presenting with complains of weight, and to show the correlation between visceral fat rates and neck circumference measurements in patients with metabolic syndrome. 179 patients with complains of weight were included to the study from 01.02.2009 to 01.02.2011, at the diabetes and obesity outpatient clinic of Baskent University.Research data were analyzed with the statistic program SPSS-16. Pearson Chi-square test were used for hypothetical analysis and levels of significance.Results: Of 179 patients, 77% n=137 were women, 23% n=42 were men F:Mratio=3.26 . The mean age was 37±13.15 years. Forty of our patients 22.3% were diagnosed as metabolic syndrome. The mean neck circumference was 35.15±3.48 cm in those without metabolic syndrome, and 38.40±4.13 cm in those with metabolic syndrome. Statistically significant positive correlation was demonstrated between neck circumference measurements and visceral fat rates in patients with metabolic syndrome r=0,71;p=0,01 .Conclusion: Our study revealed that, neck circumference measurement is a valuable and indicating measurement just as the waist circumference measurement which is one of the NCEP-ATP-III criteria, in identifying visceral fat in patients with metabolic syndrome

Anahtar Kelimeler

Neck Circumference Visceral fat Anthropometric Metabolic Syndrome

Kaynakça

  • Reaven GM. Role of insulin resistance in human disease (syndrome X): an expanded definition. Annu Rev Med 1993;44:121-31.
  • Han TS, Williams K, Sattar N, Hunt KJ, Lean ME, Haff- ner SM. Analysis of Obesity and Hyperinsulinemia In The Development of Metabolic Syndrom: San Antonio Heart Study. Obes Res 2002; 10:923-31.
  • Kendall DM, Harmel AP. The Metabolic Syndrom, Type 2 Diabetes and Cardiovascular Disease: Understanding The Role of Insulin Resistance. Am J Manag Care 2002;8:S635- 53.
  • National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blo- od Cholesterol In Adults (Adult Tretment Panel III). JAMA 2001;285:2486-97.
  • Stabe C, Vasques AC, Lima MM, Tambascia MA, Pareja JC, Yamanaka A, Geloneze B. Neck Circumference as a Simple Tool for Identifying the Metabolic Syndrome and Insulin Resistance: Results from the Brazilian Metabolic Syndrome Study (BRAMS). Clin Endocrinol (Oxf) 2013;78:874-81.
  • Onat A, Hergenc¸ G, Yuksel H, Can G, Ayhan E, Kaya Z, Dursunoglu D. Neck circumference as a measure of central obesity: associations with metabolic syndrome and obstru- ctive sleep apnea syndrome beyond waist circumference. Clin Nutr 2009;28:46–51.
  • Yang GR, Yuan SY, Fu HJ, Wan G, Zhu LX, Bu XL, Zhang JD, Du XP, Li YL, Ji Y, Gu XN, Li Y; Beijing Community Di- abetes Study Group. Neck circumference positively related with central obesity, overweight, and metabolic syndrome in Chinese subjects with type 2 diabetes: Beijing Commu- nity Diabetes Study 4. Diabetes Care 2010;33:2465-7.
  • Bastard JP, Maachi M, Lagathu C, Kim MJ, Caron M, Vidal H, Capeau J, Feve B. Recent advances in the relationship between obesity, inflammation and insulin resistance. Eur Cytokine Netw 2006;17:4-12.
  • Galletti F, Barbato A, Versiero M, Iacone R, Russo O, Barba G, Siani A, Cappuccio FP, Farinaro E, della Valle E, Straz- zullo P. Circulating leptin levels predict the development of metabolic syndrome in middle-aged men: an 8 year fol- low-up study. J Hypert 2007;25:1671-7.
  • De Lorenzo A, Del Gobbo V, Premrov MG, Bigioni M, Gal- vano F, Di Renzo L. Normal-weight obese syndrome: early inflammation? Am J Clin Nutr 2007;85:40-5.
  • Poirier P, Ecke RH. Obesity and Cardiovascular Disease. Nutrition 2002;4:448–53.
  • Grundy SM, Brewer HB Jr, Cleeman JI, Smith SC Jr, Len- fant C. Definition of Metabolic Syndrom: Report of The National Heart, Lung and Blood Institute/American Heart Association Conference on Scientific Issues Related to De- finition. Circulation 2004;109:433-8.
  • Dehghan M, Merchant AT. Is bioelectrical impedance ac- curate for use in large epidemiological studies? Nutrition J 2008;7:26-32.
  • Ryo M, Maeda K, Onda T, Katashima M, Okumiya A, Nishida M, Yamaguchi T, Funahashi T, Matsuzawa Y, Na- kamura T, Shimomura I. A New Simple Method for the Measurement of Visceral Fat Accumulation by Bioelectrical Impedance. Diabetes Care 2005;28:451-3.
  • Klein S, Allison DB, Heymsfield SB, Kelley DE, Leibel RL, Nonas C, Kahn R. Waist circumference and cardiometa- bolic risk: a consensus statement from Shaping America’s Health: Association for Weight Management and Obesity Prevention; NAASO, The Obesity Society; the American Society for Nutrition; and the American Diabetes Associ- ation. Am J Clin Nutr 2007;85:1197–202.
  • Kyle UG, Bosaeus I, De Lorenzo AD, Deurenberg P, Elia M, Gómez JM, Heitmann BL, Kent-Smith L, Melchior JC, Pirlich M, Scharfetter H, Schols AM, Pichard C, Composi- tion of the ESPEN Working Group. Bioelectrical impedan- ce analysis - part I: review of principles and methods. Clin Nutr 2004;23:1226–43.
  • Thomas EL, Collins AL, McCarthy J, Fitzpatrick J, Durig- hel G, Goldstone AP, Bell JD. Estimation of abdominal fat compartments by bioelectrical impedance: the validity of the ViScan measurement system in comparison with MRI. Eur J Clin Nutr 2010;64:525-33.
  • Alberti KG, Zimmet PZ. Definition, diagnosis and classi- fication of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 1998;15:539- 53.
  • Zimmet P, Magliano D, Matsuzawa Y, Alberti G, Shaw J. The metabolic syndrome: A Global Public Health Problem and A New Definition. J Atheroscler Thromb 2005;12:295-300.
  • Rudy DR, Singh S, Barsano CP, Baba WI. Endocrinology. Rakel Textbook of Family Practice (Rakel RE, ed). Sixth edition. Newyork, W.B. Saunders Company. 1027-1106, 2002.
  • Alexander CM , Landsmann PB , Teutsch SM , Haffner SM. NCEP-defined Metabolic Syndrom, Diabetes and Prevalen- ce of Coronary Heart Disease Among NHANES III Parti- cipants Age 50 Years and Older. Diabetes 2003;52:1210-14.
  • Ford ES, Giles WH, Dietz WH. Prevalance of metabolic syndrome among US adults: findings from the third Na- tional Health and Nutrition Examination Survey. JAMA 2002;287:356-9.
  • Metabolik Sendrom Araştırma Grubu. METSAR sonuçları. XX. Ulusal Kardiyoloji Kongresi. Antalya, 2004.
  • Katzmarzyk PT, Janssen I, Ross R, Church TS, Blair SN. The Importance Of Waist Circumference İn The Definition Of Metabolic Syndrome. Diabetes Care 2006;29:404–9.
  • Araz F. Bilinen Hastalığı Olmayan ve Ultrasonografide No- nalkolik Yağlı Karaciğer Hastalığı Saptanan Erişkinlerde İnsülin Direnci ve Metabolik Sendrom Sıklığının Araştırıl- ması. Uzmanlık tezi, Çukurova Üniversitesi Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Adana, 2007.
  • Yorulmaz E. Nondiyabetik, Hipertansif Metabolik Send- romlu Hastalarda Serum Yüksek Duyarlılık C-Reaktif Pro- tein Düzeylerinin Hemodinamik ve Metabolik Parametre- lerle İlişkisi. Uzmanlık tezi, T.C. Sağlık Bakanlığı Göztepe Eğitim ve Araştırma Hastanesi. II. Dahiliye Kliniği, İstan- bul, 2006.
  • Wildman RP, Gu D, Reynolds K, Duan X, He J. Approp- riate body mass index and waist circumference cutoffs for categorization of overweight and central adiposity among Chinese adults. Am J Clin Nutr 2004;80:1129 –36.
  • WHO expert consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 2004;363:157–63.
  • Carr DB, Utzschneider KM, Hull RL, Kodama K, Retzlaff BM, Brunzell JD, Shofer JB, Fish BE, Knopp RH, Kahn SE. Intra-abdominal fat is a major determinant of the Na- tional Cholesterol Education Program Adult Treatment Panel III criteria for the metabolic syndrome. Diabetes 2004;53:2087-94.
  • Ribeiro-Filho FF, Faria AN, Azjen S, Zanella MT, Ferreira SRG. Methods of estimation of visceral fat: advantages of ultrasonography. Obes Res 2003;11:1488-94.
  • Lukaski HC. Methods for the assesment of human body composition: Traditional and new. Am J Clin Nutr 1987;46:537-556.
  • D. Berker, S. Koparal, S. Işık, L. Paşaoğlu, Y. Aydın, K. Erol, T. Delibaşı, S. Güler. Compatibility of different methods for the measurement of visceral fat in different body mass in- dex strata. Diagn Interv Radiol 2010; 16:99–105.
  • Wang X, Xue H, Kang W, Yu J, Jın Z. Correlation of Adipose Volume Parameters with Anthropometric Data in Severe Obese Patients. Acta Acad Med Sin 2011;33:277-80.
  • Kalkan İH, Savaş Ö, Yılmazer T, Suher M. A New Antropo- metric Measurement to Detect Glucose Metabolism Defect: Neck Circumference. Erişim: (http://www.medicalnetwork. com.tr /2009/konu.asp?goster=1&Metin=163 ) Erişim tari- hi: 6/4/2011.
  • Ferretti RL, Cintra IP, Passos MAZ, Ferrari GLM, Fisberg M. Elevated Neck Circumference and Associated Factors in Adolescents. BMC Public Health 2015;15:208.
  • Mazzuca E, Battaglia S, Marrone O, Marotta AM, Cast- rogiovanni A, Esquinas C, Barcelò A, Barbé F, Bonsignore MR. Gender-specific anthropometric markers of adiposity, metabolic syndrome and visceral adiposity index (VAI) in patients with obstructive sleep apnea. J Sleep Res 2014; 23:13-21.
  • Ben-Noun LL, Sohar E, Laor A. Neck circumference as a simple screening measure for identifying overweight and obese patients. Obes Res 2001;9:470-7.
  • Ben-Noun LL, Laor A. Relationship between changes in neck circumference and cardiovascular risk factors. Exp Clin Cardiol 2006;11:14-20.
  • Onat A. Türk Halkında Lipid, Lipoprotein ve Apolipopro- teinler. TEKHARF 2009 Türk Halkının Kusurlu Kalp Sağlı- ğı Sırrına Işık, Tıbba Önemli Katkı (Onat A ed.). İstanbul, Cortex İl. Hiz. 44-46. 2009.
  • Yang L, Samarasinghe YP, Kane P, Amiel SA, Aylwin SJ. Visceral adiposity is closely correlated with neck circum- ference and represents a significant indicator of insulin re- sistance in WHO grade III obesity. Clin Endocrinol (Oxf) 2010;73:197-200.
  • Preis SR, Massaro JM, Hoffmann U, D'Agostino RB Sr, Levy D, Robins SJ, Meigs JB, Vasan RS, O'Donnell CJ, Fox CS. Neck circumference as a novel measure of cardiometabo- lic risk: the Framingham Heart study. J Clin Endoc Metab 2010;95:3701-10.
Toplam 41 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Original Article
Yazarlar

Hakan Gülmez Bu kişi benim

Altuğ Kut Bu kişi benim

Yayımlanma Tarihi 1 Mart 2017
Yayımlandığı Sayı Yıl 2017 Cilt: 27 Sayı: 1

Kaynak Göster

Vancouver Gülmez H, Kut A. Metabolik Sendromu Olan Hastalarda Visseral Yağlanma Oranı ve Boyun Çevresi Arasındaki İlişki. Genel Tıp Derg. 2017;27(1):15-22.

Genel Tıp Dergisi Creative Commons Atıf-GayriTicari 4.0 Uluslararası Lisansı (CC BY NC) ile lisanslanmıştır.