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.

[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 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.

[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.

[Dyspepsia and gastroesophageal reflux in adolescents]. / Dispepsiia i gastroézofageal'nyi refliuks u podrostkov.

AIM: To study the prevalence and risk factors for dyspepsia and gastroesophageal reflux (GER) among adolescents. MATERIAL AND METHODS: Senior schoolchildren (forms 9-11) of four randomly selected secondary schools of Novosibirsk participated in the study (189 boys and 260 girls aged 14-17 years). They filled in the Bowel Disease Questionnaire, and sera were tested for antibodies against Helicobacter pylori infection. RESULTS: Dyspepsia was reported by 21% of the schoolchildren, being more frequent in girls (25%) than boys (14%, p = 0.004). GER occurred in 22% of adolescents with the same frequency in both genders. The combination of dyspepsia with GER was found in 8%. The prevalence of H. pylori infection was 56%. No association was found between the infection and abdominal symptoms, except heartburn. Among factors associated with dyspepsia were female gender, irregular meals, family history of dyspepsia. GER was related to H. pylori infection, obesity, smoking and irregular meals, 46% of adolescents with dyspepsia and 36% of those with GER have consulted a physician, and school absenteeism was reported by 55 and 40%, respectively. CONCLUSION: Dyspepsia and gastroesophageal reflux are widespread among the adolescent population and result in frequent use of health care resources.

[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.

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.