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Cosoreanu A, Rusu E, Rusu F, Stanciu S, Enache G, Radulian G. Progression of Chronic Kidney Disease to Dialysis in the Roma Population With Type 2 Diabetes Mellitus in Comparison With Caucasian Patients. Cureus 2024; 16:e62118. [PMID: 38863771 PMCID: PMC11165289 DOI: 10.7759/cureus.62118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2024] [Indexed: 06/13/2024] Open
Abstract
Background Chronic kidney disease (CKD) poses a significant health challenge among patients, contributing to substantial morbidity and mortality outcomes. However, there remains a paucity of data within the medical literature on the Roma population, one of the most significant minority groups globally, with studies indicating that these individuals are disproportionately affected by CKD compared to the general population, with higher prevalence rates. Materials and methods We conducted an observational, cross-sectional study from October 2022 to March 2024, evaluating 735 adult patients with type 2 diabetes mellitus, of which 402 were Roma, aged 18 to 89 years, following the hospital's standard protocols for diabetes management, at the "Nicolae Malaxa" Clinical Hospital in Bucharest, Romania, a tertiary care center for diabetes. Results The prevalence of CKD was higher among the Roma patients, reaching 56.50% (n=203), in comparison with the Caucasian group (43.50%, n=156), however, with a lower mean age (55.53±10.56 years versus 63.32±10.04 years). Roma patients with CKD had a higher prevalence of cardiovascular disease compared to Caucasians, including myocardial infarction, stroke, stable angina, and heart failure. Cardiovascular risk factors, such as hypertension, obesity, and dyslipidemia, in patients with CKD, were also more prevalent among the Roma population. Taking into consideration the natural progression of CKD, the anthropometric measurements and laboratory parameters stratified by ethnicity revealed that Roma patients in the very high risk of CKD progression category had a lower mean age, and a lower median duration of diabetes (56.37±10.79 versus 59.92±7.48 years, and 4.00±2.00 versus 10.00±10.30 years, respectively), as well as a more elevated mean waist circumference (WC), body mass index (BMI), total cholesterol (TC), and low-density lipoprotein-cholesterol (LDL-c) compared to Caucasians. Moreover, patients in the very high risk of CKD progression category among both groups showed the highest level of insulin resistance, measured by the triglyceride-glucose (TyG) index (mean value of 10.13±0.60 among the Roma patients, and 10.09±0.82 among Caucasians). Among the study group, weight, WC, BMI, and A Body Shape Index (ABSI) were associated with a very high risk of progression of CKD. In Caucasian patients, it was demonstrated that weight, WC, BMI, ABSI, and triglycerides (TG) have contributed to the very high risk of progression of CKD, while among the Roma patients, no association was found. Conclusion In conclusion, our findings suggested a high prevalence of CKD among both groups. There is still a need for further investigation of additional risk factors, such as genetics, limited access to health education, and appropriate treatments that could synergistically accelerate the progression of CKD among Roma patients.
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Affiliation(s)
- Andrada Cosoreanu
- Diabetes and Endocrinology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, ROU
| | - Emilia Rusu
- Diabetes, "Carol Davila" University of Medicine and Pharmacy, Bucharest, ROU
- Diabetes, "Nicolae Malaxa" Clinical Hospital, Bucharest, ROU
| | - Florin Rusu
- Urology, "Doctor Carol Davila" Central Military University Emergency Hospital, Bucharest, ROU
| | - Silviu Stanciu
- Noninvasive Cardiovascular Laboratory, "Carol Davila" University of Medicine and Pharmacy, Bucharest, ROU
| | | | - Gabriela Radulian
- Diabetes, "Carol Davila" University of Medicine and Pharmacy, Bucharest, ROU
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Crișan D, Avram L, Grapă C, Nemeș A, Coman MV, Beldean-Galea MS, Coman RT, Călinici T, Donca V, Crăciun R. Unveiling Health Inequalities: Exploring Metabolic Dysfunction in Rural Roma Communities. Healthcare (Basel) 2024; 12:816. [PMID: 38667578 PMCID: PMC11050184 DOI: 10.3390/healthcare12080816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 03/29/2024] [Accepted: 04/05/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Europe's largest ethnic minority, the Roma, are often confronted with substantial obstacles that result in health disparities. Research indicates that there are elevated rates of both communicable and non-communicable diseases, such as metabolic syndrome (MetS), among Roma communities, often linked to living conditions, limited education, or poverty. This study centers on remote rural Roma settlements in Romania, evaluating the prevalence of metabolic dysfunction, obesity, and liver steatosis while considering socio-economic and lifestyle factors. METHODS Over a period of 36 months, local visits to a total of 25 rural Roma communities were conducted, where a medical team gathered information through a standardized questionnaire and conducted a physical exam on every participant. Liver steatosis was also recorded with the help of a portable wireless ultrasound device. RESULTS Our study included 343 participants, with a predominance of female subjects, representing 72.5% (n = 249) of the patients. The prevalence of obesity, defined by a body mass index (BMI) above 30 kg/m2, was 32.2% (n = 111). Arterial hypertension was found to have a prevalence of 54.1% (n = 185), with de novo hypertension being observed in 19.2% patients (n = 66). Type 2 diabetes mellitus was found in 28.9% patients (n = 99), with 19.5% being de novo cases. The prevalence of hepatic steatosis was 57.2% (n = 111/194). A positive association between metabolic features and at-risk behaviors was found. CONCLUSIONS This study underscores the transition from infectious to metabolic diseases in vulnerable communities and highlights the urgency of targeted public health strategies tailored to the unique needs of rural Roma populations, aiming to mitigate health disparities and promote equitable healthcare access.
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Affiliation(s)
- Dana Crișan
- Faculty of Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400000 Cluj-Napoca, Romania; (D.C.); (A.N.); (R.-T.C.); (T.C.); (V.D.); (R.C.)
- Clinical Municipal Hospital Cluj-Napoca, 400139 Cluj-Napoca, Romania
| | - Lucreția Avram
- Faculty of Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400000 Cluj-Napoca, Romania; (D.C.); (A.N.); (R.-T.C.); (T.C.); (V.D.); (R.C.)
- Clinical Municipal Hospital Cluj-Napoca, 400139 Cluj-Napoca, Romania
| | - Cristiana Grapă
- Faculty of Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400000 Cluj-Napoca, Romania; (D.C.); (A.N.); (R.-T.C.); (T.C.); (V.D.); (R.C.)
- “Prof. Dr. O. Fodor” Regional Institute of Gastroenterology and Hepatology, 400162 Cluj-Napoca, Romania
| | - Andrada Nemeș
- Faculty of Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400000 Cluj-Napoca, Romania; (D.C.); (A.N.); (R.-T.C.); (T.C.); (V.D.); (R.C.)
- Clinical Municipal Hospital Cluj-Napoca, 400139 Cluj-Napoca, Romania
| | - Maria-Virginia Coman
- “Raluca Ripan” Institute for Research in Chemistry, “Babeş-Bolyai” University, 400294 Cluj-Napoca, Romania;
| | | | - Radu-Tudor Coman
- Faculty of Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400000 Cluj-Napoca, Romania; (D.C.); (A.N.); (R.-T.C.); (T.C.); (V.D.); (R.C.)
| | - Tudor Călinici
- Faculty of Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400000 Cluj-Napoca, Romania; (D.C.); (A.N.); (R.-T.C.); (T.C.); (V.D.); (R.C.)
| | - Valer Donca
- Faculty of Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400000 Cluj-Napoca, Romania; (D.C.); (A.N.); (R.-T.C.); (T.C.); (V.D.); (R.C.)
- Clinical Municipal Hospital Cluj-Napoca, 400139 Cluj-Napoca, Romania
| | - Rareș Crăciun
- Faculty of Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400000 Cluj-Napoca, Romania; (D.C.); (A.N.); (R.-T.C.); (T.C.); (V.D.); (R.C.)
- “Prof. Dr. O. Fodor” Regional Institute of Gastroenterology and Hepatology, 400162 Cluj-Napoca, Romania
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Using the Omaha System to Determine Health and Social Problems of Roma Population in Istanbul: Secondary Data Analysis. Comput Inform Nurs 2022; 40:670-681. [PMID: 35475763 DOI: 10.1097/cin.0000000000000909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The aim of this study was to determine the health and social problems and related behaviors of the Roma population by using the Omaha System. The data were collected from 650 Roma individuals. This study was a cross-sectional secondary data analysis and the data were collected in two stages. First, the "Technical Assistance for Promoting Social Inclusion in Densely Roman Populated Areas Project (SIROMA)" Act team evaluated health problems among Roma individuals. Second, data were reanalyzed using the Omaha System. When sociodemographic and economic characteristics were evaluated, low education level, adolescent marriages, a high number of live births, soiled living areas, unemployment, and substance use were found in the Roma population. In this context, using the Omaha System, the frequently diagnosed health and social problems were Sanitation (13.5%), Healthcare supervision (11.8%), Nutrition (11.0%), Income (9.8%), Respiration (8.3%), Substance use (7.3%), and Neighborhood/workplace safety (6.0%). This study results found out that the Roma population is less prone than natives to have healthy lifestyle behaviors and more prone to experience a deterioration in both their general and mental health. The Omaha System is a valid method used to collect and analyze data for a vulnerable population in the community. Also, it has been proven that the Omaha System Problem Classification Scheme can provide a more detailed and comprehensive assessment.
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Zajc Petranović M, Rizzieri AE, Sivaraj D, Smolej Narančić N, Škarić-Jurić T, Celinšćak Ž, Stojanović Marković A, Peričić Salihović M, Kalászi J, Kalászi M, Lin JQ, Mehta S, Burleson J, Rizzieri DA. CVD Risk Factors in the Ukrainian Roma and Meta-Analysis of Their Prevalence in Roma Populations Worldwide. J Pers Med 2021; 11:jpm11111138. [PMID: 34834490 PMCID: PMC8622536 DOI: 10.3390/jpm11111138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/24/2021] [Accepted: 10/27/2021] [Indexed: 11/16/2022] Open
Abstract
The Roma population suffers from severe poverty, social exclusion, and some of the worst health conditions in the industrialized world. Herein, we report on cardiovascular disease (CVD) risk factors in the Ukrainian Roma and present a meta-analysis of the prevalence of CVD risk factors in 16 Roma populations worldwide. The meta-analyses of CVD risk factors in Roma (n = 16,552) vs. non-Roma majority population of the same country (n = 127,874) included publicly available data. Ukrainian field survey included 339 adults of both sexes and outcomes of interest were hypertension, body mass index (BMI), smoking, education, and employment status. Furthermore, 35.7% of the Ukrainian Roma were hypertensive, 69.3% unemployed, and 48.4% never went to school. Ukrainian Roma women were more likely to be underweight and more prone to be hypertensive, with odds of hypertension increasing with age, BMI, and positive smoking status. Meta-analyses showed that, in comparison with non-Roma worldwide, the Roma bear significantly higher risk factor loads related to smoking (OR = 2.850), diabetes (OR = 1.433), abdominal obesity (OR = 1.276), and metabolic syndrome (OR = 1.975), with lower loads for hypertension (OR = 0.607) and BMI ≥ 25 kg/m2 (OR = 0.872). To conclude, the CVD risk factors which are more common in Roma than in the majority population may reflect their poor health-related behaviors and inadequate access to health education.
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Affiliation(s)
- Matea Zajc Petranović
- Institute for Anthropological Research, Gajeva 32, 10000 Zagreb, Croatia; (N.S.N.); (T.Š.-J.); (Ž.C.); (A.S.M.); (M.P.S.)
- Correspondence: (M.Z.P.); (D.A.R.)
| | - Ashley Elizabeth Rizzieri
- Division of Cellular Therapy, Duke University, 2400 Pratt Street, Durham, NC 27708, USA; (A.E.R.); (D.S.); (J.K.); (M.K.); (S.M.); (J.B.)
| | - Dharshan Sivaraj
- Division of Cellular Therapy, Duke University, 2400 Pratt Street, Durham, NC 27708, USA; (A.E.R.); (D.S.); (J.K.); (M.K.); (S.M.); (J.B.)
- School of Medicine, Stanford University, 291 Campus Drive, Stanford, CA 94305, USA;
| | - Nina Smolej Narančić
- Institute for Anthropological Research, Gajeva 32, 10000 Zagreb, Croatia; (N.S.N.); (T.Š.-J.); (Ž.C.); (A.S.M.); (M.P.S.)
| | - Tatjana Škarić-Jurić
- Institute for Anthropological Research, Gajeva 32, 10000 Zagreb, Croatia; (N.S.N.); (T.Š.-J.); (Ž.C.); (A.S.M.); (M.P.S.)
| | - Željka Celinšćak
- Institute for Anthropological Research, Gajeva 32, 10000 Zagreb, Croatia; (N.S.N.); (T.Š.-J.); (Ž.C.); (A.S.M.); (M.P.S.)
| | - Anita Stojanović Marković
- Institute for Anthropological Research, Gajeva 32, 10000 Zagreb, Croatia; (N.S.N.); (T.Š.-J.); (Ž.C.); (A.S.M.); (M.P.S.)
| | - Marijana Peričić Salihović
- Institute for Anthropological Research, Gajeva 32, 10000 Zagreb, Croatia; (N.S.N.); (T.Š.-J.); (Ž.C.); (A.S.M.); (M.P.S.)
| | - Julia Kalászi
- Division of Cellular Therapy, Duke University, 2400 Pratt Street, Durham, NC 27708, USA; (A.E.R.); (D.S.); (J.K.); (M.K.); (S.M.); (J.B.)
| | - Marianna Kalászi
- Division of Cellular Therapy, Duke University, 2400 Pratt Street, Durham, NC 27708, USA; (A.E.R.); (D.S.); (J.K.); (M.K.); (S.M.); (J.B.)
| | - John Q. Lin
- School of Medicine, Stanford University, 291 Campus Drive, Stanford, CA 94305, USA;
| | - Sanica Mehta
- Division of Cellular Therapy, Duke University, 2400 Pratt Street, Durham, NC 27708, USA; (A.E.R.); (D.S.); (J.K.); (M.K.); (S.M.); (J.B.)
| | - Jill Burleson
- Division of Cellular Therapy, Duke University, 2400 Pratt Street, Durham, NC 27708, USA; (A.E.R.); (D.S.); (J.K.); (M.K.); (S.M.); (J.B.)
| | - David A. Rizzieri
- Division of Cellular Therapy, Duke University, 2400 Pratt Street, Durham, NC 27708, USA; (A.E.R.); (D.S.); (J.K.); (M.K.); (S.M.); (J.B.)
- Correspondence: (M.Z.P.); (D.A.R.)
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Chen J, Wu Z, Liu Y, Wang L, Li T, Dong Y, Qin Q, Ding S. Prevalence, Association Relation, and Dynamic Evolution Analysis of Critical Values in Health Checkup in China: A Retrospective Study. Front Public Health 2021; 9:630356. [PMID: 34368036 PMCID: PMC8339420 DOI: 10.3389/fpubh.2021.630356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 06/16/2021] [Indexed: 01/06/2023] Open
Abstract
Objective: The critical values in health checkup play a key role in preventing chronic diseases and different types of cancer. This study aimed to analyze the prevalence, association relation, and dynamic evolution of critical values in health checkups at a large physical examination center in China. Methods: Herein, we chose 33,639 samples of physical examiners from January 2017 to December 2019. After strict exclusion processes, combined with the critical values in health checkup reporting data, 4,721 participants with at least one critical value were included. We first defined a critical value list for laboratory test, imaging, cervical cancer screening, electrocardiogram, and health checkup informed on site, and then performed a cross-sectional study to analyze the distribution and significance of critical values of 4,721 participants from different views and the association relation of 628 participants with more than one critical value and a retrospective cohort study to analyze the incidence and dynamic evolution of critical values based on 2,813 participants attending the physical examination from 2017 to 2019. Results: A total of 4,721 participants were included in the retrospective study. The prevalence of 10 critical values from 33,639 participants was over 0.6%. The critical values of obesity, hypertension, Glucose_T, Liver_T, Kidney_T, Lipid_T, Urine_T, and Head_CT were significantly increased in men (P < 0.05), whereas the results were the opposite for the Blood_T and Thyroid_US (P < 0.01). The prevalence trend of critical values increased along with age, where the prevalence of men was higher than that of women under 60 years old (P < 0.01), while the prevalence of women increased by four times and exceeded the prevalence of men above 70 years old. Association relation analysis identified 16 and 6 effective rules for men and women, respectively, where the critical values of Urine_T and Glucose_T played the central roles. Furthermore, a retrospective dynamic evolution analysis found that the incidence of new critical values was about 10%, the incidence of persistent critical values was about 50%, and that most of the effective evolution paths tended to no critical values for men and women. Conclusion: In conclusion, this study provides a new perspective to explore the population health status using the critical value reporting data in a physical examination center, which can assist in decision-making by health management at the population level and in the prevention and treatment of various types of cancer and chronic diseases at the individual level.
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Affiliation(s)
- Jingfeng Chen
- Health Management Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhuoqing Wu
- Institute of Systems Engineering, Dalian University of Technology, Dalian, China
| | - Yanan Liu
- Health Management Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Lin Wang
- Health Management Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Tiantian Li
- Health Management Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yihan Dong
- Health Management Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Qian Qin
- Health Management Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Suying Ding
- Health Management Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Llanaj E, Vincze F, Kósa Z, Sándor J, Diószegi J, Ádány R. Dietary Profile and Nutritional Status of the Roma Population Living in Segregated Colonies in Northeast Hungary. Nutrients 2020; 12:nu12092836. [PMID: 32947945 PMCID: PMC7551568 DOI: 10.3390/nu12092836] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 09/07/2020] [Accepted: 09/14/2020] [Indexed: 12/14/2022] Open
Abstract
Nutrition studies among Roma are scarce and to date no quantified dietary data are available. This report provides, for the first time, quantified dietary data and comprehensive anthropometric information for the Hungarian Roma (HR) population, with Hungarian general (HG) adults as reference. Data were obtained from a complex comparative health survey, involving 387 and 410 subjects of HR and HG populations, respectively. Using corporal measurements, body composition indicators were constructed, while daily nutrient intakes were evaluated in comparison with internationally accepted guidelines on nutrient requirements and recommended intakes. Associations between Roma ethnicity and nutrient intakes, as well as odds of achieving dietary recommendations were explored using regression models, adjusted for relevant covariates (i.e., age, gender, education, marital status and perceived financial status). Results showed occasional differences for selected nutrient intakes between the groups, with HR's intake being less favorable. Total fat intake, predominantly animal-sourced, exceeded recommendations among HR (36.1 g, 95% confidence interval (CI): 35.2-37.0) and was not dissimilar to HG group (37.1 g, 95% CI: 36.3-38.0). Sodium intake among HR was significantly lower (5094.4 mg, 95% CI: 4866.0-5322.8) compared to HG (5644.0 mg, 95% CI: 5351.9-5936.0), but significantly greater than recommended intake in both groups. HR had greater estimated body fatness (25.6-35.1%) and higher average body mass index (BMI, 27.7 kg/m2, 95% CI: 26.9-28.4), compared to HG. In addition, HR had lower odds of achieving dietary recommendations (odds ratio (OR) = 0.81, 95% CI: 0.67-0.97, p < 0.05). Findings warrant further research, while highlighting the importance of establishing and integrating Roma nutrition into national surveillance and monitoring systems for key dietary risk factors.
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Affiliation(s)
- Erand Llanaj
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Kassai street 26/B, H-4028 Debrecen, Hungary; (E.L.); (F.V.); (J.S.)
- Doctoral School of Health Sciences, University of Debrecen, Kassai street 26/B, H-4028 Debrecen, Hungary
| | - Ferenc Vincze
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Kassai street 26/B, H-4028 Debrecen, Hungary; (E.L.); (F.V.); (J.S.)
- Doctoral School of Health Sciences, University of Debrecen, Kassai street 26/B, H-4028 Debrecen, Hungary
| | - Zsigmond Kósa
- Department of Methodology for Health Visitors and Public Health, Faculty of Health, University of Debrecen, Sóstói street 2–4, H-4400 Nyíregyháza, Hungary;
| | - János Sándor
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Kassai street 26/B, H-4028 Debrecen, Hungary; (E.L.); (F.V.); (J.S.)
| | - Judit Diószegi
- MTA-DE-Public Health Research Group, University of Debrecen, Kassai street 26/B, H-4028 Debrecen, Hungary;
| | - Róza Ádány
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Kassai street 26/B, H-4028 Debrecen, Hungary; (E.L.); (F.V.); (J.S.)
- MTA-DE-Public Health Research Group, University of Debrecen, Kassai street 26/B, H-4028 Debrecen, Hungary;
- Correspondence: ; Tel.: +36-52-512-765 (ext. 77147)
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Ádány R, Pikó P, Fiatal S, Kósa Z, Sándor J, Bíró É, Kósa K, Paragh G, Bácsné Bába É, Veres-Balajti I, Bíró K, Varga O, Balázs M. Prevalence of Insulin Resistance in the Hungarian General and Roma Populations as Defined by Using Data Generated in a Complex Health (Interview and Examination) Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134833. [PMID: 32635565 PMCID: PMC7370128 DOI: 10.3390/ijerph17134833] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 06/30/2020] [Accepted: 07/02/2020] [Indexed: 12/17/2022]
Abstract
Data mainly from one-off surveys clearly show that the health of Roma, the largest ethnic minority of Europe, is much worse than that of the general population. However, results from comprehensive exploratory studies are missing. The aim of our study was to create a complex database for comparative and association studies to better understand the background of the very unfavourable health of Roma, especially the high burden of cardiometabolic diseases. A three-pillar (questionnaire-based, physical and laboratory examinations) health survey was carried out on randomly selected samples of the Hungarian general (HG, n = 417) and Roma (HR, n = 415) populations, and a database consisting of more than half a million datapoints was created. Using selected data, the prevalence rates of metabolic syndrome (MetS) and of its components were determined, and to estimate the risk of insulin resistance (IR), surrogate measures (the homeostasis model assessment of insulin resistance index, quantitative insulin sensitivity check index, McAuley and TyG indices and the TG/HDL-C ratio) were calculated. Receiver operating characteristic curve analysis and Youden’s method were used to define the optimal cut-off values of each IR index. The prevalence of MetS was very high in both study populations (HG: 39.8%, HR: 44.0%) with no statistically significant difference between the two groups in females or males. The prevalence of MetS showed a very marked increase in the HR 35–49 years age group. Among surrogate measures, the TyG index showed the greatest power for predicting IR/MetS at a cut-off value of 4.69 (77% sensitivity, 84% specificity) and indicated a 42.3% (HG) and 40.5% (HR) prevalence of IR. The prevalence of MetS and IR is almost equally very unfavourable in both groups; thus, the factors underlying the high premature mortality burden of Roma should be further clarified by investigating the full spectrum of risk factors available in the database, with a special focus on the access of Roma people to preventive and curative health services.
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Affiliation(s)
- Róza Ádány
- MTA-DE Public Health Research Group, Public Health Research Institute, University of Debrecen, 4032 Debrecen, Hungary
| | - Péter Pikó
- MTA-DE Public Health Research Group, Public Health Research Institute, University of Debrecen, 4032 Debrecen, Hungary
| | - Szilvia Fiatal
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4032 Debrecen, Hungary
| | - Zsigmond Kósa
- Department of Health Methodology and Public Health, Faculty of Health, University of Debrecen, 4400 Nyíregyháza, Hungary
| | - János Sándor
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4032 Debrecen, Hungary
| | - Éva Bíró
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4032 Debrecen, Hungary
| | - Karolina Kósa
- Institute of Behavioural Sciences, Faculty of Public Health, University of Debrecen, 4032 Debrecen, Hungary
| | - György Paragh
- Institute of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Éva Bácsné Bába
- Institute of Sport Management, University of Debrecen, 4032 Debrecen, Hungary
| | - Ilona Veres-Balajti
- Department of Physiotherapy, Faculty of Public Health, University of Debrecen, 4032 Debrecen, Hungary
| | - Klára Bíró
- Department of Health Systems Management and Quality Management in Health Care, Faculty of Public Health, University of Debrecen, 4032 Debrecen, Hungary
| | - Orsolya Varga
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4032 Debrecen, Hungary
| | - Margit Balázs
- MTA-DE Public Health Research Group, Public Health Research Institute, University of Debrecen, 4032 Debrecen, Hungary
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Hubáček JA, Šedová L, Olišarová V, Adámková V, Tóthová V. Different prevalence of T2DM risk alleles in Roma population in comparison with the majority Czech population. Mol Genet Genomic Med 2020; 8:e1361. [PMID: 32578971 PMCID: PMC7507457 DOI: 10.1002/mgg3.1361] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/11/2020] [Accepted: 05/19/2020] [Indexed: 01/08/2023] Open
Abstract
Background The Czech governmental study suggests up to a 25% higher prevalence of type 2 diabetes mellitus (T2DM) in the Roma population than within the majority population. It is not known whether and to what extent these differences have a genetic background. Methods To analyze whether the frequencies of the alleles/genotypes of the FTO, TCF7L2, CDKN2A/2B, MAEA, TLE4, IGF2BP2, ARAP1, and KCNJ11 genes differ between the two major ethnic groups in the Czech Republic, we examined them in DNA samples from 302 Roma individuals and 298 Czech individuals. Results Compared to the majority population, Roma are more likely to carry risk alleles in the FTO (26% vs. 16% GG homozygotes, p < .01), IGF2BP2 (22% vs. 10% TT homozygotes, p < .0001), ARAP1 (98% vs. 95% of A allele carriers, p < .005), and CDKN2A/2B (81% vs. 66% of TT homozygotes, p < .001) genes; however, less frequently they are carriers of the TCF7L2 risk allele (34% vs. 48% of the T allele p < .0005). Finally, we found significant accumulation of T2DM‐associated alleles between the Roma population in comparison with the majority population (25.4% vs. 15.2% of the carriers of at least 12 risk alleles; p < .0001). Conclusion The increased prevalence of T2DM in the Roma population may have a background in different frequencies of the risk alleles of genes associated with T2DM development.
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Affiliation(s)
- Jaroslav A Hubáček
- Centre for Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Lenka Šedová
- Faculty of Health and Social Sciences, University of South Bohemia, České Budějovice, Czech Republic
| | - Věra Olišarová
- Faculty of Health and Social Sciences, University of South Bohemia, České Budějovice, Czech Republic
| | - Věra Adámková
- Department of Preventive Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Valérie Tóthová
- Faculty of Health and Social Sciences, University of South Bohemia, České Budějovice, Czech Republic
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Werissa NA, Piko P, Fiatal S, Kosa Z, Sandor J, Adany R. SNP-Based Genetic Risk Score Modeling Suggests No Increased Genetic Susceptibility of the Roma Population to Type 2 Diabetes Mellitus. Genes (Basel) 2019; 10:genes10110942. [PMID: 31752367 PMCID: PMC6896051 DOI: 10.3390/genes10110942] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 11/12/2019] [Accepted: 11/18/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND In a previous survey, an elevated fasting glucose level (FG) and/or known type 2 diabetes mellitus (T2DM) were significantly more frequent in the Roma population than in the Hungarian general population. We assessed whether the distribution of 16 single nucleotide polymorphisms (SNPs) with unequivocal effects on the development of T2DM contributes to this higher prevalence. METHODS Genetic risk scores, unweighted (GRS) and weighted (wGRS), were computed and compared between the study populations. Associations between GRSs and FG levels and T2DM status were investigated in separate and combined study populations. RESULTS The Hungarian general population carried a greater genetic risk for the development of T2DM (GRSGeneral = 15.38 ± 2.70 vs. GRSRoma = 14.80 ± 2.68, p < 0.001; wGRSGeneral = 1.41 ± 0.32 vs. wGRSRoma = 1.36 ± 0.31, p < 0.001). In the combined population models, GRSs and wGRSs showed significant associations with elevated FG (p < 0.001) and T2DM (p < 0.001) after adjusting for ethnicity, age, sex, body mass index (BMI), high-density Lipoprotein Cholesterol (HDL-C), and triglyceride (TG). In these models, the effect of ethnicity was relatively strong on both outcomes (FG levels: βethnicity = 0.918, p < 0.001; T2DM status: ORethnicity = 2.484, p < 0.001). CONCLUSIONS The higher prevalence of elevated FG and/or T2DM among Roma does not seem to be directly linked to their increased genetic load but rather to their environmental/cultural attributes. Interventions targeting T2DM prevention among Roma should focus on harmful environmental exposures related to their unhealthy lifestyle.
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Affiliation(s)
- Nardos Abebe Werissa
- MTA−DE Public Health Research Group of the Hungarian Academy of Sciences, Public Health Research Institute, University of Debrecen, 4028 Debrecen, Hungary; (N.A.W.); (P.P.)
- Doctorial School of Health Sciences, University of Debrecen, 4028 Debrecen, Hungary
| | - Peter Piko
- MTA−DE Public Health Research Group of the Hungarian Academy of Sciences, Public Health Research Institute, University of Debrecen, 4028 Debrecen, Hungary; (N.A.W.); (P.P.)
| | - Szilvia Fiatal
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4028 Debrecen, Hungary; (S.F.); (J.S.)
- WHO Collaborating Centre on Vulnerability and Health, University of Debrecen, 4028 Debrecen, Hungary
| | - Zsigmond Kosa
- Department of Health Visitor Methodology and Public Health, Faculty of Health, University of Debrecen, 4400 Nyíregyháza, Hungary;
| | - Janos Sandor
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4028 Debrecen, Hungary; (S.F.); (J.S.)
- WHO Collaborating Centre on Vulnerability and Health, University of Debrecen, 4028 Debrecen, Hungary
| | - Roza Adany
- MTA−DE Public Health Research Group of the Hungarian Academy of Sciences, Public Health Research Institute, University of Debrecen, 4028 Debrecen, Hungary; (N.A.W.); (P.P.)
- WHO Collaborating Centre on Vulnerability and Health, University of Debrecen, 4028 Debrecen, Hungary
- Correspondence: ; Tel: +36-5251-2764
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Why don't segregated Roma do more for their health? A complex question. Int J Public Health 2019; 64:803-804. [PMID: 31143963 DOI: 10.1007/s00038-019-01233-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 03/06/2019] [Accepted: 03/07/2019] [Indexed: 10/26/2022] Open
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DIABETES MELLITUS PREVALENCE AMONG TRADITIONAL ROMA WOMEN IN SERBIA: RESPONSE TO ČVOROVIČ. J Biosoc Sci 2019; 51:467-468. [PMID: 30890192 DOI: 10.1017/s0021932019000129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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DIABETES PREVALENCE AMONG TRADITIONAL ROMA WOMEN IN SERBIA: A COMMENTARY ON ČVOROVIČ (2018). J Biosoc Sci 2019; 51:463-464. [PMID: 30841937 DOI: 10.1017/s0021932019000105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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