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The purpose of this study was to establish associations between both serum levels and bone content of a wide range of elements (Na, K, P, Ca, Mg, Zn, Cu, Cr, Mn, Fe, and Pb), with hip strength (HS) indices derived from dual-energy X-ray absorptiometry (DXA). The study population consisted of a number of male patients aged 56-77 years following hip replacement due to osteoarthritis of the hip. Bone specimens were taken from the femoral head and neck during arthroplasty. The elemental analyses were carried out using coupled plasma optical emission spectrometry. The following DXA-HS parameters were assessed: buckling ratio (BR), cross-sectional area (CSA) and its moment of inertia (CSMI), section modulus, and Femoral Strength Index (FSI). Age was positively correlated with Na, K, and Cu in the bone. Ca in the bone was positively associated with BR and negatively with SM and CSMI. Of all the DXA-HS parameters, the weakest associations of elements in the bone were found with FSI and the strongest with BR. Among the elements in the serum, the strongest negative associations were found for K, Cr, Mn, and Zn with CSA, while the majority of bone elements were associated either positively (Ca, P, Mg, Zn, and Cu) or negatively (Mn, Fe, Pb, and Cr) with BR. In conclusion, the interactions between individual elements in blood serum and bone with DXA-HS could not be unequivocally established.
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Oligoelementos , Absorciometria de Fóton , Densidade Óssea , Colo do Fêmur , Humanos , Chumbo , Masculino , SoroRESUMO
BACKGROUND: Falls can lead to severe health loss including death. Past research has shown that falls are an important cause of death and disability worldwide. The Global Burden of Disease Study 2017 (GBD 2017) provides a comprehensive assessment of morbidity and mortality from falls. METHODS: Estimates for mortality, years of life lost (YLLs), incidence, prevalence, years lived with disability (YLDs) and disability-adjusted life years (DALYs) were produced for 195 countries and territories from 1990 to 2017 for all ages using the GBD 2017 framework. Distributions of the bodily injury (eg, hip fracture) were estimated using hospital records. RESULTS: Globally, the age-standardised incidence of falls was 2238 (1990-2532) per 100 000 in 2017, representing a decline of 3.7% (7.4 to 0.3) from 1990 to 2017. Age-standardised prevalence was 5186 (4622-5849) per 100 000 in 2017, representing a decline of 6.5% (7.6 to 5.4) from 1990 to 2017. Age-standardised mortality rate was 9.2 (8.5-9.8) per 100 000 which equated to 695 771 (644 927-741 720) deaths in 2017. Globally, falls resulted in 16 688 088 (15 101 897-17 636 830) YLLs, 19 252 699 (13 725 429-26 140 433) YLDs and 35 940 787 (30 185 695-42 903 289) DALYs across all ages. The most common injury sustained by fall victims is fracture of patella, tibia or fibula, or ankle. Globally, age-specific YLD rates increased with age. CONCLUSIONS: This study shows that the burden of falls is substantial. Investing in further research, fall prevention strategies and access to care is critical.
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Acidentes por Quedas , Carga Global da Doença , Saúde Global , Humanos , Incidência , Expectativa de Vida , Morbidade , Prevalência , Anos de Vida Ajustados por Qualidade de VidaRESUMO
Objectives: To assess the prevalences across Europe of radiological indices of degenerative inter-vertebral disc disease (DDD); and to quantify their associations with, age, sex, physical anthropometry, areal BMD (aBMD) and change in aBMD with time. Methods: In the population-based European Prospective Osteoporosis Study, 27 age-stratified samples of men and women from across the continent aged 50+ years had standardized lateral radiographs of the lumbar and thoracic spine to evaluate the severity of DDD, using the Kellgren-Lawrence (KL) scale. Measurements of anterior, mid-body and posterior vertebral heights on all assessed vertebrae from T4 to L4 were used to generate indices of end-plate curvature. Results: Images from 10 132 participants (56% female, mean age 63.9 years) passed quality checks. Overall, 47% of men and women had DDD grade 3 or more in the lumbar spine and 36% in both thoracic and lumbar spine. Risk ratios for DDD grades 3 and 4, adjusted for age and anthropometric determinants, varied across a three-fold range between centres, yet prevalences were highly correlated in men and women. DDD was associated with flattened, non-ovoid inter-vertebral disc spaces. KL grade 4 and loss of inter-vertebral disc space were associated with higher spine aBMD. Conclusion: KL grades 3 and 4 are often used clinically to categorize radiological DDD. Highly variable European prevalences of radiologically defined DDD grades 3+ along with the large effects of age may have growing and geographically unequal health and economic impacts as the population ages. These data encourage further studies of potential genetic and environmental causes.
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Degeneração do Disco Intervertebral/diagnóstico por imagem , Degeneração do Disco Intervertebral/epidemiologia , Osteocondrose/diagnóstico por imagem , Osteocondrose/epidemiologia , Osteoporose/diagnóstico por imagem , Distribuição por Idade , Idoso , Densidade Óssea , Estudos de Coortes , Europa (Continente) , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Radiografia/métodos , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Distribuição por SexoRESUMO
BACKGROUND: The aim of this study was to assess the impact of standard hypoglycaemic treatment strategies on adiponectin levels and fat distribution in patients with newly diagnosed type 2 diabetes mellitus (T2DM). MATERIAL AND METHODS: This was a prospective observational study of 50 women with newly diagnosed T2DM, aged 64·6 ± 7·9 years and treated for 12 months with lifestyle modification alone (n = 24) or in combination with metformin (n = 26), according to current standards of diabetic care and clinical practice guidelines. None of the patients required insulin therapy during the entire study period. Total (BF), abdominal (android) and hip (gynoid) fat were measured by dual-energy X-ray absorptiometry at the baseline and after 12 months of treatment. Total adiponectin, glycated haemoglobin (HbA1c) and fasting glucose were measured in 3-month intervals. RESULTS: Baseline adiponectin level was low (9·37 ± 2·81 µg/mL). Lifestyle modifications and metformin produced comparable changes in adiponectin levels, which were not associated with changes in BF, HbA1c, glucose and regional fat depots. Baseline adiponectin was inversely correlated with triglycerides (R = -0·441; P = 0·0007) and the android/gynoid ratio (R = -0·272; P = 0·042). Treatment with metformin was associated with a significant weight reduction (P = 0·033), which resulted from a decrease in BF% (P = 0·044) but was not associated with changes in android and gynoid depots. CONCLUSIONS: In postmenopausal women with newly diagnosed T2DM, lifestyle modifications alone or combined with metformin produced comparable changes in adiponectin levels. Weight reduction in patients treated with metformin was associated with significant decrease in %BF but not in regional fat depots.
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Adiponectina/metabolismo , Tecido Adiposo/patologia , Diabetes Mellitus Tipo 2/patologia , Tecido Adiposo/metabolismo , Idoso , Glicemia/metabolismo , Distribuição da Gordura Corporal , Peso Corporal/fisiologia , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/terapia , Dieta , Feminino , Hemoglobinas Glicadas/metabolismo , Humanos , Hipoglicemiantes/uso terapêutico , Síndrome Metabólica/metabolismo , Síndrome Metabólica/patologia , Metformina/uso terapêutico , Pessoa de Meia-Idade , Pós-Menopausa , Estudos Prospectivos , Circunferência da Cintura/fisiologiaRESUMO
BACKGROUND: Normal weight obesity (NWO) is defined as percentage body fat (%BF) above 30% or %BF in the upper tertile in normal weight subjects. Using these criteria, we assessed lipid profiles, glucose metabolism parameters, blood pressure and regional fat in 91 premenopausal women with NWO and 54 age-matched healthy controls. METHODS: We measured total cholesterol, high-density lipoproteins (HDL), low-density lipoproteins (LDL), triglycerides (TG), glucose, insulin, visfatin and adiponectin.%BF, abdominal fat (Android) and hip fat (Gynoid) were measured by dual-energy X-ray absorptiometry. Insulin resistance was evaluated by homoeostasis model assessment (HOMA-IR). RESULTS: Women with NWO had higher diastolic blood pressure (DBP) (P = 0·003), LDL (P = 0·048), TG (P = 0·004) Android (P = 0·008) and Gynoid (P = 0·007) levels, but lower HDL (P = 0·009) than healthy controls. The NWO women had one (P = 0·041), two (P = 0·007) or three (P = 0·002) metabolic syndrome components more frequently than the controls. Across %BF tertiles, the number of metabolic syndrome components significantly increased (R = 0·21; P = 0·02), as did Gynoid (R = 0·83; P < 0·001) and Android (R = 0·81; P < 0·001) levels. Android (but not Gynoid) level was linearly associated with DBP (R = 0·194; P = 0·019), HDL (R = -0·295; P = 0·0004) and TG (R = 0·183; P = 0·031). Visfatin and adiponectin levels were comparable in both groups. Visfatin was inversely correlated with cholesterol, LDL and HOMA-IR. Adiponectin was inversely correlated with the Android/Gynoid and Android/Total fat ratios. CONCLUSIONS: Compared with healthy controls, women with NWO had higher DBP, TG, LDL, and regional fat and lower HDL. These findings seem to be associated more with excess Android fat than excess %BF.
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Adiponectina/metabolismo , Tecido Adiposo/química , Nicotinamida Fosforribosiltransferase/metabolismo , Obesidade/metabolismo , Pré-Menopausa/metabolismo , Adulto , Antropometria , Peso Corporal , Estudos de Casos e Controles , Feminino , Humanos , Síndrome Metabólica/complicações , Síndrome Metabólica/metabolismo , Obesidade/complicações , Adulto JovemRESUMO
The definition of non-specific presentation at a hospital emergency department (ED) has not yet been formally established. The purpose of this study was to assess the relationships between primary ED diagnoses identified by ICD-10 codes and ED length of stay (LOS). Over the course of three years, we examined 134,675 visits at a tertiary hospital. LOS was examined in groups with specific (internal, surgical, neurological, and traumatic diseases) and non-specific diagnoses. Our secondary objective was to measure LOS by age, day of the week, time of day, and season. The median LOS was 182 min (interquartile range: 99-264 min). LOS was 99 min in the traumatic group, while it was 132 min in the surgical group, 141 min in the non-specific group, 228 min in the internal medicine group, and 237 min in the neurological group. Other determinants of LOS were age, revisits, day of the week, and time of arrival-but not a season of the year. In the non-specific group (21% of all diagnoses), the percentage of hospitalizations was higher than in the specific groups. Our results suggest that in clinical practice, the non-specific group should be redefined to also encompass diagnoses from ICD-10 Chapter XXI (block Z00-Z99).
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Studies to date have yielded conflicting results on associations between components of metabolic syndrome (MetS) and bone mineral density (BMD), particularly in men. This current systematic review and meta-analysis addresses the existing gap in the literature and aims to evaluate bone mineral density (BMD) at the femoral neck (FN) and lumbar spine (LS) in men diagnosed with MetS. The two study authors independently searched PubMed, Cinahl, Embase, and Web of Science up to 8 February 2022 for studies in English. The inclusion criteria were (i) diagnosis of MetS according to the NCEP-ATP III 2001 criteria; (ii) adult male demographic; (iii) analyzable data on BMD in at least two sites using dual-energy X-ray absorptiometry (DXA), and (iv) original observational studies. Case reports and non-English articles were excluded. We analyzed the results of seven studies providing data on bone density in men with MetS. Results: Based on random effect weights, the mean BMD of the femoral neck and lumbar spine were 0.84 and 1.02, respectively. The mean lumbar spine T-score was -0.92. In meta-regression analysis, the variances in mean BMD in the lumbar spine and femoral neck could not be significantly explained by BMI (lumbar BMD: Q = 1.10, df = 1, p = 0.29; femoral neck BMD: Q = 0.91, df = 1, p = 0.34). Our meta-analysis suggests normal bone mass in adult males with MetS. Due to the high heterogeneity in the seven analyzed studies and the lack of control groups in these studies, further research is needed to fully elucidate the associations between MetS and its components and BMD in men.
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OBJECTIVE: Some experimental and clinical studies suggest a possible role of irisin in central and peripheral regulation of blood pressure. The purpose of the study was to assess the associations between serum irisin levels, total and visceral fat, metabolic parameters, and blood pressure pattern during 24-h monitoring (ABPM). METHODS: In 206 patients with essential hypertension receiving standard antihypertensive treatments, we assessed anthropometric indices; serum irisin, blood lipids (total cholesterol, LDL-C, HDL-C, and triglycerides), glucose and insulin; body composition including lean mass and total, visceral, android and gynoid fat using a dual-energy x-ray absorptiometry; ABPM; and Homeostasis Model Assessment-Insulin Resistance (HOMA-IR). RESULTS: Baseline irisin levels were within normal reference ranges and comparable between the genders. There were no significant correlations of irisin with age, anthropometric variables, lipids, HOMA-IR, body composition, as well as 24-h blood pressure and dipping status. In univariate analysis, age, fat mass and distribution, lipids and glucose, HOMA-IR, and nocturnal blood pressure fall were poor predictors of irisin levels. These neutral associations were not affected by age, gender, and treatment modality. CONCLUSION: In young adult hypertensives, serum concentration of irisin was within a normal range and not associated with total and regional fat, blood lipids, insulin resistance, as well as 24-h blood pressure and the magnitude of its nocturnal fall.
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Fibronectinas/sangue , Hipertensão/diagnóstico , Resistência à Insulina , Gordura Intra-Abdominal , Pressão Sanguínea , Índice de Massa Corporal , Feminino , Humanos , Masculino , Triglicerídeos , Adulto JovemRESUMO
INTRODUCTION: Hypertension may cause target organ damage leading to hypertensive heart disease (HHD). The burden caused by HHD in Poland has not been studied systematically. The purpose of this study was to describe the burden of HHD in Poland in terms of prevalence, mortality, disability-adjusted life years lost (DALY) and key risk factors. MATERIAL AND METHODS: Data were obtained from the Global Burden of Diseases, Injuries and Risk Factors (GBD) Study database. The GBD uses a wide range of data sources and complex statistical methods to estimate disease burden for all countries by age, sex, and year. HHD was defined by ICD-9 codes 402-402.91 and ICD-10 codes I11-I11.9. From the GBD 2016 estimates, we extracted data for Poland between 1990 and 2016. RESULTS: Hypertensive heart disease is the fourth most important cause of cardio- and cerebrovascular death, after ischemic heart disease, stroke and cardiomyopathy. In 2016, there were about 180 000 people diagnosed with HHD in Poland and close to 5000 HHD-related deaths. HHD prevalence increased from 0.29% in 1990 to 0.47% in 2016 and was higher in women, while mortality increased from 11.2 to 12.7 per 100 000, largely due to population aging. Age-standardized death and DALY rates declined between 1990 and 2016 and were lower than in Central Europe but higher than in Western Europe. CONCLUSIONS: Our data suggest a need for national initiatives to improve the diagnosis and treatment of hypertension, slow the progression of HHD, and reduce the related risks and premature deaths.
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INTRODUCTION: The exact prevalence of polycystic ovary syndrome (PCOS) is difficult to assess due to the clinical heterogeneity of this condition, the lack of a universal definition as well as the lack of studies comparing differences within and between ethnic groups across geographical regions. MATERIAL AND METHODS: Using a modeling approach, we analyzed the data from Global Burden of Disease Study 2016 and extracted the national and regional estimates on PCOS prevalence since 1990 in females aged 15-49 years by country and three major European regions: Western, Central, and Eastern. RESULTS: The average prevalence of PCOS in Europe was 276.4 cases per 100,000 (95% uncertainty interval (UI): 207.8-363.2). The estimates varied markedly across countries and regions, with the highest rates per 100,000 in the Czech Republic (460.6) and the lowest in Sweden (34.10); other Nordic countries, Germany, and the UK had relatively low rates as well. The rates in Central and Eastern Europe were more than three times higher than those in Western countries. They were comparable among Eastern countries, ranging from 406.4 in Lithuania to 443.1 in Russia. Within Central Europe, PCOS prevalence was lowest in Turkey and Albania, while in the majority of the remaining countries, the prevalence ranged between 420 and 440 per 100,000. Between 1990 and 2016, the rates across European regions were relatively stable. CONCLUSIONS: We found highly variable national and regional prevalence of PCOS among European females. Our estimates encourage the search at the population level for new environmental and genetic determinants of PCOS.
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The aim of this study was to assess the associations of serum and bone zinc (Zn) and cuprum (Cu) with bone mineral density (BMD) and content (BMC), markers of bone turnover, and sex hormones. The study group comprised 144 men treated with total hip replacement due to hip osteoarthritis. We measured total, free, and bioavailable testosterone, estradiol, and sex-hormone-binding globulin (sex hormones), as well as parathyroid hormone, osteocalcin, carboxy terminal collagen crosslinks, and N-terminal propeptide of type I procollagen (markers of bone turnover). Total body BMD, BMC, total and visceral fat, and appendicular skeletal mass (ASM) were measured using dual-energy X-ray absorptiometry. ASM index, and total and visceral fat were positively correlated with BMD. Bone Zn correlated neither with sex hormones nor with bone turnover markers; however, it was positively associated both with BMD and with BMC, while bone Cu (as opposed to serum Cu) was not. In multiple regression, the ASM index, Zn/Cu ratio (in both the serum and the bone), and serum Cu concentration were significantly associated with BMD and BMC after adjustment for age and body mass index (BMI). Our results suggest that the Zn/Cu ratio in both the serum and the bone may exert a significant positive effect on total BMD and BMC.
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Osso e Ossos/fisiologia , Cobre/metabolismo , Zinco/metabolismo , Absorciometria de Fóton , Idoso , Artroplastia de Quadril , Biomarcadores/sangue , Índice de Massa Corporal , Densidade Óssea , Remodelação Óssea , Osso e Ossos/diagnóstico por imagem , Osso e Ossos/metabolismo , Colágeno/sangue , Cobre/sangue , Estradiol/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Osteocalcina/sangue , Hormônio Paratireóideo/sangue , Globulina de Ligação a Hormônio Sexual/metabolismo , Testosterona/sangue , Zinco/sangueRESUMO
BACKGROUND/AIMS: Pregnancy complicated by diabetes is associated with increased risk of unfavorable obstetric outcomes. A common abnormality in diabetes is endothelial dysfunction resulting in an altered pattern of vasoactive substance production by the endothelial cells. The aim of study was to assess serum endothelin-1 (ET-1) and cyclic guanosine monophosphate (cGMP) in pregnant women with pregravid (PGDM) or gestational diabetes (GDM). METHODS: At the time of delivery, serum ET-1, cGMP, glycated hemoglobin (A1c), fructosamine and non-fasting glucose were measured in 19 PGDM, 23 GDM and 18 controls. RESULTS: ET-1 and cGMP were similar in all groups. In GDM there was a positive association between A1c and ET-1 (r = 0.437; p < 0.05) and cGMP (r = 0.542; p < 0.02). In the controls, but not in PGDM and GDM, we found a positive correlation between ET-1 and cGMP (r = 0.634; p < 0.005). In women with diabetes, an optimal (A1c <6%) or inadequate (A1c >6%) metabolic control of diabetes did not influence ET-1 or cGMP levels. CONCLUSIONS: In women with PGDM and GDM, serum ET-1 and cGMP were similar to the levels observed in healthy pregnant women. However, the physiological balance between vasoconstrictor and vasodilator substances might be defective in pregnancies complicated by diabetes.
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GMP Cíclico/sangue , Diabetes Gestacional/sangue , Endotelina-1/sangue , Gravidez em Diabéticas/sangue , Glicemia/metabolismo , Feminino , Frutosamina/sangue , Hemoglobinas Glicadas/metabolismo , Humanos , Gravidez , Estatísticas não ParamétricasRESUMO
OBJECTIVES: The aim of our study was to evaluate whether mild to moderate infant respiratory distress syndrome (RDS) treated with nasal continuous positive airway pressure (NCPAP) might affect the pulmonary function in school-aged children. MATERIAL AND METHODS: 50 children, aged 10.2 +/- 2.8 years, with a history of RDS and 90 controls without a neonatal history of lung diseases, matched for age and gestational age at birth, were studied. Pulmonary function was assessed by spirometry and oxygen saturation measured by pulse oximeter RESULTS: The incidence of respiratory tract infections within the first 6 years after discharge from the intensive care neonatal unit was higher in the RDS group than in controls (P < 0.05). Spirometric parameters of the pulmonary function were comparable in both groups. Oxygen saturation was significantly lower in the RDS group (96.2 +/- 7 vs. 97.3 +/- 7%; P < 0.05). A significant negative correlation between spirometric parameters and the duration of NCPAP application and the duration of oxygen supplementation has been found. CONCLUSIONS: Pulmonary function assessed by spirometry was normal in school-aged children with infant RDS. However; spirometric parameters were negatively correlated with the duration of NCPAP and the duration of oxygen supplementation. In comparison with the controls, children with infant RDS had a higher incidence of respiratory tract infections (laryngitis, acute bronchitis and pneumonia) within the first 6 years of life, as well as lower oxygen saturation.
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Pressão Positiva Contínua nas Vias Aéreas/estatística & dados numéricos , Transtornos Respiratórios/epidemiologia , Testes de Função Respiratória/estatística & dados numéricos , Adolescente , Estudos de Casos e Controles , Causalidade , Criança , Serviços de Saúde da Criança/organização & administração , Proteção da Criança , Pré-Escolar , Comorbidade , Pressão Positiva Contínua nas Vias Aéreas/efeitos adversos , Feminino , Humanos , Incidência , Recém-Nascido , Masculino , Polônia/epidemiologia , Transtornos Respiratórios/etiologia , Respiração Artificial/efeitos adversos , Síndrome do Desconforto Respiratório do Recém-Nascido/epidemiologia , Síndrome do Desconforto Respiratório do Recém-Nascido/terapia , Fatores de Risco , Espirometria/métodosRESUMO
It has been suggested that visceral fat (VF) might be a negative determinant of bone health. The purpose of this cross-sectional study was to assess an interplay among fat, visceral fat (VF), muscle mass, bone mineral density (BMD), and markers of bone turnover in men aged 60-75 years. BMD, lean mass, total fat, VF and appendicular skeletal muscle mass (ASM) were assessed using dual-energy X-ray absorptiometry. Using ELISA assays, we measured serum levels of markers of bone turnover (osteocalcin, parathyroid hormone, human procollagen I N-terminal peptide, and degradation products of C-terminal telopeptide of type I collagen). Mean values of bone markers were within normal range. VF was found not to be associated with BMD and bone turnover markers. ASM was inversely correlated with age, and positively with BMD and lean mass. In linear regression, ASM, VF, total fat, lean mass and body mass index were significant single predictors of BMD. However, after adjustment for age, all these associations were no longer significant. In conclusion, in contrast to some studies on postmenopausal women, in older non-diabetic men with normal lean mass and body fat VF was not associated with BMD and markers of bone formation and resorption.
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BACKGROUND: Systematic collection of mortality/morbidity data over time is crucial for monitoring trends in population health, developing health policies, assessing the impact of health programs. In Poland, a comprehensive analysis describing trends in disease burden for major conditions has never been published. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides data on the burden of over 300 diseases in 195 countries since 1990. We used the GBD database to undertake an assessment of disease burden in Poland, evaluate changes in population health between 1990-2017, and compare Poland with other Central European (CE) countries. METHODS: The results of GBD 2017 for 1990 and 2017 for Poland and CE were used to assess rates and trends in years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life years (DALYs). Data came from cause-of-death registration systems, population health surveys, disease registries, hospitalization databases, and the scientific literature. Analytical approaches have been used to adjust for missing data, errors in cause-of-death certification, and differences in data collection methodology. Main estimation strategies were ensemble modelling for mortality and Bayesian meta-regression for disability. RESULTS: Between 1990-2017, age-standardized YLL rates for all causes declined in Poland by 46.0% (95% UI: 43.7-48.2), YLD rates declined by 4.0% (4.2-4.9), DALY rates by 31.7% (29.2-34.4). For both YLLs and YLDs, greater relative declines were observed for females. There was a large decrease in communicable, maternal, neonatal, and nutritional disease DALYs (48.2%; 46.3-50.4). DALYs due to non-communicable diseases (NCDs) decreased slightly (2.0%; 0.1-4.6). In 2017, Poland performed better than CE as a whole (ranked fourth for YLLs, sixth for YLDs, and fifth for DALYs) and achieved greater reductions in YLLs and DALYs than most CE countries. In 2017 and 1990, the leading cause of YLLs and DALYs in Poland and CE was ischaemic heart disease (IHD), and the leading cause of YLDs was low back pain. In 2017, the top 20 causes of YLLs and YLDs in Poland and CE were the same, although in different order. In Poland, age-standardized DALYs from neonatal causes, other cardiovascular and circulatory diseases, and road injuries declined substantially between 1990-2017, while alcohol use disorders and chronic liver diseases increased. The highest observed-to-expected ratios were seen for alcohol use disorders for YLLs, neonatal sepsis for YLDs, and falls for DALYs (3.21, 2.65, and 2.03, respectively). CONCLUSIONS: There was relatively little geographical variation in premature death and disability in CE in 2017, although some between-country differences existed. Health in Poland has been improving since 1990; in 2017 Poland outperformed CE as a whole for YLLs, YLDs, and DALYs. While the health gap between Poland and Western Europe has diminished, it remains substantial. The shift to NCDs and chronic disability, together with marked between-gender health inequalities, poses a challenge for the Polish health-care system. IHD is still the leading cause of disease burden in Poland, but DALYs from IHD are declining. To further reduce disease burden, an integrated response focused on NCDs and population groups with disproportionally high burden is needed.
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Comparação Transcultural , Carga Global da Doença/estatística & dados numéricos , Análise de Sistemas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Carga Global da Doença/tendências , Humanos , Lactente , Recém-Nascido , Expectativa de Vida/tendências , Masculino , Pessoa de Meia-Idade , Mortalidade Prematura/tendências , Polônia/epidemiologia , Anos de Vida Ajustados por Qualidade de Vida , Fatores de Risco , Fatores Sexuais , Adulto JovemRESUMO
OBJECTIVES: The aim of the study was to assess the relationship between maternal and umbilical cord plasma concentrations of endothelin 1 (ET-1) and cyclic guanosine monophosphate (cGMP) in women with diabetes mellitus (DM). MATERIAL AND METHODS: The study was performed on 19 neonates of women with pregestational DM, 23 neonates of women with gestational diabetes (GDM), and 18 neonates of healthy uncomplicated pregnancies. RESULTS: We found that umbilical and maternal ET-1 and cGMP concentrations in pregestational DM or GDM women were not changed in comparison with the controls. In women without DM, positive correlations between maternal (r=0.64; p<0.005) and umbilical cord plasma (r=0.60; p<0.009) ET-1 and cGMP concentrations were found. However in pregnancies complicated by pregestational DM or GDM such associations were not observed. CONCLUSIONS: Umbilical and maternal plasma concentrations of ET-1 and cGMP in pregnant women with pregestational diabetes as well as gestational diabetes were not changed in comparison with the non-diabetic women. In women without DM maternal and umbilical cord plasma ET-1 and cGMP concentrations showed positive correlations. In pregnancies complicated by pregestational DM or GDM maternal and umbilical cord plasma ET-1 and cGMP concentrations were not interdependent.
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GMP Cíclico/sangue , Diabetes Gestacional/sangue , Endotelina-1/sangue , Sangue Fetal/metabolismo , Gravidez em Diabéticas/sangue , Adulto , Feminino , Humanos , Gravidez , Fatores de Risco , Adulto JovemRESUMO
The aims of this study were to assess associations of body fat levels and distribution with metabolic profiles and 24-hour blood pressure in young adults with primary hypertension. Visceral fat (VF) was estimated using dual-energy X-ray absorptiometry. VF was highly significantly associated with a high frequency of overweight/obesity, impaired fasting glucose, increased levels of triglycerides and LDL-cholesterol, and lowered level of HDL-cholesterol. The value of systolic blood pressure (SBP) nocturnal fall was similar between patients receiving RAAS inhibitors, beta-blockers, and calcium channel blockers. In multiple regression, the VF/weight ratio after adjusting for age, gender, total fat, and chronotherapeutic drug delivery was associated with the percentage SBP nocturnal fall (ß = -.3108; 95% CI: -0.5923; -0.0980; P = .013). In males, excess VF increased the odds by 2.3 times for non-dipping blood pressure. Our results suggest that in young adult hypertensives, the VF/weight ratio might be associated with non-dipping blood pressure.
Assuntos
Pressão Sanguínea/fisiologia , Doenças Cardiovasculares/etiologia , Hipertensão/fisiopatologia , Gordura Intra-Abdominal/diagnóstico por imagem , Síndrome Metabólica/etiologia , Absorciometria de Fóton/métodos , Tecido Adiposo/fisiopatologia , Adulto , Anti-Hipertensivos/efeitos adversos , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea/efeitos dos fármacos , Determinação da Pressão Arterial/métodos , Composição Corporal , Índice de Massa Corporal , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/epidemiologia , Ritmo Circadiano/fisiologia , Feminino , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Masculino , Síndrome Metabólica/sangue , Síndrome Metabólica/epidemiologia , Obesidade/complicações , Obesidade/epidemiologia , Sobrepeso/complicações , Sobrepeso/epidemiologia , Fatores de RiscoRESUMO
Introduction: The purpose of this study was to analyze the relationship between the parameters of bone turnover and the levels of hormonal parameters, such as total testosterone (TT), bioavailable and free testosterone (FT), and estradiol (E2) in men. Material and methods: The study group included 63 men with testosterone deficiency syndrome (TDS). The control group consisted of 112 patients without TDS. Enzyme-linked immunosorbent assay (ELISA) was used to determine the levels of osteocalcin (OC), parathyroid hormone (PTH), E2, sex hormone binding globulin (SHBG), dehydroepiandrosterone sulphate (DHEAS), insulin (I), Serum CrossLaps (CtX-I), human procollagen I N-terminal peptide (PINP), and TT. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry. Results: The groups with TSD and without TDS differed in terms of the following parameters: body weight (p = 0.001), BMI (p = 0.003), TT (p = 0.001), FT (p = 0.004), bioavailable testosterone (p = 0.001), E2 (p = 0.003), SHBG (p = 0.003), and PINP (p = 0.004). In the group without TDS, higher PINP levels were accompanied by higher levels of E2 (beta = 0.360, p = 0.002) and TT (beta = 0.389, p = 0.001). In the group without TDS, PINP was positively correlated with E2 (beta = 0.726, p <0.001). Patients with TDS had significantly lower PINP levels (p < 0.004). Conclusions: Analysis of sex hormones and biochemical bone markers in reflecting the quality of the bone tissue in men may suggest a relationship between these parameters. Nevertheless, further research based on a larger sample size is necessary to better describe this relationship.