Search results for: Dursun Aydin

Authors: Dursun Aydin

Abstract:

This paper study about using of nonparametric models for Gross National Product data in Turkey and Stanford heart transplant data. It is discussed two nonparametric techniques called smoothing spline and kernel regression. The main goal is to compare the techniques used for prediction of the nonparametric regression models. According to the results of numerical studies, it is concluded that smoothing spline regression estimators are better than those of the kernel regression.

Keywords: Kernel regression, Nonparametric models, Prediction, Smoothing spline.

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Authors: Dursun Aydın, Bilgin Senel

Abstract:

In this paper, the sum of squares in linear regression is reduced to sum of squares in semi-parametric regression. We indicated that different sums of squares in the linear regression are similar to various deviance statements in semi-parametric regression. In addition to, coefficient of the determination derived in linear regression model is easily generalized to coefficient of the determination of the semi-parametric regression model. Then, it is made an application in order to support the theory of the linear regression and semi-parametric regression. In this way, study is supported with a simulated data example.

Keywords: Semi-parametric regression, Penalized LeastSquares, Residuals, Deviance, Smoothing Spline.

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Authors: Zeynep Sener, Mehtap Dursun

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Supplier evaluation and selection is one of the most important components of an effective supply chain management system. Due to the expanding competition in healthcare, selecting the right medical device suppliers offers great potential for increasing quality while decreasing costs. This paper proposes a fuzzy decision making approach for medical supplier selection. A real-world medical device supplier selection problem is presented to illustrate the application of the proposed decision methodology.

Keywords: Fuzzy decision making, fuzzy multiple objective programming, medical supply chain, supplier selection.

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Authors: Mehtap Dursun, Zeynep Şener

Abstract:

Supplier selection is considered as one of the most critical issues encountered by operations and purchasing managers to sharpen the company’s competitive advantage. In this paper, a novel fuzzy multi-criteria group decision making approach integrating quality function deployment (QFD) and decision making trial and evaluation laboratory (DEMATEL) method is proposed for supplier selection. The proposed methodology enables to consider the impacts of inner dependence among supplier assessment criteria. A house of quality (HOQ) which translates purchased product features into supplier assessment criteria is built using the weights obtained by DEMATEL approach to determine the desired levels of supplier assessment criteria. Supplier alternatives are ranked by a distance-based method.

Keywords: DEMATEL, Group decision making, QFD, Supplier selection.

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Authors: Dursun M., Koc F., Ozbay H.

Abstract:

In this study, a double-sided linear switched reluctance motor (LSRM) drive was investigated as an alternative actuator for vertical linear transportation applications such as a linear elevator door, hospital and subway doors which move linearly and where accurate position control and rapid response is requested. A prototype sliding elevator door that is focused on a home elevator with LSRMs is designed. The motor has 6/4 poles, 3 phases, 8A, 24V, 250 W and 250 N pull forces. Air gap between rotor and translator poles of the designed motor and phase coil-s ideal inductance profile are obtained in compliance with the geometric dimensions. Operation and switching sections as motor and generator has been determined from the inductance profile.

Keywords: Linear switched reluctance motor, sliding door, elevator door, linear motor design.

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Authors: Dursun Aydın

Abstract:

In this paper, estimation of the linear regression model is made by ordinary least squares method and the partially linear regression model is estimated by penalized least squares method using smoothing spline. Then, it is investigated that differences and similarity in the sum of squares related for linear regression and partial linear regression models (semi-parametric regression models). It is denoted that the sum of squares in linear regression is reduced to sum of squares in partial linear regression models. Furthermore, we indicated that various sums of squares in the linear regression are similar to different deviance statements in partial linear regression. In addition to, coefficient of the determination derived in linear regression model is easily generalized to coefficient of the determination of the partial linear regression model. For this aim, it is made two different applications. A simulated and a real data set are considered to prove the claim mentioned here. In this way, this study is supported with a simulation and a real data example.

Keywords: Partial Linear Regression Model, Linear RegressionModel, Residuals, Deviance, Smoothing Spline.

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Authors: Oktay Nusratov, Ramin Rzaev, Aydin Goyushov

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Fuzzy inference method based approach to the forming of modular intellectual system of assessment the quality of communication services is proposed. Developed under this approach the basic fuzzy estimation model takes into account the recommendations of the International Telecommunication Union in respect of the operation of packet switching networks based on IPprotocol. To implement the main features and functions of the fuzzy control system of quality telecommunication services it is used multilayer feedforward neural network.

Keywords: Quality of communication, IP-telephony, Fuzzy set, Fuzzy implication, Neural network.

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Authors: Mehtap Dursun, E. Ertugrul Karsak, Melis Almula Karadayi

Abstract:

Disposal of health-care waste (HCW) is considered as an important environmental problem especially in large cities. Multiple criteria decision making (MCDM) techniques are apt to deal with quantitative and qualitative considerations of the health-care waste management (HCWM) problems. This research proposes a fuzzy multi-criteria group decision making approach with a multilevel hierarchical structure including qualitative as well as quantitative performance attributes for evaluating HCW disposal alternatives for Istanbul. Using the entropy weighting method, objective weights as well as subjective weights are taken into account to determine the importance weighting of quantitative performance attributes. The results obtained using the proposed methodology are thoroughly analyzed.

Keywords: Entropy weighting method, group decision making, health-care waste management, hierarchical fuzzy multi-criteriadecision making

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Authors: Aydin Azizi, Poorya Ghafoorpoor Yazdi

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This paper presents the review of the studies on the ergonomics, virtual reality, and work measurement (time study) at the industrial workstations because each of these three individual techniques can be used to improve the design of workstations and task position. The objective of this paper is to give an overall literature review that if there is any relation between these three different techniques. Therefore, it is so important to review the scientific studies to find a better and effective way for improving design of workstations. On the other hand, manufacturers found that instead of using one of the approaches, utilizing the combination of these individual techniques are more effective to reduce the cost and production time.

Keywords: Ergonomics, time study, virtual reality, workplace.

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Authors: A. Aydin, E. Akyol, N. Soyatik

Abstract:

This study has been presented which is a detailed work of seismic microzonation of the city center. For seismic microzonation area of 225 km2 has been selected as the study area. MASW (Multichannel analysis of surface wave) and seismic refraction methods have been used to generate one-dimensional shear wave velocity profile at 250 locations and two-dimensional profile at 60 locations. These shear wave velocities are used to estimate equivalent shear wave velocity in the study area at every 2 and 5 m intervals up to a depth of 60 m. Levels of equivalent shear wave velocity of soil are used the classified of the study area. After the results of the study, it must be considered as components of urban planning and building design of Denizli and the application and use of these results should be required and enforced by municipal authorities.

Keywords: Seismic microzonation, liquefaction, land use management.

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Authors: Ahmet Selim Durna, Bayram Celik, Aydin Misirlioglu

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Flows over a harmonically oscillating NACA 0012 airfoil are simulated here using a two-dimensional, unsteady, incompressibleNavier-Stokes solver.Both pure-plunging and pitching-plunging combined oscillations are considered at a Reynolds number of 5000. Special attention is paid to the vortex shedding and interaction mechanism of the motions. For all the simulations presented here, the reduced frequency (k) is fixed at a value of 2.5 and plunging amplitude (h) is selected to be in the range of 0.2-0.5. The simulation results show that the interaction mechanism between the leading and trailing edge vortices has a decisive effect on the values of the resulting thrust and propulsive efficiency.

Keywords: pithing and plunging airfoil, leading edge vortex, trailing edge vortex, vortex interaction, wake structure.

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Authors: Duygu Aydin

Abstract:

Advertising today has already become an integral part of human life as a building block of the consumer community. A component of the value chain of the media, advertising sector is struggling increasingly harder to find new methods to reach consumers. The tendency towards experimental marketing practices is increasing day by day, especially to divert consumers from the idea “They are selling something to me.” It is therefore considered a good idea to investigate the trust in ad media of consumers, who are today exposed to a great bulk of information from advertising sector. In this study, the current value of ad media for the young consumer will be investigated. Data on various ad media reliability will be comparatively analyzed and young consumers will be traced by including university students in the study. In this research, which will be performed on students studying at the Selçuk University (Turkey) by random sampling method, data will be obtained by survey technique and evaluated by a statistical analysis.

Keywords: Trust in advertising, ad medium, media.

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Authors: Erdal Akyol, Mutlu Alkan, Ali Aydin

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Multi criteria decision analysis (MDCA) covers both data and experience. It is very common to solve the problems with many parameters and uncertainties. GIS supported solutions improve and speed up the decision process. Weighted grading as a MDCA method is employed for solving the geotechnical problems. In this study, geotechnical parameters namely soil type; SPT (N) blow number, shear wave velocity (Vs) and depth of underground water level (DUWL) have been engaged in MDCA and GIS. In terms of geotechnical aspects, the settlement suitability of the municipal area was analyzed by the method. MDCA results were compatible with the geotechnical observations and experience. The method can be employed in geotechnical oriented microzoning studies if the criteria are well evaluated.

Keywords: GIS, spatial analysis, multi criteria decision analysis, geotechnics.

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Authors: Bilge S. Oduncu, Sevil Yucel, Ismail Aydin, Isil D. Sener, Gokhan Yamaner

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The dental composites are preferably used as filling materials due to their esthetic appearances. Nevertheless one of the major problems, during the application of the dental composites, is shape change named as “polymerisation shrinkage" affecting clinical success of the dental restoration while photo-polymerisation. Polymerisation shrinkage of composites arises basically from the formation of a polymer due to the monomer transformation which composes of an organic matrix phase. It was sought, throughout this study, to detect and evaluate the structural polymerisation shrinkage of prepared dental composites in order to optimize the effects of various fillers included in hydroxyapatite (HA)-reinforced dental composites and hence to find a means to modify the properties of these dental composites prepared with defined parameters. As a result, the shrinkage values of the experimental dental composites were decreased by increasing the filler content of composites and the composition of different fillers used had effect on the shrinkage of the prepared composite systems.

Keywords: Dental composites, hydroxyapatite (HA), BisGMA, shrinkage.

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Authors: Hasan Karal, Yasemin Aydin, Ömer Faruk Ursavas

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Primary studies are being carried out in Turkey for expanding information and communication technologies (ICT) aided instruction activities. Subject of the present study is to identify whether those studies achieved their goals in the application. Information technologies (IT) formative teachers in the primary schools, and academicians in the faculties of education were interviewed to investigate the process and results of implementing computer-aided instruction methods whose basis is strengthened in theory. Analysis of the results gained from two separate surveys demonstrated that capability of the teachers in elementary education institutions for carrying into effect computer-aided instruction and technical infrastructure has not been established for computer-aided instruction practices yet. Prospective teachers must be well-equipped in ICT to duly fulfill requirements of modern education and also must be self-confident. Finally, scope and intensity of the courses given in connection with teaching of the ICT in faculties of education needs to be revised.

Keywords: Information and Communication Technologies, Teacher, Education

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Authors: Y. Yılmaz, C. Ünal, A. Dursun

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Distribution channels play significant role for hotels. Direct and indirect selling options of hotel rooms have been increased especially with the help of new technologies, i.e. hotel’s own web sites and online booking sites. Although these options emerged as tools for diversifying the distribution channels, vast number of hotels -mostly resort hotels- is still heavily dependent upon international tour operators when selling their products. On the other hand, hotel sector is so vulnerable against crises. Economic, political or any other crisis can affect hotels very badly and so it is critical to have the right balance of distribution channel to avoid the adverse impacts of a crisis. In this study, it is aimed to search the impacts of a general crisis on the selling prices of hotels which have different weights of distribution channels. The study was done in Turkey where various crises occurred in 2015 and 2016 which had great negative impacts on Turkish tourism and led enormous occupancy rate and selling price reductions. 112 upscale resort hotel in Antalya, which is the most popular tourism destination of Turkey, joined to the research. According to the results, hotels with high dependency to international tour operators are more forced to reduce their room prices in crisis time compared to the ones which use their own web sites more. It was also found that the decline in room prices is limited for hotels which are working with national tour operators and travel agencies in crisis time.

Keywords: Marketing channels, crisis, hotel, international tour operators, online travel agencies.

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Authors: Zeynep R. Ege, Aydin Akan, Faik N. Oktar, Betul Karademir, Oguzhan Gunduz

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Early detection of cancer could save human life and quality in insidious cases by advanced biomedical imaging techniques. Designing targeted detection system is necessary in order to protect of healthy cells. Electrospun nanofibers are efficient and targetable nanocarriers which have important properties such as nanometric diameter, mechanical properties, elasticity, porosity and surface area to volume ratio. In the present study, indocyanine green (ICG) organic dye was stabilized and encapsulated in polymer matrix which polyethylene oxide (PEO) and chitosan (CHI) multilayer nanofibers via co-axial electrospinning method at one step. The co-axial electrospun nanofibers were characterized as morphological (SEM), molecular (FT-IR), and entrapment efficiency of Indocyanine Green (ICG) (confocal imaging). Controlled release profile of PEO/CHI/ICG nanofiber was also evaluated up to 40 hours.

Keywords: Chitosan, coaxial electrospinning, controlled releasing, indocyanine green, nanoprobe, polyethylene oxide.

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Authors: Mehtap Dursun, E. Ertugrul Karsak, Melis Almula Karadayi

Abstract:

The management of the health-care wastes is one of the most important problems in Istanbul, a city with more than 12 million inhabitants, as it is in most of the developing countries. Negligence in appropriate treatment and final disposal of the healthcare wastes can lead to adverse impacts to public health and to the environment. This paper employs a fuzzy multi-criteria group decision making approach, which is based on the principles of fusion of fuzzy information, 2-tuple linguistic representation model, and technique for order preference by similarity to ideal solution (TOPSIS), to evaluate health-care waste (HCW) treatment alternatives for Istanbul. The evaluation criteria are determined employing nominal group technique (NGT), which is a method of systematically developing a consensus of group opinion. The employed method is apt to manage information assessed using multigranularity linguistic information in a decision making problem with multiple information sources. The decision making framework employs ordered weighted averaging (OWA) operator that encompasses several operators as the aggregation operator since it can implement different aggregation rules by changing the order weights. The aggregation process is based on the unification of information by means of fuzzy sets on a basic linguistic term set (BLTS). Then, the unified information is transformed into linguistic 2-tuples in a way to rectify the problem of loss information of other fuzzy linguistic approaches.

Keywords: Group decision making, health care waste management, multi-criteria decision making, OWA, TOPSIS, 2-tuple linguistic representation

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Authors: Gokhan Dok, Hakan Ozturk, Aydin Demir

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The behavior of reinforced concrete (RC) members is quite important in RC structures. When evaluating the performance of structures, the nonlinear properties are defined according to the cross sectional behavior of RC members. To be able to determine the behavior of RC members, its cross sectional behavior should be known well. The moment-curvature (MC) relationship is used to represent cross sectional behavior. The MC relationship of RC cross section can be best determined both experimentally and numerically. But, experimental study on RC members is very difficult. The aim of the study is to obtain the MC relationship of RC shear walls. Additionally, it is aimed to determine the parameters which affect MC relationship. While obtaining MC relationship of RC members, XTRACT which can represent robustly the MC relationship is used. Concrete quality, longitudinal and transverse reinforcing ratios, are selected as parameters which affect MC relationship. As a result of the study, curvature ductility and effective flexural stiffness are determined using this parameter. Effective flexural stiffness is compared with the values defined in design codes.

Keywords: Moment-curvature, reinforced concrete, shear wall, numerical.

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Authors: Tugrul Oktay, Mehmet Konar, Mohamed Abdallah Mohamed, Murat Aydin, Firat Sal, Murat Onay, Mustafa Soylak

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In this paper, it is aimed to improve autonomous flight performance of a load-carrying (payload: 3 kg and total: 6kg) unmanned aerial vehicle (UAV) through active wing and horizontal tail active morphing and also integrated autopilot system parameters (i.e. P, I, D gains) and UAV parameters (i.e. extension ratios of wing and horizontal tail during flight) design. For this purpose, a loadcarrying UAV (i.e. ZANKA-II) is manufactured in Erciyes University, College of Aviation, Model Aircraft Laboratory is benefited. Optimum values of UAV parameters and autopilot parameters are obtained using a stochastic optimization method. Using this approach autonomous flight performance of UAV is substantially improved and also in some adverse weather conditions an opportunity for safe flight is satisfied. Active morphing and integrated design approach gives confidence, high performance and easy-utility request of UAV users.

Keywords: Unmanned aerial vehicles, morphing, autopilots, autonomous performance.

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Authors: Batin Latif Aylak, Bernd Noche, M. Baran Cantepe, Aydin Karakaya

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Ultra-light overhead conveyor systems are rope-based conveying systems with individually driven vehicles. The vehicles can move automatically on the rope and this can be realized by energy and signals. The ultra-light overhead conveyor systems always must be integrated with a logistical process by finding a best way for a cheaper material flow in order to guarantee precise and fast workflows. This paper analyzes the process of an ultra-light overhead conveyor system using necessary assumptions. The analysis consists of three scenarios. These scenarios are based on raising the vehicle speeds with equal increments at each case. The correlation between the vehicle speed and system throughput is investigated. A discrete-event simulation model of an ultra-light overhead conveyor system is constructed using DOSIMIS-3 software to implement three scenarios. According to simulation results; the optimal scenario, hence the optimal vehicle speed, is found out among three scenarios. This simulation model demonstrates the effect of increased speed on the system throughput.

Keywords: Logistics, material flow, simulation, ultra-light overhead conveyor.

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Authors: T. Aydin, M. F. Alaeddinoglu

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People, throughout the history, have made estimates and inferences about the future by using their past experiences. Developing information technologies and the improvements in the database management systems make it possible to extract useful information from knowledge in hand for the strategic decisions. Therefore, different methods have been developed. Data mining by association rules learning is one of such methods. Apriori algorithm, one of the well-known association rules learning algorithms, is not commonly used in spatio-temporal data sets. However, it is possible to embed time and space features into the data sets and make Apriori algorithm a suitable data mining technique for learning spatiotemporal association rules. Lake Van, the largest lake of Turkey, is a closed basin. This feature causes the volume of the lake to increase or decrease as a result of change in water amount it holds. In this study, evaporation, humidity, lake altitude, amount of rainfall and temperature parameters recorded in Lake Van region throughout the years are used by the Apriori algorithm and a spatio-temporal data mining application is developed to identify overflows and newlyformed soil regions (underflows) occurring in the coastal parts of Lake Van. Identifying possible reasons of overflows and underflows may be used to alert the experts to take precautions and make the necessary investments.

Keywords: Apriori algorithm, association rules, data mining, spatio-temporal data.

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Authors: Mahmud Gungor, Ali Aydin, Erdal Akyol, Suat Tasdelen

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The understanding of geotechnical characteristics of near-surface material and the effects of the groundwater is very important problem in such as site studies. For showing the relations between seismic data and groundwater, we selected about 25 km2 as the study area. It has been presented which is a detailed work of seismic data and groundwater depths of Gokpinar Damp area. Seismic waves velocity (Vp and Vs) are very important parameters showing the soil properties. The seismic records were used the method of the multichannel analysis of surface waves near area of Gokpinar Damp area. Sixty sites in this area have been investigated with survey lines about 60 m in length. MASW (Multichannel analysis of surface wave) method has been used to generate onedimensional shear wave velocity profile at locations. These shear wave velocities are used to estimate equivalent shear wave velocity in the study area at every 2 and 5 m intervals up to a depth of 45 m. Levels of equivalent shear wave velocity of soil are used the classified of the study area. After the results of the study, it must be considered as components of urban planning and building design of Gokpinar Damp area, Denizli and the application and use of these results should be required and enforced by municipal authorities.

Keywords: Seismic data, Gokpinar Damp, urban planning, Denizli.

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Authors: Nesli Aydin

Abstract:

Waste management decision making in developing countries has moved towards being more pragmatic, transparent, sustainable and comprehensive. Turkey is required to make its waste related legislation compatible with European Legislation as it is a candidate country of the European Union. Improper Turkish practices such as open burning and open dumping practices must be abandoned urgently, and robust waste management systems have to be structured. The determination of an optimum waste management system in any region requires a comprehensive analysis in which many criteria are taken into account by stakeholders. In conducting this sort of analysis, there are two main criteria which are evaluated by waste management analysts; economic viability and environmentally friendliness. From an analytical point of view, a central characteristic of sustainable development is an economic-ecological integration. It is predicted that building a robust waste management system will need significant effort and cooperation between the stakeholders in developing countries such as Turkey. In this regard, this study aims to provide data regarding the cost and environmental burdens of waste treatment technologies such as an incinerator, an autoclave (with different capacities), a hydroclave and a microwave coupled with updated information on calculation methods, and a framework for comparing any proposed scenario performances on a cost and environmental basis.

Keywords: Decision making, economic viability, environmentally friendliness, stakeholder, waste management systems.

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Authors: Yusri Yusof, Stephen Newman, Aydin Nassehi, Keith Case

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The changing economic climate has made global manufacturing a growing reality over the last decade, forcing companies from east and west and all over the world to collaborate beyond geographic boundaries in the design, manufacture and assemble of products. The ISO10303 and ISO14649 Standards (STEP and STEP-NC) have been developed to introduce interoperability into manufacturing enterprises so as to meet the challenge of responding to production on demand. This paper describes and illustrates a STEP compliant CAD/CAPP/CAM System for the manufacture of rotational parts on CNC turning centers. The information models to support the proposed system together with the data models defined in the ISO14649 standard used to create the NC programs are also described. A structured view of a STEP compliant CAD/CAPP/CAM system framework supporting the next generation of intelligent CNC controllers for turn/mill component manufacture is provided. Finally a proposed computational environment for a STEP-NC compliant system for turning operations (SCSTO) is described. SCSTO is the experimental part of the research supported by the specification of information models and constructed using a structured methodology and object-oriented methods. SCSTO was developed to generate a Part 21 file based on machining features to support the interactive generation of process plans utilizing feature extraction. A case study component has been developed to prove the concept for using the milling and turning parts of ISO14649 to provide a turn-mill CAD/CAPP/CAM environment.

Keywords:

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Authors: Orkide Donma, M. Metin Donma, Burcin Nalbantoglu, Birol Topcu, Feti Tulubas, Murat Aydin, Tuba Gokkus, Ahmet Gurel

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Increasing prevalence of childhood obesity has increased the interest in early and late indicators of gaining weight. Cell blood counts may be indicators of pro-inflammatory states. The aim was to evaluate associations of hematological parameters, including hematocrit (HTC), hemoglobin, blood cell counts and their indices with the degree of obesity in pediatric population. A total of 249; -139 morbidly obese (MO), 82 healthy normal weight (NW) and 28 overweight (OW) children were included into the scope of the study. WHO BMI-for age percentiles were used to form age- and sexmatched groups. Informed consent forms and the Ethics Committee approval were obtained. Anthropometric measurements were performed. Hematological parameters were determined. Statistical analyses were performed using SPSS. The degree for statistical significance was p≤0.05. Significant differences (p=0.000) between waist-to-hip ratios and head-to- neck ratios (hnrs) of MO and NW children were detected. A significant difference between hnrs of OW and MO children (p=0.000) was observed. Red cell distribution width (RDW) was higher in OW children than NW group (p=0.030). Such finding couldn’t be detected between MO and NW groups. Increased RDW was prominent in OW children. The decrease in mean corpuscular hemoglobin concentration (MCHC) values in MO children was sharper than the values in OW children (p=0.006 vs p=0.042) compared to those in NW group. Statistically higher HTC levels were observed between MO-NW (p=0.014), but none between OW-NW. Though the cause-effect relationship between obesity and erythrocyte indices still needs further investigation, alterations in RDW, HTC, MCHC during obesity may be of significance in the early life.

Keywords: Anthropometry, children, erythrocytes, obesity.

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Authors: Mustafa M. Donma, Orkide Donma, Murat Aydin, Muhammet Demirkol, Burcin Nalbantoglu, Aysin Nalbantoglu, Birol Topcu

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Childhood obesity is an ever increasing global health problem, affecting both developed and developing countries. Accurate evaluation of obesity in children requires difficult and detailed investigation. In our study, obesity in children was evaluated using new body fat ratios and indices. Assessment of anthropometric measurements, as well as some ratios, is important because of the evaluation of gender differences particularly during the late periods of obesity. A total of 239 children; 168 morbid obese (MO) (81 girls and 87 boys) and 71 normal weight (NW) (40 girls and 31 boys) children, participated in the study. Informed consent forms signed by the parents were obtained. Ethics Committee approved the study protocol. Mean ages (years)±SD calculated for MO group were 10.8±2.9 years in girls and 10.1±2.4 years in boys. The corresponding values for NW group were 9.0±2.0 years in girls and 9.2±2.1 years in boys. Mean body mass index (BMI)±SD values for MO group were 29.1±5.4 kg/m² and 27.2±3.9 kg/m² in girls and boys, respectively. These values for NW group were calculated as 15.5±1.0 kg/m² in girls and 15.9±1.1 kg/m² in boys. Groups were constituted based upon BMI percentiles for age-and-sex values recommended by WHO. Children with percentiles >99 were grouped as MO and children with percentiles between 85 and 15 were considered NW. The anthropometric measurements were recorded and evaluated along with the new ratios such as trunk-to-appendicular fat ratio, as well as indices such as Index-I and Index-II. The body fat percent values were obtained by bio-electrical impedance analysis. Data were entered into a database for analysis using SPSS/PASW 18 Statistics for Windows statistical software. Increased waist-to-hip circumference (C) ratios, decreased head-to-neck C, height ‘to’ ‘two’-‘to’-waist C and height ‘to’ ‘two’-‘to’-hip C ratios were observed in parallel with the development of obesity (p≤0.001). Reference value for height ‘to’ ‘two’-‘to’-hip ratio was detected as approximately 1.0. Index-II, based upon total body fat mass, showed much more significant differences between the groups than Index-I based upon weight. There was not any difference between trunk-to-appendicular fat ratios of NW girls and NW boys (p≥0.05). However, significantly increased values for MO girls in comparison with MO boys were observed (p≤0.05). This parameter showed no difference between NW and MO states in boys (p≥0.05). However, statistically significant increase was noted in MO girls compared to their NW states (p≤0.001). Trunk-to-appendicular fat ratio was the only fat-based parameter, which showed gender difference between NW and MO groups. This study has revealed that body ratios and formula based upon body fat tissue are more valuable parameters than those based on weight and height values for the evaluation of morbid obesity in children.

Keywords: Anthropometry, childhood obesity, gender, Morbid obesity.

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Authors: Orkide Donma, Mustafa M. Donma, Muhammet Demirkol, Murat Aydin, Tuba Gokkus, Burcin Nalbantoglu, Aysin Nalbantoglu, Birol Topcu

Abstract:

Obesity in childhood establishes a ground for adulthood obesity. Especially morbid obesity is an important problem for the children because of the associated diseases such as diabetes mellitus, cancer and cardiovascular diseases. In this study, body mass index (BMI), body fat ratios, anthropometric measurements and ratios were evaluated together with different laboratory indices upon evaluation of obesity in morbidly obese (MO) children. Children with nutritional problems participated in the study. Written informed consent was obtained from the parents. Study protocol was approved by the Ethics Committee. Sixty-two MO girls aged 129.5±35.8 months and 75 MO boys aged 120.1±26.6 months were included into the scope of the study. WHO-BMI percentiles for age-and-sex were used to assess the children with those higher than 99^th as morbid obesity. Anthropometric measurements of the children were recorded after their physical examination. Bio-electrical impedance analysis was performed to measure fat distribution. Anthropometric ratios, body fat ratios, Index-I and Index-II as well as insulin sensitivity indices (ISIs) were calculated. Girls as well as boys were binary grouped according to homeostasis model assessment-insulin resistance (HOMA-IR) index of <2.5 and >2.5, fasting glucose to insulin ratio (FGIR) of <6 and >6 and quantitative insulin sensitivity check index (QUICKI) of <0.33 and >0.33 as the frequently used cut-off points. They were evaluated based upon their BMIs, arms, legs, trunk, whole body fat percentages, body fat ratios such as fat mass index (FMI), trunk-to-appendicular fat ratio (TAFR), whole body fat ratio (WBFR), anthropometric measures and ratios [waist-to-hip, head-to-neck, thigh-to-arm, thigh-to-ankle, height/2-to-waist, height/2-to-hip circumference (C)]. SPSS/PASW 18 program was used for statistical analyses. p≤0.05 was accepted as statistically significance level. All of the fat percentages showed differences between below and above the specified cut-off points in girls when evaluated with HOMA-IR and QUICKI. Differences were observed only in arms fat percent for HOMA-IR and legs fat percent for QUICKI in boys (p≤ 0.05). FGIR was unable to detect any differences for the fat percentages of boys. Head-to-neck C was the only anthropometric ratio recommended to be used for all ISIs (p≤0.001 for both girls and boys in HOMA-IR, p≤0.001 for girls and p≤0.05 for boys in FGIR and QUICKI). Indices which are recommended for use in both genders were Index-I, Index-II, HOMA/BMI and log HOMA (p≤0.001). FMI was also a valuable index when evaluated with HOMA-IR and QUICKI (p≤0.001). The important point was the detection of the severe significance for HOMA/BMI and log HOMA while they were evaluated also with the other indices, FGIR and QUICKI (p≤0.001). These parameters along with Index-I were unique at this level of significance for all children. In conclusion, well-accepted ratios or indices may not be valid for the evaluation of both genders. This study has emphasized the limiting properties for boys. This is particularly important for the selection process of some ratios and/or indices during the clinical studies. Gender difference should be taken into consideration for the evaluation of the ratios or indices, which will be recommended to be used particularly within the scope of obesity studies.

Keywords: Anthropometry, childhood obesity, gender, insulin sensitivity index.

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