The Turkish Lipid Problem: Low Levels of High Density Lipoproteins
Journal Title: Turkish Journal of Endocrinology and Metabolism - Year 2002, Vol 6, Issue 1
Abstract
The unique lipid and lipoprotein profile of Turks is characterized primarily by very low plasma levels of high density lipoprotein cholesterol (HDL-C), specifically low levels of the protective subclasses of HDL, HDL2 and LpAl. The low HDL-C levels are associated with a 25-30% elevation of hepatic lipase activity that would be predicted to lower HDL levels. Low HDL-C levels occur in Turks living in Germany and the United States, suggesting that the reduced HDL-C levels are at least partly of genetic origin. Turkish girls and boys exhibit a marked 10-20 mg/dl drop in HDL-C levels associated with puberty, suggesting that the low HDL-C levels in Turks may reflect an ethnic difference in hormonal balance. Data generated in the early 1990s in the original Turkish Heart Study and recently updated by a study of Turkish men and women living in istanbul indicate that the lipid profile and other risk factors for coronary heart disease have not improved in this decade. Despite their relatively low plasma total cholesterol levels, Turks have extremely low HDL-C (<40 mg/dl in 70% of men and ~50% of women) resulting in very high total cholesterol/HDL-C ratios that predict increased coronary heart disease in other populations. The 2001 National Cholesterol Education Program guidelines continue to focus on low density lipoprotein cholesterol levels and underestimate the importance of low HDL-C levels, which undoubtedly are a powerful risk factor in Turks. We suggest that guidelines for Turkey consider both low density lipoprotein cholesterol levels and total cholesterol/HDL-C ratio as thresholds for initiating lifestyle changes or drug treatment for patients with coronary heart disease risk.
Authors and Affiliations
Robert W. Mahley, Linda L. Mahley, Thomas P. Bersot, Guy M. Pepin, K. Erhan Palaoğlu
Keywords
Related Articles
- EP ID EP84424
- DOI -
- Views 200
- Downloads 0
Homocysteine Levels in Type 2 Diabetic Patients with Nephropathy and Coronary Artery Disease
The aim of the study was to investigate the relationship between plasma homocysteine (Hcy) levels and diabetic vascular complications and family history of diabetes mellitus (DM) and coronary artery disease (CAD) in pati...
The Prevalence of Hypertension in Diabetes Mellitus and the Effects of Hypertension on the Progression of Diabetes
Between the years 1990 and 1996, 802 patients with Diabetes Mellitus (DM) were scanned for hypertension prevalence and the effect of hypertension on diabetic complications. Over 6 years, 103 patients with IDDM and 699 pa...
Relationship of Early Atherosclerotic Vascular Changes with Serum Lipoprotein(a) in Predialysis Chronic Renal Failure and Maintenance Hemodialysis Patients
In renal failure studies revealed an increase in plasma concentration of lipoprotein(a)[ Lp(a)]. Elevated plasma Lp(a) levels in chronic renal failure patients is recognized as an independent risk factor for premature at...
Medial Arterial Calcification is a Predictor of Cardiac Autonomic Neuropathy in Diabetic Patients
Medial arterial calcification (MAC) is one of the complications of diabetes mellitus and recently, a relationship between cardiac autonomic neuropathy and MAC has been pointed out. By means of this relationship, we evalu...
Turner Syndrome; A Case Report With Growth Failure
Turner syndrome which afflicts approximately 50 per 100000 females is characterized by retarded growth, gonadal dysgenesis, and infertility. Growth failure is a consistent finding at birth in infants with Turner's syndro...