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Li Y, Babazono A, Jamal A, Liu N, Fujita T, Zhao R, Maeno Y, Su Y, Liang L, Yao L. The impact of lifestyle guidance intervention on health outcomes among Japanese middle-aged population with metabolic syndrome: A regression discontinuity study. Soc Sci Med 2022; 314:115468. [PMID: 36327638 DOI: 10.1016/j.socscimed.2022.115468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 09/28/2022] [Accepted: 10/16/2022] [Indexed: 11/06/2022]
Abstract
Metabolic syndrome (MetS) prevalence has increased globally with considerable morbidity and economic burden at both individual and national levels. Japan is the first and only country that has introduced a nationwide lifestyle guidance intervention program to manage and control MetS. We conducted a quasi-experiment approach-regression discontinuity design-to evaluate the impact of this intervention on health outcomes at the population level. We retrospectively collected data of adults aged ≥35 years who participated in health checkups in 2015. Age in 2015 was used as the assignment variable, and an age of 40 years old was the threshold because those with MetS aged ≥40 were required to receive lifestyle guidance intervention. Among 26,772 MetS adults, those who received the intervention had significant reductions in obesity measurements (bodyweight, waist circumference, and body mass index [BMI]) after 1 year of this intervention. Blood pressure was also significantly reduced in men after 1 year of undertaking the intervention. The results were similar when including demographic, socioeconomic, and behavioral covariates and using alternative functional forms to estimate the impact, or when bandwidths around intervention thresholds were changed. Our results showed that lifestyle guidance intervention for MetS has an important impact on weight loss and blood pressure reduction at the population level. This intervention could address the high burden of obesity and cardiovascular diseases in Japan and other countries with an unmet need for MetS prevention and management.
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Affiliation(s)
- Yunfei Li
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan; Department of Health Care Administration & Management, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Akira Babazono
- Department of Health Care Administration & Management, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Aziz Jamal
- Health Administration Program, Faculty of Business & Management, Universiti Teknologi MARA, Selangor, Malaysia.
| | - Ning Liu
- Department of Preventive Medicine and Community Health, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Takako Fujita
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Rui Zhao
- National Center for Medicine and Technology Assessment, China National Health Development Research Center, Beijing, China
| | - Yukari Maeno
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ya Su
- Shanghai Jiao Tong University, School of Nursing, Shanghai, China
| | - Lifan Liang
- Department of Human Genetics, University of Chicago, Chicago, IL, USA
| | - Lan Yao
- School of Medicine & Health Management, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
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Oivio UM, Pesonen P, Ylipalosaari M, Kullaa A, Salo T. Prevalence of oral mucosal normal variations and lesions in a middle-aged population: a Northern Finland Birth Cohort 1966 study. BMC Oral Health 2020; 20:357. [PMID: 33298037 PMCID: PMC7727189 DOI: 10.1186/s12903-020-01351-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 11/30/2020] [Indexed: 11/12/2022] Open
Abstract
Background In this cross-sectional study we investigated the oral mucosal changes in a middle-aged Finnish population. We analyzed the prevalence of potentially malignant disorders and the influence of smoking, snuff and alcohol use on the mucosal changes. Methods Of the 12,068 members of the NFBC 1966, a total of 1961 participants (16.2%) constituted the study population. Mucosal changes were diagnosed and photographed by seven general dentists, and two specialists re-analyzed all the diagnoses based on the documentation Cross-tabulation with Chi-square tests and logistic regression analysis were used to analyze the data. Results Of the participants, 10.5% had some mucosal changes, of which 81.8% were diagnosed as oral mucosal lesions (OML) and 18.2% as normal variations. Of the normal variations, the most common were Fordyce granules (1.2%), fissured tongue (1.1%) and geographic tongue (0.9%). The most common OMLs were white lesions (6.5%), of which oral lichen planus (OLP) and lichenoid reactions (OLR), grouped as oral lichenoid diseases, were present in 3.5%, males more often (3.8% vs. 3.1%). OLP was found in 1.5% of all participants, females more often (1.8% vs. 1.2%), while OLR was more common in males (2.7% vs. 1.3%). Leukoplakia was identified in 0.5% of the population; twice more often in males (0.6% vs. 0.3%). Erythroplakia was not found. Current smokers had higher risk for oral mucosal changes than former or non-smokers (OR 3.0, 95% CI 2.11–4.28), and snuff, used occasionally or regularly, also raised the risk (OR 2.6, 95% CI 1.48–4.70). Conclusions In the middle-aged northern Finland population, 4% of OMLs were potentially malignant disorders, including OLR (2%), OLP (1.5%) and leukoplakia (0.5%). In particular, smoking and snuff use increased the risk for having any oral mucosa changes.
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Affiliation(s)
- Ulla-Maija Oivio
- Cancer and Translational Medicine Research Unit, Faculty of Medicine, University of Oulu, P.O. Box 5281, 90014, Oulu, Finland
| | - Paula Pesonen
- Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
| | - Merja Ylipalosaari
- Research Unit of Oral Health Sciences, University of Oulu, P.O. Box 5281, 90014, Oulu, Finland
| | - Arja Kullaa
- Institute of Dentistry, Faculty of Health Sciences, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland.,Department of Oral Diagnostics, Educational Dental Clinic, Kuopio University Hospital, Yliopistonranta 1 C, 70210, Kuopio, Finland
| | - Tuula Salo
- Cancer and Translational Medicine Research Unit, Faculty of Medicine, University of Oulu, P.O. Box 5281, 90014, Oulu, Finland. .,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5281, 90014, Oulu, Finland. .,Institute of Oral and Maxillofacial Disease, University of Helsinki, 00014, Helsinki, Finland. .,HUSLAB, Department of Pathology, Helsinki University Hospital, Helsinki, Finland.
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Szcześniak D, Rymaszewska J, Zimny A, Sąsiadek M, Połtyn-Zaradna K, Smith EE, Zatońska K, Zatoński T, Rangarajan S, Yusuf S, Szuba A. "Cerebral small vessel disease and other influential factors of cognitive impairment in the middle-aged: a long-term observational cohort PURE-MIND study in Poland". GeroScience 2021; 43:279-95. [PMID: 33074422 DOI: 10.1007/s11357-020-00271-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 09/15/2020] [Indexed: 01/13/2023] Open
Abstract
A complex picture of factors influencing cognition is necessary to be drawn for a better understanding of the role of potentially modifiable factors in dementia. The aim was to assess the prevalence and determinants of cognitive impairment, including the role of cerebral small vessel disease (CSVD) in Polish middle-aged cohort. A comprehensive set of clinical (hypertension, coronary heart disease, diabetes mellitus, hyperlipidaemia, body mass index, smoking status, alcohol intake) and socio-demographic data was collected in the PURE study in years 2007-2016, which was the basis for detailed analysis of risk factors of cognitive impairments in years 2016-2018 in the PURE-MIND sub-study. Five hundred forty-seven subjects (age range 39-65, mean 56.2 ± 6.5) underwent neuropsychological assessment with Montreal Cognitive Assessment (MoCA), Trail Making Test (TMT) and Digit Symbol Substitution Test (DSST) followed by brain MRI. Mean MoCA score was 26.29 and 33% participants met criteria for mild cognitive impairment (MCI) (MoCA< 26). Seventy-three percent showed findings related to CSVD. Higher WMH burden and lacunar infarcts were associated with lower MoCA and DSST scores. Severe CSVD was associated with twofold incidence of MCI, and obesity increased its probability by 53% and hypertension by 37%. The likelihood of MCI was reduced in nonsmokers. One factor analysis showed the important role of lower level of education, older age, rural area of residence and hypertension. MCI and CSVD are highly prevalent in the middle-aged population in Poland. A greater importance should be given to potentially modifiable risk factors of dementia which are already present in mid-life.
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Kutkiene S, Petrulioniene Z, Laucevicius A, Cerkauskiene R, Staigyte J, Saulyte A, Petrulionyte E, Gargalskaite U, Skiauteryte E, Matuzeviciene G, Kovaite M, Rinkuniene E. Lipid profile evaluation and severe hypercholesterolaemia screening in the middle-aged population according to nationwide primary prevention programme in Lithuania. Atherosclerosis 2019; 277:267-272. [PMID: 30270057 DOI: 10.1016/j.atherosclerosis.2018.06.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 05/29/2018] [Accepted: 06/07/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND AIMS Cardiovascular disease (CVD) is a major cause of premature death in Lithuania where abnormal lipid levels are very common among middle-aged adults. The aim of this study was to evaluate lipid profile in middle-aged Lithuanians and perform population-based severe hypercholesterolaemia (SH) screening. METHODS This study included men aged 40-54 and women aged 50-64 years without overt CVD, participating in the Lithuanian High Cardiovascular Risk (LitHiR) primary prevention programme during the period 2009-2016. Lipidograms of 92,373 adults (58.4% women and 41.6% men) included in the database were analysed and screening for SH was performed. RESULTS The mean levels of total cholesterol, LDL cholesterol (LDL-C) and triglycerides (TG) among participants were 6.08 mmol/l, 3.87 mmol/l, and 1.59 mmol/l, respectively. Any type of dyslipidaemia was present in 89.7%, and severe dyslipidaemia in 13.4% of the study population. 80.2% of adults without overt CVD had LDL-C ≥3 mmol/l. SH (LDL-C ≥6 mmol/l) was detected in 3.2% of study participants. Prevalence of SH decreased from 2.91% to 2.82% during the period 2009-2016 (p for trend = 0.003). LDL-C ≥6.5 mmol/l was observed in 1.5% of subjects while both LDL-C ≥6.5 mmol/l, and TG ≤ 1.7 mmol/l was found in 0.6% of subjects. CONCLUSIONS SH was present in 3.2% of the middle-aged population without overt CVD. Slightly decreasing prevalence of SH was observed during the period 2009-2016 in Lithuania. Likely phenotypic familial hypercholesterolaemia was observed in 1.5% of middle-aged Lithuanians. Further clinical and genetic evaluation of people with SH is needed to detect familial forms of SH.
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Affiliation(s)
- Sandra Kutkiene
- Vilnius University, Faculty of Medicine, Clinic of Cardiac and Vascular Diseases, Santariskiu str. 2, LT-08661, Vilnius, Lithuania; Vilnius University, Faculty of Medicine, M. K. Ciurlionio str. 21, 03101, Vilnius, Lithuania; Vilnius University Hospital Santaros Klinikos, Santariskiu str. 2, 08661, Vilnius, Lithuania.
| | - Zaneta Petrulioniene
- Vilnius University, Faculty of Medicine, Clinic of Cardiac and Vascular Diseases, Santariskiu str. 2, LT-08661, Vilnius, Lithuania; Vilnius University, Faculty of Medicine, M. K. Ciurlionio str. 21, 03101, Vilnius, Lithuania; Vilnius University Hospital Santaros Klinikos, Santariskiu str. 2, 08661, Vilnius, Lithuania
| | - Aleksandras Laucevicius
- Vilnius University, Faculty of Medicine, Clinic of Cardiac and Vascular Diseases, Santariskiu str. 2, LT-08661, Vilnius, Lithuania; Vilnius University, Faculty of Medicine, M. K. Ciurlionio str. 21, 03101, Vilnius, Lithuania; Vilnius University Hospital Santaros Klinikos, Santariskiu str. 2, 08661, Vilnius, Lithuania
| | - Rimante Cerkauskiene
- Children's Hospital, Vilnius University Hospital Santaros Klinikos, Santariskiu str. 7, LT-08406, Vilnius, Lithuania; Vilnius University, Faculty of Medicine, M. K. Ciurlionio str. 21, 03101, Vilnius, Lithuania
| | - Justina Staigyte
- Vilnius University, Faculty of Medicine, M. K. Ciurlionio str. 21, 03101, Vilnius, Lithuania
| | - Akvile Saulyte
- Vilnius University, Faculty of Medicine, M. K. Ciurlionio str. 21, 03101, Vilnius, Lithuania
| | - Emilija Petrulionyte
- Vilnius University, Faculty of Medicine, M. K. Ciurlionio str. 21, 03101, Vilnius, Lithuania
| | - Urte Gargalskaite
- Vilnius University, Faculty of Medicine, M. K. Ciurlionio str. 21, 03101, Vilnius, Lithuania; Vilnius University Hospital Santaros Klinikos, Santariskiu str. 2, 08661, Vilnius, Lithuania
| | - Egle Skiauteryte
- Vilnius University, Faculty of Medicine, M. K. Ciurlionio str. 21, 03101, Vilnius, Lithuania; Vilnius University Hospital Santaros Klinikos, Santariskiu str. 2, 08661, Vilnius, Lithuania
| | - Gabija Matuzeviciene
- Vilnius University, Faculty of Medicine, M. K. Ciurlionio str. 21, 03101, Vilnius, Lithuania; Vilnius University Hospital Santaros Klinikos, Santariskiu str. 2, 08661, Vilnius, Lithuania
| | - Milda Kovaite
- Vilnius University Hospital Santaros Klinikos, Santariskiu str. 2, 08661, Vilnius, Lithuania
| | - Egidija Rinkuniene
- Vilnius University, Faculty of Medicine, Clinic of Cardiac and Vascular Diseases, Santariskiu str. 2, LT-08661, Vilnius, Lithuania; Vilnius University, Faculty of Medicine, M. K. Ciurlionio str. 21, 03101, Vilnius, Lithuania; Vilnius University Hospital Santaros Klinikos, Santariskiu str. 2, 08661, Vilnius, Lithuania
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Raznahan M, Emamian MH, Alipour F, Hashemi H, Zeraati H, Fotouhi A. Horizontal inequity in the utilization of cataract surgery in Iran: Shahroud Eye Cohort Study, 2009-2014. Med J Islam Repub Iran 2019; 33:116. [PMID: 31934575 PMCID: PMC6946921 DOI: 10.34171/mjiri.33.116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Indexed: 01/01/2023] Open
Abstract
Background: Since there was no evidence about economic inequity in utilization of cataract surgery in developing countries, such as Iran, this study was designed to measure horizontal inequity in the utilization of cataract surgery and its changes in an Iranian middleaged population in 2009 and 2014. Methods: Using data from the first and second phases of Shahroud Eye Cohort Study (2009-2014), the economic inequity in the utilization of cataract surgery in an Iranian middle-aged population aged 40-64 years in 2009 and 2014 was evaluated. The horizontal inequity index (HI) was determined using the indirect standardization method based on a nonlinear (probit) model and the concentration index (C) was decomposed into the contribution of each factor. The analyses were performed using STATA software version 12/SE, and significance level was set at less than 0.05. Results: The HI in the utilization of cataract surgery increased from 0.080 (95% CI: 0.011-0.098) in 2009 to 0.166 (95% CI: 0.0821- 0.228) in 2014. Decomposition of changes in the concentration index showed that among need and non-need variables, older age and economic status (being among the wealthiest 20%) were the greatest contributors, with shares of 67.5% and 57.5%%, respectively, which led to pro-rich inequity during the study periods. Conclusion: The present study demonstrated that utilization of cataract surgery did not have an equal distribution among economic quintiles, despite considering equal needs based on cataract severity. Results demonstrated that older age and economic status were the greatest contributors to HI increase in 2009 and 2014.
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Affiliation(s)
- Maedeh Raznahan
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
- Deputy of Research, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hassan Emamian
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Fateme Alipour
- Eye Research Center, Farabi Eye Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Hojjat Zeraati
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Tamosiunas A, Petkeviciene J, Radisauskas R, Bernotiene G, Luksiene D, Kavaliauskas M, Milvidaitė I, Virviciute D. Trends in electrocardiographic abnormalities and risk of cardiovascular mortality in Lithuania, 1986-2015. BMC Cardiovasc Disord 2019; 19:30. [PMID: 30700252 PMCID: PMC6354422 DOI: 10.1186/s12872-019-1009-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 01/23/2019] [Indexed: 01/15/2023] Open
Abstract
Background This study aimed to assess the trends in the prevalence of electrocardiographic (ECG) abnormalities from 1986 to 2015 and impact of ECG abnormalities on risk of death from cardiovascular diseases (CVD) in the Lithuanian population aged 40–64 years. Methods Data from four surveys carried out in Kaunas city and five randomly selected municipalities of Lithuania were analysed. A resting ECG was recorded and CVD risk factors were measured in each survey. ECG abnormalities were evaluated using Minnesota Code (MC). Trends in age-standardized prevalence of ECG abnormalities were estimated for both sexes. Multivariate Cox proportional hazards models were used to estimate hazard ratios (HR) for coronary heart disease (CHD) and CVD mortality. Net reclassification index (NRI), integrated discrimination improvement and other indices were used for evaluation of improvement in the prediction of CVD and CHD mortality risk after addition of ECG abnormalities variable to Cox models. Results From1986 to 2008, the decrease in the prevalence of Q-QS MC was observed in both genders. The prevalence of high R waves increased in men, while the prevalence of ST segment and T wave abnormalities as well as arrhythmias decreased in women. Ischemic changes and possible MI were associated with a 2.5-fold and 4.4-fold higher risk of death from CVD in men and 1.51-fold and 2.56-fold higher mortality risk from CVD in women as compared to individuals with marginal or no ECG abnormalities. The addition of ECG abnormalities to traditional CVD risk factors improved Cox regression models performance. According to NRI, 18.6% of men were correctly reclassified in CVD mortality prediction model and 25.2% of men - in CHD mortality prediction model. Conclusions the decreasing trends in the prevalence of ischemia on ECG in women and increasing trends in the prevalence of left VH in men were observed. ECG abnormalities were associated with higher risk of CVD mortality. The addition of ECG abnormalities to the prediction models modestly improved the prediction of CVD mortality beyond traditional CVD risk factors. The use of ECG as routine screening to identify high risk individuals for more intensive preventive interventions warrants further research.
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Affiliation(s)
- Abdonas Tamosiunas
- Institute of Cardiology, Academy of Medicine, Lithuanian University of Health Sciences, Sukileliu av. 15, LT-50162, Kaunas, Lithuania. .,Faculty of Public Health, Academy of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | - Janina Petkeviciene
- Faculty of Public Health, Academy of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Ricardas Radisauskas
- Institute of Cardiology, Academy of Medicine, Lithuanian University of Health Sciences, Sukileliu av. 15, LT-50162, Kaunas, Lithuania.,Faculty of Public Health, Academy of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Gailute Bernotiene
- Institute of Cardiology, Academy of Medicine, Lithuanian University of Health Sciences, Sukileliu av. 15, LT-50162, Kaunas, Lithuania
| | - Dalia Luksiene
- Institute of Cardiology, Academy of Medicine, Lithuanian University of Health Sciences, Sukileliu av. 15, LT-50162, Kaunas, Lithuania.,Faculty of Public Health, Academy of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Mindaugas Kavaliauskas
- Faculty of Mathematics and Natural Sciences, Kaunas University of Technology, Kaunas, Lithuania
| | - Irena Milvidaitė
- Institute of Cardiology, Academy of Medicine, Lithuanian University of Health Sciences, Sukileliu av. 15, LT-50162, Kaunas, Lithuania
| | - Dalia Virviciute
- Institute of Cardiology, Academy of Medicine, Lithuanian University of Health Sciences, Sukileliu av. 15, LT-50162, Kaunas, Lithuania
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Kutkiene S, Petrulioniene Z, Laucevicius A, Serpytis P, Kasiulevicius V, Staigyte J, Saulyte A, Petrulionyte E, Gargalskaite U, Skiauteryte E, Matuzeviciene G, Kovaite M, Rinkuniene E. Cardiovascular risk assessment of dyslipidemic middle-aged adults without overt cardiovascular disease over the period of 2009-2016 in Lithuania. Lipids Health Dis 2018; 17:233. [PMID: 30305084 PMCID: PMC6180581 DOI: 10.1186/s12944-018-0883-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 10/01/2018] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Cardiovascular mortality in Lithuania is extremely high and abnormal lipid levels are very common among Lithuanian adults. Dyslipidemia is one of the main independent risk factors for cardiovascular diseases (CVD) leading to high absolute CVD risk. The aim of this study was to assess CVD risk in dyslipidemic middle-aged subjects. METHODS During the period of 2009-2016 a total of 92,373 people (58.4% women and 41.6% men) were evaluated. This study included men aged 40-54 and women aged 50-64 without overt CVD. RESULTS Any type of dyslipidemia was present in 89.7% of all study population. 7.5% of dyslipidemic patients did not have any other conventional risk factors. Three and more risk factors were detected in 60.1% of dyslipidemic subjects. All analyzed risk factors, except smoking, were more common in dyslipidemic adults compared to subjects without dyslipidemia: arterial hypertension (55.8% vs. 43.3%, p < 0.001), diabetes (11.1% vs. 7.3%, p < 0.001), abdominal obesity (45.3% vs. 30.2%, p < 0.001), BMI ≥30 kg/m2 (35.8% vs. 23.7%, p < 0.001), metabolic syndrome (34.0% vs. 9.2%, p < 0.001), family history of coronary heart disease (26.3% vs. 23.1%, p < 0.001), unbalanced diet (62.5% vs. 52.9%, p < 0.001) and insufficient physical activity (52.0% vs. 44.2%, p < 0.001). The prevalence of all evaluated risk factors, except smoking, increased with age. Average SCORE index was 1.87 in all study population, while dyslipidemic subjects had higher SCORE compared to control group (1.95 vs 1.20, p < 0.001). CONCLUSIONS Almost two thirds of dyslipidemic middle-aged Lithuanian adults without overt cardiovascular disease had three or more other CVD risk factors, which synergistically increase absolute risk of CVD. The average 10-year risk of CVD death in patients with dyslipidemia was 1.95%. The importance of managing dyslipidemia as well as other risk factors in order to reduce burden of cardiovascular disease in Lithuania is evident.
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Affiliation(s)
- Sandra Kutkiene
- Vilnius University, Faculty of Medicine, Clinic of Cardiac and Vascular Diseases, Vilnius, Lithuania
- Vilnius University, Faculty of Medicine, Vilnius, Lithuania
- Vilnius University Hospital Santaros Klinikos, Santariskiu str. 2, 08661 Vilnius, Lithuania
| | - Zaneta Petrulioniene
- Vilnius University, Faculty of Medicine, Clinic of Cardiac and Vascular Diseases, Vilnius, Lithuania
- Vilnius University, Faculty of Medicine, Vilnius, Lithuania
- Vilnius University Hospital Santaros Klinikos, Santariskiu str. 2, 08661 Vilnius, Lithuania
| | - Aleksandras Laucevicius
- Vilnius University, Faculty of Medicine, Clinic of Cardiac and Vascular Diseases, Vilnius, Lithuania
- Vilnius University, Faculty of Medicine, Vilnius, Lithuania
- Vilnius University Hospital Santaros Klinikos, Santariskiu str. 2, 08661 Vilnius, Lithuania
| | - Pranas Serpytis
- Vilnius University, Faculty of Medicine, Clinic of Cardiac and Vascular Diseases, Vilnius, Lithuania
- Vilnius University, Faculty of Medicine, Vilnius, Lithuania
- Vilnius University Hospital Santaros Klinikos, Santariskiu str. 2, 08661 Vilnius, Lithuania
| | - Vytautas Kasiulevicius
- Vilnius University, Faculty of Medicine, Clinic of Internal Diseases, Family Medicine and Oncology, Vilnius, Lithuania
- Vilnius University, Faculty of Medicine, Vilnius, Lithuania
- Vilnius University Hospital Santaros Klinikos, Santariskiu str. 2, 08661 Vilnius, Lithuania
| | | | - Akvile Saulyte
- Vilnius University, Faculty of Medicine, Vilnius, Lithuania
| | | | - Urte Gargalskaite
- Vilnius University, Faculty of Medicine, Vilnius, Lithuania
- Vilnius University Hospital Santaros Klinikos, Santariskiu str. 2, 08661 Vilnius, Lithuania
| | - Egle Skiauteryte
- Vilnius University, Faculty of Medicine, Vilnius, Lithuania
- Vilnius University Hospital Santaros Klinikos, Santariskiu str. 2, 08661 Vilnius, Lithuania
| | - Gabija Matuzeviciene
- Vilnius University, Faculty of Medicine, Vilnius, Lithuania
- Vilnius University Hospital Santaros Klinikos, Santariskiu str. 2, 08661 Vilnius, Lithuania
| | - Milda Kovaite
- Vilnius University Hospital Santaros Klinikos, Santariskiu str. 2, 08661 Vilnius, Lithuania
| | - Egidija Rinkuniene
- Vilnius University, Faculty of Medicine, Clinic of Cardiac and Vascular Diseases, Vilnius, Lithuania
- Vilnius University, Faculty of Medicine, Vilnius, Lithuania
- Vilnius University Hospital Santaros Klinikos, Santariskiu str. 2, 08661 Vilnius, Lithuania
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Tamosiunas A, Klumbiene J, Petkeviciene J, Radisauskas R, Vikhireva O, Luksiene D, Virviciute D. Trends in major risk factors and mortality from main non-communicable diseases in Lithuania, 1985-2013. BMC Public Health 2016; 16:717. [PMID: 27492379 PMCID: PMC4972981 DOI: 10.1186/s12889-016-3387-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 07/27/2016] [Indexed: 12/31/2022] Open
Abstract
Background This study aimed to assess the trends in the prevalence and levels of risk factors and mortality from main non-communicable diseases in the Lithuanian population aged 45–64 years during 1985 to 2013. Methods Data from four general population surveys conducted between 1985 and 2008 were used. All these surveys were carried out in Kaunas city and five randomly selected municipalities of Lithuania. Risk factors measured at each survey included regular smoking, overweight, obesity, arterial hypertension, and high levels of blood lipids. In total, data of 10,719 subjects (4,965 men and 5,754 women) aged 45–64 were analysed. Trends in standardized all-cause mortality and mortality from cardiovascular disease (CVD), coronary heart disease (CHD), and malignant neoplasms were estimated for both sexes by joinpoint regression analysis. Results In 1985–2013, some favourable trends were observed in the age-standardized mean levels and prevalence of risk factors and mortality from main non-communicable diseases in the Lithuanian middle-aged population. The mean values of blood lipids (with the exception of triglycerides) and the prevalence of dyslipidemias declined. In women, mean levels of systolic blood pressure and body mass index decreased, while in men, the levels of these factors increased. The prevalence of arterial hypertension and obesity increased in men. The proportion of obese women decreased. Smoking prevalence increased in both men and women. From 2007 to 2008, significant downward trends, which were steeper in women than in men, were observed in all-cause, CVD, and CHD mortality. Conclusions Despite the favourable changes in some risk factors and mortality rates, the prevalence of risk factors and mortality from main non-communicable diseases in Lithuania are still high. This indicates the importance of the ongoing primary and secondary prevention and optimal treatment of these diseases.
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Affiliation(s)
- Abdonas Tamosiunas
- Institute of Cardiology, Academy of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania. .,Faculty of Public Health, Academy of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | - Jurate Klumbiene
- Faculty of Public Health, Academy of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Janina Petkeviciene
- Faculty of Public Health, Academy of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Ricardas Radisauskas
- Institute of Cardiology, Academy of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania.,Faculty of Public Health, Academy of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Olga Vikhireva
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Dalia Luksiene
- Institute of Cardiology, Academy of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania.,Faculty of Public Health, Academy of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Dalia Virviciute
- Institute of Cardiology, Academy of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Sun XM, Yao S, Hu SJ, Liu ZY, Yang YJ, Yuan ZY, Ye WM, Jin L, Wang XF. Short sleep duration is associated with increased risk of pre-hypertension and hypertension in Chinese early middle-aged females. Sleep Breath 2016; 20:1355-1362. [PMID: 27491292 DOI: 10.1007/s11325-016-1392-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 07/05/2016] [Accepted: 07/25/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE The aim of this study is to investigate the relationship between sleep duration and hypertension in a middle-aged Chinese population. METHODS Cross-sectional data of 20,505 individuals aged 35-64 years from Taizhou longitudinal study was used. Logistic regression models were used to calculate odds ratios (ORs) for the risk of pre-hypertension and hypertension in association with sleep duration. RESULTS Short sleep duration was associated with high systolic and diastolic blood pressure in comparison with sleep duration of 7-8 h in females. Short sleep duration was also associated with an increased risk of hypertension in females. Age-stratified analysis showed that as compared with sleep duration of 7-8 h, sleep duration <6 h increased risk of hypertension after controlling for multiple covariates with an OR of 1.766 (1.024-2.775) in early middle-aged females of 35-44 years. More importantly, sleeping less than 6 h is associated with increased risk of pre-hypertension in females of this age category, after controlling for multiple covariates with an OR of 1.769 (1.058-2.958). CONCLUSIONS Sleeping less than 6 h a day is associated with increased risk of pre-hypertension and hypertension in Chinese early middle-aged females. The high-risk populations require sufficient sleep, which could probably prevent the increased risk of pre-hypertension as well as hypertension.
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Affiliation(s)
- Xun-Ming Sun
- Unit of Epidemiology, State Key Laboratory of Genetic Engineering and MOE Key Laboratory of Contemporary Anthropology, School of Life Sciences and Institutes of Biomedical Sciences, Fudan University, 220 Handan Rd, Shanghai, 200433, China
| | - Shun Yao
- Unit of Epidemiology, State Key Laboratory of Genetic Engineering and MOE Key Laboratory of Contemporary Anthropology, School of Life Sciences and Institutes of Biomedical Sciences, Fudan University, 220 Handan Rd, Shanghai, 200433, China
| | - Shu-Juan Hu
- Unit of Epidemiology, State Key Laboratory of Genetic Engineering and MOE Key Laboratory of Contemporary Anthropology, School of Life Sciences and Institutes of Biomedical Sciences, Fudan University, 220 Handan Rd, Shanghai, 200433, China
| | - Zu-Yun Liu
- Unit of Epidemiology, State Key Laboratory of Genetic Engineering and MOE Key Laboratory of Contemporary Anthropology, School of Life Sciences and Institutes of Biomedical Sciences, Fudan University, 220 Handan Rd, Shanghai, 200433, China
| | - Ya-Jun Yang
- Taizhou Research Institute of Health Sciences, Taizhou, Jiangsu, 225312, China
| | - Zi-Yu Yuan
- Taizhou Research Institute of Health Sciences, Taizhou, Jiangsu, 225312, China
| | - Wei-Min Ye
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Li Jin
- Unit of Epidemiology, State Key Laboratory of Genetic Engineering and MOE Key Laboratory of Contemporary Anthropology, School of Life Sciences and Institutes of Biomedical Sciences, Fudan University, 220 Handan Rd, Shanghai, 200433, China
| | - Xiao-Feng Wang
- Unit of Epidemiology, State Key Laboratory of Genetic Engineering and MOE Key Laboratory of Contemporary Anthropology, School of Life Sciences and Institutes of Biomedical Sciences, Fudan University, 220 Handan Rd, Shanghai, 200433, China.
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Akbaraly TN, Shipley MJ, Ferrie JE, Virtanen M, Lowe G, Hamer M, Kivimaki M. Long-term adherence to healthy dietary guidelines and chronic inflammation in the prospective Whitehall II study. Am J Med 2015; 128:152-160.e4. [PMID: 25305231 PMCID: PMC4315808 DOI: 10.1016/j.amjmed.2014.10.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 09/29/2014] [Accepted: 10/01/2014] [Indexed: 01/02/2023]
Abstract
BACKGROUND Inflammation plays an important role in the cause of cardiovascular diseases and may contribute to the association linking an unhealthy diet to chronic age-related diseases. However, to date the long-term associations between diet and inflammation have been poorly described. Our aim was to assess the extent to which adherence to a healthy diet and dietary improvements over a 6-year exposure period prevented subsequent chronic inflammation over a 5-year follow-up in a large British population of men and women. METHODS Data were drawn from 4600 adults (mean ± standard deviation, age 49.6 ± 6.1 years, 28% were women) from the prospective Whitehall cohort II study. Adherence to a healthy diet was measured using Alternative Healthy Eating Index (AHEI) scores in 1991-1993 (50.7 ± 11.9 points) and 1997-1999 (51.6 ± 12.4 points). Chronic inflammation, defined as average levels of serum interleukin-6 from 2 measures 5 years apart, was assessed in 1997-1999 and 2002-2004. RESULTS After adjustment for sociodemographic factors, health behaviors, and health status, participants who maintained a high AHEI score (ie, a healthy diet, n = 1736, 37.7%) and those who improved this score over time (n = 681, 14.8%) showed significantly lower mean levels of interleukin-6 (1.84 pg/mL, 95% confidence interval [CI], 1.71-1.98 and 1.84 pg/mL, 95% CI, 1.70-1.99, respectively) than those who had a low AHEI score (n = 1594, 34.6%) over the 6-year exposure period (2.01 pg/mL, 95% CI, 1.87-2.17). CONCLUSIONS These data suggest that maintaining and improving adherence to healthy dietary recommendations may reduce the risk of long-term inflammation.
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Affiliation(s)
- Tasnime N Akbaraly
- Inserm U710, Montpellier, F-34000, France; University Montpellier II, Montpellier, France; EPHE, Paris, France; Department of Epidemiology and Public Health, University College London, London, United Kingdom.
| | - Martin J Shipley
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Jane E Ferrie
- Department of Epidemiology and Public Health, University College London, London, United Kingdom; School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | | | - Gordon Lowe
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Mark Hamer
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Mika Kivimaki
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
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