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Metabolik sendrom, insülin direnci, diabetes mellitus ve hipertansiyonu öngörmede visseral adipozite indeksi kesme değerlerinin belirlenmesi

Year 2022, Volume: 7 Issue: 2, 41 - 48, 31.05.2022

Hatice Kılıç Türk Selma Pekgör , Mehmet Eryılmaz

https://doi.org/10.22391/fppc.1001148

Abstract

Giriş: Visseral adipozite indeksi, visseral yağ doku disfonksiyonunun güvenilir bir göstergesidir. Bu çalışmada belirli yaş aralıklarında ve her iki cinsiyette ayrı ayrı metabolik sendrom, insülin direnci, tip 2 diabetes mellitus ve hipertansiyonu öngörmede visseral adipozite indeksi kesme noktalarının belirlenmesi amaçlandı.

Yöntem: Bu araştırma tanımlayıcı analitik bir araştırmadır. Araştırma Temmuz-2019 ile Temmuz-2020 tarihleri arasında 18 yaş ve üzeri 951 katılımcı ile planlandı. Çalışma kriterlerine uymayan 51 katılımcı araştırmadan çıkartıldı. Araştırma 577 kadın, 373 erkek toplam 900 katılımcı ile tamalandı. Tüm katılımcıların fizik muayeneleri ve antropometrik (boy, kilo, bel çevresi, ve tansiyon) ölçümleri yapıldı. Katılımcılarda 12 saat açlık sonrası HDL, TG, glukoz ve insülin düzeyleri bakıldı. Katılımcıların 15 dakika istirahat sonrasında kan basıncı ölçüldü. Metabolik sendrom tanısı için Yetişkin Tedavi Paneli III kriterleri kullanıldı. Hemostasis model assessment hesaplandı. Tüm popülasyonda, kadınlarda, erkeklerde, 18-30, 31-40, 41-50, 51-65, 66 ve üzeri yaş gruplarında; metabolik sendrom, insülin direnci, diyabet ve hipertansiyonu öngörmede visseral adipozite indeksi hesaplandı.

Bulgular: Metabolik sendromu öngörmede visseral adipozite indeksi kesme değerleri toplam nüfusta ve erkeklerde 4,53, kadınlarda 4,28, 18-30 yaş aralığında 4,76, 31-40 yaş aralığında 4,96, 41-50 yaş aralığında 4,87, 51-65 yaş aralığında 5,04, 66 yaş ve üzerinde 4,59 saptanmıştır. İnsülin direncini öngörmede visseral adipozite indeksi kesme değerleri toplam nüfusta ve kadınlarda 4,24, erkeklerde 4,68, 18-30 yaş aralığında 3,45, 31-40 yaş aralığında 4,15, 41-50 yaş aralığında 4,66, 51-65 yaş aralığında 4,87 olarak saptandı. Tip 2 diabetes mellitusu öngörmede visseral adipozite indeksi kesme değerleri toplam nüfusta 4,89, kadınlarda 6,43, 31-40 yaş aralığında 7,02, 41-50 yaş aralığında 7,29, 51-65 yaş aralığında 5,98 olarak saptandı. Hipertansiyonu öngörmede visseral adipozite indeksi kesme değerleri toplam nüfusta 4,26, kadınlarda 4,07, 18-30 yaş aralığında 4,64, 51-65 yaş aralığında 4,43 olarak saptandı.

Sonuç: Visseral adipozite indeksi; metabolik sendrom, insülin direnci, tip 2 diabetes mellitusu ve hipertansiyonu öngörmede kullanılabileceğine kanaat getirildi.  

Keywords

Visseral Adipozite İndeksi kardiyometabolik risk insülin direnci metabolik sendrom tip 2 diabetes mellitus abdominal obezite

References

  • 1. Demirci S, Cennet G. Adipose tissues and some proteins secreted from adipose tissue. Mehmet Akif Ersoy Univ Inst Health Sci 2019;5(2):155-79.
  • 2. Amato MC, Guarnotta V, Giordano C. Body composition assessment for the definition of cardiometabolic risk. J Endocrinol Invest. 2013;36(7):537-43.
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  • 2. Amato MC, Guarnotta V, Giordano C. Body composition assessment for the definition of cardiometabolic risk. J Endocrinol Invest. 2013;36(7):537-43.
  • 3. González N, Moreno-Villegas Z, González-Bris A, Egido J, Lorenzo Ó. Regulation of visceral and epicardial adipose tissue for preventing cardiovascular injuries associated to obesity and diabetes. Cardiovascular diabetology. 2017;16(1):44. https://doi.org/10.1186/s12933-017-0528-4
  • 4. Bjørndal B, Burri L, Staalesen V, Skorve J, Berge RK. Different adipose depots: their role in the development of metabolic syndrome and mitochondrial response to hypolipidemic agents. J Obes. 2011;2011:490650. https://doi.org/10.1155/2011/490650
  • 5. Lee MJ, Wu Y, Fried SK. Adipose tissue heterogeneity: implication of depot differences in adipose tissue for obesity complications. Mol Aspects Med. 2013;34(1):1-11. https://doi.org/10.1016/j.mam.2012.10.001
  • 6. Thomas DM, Bredlau C, Bosy-Westphal A, Mueller M, Shen W, Gallagher D, et al. Relationships between body roundness with body fat and visceral adipose tissue emerging from a new geometrical model. Obesity (Silver Spring). 2013;21(11):2264-71. https://doi.org/10.1002/oby.20408
  • 7. Krakauer NY, Krakauer JC. A new body shape index predicts mortality hazard independently of body mass index. PloS one. 2012;7(7):e39504.https://doi.org/10.1371/journal.pone.0039504
  • 8. Baveicy K, Mostafaei S, Darbandi M, Hamzeh B, Najafi F, Pasdar Y. Predicting metabolic syndrome by visceral adiposity index, body roundness index and a body shape index in adults: a cross-sectional study from the Iranian RaNCD cohort data. Diabetes Metab Syndr Obes. 2020;13:879-87. https://doi.org/10.2147/DMSO.S238153
  • 9. Pekgor S, Duran C, Berberoglu U, Eryilmaz MA. The role of visceral adiposity index levels in predicting the presence of metabolic syndrome and insulin resistance in overweight and obese patients. Metab Syndr Relat Disord. 2019;17(5):296-302. https://doi.org/10.1089/met.2019.0005
  • 10. Amato MC, Giordano C, Pitrone M, Galluzzo A. Cut-off points of the visceral adiposity index (VAI) identifying a visceral adipose dysfunction associated with cardiometabolic risk in a Caucasian Sicilian population. Lipids Health Dis. 2011;10:183. https://doi.org/10.1186/1476-511X-10-183
  • 11. Wei J, Liu X, Xue H, Wang Y, Shi Z. comparisons of visceral adiposity index, body shape index, body mass index and waist circumference and their associations with diabetes mellitus in adults. Nutrients. 2019;11(7):1-13. https://doi.org/10.3390/nu11071580
  • 12. Amato MC, Giordano C. Visceral adiposity index: an indicator of adipose tissue dysfunction. Int J Endocrinol. 2014;2014:730827. https://doi.org/10.1155/2014/730827
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  • 14. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28(7):412-9. https://doi.org/10.1007/BF00280883
  • 15. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005;112(17):2735-52. https://doi.org/10.1161/CIRCULATIONAHA.105.169404
  • 16. Graffy PM, Pickhardt PJ. Quantification of hepatic and visceral fat by CT and MR imaging: relevance to the obesity epidemic, metabolic syndrome and NAFLD. Br J Radiol. 2016;89(1062):20151024. https://doi.org/10.1259/bjr.20151024
  • 17. Li R, Li Q, Cui M, Yin Z, Li L, Zhong T, et al. Clinical surrogate markers for predicting metabolic syndrome in middle-aged and elderly Chinese. J Diabetes Investig. 2018;9(2):411-8. https://doi.org/10.1111/jdi.12708
  • 18. Goldani H, Adami FS, Antunes MT, Rosa LH, Fassina P, Quevedo Grave MT, et al. Applicatility of the visceral adiposity index (vai) in the prediction of the components of the metabolic syndrome in elderly. Nutr Hosp. 2015;32(4):1609-15.
  • 19. Laakso M. Tip 2 diyabetin epidemiyolojisi ve tanısı. Tip. 2004;2:2-12.
  • 19. Laakso M. Tip 2 diyabetin epidemiyolojisi ve tanısı. Tip. 2004;2:2-12.
  • 19. Laakso M. Tip 2 diyabetin epidemiyolojisi ve tanısı. Tip. 2004;2:2-12.
  • 20. Štěpánek L, Horáková D, Cibičková Ľ, Vaverková H, Karásek D, Nakládalová M, et al. Can visceral adiposity index serve as a simple tool for identifying individuals with insulin resistance in daily clinical practice? Medicina (Kaunas). 2019;55(9). https://doi.org/10.3390/medicina55090545
  • 21. Ji B, Qu H, Wang H, Wei H, Deng H. Association between the visceral adiposity index and homeostatic model assessment of insulin resistance in participants with normal waist circumference. Angiology. 2017;68(8):716-21. https://doi.org/10.1177/0003319716682120
  • 22. Stepien M, Stepien A, Wlazel RN, Paradowski M, Rizzo M, Banach M, et al. Predictors of insulin resistance in patients with obesity: a pilot study. Angiology. 2014;65(1):22-30. https://doi.org/10.1177/0003319712468291
  • 23. Oh JY, Sung YA, Lee HJ. The visceral adiposity index as a predictor of insulin resistance in young women with polycystic ovary syndrome. Obesity (Silver Spring). 2013;21(8):1690-4. https://doi.org/10.1002/oby.20096
  • 24. Gu D, Ding Y, Zhao Y, Qu Q. Visceral adiposity index was a useful predictor of prediabetes. Exp Clin Endocrinol Diabetes 2018; 126(10): 596-603. https://doi.org/10.1055/s-0043-120440
  • 25. Chen C, Xu Y, Guo ZR, Yang J, Wu M, Hu XS. The application of visceral adiposity index in identifying type 2 diabetes risks based on a prospective cohort in China. Lipids Health Dis. 2014;13:108. https://doi.org/10.1186/1476-511X-13-108
  • 26. Liu PJ, Ma F, Lou HP, Chen Y. Visceral adiposity index is associated with pre-diabetes and type 2 diabetes mellitus in Chinese adults aged 20-50. Ann Nutr Metab. 2016;68(4):235-43. https://doi.org/10.1159/000446121
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  • 27. Turkey Endocrinology and Metabolism Association, Hypertension Diagnosis and Treatment Guidelines. 3. Edition April 2019
  • 28. Zhang Z, Shi D, Zhang Q, Wang S, Liu K, Meng Q, et al. Visceral adiposity index (VAI), a powerful predictor of incident hypertension in prehypertensives. Intern Emerg Med. 2018;13(4):509-16. https://doi.org/10.1007/s11739-018-1836-8
  • 29. Ding Y, Gu D, Zhang Y, Han W, Liu H, Qu Q. Significantly increased visceral adiposity index in prehypertension. PloS one. 2015;10(4):e0123414. https://doi.org/10.1371/journal.pone.0123414

The determination of cut-off points of the visceral adiposity index in predicting metabolic syndrome, insulin resistance, diabetes mellitus, and hypertension

Year 2022, Volume: 7 Issue: 2, 41 - 48, 31.05.2022

Hatice Kılıç Türk Selma Pekgör , Mehmet Eryılmaz

https://doi.org/10.22391/fppc.1001148

Abstract

Introduction: The visceral adiposity index is a reliable indicator of visceral adipose tissue dysfunction. The aim of this research was to determine the cut-off points of the visceral adiposity index in predicting metabolic syndrome, insulin resistance, type 2 diabetes mellitus, and hypertension at specific age ranges and in both sexes separately.

Methods: This research is both descriptive and analytical. The research was conducted with 951 participants aged 18 and over between July 2019 and July 2020. 51 participants that did not meet study criteria were excluded from the research. The research was completed with a total of 900 participants, 577 females and 373 males. A physical examination and anthropometric measurements (height, weight, waist circumference, and blood pressure) of all participants were conducted. After 12 hours of fasting, the HDL, TG, glucose, and insulin levels of participants were measured. The blood pressure of participants was measured after 15 minutes of rest. Adult treatment panel 3 criteria were used for the diagnosis of metabolic syndrome. A homeostatic model assessment was calculated. The visceral adiposity index is calculated in the entire population for the prediction of metabolic syndrome, insulin resistance, diabetes, and hypertension: women, men, age groups 18–30, 31–40, 41–50, 51–65, 66 and over.

Results: Cut-off points of the visceral adiposity index in predicting metabolic syndrome were 4.53 in the total population and males, 4.28 in females, 4.76 in the 18-30 age range, 4.96 in the 31-40 age range, 4.87 in the 41-50 age range, 5.04 in the 51-65 age range, and 4.59 in the age range 66 and above. Cut-off points of the visceral adiposity index in predicting insulin resistance were 4.24 in the total population and females, 4.68 in males, 3.45 in the 18-30 age range, 4.15 in the 31-40 age range, 4.66 in the 41-50 age range, and 4.87 in the 51-65 age range. Cut-off points of the visceral adiposity index in predicting type 2 diabetes mellitus were 4.89 in the total population, 6.43 in females, 7.02 in the 31-40 age range, 7.29 in the 41-50 age range, and 5.98 in the 51-65 age range. Cut-off points of the visceral adiposity index in predicting hypertension were 4.26 in the total population, 4.07 in females, 4.64 in the 18–30 age range, and 4.43 in the 51–65 age range.

Conclusions: The visceral adiposity index can be used to predict metabolic syndrome, insulin resistance, type 2 diabetes mellitus and hypertension.

Keywords

visceral adiposity index cardiometabolic risk insulin resistance metabolic syndrome type 2 diabetes mellitus abdominal obesity

Supporting Institution

The financial support for this research was provided by the Health Sciences University Konya Health Practice and Research Center.

Thanks

Prior publication: This research was presented as an oral presentation at the National Izmir Association of Family Medicine Congress 2020, which was held online. It is not published in any other journal.

References

  • 1. Demirci S, Cennet G. Adipose tissues and some proteins secreted from adipose tissue. Mehmet Akif Ersoy Univ Inst Health Sci 2019;5(2):155-79.
  • 2. Amato MC, Guarnotta V, Giordano C. Body composition assessment for the definition of cardiometabolic risk. J Endocrinol Invest. 2013;36(7):537-43.
  • 2. Amato MC, Guarnotta V, Giordano C. Body composition assessment for the definition of cardiometabolic risk. J Endocrinol Invest. 2013;36(7):537-43.
  • 2. Amato MC, Guarnotta V, Giordano C. Body composition assessment for the definition of cardiometabolic risk. J Endocrinol Invest. 2013;36(7):537-43.
  • 3. González N, Moreno-Villegas Z, González-Bris A, Egido J, Lorenzo Ó. Regulation of visceral and epicardial adipose tissue for preventing cardiovascular injuries associated to obesity and diabetes. Cardiovascular diabetology. 2017;16(1):44. https://doi.org/10.1186/s12933-017-0528-4
  • 4. Bjørndal B, Burri L, Staalesen V, Skorve J, Berge RK. Different adipose depots: their role in the development of metabolic syndrome and mitochondrial response to hypolipidemic agents. J Obes. 2011;2011:490650. https://doi.org/10.1155/2011/490650
  • 5. Lee MJ, Wu Y, Fried SK. Adipose tissue heterogeneity: implication of depot differences in adipose tissue for obesity complications. Mol Aspects Med. 2013;34(1):1-11. https://doi.org/10.1016/j.mam.2012.10.001
  • 6. Thomas DM, Bredlau C, Bosy-Westphal A, Mueller M, Shen W, Gallagher D, et al. Relationships between body roundness with body fat and visceral adipose tissue emerging from a new geometrical model. Obesity (Silver Spring). 2013;21(11):2264-71. https://doi.org/10.1002/oby.20408
  • 7. Krakauer NY, Krakauer JC. A new body shape index predicts mortality hazard independently of body mass index. PloS one. 2012;7(7):e39504.https://doi.org/10.1371/journal.pone.0039504
  • 8. Baveicy K, Mostafaei S, Darbandi M, Hamzeh B, Najafi F, Pasdar Y. Predicting metabolic syndrome by visceral adiposity index, body roundness index and a body shape index in adults: a cross-sectional study from the Iranian RaNCD cohort data. Diabetes Metab Syndr Obes. 2020;13:879-87. https://doi.org/10.2147/DMSO.S238153
  • 9. Pekgor S, Duran C, Berberoglu U, Eryilmaz MA. The role of visceral adiposity index levels in predicting the presence of metabolic syndrome and insulin resistance in overweight and obese patients. Metab Syndr Relat Disord. 2019;17(5):296-302. https://doi.org/10.1089/met.2019.0005
  • 10. Amato MC, Giordano C, Pitrone M, Galluzzo A. Cut-off points of the visceral adiposity index (VAI) identifying a visceral adipose dysfunction associated with cardiometabolic risk in a Caucasian Sicilian population. Lipids Health Dis. 2011;10:183. https://doi.org/10.1186/1476-511X-10-183
  • 11. Wei J, Liu X, Xue H, Wang Y, Shi Z. comparisons of visceral adiposity index, body shape index, body mass index and waist circumference and their associations with diabetes mellitus in adults. Nutrients. 2019;11(7):1-13. https://doi.org/10.3390/nu11071580
  • 12. Amato MC, Giordano C. Visceral adiposity index: an indicator of adipose tissue dysfunction. Int J Endocrinol. 2014;2014:730827. https://doi.org/10.1155/2014/730827
  • 13. Turkey Endocrinology and Metabolism Association, Obesity Diagnosis and Treatment Guideline, 8. Edition April 2019. 13 p.
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  • 13. Turkey Endocrinology and Metabolism Association, Obesity Diagnosis and Treatment Guideline, 8. Edition April 2019. 13 p.
  • 14. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28(7):412-9. https://doi.org/10.1007/BF00280883
  • 15. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005;112(17):2735-52. https://doi.org/10.1161/CIRCULATIONAHA.105.169404
  • 16. Graffy PM, Pickhardt PJ. Quantification of hepatic and visceral fat by CT and MR imaging: relevance to the obesity epidemic, metabolic syndrome and NAFLD. Br J Radiol. 2016;89(1062):20151024. https://doi.org/10.1259/bjr.20151024
  • 17. Li R, Li Q, Cui M, Yin Z, Li L, Zhong T, et al. Clinical surrogate markers for predicting metabolic syndrome in middle-aged and elderly Chinese. J Diabetes Investig. 2018;9(2):411-8. https://doi.org/10.1111/jdi.12708
  • 18. Goldani H, Adami FS, Antunes MT, Rosa LH, Fassina P, Quevedo Grave MT, et al. Applicatility of the visceral adiposity index (vai) in the prediction of the components of the metabolic syndrome in elderly. Nutr Hosp. 2015;32(4):1609-15.
  • 19. Laakso M. Tip 2 diyabetin epidemiyolojisi ve tanısı. Tip. 2004;2:2-12.
  • 19. Laakso M. Tip 2 diyabetin epidemiyolojisi ve tanısı. Tip. 2004;2:2-12.
  • 19. Laakso M. Tip 2 diyabetin epidemiyolojisi ve tanısı. Tip. 2004;2:2-12.
  • 20. Štěpánek L, Horáková D, Cibičková Ľ, Vaverková H, Karásek D, Nakládalová M, et al. Can visceral adiposity index serve as a simple tool for identifying individuals with insulin resistance in daily clinical practice? Medicina (Kaunas). 2019;55(9). https://doi.org/10.3390/medicina55090545
  • 21. Ji B, Qu H, Wang H, Wei H, Deng H. Association between the visceral adiposity index and homeostatic model assessment of insulin resistance in participants with normal waist circumference. Angiology. 2017;68(8):716-21. https://doi.org/10.1177/0003319716682120
  • 22. Stepien M, Stepien A, Wlazel RN, Paradowski M, Rizzo M, Banach M, et al. Predictors of insulin resistance in patients with obesity: a pilot study. Angiology. 2014;65(1):22-30. https://doi.org/10.1177/0003319712468291
  • 23. Oh JY, Sung YA, Lee HJ. The visceral adiposity index as a predictor of insulin resistance in young women with polycystic ovary syndrome. Obesity (Silver Spring). 2013;21(8):1690-4. https://doi.org/10.1002/oby.20096
  • 24. Gu D, Ding Y, Zhao Y, Qu Q. Visceral adiposity index was a useful predictor of prediabetes. Exp Clin Endocrinol Diabetes 2018; 126(10): 596-603. https://doi.org/10.1055/s-0043-120440
  • 25. Chen C, Xu Y, Guo ZR, Yang J, Wu M, Hu XS. The application of visceral adiposity index in identifying type 2 diabetes risks based on a prospective cohort in China. Lipids Health Dis. 2014;13:108. https://doi.org/10.1186/1476-511X-13-108
  • 26. Liu PJ, Ma F, Lou HP, Chen Y. Visceral adiposity index is associated with pre-diabetes and type 2 diabetes mellitus in Chinese adults aged 20-50. Ann Nutr Metab. 2016;68(4):235-43. https://doi.org/10.1159/000446121
  • 27. Turkey Endocrinology and Metabolism Association, Hypertension Diagnosis and Treatment Guidelines. 3. Edition April 2019
  • 27. Turkey Endocrinology and Metabolism Association, Hypertension Diagnosis and Treatment Guidelines. 3. Edition April 2019
  • 27. Turkey Endocrinology and Metabolism Association, Hypertension Diagnosis and Treatment Guidelines. 3. Edition April 2019
  • 28. Zhang Z, Shi D, Zhang Q, Wang S, Liu K, Meng Q, et al. Visceral adiposity index (VAI), a powerful predictor of incident hypertension in prehypertensives. Intern Emerg Med. 2018;13(4):509-16. https://doi.org/10.1007/s11739-018-1836-8
  • 29. Ding Y, Gu D, Zhang Y, Han W, Liu H, Qu Q. Significantly increased visceral adiposity index in prehypertension. PloS one. 2015;10(4):e0123414. https://doi.org/10.1371/journal.pone.0123414
There are 37 citations in total.

Details

Primary Language English
Subjects Endocrinology
Journal Section Original Research
Authors

Hatice Kılıç Türk 0000-0002-0051-8622

Selma Pekgör 0000-0001-9907-1842

Mehmet Eryılmaz

Publication Date May 31, 2022
Submission Date September 29, 2021
Acceptance Date March 29, 2022
Published in Issue Year 2022 Volume: 7 Issue: 2

Cite

APA Kılıç Türk, H., Pekgör, S., & Eryılmaz, M. (2022). The determination of cut-off points of the visceral adiposity index in predicting metabolic syndrome, insulin resistance, diabetes mellitus, and hypertension. Family Practice and Palliative Care, 7(2), 41-48. https://doi.org/10.22391/fppc.1001148
AMA Kılıç Türk H, Pekgör S, Eryılmaz M. The determination of cut-off points of the visceral adiposity index in predicting metabolic syndrome, insulin resistance, diabetes mellitus, and hypertension. Fam Pract Palliat Care. May 2022;7(2):41-48. doi:10.22391/fppc.1001148
Chicago Kılıç Türk, Hatice, Selma Pekgör, and Mehmet Eryılmaz. “The Determination of Cut-off Points of the Visceral Adiposity Index in Predicting Metabolic Syndrome, Insulin Resistance, Diabetes Mellitus, and Hypertension”. Family Practice and Palliative Care 7, no. 2 (May 2022): 41-48. https://doi.org/10.22391/fppc.1001148.
EndNote Kılıç Türk H, Pekgör S, Eryılmaz M (May 1, 2022) The determination of cut-off points of the visceral adiposity index in predicting metabolic syndrome, insulin resistance, diabetes mellitus, and hypertension. Family Practice and Palliative Care 7 2 41–48.
IEEE H. Kılıç Türk, S. Pekgör, and M. Eryılmaz, “The determination of cut-off points of the visceral adiposity index in predicting metabolic syndrome, insulin resistance, diabetes mellitus, and hypertension”, Fam Pract Palliat Care, vol. 7, no. 2, pp. 41–48, 2022, doi: 10.22391/fppc.1001148.
ISNAD Kılıç Türk, Hatice et al. “The Determination of Cut-off Points of the Visceral Adiposity Index in Predicting Metabolic Syndrome, Insulin Resistance, Diabetes Mellitus, and Hypertension”. Family Practice and Palliative Care 7/2 (May2022), 41-48. https://doi.org/10.22391/fppc.1001148.
JAMA Kılıç Türk H, Pekgör S, Eryılmaz M. The determination of cut-off points of the visceral adiposity index in predicting metabolic syndrome, insulin resistance, diabetes mellitus, and hypertension. Fam Pract Palliat Care. 2022;7:41–48.
MLA Kılıç Türk, Hatice et al. “The Determination of Cut-off Points of the Visceral Adiposity Index in Predicting Metabolic Syndrome, Insulin Resistance, Diabetes Mellitus, and Hypertension”. Family Practice and Palliative Care, vol. 7, no. 2, 2022, pp. 41-48, doi:10.22391/fppc.1001148.
Vancouver Kılıç Türk H, Pekgör S, Eryılmaz M. The determination of cut-off points of the visceral adiposity index in predicting metabolic syndrome, insulin resistance, diabetes mellitus, and hypertension. Fam Pract Palliat Care. 2022;7(2):41-8.
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