Central corneal thickness and its associations in a Russian population. The Ural eye and Medical Study.

BACKGROUND: To assess central corneal thickness (CCT) and its associations in a Russian population. METHODS: The population-based Ural Eye and Medical Study included 5899 (80.5%) out of 7328 eligible individuals. As part of an ophthalmological and general examination, CCT was measured by Scheimflug imaging. RESULTS: The study included 5792 (98.2%) participants (age:58.8 ± 10.6 years;range: 40-94 years) with available bilateral CCT measurements. Mean CCT was larger in Russians than non-Russians (549.5 ± 32.8 µm versus 539.2 ± 33.9 µm; P < 0.001). In multivariable analysis, thicker CCT was associated (regression coefficient r:0.43) with younger age (standardized regression coefficient beta:-0.09; non-standardized regression coefficient B:-0.29;95% confidence interval (CI):-0.39,-0.20; P < 0.001), male sex (beta:0.05; B:3.10; 95%CI:1.18,5.03; P = 0.002), urban region of habitation (beta:0.10; B:6.83; 95%CI:4.61, 9.05; P < 0.001), Russian ethnicity (beta:0.04; B:3.48; 95%CI:1.04, 5.91; P = 0.005), higher level of education (beta:0.04; B:0.97;95%CI:0.29,1.66; P = 0.006), higher serum bilirubin concentration (beta:0.05;B:0.15; 95%CI:0.07,0.23;P < 0.001), lower corneal refractive power (beta:-0.09;B:11.92; 95%CI:-2.50,-1.35; P < 0.001), smaller anterior chamber angle (beta:-0.07;B:-0.38;95%CI:-0.52,-0.24;P < 0.001), higher IOP readings (beta:0.38; B:3.47; 95%CI:3.21,3.73; P < 0.001), and higher rise in IOP readings by medical mydriasis (beta:0.07; B:0.88;95%CI:0.54,1.22;P < 0.001). In that model, CCT was not associated with body height (P = 0.14), previous cataract surgery (P = 0.10), axial length (P = 0.18) or prevalence of glaucoma (P = 0.11). The mean inter-eye difference in CCT was 8.52 ± 13.9 µm (median:6.0;95CI:8.16,8.88). A higher inter-eye CCT difference was associated with older age (beta:0.08; B:0.11;95%CI:0.07,0.15; P = 0.01), lower level of education (beta:-0.04;B:-0.34; 95%CI:-0.60,-0.08; P < 0.001) and status after cataract surgery (beta:0.04; B:2.92;95%CI:1.02,4.83; P = 0.003). INTRODUCTION CONCLUSIONS: In this ethnically mixed population from Russia with an age of 40+ years, mean CCT (541.7 ± 33.7 µm) was associated with parameters such as younger age, male sex, Russian ethnicity, and higher educational level. These associations may be taken into account when the dependence of IOP readings on CCT are considered. Glaucoma prevalence was unrelated to CCT.

Prevalence and associated factors of glaucoma in the Russian Ural Eye and Medical Study.

To assess the prevalence and associated factors of glaucoma in a Russian population. The population-based Ural Eye and Medical Study included 5899 (mean age 59.0 ± 10.7 years; range 40-94 years). Glaucomatous optic neuropathy was diagnosed using International Society of Geographical and Epidemiological Ophthalmology (ISGEO) criteria. Among 5545 participants with assessable optic disc photographs, 246 individuals [4.4%; 95% confidence interval (CI) 3.9, 5.0] had glaucoma, with open-angle glaucoma (OAG) in 177 individuals (3.2%; 95% CI 2.7, 3.7) and angle-closure glaucoma (ACG) in 69 individuals (1.2; 95% CI 1.0, 1.5), with IOP > 21 mmHg in 79 (32.1%) patients, and with 80 (32.5%) patients on glaucoma therapy. Glaucoma prevalence increased from 3/485 (0.6%; 95% CI 0.0, 1.3) in the age group of 40-45 years to 33/165 (20.0%; 95% CI 13.8, 26.2) in the group aged 80 + years. Higher OAG prevalence correlated with older age [odds ratio (OR) 1.07; 95% CI 1.04, 1.09; P < 0.001], longer axial length (OR 1.36; 95% CI 1.17, 1.58; P < 0.001), higher intraocular pressure (IOP) (OR 1.18; 95% CI 1.13, 1.23; P < 0.001), higher stage of lens pseudoexfoliation (OR 1.26; 95% CI 1.08, 1.47; P = 0.004) and lower diastolic blood pressure (OR 0.98; 95% CI 0.96, 0.99; P = 0.035). Higher ACG prevalence correlated with older age (OR 1.07; 95% CI 1.03, 1.11; P < 0.001), narrower anterior chamber angle (OR 0.81; 95% CI 0.77, 0.86; P < 0.001), and higher IOP (OR 1.30; 95% CI 1.23, 1.38; P < 0.001). Glaucoma caused moderate to severe vision impairment (MSVI) in 9 (4.9%; 95% CI 1.8, 8.1) out of 184 individuals with MSVI (OAG, n = 7; ACG, n = 2), and blindness in one (9.1%) of 11 blind individuals. In this population from Russia, two thirds of glaucoma patients were not on therapy, and in two thirds of the glaucoma patients IOP was ≤ 21 mmHg. Otherwise, glaucoma prevalence, OAG-to-ACG ratio, and glaucoma associations did not differ markedly from Caucasian and East Asian populations.

Prevalence and causes of vision impairment and blindness in the Russian ural eye and medical study.

To assess prevalence of mild vision impairment (MVI; best corrected visual acuity (BCVA) < 6/12 to 6/18 in the better eye), moderate-to-severe vision impairment (MSVI; BCVA < 6/18 but ≥ 3/60) and blindness (BCVA < 3/60) in a local population in Russia, we conducted the population-based Ural Eye and Medical Study. Out of 7,328 eligible individuals aged 40 + years, 5,899 (80.5%) individuals participated. MVI was present in 184 (3.1%; 95% confidence interval (CI) 2.7, 3.6) individuals, MSVI in 182 (3.1%; 95% CI 2.7, 3.5) individuals, and 11 individuals (0.19%; 95% CI 0.008, 0.30) were blind. Causes for MSVI were cataract (n = 109; 59.9%), late stage of age-related macular degeneration (n = 14; 7.7%; geographic atrophy and neovascular AMD in 7 (3.8%) individuals) each), myopic maculopathy (n = 11; 6.0%), glaucoma (n = 9; 4.9%), non-glaucomatous optic nerve damage (n = 5; 2.7%), and diabetic retinopathy (n = 4; 2.2%). Causes for blindness were cataract (n = 3; 27.3%), myopic maculopathy (n = 2; 18.2%), retinal dystrophies (n = 2; 18.2%), glaucoma (n = 1; 9.1%), and corneal scars (n = 1; 9.1%). Higher prevalence of MSVI/blindness was associated with age (P < 0.001; odds ratio (OR)1.10; 95% CI 1.08, 1.12), male gender (P < 0.001; OR 2.32; 95% CI 1.47, 3.66), educational level (P < 0.001; OR 0.83; 95% CI 0.76,0.92), manual grip force (P < 0.001; OR 0.94; 95% CI 0.92, 0.96), diabetes prevalence (P = 0.006; OR 1.67; 95% CI 1.08, 2.56) and axial length (P < 0.001; OR 1.43; 95% CI 1.26,1.62). In this population from Bashkortostan/Russia, prevalence of MVI, MSVI and blindness was 3.1%, 3.1% and 0.19%, respectively. Cataract was the most frequent cause of reversible vision impairment, while AMD, myopic maculopathy and glaucoma were the most common reasons for irreversible vision impairment.

Prevalence of Myopic Maculopathy Among Adults in a Russian Population.

Importance: Although myopic maculopathy has become a major cause of vision impairment worldwide, few data from Russia and Central Asia on the prevalence of myopic maculopathy have been available. Objective: To assess the prevalence of myopic maculopathy and its associations with ocular and systemic parameters in a population in Russia. Design, Setting, and Participants: The Ural Eye and Medical Study, a population-based case-control study, was conducted in rural and urban areas in Bashkortostan, Russia, from October 26, 2015, to July 4, 2017. Data analysis was performed from September 13 to September 15, 2019. The Ural Eye and Medical Study included 5899 of 7328 eligible individuals (80.5%) aged 40 years or older. Exposures: A detailed ocular and systemic examination included fundus photography and optic coherence tomography for the assessment of myopic maculopathy. Main Outcomes and Measures: Prevalence of myopic maculopathy. Results: The present investigation included 5794 of the 5899 eligible individuals (98.2%; 3277 [56.6%] women; mean [SD] age, 58.9 [10.7] years) with available information about myopic maculopathy. Mean (SD) axial length was 23.3 (1.1) mm (range, 19.78-32.87 mm). Prevalence of any myopic maculopathy was 1.3% (95% CI, 1.0%-1.6%); myopic maculopathy stage 2, 0.8% (95% CI, 0.6%-10.0%); stage 3, 0.2% (95% CI, 0.1%-0.4%); and stage 4, 0.2% (95% CI, 0.1%-0.4%). The prevalence of moderate to severe vision impairment and blindness was 29.8% (14 of 47 participants; 95% CI, 16.2%-43.3%) in stage 2 myopic maculopathy, 57.1% (8 of 14 participants; 95% CI, 27.5%-86.8%) in stage 3, and 100% (13 of 13 participants; 95% CI, 100%-100%) in stage 4. In multivariable analysis, a higher myopic maculopathy prevalence was associated with longer axial length (odds ratio [OR], 4.54; 95% CI, 3.48-5.92; P < .001), older age (OR, 1.04; 95% CI, 1.01-1.07; P = .03), and thinner peripapillary retinal nerve fiber layer thickness (OR, 0.96; 95% CI, 0.95-0.98; P < .001). After exclusion of glaucomatous eyes, the association between myopic maculopathy prevalence and thinner retinal nerve fiber layer remained significant (OR, 0.96; 95% CI, 0.95-0.98; P < .001). Myopic maculopathy prevalence was not significantly associated with sex; region of habitation; level of education; ethnicity; prevalence of arterial hypertension, chronic obstructive pulmonary disease, chronic kidney disease, diabetes, and inflammatory liver disease; hearing loss; depression score; or anxiety score. Conclusions and Relevance: In this ethnically mixed population from Russia, myopic maculopathy prevalence was mainly associated with elongated axial length and thinner peripapillary retinal nerve fiber layer, but was not associated with any major internal medical disease, level of education, ethnicity, or sex. Higher myopic maculopathy stage was associated with vision impairment and blindness. In addition to a known association between high axial myopia and glaucoma, myopic maculopathy may be associated with nonglaucomatous optic neuropathy.

Prevalence of and factors associated with low Back pain, thoracic spine pain and neck pain in Bashkortostan, Russia: the Ural Eye and Medical Study.

BACKGROUND: Back pain and neck pain are leading causes of the burden of disease worldwide, while information about their prevalence in Russia is missing. METHODS: The population-based Ural Eye and Medical Study was conducted in a rural and urban region in Bashkortostan/Russia. As part of a detailed systematic examination, we assessed the prevalence of low back pain, thoracic spine pain and neck pain in an interview with standardized questions in 5397 study participants (mean age:58.6 ± 10.6 years;range:40-94 years). RESULTS: The mean prevalence of low back pain, thoracic spine pain and neck pain was 2912/5397 (54.0%;95% confidence interval (CI):52.6,55.3), 1271/5397 (23.6%;95%CI:22.4,24.7), and 1570/5397 (29.1%;95%CI:27.9,30.3), respectively. A higher prevalence of low back pain was associated with females (P = 0.04;odds ratio (OR):1.14;95%CI:1.004,1.30), younger age (P < 0.001;OR:0.99;95%CI:0.98,0.99), higher body mass index (P = 0.002;OR:1.02;95%CI:1.01,1.03), lower frequency of vigorous activities during leisure time (P = 0.001;OR:0.79;95%CI:0.69,0.90), more time spent sitting and reclining (P = 0.03;OR:1.00;95%CI:1.00,1.00), higher serum concentration of high-density lipoproteins (P = 0.004;OR:1.10;95%CI:1.03,1.18), higher prothrombin index (P = 0.003;OR:1.01;95%CI:1.003,1.01), higher prevalence of a history of cardiovascular disease (P = 0.004;OR:1.23;95%CI:1.07,1.42), falls (P < 0.004;OR:1.71;95%CI:1.45,2.00), bone fractures (P = 0.01;OR:1.18;95% CI:1.03,1.34), unconsciousness (P < 0.001;OR:1.78;95%CI:1.40,2.25), osteoarthritis (P < 0.001;OR:2.76;95%CI:2.34,3.26), iron-deficiency anemia (P < 0.001;OR:1.87;95%CI:1.41,2.50), and thyroid disorder (P = 0.004;OR:1.37;95%CI:1.10,1.70), fewer days of vegetable intake (P < 0.001;OR:0.89;95%CI:0.85,0.93), smaller amounts of salt intake (P = 0.008;OR:0.97;95%CI:0.94,0.99), higher anxiety score (P < 0.001;OR:1.05;95%CI:1.03,1.06), and in women, history of menopause (P = 0.02;OR:1.36;95%CI:1.05,1.75). The prevalence of thoracic spine pain and neck pain showed similar associations. CONCLUSIONS: In a Russian population, the prevalence of low back pain, thoracic spine pain and neck pain (54.0, 23.6 and 29.1%, respectively) were correlated with parameters such as the female sex, younger age, higher body mass index, higher anxiety score, higher prevalence of a history of cardiovascular disease, lower frequency of vigorous activities and more time spent sitting or reclining. These data may be of interest for assessing the burden of back and neck pain in Russia as part of the global burden of disease.

Prevalence and Associated Factors of Age-Related Macular Degeneration in a Russian Population: The Ural Eye and Medical Study.

PURPOSE: To assess the prevalence of age-related macular degeneration (AMD) in a Russian population. DESIGN: Population-based prevalence assessment. METHODS: The Ural Eye and Medical Study was conducted in a rural and urban area in the Russian republic of Bashkortostan. The study included 5,899 participants aged 40+ years old. AMD, defined according to the Beckman Initiative for Macular Research, was assessed by fundus photographs and optical coherence tomographic images of 4,932 (83.6%) participants. RESULTS: The prevalence of any AMD, early AMD, intermediate AMD, or late AMD, geographic atrophy, and neovascular AMD were 18.2% (95% confidence interval [CI], 16.8-19.6), 11.6% (95% CI, 10.4-12.8), 5.0% (95% CI, 4.2-5.8), 1.6% (95% CI, 1.1-2.0), 0.7% (95% CI, 0.4-1.0) and 0.9% (95% CI, 0.6-1.3), respectively, for individuals >55 years old. Applying an age limit of 40+ years for the AMD definition, prevalence of any AMD, early AMD, intermediate AMD, late AMD, geographic atrophy and neovascular AMD were 14.1% (95% CI, 13.1-15.1), 9.4% (95% CI, 8.6-10.2), 3.8% (95% CI, 3.2-4.3), 1.0% (95% CI, 0.7-1.2), 0.4% (95% CI, 0.2-0.6) and 0.5% (95% CI, 0.3-0.7), respectively, for individuals aged 40+ years. Higher AMD prevalence was correlated with older age (odds ratio [OR], 1.15; 95% CI, 1.13-1.16; P < 0.001), rural region (OR, 1.69; 95% CI, 1.32-2.17; P < 0.001), lower diabetes prevalence (OR, 0.56; 95% CI, 0.38-0.82; P = 0.003), and shorter axial length (OR, 0.89; 95% CI, 0.79-0.99; P = 0.04). AMD prevalence was not significantly (all P ≥ 0.20) correlated with any systemic parameter examined, except for lower prevalence of diabetes. CONCLUSIONS: In this typical, ethnically mixed, urban and rural population from Russia, a higher prevalence for AMD was associated mainly with older age, rural region of habitation, shorter axial length, and lower prevalence of diabetes mellitus. The AMD prevalence was lower than in Europeans and higher than in East Asians.

Prevalence and Associated Factors of Pseudoexfoliation in a Russian Population: The Ural Eye and Medical Study.

PURPOSE: To assess the prevalence of pseudoexfoliation (PEX) and its associations in a Russian population. DESIGN: Population-based cross-sectional study. METHODS: Setting: Ufa capital of Bashkortostan, Russia and a rural region in Bashkortostan. PARTICIPANTS: the Ural Eye and Medical Study included 5,899 (80.5%) of 7,328 eligible individuals (mean age, 59.0 ± 10.7 years old; range, 40-94 years). OBSERVATION PROCEDURES: as part of an ophthalmological and general examination, presence and degree of PEX was assessed using slit-lamp biomicroscopy after medical pupillary dilation. MAIN OUTCOME MEASUREMENTS: PEX prevalence. RESULTS: After excluding pseudophakic and aphakic individuals, the study included 5,451 (92.4%) participants. PEX prevalence (3.6%; 95% confidence interval [CI]:3.1-4.1), increased from 0.5% (95% CI, 0.1-0.9) in individuals 40 to <50 years old to 10.4% (95% CI, 5.0-15.8) in individuals aged 80+ years. Higher PEX prevalence was associated (multivariate analysis) with older age (odds ratio [OR], 1.09; 95% CI, 1.07-1.11; P < 0.001), Russian ethnicity (OR, 1.50; 95% CI, 2.09-1.11;P = 0.02), higher prevalence of open-angle glaucoma (OR, 2.40; 95% CI, 1.36-4.23;P = 0.003), and higher intraocular pressure (OR, 1.06; 95% CI, 1.02-1.09;P = 0.001). PEX prevalence was not significantly associated with gender (P = 0.49), region of habitation (P = 0.11), body mass index (P = 0.68), level of education (P = 0.26), smoking (P = 0.11), alcohol consumption (P = 0.52), history of cardiovascular or cerebrovascular disease (P = 0.94) and dementia (P = 0.77), prevalence of diabetes mellitus (P = 0.16), arterial hypertension (P = 0.45), chronic obstructive pulmonary disease (P = 0.73), chronic kidney disease (P = 0.09), and hearing loss (P = 0.31). CONCLUSIONS: In this typical, ethnically mixed, population from Russia with an age of 40+ years, PEX prevalence (3.6%; 95% CI, 3.1-4.1) was associated with older age, Russian ethnicity, higher intraocular pressure and open-angle glaucoma. It was independent of any systemic parameter including diabetes, arterial hypertension, previous cardiovascular and cerebrovascular diseases and dementia.

Prevalence, Awareness, and Associated Factors of Airflow Obstruction in Russia: The Ural Eye and Medical Study.

Background: Although chronic obstructive pulmonary disease and asthma belong to the most important causes of disability and death in all world regions, data about the prevalence of airflow obstruction and asthma in Russia and the associated parameters have been scarce so far. We therefore assessed the prevalence of airflow obstruction and asthma in a Russian population. Methods: The population-based Ural Eye and Medical Study, conducted in a rural and urban region of Bashkortostan/Russia, included 5,392 participants (mean age: 58.6 ± 10.6 years; range: 40-94 years) out of 7,328 eligible individuals. Airflow obstruction was defined spirometrically and asthma by self-reported diagnosis. Results: Airflow obstruction was present in 369 individuals (6.8%; 95% confidence interval (CI): 6.2, 7.5) with an awareness rate of 63.4% (95%CI: 58.5, 68.4) and known duration of 19.5 ± 15.8 years (median: 16 years). Prevalence of undiagnosed airflow obstruction was 2.6% (95%CI: 2.2, 3.1). Higher prevalence of airflow obstruction was associated (multivariable analysis) with higher prevalence of current smoking [P < 0.001; odds ratio (OR): 2.91; 95%CI: 1.76, 4.83] and number of cigarette package years (P < 0.001; OR: 1.03; 95%CI: 1.02, 1.08), female gender (P = 0.03; OR: 1.42; 95%CI: 1.04, 1.93), urban region (P = 0.003; OR: 1.43; 95% CI: 1.12, 1.79), higher prevalence of cardiovascular diseases/stroke (P < 0.001; OR: 1.86; 95%CI: 1.45, 2.39), higher depression score (P = 0.002; OR: 1.05; 95%CI: 1.02, 1.08), and lower physical activity (P = 0.01; OR: 0.71; 95%CI: 0.54, 0.93). Asthma prevalence (2.6%; 95%CI: 2.0, 3.1; known duration: 17.2 ± 15.0 years) was associated with less alcohol consumption (OR: 0.53; 95%CI: 0.33, 0.87; P = 0.01), higher depression score (OR: 1.08; 95%CI: 1.03, 1.12; P < 0.001), and urban region (OR: 0.68; 95CI: 0.49, 0.95; P = 0.0.03). Conclusions: In this Russian population aged 40+ years, the prevalence of airflow obstruction was 6.8% with an awareness rate of 63.4% and smoking as main risk factor. Asthma prevalence was 2.6%.

Prevalence and associated factors of anemia in a Russian population: the Ural eye and medical study.

BACKGROUND: Although anemia is one of the leading causes of the global burden of disease, information about its prevalence in Russia is mostly missing. We therefore assessed its prevalence and associated factors in a Russian population. METHODS: The population-based Ural Eye and Medical Study included 5899 (80.5%) out of 7328 eligible individuals (mean age:59.0 ± 10.7 years;range:40-94 years) who underwent a standardized interview and detailed general examination. The definition of anemia was based on the hemoglobin concentration (definition #1:hemoglobin concentration < 140 g/L in men,< 130 g/L in women; definition #2:hemoglobin concentration < 130 g/L in men,< 120 g/L in women [World Health Organization definition]). RESULTS: Higher hemoglobin concentration (mean:142.6 ± 14.8 g/L; range:80-171 g/L) was associated (multivariable analysis) with male gender (P < 0.001; standardized regression coefficient beta:-0.20), higher waist-hip circumference ratio (P < 0.001;beta:0.05), higher prevalence of car ownership (P < 0.001;beta:0.05), higher blood concentrations of bilirubin (P < 0.001;beta:0.05) and triglycerides (P < 0.001;beta:0.06), lower erythrocyte sedimentation rate (P < 0.001;beta:-0.32), and shorter blood clotting time (P < 0.001;beta:-0.39). Using definition #1 and #2, anemia was detected in 1385 individuals (23.6%;95% confidence interval CI)CI:22.5,24.7) and in 453 individuals (7.7%;95%CI:7.0,8.4), respectively. Prevalence of moderate anemia (hemoglobin concenttration:110 g/L-80 g/L), detected in 165 individuals (2.8%;95%CI:2.4,3.2), increased with younger age (P = 0.008;odds ratio (OR):0.98;95%CI:0.96,0.99), female gender (P < 0.001;OR:2.52;95%CI:1.47,4.33), higher erythrocyte sedimentation rate (P < 0.001;OR:1.08;95%CI:1.06,1.09), longer blood clotting time (P < 0.001;OR:8.56;95%CI:5.68,12.9), and marginally significantly, with a lower waist-hip circumference ratio (P = 0.058;OR:0.13;95%CI:0.02,1.07). In women, it was significantly (P < 0.001) higher before menopause (8.8%;95%CI:6.4,11.1) than after menopause (3.5%;95%CI:2.8,4.3). CONCLUSIONS: In this Russian population as compared to populations from countries with a similar socio-demographic index, anemia prevalence was relatively low. As in other populations, higher anemia prevalence was strongly and inversely associated with menopause, and to a minor degree, with lower waist-hip circumference ratio and lower socio-economic background.

Prevalence, awareness and control of diabetes in Russia: The Ural Eye and Medical Study on adults aged 40+ years.

PURPOSE: Non-communicable chronic diseases have become the leading causes of mortality and disease burden worldwide. With information about the frequency of diabetes as a major non-communicable chronic disease in Russia being scarce, we assessed the prevalence of diabetes and its associated factors in a rural and urban population in Russia. METHODS: The Ural Eye and Medical Study is a population-based study in the city of Ufa/Russia and in villages in a distance of 65 km from Ufa. Inclusion criterion was an age of 40+ years. All study participants underwent a standardized interview and a detailed general examination. Diabetes mellitus was defined by a plasma glucose concentration ≥7.0 mmol/L or self-reported history of physician diagnosis of diabetes. RESULTS: Out of a population of 7328 eligible individuals, 5899 individuals (2580 (43.7%) men) (participation rate:80.5%) participated (mean age:59.0±10.7 years (range:40-94 years)). Diabetes mellitus was present in 687 individuals (11.7%;95% confidence interval (CI):11.9,12.5). Awareness rate of having diabetes was 500/687 (72.8%;95%CI:69.0,76.0), with mean known duration of diabetes of 10.0±9.4 years. Known type 1 diabetes was present in 44 subjects and known type 2 diabetes in 358 subjects. Prevalence of undiagnosed diabetes was 3.2% (95%CI:2.7,3.6) in the study population. Among patients with diabetes, 59.1% (95%CI:55.4,62.8) received treatment for diabetes, among whom 237 (58.5%;95%CI:53.7,63.3) individuals had adequate glycemic control. In multivariable analysis, higher prevalence of diabetes mellitus was associated with older age (P<0.001; odds ratio (OR):1.03;95%CI:1.01,1.04), higher body mass index (P<0.001;OR:1.07;95%CI:1.04,1.10), lower prevalence of vigorous daily work (P = 0.002;OR0.68;95%CI:0.53,0.87), positive history of arterial hypertension (P = 0.03;OR:1.40;95%CI:1.03,1.89) and cardiovascular diseases (P = 0.001;OR:1.60;95%CI:1.21,2.13) including heart attacks (P = 0.01;OR:1.80;95%CI:1.15,2.81), higher serum concentration of triglycerides (P<0.001;OR:1.51;95%CI:1.30,1.75), higher systolic blood pressure (P = 0.01;OR:1.01;95%CI:1.01,1.02), higher number of meals taken daily (P<0.001;OR:1.46;95%CI:1.25,1.69), and non-Muslim religion (P = 0.02;OR:0.73;95%CI:0.56,0.94). CONCLUSIONS: In this ethnically mixed, urban and rural Russian population aged 40+ years, the awareness rate of diabetes (72.8%) was relatively high, while the diabetes prevalence (11.7%) was comparable with that of other countries such as China and the USA. Factors associated with higher diabetes prevalence were similar in Russia and these other countries and included older age, higher body mass index and higher serum concentration of triglycerides, lower prevalence of vigorous daily work, arterial hypertension and cardiovascular diseases.

Self-reported hearing loss in Russians: the population-based Ural Eye and Medical Study.

OBJECTIVE: With data on frequency of hearing loss in Russia and Eastern Europe generally lacking, we assessed the prevalence of hearing loss in a Russian population. SETTING: The population-based Ural Eye and Medical Study was conducted in the rural and urban regions of Bashkortostan, Russia. PARTICIPANTS: With an inclusion criterion of age 40+ years, the study included 5899 (80.5%) out of 7328 eligible individuals (mean age: 59.0±10.7 years; range: 40-94 years). PRIMARY AND SECONDARY OUTCOME MEASURES: Hearing loss was examined in 5397 (91.5%) study participants, assessed using a standardised interview with questions from the 'Hearing Handicap Inventory for the Elderly Screening Version (HHIE-S)'. RESULTS: The prevalence of self-reported hearing loss (26.1%, 95% CI 24.2 to 27.2) increased from 10.9% (95% CI 8.0 to 13.7) in participants aged 40-45 years old to 59.0% (95% CI 51.6 to 66.4) in those aged 80+ years old. It was higher for men than for women in the 60-80 years age group (38.93%, 95% CI 35.8 to 42.1, vs 32.8%, 95% CI 30.2 to 35.3; p=0.003). On multivariable analysis, higher prevalence of hearing loss was associated with older age (p<0.001; OR [per year of age]: 1.06 [1.06 to 1.07]), male gender (p<0.001; OR: 1.26 [1.09 to 1.47]), higher depression score (p<0.001; OR: 1.06 [1.04 to 1.08]), higher prevalence of headache (p=0.001; OR: 1.27 [1.10 to 1.47]), history of cardiovascular diseases including stroke (p=0.001; OR: 1.32 [1.13 to 1.55]), and osteoarthritis (p<0.001; OR: 1.40 [1.18 to 1.67]), physically vigorous activity during work (p<0.001; OR: 1.40 [1.21 to 1.62]), alcohol consumption (p<0.001; OR: 1.51 [1.28 to 1.78]), and dry eye feeling (p<0.001; OR: 1.67 [1.30 to 2.16]). It was marginally correlated with a higher anxiety score (p=0.07; OR: 1.03 [0.998 to 1.06]). It was independent of diabetes (p=0.52), arterial hypertension (p=0.20), level of education (p=0.11), region of habitation (p=0.70), blood concentration of high-density lipoproteins (p=0.17) and low-density lipoproteins (p=0.52), current smoking (p=0.95) and smoking pack-years (p=0.37), and best corrected visual acuity (p=0.93). CONCLUSIONS: As in other countries the prevalence of hearing loss is high in this elderly population in Russia. It is primarily or secondarily associated with older age, depression, male gender, cardiovascular disease and alcohol consumption.

Intraocular Pressure and Its Associations in a Russian Population: The Ural Eye and Medical Study.

PURPOSE: To assess the normal distribution of intraocular pressure (IOP) and its associations with ocular, medical, and socioeconomic factors in a Russian population. DESIGN: Population-based cross-sectional study. METHODS: The Ural Eye and Medical Study conducted in a rural and urban area in Ufa/Bashkortostan included 5899 (80.5%) participants out of 7328 eligible individuals aged 40+ years. IOP was measured by noncontact tonometry. RESULTS: After exclusion of individuals after glaucoma surgery or with antiglaucomatous therapy, mean IOP was 13.6 ± 3.8 mm Hg (median: 13 mm Hg; range: 3-49 mm Hg; 95% confidence interval [CI]: 8-23 mm Hg). The IOP range within the mean ± 2 standard deviations was 6.0-21.2 mm Hg. In multivariable analysis higher IOP was associated (regression coefficient r: 0.40) with the systemic parameters of female sex (nonstandardized regression coefficient B: 0.44; 95%CI: 0.22, 0.66; standardized regression coefficient beta: 0.06; P < .001), urban region of habitation (B: -0.27; 95% CI: 0.51, 0.03; beta: 0.03; P = .03), Russian ethnicity (B: 0.47; 95% CI: 0.20, 0.74; beta: 0.05; P = .001), higher body mass index (B: 0.06; 95% CI: 0.04, 0.08; beta: 0.08; P < .001), lower physical activity score (B: -0.02; 95% CI: -0.03, -0.002; beta: -0.03; P = .02), higher prevalence of diabetes mellitus (B: 0.42; 95% CI: 0.08, 0.76; beta: 0.03; P = .02), higher systolic blood pressure (B: 0.01; 95% CI: 0.01, 0.02; beta: 0.08; P < .001), fewer days with intake of fruits (B: -0.07; 95% CI: -0.12, -0.01; beta: 0.03; P = .01), lower blood concentration of bilirubin (B: -0.01; 95% CI: -0.02, -0.003; beta: -0.04; P = .008) and urea (B: -0.11; 95% CI: -0.17, -0.04; beta: -0.04; P = .003), worse best-corrected visual acuity (B: 0.64; 95% CI: 0.38, 0.90; beta: 0.13; P < .001), thicker central corneal thickness (B: 0.036; 95% CI: 0.033, 0.039; beta: 0.32; P < .001), higher anterior corneal refractive power (B: 0.11; 95% CI: 0.04, 0.18; beta: 0.05; P = .003), lower anterior chamber depth (B: -0.57; 95% CI: -0.83, -0.30; beta: -0.07; P < .001) (or lower prevalence of cataract surgery [B: -0.78; 95% CI: -1.44, -0.13; beta: -0.03; P = .02]), longer axial length (B: 0.30; 95% CI: 0.18, 0.42; beta: 0.07; P < .001), and higher prevalence of pseudoexfoliation (B: 1.08; 95% CI: 0.52, 1.63; beta: 1.01; P < .001). Measured IOP decreased by 0.36 mm Hg (95% CI: 0.33, 0.39) for each increase in central corneal thickness by 10 µm. CONCLUSIONS: IOP was associated with a multitude of systemic and ocular parameters, the associations of which may be considered in defining the normal range of IOP.

Pterygium Prevalence and Its Associations in a Russian Population: The Ural Eye and Medical Study.

PURPOSE: To assess the prevalence of pterygia and its associations in a population in Russia. DESIGN: Population-based cross-sectional study. METHODS: The Ural Eye and Medical Study was performed in a rural and urban area in Ufa/Bashkortostan 1300 km east of Moscow. Out of 7328 eligible individuals aged 40+ years, 5899 (80.5%) individuals participated and underwent an ocular and systemic examination. Pterygia, defined as conjunctival extensions onto the clear cornea, were diagnosed upon slit-lamp examination and on corneal photographs. RESULTS: Mean pterygium prevalence (per individual) was 138/5888 (2.3%; 95% confidence intervals [CI]:2.0, 2.7), with bilateral occurrence in 45 individuals (32.6% of patients with pterygium; 0.8% of study population). Pterygium prevalence increased from 0.8% (95% CI: 0.02, 1.6) in the age group from 40 to <45 years to 3.6% (95% CI: 2.1, 5.1) in the age group of 75+ years. In multivariable analysis, higher pterygium prevalence was associated with older age (P = .006; odds ratio [OR]: 1.03; 95% CI: 1.01, 1.04), rural vs urban region of habitation (P < .001; OR: 2.33; 95% CI: 1.57, 3.46), and lower level of education (P = .03; OR: 0.89; 95% CI: 0.81, 0.99), while the pterygium prevalence was statistically independent of sex (P = .34), Russian vs non-Russian ethnicity (P = .59), presence of diabetes mellitus (P = 1.00), arterial hypertension (P = .86), vegetarian vs mixed diet (P = 1.00), blood lipid concentration (P > .30), history of cardiovascular disease (P = .49), or axial length (P = .52). CONCLUSIONS: In this rural and urban, typically multiethnic Russian study population aged 40+ years, a higher pterygium prevalence (mean: 2.3%) was correlated with older age, rural region of habitation, and lower educational level, while it was statistically independent of most other systemic or ocular parameters. A pterygium was not a biomarker for an internal medical disease.

Axial length and its associations in a Russian population: The Ural Eye and Medical Study.

PURPOSE: To assess the normal distribution of axial length and its associations in a population of Russia. METHODS: The population-based Ural Eye and Medical Study included 5,899 (80.5%) individuals out of 7328 eligible individuals aged 40+ years. The participants underwent an ocular and systemic examination. Axial length was measured sonographically (Ultra-compact A/B/P ultrasound system, Quantel Medical, Cournon d'Auvergne, France). RESULTS: Biometric data were available for 5707 (96.7%) individuals with a mean age of 58.8±10.6 years (range:40-94 years; 25%, 50%, 75% quartile: 51.0, 58.0, 66.0 years, respectively). Mean axial length was 23.30±1.10 mm (range: 19.02-32.87mm; 95% confidence interval (CI): 21.36-25.89; 25%, 50%, 75% quartile: 22.65mm, 23.23mm, 23.88mm, resp.). Prevalences of moderate myopia (axial length:24.5-<26.5mm) and high myopia (axial length >26.5mm) were 555/5707 (8.7%;95%CI:9.0,10.5) and 78/5707 (1.4%;95%CI:1.1,1.7), respectively. Longer axial length (mean:23.30±1.10mm) was associated (correlation coefficient r2:0.70) with older age (P<0.001;standardized regression coefficient beta:0.14), taller body height (P<0.001;beta:0.07), higher level of education (P<0.001;beta:0.04), higher intraocular pressure (P<0.001;beta:0.03), more myopic spherical refractive error (P<0.001;beta:-0.55), lower corneal refractive power (P<0.001;beta:-0.44), deeper anterior chamber depth (P<0.001;beta:0.20), wider anterior chamber angle (P<0.001;beta:0.05), thinner peripapillary retinal nerve fiber layer thickness (P<0.001;beta:-0.04), higher degree of macular fundus tessellation (P<0.001;beta:0.08), lower prevalence of epiretinal membranes (P = 0.01;beta-0.02) and pseudoexfoliation (P = 0.007;beta:-0.02) and higher prevalence of myopic maculopathy (P<0.001;beta:0.08). In that model, prevalence of age-related macular degeneration (any type: P = 0.84; early type: P = 0.46), diabetic retinopathy (P = 0.16), and region of habitation (P = 0.27) were not significantly associated with axial length. CONCLUSIONS: Mean axial length in this typically multi-ethnic Russian study population was comparable with values from populations in Singapore and Beijing. In contrast to previous studies, axial length was not significantly related with the prevalences of age-related macular degeneration and diabetic retinopathy or region of habitation.

Prevalence, Awareness, and Control of Arterial Hypertension in a Russian Population. The Ural Eye and Medical Study.

Background: Applying the criteria recently published by the American College of Cardiology/American Heart Association for the definition of arterial hypertension, we investigated prevalence and awareness of arterial hypertension in Russia. This new definition differentiates between normal BP [SBP (systolic blood pressure)/DBP (diastolic blood pressure) < 120/80 mmHg], elevated BP (SBP 120-129 mmHg; DBP < 80 mmHg), hypertension stage 1 (SBP 130-139 mmHg or DBP 80-89 mmHg), hypertension stage 2 (SBP ≥ 140 and ≤180 mmHg or DBP ≥ 90 and ≤120 mm Hg) and hypertensive crisis (SBP > 180 mmHg and/or DBP > 120). Methods: The population-based Ural Eye and Medical Study, performed in an urban and rural region in the Russian republic Bashkortostan, included 5,891 (80.5%) individuals aged 40+ years out of 7,328 eligible individuals. The participants underwent a detailed interview and medical examination. Arterial hypertension was defined using the criteria defined by the American College of Cardiology/American Heart Association. Results: The prevalence of normal blood pressure (BP), elevated BP, hypertension stage 1, stage 2, and hypertensive crisis was 750/5,891 [12.7%; 95% confidence interval (CI): 4.7, 5.9], 312/5, 891 (5.3%; 95% CI: 4.7, 5.9), 2,187/5,891 (37.1%; 95% CI: 35.9, 38.4), 2,484/5,891 (42.2%; 95% CI: 40.9, 43.4), and 158/5,891 (2.7%; 95% CI: 2.3, 3.1), respectively. The overall prevalence of elevated BP/hypertension was 5,141/5,891 (87.3%; 95% CI: 86.4, 88.1). Awareness of elevated BP/hypertension was 2,289/5,223 (45.4%; 95% CI: 44.0, 47.0). Among 1,055 (20.2%; 95% CI: 19.1, 21.3) individuals under anti-hypertensive treatment, 33 (3.1%) individuals had normal BP values. Higher risk of elevated BP/hypertension was associated with older age [odds ratio (OR): 1.04; 95% CI: 1.03,1.05], male gender (OR: 2.56; 95% CI: 2.10, 3.16), urban region (OR: 1.26; 95% CI: 1.05, 1.51), lower educational level (OR: 0.92; 95% CI: 0.87, 0.97), higher body mass index (OR: 1.15; 95% CI: 1.12, 1.18), higher waist-hip circumference ratio (OR: 6.16; 95% CI: 1.89, 20.0), higher prevalence of sitting or reclining for more than 18 h per week (OR: 1.33; 95% CI: 1.10, 1.61), higher prevalence of alcohol consumption (OR: 1.61; 95% CI: 1.27, 2.05), and higher serum concentrations of triglycerides (OR: 1.22; 95% CI: 1.05, 1.43) and glucose (OR: 1.15; 95% CI: 1.07, 1.24). Using the former definition of hypertension (systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg), the prevalence of hypertension was 3,134/5,891 (53.2%; 95% CI: 51.9, 54.5). Conclusions: Using the new definition of arterial hypertension, the prevalence of elevated BP/hypertension in a typically mixed Russian population aged 40+ years was high (87.3%), with an awareness rate of 45.4% and treatment rate of 20.2%. The rate of therapeutic control of BP elevation in the individuals under treatment was <5%.

Frequency and Associated Factors of Bone Fractures in Russians: The Ural Eye and Medical Study.

With information about frequency of bone fractures in Russia mostly missing, we assessed the frequency of previous bone fractures in a Russian population. The population-based study Ural Eye and Medical Study included 5899 (80.5%) out of 7328 eligible individuals (mean age: 59.0 ± 10.7 years; range: 40-94 years). The history of previous bone fractures was assessed in a standardized interview for 5397 (91.5%) individuals. Mean frequency of any previous bone fracture was 1650/5397 (30.6%; 95% confidence interval (CI): 29, 3, 31.8). In multivariate analysis, higher frequency of bone fractures was associated with male sex (P < 0.001; odds ratio (OR): 1.67; 95% CI: 1.41, 2.00), urban region (P < 0.001; OR: 1.45; 95% CI: 1.23, 1.72), higher prevalence of vigorous activity during leisure (P < 0.001; OR: 1.42; 95% CI: 1.20, 1.68), current smoking (P = 0.001; OR: 1.46; 95% CI: 1.16, 1.82) and higher prevalence of cardiovascular disease (P = 0.007; OR: 1.29; 95% CI: 1.07, 1.56), low blood pressure episodes with hospital admission (P = 0.001; OR: 2.08; 95% CI: 1.37, 3.16), tumbling (P < 0.001; OR: 2.58; 95% CI: 1.37, 3.16) and thoracic spine pain (P < 0.001; OR: 1.43; 95% CI: 1.18, 1.73). In women, menopause (P < 0.001; OR: 2.17; 95% CI: 1.47, 3.22) was additionally associated. The most common single-bone fractures involved leg and knee (229/5397; 4.2%), hand in general (n = 169; 3.1%) or hand wrist only (n = 97; 1.8%), arm (n = 94; 1.7%) and ankle (n = 67; 1.2%). Severe fractures included spine (n = 35; 0.6%), os sacrum (n = 10; 0.2%), skull (n = 6; 0.1%), pelvis (n = 5; 0.1%) and hip (n = 22; 0.4%). Most frequent combined fractures included as most important part the leg (n = 90; 1.7%), spine (n = 18; 0.3%), and hip (n = 18; 0.3). These data give hints on the epidemiology of bone fractures in Russia.