A six decades long follow-up on body size in adolescents from Zagreb, Croatia (1951-2010).

Most studies analysing the influence of socioeconomic deterioration on body size focus on the impact of food shortages and diseases on the growth in early childhood. To evaluate how socioeconomic conditions influence the growth during the adolescence, we tracked the body size of 15-19 year-olds over the last sixty years covering the socialist period (1951-1990), the war (1991-1995) and the transition to capitalistic economy. This study of Zagreb, Croatia, adolescent population provides information on the secular trend in height, weight and Body Mass Index (BMI) and examines their relation with Real Gross Domestic Product. From 1951 to 2010 the girls' height approximately increased by 6.2cm and weight by 6.8kg, while the boys' height increased by 12.2cm and weight by 17.3kg. Prior to 1991 mean BMI in girls was higher than in boys, but from 1991 on, the interrelation between the sexes has been opposite, possibly mirroring the cultural trends that started in mid-1970s and reflecting higher sensitivity of boys to the socioeconomic changes. In conclusion, the secular trend in body size over the investigated period reflects the positive economic trends interrupted by the war. The recent increase in BMI corresponds to the country's economic recovery and indicates the "nutrition transition".

Are the physically active adolescents belonging to the "at risk of overweight" BMI category really fat?

The adolescence is recognized as one of the critical periods for the development of obesity. Children and adolescents who practice sports regularly have higher muscle mass and lower percentage of body fat than their peers who are physically less active. Since body mass index (BMI) is a widely used indicator of overweight/obesity in spite of the fact that it directly measures excess in weight but not in fat, it often misclassifies athletic populations, both children and adults. The specific aim of this study was to evaluate whether BMI adequately assesses fatness in adolescents, especially physically active ones. The analysis was performed on anthropometric data from two surveys (1997 and 2009/2010) of Zagreb secondary school adolescents, 1315 girls and 1034 boys, aged 15-19 years. The group defined as "physically active" consisted of adolescents who practice organized sports (36.2% girls, 44.6% boys), while the "physically inactive" group was made of their peers who practice sport only as a part of physical education in schools. The standardized values, calculated within each sex by survey, were used for comparison of adolescents with different levels of physical activity. Physically active adolescents of both sexes had lower sum of skinfolds mean Z-valutes (Pgirls<0.05, Pboys<0.001); additionally, boys had higher Z-values for body weight (p<0.05) and triceps/subscaputar ratio (indicating peripheral distribution of body fat) (p<0.05) than their less active peers. In order to evaluate whether BMI was adequate indicator for body composition during adolescence, we estimated the concordance of above-median category defined by BMI and the other body fat indicators. The largest discrepancy was found for sum of skinfolds in both sexes and was more pronounced in physically active adolescents. This finding was further confirmed in more extreme BMI category (85th - 95th percentile) which indicated that adolescents categorized as "at risk of overweight" were predominantly characterized by larger lean body mass and not by increased fatness.

Age trends in prevalence of cardiovascular risk factors in Roma minority population of Croatia.

The Roma (Gypsy) are the largest European minority population characterized by poverty, social exclusion as well as by numerous life-style and cultural specificities, which all could have an adverse impact on their cardiovascular health. This study assesses the prevalence of cardiovascular diseases (CVD) risk factors in community-based sample of 430 adult Roma, living in rural area of Croatia, by providing the actual and age-adjusted estimates using the European standard population. The most prominent classical CVD risk phenotypes (blood pressure, obesity, smoking, glucose and lipid profile) were selected, and the standard risk cut-offs were applied. The study has shown that compared to general population of Croatia, the Roma population bears a high CVD risk factors load related to smoking and high glucose level. The CVD risk factors prevalence in Roma also showed important sex and age patterns, the most imposing of which are the findings of higher prevalence of CVD risks in women (especially obesity and triglyceride levels) and the trend of higher body mass index (BMI) level in younger age group (18-34 years) which both stand in contrast to the trends characterizing the general population of Croatia. These findings are complemented by the trend of decreased risk in the oldest age group (65+ years) for all investigated CVD risk factors (with exception of triglycerides level) compared to the 50-64 age group. We conclude that the age and sex CVD risks pattern point to the health transition of this rural Roma population. As we expect the proportion of CVD in the Roma minority of Croatia to increase in the future along with further modernization of their lifestyle, the CVD prevention measures in this population are urgent and should be primarily targeted at women and at the younger segment of this population.

Dermatoglyphics in patients with hypothyreosis.

About 15% of all females and 3% of all males suffers from hypothyreosis. The thyroid disease is the most frequent cause of hypothyreosis, and among people in Croatia who are suffering from that disease 90% have been affected by its autoimmune form. The thyroid diseases are supposed to be caused by the influence of various genetic and external factors and some forms of genetic influences have not yet been studied. Analysis of digito-palmar dermatoglyphics has been used in the research of the role of genetic predisposition in many various diseases. We have analyzed correlation of qualitative and quantitative traits between the group of 50 females suffering from hypothyreosis and a control group of 100 phenotypically healthy females. Quantitative statistical analysis using t-test has indicated only few significantly different variables, while the discriminant analysis has shown 76.9% correctly classified samples. The factor analysis has shown a high percentage of total variance within patients suffering from hypothyreosis, as well as the different structure of individual factors. Qualitative analysis has shown the heterogeneity between the two examined groups. The results of the research have proved that the qualitative characteristics are more unstable than the quantitative ones and they have also shown the instability of genes taking part in hypothyreosis development implying genetic predisposition of the disease.

Angiotensin-converting enzyme deletion allele is beneficial for the longevity of Europeans.

The human angiotensin converting enzyme (ACE) gene is one of the most investigated candidate genes for cardiovascular diseases (CVD), but the understanding of its role among the elderly is vague. Therefore, this study focuses at: (a) testing the association of ACE polymorphism with CVD risk factors among the elderly, and (b) detecting the possible unequal distribution of ACE genotypes between senescent and younger segments of the European populations. The association of ACE I/D polymorphism with CVD health status [hypertension (HT), obesity, dislypidemia] in 301 very old subjects (88.2 ± 5 years; F/M = 221/80) was tested by means of logistic regression analysis. The meta-analysis of D allele frequency in general vs. elderly (80+ years) groups was conducted using all publicly available data for European populations comprising both age cohorts. Multiple multinomial logistic regression revealed that within this elderly sample, age (younger olds, 80-90 years), female sex (OR = 3.13, 95% CI = 1.59-6.19), and elevated triglycerides (OR = 2.53, 95% CI = 1.29-4.95) were positively associated with HT, while ACE polymorphism was not. It was also established that the DD genotype was twice as high in 80+ cohort compared to general population of Croatia (p < 0.00001). This trend was confirmed by the meta-analysis that showed higher D allele frequencies in olds from nine of ten considered European populations (OR = 1.19, 95% CI = 1.08-1.31). The data in elderly cohort do not confirm previously reported role of ACE DD genotype to the development of HT. Moreover, meta-analysis indicated that ACE D allele has some selective advantage that contributes to longevity in majority of European populations.

Secular trend of menarche in Zagreb (Croatia) adolescents.

OBJECTIVE: To study the secular trend of menarche in high-school urban adolescent girls (Zagreb, Croatia) over the last two decades, and to evaluate the possible impact of worsening of socio-economic conditions on age at menarche during the Croatian War of Independence (1991-1995). STUDY DESIGN: Three surveys of female adolescents aged 15-19 years: (a) 523 girls interviewed in 1990, (b) 888 girls interviewed in 1997, and (c) 399 girls interviewed in 2010. Self-reported age at menarche (in decimal years) was presented by age groups and year of interview. Differences in mean age at menarche between adolescent age groups as well as between surveys were tested using One-way ANOVA. RESULTS: The mean age at menarche was 12.82 years in 1990, 12.92 years in 1997 and 12.31 years in 2010. It increased by 0.10 years from 1990 to 1997 (p=0.290) and then declined by 0.61 years from 1997 to 2010 (p<0.001). Over the 20-year period, the overall mean age at menarche declined by 0.51 years (p<0.001). CONCLUSION: The age at menarche in Zagreb adolescents continued to decline significantly from 1990 to 2010 (p<0.001), in spite of a statistically insignificant initial increase between 1990 and 1997. When put in broader context, age at menarche mirrored socio-economic changes in the war period.

A detection of microevolutionary changes by the analysis of qualitative dermatoglyphic traits: an example of Albanians from Kosovo.

In this study we analyzed the qualitative dermatoglyphic traits in the Albanians from three Kosovo distinct regions. We aimed to detect possible microevolutionary changes, which could have happened as a consequence of geographical and cultural isolation. The dermatoglyphic traits were analyzed for total 641 Albanians of both sexes. The analysis included 4 variables on fingers, 8 on palms and terminations of A, B, C, D and T main-lines. The differences in patterns incidence were tested using the chi-square test. The frequencies of several pattern types varied to a great extent between distinct groups with statistically significant difference in most of the cases. Our results indicated that the Albanians from South Morava valley and from Kosovo plain were genetically close, and the population from Dukagjini valley is less close to any of them. The analysis of qualitative dermatoglyphic patterns may be utilized effectively to track the microevolutionary changes. This is especially useful in a developing country like Kosovo, since it is an inexpensive and effective tool for screening and studying the patterns influenced by the divergence of population.

Comparative analysis of qualitative dermatoglyphic traits of Albanian and Turkish populations living in the area of Dukagjin Valley in Kosovo.

Dermatoglyphic prints were collected from 800 inhabitants of Dukagjin valley in Kosovo. The sample consisted of two ethnically different sub-populations who refer themselves as Albanians (N = 400) and Turks (N = 400). Qualitative analysis of prints concerned the frequency of the patterns on fingers (arch, ulnar and radial loop, whorl, accidental whorl) and on palms (Thenar and I, II, III, and IV interdigital area and the hypothenar, main line index, and the axial "t" triradius position). As was expected due to previous study of quantitative dermatoglyphic traits, in the same population the Alba-nians and Turks showed to be significantly different in most explored qualitative dermatoglyphic variables. Found differences indicated that the reproductive isolation between the Albanian and Turkish population in Kosovo is substantial, despite the fact that those two ethnic sub-populations live in the close vicinity through several centuries.

Biological aspects of the development and self-concept in adolescents living in single-parent families.

In this study we investigate whether there are differences between adolescents who grow up in single-parent families and those who grow up in nucleus families. We have decided that there are no differences in the physical development between the adolescents who are growing up in single parent families and those growing up in nucleus families. There is no difference in the self-concept between these two groups, except in the ethical and moral self-image of adolescents living with one parent. Adolescents living in single-parent families have a weaker moral self-image. It can thus be concluded that physical development and positive self-concept (a favorable image of oneself) in adolescents do not depend on whether an adolescent is growing up in a single-parent or a nucleus family, but on the different characteristics of parents and their relationship with children, whether they are married or not. For the children development the best is healthy marriage of their parents.

Comparison of digito-palmar dermatoglyphic traits in children with cerebral palsy and their close family members.

Cerebral palsy is one of the main causes of severe disability in children. Sixty children (30 boys and 30 girls) were included in the study. Quantitative digito-palmar dermatoglyphic traits were analyzed. Prints of digito-palmar dermatoglyphs obtained from the children's parents (60 mothers and 60 fathers) and from 400 phenotypically healthy adults from the Zagreb ware used as control groups. Analysis of quantitative dermatoglyphic traits of the digito-palmar complex revealed statistically significant differences in a number of variables between the fathers and their children suffering from cerebral palsy (TRC 180.3 > 158.6), with a greater number of variables involved in male children with cerebral palsy. Some variables showed statistically significant differences in dermatoglyphic patterns between fathers and control group of healthy males as well as between boys with cerebral palsy and healthy control males. Differences in dermatoglyphic patterns were significantly lower between mothers and girls with cerebral palsy (TRC 152.1 < 152.3) as well as between mothers and healthy control females. Study results support the hypothesis on the possible role of genetic predisposition in the occurrence of central nervous system lesion, with a more pronounced paternal impact.

Qualitative analysis of dermatoglyphics of the digito-palmar complex in children with severe recessive perceptively impaired hearing.

The possible hereditary indicated differences in the ascending family tree was investigated in children with severe recessive perceptively impaired hearing, their parents, and healthy controls, using qualitative analysis of dermatoglyphics of the digito-palmar complex. The chi2 test was performed and biological distance was investigated by means according to Hiernaux Ag methods, and presented using Ward's method for the examined groups. The results show that the healthy control group differs from the groups of boys and girls with impaired hearing and also from their fathers mostly in palmar variables. The mothers were biologically more distant from the examined groups of patients, and more similar to the control group of randomly selected healthy female controls. The results indicate polygenic inheritance of sporadic sensoneurial hearing loss.

Comparative study on dermatoglyphics in alcoholic patients.

According to the world's prevalence rate, alcoholism is in the third place after heart and blood vessel diseases and malignant tumors. With the development of neuroscience, the causes of alcoholism's biological etiologic sources are still being studied. Considering that dermatoglyphics are highly determined by heritage, we contemplated the possibilities of their discrimination in alcoholic patients in relation to phenotypically healthy subjects. We analyzed the quantitative and qualitative dermatoglyphics properties of 100 alcoholic patients without psychiatric comorbidity, who have been cured in the Psychiatric Hospital Sveti Ivan two or more times, and those of 100 phenotypically healthy men. Through the t-test we evaluated the heterogeneity of the examined groups. Results showed a statistically significant difference on five examined variables. In the calculation of fluctuating asymmetry measure, we found no statistically significant differences in the correlation of values of the right and the left hand on the tested variables, beside one. Chi-square tests showed that there is no relation between the dermatoglyphic qualitative properties of alcoholic patients and those of the examinees from the comparison group. Despite the indisputable genetic role in the genesis of alcoholism, the analysis of the dermatoglyphics carried out in our study did not show any etiological connection between the results of the test on dermatoglyphics and the appearance of alcoholism.

Comparative study on dermatoglyphics in patients with PTSD.

The factors situated at the bases of the genesis and development of PTSD are divided in: biological, psychological and social factors. Primary factor is a stressful event of extremely dangerous and threatening nature. The sort and the intensity of the stressful event too play an important role, followed by the personality structure, the relation with the environment and the genetic constitution. The study was thought to determine the quantitative dermatoglyphic properties of the digito-palmar complex in patients with PTSD aiming to establish whether there are biological, that is, genetic bases for PTSD, in what measure they determine the clinical manifestation of the disorder, and whether there is a dermatoglyphic marker, characteristic for people with PTSD. We analyzed the quantitative properties of the digito-palmer complex on a group of 100 male examinees over 18 years of age with PTSD, no psychiatric comorbidity, and who were two or more times cured at the Psychiatric Hospital "Sveti Ivan", comparing them with the quantitative dermatoglyphic properties of a group of 100 phenotypically healthy male examinees over 18 years of age. Using the method of descriptive statistics, we found no statistically significant differences among the results of the examined groups. With the T-test we evaluated the heterogeneity of the groups, and the results showed the existence of statistically significant differences among the comparison group and the group of patients with PTSD on three variables. We calculated the Fluctuating Asymmetry (FA) measure, which illustrates the compatibility, that is, the symmetry of the observed property on the right and on the left side of the body, indicating a difference on one variable. The outcome did not confirm the existence of a connection between a particular dermatoglyphic result and the genesis of PTSD. This is, however, in line with the hypothesis that, in patients with PTSD and other psychiatric disorders, there is a multiple effect of several micro-abnormalities in different genes, along with the inevitable and essential influence of environmental and/or physical and/or psychosocial stressogenic factors.

New reference equations for forced spirometry in elderly persons.

This study identifies equations for predicting lung function values in a population of 'healthy', nonsmoking older adults, explores the applicability of prediction equations derived from younger adult populations to the elderly, and examines the justification of developing population-specific reference equations for older age. FVC, FEV(1), and PEF were measured according to the ATS criteria in 651 ambulatory volunteers aged 65-86 years, representative for the Croatian Mediterranean population. After exclusion of eversmokers and subjects with respiratory symptoms and/or diseases, 261 asymptomatic subjects were included in the analyses. Sex-specific reference equations and lower limits of normal were derived by using a linear model with height and age as predictors. The equations for lung volumes were more reliable than those for PEF. The new FVC and FEV(1) reference equations were found to be in agreement with those generated previously from primarily young and middle-aged adults. The latter perform reasonably well when extrapolated for ages beyond 65 years. Cross-validation of reference equations existing for the elderly showed that almost all European and U.S. equations systematically overpredicted lung function parameters in the Croatian sample. The overpredictions in means ranged between 14% and 34% for FVC and between 10% and 20% for FEV(1). Differences increased towards the extremes of distribution, which rendered these equations inappropriate for our elderly subjects. They identified FVC in 25-55% of the subjects as being below the lower limit of normal. The observed discrepancies strongly support the establishment of age- and population-specific reference equations for lung function assessment in older age.

Comparative analysis of dermatoglyphic traits in Albanian and Turkish population living in Kosovo.

The aim of the study was to compare quantitative dermatoglyphic traits of two ethnic groups with different origin and customs, living on the same territory. The dermatoglyphic prints were collected from 800 inhabitants of the Dukagjin valley in southwest Kosovo, of Albanian (400) and Turkish (400) ethnic origin. The quantitative analysis comprised the number of ridges and triradii on the fingers, and the number of ridges in the interdigital areas on the palm (a-b, b-c, and c-d) as well as the size of the atd angle. The statistical analysis showed significant differences between the Albanian and the Turkish males for two fingers and pattern intensity index left, and on palms for a-b rc and c-d rc on both hands and b-c re on the left hand, and between females for six fingers and almost all palmar traits. Significant inter-population variations were observed for most palmar areas in both sexes but more pronouncedly in females. The differences found between the examined population groups show that admixture between Albanian and Turkish population in Kosovo has been small, and the Turks have retained their ethnic identity for several centuries.

Trapped between tradition and transition--anthropological and epidemiological cross-sectional study of Bayash Roma in Croatia.

AIM: To assess the key characteristics related to living conditions and health in the Bayash Roma population in Baranja and Medimurje regions of Croatia and identify possible demographic and socio-economic sources of variance in self-reported health and reproductive profile. METHODS: The study comprised a total of 266 adult Bayash individuals from Baranja and 164 from Medimurje (aged 41.3+/-15.1 years). Data on ethno-historical and demographic background, self-identity, life and hygiene conditions, education, employment, health insurance, and health (dietary and smoking habits, reproductive characteristics, diagnosed and undiagnosed health problems, use of medications). were obtained through interviews. Bivariate and multivariate methods were used in statistical analyses. RESULTS: The reported migratory pattern demonstrated that 88.8% of the examinees were born in the region of residence, which showed that the Bayash population was autochthonous and sedentary one. Financially, the Bayash primarily relayed on social welfare support allowance (84%) and child allowance (47%), while merely 2% were permanently and 23% occasionally employed. The proportion of the Bayash who had never attended school amounted to 33.3% (19.3% men and 40.6% women). The access to public water supply system was available to 52.5% of examinees, whereas only 1.7% had public sewage system, and 23.4% had private septic tanks. The most commonly reported health burden were frequent headaches (20.3%), stomach pain (16.3%), anxiety or insomnia (13.1%), hypertension (9.3%), and chronic obstructive pulmonary disease (COPD) (8.6%). The logistic regression identified level of education (odds ratio [OR], 0.77; 95% confidence interval [CI], 0.63-0.94) and access to health insurance (OR, 4.32; 95% CI, 1.46-12.77) as socio-economic/life-style factors playing a significant role in the occurrence of COPD. CONCLUSION: Our results indicate poor inclusion of the Bayash in the essential social service sectors such as health care, education, and employment, as well as substandard living conditions and unfavorable health-related behavior. Since education and health insurance were found to have significant effects on the observed reproductive status and self-reported health, they should be targeted in planning public health actions for socially marginalized and economically deprived groups.

Qualitative dermatoglyphic traits in brachial plexus palsy.

It has been considered for many years that the cause of perinatal brachial plexus palsy (PBPP) is excessive lateral traction applied to the fetal head at delivery, in association with anterior shoulder dystocia, but this do not explain all cases of brachial plexus palsy. The incidence found in several family members could be suggestive for inheritance with variable expression. The aim of this study was to prove early found confirmations of genetic predisposition for PBPP In the previous studies, the quantitative dermatoglyphic analysis showed some differences in digito-palmar dermatoglyphs between patients with PBPP and healthy controls. Now this qualitative analysis will try to determine hereditary of those diseases. We analyzed digito-palmar dermatoglyphics from 140 subjects (70 males and 70 females) diagnosed with PBPP and 400 phenotypically healthy adults (200 males and 200 females) from Zagreb area as control group. The results of Chi-square test showed statistically significant differences for frequencies of patterns on fingers in females between the groups observed. Statistically significant differences were found on palms in III and IV interdigital areas in both males and females and in thenar and I interdigital area only in females. As it was found in previous researches on quantitative dermatoglyphic traits, more differences are found between females with PBPP and control group, than between males. The fact, that the main presumed cause of PBPP is obstetrical trauma, it could be associated with congenital variability in formation of brachial plexus.

Dermatoglyphs and brachial plexus palsy.

Perinatal brachial plexus palsy (PBPP) is a handicap quite commonly encountered in daily routine. Although birth trauma is considered to be the major cause of the defect, it has been observed that PBPP occurs only in some infants born under identical or nearly identical conditions. The aim of this study was to test the hypothesis of genetic predisposition for PBPP. It is well known that digito-palmar dermatoglyphs can be used to determine hereditary roots of some diseases. Thus, we found it meaningful to do a study analysis of digito-palmar dermatoglyphs in this disease as well, conducting it on 140 subjects (70 males and 70 females) diagnosed with PBPP. The control group was composed of fingerprints obtained from 400 adult and phenotypically healthy subjects (200 males and 200 females) from the Zagreb area. The results of multivariate and univariate analysis of variance have shown statistically significant differences between the groups observed. In spite of lower percentage of accurately classified female subjects by discriminant analysis, the results of quantitative analysis of digito-palmar dermatoglyphs appeared to suggest a genetic predisposition for the occurrence of PBPP.

Analysis of the qualitative dermatoglyphics of the digito-palmar complex in patients with primary open angle glaucoma.

The primary open-angle glaucomas are a group of diseases that have in common characteristic morphological changes at the optic nerve head and retinal nerve fiber layer, progressive retinal ganglion cells death and characteristic visual field loss. The risk for primary open angle glaucoma rises continuously with the level of the intraocular pressure. The disease advances slowly and there are no symptoms. Primary open angle glaucoma is caused by abnormal aqueous humour outflow in the trabecular meshwork in the open angle. Etiopathogenesis of primary open angle glaucoma is unclear. The increased risk of glaucoma in relatives has long been recognized. Frequency for manifestation of the disease is 10-30% in family members. The discovery of the specific gene loci responsible for the manifestation of glaucoma has helped us to understand its mechanism of origin and definitely confirmed the hereditary nature of this disease. Digito-palmar dermatoglyphs were already used to determine hereditary base of many diseases and it was the reason for investigation of their qualitative patterns in patients with glaucoma (22 males and 23 females), their immediate relatives (19 males and 23 females) in comparison to a group of phenotypically healthy population (52 males and 56 females). The results pointed a connection with the dermatoglyphic traits of the digito-palmar complex between patients with glaucoma and their immediate relatives. There is a possible discrimination of patients and their immediate relatives from phenotypically healthy population, too.

Body mass index and nutritional status of the Bayash Roma from eastern Croatia.

This study examines anthropometrically assessed nutritional status of the Bayash, the Roma population from the eastern Croatian region of Baranya, and compares it to the non-Roma general population of eastern Croatia. The analysis of nutritional status and diets is a segment of multidisciplinary anthropological and epidemiological survey of the Roma minority population in Croatia began in 2005. The Bayash are an ethnic group that arrived to Croatia from Romania most likely in the 19th century and speaks a distinct archaic dialect of the Romanian language. The Roma population of Baranya approximates 1,000 according to the 2001 census. The Bayash sample comprised 227 adults aged 18-65yrs. The women fall below the Croatian 10th percentile for stature and men track about the 10th percentile. Both sexes approximate the 25th percentile for body weight. Despite their diminutive size, the Bayash appear to have adequate nutritional status until the age of 35yrs after which their average BMI exceeds the value of 25 kg/m(2) and falls in the overweight category. However, 8% of Bayash are underweight (BMI<18.5) in contrast to 1% of the majority population in the region. Underweight rates are especially high in women (11%) compared to men (4%). The prevalence of overweight (BMI 25.0 to 29.9) of 30% is considerably lower than in the majority population (42%) while the prevalence of obesity (BMI>or=30.0) of 23% is approximately equal. Overall unsatisfactory nutritional status of the Bayash merits attention. It appears to be the product of unhealthy dietary habits and their socio-economic deprivation that resulted from their poor education and extremely high unemployment.