Prevalence, symptom burden and under-diagnosis of chronic obstructive pulmonary disease in Polish lung cancer screening population: a cohort observational study.

OBJECTIVES: Lung cancer screening using low-dose CT may be not effective without considering the presence of comorbidities related to chronic smoking. The aim of the study was to establish the prevalence of chronic obstructive pulmonary disease (COPD) in group of phighlight the potential benefits atients participating in the largest Polish lung cancer screening programme MOLTEST-BIS and attempt to confirm the necessity of combined lung cancer and COPD screening. DESIGN: Cohort, prospective study. SETTING: Medical University of Gdansk, Poland PARTICIPANTS: The study included 754 participants in lung cancer screening trial from the Pomeranian region, aged 50-70 years old, current and former smokers with a smoking history ≥30 pack-years. PRIMARY AND SECONDARY OUTCOME MEASURES: Questionnaire, physical examination, anthropometric measurements, spirometry test before and after inhaled bronchodilator (400 µg of salbutamol) RESULTS: Obstructive disorders were diagnosed in 186 cases (103 male and 83 female). In the case of 144 participants (19.73%), COPD was diagnosed. Only 13.3% of participants with COPD were known about the disease earlier. According to classification of airflow limitation 55.6% of diagnosed COPD were in Global Initiative for Chronic Obstructive Lung Disease (GOLD) 1 (mild), 38.9% in GOLD 2 (moderate), 4.9% in GOLD 3 (severe) and 0.7% in GOLD 4 (very severe) stage. Women with recognition of COPD were younger than men (63.7 vs 66.3 age) and they smoked less cigarettes (41.1 vs 51.9 pack-years). CONCLUSIONS: Prevalence of COPD in Polish lung cancer screening cohort is significant. The COPD in this group is remarkably under-diagnosed. Most diagnosed COPD cases were in the initial stage of advancement. This early detection of airflow limitation highlights the potential benefits arising from combined oncological-pulmonary screening.NKBBN.

Relationship between diabetes mellitus and atrial fibrillation prevalence in the Polish population: a report from the Non-invasive Monitoring for Early Detection of Atrial Fibrillation (NOMED-AF) prospective cross-sectional observational study.

BACKGROUND: The global burden of atrial fibrillation (AF) and diabetes mellitus (DM) is constantly rising, leading to an increasing healthcare burden of stroke. AF often remains undiagnosed due to the occurrence in an asymptomatic, silent form, i.e., silent AF (SAF). The study aims to evaluate the relationships between DM and AF prevalence using a mobile long-term continuous ECG telemonitoring vest in a representative Polish and European population ≥ 65 years for detection of AF, symptomatic or silent. METHODS: A representative sample of 3014 participants from the cross-sectional NOMED-AF study was enrolled in the analyses (mean age 77.5, 49.1% female): 881 (29.2%) were diagnosed with DM. AF was screened using a telemonitoring vest for a mean of 21.9 ± 9.1days. RESULTS: Overall, AF was reported in 680 (22.6%) of the whole study population. AF prevalence was higher among subjects with concomitant DM (DM+) versus those without DM (DM-) [25%, 95% CI 22.5-27.8% vs 17%; 95% CI 15.4-18.5% respectively, p < 0.001]. DM patients were commonly associated with SAF [9%; 95% CI 7.9-11.4 vs 7%; 95% CI 5.6-7.5 respectively, p < 0.001], and persistent/permanent AF [12.2%; 95% CI 10.3-14.3 vs 6.9%; 95% CI 5.9-8.1 respectively, p < 0.001] compared to subjects without DM. The prolonged screening was associated with a higher percentage of newly established AF diagnosis in DM+ vs DM- patients (5% vs 4.5% respectively, p < 0.001). In addition to shared risk factors, DM+ subjects were associated with different AF and SAF independent risk factors compared to DM- individuals, including thyroid disease, peripheral/systemic thromboembolism, hypertension, physical activity and prior percutaneous coronary intervention/coronary artery bypass graft surgery. CONCLUSIONS: AF affects 1 out of 4 subjects with concomitant DM. The higher prevalence of AF and SAF among DM subjects than those without DM highlights the necessity of active AF screening specific AF risk factors assessment amongst the diabetic population. TRIAL REGISTRATION: NCT03243474.

Increase in the prevalence of metabolic syndrome in Poland: comparison of the results of the WOBASZ (2003-2005) and WOBASZ II (2013-2014) studies.

INTRODUCTION Metabolic syndrome (MS) significantly increases cardiovascular risk. Knowledge about the current prevalence of MS in the Polish population is limited. OBJECTIVES The aim of this study was to assess the prevalence of MS in the Polish population based on the results of the WOBASZ II study (2013-2014) and to compare the obtained data with the results of the WOBASZ study (2003-2005). PATIENTS AND METHODS A representative sample of 19 751 Polish adults from the WOBASZ and WOBASZ II studies was analyzed. Diagnostic criteria for MS included abdominal obesity, elevated blood pressure, elevated fasting glucose values, and lipid disorders; MS was diagnosed if at least 3 individual components were present. RESULTS Based on the WOBASZ II study (2013-2014), the prevalence of MS in Poland was 32.8% in women and 39% in men. In women, the most frequent component of MS was abdominal obesity (64.7%), while in men it was increased blood pressure (62%). In the decade between the WOBASZ and WOBASZ II studies, there was a significant increase in the prevalence of MS in Polish adults aged 20 to 74 years: by 3.3 percentage points in women (26.6% vs 29.9%; P <0.001) and by 8.8 percentage points in men (30.7% vs 39.4%; P <0.001). The increase in the frequency of carbohydrate metabolism disorders was the greatest contributor to this phenomenon; however, abdominal obesity and lipid disorders were also significantly more frequent. CONCLUSIONS It is alarming that in the decade between the WOBASZ and WOBASZ II studies there was such a significant increase in the prevalence of MS and its individual components in Poland.