Associations of ECG Signs of Ischemic and Non-Specific Signs of Metabolic Changes in the Myocardium With Unfavorable Cardiovascular Prognosis in a 7-Year Prospective Follow-Up of Young People Under 45 Years.

AIM: To study ischemic and/or nonspecific ECG signs of metabolic changes in the myocardium and to determine their relationship with unfavorable cardiovascular prognosis in a 7-year prospective observation of young people under 45 years of age. MATERIAL AND METHODS: A cross-sectional population survey of a random sample aged 25-44 years (n=1363) was conducted in Novosibirsk. The survey program used the standardized epidemiological Rose questionnaire. Biochemical tests were used to measure blood concentrations of total cholesterol (C), triglycerides (TG), low- and high-density lipoprotein cholesterol (LDL-C, HDL-C), and fasting blood plasma glucose. Systolic and diastolic BP (SBP, DBP), the presence of arterial hypertension (AH), body mass index (BMI), waist circumference (WC), and smoking status were assessed. ECG was recorded at rest in 12 standard leads followed by interpretation according to the Minnesota Code. The presence of ischemic and/or nonspecific ECG signs of metabolic changes in the myocardium was determined. Subjects with ECG signs of ischemic changes in the myocardium were selected for long-term follow-up and additional examination by cardiologists. Then the whole cohort was monitored for 7 years, and cardiovascular events were recorded, including using data from the WHO Myocardial Infarction Registry in Novosibirsk. For statistical analysis of the results, cardiovascular events were combined into a composite endpoint. RESULTS: During 7 years, 40 people (27 men and 13 women) had an unfavorable cardiovascular prognosis. Multivariate regression analysis showed that a 7-year unfavorable cardiovascular prognosis in people younger than 45 years was associated with signs of ischemic myocardial alterations identified on the background ECG (OR 5.319, 95% CI: 1.543-18.342, p=0.008) and nonspecific ECG signs of metabolic changes in the myocardium (OR 2.978, 95% CI: 1.216-7.216, p=0.017) regardless of age, gender, the presence of arterial hypertension (AH) and type 2 diabetes mellitus (DM2). CONCLUSION: In young people under 45 years of age, not only ECG signs of ischemic changes in the myocardium, but also nonspecific ECG signs of metabolic changes in the myocardium are associated with an unfavorable cardiovascular prognosis, directly and independently on age and gender, in a long-term, 7-year period.

Association between soft drink, fruit juice consumption and obesity in Eastern Europe: cross-sectional and longitudinal analysis of the HAPIEE study.

BACKGROUND: Fruit juice and soft drink consumption have been shown to be related to obesity. However, this relationship has not been explored in Eastern Europe. The present study aimed to assess the cross-sectional and longitudinal relationships between fruit juice, soft drink consumption and body mass index (BMI) in Eastern European cohorts. METHODS: Data from the Health, Alcohol and Psychosocial factors in Eastern Europe population-based prospective cohort study, based in Russia, Poland and the Czech Republic, were used. Intakes of sugar-sweetened beverage (SSB), artificially-sweetened beverage (ASB) and fruit juice were estimated from a food frequency questionnaire. Participant BMI values were assessed at baseline (n = 26 634) and after a 3-year follow-up (data available only for Russia, n = 5205). RESULTS: Soft drink consumption was generally low, particularly in Russia. Compared to never drinkers of SSB, participants who drank SSB every day had a significantly higher BMI in the Czech [ß-coefficient = 0.28; 95% confidence interval (CI) = 0.02-0.54], Russian (ß-coefficient = 1.38; 95% CI = 0.62-2.15) and Polish (ß-coefficient = 0.83; 95% CI = 0.29-1.37) cohorts. Occasional or daily ASB consumption was also positively associated with BMI in all three cohorts. Results for daily fruit juice intake were inconsistent, with a positive association amongst Russians (ß-coefficient = 0.75; 95% CI = 0.28-1.21) but a negative trend in the Czech Republic (ß-coefficient = -0.42; 95% CI = -0.86 to 0.02). Russians participants who drank SSB or ASB had an increased BMI after follow-up. CONCLUSIONS: Our findings support previous studies suggesting that soft drink consumption (including SSBs and ASBs) is positively related to BMI, whereas our results for fruit juice were less consistent. Policies regarding these beverages should be considered in Eastern Europe to lower the risk of obesity.

Blood Pressure Levels and Prevalence of Arterial Hypertension in the Population of Residents of the Central Region of Siberia Aged 25­45 Years.

PURPOSE: to study blood pressure levels and the prevalence of hypertension in persons aged 25-45 years in Novosibirsk. MATERIALS AND METHODS: A cross-sectional population study in one of typical areas of Novosibirsk was performed in 2013-2016. The study included 479 men and 612 women aged 25-45 years. Arterial hypertension was defined as blood pressure (BP) ≥140 / 90 mmHg according to Russian recommendations (2004). For analysis two age groups were distinguished: 25-34 years and 35-45 years. RESULTS: Mean values of systolic and diastolic BP were significantly lower in women than in men in age groups. In men and women, the analyzed indicators were significantly higher in the older than in the younger age group. Mean values of pulse pressure in men were significantly higher than in women in both age groups, there were no differences in the analyzed index between age groups in either men or women. Optimal BP was more often recorded among women than among men in both age groups. The proportion of persons with normal BP among men was grate than among women in both age groups. In the age group 35-45 years compared with the younger group, in men there was a decrease in incidence of category with BP<140 / 90 mmHg, an increase of the proportion of persons with hypertension grades 1 and 2, the appearance of persons with grade 3 hypertension; in women - an increase of the proportion of individuals with normal, high-normal BP, and with grade 1 hypertension, appearance of individuals with grades 2 and 3 hypertension. Frequency of BP categories ≥140 / 90 mmHg in age group 25-34 years among men was 17.6 %, among women 3.1 % (p<0.0001); in age group 35-45 years among men - 34.7 %, among women - 12.5 % (p<0.0001). CONCLUSIONS: Prevalence of hypertension in men was 28 %, in women - 9 %. Favorable tendencies of BP indicators in both sexes were revealed over a 30-year period, while gender differences did not change.

[Central Aortic Pressure: Reference and Diagnostic Values].

OBJECTIVE: Practical application of central aortic pressure (CAP) parameters is limited by the absence of generally recognized reference and threshold diagnostic indices. The purpose of this work is to establish their values in the general population of Novosibirsk. Materials and Methods. A total of 327 people were examined: 155 men and 172 women aged 25-44 years from a representative sample from the general population of Novosibirsk. Applanation tonometry of the radial artery was performed by the SphygmoCor system. The reference values of CAP parameters were obtained by a nonparametric method according to the Clinical and Laboratory Standards Institute (CLSI) recommendations (95 % percentile interval with 2.5 % and 97.5 % cut-off points and their 90 % confidence intervals). Diagnostic thresholds and categories of CAP were determined as mean values depending on the categories of brachial arterial pressure (BP) and on the basis of risk estimates, as well as sensitivity and specificity values for left ventricular hypertrophy similar to risk and sensitivity and specificity values of threshold levels (categories) of brachial BP. RESULTS: The reference values of the parameters of the CAP were: 18-43 mm Hg for pulse pressure; 5-24 mm Hg for the amplification of pulse pressure; - 8.8-40 % for the augmentation index. Diagnostic categories of CAP were determined to be: optimal - less than 110 / 80, normal - 110 / 80-114 / 84, high normal - 115 / 85-124 / 89, hypertension - more than 125 / 90 mm Hg. CONCLUSION: The reference values, diagnostic thresholds and categories of parameters of CAP in the general population of Novosibirsk aged 25-44 years have been determined. It is expedient to further study them.

[Blood lipids and angina pectoris (by epidemiological cardiological Rose questionnaire) in the population of 25-45 years of Novosibirsk].

The aim of the study was to investigate the prevalence of angina pectoris (AP) according to the standardized epidemiological questionnaire of Rose in the population of 25-45 years of Novosibirsk and to identify its association with some lipid and non-lipid risk factors for coronary heart disease (CHD). MATERIAL AND METHODS: Cross-sectional survey of the population aged 25-45 in Novosibirsk was carried out. The study included 1439 people (656 men and 783 women). Within the framework of the complex survey program, the standardized epidemiological questionnaire of Rose (WHO, 1984) was used. Blood levels of total cholesterol (total C), triglycerides (TG), low and high density lipoprotein cholesterol (LDL-C, HDL-C) were determinate by biochemical methods. RESULTS: For all lipid indicators, significant differences were found between men and women. The levels of total C, TG and LDL-C were significantly higher, and the level of HDL-C was lower in men, than in women. According to the Rose questionnaire, out of 1439 people included in the study, 12 patients (0.8%) had AP (75% women). In persons with AP, blood levels of TG were 1.8 times higher, and the levels of HDL-C in blood was 1.2 times lower compared to persons without AP. Univariate analysis of associations of AP with CHD risk factors showed that the chance of developing angina pectoris in the population of 25-45 years was significantly increased in individuals with high blood TG levels (OR 3,515, DI 1,106-11,168, p = 0.039) and low HDL-C (OR 1,203, DI 1,054-1,372, p = 0.006). A natural, although statistically not significant (OR 3,165, p=0,055, due to the small number of groups with AP) increasing in the chance of developing AP in hypertension was detected. CONCLUSION: In the young population of 25-45 years in Novosibirsk, elevated blood levels of TG, reduced levels of HDL-C, and hypertension were associated with AP, according to Rosecardiological questionnaire, which underlines the importance of conducting screening surveys of the young population to improve effective prevention and treatment of diseases.

Relationships of arterial hypertension and reduced renal function in a population 25-45 years.

AIM: To study relationships of reduced renal function with hypertension and other cardiometabolic risk factors in persons aged 25-45 years. MATERIALS AND METHODS: A cross-sectional population study of one of the typical district of Novosibirsk (Russia) was performed during 2013-2016 years. The study included 468 men and 606 women aged 25-45 years. Blood pressure (BP), waist circumference (WC), blood lipids, glucose, creatinine were measured. Glomerular filtration rate (GFR) was calculated with the formula CKD-EPI. Hypertension was registered if blood pressure (BP) was ≥140/90 mm Hg, reduced kidney function - at GFR<90 ml/min/1.73 cm2. RESULTS: Prevalence of hypertension among men was 28%, among women - 9%. The proportion of people with GFR<90 ml/min/1.73 cm2 among men was 9.8%, among women - 34%. Among all examined people GFRs <60 ml/min/1.73 cm2 was revealed in 0.3% only. The association of hypertension with reduced renal function was determined only in men. Based on results of multivariate linear regression analysis, a significant negative association of GFR with age was determined, there was no association of GFR with systolic BP (SBP) in either men or women. In men, inverse relationships of GFR with low-density lipoprotein cholesterol (LDL-С), triglycerides (TG), direct - with WC were determined. Significant inverse association of GFR with diastolic BP (DBP) was revealed only after exception of TG from the regression model. In women, GFR's inverse relationship with LDL-С and DBP was observed, and the direct - with WC. In stepwise analysis the validity of all associations was confirmed after exception of the association of GFR with WC in men. CONCLUSION: In a population of 25-45 years a reduced GFR was associated with increased DBP; levels of LDL-С, TG showed negative association with GFR; in men increased TG levels were more important in reducing GFR than elevated DBP.

[The prevalence of components of metabolic syndrome in the patients with diabetes melitus type 2 and mody diabetes in young people of Novosibirsk].

AIM: To estimate the prevalence of type 2 diabetes mellitus (DM2) and MODY diabetes as well as the prevalence of metabolic syndrome (MS) components for these types of diabetes in the young population of the city of Novosibirsk. MATERIALS AND METHODS: In 2013-2017 years a population survey was conducted of a random representative sample of the population of 25-45 years of both sexes, residents of one of the typical districts of Novosibirsk. WHO criteria (1999-2013) were used for the diagnosis of diabetes: fasting blood glucose ≥7.0 mmol / l after an 8-hour fasting. Also group with DM2 included persons with a fasting blood glucose level.

[Associations between metabolic syndrome and reduced lung function in young people]. / Assotsiatsii metabolicheskogo sindroma i snizhennoi funktsii legkikh u lits molodogo vozrasta.

AIM: To reveal possible associations between metabolic syndrome (MS) and reduced lung function. SUBJECTS AND METHODS: In 2013-016, a cross-sectional survey was conducted in 908 Novosibirsk dwellers, which included spirometry to evaluate external respiratory function (ERF). For the detection of MS, the investigators used the 2009 All-Russian Research Society of Cardiologists criteria: waist circumference (WC) > 80 cm for women and >94 cm for men in combination with two of the following criteria: blood pressure (BP) ≥130/85 mm Hg, triglycerides (TG) ≥1.7 mmol/l, high-density lipoproteins (HDL) cholesterol <1.0 mmol/l for men and <1.2 mmol/l for women, low-density lipoprotein (LDL) cholesterol >3.0 mmol/l, and glucose ≥6.1 mmol/l. RESULTS: The mean values of WC were significantly greater with a forced expiratory volume in one second (FEV1) <80% than those with a FEV1 of ≥80% in both men (p=0.002) and women (p=0.050); in women, the mean values of WS were higher than those with a FEV1/forced vital capacity (FVC) <70% than those with a FEV1/FVC of ≥70% (p=0.047); the mean systolic and diastolic BP levels were significantly more with reductions in FEV1 and FVC, and the level of HDL cholesterol was significantly lower than that with a FEV1 of < 80% in men only. Significant correlations were found between FEV1 and all components of MS in men, between the majority of components of MS and FVC in men, between WC, BP, and FEV1/FVC in men and women, between plasma glucose levels and FEV1/FVC in women. Linear regression analysis revealed significant inverse correlations of FEV1 with TG, glucose, BP; those of FVC with TG, glucose; at the same time a positive association with HDL cholesterol in men, and only a negative correlation of FEV1/FVC with WC. CONCLUSION: The revealed associations between MS and reduced lung function can most likely be explained by the greater prevalence of both MS and its components (hypertension, hypertriglyceridemia, hyperglycemia, LDL hypercholesterolemia) among Novosibirsk men. This is consistent with the assertion that the decline in ERF, particularly FEV1, may be a marker of future cardiovascular disease morbidity and mortality.

[The incidence of respiratory symptoms and their associations with serum cotinine levels as a marker of tobacco smoking in 25-45-year-old Novosibirsk dwellers].

AIM: To study the incidence of respiratory symptoms and to reveal their associations with serum cotinine levels (SCL) in 25-45-year-old Novosibirsk dwellers. SUBJECTS AND METHODS: The WHO respiratory symptom questionnaire and the ECRHS screening questionnaire were used for a population-based survey conducted in Novosibirsk to identify respiratory symptoms; 545 people replied to the questions available in the questionnaires. SCL was determined by enzyme immunoassay on a random subsample of 182 examinees. RESULTS: The incidence of respiratory symptoms was determined among the 25-45-year-old Novosibirsk dwellers: cough (27.7%), more than 3-month cough per year (22%), sputum discharge (25%), forced respiration/wheezing in the past year (22.6%), suffocation fits in the past year (5.3%), and cough/forced respiration/stertor bouts by breathing cold air (14.9%) or contacting animals, plants, or chemical agents (16.5%). There was a significant positive correlation between SCL and the presence of cough, more than 3-month cough per year, sputum discharge, forced respiration/wheezing in the past year (compared to the examinees who did not report these symptoms). The median SCL proved to be significantly higher in the people who complained of cough, more than 3-month cough per year, sputum discharge, and forced respiration/wheezing in the past year (compared to the examinees who did not report these symptoms). The people who had a SCL of more than 3 ng/ml were ascertained to be at higher risk of cough, more than 3-month cough per year, sputum discharge, and forced respiration/wheezing in the past year than those who had a SCL of less than 3 ng/ml. CONCLUSION: The incidence of respiratory symptoms was determined among the 25-45-year-old Novosibirsk dwellers; SCL was found to be associated with the symptoms characteristic of bronchial obstructive diseases; the expediency of using the SCL threshold of 3 ng/ml as a marker of tobacco smoking was confirmed.

[Prevalence of metabolic syndrome in 25-45-year-old Novosibirsk dwellers]. / Rasprostranennost' metabolicheskogo sindroma u zhitelei Novosibirska v vozraste ot 25 do 45 let.

AIM: To study the prevalence of metabolic syndrome (MS) and its components in a 25-45-year-old Novosibirsk population. SUBJECTS AND METHODS: The Novosibirsk Research Institute of Internal and Preventive Medicine conducted a cross-sectional population-based survey in one of the typical districts of Novosibirsk in 2013-2015. The survey covered 346 men and 408 women. The criteria of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (NCEP-ATP III, 2001), the International Diabetes Federation (IDF, 2005), the Joint Interim Statement (JIS, 2009), and the All-Russian Research Society of Cardiologists (ARRSC, 2009) were used to detect MS. According to the ARRSC criteria, MS was recorded if a waist circumference (WC) was >80 cm for women and >94 cm for men in conjunction with 2 of the following criteria: a blood pressure ≥130/85 mm Hg, triglycerides (TG) ≥1.7 mmol/l, high-density lipoprotein (HDL) cholesterol <1.0 mmol/l for men and <1.2 mmol/l for women, low-density lipoprotein (LDL) cholesterol >3.0 mmol/l, and plasma glucose level ≥6.1 mmol/l. RESULTS: According to the 2009 ARRSC criteria, the prevalence of abdominal obesity, hypertension, hypertriglyceridemia, HDL hypocholestrolemia, LDL hypercholesterolemia, and high plasma glucose level was 42.6, 33.5, 17.5, 24.3, 64.8, and 29%, respectively. The prevalence of MS in 25-45-year-old Novosibirsk people was 17% (19.9% in men and 14.5% in women) according to the 2001 NCEP-ATP III, 27% (29.5% in men and 24.5% in women) according to the 2005 IDF criteria, 30% (35.8% in men and 25% in women) according to the 2009 JIS criteria, and 29.3% (33.2% in men and 26% in women) according to the 2009 ARRSC criteria, this was higher among men than women. There was an increase in the prevalence of MS with age. CONCLUSION: The highest prevalence of MS was 30 and 29.3% when using the 2009 JIS and the 2009 ARRSC criteria, respectively. Whatever the criterion was used, MS was more frequently recorded in men than women.

PREVALENCE AND RISK FACTORS OF GERD IN ADOLESCENTS IN NOVOSIBIRSK: TEN-YEAR TRENDS.

The aim of the study was the study of ten-year trends (1999-2009) of GERD symptoms and risk factors in schoolchildren in Novosibirsk from 14 to 17 years. MATERIALS AND METHODS: The comparison of the results of the screenings performed at 1999 and 2009 was analyzed. Anthropometry, the survey to identify the symptoms of GERD and eating habits, smoking and alcohol consumption, determination of lgG and CagA antibodies to Helicobacterpylori were included at the program of screenings. RESULTS: No significant dynamics of GER symptoms in adolescents, except weekly heartburn among boys. Among the factors associated with dyspepsia and GER, there have been some mixed changes: the frequency of smoking significantly reduced, but the proportion adolescents with excess body weight have increased. Violations of the regime and diet, and Helicobocrerpylori-infection has not changed significantly. CONCLUSION: The frequency of GERD in adolescents remains high but does not reach the prevalence of GERD in adults.

[Symptoms of gastroesophageal reflux disease and associated factors in adolescents: population survey].

OBJECTIVES: Gastroesophageal reflux (GER) is frequent among the general population affecting 10-20% of adults. However, there is a notable lack of epidemiological data describing prevalence of GER in children. The aims of the present study were to assess the prevalence of GER symptoms (GERS) in adolescents and to evaluate factors associated with GERS including markers of H. pylori infection. METHODS: All school students in grades 9-11 in four randomly selected secondary schools in Novosibirsk participated (449 adolescents, 189 boys, 260 girls aged 14-17). They completed the Bowel Disease Questionnaire, life-style questionnaire, and sera were tested for antibodies against Helicobacter pylori infection. RESULTS: Overall, 60% of adolescents experienced GERS (heartburn and/or acid regurgitation) over the previous year. GER symptoms on a monthly basis were reported by 22% of students, weekly GERS were reported by 9% of adolescents with the same frequency in both genders. GERS were related to family history of dyspepsia or GER, mother's lower educational attainment, overweight, unhealthy eating patterns, alcohol consumption, smoking, and H. pylori infection, as well as concomitant dyspepsia and irritable bowel syndrome. The majority of associations were more prominent in girls. Visiting a physician, endoscopic study, and school absenteeism were reported in the last year more frequently by adolescents with GERS vs those without GERS. CONCLUSIONS: Gastroesophageal reflux symptoms are frequent among the adolescent population and result in frequent use of health care resources. Some precipitated factors found in this study are modifiable and may be corrected in adolescent population.

Trends in cardiovascular risk factors of Siberian adolescents during socioeconomic reforms in Russia (1989-2003).

OBJECTIVE: Prevalence and trends of cardiovascular risk factors among adolescent population in Novosibirsk during the reforms in Russia (1989-2003). STUDY DESIGN: Four cross-sectional surveys of representative samples of schoolchildren aged 14-17 since 1989 (total--2,569). METHODS: Body mass index (BMI) was calculated (kg/m2), blood pressure was double measured with Korotkov's method, and serum total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C) were estimated with enzymatic methods. Low-density lipoprotein cholesterol (LDL-C) was calculated with Friedwald's formula. Self-report of smoking (1 cig/week and more) and physical inactivity (2 h/week and less) was obtained. Diet was estimated using 24-hour dietary recall. RESULTS: Prevalence of high TC, high LDL-C and low HDL-C significantly decreased in both gender groups. Prevalence of arterial hypertension also decreased in boys and girls. Frequency of overweight decreased more in girls. Trends in diet showed significant decreasing of total energy and basic nutrient intakes. Cigarette smoking rate decreased in boys and increased in girls. Physical inactivity rate was high in boys and girls. CONCLUSION: Obtained data indicate similar trends to reduction in classical CVD risk factors, energy intake and life style changes among Siberian adolescents during the period of socioeconomic reforms in Russia.

[Secular trends in blood lipid disorders among adolescents: population study in Novosibirsk (1989-2003)].

UNLABELLED: Hyperlipidemia is a known risk factor of coronary artery disease. The reduction of elevated serum total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels in childhood may reduce cardiovascular morbidity and mortality in adulthood. Aim of the study was to assess prevalence and trends in lipid profile and lipid disorders in adolescent population in Novosibirsk (1989-2003). METHODS: Four cross-sectional surveys of school children aged 14-17 years in 1989 (n=656), in 1994 (n=620), in 1999 (n=626) and in 2003 (n=667) were carried out. Total sample was 2569 (1214 males and 1355 females). Blood total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG) were measured by enzymatic methods. LDL-C was calculated with Friedwald's formula. Associations of blood lipids with age, sex, year of study, body mass index (kg/m2), blood pressure and main nutrients of diet were measured by GLM method. Prevalence of dyslipidemia was evaluated with NCEP-peds criteria. Diet was estimated using 24-hour dietary recall. RESULTS: During the 15-year period (1989-2003) mean serum TC decreased from 175 to 162 mg/dl in males and from 191 to 175 mg/dl in females (p < 0.001). Average levels of LDL-C also fell significantly during this period, but no changes in HDL-C levels were found. Females had significantly higher mean TC and LDL-C than did males at all surveys (p < 0.001). According to NCFP-peds criteria prevalence of high TC (200 mg/dl und more) during the period (1989-2003) significantly decreased from 22% to 8% (p < 0.01) in males and from 32% to 17% (p < 0.05) in females. Frequencies of low HDL-C (< 40 mg/dl) also decreased in boys and girls (p < 0.05 for both gender groups). Significant regression coefficients for TC controlled by age, sex and year of study were revealed with body mass index, diastolic blood pressure and triceps skinfolds. Trends in diet during the period showed significant decrease of total energy and basic nutrient intakes (proteins, fats and carbohydrates). CONCLUSION: During the period of socioeconomic reforms in Russia (1989-2003) the lipid profile and prevalence of atherogenic dislipidemias in adolescents of Novosibirsk significantly changed following the changes of body mass index and diet.

The Relationship between Body Mass Index and 10-Year Trajectories of Physical Functioning in Middle-Aged and Older Russians: Prospective Results of the Russian HAPIEE Study.

OBJECTIVE: To investigate the associations of overweight and obesity with longitudinal decline in physical functioning (PF) among middle-aged and older Russians. DESIGN: Prospective cohort study. SETTING: Four rounds of data collection in the Russian Health, Alcohol and Psychosocial factors In Eastern Europe study with up to 10 years of follow-up. PARTICIPANTS: 9,222 men and women aged 45-69 years randomly selected from the population of two districts of Novosibirsk, Russia. MEASUREMENTS: PF score (range 0-100) was measured by the Physical Functioning Subscale (PF-10) of the 36-item Short Form Health Survey (SF-36) at baseline and three subsequent occasions. Body mass index (BMI), derived from objectively measured body height and weight at baseline, was classified into normal weight (BMI 18.5-24.9), overweight (BMI 25.0-29.9), obesity class I (BMI 30.0-34.9), and obesity class II+ (BMI≥35.0). RESULTS: The mean annual decline in the PF score during the follow-up was -1.92 (95% confidence interval -2.17; -1.68) in men and -1.91 (-2.13; -1.68) in women. At baseline, compared with normal weight, obesity classes I and II+ (but not overweight) were associated with significantly lower PF in both sexes. In prospective analyses, the decline in PF was faster in overweight men (difference from normal weight subjects -0.38 [-0.63; -0.14]), class I obese men and women (-0.49 [-0.82; -0.17] and -0.44 [-0.73; -0.15] respectively) and class II+ obese men and women (-1.13 [-1.73; -0.53] and -0.43 [-0.77; -0.09] respectively). Adjustment for physical activity and other covariates did not materially change the results. CONCLUSIONS: PF decreased more rapidly in obese men and women than among those with normal weight. The adverse effect of high BMI on PF trajectories appeared to be more pronounced in men than in women, making more extremely obese Russian men an important target population to prevent/slow down the process of decline in PF.

Cardiovascular risk factors in the adolescent population of Chukotka.

Representative samples of adolescents of both sexes, aged 15-17, who were residents of coastal and tundra Chukotka settlements (325 subjects) have been examined. The survey was conducted according to methods based on WHO recommendations. The program included a questionnaire, two measurements of arterial blood pressure, anthropometry, and assessment of blood lipid levels. The prevalence of smoking in boys was 40%; in girls, 19%. High systolic BP occurred more often in newly arrived boys (25%). Hypercholesterolemia was minimal in Chukotka Natives (5%), as was hypertriglyceridemia. The prevalence of low HDL cholesterol was highest (48%) in Native boys. Lipid disorders in Chukotka Native children obviously result from an unbalanced diet. High levels of arterial blood pressure in non-Native adolescents of Chukotka are probably caused by stress on the adaptation system under severe conditions in the North.

Nutrition of Chukotka Native children.

We estimated nutrient and food intakes of adolescents aged 14 to 17 who inhabit the coastal and tundra zones of the Chukotka Autonomous Region, Russia, and developed approaches to improving their diet. We reassessed the dietary intakes of Native (n = 162) and non-Native (n = 155) adolescents of both sexes. We found that mean energy and nutrient intakes (protein, fat, carbohydrates) among schoolchildren were similar in different ethnic and sex groups. The diet of the subjects studied is high in sugar (18-19% of energy) and has an unfavorable fat composition, with saturated fatty acids (SFAs) contributing 14-15% of energy, and polyunsaturated fatty acids (PUFAs) contributing 5-6% of energy. Our results demonstrate that the children's diet approaches that of "Western society" to a greater extent than that of adults. A program on nutrition based on the national government project "Children of the North" has been developed at the Institute of Internal Medicine in collaboration with the Chukotka Sanitary and Epidemiology Supervision Services. This program includes the list of food products recommended for children. Some ecological factors and ethnic idiosyncrasies are considered.

Prevalence of dyspepsia and irritable bowel syndrome among adolescents of Novosibirsk, western Siberia.

The study was undertaken to determine the prevalence of gastrointestinal symptoms in a community-based population of adolescents. All students in grades 9-11 of four randomly chosen schools in one of the typical districts of Novosibirsk were invited to participate. A total of 449 students participated (189 boys, 260 girls aged 14-17), all of them completed the Russian version of the Bowel Disease Questionnaire. Dyspepsia was reported more frequently by girls than boys (27% vs 16%). The prevalence of irritable bowel syndrome defined according to the Rome criteria was 24% in girls and 14% in boys. Among students with dyspepsia, 49% had sought medical advice, and 37% had undergone upper gastrointestinal endoscopy or X-ray series, for IBS the corresponding figures were 49% and 24%. School absenteeism was reported by 57% of dyspepsia sufferers, and by 62% of subjects with IBS. In conclusion, dyspepsia and IBS are common among adolescents of Novosibirsk with prevalence rates similar to those described in adults in Western Europe and the USA. These disorders are associated with significant disability and health care costs.

[Functional polymorphism of p53 and CCR5 genes in the long-lived of the Siberian region]. / Funktsional'nyi polimorfizm genov p53 i CCR5 u dolgozhitelei Sibirskogo regiona.

The P53 protein is a key regulator of modified-cell apoptosis. The functional oligonucleotide polymorphism of the p53 gene causes the substitution of arginine (Arg) for praline (Pro) in the codon 72. A reduced apoptotic activity of p53 and, as a consequence, development of oncology pathology is associated with the above polymorphism. CCR5 is a compound transmembrane receptor-protein, which apart from chemokines, binds with some molecules and is a coreceptor for HIV-1. 32 bp deletion within the CCR5 encoding region results in the loss of the protein's receptor function. It has been demonstrated that the transmission of the "external" (in respect to cell) stimulus, via the CCR5 system, induces expression of the p53 gene and initiates apoptosis. Allele variants and p53 and CCR5 genotypes (separately and in combinations) were investigated, within the present case study, for 131 long-livers from Novosibirsk and Tyumen Regions. A trend was detected towards accumulation of the p53 Pro alleles in association with the CCR5del32 allele in the study group, which, as the authors believe, can enhance the genome resistance to variable factors that cut the life span.

[Prevalence and risk factors of the development of irritable bowel syndrome in adolescents: a population study]. / Rasprostranennost' i faktory riska razvitiia sindroma razdrazhennogo kishechnika u podrostkov: populiatsionnoe issledovanie.

AIM: To determine prevalence of irritable bowel syndrome (IBS) and associated factors in a community-based population of adolescents. MATERIAL AND METHODS: 189 schoolboys and 250 schoolgirls aged 14-17 years from four randomly chosen schools of Novosibirsk participated in the study. RESULTS: The prevalence of IBS defined according to Rome criteria was higher in girls (24 vs 14% in boys, p = 0.01). Colonic pain frequency was similar in both genders (11% in girls vs 9% in boys, p = 0.46), however disturbed defecation occurred significantly more often in girls than in boys (16 vs 7%, p = 0.003). Half of the subjects who reported IBS had also dyspeptic symptoms. Fiber-rich diet and/or laxatives to prevent constipation were used by 2% of boys and 7% of girls (p = 0.012). However, only one third of those having less than 3 stools a week thought it abnormal. IBS is associated with the age over 15-16 years, female gender, abdominal pain in childhood, appendectomy, irregular meals and smoking (in girls). No association was found with other socio-demographic factors and serological markers of some infections and invasions (H. pylori, G. lamblia, O. felineus, hepatitis viruses B and C). Of the persons with diagnosable IBS, 49% have consulted a physician about it, 21% have undergone upper endoscopy. School absenteeism was reported by 62% of the IBS sufferers. CONCLUSION: IBS is common among adolescents (especially girls) with the prevalence rates similar to those described in adults from West Europe and USA. These disorders are associated with significant disability and health care costs.