Adolescent Pregnancy Outcomes and Risk Factors.

One of the major social and public health problems in the world is adolescent pregnancy. Adolescent pregnancy is strongly associated to less favorable results for both the mother and the newborn. We conducted this research to ascertain the impact of teenage age on neonatal outcomes and also observed the lifestyles of pregnant teenage girls. We conducted a study of 2434 mothers aged ≤19 years (n = 294) or 20-34 years (n = 2140) who gave birth in 2019-2020 at the Department of Gynaecology and Obstetrics of Louis Pasteur University Hospital in Kosice. The data on mothers and newborn infants have been reported from the reports on mothers at childbirth. Women between the ages of 20 and 34 served as the reference group. The teenage mothers were more likely to become pregnant if they were unmarried (OR = 14.2; 95% CI = 9.3-21.6; p < 0.001) and had a basic education or lack of education (OR = 16.8; 95% CI = 11.5-24.6; p < 0.001). Additionally, they were more likely to smoke when pregnant (OR = 5.0; 95% CI = 3.8-6.6; p < 0.001). Low birth weight was more common in newborns born to adolescent mothers than in those born to adult mothers (p < 0.001). Our findings showed that infants of teenage mothers often had lower birth weights (-332.6 g, p < 0.001). Adolescent mothers were associated with lower Apgar scores at the first minute (p = 0.003). As compared with the control group, pregnant teenage girls had a greater prevalence of preterm deliveries in our research (p = 0.004). This study finds significant age-related disparities in neonatal outcomes between mothers. These results might be used to identify vulnerable groups who need special assistance and actions to reduce the probability of negative outcomes for such groups.

Seroprevalence of Borrelia IgG antibodies among individuals from Eastern Slovakia.

OBJECTIVES: Lyme borreliosis is a tick-borne disease of increasing incidence and public concern. Our cross-sectional study was aimed at evaluating seroprevalence of Borrelia burgdorferi in a group of respondents from Eastern Slovakia. METHODS: In total, 515 blood samples collected in 2013-2016 were analysed with NovaLisaTM, NovaTec - Borrelia IgG/IgM kit (Immunodiagnostica, Dietzenbach, Germany). Positive and equivocal IgG-antibody results were further examined with immunoblotting (LYMECHECK® OPTIMA IgG and IgM kits, BIOSYNEX, France). Data detected by serological methods were matched with those obtained from a questionnaire. Differences between groups by residence/seropositivity were tested by χ2 test. The effect of socio-demographic and risk factors on seropositivity of IgG antibodies was assessed using binary logistic regression. RESULTS: IgG antibodies against Borrelia burgdorferi were detected in 67 cases (13.01%) and IgM antibodies in 40 cases (7.8%). Previous tick bite had been noted in 67.2% of these seropositive individuals. Higher seropositivity was observed in men and persons aged over 61 years. Rural residents had higher seropositivity (39%) than those living in urban (29%) areas. Very few of these seropositive persons reported prior symptoms. CONCLUSION: The study reveals that IgG-seropositivity for Borrelia burgdorferi in Eastern Slovakia is predominant in men and occurs mainly in rural areas. The findings also suggest that exposure to Borrelia burgdorferi (with subsequent antibody response in serum) does occur, mostly without giving rise to clinical Lyme borreliosis.

Genetically modified rodent models and celiac, non-celiac gluten sensitivity: a minireview.

Celiac disease (CD) is a disorder that affects both children and adults. Over the few last decades, several new atypical cases have been identified through improved diagnostic tools. On the other hand, the onset of CD at a later age, including atypical CD forms whose clinical picture overlaps with other autoimmune diseases, shows that currently there are several unknown gene mutations, which could be responsible for the disease development. Non-celiac gluten sensitivity (NCGS) is entity included by the ingestion of gluten leading to intestinal, or extraintestinal symptoms that improve once the gluten is removed from the nutrition. In this article relationships between genetically modified rodent animals with previously unknown multiple organ changes and CD, respectively NCGS are reviewed. Relationships between the small bowel histological changes and other organs pathology are discussed. Results of research document that changes have similar genetic background and can develop to serious autoimmune systematic diseases, including small bowel inflammation resembling atypical CD or NCGS. These may have extra-intestinal symptomatology but without a clear explanation of causes and differences in their manifestations. Research on animal models helps to discover links between several disorders associated with gastrointestinal damage. New methods based on individual gene mutations can help in atypical adult CD and NCGS recognitions in the future.

Influence of maternal smoking during pregnancy on birth outcomes.

OBJECTIVES: Smoking during pregnancy is causally associated with reduced birth weight and is strongly related to preterm birth. This study analyses the differences in birth outcomes between non-smokers and women who continued to smoke during pregnancy. METHODS: We conducted a study of 1,359 mothers who gave birth in 2017-2019 at the Department of Gynaecology and Obstetrics of Louis Pasteur University Hospital in Kosice. Data on mothers and newborn infants have been reported from the birth book and from the reports on mothers at childbirth. For low birth weight we considered the weight of a newborn being less than 2,500 g and as for premature birth we referred to childbirth before pregnancy week 37. Two groups of mothers were classified according to the smoking habit during pregnancy and statistically processed in IBM SPSS Statistics 23.0. RESULTS: Infants born by women who smoked during pregnancy had the lower birth weight (2,769.0 grams on average) compared to non-smokers (3,224.1 grams) (p < 0.001). The differences in prevalence of premature birth have not been confirmed as statistically significant. Women who continued smoking during pregnancy were significantly more likely to be very young (OR = 5.9; 95% CI: 3.9-8.9; p < 0.001), unmarried (OR = 9.3; 95% CI: 6.1-14.0; p < 0.001), of lower level of education (OR = 39.6; 95% CI: 22.6-69.5; p < 0.001), and more likely to consume alcohol (OR = 6.6; 95% CI: 5.8-7.5; p < 0.01), and drugs (OR = 6.6; 95% CI: 5.8-7.5; p < 0.01) during pregnancy. When pregnant, they were most likely to see a doctor for the first time after the first trimester (OR = 0.1; 95% CI: 0.1-0.2; p < 0.001) and were more likely to see a doctor less than 8 times (OR = 6.1; 95% CI: 4.2-8.8; p < 0.001) during pregnancy. CONCLUSION: Tobacco prevention and cessation campaigns should focus on improving pregnancy outcomes in the future.

Risk factors associated with low birth weight.

OBJECTIVES: Low birth weight (LBW) is one of the major factors affecting child morbidity and mortality worldwide. Every day, approximately 800 women die from causes related to pregnancy and childbirth worldwide. Maternal ill health increases the risk of LBW. This study seeks to investigate determinants and incidence of LBW. METHODS: This study was conducted based on the medical records of mothers and their 1,946 infants born in 2016-2019 at the Department of Gynaecology and Obstetrics of Louis Pasteur University Hospital in Kosice. Data on mothers and newborn infants were obtained from the Reports on mothers at childbirth. The inclusion criteria were singleton births and birth weight > 500 g. The exclusion criteria were twins or multiple births, congenital anomalies and stillbirths, birth weight ≥ 4,000 g or ≤ 500 g, and Roma ethnicity. Roma children are more likely to be born prematurely, with low birth weight. Roma mothers have different lifestyle. Univariate analysis was employed to evaluate the association between the independent variables and LBW. Variables that were found to be statistically significant were then further analysed using multivariable logistic analysis for each dependent variable. The implementation of the research was approved by the Ethics Committee. RESULTS: Of 1,946 newborns, 271 (13.90%) have low birth weight. The mean of birth weight at delivery was 3,068.62 (SD 671.16) grams. Factors that were associated with LBW were primary maternal education (OR = 2.98, 95% CI: 1.08-8.21, p = 0.034), marital status single (OR = 2.88, 95% CI: 1.68-4.94, p < 0.001), number of prenatal care visits less than 8 (OR = 1.62, 95% CI: 1.01-2.61, p = 0.047), and preterm birth (OR = 74.94, 95% CI: 45.44-123.61, p < 0.001). CONCLUSION: The reducing of LBW requires strategies to improve maternal lifestyle, maternal care before, during and after birth and to strengthen social support.

Potential differences in occurrence of preterm births according to quality of relationship between mothers and fathers of the children.

OBJECTIVES: Premature birth is a serious pregnancy complication that is affected by many biological as well as psychosocial factors. Several studies have shown that a mother's positive relationship with her child's father reduces the mother's stress, anxiety and depression during pregnancy, promotes a healthier mother's lifestyle and thus has a positive effect on pregnancy as such. This research was therefore aimed at identifying possible differences in the incidence of premature births in mothers depending on the quality of the relationship with the father of their child. METHODS: The research involved 210 mothers after childbirth in the period from October 2020 to September 2021. A questionnaire aimed at obtaining descriptive data about the mother and her child and a questionnaire aimed at determining the quality of the relationship - Quality of Relationship Inventory (QRI) were distributed. Mann-Whitney U tests were used to determine differences between groups. RESULTS: Of 210 children, 44 (21%) were born prematurely, 154 (73.3%) mothers were married and 176 (83.8%) lived with the father of their child in the same household. The results showed that the degree of quality of the mother's relationship with the child's father is approximately the same for mothers who gave birth prematurely and for those who gave birth at term, so there were no differences in this factor between the two groups of mothers. CONCLUSION: The results of other researchers have shown the positive impact of partners on pregnancy and the overall well-being of the mothers. However, our research has not confirmed the positive effect of the quality of the relationship between mother and father of her child on reducing the incidence of premature births. Further research is needed to clarify how specifically and whether the quality of the relationship between parents can affect the incidence of premature births at all.

Generational differences in selected aspects of social situation and health status of foreigners living in the Czech Republic.

OBJECTIVES: Demographic differentiation caused by the history of migration in the Czech and Slovak Republics led the authors of this article to analyse generational differences in the groups of foreigners living in the Czech Republic (CR) and the impact of generational differences on selected aspects of their social situation and perceived health. The crucial research question was whether and to what degree do different generations of foreigners vary from each other and what impact this has had on their social situation and health determinants. METHODS: The main goal was to examine mutual relationships between selected characteristics of social situation and health determinants in various groups of foreigners living in the CR. A total of 1,003 questionnaires among foreigners officially living in the Czech Republic were collected and analysed. In the area of subjective perception of health, a comparison of foreigners with Czech citizens (representative sample of Czech seniors; 1,172 respondents) in the age category 65+ was made in order to find out whether this perception differs between senior foreign nationals and senior Czechs. RESULTS: Older individuals (50-64 years and 65+ years) appeared to have the best integration into Czech society. This age generation felt positive about stay and migration status in the CR. Older foreigners differ from older Czech citizens who tend to refer to their health as very good to rather good compared to foreigners who described their health as neither good nor bad. The middle generation (30-49 years) of foreigners was characterized by hard work and the initial stages of integration into Czech society. This group also reported positive feelings about living in the CR relative to their home country. CONCLUSION: The oldest generation of foreigners is the best integrated in the Czech Republic (with regard to selected aspects tested in this article). This generation is able to offer new immigrant effective integration strategies. However, they assess their subjective health one degree worse in comparison with Czech seniors (representative sample), this finding should lead to the setting of preventive programmes related to a healthy lifestyle, including lifestyle for foreigners living in the Czech Republic.

Compliance with gluten-free diet in a selected group of celiac children in the Slovak Republic.

OBJECTIVE: Celiac disease (CD) is a chronic long-term disease with autoimmune disorder connected to an allergic reaction to the molecule of gluten. CD is manifested in persons who are genetically predisposed. The only therapy for CD is a strong gluten-free (GF) diet. The aim of our study was to follow the adherence to the gluten-free diet in the selected group of parents and caregivers of children with CD, and to compare factors influencing the adherence to GF diet and therefore influencing also clinical symptoms of CD. We compared and examined important food-related activities as well, by using a personal questionnaire in the group of CD children's parents or caregivers. METHODS: We designed a cross-sectional study; 325 parents or caregivers of children with CD were recruited in the sample. CD was confirmed by the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) criteria. The anonymous questionnaires were collected at summer camps within period data 2012-2016 and followed factors which might have an influence on compliance with GF diet, according to parents' opinions. RESULTS: Adherence to GF diet was statistically significantly higher among girls compared to boys. Parents' questionnaires confirmed that younger group of children and children with the family history of CD had statistically higher compliance with GF diet. Parents with higher education confirmed better adherence to GF diet, statistical analyses confirmed higher adherence in mother´s education compared to father's education. Duration of CD, socio-demographic factors of parents - age of parent, gender of parent, and residency were not statistically significant in terms of compliance with the diet. CONCLUSIONS: Our study confirmed important factors influencing adherence to the GF diet, which are connected to the symptoms and consequences of CD. The assessment of parents' opinions and burden on the families of children with celiac disease should be also reflected in the evaluation of patient's status. Important is also the role of parents in order to facilitate and support clinical interventions and prevention of CD.

Prevalence of lifestyle and cardiovascular risk factors in a group of medical students.

OBJECTIVE: The aim of the cross-sectional study was to evaluate cardiovascular risk factors in the group of medical students with gender, overweight and obesity categorisation. METHODS: Cross-sectional study included 364 medical students, 207 females and 157 males. We investigated anthropometric parameters, BMI, body fat percentage, WHR (waist-hip ratio), TCH (total cholesterol) and LDL-CH (LDL-cholesterol), SBP and DBP (systolic and diastolic blood pressure). The participants also completed questionnaires with socio-demographic characteristic, including smoking, unhealthy eating, self-perceived health, and physical activity status. Statistical analysis used t-test differences in arithmetic means and OR calculation with 95% CI. RESULTS: Prevalence of increased blood pressure (> SBP/DBP 120/80 mmHg) among participants was 10.99% (SBP) and 9.07% (DBP). The results confirmed risk of "overweight + obesity" in 15.38% (using BMI evaluation) versus 18.54% cases (using body fat percentage evaluation). The results of the study confirmed statistically higher risk for males compared to females in the following parameters: SBP, DBP, BMI, body fat percentage, self-perceived health, unhealthy eating and body weight watching. "Overweight and obesity" group (BMI evaluation) confirmed all factors on statistically significant level a risky group: SBP, DBP, body fat percentage, TCH, self-perceived health, smoking, stress at university, and body weight watching. The outputs confirmed, on the other hand, low amount of clinical obesity (0.8%), clinical hypertension (BP > 140/90) 1.1%, and clinically higher cholesterol level (TCH > 5.2 mmol/l) in 8.7% participants. CONCLUSIONS: We confirmed higher prevalence or cardiovascular risk factors among males. Also, group of "overweight and obese" students had higher frequency of cardiovascular risk factors. Border limits for risk evaluation were strong, so on clinical level we can evaluate the group of medical students as healthy. In the group of young medical students, we confirmed lower frequency of risk factors compared to the Slovak population average.

West Nile virus - a new infection in the Slovak Republic?

OBJECTIVE: The aim of the study was to evaluate the seroprevalence of West Nile virus (WNV) among the variable population of Eastern Slovakia. METHODS: A serologic survey was conducted using 464 serum samples. The basic demographic, epidemiologic and clinical information was obtained for each serum sample at the time of specimen collection. The presence of antibodies against WNV was investigated using a commercial enzyme-linked immunosorbent assay (ELISA). All the ELISA positive samples were further analysed by a neutralization test with WNV and Usutu virus. RESULTS: Three serum samples (0.65%) from the participants (N = 464) were considered positive for antibodies to WNV. A 29-year-old female was repeatedly exposed to mosquito bites working as a shepherdess and participating in many outdoor activities. Two other females (61 and 76 years old) were treated at the Department of Neurology due to monoparesis of the upper extremity, vertigo; both had a significant epidemiological history with frequent tick and mosquito bites and stay in an endemic region. CONCLUSIONS: Although there was no evidence of WNV infection in the Slovak Republic, the epidemiological situation in the neighbouring countries warrants vigilance and appropriate measures, including the introduction of specific diagnostic tools into clinical practice. The constant monitoring of birds and mosquitoes also seems necessary.

Anthropometric predictors of systolic and diastolic blood pressure considering intersexual differences in a group of selected schoolchildren.

OBJECTIVES: Although the association between anthropometric parameters and blood pressure has been established for adults, the relationship for children has not been thoroughly studied in Slovakia. Present study investigates the association between anthropometric parameters and systolic and diastolic blood pressure in the group of randomly selected schoolchildren. METHODS: Examinations were conducted as a cross-sectional study with 760 schoolchildren from Eastern Slovakia, 381 boys and 379 girls. The blood pressure evaluation included sphygmomanometer technique (seated, 3 times repeated) measurement of systolic and diastolic blood pressure (SBP; DBP). Anthropometric measurements included: body weight, height, circumference of waist, hip and chest, BMI, WHR (waist-hip ratio), fat skinfolds measurement, triceps skinfold, and derivation of body fat percentage. The parents' questionnaires incorporated basic demographic and socioeconomic characteristics of the family, reported BMI of father and mother, and child's birth-weight and birth-length. Statistical analysis included Student's t-test gender differences in measured parameters, partial Pearson's correlations and linear regression model of the impact of body parameters Z-scores on SBP and DPB. RESULTS: Statistical analysis confirmed gender difference in basic anthropometric parameters. Pearson's correlations revealed highly significant relationship of anthropometric indices to SBP compared to DBP. Correlations of anthropometric parameters with SBP and DPB were more significant for boys compared to girls. Linear regression analysis showed that the highest impact on SBP and DBP had Z-score of BMI, followed by weight and height. Z-score of body weight has statistical impact on SBP and DBP in all group and group of boys (p < 0.001), lower significance was in DBP of girls (p < 0.01). Similar results were obtained for Z-score of height and BMI for SBP and DBP in both total group and group of boys on level p < 0.001. Z-score for BMI and height in DBP has lower statistical significance. CONCLUSIONS: Linear regression model confirmed higher statistical relationship of SBP and DBP in the group of boys compared to the group of girls. SBP correlations and linear regression model of anthropometric parameters revealed more significant outputs compared to DPB. The results confirmed the fact that we have to consider anthropometric indices in paediatric blood pressure evaluation.

Risk factors of preterm birth and low birth weight neonates among Roma and non-Roma mothers.

OBJECTIVE: This study analyses the differences in birth outcomes between Roma and non-Roma mothers and investigates the potential causes of such differences. METHODS: We conducted a retrospective cohort study of 1,989 non-Roma and 799 Roma mothers who gave birth in 2014 and 2015 at the Gynaecology and Obstetrics Clinic of Louis Pasteur University Hospital in Kosice. Data on mothers and new-born infants have been obtained from the birth book and from the reports on mothers at childbirth. For low birth weight we considered the weight of a new-born weighing less than 2,500 grams and as for premature birth we referred to childbirth before pregnancy week 37. The file was split by ethnicity and statistically processed in IBM SPSS Statistics 21.0. RESULTS: Our results confirmed a lower birth weight among Roma children (-365.4 grams, p < 0.001). The shorter gestation age and higher risk of premature birth were not statistically significant regarding Roma children. Based on the characteristics of Roma mothers, they are at higher risk of giving birth as minor (OR = 23.64; 95% CI = 15.29-36.54; p < 0.001), as single mothers (OR = 7.13; 95% CI = 5.80-8.76; p < 0.001), with basic education or lack of education (OR = 141.31; 95% CI = 100.47-198.76; p < 0.001). They also have a higher risk of smoking during pregnancy (OR = 23.84; 95% CI = 18.06-31.49; p < 0.001); drinking alcohol (OR = 11.71; 95% CI = 3.36-40.90; p < 0.001) and taking drugs (OR = 8.70; 95% CI = 1.81-42.02; p < 0.001). Roma women attended gynaecologists more rarely. CONCLUSION: It is therefore important to support the work of community health workers and stimulate collaboration between community health professionals, paediatricians and gynaecologists to overcome institutional barriers in maternity and child care for mothers living in Roma settlement.

Association of seroprevalence and risk factors in Lyme disease.

OBJECTIVE: The aim of the presented cross-sectional seroepidemiological study was to determine the current presence of antibodies against B. burgdorferi s.l. in the groups of Slovak population, and to identify potential risk factors to Lyme borreliosis. METHODS: A group of 261 adults (patients from the Neurological Clinic with possible symptoms of LB and healthy persons with possible working exposure to tick bite: gardeners and soldiers working in afforested areas) were examined in order to assess the seroprevalence of anti-Borrelia antibodies. Sera were screened by commercial enzyme-linked immunosorbent assay (ELISA). The respondents completed questionnaires with general demographic, epidemiological and clinical data. RESULTS: We detected 17.2% presence of positive IgG and 5.7% presence of positive IgM antibodies in all investigated groups. Our results confirmed that the following risk factors such as age and gender are significantly associated with the presence of positive specific antibodies against investigated disease. CONCLUSION: The results of seroprevalence obtained in the present study confirm the possibility of infection with B. burgdorferi among respondents exposed to contact with ticks.

Seroprevalence of Lyme disease in Eastern Slovakia.

OBJECTIVE: Lyme disease (LD) is chronic, multi-system zoonosis transmitted by ticks, and LD aetiological agents are spirochetes of the Borrelia burgdorferi sensu lato complex. The aim of the cross-sectional study was to analyze the LD incidence on the basis of the presence of specific antibodies in the serum of patients in Eastern Slovakia, and to compare the results of serological ELISA and immunoblot assays. METHODS: Venous blood with questionnaires was obtained by field sampling of respondents from Eastern Slovakia. Overall, we examined 537 human sera by the ELISA and for confirmation we tested all positive IgG antibodies against the Borrelia immunoblot assay. RESULTS: Our results confirmed the high serum prevalence of anti-Borrelia antibodies (17.9% for IgG), while the immunoblot seropositive test was confirmed in 69.8% of responders from ELISA IgG positive sera. Positive antibodies of the IgM class were found in 7.6% of the population under study. Most commonly found were antibodies against VlsE (80.2%), p41 (66.7%), p18 (56.3%), p100 (41.7%), p58 (31.3%), and p39 (30.2%). CONCLUSION: It should be noted that detection of antibodies against B. burgdorferi s.l. is only an indirect evidence of the presence of this bacterium in the development of clinical signs of LD in humans. Laboratory LD tests should be performed in accordance with valid standards, positive and uncertain results must be confirmed by the Western Blot/Immunoblot assay.

Serostatus and risk factors of tick-borne encephalitis.

OBJECTIVE: The aim of this seroepidemiological study was to determine the current prevalence of antibodies against tick-borne encephalitis virus (TBEV) in the representative group of Slovak population with included potential risk factors for TBEV. METHODS: Representative group consisted of 428 persons (also with possible exposure to risk factors for tick bite or raw milk consumption). Serum samples were screened by commercial enzyme-linked immunosorbent assay (ELISA). The persons involved in the study completed questionnaires with general demographic, epidemiological and clinical data. During the analysis, we used linear regression to interpret the influence between selected variables. RESULTS: We detected 1.2% prevalence of positive IgG and 1.6% prevalence of positive IgM antibodies in all tested groups. Our results also confirmed that the following risk factors such as tourism, hunting, fishing, and consumption of raw milk are significantly associated with the prevalence of specific antibodies against TBEV. CONCLUSION: The results of seroprevalence obtained by this study confirm the possibility of infection with TBEV among respondents exposed to possible contact with ticks.

Prevalence and Trends of Metabolic Syndrome in Slovakia during the Period of 2003-2012.

OBJECTIVE: Metabolic syndrome is a combination of clinical risk factors for cardiovascular disease as well as for diabetes. Metabolic syndrome arises from insulin resistance accompanied with abnormal adipose deposition. The aim of our cross-sectional time trends study was to characterize the prevalence of metabolic syndrome and its five risk determinants among the clients of Health Advice Centres of Regional Public Health Authorities in Slovakia. The study was stratified by gender and age groups during the 10 year period from 2003­2012. METHODS: Prevalence data were estimated in adults and children (≥10 years, N=79,904) from the nationwide electronic database of Health Advice Centres of Regional Public Health Authorities in Slovak Republic "Test of healthy heart" from 2003 to 2012. RESULTS: The overall prevalence of metabolic syndrome was 30.2% in males and 26.6% in females, abdominal obesity was confirmed in 48.3% of males and 53.9% of females. Increased triglyceride level has higher prevalence among males (33.3%) compared to females (24.2%). Blood pressure (BP) values and fasting glucose values were significantly higher in males (58.2%) than females (41.9%). During the 10 year period from 2003 to 2012, we confirmed an increased trend in the age-adjusted prevalence of metabolic syndrome. Abdominal obesity and elevated triglycerides had also increased time trends prevalence in both sexes. The prevalence of people without risk determinants of metabolic syndrome had a time decreasing trend. A surprising finding is a decrease in the proportion of persons with suboptimal HDL-cholesterol. The proportion of people with elevated BP and glucose showed little change during the reporting period. CONCLUSION: The increasing prevalence of metabolic syndrome, abdominal obesity, and elevated triglycerides highlights the urgency of addressing these health problems as a healthcare priority to reduce cardiovascular mortality in the Slovak Republic.