Cardiovascular risk and preclinical atherosclerosis are associated with white matter hyperintensities in apparently healthy adults: the population-based cross-sectional study BIALYSTOK PLUS.

INTRODUCTION: White matter hyperintensities, present in patients and asymptomatic individuals, have been previously shown to be associated with atherosclerosis risk factors like high blood pressure, hypercholesterolemia, smoking, and diabetes. OBJECTIVES: To assess the associations between white matter hyperintensities volume and cardiovascular risk factors in a general apparently healthy population. PATIENTS AND METHODS: The analysis includes 735 participants (age range 20 to 79) without neurological or severe cardiac diseases. The participants were subjected to detailed clinical examination, including medical history, biochemical analyses, carotid arteries ultrasound, and brain magnetic resonance imaging, followed by white matter hyperintensities segmentation using the Freesurfer tool. Participant were divided into three cardiovascular risk categories based on the 2021 European Society of Cardiology guidelines. RESULTS: The median volume of white matter hyperintensities was 95.2 mm3 (interquartile range 2.1 to 482.0 mm3). Multivariable analysis revealed positive, independent association between white matter hyperintensities volume and cardiovascular risk categories, glycated hemoglobin, presence of carotid plaques, and central systolic pressure. Analysis including people without hypertension or diabetes revealed mean intima-media thickness and high or very high cardiovascular risk class as independent predictors of white matter hyperintensities percentiles. CONCLUSION: The cardiovascular risk class, presence of carotid plaques, increased intima-media complex thickness and diabetes are the main risk factors for white matter hyperintensities in apparently healthy adults. People without hypertension or diabetes but with higher cardiovascular risk are also at risk of developing white matter hyperintensities, what emphasizes the value of assessment of the cardiovascular risk in the aspect of prediction of neurodegenerative changes.

Inflammation and Neurodegeneration in Glaucoma: Isolated Eye Disease or a Part of a Systemic Disorder? - Serum Proteomic Analysis.

Introduction: Glaucoma is the most common optic neuropathy and the leading cause of irreversible blindness worldwide, which affects 3.54% of the population aged 40-80 years. Despite numerous published studies, some aspects of glaucoma pathogenesis, serum biomarkers, and their potential link with other diseases remain unclear. Recent articles have proposed that autoimmune, oxidative stress and inflammation may be involved in the pathogenesis of glaucoma. Methods: We investigated the serum expression of 92 inflammatory and neurotrophic factors in glaucoma patients. The study group consisted of 26 glaucoma patients and 192 healthy subjects based on digital fundography. Results: Patients with glaucoma had significantly lower serum expression of IL-2Rß, TWEAK, CX3CL1, CD6, CD5, LAP TGF-beta1, LIF-R, TRAIL, NT-3, and CCL23 and significantly higher expression of IL-22Rα1. Conclusion: Our results indicate that patients with glaucoma tend to have lower levels of neuroprotective proteins and higher levels of neuroinflammatory proteins, similar to those observed in psychiatric, neurodegenerative and autoimmune diseases, indicating a potential link between these conditions and glaucoma pathogenesis.

The prevalence of age-related macular degeneration and osteoporosis in the older Polish population: Is there a link?

BACKGROUND: Age-related macular degeneration is the primary cause of irreversible blindness in developed countries, whereas the global prevalence of osteoporosis-a major public health problem-is 19.7%. Both diseases may coincide in populations aged >50 years, leading to serious health deterioration and decreased quality of life. OBJECTIVES: This study aimed to analyze the relationship between age-related macular degeneration and osteopenia, defined as decreased bone mineral density, in the Polish population. METHODS: Participants were derived from the population-based Bialystok PLUS Study. Randomized individuals were stratified into two groups, those with age-related macular degeneration (AMD-1 group) or without age-related macular degeneration (AMD-0 group). Using a cutoff value of -1.0 to identify low bone mass, participants with femoral bone mineral density T-scores above -1.0 were assigned to the normal reference, and those with T-scores below -1.0 were assigned to the osteopenia category. Among 436 Caucasian participants aged 50-80 years (252 women, 184 men), the prevalence of age-related macular degeneration was 9.9% in women and 12.0% in men. Decreased bone mineral density based on T-scores was observed in 36.9% of women and in 18.9% of men. Significant differences in femoral bone mineral density between the AMD-0 and AMD-1 groups were detected only in men (mean difference [95% confidence interval] = 0.11 (0.02; 0.13); p = 0.012 for femoral bone mineral density, and 0.73 [0.015; 0.94]; p = 0.011 for the femoral T-score). No associations were observed between bone mineral density and age-related macular degeneration in women. CONCLUSION: Decreased femoral bone mineral density may be associated with a higher risk of age-related macular degeneration in men, but a causal link remains unclear.

The relationship between subclinical depressive symptoms and metabolic parameters in women: a subanalysis of the Bialystok PLUS study.

INTRODUCTION: Clinically overt depression is associated with an increased risk for insulin resistance. Data regarding the impact of subclinical depressive symptoms on the risk of diabetes are limited. OBJECTIVES: The study aimed to assess the relationship of subclinical depressive symptoms with body fat distribution and diabetes risk in women. PATIENTS AND METHODS: The analysis included 250 women, 68 with subclinical depressive symptoms and 182 controls. A clinical examination, oral glucose tolerance test, and lipid and liver enzyme level assessments were performed. Body composition was estimated by dual­energy X­ray absorptiometry. The participants completed the Beck Depression Inventory (BDI) questionnaire. RESULTS: The women with subclinical depressive symptoms had higher visceral adipose tissue (VAT) mass than the control group. The groups did not differ in the body mass index, waist circumference, total fat, fat­free, android, and gynoid fat mass. Homeostatic Model Assessment for Insulin Resistance (HOMA­IR) and alanine aminotransferase (ALT) activity were higher in the women with subclinical depressive symptoms than in the control group. In the women with subclinical depressive symptoms, we observed a positive correlation between the severity of somatic­vegetative symptoms reported in the BDI and VAT mass, HOMA­IR, and gamma glutamyltransferase (GGT) activity. Dysglycemia occurred more frequently in the women with subclinical depressive symptoms. In a subgroup analysis of postmenopausal women, the individuals with subclinical depressive symptoms had higher HOMA­IR, GGT, ALT, and triglyceride / high­density lipoprotein cholesterol ratios than the control group. CONCLUSIONS: Subclinical depressive symptoms in women might predispose to dysglycemia.

Body Composition and Serum Concentration of Thyroid Hormones in Euthyroid Men and Women from General Population.

Body composition, especially an increased amount of fat mass and decreased lean body mass, is connected with metabolic complications. Thyroid hormones can influence body composition pattern. To date, scarce data defining the relationships between thyroid hormones and parameters of body composition using dual-energy X-ray absorptiometry (DXA), especially in cohort studies, are available. Therefore, the aim of the present study was to investigate the relationships among serum concentrations of (thyroid-stimulating hormone (TSH), thyroid hormones, and distribution of fat tissue assessed using the DXA method in a euthyroid cohort from the Bialystok PLUS study. We examined 582 euthyroid subjects who were divided into lean (body mass index (BMI) < 25 kg/m2) and overweight/obese (BMI ≥ 25 kg/m2) (84 lean men, 182 overweight/obese men, 160 lean women, and 156 overweight/obese women). Serum concentrations of TSH, free T3 (fT3), and free T4 (fT4) were assessed, and DXA was performed. We observed lower serum levels of fT4 (p = 0.03) and higher serum levels of fT3 (p = 0.04) in overweight/obese vs. lean men, whereas serum levels of TSH did not differ between these groups (p = 0.38). In lean men, we only observed a relationship between serum levels of TSH and visceral adipose tissue (VAT) (r = −0.24, p = 0.02). In overweight/obese men, we found that serum levels of fT3 were positively connected with total fat mass (r = 0.16, p = 0.02), android fat mass (r = 0.15, p = 0.03), and gynoid fat mass (r = 0.17, p = 0.01), but not with VAT (r = 0.03, p = 0.63). We did not observe differences in serum levels of TSH, fT3, and fT4 between lean and overweight/obese women. Additionally, we did not notice relationships between serum levels of thyroid hormones and fat in different regions estimated by DXA in lean and overweight/obese women (all p > 0.05). We concluded that the serum concentration of TSH is connected with VAT in lean men, whereas, in overweight/obese men, higher fT3 is connected with an increased fat amount. These associations are absent in women.

The relationships between FLAIS, a novel insulin sensitivity index, and cardiovascular risk factors in a population-based study.

BACKGROUND: Insulin resistance is a risk factor for cardiovascular disease. Recently, we have developed a novel index, FLAIS (Fasting Laboratory Assessment of Insulin Sensitivity), which accurately reflects insulin sensitivity, measured with hyperinsulinemic-euglycemic clamp, in different groups of subjects. The aim of the present study was to assess the relationship of FLAIS with cardiovascular risk factors in a population-based study. METHODS: The study group comprised 339 individuals from the ongoing Bialystok Plus study, without previously known diabetes. Clinical examination, oral glucose tolerance test and the measurement of blood laboratory parameters were performed. RESULTS: Prediabetes (impaired fasting glucose and/or impaired glucose tolerance) was diagnosed in 165 individuals whereas type 2 diabetes was diagnosed in 19 subjects. FLAIS was lower in individuals with prediabetes and diabetes in comparison with individuals with normal glucose tolerance. FLAIS was significantly related to waist circumference, systolic and diastolic blood pressure, triglycerides, HDL-cholesterol and LDL-cholesterol in the entire study group and in the subgroups with normal glucose tolerance and with prediabetes/diabetes. HOMA-IR, QUICKI and Matsuda index were not related to blood pressure and LDL-cholesterol in individuals with normal glucose tolerance. Majority of the adjusted models with FLAIS were characterized by better fit with the data in comparison with other indices for all cardiovascular risk factors except waist circumference. CONCLUSIONS: FLAIS represents useful index to assess the cluster of insulin resistance-associated cardiovascular risk factors in general population.

Factors Associated with Tooth Loss in General Population of Bialystok, Poland.

BACKGROUND: The aim of this study was to assess risk factors for tooth loss in the population of the city of Bialystok, in north-eastern Poland, taking into account the entire population and different age groups. The study included 1138 subjects divided into three subgroups: 20-44 years, 45-64 years, and 65-79 years. Participants were classified according to the number of teeth lost (0-8 vs. 9-28). Socio-economic variables, smoking history, and dental habits were collected through a questionnaire. Medical examinations provided data on the body mass index and the fasting blood glucose level. Data were statistically analysed using Mann-Whitney U, Student's t, chi2 tests, and binary logistic regression, p < 0.05. RESULTS: For the general population, being female (OR 1.38, 1.07-1.79, p = 0.015), having secondary education (OR 4.18, Cl 2.97-5.87, p < 0.000), higher body mass index (OR 1.13, Cl 1.10-1.17, p < 0.000), higher fasting blood glucose level (OR 1.03 1.03-1.04, p < 0.000), being former smoker (OR 1.72, Cl 1.29-2.31, p < 0.000), ever smoker (OR 1.69, Cl 1.29-2.20, p < 0.000), current smoker (OR 1.62, Cl 1.15-2.29, p < 0.006), longer smoking period (OR 1.11, Cl 1.09-1.14, p < 0.000), last visit to the dentist over a year ago (OR 1.92, Cl 0.44-2.58, p < 0.000) and tooth brushing less than two times a day (OR 1.6, Cl 1.14-2.23, p < 0.006) were associated with losing more than 8 teeth. In the subgroup aged 20-44 years, only smoking duration was a risk factor for tooth loss (p = 0.02). For the middle-aged and oldest groups, education level (respectively p < 0.001, and p = 0.001), body mass index (respectively, p < 0.001, and p = 0.037), smoking status ever/former/current (respectively p < 0.001 and p = 0.002), smoking status never/ever (respectively p < 0.001 and p = 0.009), smoking duration (p < 0.001) were related to tooth loss. Additionally, in the elderly group, fasting blood glucose level (p = 0.044) and frequency of dental visits (p = 0.007) were related to tooth loss. We concluded that in the evaluated population, tooth loss was associated with socio-demographic, medical, and behavioural factors.

Oral Health-Related Quality of Life and Missing Teeth in an Adult Population: A Cross-Sectional Study from Poland.

The aim of the study was to determine oral health-related quality of life (OHRQoL) using the measures Geriatric/General Oral Health Assessment (GOHAI) and Oral Health Impact Profile (OHIP-14) in relation to missing teeth in the Polish population aged 20-79. This was a cross-sectional study carried out among 1112 randomly selected participants. The mean age was 48.72 and mean number of teeth was 20.12. Altogether, in the GOHAI, the percentage that gave a positive response to each question ranged from 3.3% to 48.0%; in the OHIP-14, these answers ranged from 2.4% to 25.1%. The GOHAI measure was statistically significant, with more grouping variables than the OHIP-14 measure. Both measures showed significant associations with gender, age, dry mouth, education, professional status, number of teeth, and upper and lower total dentures. We detected a significant relationship between oral health-related quality of life and the factors influencing the presence or absence of dentition. Missing teeth were statistically associated with GOHAI, OHIP-14, advanced age, self-reported dry mouth, lower education, higher Body Mass Index (BMI), lower professional status, diabetes, myocardial infraction, and total dentures in upper or/and lower jaws. However, edentulous individuals had two times higher risk of having an OHIP-14 score above the median. This suggests that oral health practitioners should work to prevent oral diseases that lead to tooth loss in their patients, starting from an early age.

Secondary prevention of coronary heart disease in Poland: does sex matter? Results from the POLASPIRE survey.

INTRODUCTION: Adherence to health­promoting behaviors intended to mitigate modifiable risk factors plays an important role in secondary cardiovascular prevention. OBJECTIVES: We aimed to evaluate sex differences in the prevalence and control of risk factors in patients with coronary heart disease (CHD). PATIENTS AND METHODS: The study included 1236 patients who experienced acute coronary syndrome or coronary revascularization within the last 6 to 24 months. Definitions of risk factors and treatment goals were based on the 2016 European Society of Cardiology guidelines on cardiovascular prevention. RESULTS: The prevalence of modifiable risk factors in both sexes was high, and their control inadequate. Women were older (P <0.001) and had a higher accumulation of multiple cardiovascular risk factors than men (P = 0.036). They more frequently had central obesity (P <0.001) and reduced values of glomerular filtration rate (P <0.001). Women more often experienced anxiety (P <0.001), reported lower levels of education (P <0.001) and lower income (P = 0.001), and those in the youngest age group were more likely to be exposed to second­hand smoking (P = 0.01). A large fraction of the study patients, men and women alike, did not meet the recommended therapeutic goals. For both sexes, participation in cardiac rehabilitation programs was associated with more frequent attainment of the recommended level of physical activity (P = 0.046) and smoking cessation (P = 0.01). CONCLUSIONS: The prevalence of cardiovascular risk factors in patients with CHD is high, especially in women. Therapeutic goals are met infrequently in both sexes. This situation calls for widening the access to educational programs and paying greater attention to their proper implementation.

Gut Microbiome in Chronic Coronary Syndrome Patients.

Despite knowledge of classical coronary artery disease (CAD) risk factors, the morbidity and mortality associated with this disease remain high. Therefore, new factors that may affect the development of CAD, such as the gut microbiome, are extensively investigated. This study aimed to evaluate gut microbiome composition in CAD patients in relation to the control group. We examined 169 CAD patients and 166 people in the control group, without CAD, matched in terms of age and sex to the study group. Both populations underwent a detailed health assessment. The microbiome analysis was based on the V3-V4 region of the 16S rRNA gene (NGS method). Among 4074 identified taxonomic units in the whole population, 1070 differed between study groups. The most common bacterial types were Firmicutes, Bacteroidetes, Proteobacteria, and Actinobacteria. Furthermore, a higher Firmicutes/Bacteroidetes ratio in the CAD group compared with the control was demonstrated. Firmicutes/Bacteroidetes ratio, independent of age, sex, CAD status, LDL cholesterol concentration, and statins treatment, was related to altered phosphatidylcholine concentrations obtained in targeted metabolomics. Altered alpha-biodiversity (Kruskal-Wallis test, p = 0.001) and beta-biodiversity (Bray-Curtis metric, p < 0.001) in the CAD group were observed. Moreover, a predicted functional analysis revealed some taxonomic units, metabolic pathways, and proteins that might be characteristic of the CAD patients' microbiome, such as increased expressions of 6-phospho-ß-glucosidase and protein-N(pi)-phosphohistidine-sugar phosphotransferase and decreased expressions of DNA topoisomerase, oxaloacetate decarboxylase, and 6-beta-glucosidase. In summary, CAD is associated with altered gut microbiome composition and function.

Management of Dyslipidemia in Women and Men with Coronary Heart Disease: Results from POLASPIRE Study.

Cardiovascular diseases (CVDs) are the leading cause of death in Poland. Starting from 1992, a gradual decrease in mortality due to CVDs has been observed, which is less noticeable in women. Following this notion, we assessed sex differences in the implementation of ESC recommendations regarding lipid control and the use of statins as part of secondary CVDs prevention in 1236 patients with acute coronary syndrome or elective coronary revascularization within the last 6-24 months. During hospitalization women had more frequently abnormal TC levels than men (p = 0.035), with overall higher TC levels (p = 0.009) and lower HDL-C levels (p = 0.035). In the oldest group, they also had more frequently elevated LDL-C levels (p = 0.033). Similar relationships were found during the follow-up visit. In addition, women less often achieved the secondary lipid therapeutic goal for non-HDL-C (p = 0.009). At discharge from hospital women were less frequently prescribed statins (p = 0.001), which included high-intensity statins (p = 0.002). At the follow-up visit the use of high-intensity statins was still less frequent in women (p = 0.02). We conclude that women generally have less optimal lipid profiles than men and are less likely to receive high-intensity statins. There is a need for more organized care focused on the management of risk factors.