[Mortality of old-aged (60 years and older) population in Yakutia subject to data of prospective cohort seven-year study].

Level of total mortality and mortality from cardiovascular diseases was defined subsequent to the results of carried out novel prospective study of cohort of old-age population of the Republic. Subject to seven-year cohort study high indexes of mortality from all reasons (42,7%) and from cardiovascular diseases (28,4%) were registered for the population of Yakutia aged 60 years and older. Circulatory diseases comprise 68% of all died; ischemic heart diseases (59%) and cerebrovascular diseases (22%) are the main reasons among the cardiovascular pathology. In the studied cohort there were found no ethnic and gender differences in mortality levels. Total mortality and mortality from cardiovascular pathology, relative risk of fatal issue development increase statistically significant with the age. The growth rate of total and cardiovascular mortality are practically identical in both ethnic groups.

[Arterial blood pressure in persons of elderly, senile age and long-livers of Yakutsk: population screening].

The values of arterial blood pressure according to the Yakutsk population screening at the age of 60 and older have been studied. The average values of systolic arterial pressure (both sexes--148, men--145, women--151 mm Hg) are higher than normal values specified by Society of Cardiology of Russian Federation. Long-living persons show its decrease that is more marked in men. The average values of diastolic arterial pressure (both sexes--87, men--88, women--87 mm Hg) correspond to the category of high normal pressure and are decreasing with age to more extent in men than in women. The average values of pulse pressure in elderly and senile age are higher than normal values (both sexes--61, men--57, women--64 mm Hg) with a tendency to grow by 90 years old. Differences in arterial blood pressure levels are educed in gerontic persons depending on presence of abdominal obesity, hypercholesterolemia, hyperglycemia, smoking and family anamnesis with cases of hypertension.

[Features of arterial blood pressure in elderly persons of different ethnic groups in Yakutsk].

The differences in arterial blood pressure in the sample of population in the age of 60 and older of different ethnic groups in Yakutsk, as well as its connection with the other cardiovascular diseases risk factors have been analyzed. It was shown that the average values of systolic and diastolic blood pressure in subsample of the Yakuts appeared to be lower than in Caucasoid gerontic persons. The average values of systolic arterial blood pressure both in the Yakuts and in the Caucasoids were detected higher than normal values in all age-dependent subgroups. The average values of diastolic blood pressure in both ethnic groups were within the limits of high normal level. From 60 to 90 years and older the decrease in systolic and diastolic arterial blood pressure was detected; it was more marked in Caucasoid gerontic persons. The average values of pulse pressure in the Yakuts and in the Caucasoids appeared to be higher than the existing standard and didn't have any differences in ethnic groups. In both ethnical subsamples, pulse pressure values increase was observed in persons of 60-89 years old and its decrease after 90. Persons with overweight, obesity, central (abdominal) obesity, dyslypoproteidemias irrespective of belonging to ethnical group were characterized as having higher levels of arterial blood pressure. Statistically significant differences in the levels of arterial blood pressure in the Yakuts and in the Caucasoids depending on hyperglycemia, smoking, the presence of burdened anamnesis, educational level, marital status was not detected.

[24-Hour arterial pressure variability and 24-hour variability of pulse carries unidirectional character and is not associated with left ventricular hypertrophy (results of population study)].

Alternative prognostic interpretation of variability of arterial pressure (AP) and pulse seems contradictory if one considers classical conceptions of close physiological connection between AP and pulse. It is logical to expect that elevated variability of AP should be associated with elevated variability of pulse and vice versa. Within framework of the project EPOCH we examined a populational sample of inhabitants of Novosibirsk (129 men and 170 women) formed according to the family principle. Ambulatory 24-hour registration of AP and pulse was carried out with 15-30 minutes interval. Variability of AP turned out to be unidirectionally interconnected with variability of pulse and was not an independent marker of hypertrophy of the left ventricle but was associated with it at the account of concealed dependence on mean 24-hour AP. Cornell voltage index in persons with normal AP, "white coat" arterial hypertension (AH), "masked" AH was comparable and significantly lower than in subjects with sustained AH.

[Diabetes mellitus and metabolic syndrome in Siberia and in the Far East].

In Siberia and in the Far East region overall incidence of diabetes mellitus is somewhat lower than in the European part of the country, though these indices reduplicate on average in 10-15 years. The prevalence of both diabetes (both types) and metabolic syndrome among indigenous mongoloid population is lower than among Caucasian.

[Oxidized fibrinogen and its relationship with hemostasis disturbances and endothelial dysfunction during coronary heart disease and myocardial infarction].

The highest oxidative modification of fibrinogen was found in acute myocardial infarction (MI) men and it was 1.26 and 1.56 times higher in comparison with coronary heart disease (CHD) men with anamnesis of MI and with men without CHD, respectively. Increased oxidized fibrinogen level correlated with increased levels of plasma lipid peroxidation products, Willebrand factor, fibrin degradation products, accelerated leukocyte-platelet aggregation and decreased level of plasma NO metabolites. Associations of oxidized fibrinogen with MI and typical parameters of thrombosis and hypercoagulatory hemostasis disturbances and endothelial function were revealed.

[Lipoprotein(a)--a new independent cholelithiasis risk factor?].

AIM: To study the level of lipoprotein(a)--Lp(a) in the blood serum and incidence of isoforms of apolipoprotein(a)--apo(a) in males and females with cholelithiasis and free of it in population of Novosibirsk; to assess possible correlations between Lp(a) level in the blood, apo(a) isoforms and bile lithogenicity in females with cholesterol cholelithiasis. MATERIAL AND METHODS: Examination of the representative samples of 870 females aged 25-64 years and 405 males aged 35-54 years has detected cholelithiasis in 91 females and 19 males. RESULTS: Serum levels of Lp(a) are associated with cholelithiasis. Risk of the latter in males (Lp(a) > 28 mg/dl) and females (Lp(a) > 24 mg/dl) is estimated. It is confirmed that isoforms of apo(a) B, S1 and S2 in females and isoforms of apo(a) B, S2 in males with cholelithiasis occur much more frequently than in individuals free of cholelithiasis while isoform apo(a) S4 is rare. Females with cholesterol cholelithiasis have positive correlation between blood Lp(a) levels, the presence of isoforms apo(a) B, S1 and bile lithogenicity. CONCLUSION: Males and females with cholelithiasis have more frequent high concentrations of Lp(a) (> 30 mg.dl) while low levels (0-5 mg/dl) are rare. There is a correlation between blood levels of Lp(a), apo(a) isoforms, bile lithogenicity in females with cholesterol cholelithiasis.

[The spectrum of mutations in the low-density lipoprotein receptor gene in the Russian population].

The spectrum of mutations in the low-density lipoprotein (LDL) receptor gene was studied in a sample of hypercholesterolemia patients of Caucasoid origin from the population of Russia. The examined patients were 45 to 49-years-old and had the highest level of total serum cholesterol in this age group. Seven previously non-described mutations have been revealed in exon 9 (R410G; M412V) and in exon 12 (Y/Y576; N/N591; L605V; L605R; A612G). Twelve previously described mutations have been identified in exons 2 (C/C27), 5 (C261F; E240X), 6 (E288K), 8 (A391T), 9 (E418G; L432R; D433E), 11 (G/G549; E558K; L/L568), and 12 (G592E). Only one of these mutations was previously described in Russia in a clinical sample of patients with familial hypercholesterolemia. The spectrum of LDL receptor gene mutations in the population sample of patients with hypercholesterolemia significantly differs from the mutation spectrum in patients with familial hypercholesterolemia (clinical samples). Sequencing of the LDL receptor gene is a highly efficient method for identifying the markers of hypercholesterolemia predisposition in a population.

[Phenomenon of super-longevity in Yakutia].

According to preliminary data of UNESCO the oldest inhabitant of a planet now lives in the Republic Sakha (Yakutia). The article presents some results of the examination of a 117-years long-liver Semennikova (Djakonova) Varvara Konstantinovna. The age of the supercentenarian is certified by the record in the metric book of Yakutsk Spiritual Consistory for the Bulunskiy Spasskiy Church. The standard methods and unified criteria of estimation applied in epidemiological researches and at examination of elderly contingent were used. The health state, lifestyle and quality of life of the supercentenarian have been studied. During physical and instrumental examination of the centenarian the following data have been obtained: asthenic type of the constitution, the lowered index of body weight; the pathology of organism's functional systems (cardiovascular, respiratory, osteomuscular), appeared in senior age. The basic biochemical parameters of the blood are registered within the limits of the norm. The centenarian almost has not suffered from serious diseases. She does not remember long-livers among her relatives. The phenomenon of supercentenarian in Yakutia is the unique example of the extremely high level of adaptation to the extreme climate with prevailing clinically slightly expressed form.

[Gamma-glytamiltransferase activity and cardiovascular diseases (ischemic heart disease and cerebral stroke)].

PURPOSE: To investigate association between gamma-glytamiltransferase levels and the development of CVD. The data were taken from materials of the epidemiological study " Determinants of cardiovascular disease in Eastern Europe " , the HAPPIE project. We investigated representative samples from non-organized population of men and women 45 - 69 years old living in Novosibirsk - 9361 subjects (4275 men and 5086 women). The program of study included: questionnaire of previous CVD, smoking status and alcohol consumption; two blood pressure measurements; anthropometry, biochemical analysis (gamma-glytamiltransferase, total cholesterol, HDL cholesterol, and triglycerides) and rest ECG. Among all subjects we distinguished three groups: first - patients with diagnosed ischemic heart disease (angina pectoris or myocardial infarction) and without previous cerebral stroke; second - patients with previous cerebral stroke (without ischemic heart disease); third - patients without previous ischemic heart disease and cerebral stroke (control group). We revealed reliable data on sex-dependent difference of gamma-glytamiltransferase activity: men have higher gamma-glytamiltransferase activity compared with women in all age groups. Subjects who didn t take alcoholic drinks during the last year have noticeably lower gamma-glytamiltransferase level than those who took alcoholic drinks during that period. Gamma-glytamiltransferase activity was higher both in men and women in group with ischemic heart disease, than in control group. We did not reveal difference in gamma-glytamiltransferase activity between groups with cerebral stroke and control group. The similar patterns were revealed in subjects who didn't take alcoholic drinks during the last year.

[Cholesterol lowering properties of a complex compound simvastatin with glycyrrhizic acid (simvaglyzin) in experimental models].

A molecular complex of simvastatin (SV) and glycyrrhyzic acid (GA) (at the ratio of 1 : 4), has been synthesized. The complex named "simvaglyzin" (SVG) was stable in aqeous and aqua-alcohol solutions at GA concentrations exceeding 0.2 mM. In vitro SVG acted as uncompetitive inhibitor of 3-hydroxy-3-methyl-glutaryl-CoA reductase (Ki = 94 nM). Appearance of this inhibitory activity is associated with the cytochrome P450-dependent conversion of SVG. The addition of 1 mM methyrapone into incubation medium fully prevented the inhibition of 3-HMG-CoA reductase. SV and SVG (used at 300 nM concentration) inhibited mevalonate synthesis rate by 39.15+/-8.27% and 38.85+/-3.04%, respectively. In vivo SVG showed dose-dependent cholesterol-lowering effect. In rats the cholesterol-lowering effect of SVG used at daily doses corresponding to 66 and 100 mg/kg of SV was equal to the effect of the daily dose 200 mg/kg of SV. The decreases of total cholesterol level in blood serum were 7%, 9% and 8%, respectively. Myotoxicity of those SVG doses estimated by creatine phosphokinase (CPK) activity in blood serum was lower than that of SV. In rats treated with SV the activity of CPK increased by 79% (p<0.01), while in SVG treated rats by 30% and 36% (p<0.05). Any increase of hepatotoxicity markers alanine aminotransferse or aspartate aminotransferase in blood serum was not observed. The data suggest pharmacological synergism attributed to the SV-GA complex formation and elevated safety of the resultant complex compared with the parent compound.

[Providing of adult population of Novosibirsk with iodine].

32,7% of the population of Novosibirsk consume iodine salt. The median of iodine is revealed 106,8 mkg/l. The iodine deficiency is revealed 46,3%. It is not received an authentic difference in volumes of thyroid gland and parameters of TSH at surveyed with normal parameters of excretion of iodine in urine and at a various degree of expressiveness of iodine deficiency (p>0,05). Structural pathology of thyroid gland equally frequently meets at people with iodine deficiency and without iodine deficiency (p>0,05).

[The frequency of some infections in patients with coronary artery disease].

The paper is dedicated to associations between infective agents and coronary artery disease (CAD). The study design included examination of a random sample of non-organized population (389 adults aged 25 to 64 years). Using immune-enzyme assay, IgM and IgG antibodies to seven infective and parasite agents (Chlamydia trachomatis, Mycoplasma hominis, Ureaplasma urealyticum, Trichomonas vaginalis, Candida albicans, Opisthorchis felineus, and Giardia lamblia), as well as the level of IgE were measured. In patients with CAD, IgE level was significantly higher vs. controls, but is was not connected with the infections under study except opisthorchosis invasion. The incidence of some pathogens was higher in CAD patients vs. controls. The total number of infections detected in an individual was associated with a higher frequency of CAD and some atherosclerotic risk factors.

[Demographic indices of the aging and longevity in Yakutia].

The basic demographic indices of the aging and longevity of population in Yakutia have been analyzed. The Sakha Republic (Yakutia) is one of the biggest regions of Russia, which occupies 18% of the territory. Aging of population is shown as one of the main tendencies in the modern demographic development in the Republic and reflection of the world process. In spite of the extreme living conditions, Yakutia was considered to be one of the longevity centres in the country. Regarding this, the basic demographic longevity's indices for recent years were investigated in details. The decrease tendencies of longevity level have been determined in the following: among men and women, urban and rural inhabitants and in the Republic, in the whole.

[Prevalence of cholelithiasis in different regions].

The review characterizes the prevalence of cholelithiasis in Russia and other countries taking into account the evolution of diagnostic methods from necropsy to billiary tract ultrasonography. The authors demonstrate the dynamics of cholelithiasis prevalence in different world's regions, climate-geographic zones, urban and rural areas, as well as the growth of cholelithiasis incidence in Russia and the world during the 20th century. The results of clinical and epidemiological studies on the prevalence of cholelithiasis among aborigines and non-aborigines of Chukotka, Republic of Sakha (Yakutia), Khakasia, and North and South America are given.

[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.

[Hyperhomocysteinemia in men of Novosibirsk].

Prevalence of hyperhomocysteinemia (HHC) in a sample of male population (n=84, age 50-64 year) of Novosibirsk assessed in the framework of the international project "Determinants of cardio-vascular diseases in the Eastern Europe: multicentral cohort research" during winter-spring period of vitamin deficiency was 50%. In 90.5% of cases HHC was moderate (15-30 micromol/l) and in 9.5% of cases -- medium (30-100 micromol/l). No correlations or independent associations were found between homocysteine blood level and CHD, as well as main risk factors (hyperlipidemia, hypertension, smoking and excessive body weight). No cases of CHD were registered among men with medium HHC. Homocysteinemia correlated positively with age, history of stroke, and negatively -- with alpha-tocopherol concentration in LDL. Men with medium HHC compared with those with normohomocysteinemia had higher systolic and diastolic blood pressure and 29% lower alpha-tocopherol concentration in LDL.

[Arterial stiffness: parameters, methods of assessment and methodological difficulties].

Arterial stiffness has been shown to be an independent marker of morbidity and cardiovascular mortality in multiple prospective studies of various populations. The purpose of this review is to present different parameters of arterial stiffness (compliance; distensibility; elastic modulus; pulse wave velocity; wave reflection), and to discuss existing difficulties of their application. Means of evaluation of various types of arterial stiffness and principles of their use are also described. Arterial stiffness is not a static but dynamic characteristic, thus prior to its evaluation it is necessary to standardize both the state of a patient and methodology of measurements. Diagnostic value of noninvasive methods of assessment of arterial stiffness is similar to that of invasive techniques, therefore stress can be made on less traumatic investigation of vascular properties.

[Oxidized low density lipoproteins and their association with some atherosclerosis risk factors in a population of Novosibirsk men].

Lipid peroxidation products (LPP) and liposoluble antioxidants in low density lipoproteins (LDL), resistance of LDL to oxidation were determined in 305 male inhabitants of Novosibirsk aged 30-70 years. Other methods of examination included questionnaires, anthropometry, registration of blood pressure (BP) and ECG, measurement of total cholesterol (TCH), high density lipoprotein cholesterol (HDLCH), triglycerides (TG). Ten and 90% cut points of percentile distribution of LPP in LDL and parameters of their resistance to oxidation in male population of Novosibirsk were used as regional reference values. Interrelationships were found between LPP in LDL, parameters of LDL resistance to oxidation, levels of antioxidants in LDL, and TCH, TG, HDL CH, smoking, BP and body mass index. Associations between LPP in LDL, LDL resistance to oxidation and TCH, HDLCH, TG, smoking and systolic BP were independent.