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THE RELATIONSHIP BETWEEN BLOOD GROUPS AND PLATELETCRIT IN HEALTHY TURKISH POPULATION

Year 2022, , 314 - 323, 30.09.2022
https://doi.org/10.17343/sdutfd.1073876

Abstract

Objective
Plateletcrit (PCT) and mean platelet volume (MPV)
are important platelet indices that are associated
with various systemic and inflammatory disorders.
The aims of this study are, first to determine normal
ranges of PCT in a healthy population and second,
evaluation of the possible link between blood groups
and two platelet indices, PCT and MPV.
Material and Method
One thousand five hundred healthy subjects were
chosen for the study from 2011 to 2021 retrospectively.
Hemoglobin, hematocrit, mean corpuscular volume,
leukocyte count, leukocyte differentials, MPV, PCT
and platelet counts were analysed.
Results
In 1082 subjects, the mean PCT count was 0.20±0.04
% (min 0.11-max 0.46 %) and mean MPV was
8.41±0.92 fL (min 6.20-max 11.90 fL). The mean
PCT, MPV and platelet counts of the study group were
found to be significantly higher in women than in men
(p<0.001). PCT and platelet counts were inversely
related to age and mean PCT was significantly
higher in 18-40 than 41-60 age group (p=0.021).
There was no association between ABO groups and
platelet indices. When blood groups were separated
according to their Rh status; it was found that subjects
who were Rh positive had a significantly higher mean
PCT and platelet count than Rh negatives (p=0.003
and p=0.006).
Conclusion
Mean PCT was 0.20 %. Women had significantly
higher PCT, and platelet counts compared to men
and these counts were significantly lower compared to
other studies in our country. There was no association
between ABO groups and platelet indices. PCT and
platelet counts were significantly higher in Rh positive
study subjects compared to Rh negatives.

Supporting Institution

Yok

Project Number

Yok

Thanks

The authors appreciate the efforts of Dr. Hande Nur Eroglu for the article

References

  • 1. Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des. 2011;17(1):47-58. doi:10.2174/138161211795049804. PMID: 21247392.
  • 2. Wiwanitkit V. Plateletcrit, mean platelet volume, platelet distribution width: its expected values and correlation with parallel red blood cell parameters. Clin Appl Thromb Hemost. 2004 Apr;10(2):175-8. doi: 10.1177/107602960401000208. PMID: 15094938.
  • 3. Hur JY, Lee HY, Chang HJ, Choi CW, Kim DH, Eo WK. Preoperative plateletcrit is a Prognostic Biomarker for Survival in Patients with Non-Small Cell Lung Cancer. J Cancer. 2020 Feb 25;11(10):2800-2807. doi: 10.7150/jca.41122. PMID: 32226498; PMCID: PMC7086273.
  • 4. Ustaoglu G, Erdal E, Inanır M. Does periodontitis affect mean platelet volume (MPV) and plateletcrit (PCT) levels in healthy adults? Rev Assoc Med Bras (1992). 2020 May 15;66(2):133- 138. doi: 10.1590/1806-9282.66.2.133. PMID: 32428146.
  • 5. Cetin MS, Ozcan Cetin EH, Akdi A, Aras D, Topaloglu S, Temizhan A, et al. Platelet distribution width and plateletcrit: novel biomarkers of ST elevation myocardial infarction in young patients. Kardiol Pol. 2017;75(10):1005-1012. doi: 10.5603/KP. a2017.0135. Epub 2017 Jul 17. PMID: 28715073.
  • 6. Giovanetti TV, do Nascimento AJ, de Paula JP. Platelet indices: laboratory and clinical applications. Rev Bras Hematol Hemoter. 2011;33(2):164-5. doi: 10.5581/1516-8484.20110040. PMID: 23284267; PMCID: PMC3520644.
  • 7. Chandrashekar V. Plateletcrit as a Screening Tool for Detection of Platelet Quantitative Disorders. J Hematol • 2013;2(1):22-26. doi: http://dx.doi.org/10.4021/jh70w
  • 8. Adibi P, Faghih Imani E, Talaei M, Ghanei M. Population-based platelet reference values for an Iranian population. Int J Lab Hematol. 2007 Jun;29(3):195-9. doi: 10.1111/j.1751- 553X.2006.00843. x. PMID: 17474897.
  • 9. Kumas LT. [Kan grup antijenleri ve antikorları]. In: [HematoLog. Kan Bankacılığı, Transfüzyon Tıbbı ve Aferez]. Soysal T, Bayık B, Demir AM, Tiftik EC, (eds). Türk Hematoloji Derneği Ankara, Mart 2015 Cilt 5, Sayı 1. (In Turkish)
  • 10. Oral A, Sahin T. Prognostic role of ABO blood group and Rhesus factor in cirrhotic patients with hepatocellular carcinoma. Sci Rep. 2019 Dec 13;9(1):19087. doi: 10.1038/s41598-019- 55685-8. PMID: 31836844; PMCID: PMC6910915.
  • 11. Solmaz I, Araç S. ABO blood groups in COVID-19 patients; Cross-sectional study. Int J Clin Pract. 2021 Apr;75(4): e13927. doi: 10.1111/ijcp.13927. Epub 2020 Dec 19. PMID: 33296536; PMCID: PMC7883261.
  • 12. Cildag S, Kara Y, Senturk T. ABO blood groups and rheumatic diseases. Eur J Rheumatol. 2017 Dec;4(4):250-253. doi: 10.5152/eurjrheum.2017.17044. Epub 2017 Nov 2. PMID: 29308278; PMCID: PMC5741336.
  • 13. Celik H, Duzenli U, Aslan M, Altiparmak IH, Kirmit A, Kara E, et al. The relationship between platelet indices and ABO blood groups in healthy adults. J Clin Lab Anal. 2019 Mar;33(3): e22720. doi: 10.1002/jcla.22720. Epub 2018 Nov 21. PMID: 30461052; PMCID: PMC6818600.
  • 14. Sherry A, Henson RK. Conducting and interpreting canonical correlation analysis in personality research: a user-friendly primer. J Pers Assess. 2005 Feb;84(1):37-48. doi: 10.1207/ s15327752jpa8401_09. PMID: 15639766.
  • 15. Gill GV, England A, Marshal C. Low platelet counts in Zambians. Trans R Soc Trop Med Hyg. 1979;73(1):111-2. doi: 10.1016/0035-9203(79)90142-1. PMID: 442169.
  • 16. Boshnak NH. Reference intervals for platelet indices using Sysmex XT-1800i in Egyptian population. Hematol., Transfus. Cell Ther. 41 (2) • Apr-Jun 2019https://doi.org/10.1016/j. htct.2018.09.005
  • 17. Ali U, Gibbs R, Knight G, Tsitsikas D. Sex-divided reference intervals for mean platelet volume, platelet large cell ratio and plateletcrit using the Sysmex XN-10 automated haematology analyzer in a UK population. Hematol Transfus Cell Ther. 2019 Apr-Jun;41(2):153-157. doi: 10.1016/j.htct.2018.09.005. Epub 2018 Dec 31. PMID: 31079661; PMCID: PMC6517618.
  • 18. Kim MJ, Park PW, Seo YH, Kim KH, Seo JY, Jeong JH, et al. Reference intervals for platelet parameters in Korean adults using ADVIA 2120. Ann Lab Med. 2013 Sep;33(5):364-6. doi: 10.3343/alm.2013.33.5.364. Epub 2013 Aug 8. PMID: 24003429; PMCID: PMC3756243.
  • 19. Kabasakal EA, Ergene U, Ozlu C. Normal complete blood count reference intervals in the Turkish population: a prospective study. Hematol Transfus Int J. 2018;6(4):135-139. DOI: 10.15406/htij.2018.06.00169
  • 20. Alper AT, Sevimli S, Hasdemir H, Nurkalem Z, Guvenc TS, Akyol A, et al. Effects of high altitude and sea level on mean platelet volume and platelet count in patients with acute coronary syndrome. J Thromb Thrombolysis. 2009 Feb;27(2):130- 4. doi: 10.1007/s11239-007-0159-9. Epub 2007 Nov 4. PMID: 17978877.
  • 21. Tekkesin, N, Bekoz, H. and Tukenmez, F. The largest reference range study for hematological parameters from Turkey: A case control study. Journal of Clinical and Experimental Investigations, 5(4), 548-552. https:// dx.doi.org/ 10.5799/ahinjs. 01.2014.04.0455
  • 22. Kaya H, Kiki I, Akarsu E, Gundogdu M, Basol Tekin S, Inandı T. Hematological Values of Healthy Adult Population Living at Moderate Altitude (1869 m, Erzurum, Turkey). Turk J Haematol. 2000 Sep 5;17(3):123-8. PMID: 27263502.
  • 23. Ozarda Y, Ichihara K, Bakan E, Polat H, Ozturk N, Baygutalp NK, et al. A nationwide multicentre study in Turkey for establishing reference intervals of haematological parameters with novel use of a panel of whole blood. Biochem Med (Zagreb). 2017 Jun 15;27(2):350-377. doi: 10.11613/BM.2017.038. PMID: 28694726; PMCID: PMC5493180.
  • 24. Dunbar NM. Does ABO and RhD matching matter for platelet transfusion? Hematology Am Soc Hematol Educ Program. 2020 Dec 4;2020(1):512-517. doi: 10.1182/hematology.2020000135. PMID: 33275681; PMCID: PMC7727583.
  • 25. Curtis BR, Edwards JT, Hessner MJ, Klein JP, Aster RH. Blood group A and B antigens are strongly expressed on platelets of some individuals. Blood. 2000 Aug 15;96(4):1574-81. PMID: 10942408.
  • 26. Thibault L, de Grandmont MJ, Cayer MP, Dussault N, Jacques A, Ducas E, et al. Rhesus D Antigenic Determinants on Residual Red Blood Cells in Apheresis and Buffy Coat Platelet Concentrates. Transfus Med Hemother. 2020 Apr;47(2):129-134. doi: 10.1159/000501106. Epub 2019 Jun 27. PMID: 32355472; PMCID: PMC7184823.
  • 27. Ward SE, O'Sullivan JM, O'Donnell JS. The relationship between ABO blood group, von Willebrand factor, and primary hemostasis. Blood. 2020 Dec 17;136(25):2864-2874. doi: 10.1182/ blood.2020005843. PMID: 32785650; PMCID: PMC7751360.
  • 28. Karolczak K, Soltysik B, Kostka T, Witas PJ, Watala C. Platelet and Red Blood Cell Counts, as well as the Concentrations of Uric Acid, but Not Homocysteinaemia or Oxidative Stress, Contribute Mostly to Platelet Reactivity in Older Adults. Oxid Med Cell Longev. 2019 Jan 16; 2019:9467562. doi: 10.1155/2019/9467562. PMID: 30800213; PMCID: PMC6360040.
  • 29. Yanasik M, Oguz FS, Besisik SK, Huslu M, Ozturk G, Temurhan S, et al. Frequency of RHD variants in serologically weak D Turkish blood donors. Transfus Apher Sci. 2021 Apr;60(2):103024. doi: 10.1016/j.transci.2020.103024. Epub 2020 Nov 27. PMID: 33308979.
  • 30. Daniels G. Variants of RhD--current testing and clinical consequences. Br J Haematol. 2013 May;161(4):461-70. doi: 10.1111/bjh.12275. Epub 2013 Feb 25. PMID: 23432139.
  • 31. Salduz ZIY, Cetin G, Karatoprak C, Ozder A, Bilginc M, Gultepe I, et al. ABO and Rh Blood Group Distribution in Istanbul Province (Turkey). İstanbul Med J 2015; 16: 98-100. DOI: 10.5152/ imj.2015.14890

SAĞLIKLI TÜRK NÜFUSUNDA KAN GRUPLARI İLE PLATELETKRİTİN İLİŞKİSİ

Year 2022, , 314 - 323, 30.09.2022
https://doi.org/10.17343/sdutfd.1073876

Abstract

Amaç
Plateletkrit (PCT) ve ortalama trombosit hacmi (MPV),
çeşitli sistemik ve inflamatuar bozukluklarla ilişkili
önemli trombosit göstergeleridir. Bu çalışmanın amacı,
öncelikle sağlıklı popülasyonda normal PCT aralıklarının
belirlenmesi ve ikincil olarak kan grupları ile
PCT ve MPV arasındaki olası bağlantının değerlendirilmesidir.
Gereç ve Yöntem
Çalışma için, 2011’den 2021’e kadar, retrospektif olarak,
bin beş yüz sağlıklı birey seçildi. Hemoglobin, hematokrit,
ortalama alyuvar hacmi, lökosit sayısı, lökosit
farklılıkları, MPV, PCT ve trombosit sayıları analiz
edildi.
Bulgular
1082 denekte ortalama PCT 0,20±0,04 % (min 0,11-
maks 0,46 %) ve ortalama MPV 8,41±0,92 fL (min
6,20-maks 11,90 fL) idi. Çalışma grubunun ortalama
PCT, MPV ve trombosit düzeyleri kadınlarda erkeklere
göre anlamlı derecede yüksek bulundu (p<0,001).
PCT ve trombosit sayıları yaşla ters orantılıydı ve ortalama
PCT 18-40 yaş grubunda, 41-60 yaş grubuna
göre anlamlı derecede yüksekti (p=0,021). ABO grupları
ile trombosit indeksleri arasında ilişki yoktu. Kan
grupları Rh durumlarına göre ayrıldığında; Rh pozitif
olan deneklerin ortalama PCT ve trombosit sayısının
Rh negatif olanlara göre anlamlı derecede yüksek olduğu
bulundu (p=0,003 ve p=0,006).
Sonuç
Ortalama PCT 0,20 % idi. Kadınlarda PCT ve trombosit
sayıları erkeklere göre anlamlı derecede yüksekti
ve bu değerler, ülkemizdeki diğer çalışmalara göre
anlamlı derecede düşüktü. ABO grupları ile trombosit
indeksleri arasında ilişki yoktu. PCT ve trombosit
sayıları, Rh negatif olanlara kıyasla Rh pozitif çalışma
deneklerinde önemli ölçüde daha yüksekti.

Project Number

Yok

References

  • 1. Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des. 2011;17(1):47-58. doi:10.2174/138161211795049804. PMID: 21247392.
  • 2. Wiwanitkit V. Plateletcrit, mean platelet volume, platelet distribution width: its expected values and correlation with parallel red blood cell parameters. Clin Appl Thromb Hemost. 2004 Apr;10(2):175-8. doi: 10.1177/107602960401000208. PMID: 15094938.
  • 3. Hur JY, Lee HY, Chang HJ, Choi CW, Kim DH, Eo WK. Preoperative plateletcrit is a Prognostic Biomarker for Survival in Patients with Non-Small Cell Lung Cancer. J Cancer. 2020 Feb 25;11(10):2800-2807. doi: 10.7150/jca.41122. PMID: 32226498; PMCID: PMC7086273.
  • 4. Ustaoglu G, Erdal E, Inanır M. Does periodontitis affect mean platelet volume (MPV) and plateletcrit (PCT) levels in healthy adults? Rev Assoc Med Bras (1992). 2020 May 15;66(2):133- 138. doi: 10.1590/1806-9282.66.2.133. PMID: 32428146.
  • 5. Cetin MS, Ozcan Cetin EH, Akdi A, Aras D, Topaloglu S, Temizhan A, et al. Platelet distribution width and plateletcrit: novel biomarkers of ST elevation myocardial infarction in young patients. Kardiol Pol. 2017;75(10):1005-1012. doi: 10.5603/KP. a2017.0135. Epub 2017 Jul 17. PMID: 28715073.
  • 6. Giovanetti TV, do Nascimento AJ, de Paula JP. Platelet indices: laboratory and clinical applications. Rev Bras Hematol Hemoter. 2011;33(2):164-5. doi: 10.5581/1516-8484.20110040. PMID: 23284267; PMCID: PMC3520644.
  • 7. Chandrashekar V. Plateletcrit as a Screening Tool for Detection of Platelet Quantitative Disorders. J Hematol • 2013;2(1):22-26. doi: http://dx.doi.org/10.4021/jh70w
  • 8. Adibi P, Faghih Imani E, Talaei M, Ghanei M. Population-based platelet reference values for an Iranian population. Int J Lab Hematol. 2007 Jun;29(3):195-9. doi: 10.1111/j.1751- 553X.2006.00843. x. PMID: 17474897.
  • 9. Kumas LT. [Kan grup antijenleri ve antikorları]. In: [HematoLog. Kan Bankacılığı, Transfüzyon Tıbbı ve Aferez]. Soysal T, Bayık B, Demir AM, Tiftik EC, (eds). Türk Hematoloji Derneği Ankara, Mart 2015 Cilt 5, Sayı 1. (In Turkish)
  • 10. Oral A, Sahin T. Prognostic role of ABO blood group and Rhesus factor in cirrhotic patients with hepatocellular carcinoma. Sci Rep. 2019 Dec 13;9(1):19087. doi: 10.1038/s41598-019- 55685-8. PMID: 31836844; PMCID: PMC6910915.
  • 11. Solmaz I, Araç S. ABO blood groups in COVID-19 patients; Cross-sectional study. Int J Clin Pract. 2021 Apr;75(4): e13927. doi: 10.1111/ijcp.13927. Epub 2020 Dec 19. PMID: 33296536; PMCID: PMC7883261.
  • 12. Cildag S, Kara Y, Senturk T. ABO blood groups and rheumatic diseases. Eur J Rheumatol. 2017 Dec;4(4):250-253. doi: 10.5152/eurjrheum.2017.17044. Epub 2017 Nov 2. PMID: 29308278; PMCID: PMC5741336.
  • 13. Celik H, Duzenli U, Aslan M, Altiparmak IH, Kirmit A, Kara E, et al. The relationship between platelet indices and ABO blood groups in healthy adults. J Clin Lab Anal. 2019 Mar;33(3): e22720. doi: 10.1002/jcla.22720. Epub 2018 Nov 21. PMID: 30461052; PMCID: PMC6818600.
  • 14. Sherry A, Henson RK. Conducting and interpreting canonical correlation analysis in personality research: a user-friendly primer. J Pers Assess. 2005 Feb;84(1):37-48. doi: 10.1207/ s15327752jpa8401_09. PMID: 15639766.
  • 15. Gill GV, England A, Marshal C. Low platelet counts in Zambians. Trans R Soc Trop Med Hyg. 1979;73(1):111-2. doi: 10.1016/0035-9203(79)90142-1. PMID: 442169.
  • 16. Boshnak NH. Reference intervals for platelet indices using Sysmex XT-1800i in Egyptian population. Hematol., Transfus. Cell Ther. 41 (2) • Apr-Jun 2019https://doi.org/10.1016/j. htct.2018.09.005
  • 17. Ali U, Gibbs R, Knight G, Tsitsikas D. Sex-divided reference intervals for mean platelet volume, platelet large cell ratio and plateletcrit using the Sysmex XN-10 automated haematology analyzer in a UK population. Hematol Transfus Cell Ther. 2019 Apr-Jun;41(2):153-157. doi: 10.1016/j.htct.2018.09.005. Epub 2018 Dec 31. PMID: 31079661; PMCID: PMC6517618.
  • 18. Kim MJ, Park PW, Seo YH, Kim KH, Seo JY, Jeong JH, et al. Reference intervals for platelet parameters in Korean adults using ADVIA 2120. Ann Lab Med. 2013 Sep;33(5):364-6. doi: 10.3343/alm.2013.33.5.364. Epub 2013 Aug 8. PMID: 24003429; PMCID: PMC3756243.
  • 19. Kabasakal EA, Ergene U, Ozlu C. Normal complete blood count reference intervals in the Turkish population: a prospective study. Hematol Transfus Int J. 2018;6(4):135-139. DOI: 10.15406/htij.2018.06.00169
  • 20. Alper AT, Sevimli S, Hasdemir H, Nurkalem Z, Guvenc TS, Akyol A, et al. Effects of high altitude and sea level on mean platelet volume and platelet count in patients with acute coronary syndrome. J Thromb Thrombolysis. 2009 Feb;27(2):130- 4. doi: 10.1007/s11239-007-0159-9. Epub 2007 Nov 4. PMID: 17978877.
  • 21. Tekkesin, N, Bekoz, H. and Tukenmez, F. The largest reference range study for hematological parameters from Turkey: A case control study. Journal of Clinical and Experimental Investigations, 5(4), 548-552. https:// dx.doi.org/ 10.5799/ahinjs. 01.2014.04.0455
  • 22. Kaya H, Kiki I, Akarsu E, Gundogdu M, Basol Tekin S, Inandı T. Hematological Values of Healthy Adult Population Living at Moderate Altitude (1869 m, Erzurum, Turkey). Turk J Haematol. 2000 Sep 5;17(3):123-8. PMID: 27263502.
  • 23. Ozarda Y, Ichihara K, Bakan E, Polat H, Ozturk N, Baygutalp NK, et al. A nationwide multicentre study in Turkey for establishing reference intervals of haematological parameters with novel use of a panel of whole blood. Biochem Med (Zagreb). 2017 Jun 15;27(2):350-377. doi: 10.11613/BM.2017.038. PMID: 28694726; PMCID: PMC5493180.
  • 24. Dunbar NM. Does ABO and RhD matching matter for platelet transfusion? Hematology Am Soc Hematol Educ Program. 2020 Dec 4;2020(1):512-517. doi: 10.1182/hematology.2020000135. PMID: 33275681; PMCID: PMC7727583.
  • 25. Curtis BR, Edwards JT, Hessner MJ, Klein JP, Aster RH. Blood group A and B antigens are strongly expressed on platelets of some individuals. Blood. 2000 Aug 15;96(4):1574-81. PMID: 10942408.
  • 26. Thibault L, de Grandmont MJ, Cayer MP, Dussault N, Jacques A, Ducas E, et al. Rhesus D Antigenic Determinants on Residual Red Blood Cells in Apheresis and Buffy Coat Platelet Concentrates. Transfus Med Hemother. 2020 Apr;47(2):129-134. doi: 10.1159/000501106. Epub 2019 Jun 27. PMID: 32355472; PMCID: PMC7184823.
  • 27. Ward SE, O'Sullivan JM, O'Donnell JS. The relationship between ABO blood group, von Willebrand factor, and primary hemostasis. Blood. 2020 Dec 17;136(25):2864-2874. doi: 10.1182/ blood.2020005843. PMID: 32785650; PMCID: PMC7751360.
  • 28. Karolczak K, Soltysik B, Kostka T, Witas PJ, Watala C. Platelet and Red Blood Cell Counts, as well as the Concentrations of Uric Acid, but Not Homocysteinaemia or Oxidative Stress, Contribute Mostly to Platelet Reactivity in Older Adults. Oxid Med Cell Longev. 2019 Jan 16; 2019:9467562. doi: 10.1155/2019/9467562. PMID: 30800213; PMCID: PMC6360040.
  • 29. Yanasik M, Oguz FS, Besisik SK, Huslu M, Ozturk G, Temurhan S, et al. Frequency of RHD variants in serologically weak D Turkish blood donors. Transfus Apher Sci. 2021 Apr;60(2):103024. doi: 10.1016/j.transci.2020.103024. Epub 2020 Nov 27. PMID: 33308979.
  • 30. Daniels G. Variants of RhD--current testing and clinical consequences. Br J Haematol. 2013 May;161(4):461-70. doi: 10.1111/bjh.12275. Epub 2013 Feb 25. PMID: 23432139.
  • 31. Salduz ZIY, Cetin G, Karatoprak C, Ozder A, Bilginc M, Gultepe I, et al. ABO and Rh Blood Group Distribution in Istanbul Province (Turkey). İstanbul Med J 2015; 16: 98-100. DOI: 10.5152/ imj.2015.14890
There are 31 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Articles
Authors

Demircan Özbalcı 0000-0002-9635-3091

Emine Güçhan Alanoğlu 0000-0002-8089-9401

Funda Yıldırım Baş 0000-0001-6852-3180

Nur Banu Tatar 0000-0002-4119-5938

Yavuz Özcan 0000-0002-6608-4732

Hasan Yasan 0000-0002-5470-6784

Erşan Kaya 0000-0002-7612-9367

Project Number Yok
Publication Date September 30, 2022
Submission Date February 15, 2022
Acceptance Date May 27, 2022
Published in Issue Year 2022

Cite

Vancouver Özbalcı D, Alanoğlu EG, Yıldırım Baş F, Tatar NB, Özcan Y, Yasan H, Kaya E. THE RELATIONSHIP BETWEEN BLOOD GROUPS AND PLATELETCRIT IN HEALTHY TURKISH POPULATION. Med J SDU. 2022;29(3):314-23.

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