Independent association of FTO rs9939609 polymorphism with overweight and obesity in Polish adults. Results from the representative population-based WOBASZ study.

Genetic factors play an important role in the origin of obesity. We investigated the association between the FTO rs9939609 genotype and overweight and obesity, along with additional anthropometric variables in the representative sample of adult Polish population. We genotyped a random sample of 3369 adult individuals examined in a cross-sectional population survey (WOBASZ 2003-2005). More than 40% of men and women had at least one A allele. The AA genotype was found in approximately one fifth of both men and women. The frequency of the AA genotype increased with higher BMI in both sexes and was associated with higher anthropometric obesity indicators in both men and women. The FTO rs9939609 AA genotype was significantly related to abnormal BMI [OR=1.55 (1.14-2.11)] and overweight [OR=1.55 (1.11-2.16)] or obesity [OR=1.56 (1.04-235)] in men regardless of age, tobacco smoking, physical activity, diet and diabetes, while in women it was related to abnormal BMI [OR=1.45 (1.05-2.01)] and overweight [OR=1.59 (1.11-2.29)] after adjustment in addition for menopause. The frequency of the A allele in the Polish population was the same as in other European countries. About one fifth of both men and women have the FTO rs9939609 AA variant. A significant relationship was found between the FTO genotype and anthropometric obesity indicators. The AA genotype was significantly associated with abnormal BMI and overweight in both sexes, but the relation to the obesity phenotype was observed only in men.

Prevalence of diabetes and impaired fasting glucose in Poland in 2005-2014: results of the WOBASZ surveys.

AIMS: To evaluate the prevalence of diabetes and impaired fasting glucose in Poland in 2013-2014 and to determine the temporal trends between 2003-2005 and 2013-2014. METHODS: A questionnaire survey was conducted in a representative sample of Polish adults, complemented by anthropometric and fasting plasma glucose measurements. The research was part of the national cross-sectional WOBASZ study. Diabetes was assessed as self-reported or screened (fasting plasma glucose level ≥ 7 mmol/l, based on one blood sample). RESULTS: In the years 2013-2014 among 5694 participants aged 20-74 years, 6.0% (95% CI 5.4-6.6) reported a previous diagnosis of diabetes (5.8% in women and 6.2% in men). In addition, 2.4% of the participants (95% CI 2.0-2.8) without a previous diagnosis of diabetes (1.8% of women and 3.1% of men) had a fasting blood glucose level ≥7.0 mmol/l in a single measurement. In a single measurement, 18.4% of the participants (95% CI 17.4-19.4; 13.2% of women and 23.8% of men) had impaired fasting glucose. The prevalence of dysglycaemia in the WOBASZ II study was significantly higher compared to the WOBASZ I study findings from 2003-2005, increased from 6.6% to 8.4% for diabetes and from 9.3% to 18.4% for impaired fasting glucose (after age and sex standardization to the 2013 Polish population). CONCLUSIONS: The prevalence of diabetes in Poland is similar to that observed in other European populations and has increased significantly over the last decade.

Association between soft drink, fruit juice consumption and obesity in Eastern Europe: cross-sectional and longitudinal analysis of the HAPIEE study.

BACKGROUND: Fruit juice and soft drink consumption have been shown to be related to obesity. However, this relationship has not been explored in Eastern Europe. The present study aimed to assess the cross-sectional and longitudinal relationships between fruit juice, soft drink consumption and body mass index (BMI) in Eastern European cohorts. METHODS: Data from the Health, Alcohol and Psychosocial factors in Eastern Europe population-based prospective cohort study, based in Russia, Poland and the Czech Republic, were used. Intakes of sugar-sweetened beverage (SSB), artificially-sweetened beverage (ASB) and fruit juice were estimated from a food frequency questionnaire. Participant BMI values were assessed at baseline (n = 26 634) and after a 3-year follow-up (data available only for Russia, n = 5205). RESULTS: Soft drink consumption was generally low, particularly in Russia. Compared to never drinkers of SSB, participants who drank SSB every day had a significantly higher BMI in the Czech [ß-coefficient = 0.28; 95% confidence interval (CI) = 0.02-0.54], Russian (ß-coefficient = 1.38; 95% CI = 0.62-2.15) and Polish (ß-coefficient = 0.83; 95% CI = 0.29-1.37) cohorts. Occasional or daily ASB consumption was also positively associated with BMI in all three cohorts. Results for daily fruit juice intake were inconsistent, with a positive association amongst Russians (ß-coefficient = 0.75; 95% CI = 0.28-1.21) but a negative trend in the Czech Republic (ß-coefficient = -0.42; 95% CI = -0.86 to 0.02). Russians participants who drank SSB or ASB had an increased BMI after follow-up. CONCLUSIONS: Our findings support previous studies suggesting that soft drink consumption (including SSBs and ASBs) is positively related to BMI, whereas our results for fruit juice were less consistent. Policies regarding these beverages should be considered in Eastern Europe to lower the risk of obesity.

Modulation of mtDNA copy number ameliorates the pathological consequences of a heteroplasmic mtDNA mutation in the mouse.

Heteroplasmic mtDNA mutations typically act in a recessive way and cause mitochondrial disease only if present above a certain threshold level. We have experimentally investigated to what extent the absolute levels of wild-type (WT) mtDNA influence disease manifestations by manipulating TFAM levels in mice with a heteroplasmic mtDNA mutation in the tRNAAla gene. Increase of total mtDNA levels ameliorated pathology in multiple tissues, although the levels of heteroplasmy remained the same. A reduction in mtDNA levels worsened the phenotype in postmitotic tissues, such as heart, whereas there was an unexpected beneficial effect in rapidly proliferating tissues, such as colon, because of enhanced clonal expansion and selective elimination of mutated mtDNA. The absolute levels of WT mtDNA are thus an important determinant of the pathological manifestations, suggesting that pharmacological or gene therapy approaches to selectively increase mtDNA copy number provide a potential treatment strategy for human mtDNA mutation disease.

Coffee consumption and risk of hypertension in the Polish arm of the HAPIEE cohort study.

BACKGROUND/OBJECTIVES: Coffee consumption has been hypothesized to be associated with blood pressure (BP), but previous findings are not homogeneous. The aim of this study was to evaluate the association between coffee consumption and the risk of developing hypertension. SUBJECTS/METHODS: Data on coffee consumption, BP and use of anti-hypertensive medicament were derived from 2725 participants of the Polish arm of the HAPIEE project (Health, Alcohol and Psychosocial factors In Eastern Europe) who were free of hypertension at baseline and followed up for an average of 5 years. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by multivariate logistic regression analyses and stratified for potential confounding factors. RESULTS: Coffee consumption was related to decreased age, smoking status and total energy intake. Compared with persons who drink <1 cup coffee per day, systolic BP was significantly associated with coffee consumption and the risk of hypertension was lower for individuals consuming 3-4 cups per day. Despite the analysis stratified by gender showed that the protective effect of coffee consumption on hypertension was significant only in women, the analysis after stratification by smoking status revealed a decreased risk of hypertension in non-smokers drinking 3-4 cups of coffee per day in both sexes (OR 0.41, 95% CI: 0.21, 0.79 for men and OR 0.54, 95% CI: 0.29, 0.99 for women). Upper category coffee consumption (>4 cups per day) was not related to significant increased risk of hypertension. CONCLUSIONS: Relation between coffee consumption and incidence of hypertension was related to smoking status. Consumption of 3-4 cups of coffee per day decreased the risk of hypertension in non-smoking men and women only.

[Blood Lipid Parameters In Populations of Russia, Poland And Czech Republic: The Hapiee Study].

PURPOSE: to analyze population values of blood lipid parameters in general populations of Russia, Poland and Czech Republic. MATERIALS AND METHODS: In the frame of international project HAPIEE representative samples of general population were examined in Novosibirsk (Russia), Krakow (Poland) and six centers in the Czech Republic. The analysis included data of 25,469 men and women aged 45-69 years old. RESULTS: The average levels of total cholesterol (TC), non-high density lipoprotein cholesterol (non-HDL-C) and low density lipoprotein cholesterol (LDL-C) were found relatively high in all centers, though average levels of blood triglycerides (TG) and high-density lipoprotein (HDL) were within "normal" range. In Novosibirsk mean levels of blood TC and LDL-C in persons of both sexes were obtained the highest among the study participants: 6.3 mmol/ and 4.1 mmol/l, respectively (p < 0.001). But the level of blood triglycerides (1.5 mmol/l) in Novosibirsk was the lowest, and HDL-C (1.5 mmol/l) was the highest among three centres. There were clear trend of increasing concentration of blood TC, non-HDL-C,LDL-C and blood atherogenic indexes with increasing age in both sexes of all participating countries. In Czech Republic levels of blood TC, LDL-C, HDL-C in both sexes were relatively low: 5.7 mmol/l, 3.5 mmol/l, 1.4 mmol/l, respectively, but the level of blood TG were higher, than in other centers (1.9 mmol/l). Women of all centers had more demonstrative age changes of the blood lipid profile, than men. CONCLUSIONS: The average levels of blood TC, non-HDL-C and LDL-C in men and women aged 45-69 years old in Russia (Novosibirsk) were higher and level of blood TG was lower than in Poland and the Czech Republic.

Changing 14-year trends in the epidemiology of hepatitis B virus infection in rural and urban Central-Eastern European areas.

In Poland, the prevalence of HBV infection constitutes an emerging public health concern. The aim of the study was to analyse changes in hepatitis B incidence rate by age, gender and place of residence in Poland between 1999 and 2012. The data were obtained from Polish state statistics institutions such as the National Institute of Public Health and State Sanitary Inspection. Relationships of hepatitis B incidence with age, gender and rural/urban areas were investigated using χ(2) and tests for two proportions with Bonferroni adjustment. The incidence of hepatitis B in rural and urban populations was compared using Wilcoxon's signed-rank tests. Joinpoint regression was used to analyse trends in hepatitis B incidence rate. In Poland, a total of 26 660 cases of hepatitis B were reported in the studied period and 31.6% of these cases occurred in rural areas. There was significantly declining tendency in the hepatitis B incidence rate in the initial period of the study. However, there were periods of significant increase of HBV incidence rate in women from rural areas aged 15-24 years (9.4%/year) and in women from urban areas aged 15-24 years (10.9%/year) and 25-64 years (3.8%/year) in the final years of the observation. Despite the success in controlling this infection, a significant increase in the incidence of hepatitis B among young women living in rural and urban areas, as well as in adult women in urban areas, has been noted.

Protective role of the Mediterranean diet on several cardiovascular risk factors: evidence from Sicily, southern Italy.

BACKGROUND AND AIMS: Epidemiological studies conducted in European countries demonstrated that the adoption of a Mediterranean diet protect against clustered risk factors but those evaluating such benefits specifically in southern Italy are scarce. Thus, the aim of this study was to assess the association between the adherence to the Mediterranean diet and cardiovascular risk factors obesity, diabetes, and hypertension. METHODS AND RESULTS: A cross-sectional population-based survey including 3090 subjects was conducted in Sicily, southern Italy. Food intake was evaluated through a validated food frequency questionnaire and adherence to the dietary pattern was assessed using the MedDietScore. Linear and logistic regression models were performed to estimate odds ratios (ORs) and respective confidence intervals (CIs). After adjusting for confounding factors such as age and gender, participants in the highest tertile of the MedDietScore were less likely to be obese (OR 0.35, 95% CI: 0.24-0.51), hypertensive (OR 0.73, 95% CI: 0.55-0.97), and diabetic (OR 0.43, 95% CI: 0.24-0.77). Linear inverse relation between the MedDietScore and BMI (r(2) = 0.34, P < 0.001), waist circumference (r(2) = 0.17, P < 0.001), and waist-to-hip ratio (r(2) = 0.06, P < 0.001) was found. CONCLUSION: Despite the prevalence rates of nutrition-related diseases are high in Sicily, greater adherence to the Mediterranean dietary pattern is still associated with a better health status.

Age at natural menopause in three central and eastern European urban populations: the HAPIEE study.

OBJECTIVES: To investigate the age at menopause in three urban populations in Central and Eastern Europe and to assess whether the (suspected) differences can be explained by a range of socioeconomic, reproductive and behavioural factors. METHODS: The Health, Alcohol and Psychosocial factors in Eastern Europe (HAPIEE) Study examined random samples of populations aged 45-69 years in Novosibirsk (Russia), Krakow (Poland) and six Czech towns. Participants completed a questionnaire and attended an examination in clinic. A total of 12,676 of women were included in these analyses. RESULTS: The median age at menopause was 50 years in Novosibirsk, 51 years in Czech towns and 52 years in Krakow; the Cox regression hazard ratios of menopause, compared with Krakow, were 1.47 (95% CI 1.40-1.55) for Novosibirsk and 1.10 (1.04-1.16) for Czech women. In multivariate analyses, higher education, using vitamin and mineral supplements and ever use of oral contraceptives were associated with later menopause, while smoking, abstaining from alcohol and low physical activity were associated with earlier menopause. These factors, however, did not explain the differences between populations; the multivariate hazard ratios of menopause, compared with Krakow, were 1.48 (1.40-1.57) for Novosibirsk and 1.11 (1.05-1.17) for Czech women. CONCLUSIONS: In this large population based study, differences in age at menopause between Central and Eastern Europe populations were substantial and unexplained by a range of risk factors. Associations of age at menopause with risk factors were largely consistent with studies in other populations.

Diabetes, prediabetes and cancer mortality.

AIMS/HYPOTHESIS: We aimed to investigate the risk of cancer mortality in relation to the glucose tolerance status classified according to the 2 h OGTT. METHODS: Data from 17 European population-based or occupational cohorts involved in the DECODE study comprising 26,460 men and 18,195 women aged 25-90 years were collaboratively analysed. The cohorts were recruited between 1966 and 2004 and followed for 5.9 to 36.8 years. Cox proportional hazards analysis with adjustment for cohort, age, BMI, total cholesterol, blood pressure and smoking status was used to estimate HRs for cancer mortality. RESULTS: Compared with people in the normal glucose category, multivariable adjusted HRs (95% CI) for cancer mortality were 1.13 (1.00, 1.28), 1.27 (1.02, 1.57) and 1.71 (1.35, 2.17) in men with prediabetes, previously undiagnosed diabetes and known diabetes, respectively; in women they were 1.11 (0.94, 1.30), 1.31 (1.00, 1.70) and 1.43 (1.01, 2.02), respectively. Significant increases in deaths from cancer of the stomach, colon-rectum and liver in men with prediabetes and diabetes, and deaths from cancers of the liver and pancreas in women with diabetes were also observed. In individuals without known diabetes, the HR (95% CI) for cancer mortality corresponding to a one standard deviation increase in fasting plasma glucose was 1.06 (1.02, 1.09) and in 2 h plasma glucose was 1.07 (1.03, 1.11). CONCLUSIONS/INTERPRETATION: Diabetes and prediabetes were associated with an increased risk of cancer death, particularly death from liver cancer. Mortality from all cancers rose linearly with increasing glucose concentrations.

Socio-demographic and lifestyle correlates of commuting activity in Poland.

OBJECTIVES: The aim of this study is to analyse the epidemiology of active transportation and to investigate the relationship between commuting physical activity (PA) and socio-demographic and lifestyle characteristics in Poland. METHODS: A cross sectional analysis was conducted among 7280 randomly selected individuals (3747 men and 3533 women) aged 20-74 years participating in the National Multicentre Health Survey WOBASZ (2002-2005). Socio-demographic, smoking and physical activity details were assessed by an interviewer-administered questionnaire. RESULTS: Only 36% of the participants (30% men and 42% of women) are active commuters. Moreover, 55.4% of them spend less than 15 min/day on walking or cycling. The highest risk of commuting inactivity was noticed among residents of large urban settings, with university education, the highest income and low occupational PA in both genders. Smoking and leisure-time PA were not significantly associated with commuting activity. CONCLUSIONS: Active commuting is not common in Poland. There are several differences in commuting patterns as compared with the US or Western European populations. Due to important differences between various socio-demographic groups, future interventions should be specific for the targeted subpopulations.

Work stress and health in Western European and post-communist countries: an East-West comparison study.

BACKGROUND: There is evidence that psychosocial factors at work influence the risk of poor health in Western societies, but little is known about the effect of work stress in the former communist countries. The aim of this paper is to compare the association of work stress with self-rated health in Western European and post-communist countries. METHODS: Data from four epidemiological studies were used: the HAPIEE study (Poland, Russia and the Czech Republic), the Hungarian Epidemiological Panel (Hungary), the Heinz Nixdorf Recall study (Germany) and the Whitehall II study (UK). The overall sample consisted of 18 494 male and female workers aged 35-65 years. RESULTS: High effort-reward imbalance at work was associated with poor self-rated health. The adjusted odds ratios for the highest versus lowest quartile of the effort-reward ratio were 3.8 (95% CI 1.9 to 7.7) in Hungary, 3.6 (95% CI 2.3 to 5.7) in the Czech Republic, 2.5 (95% CI 1.5 to 4.1) in the UK, 2.3 (95% CI 1.6 to 3.5) in Germany, 1.5 (95% CI 1.0 to 2.1) in Poland and 1.4 (95% CI 1.1 to 1.8) in Russia. The differences in odds ratios between countries were statistically significant (p<0.05). A similar pattern was observed for the effect of overcommitment on poor health. CONCLUSION: The association of effort-reward imbalance at work and of a high degree of work-related overcommitment with poor self-rated health was seen in all countries, but the size of the effects differed considerably. It does not appear that the effects in Eastern Europe are systematically stronger than in the West.

Epidemiology of physical inactivity in Poland: prevalence and determinants in a former communist country in socioeconomic transition.

OBJECTIVES: The aim of this study was to identify physical activity patterns and determinants of physical inactivity in a representative sample of Polish adults. STUDY DESIGN: A cross-sectional analysis of 14 769 randomly selected individuals (52.7% women and 47.3% men) aged 20-74 years participating in the National Polish Health Survey, WOBASZ (2002-2005). METHODS: Sociodemographic and lifestyle details were collected. Assessment of physical activity was based on selected questions from the CINDI Health Monitor Questionnaire. RESULTS: Approximately 35% of Polish adults are not physically active in leisure time, whilst 39.5% declare sufficient level of leisure-time physical activity. Leisure-time inactivity is significantly less likely in persons aged <35 years, those with university education and those living in rural areas. Almost 48% of men and 28.4% of women employed full- or part-time report highly active work, whilst sedentary work is reported by 42.7% of women and 30.2% of men. Low occupational activity is more prevalent in young adults, persons with university education and those living in large urban areas. Nearly 67% of the entire working population report no active commuting. CONCLUSIONS: There is a need to promote various forms of physical activity, with special attention on active commuting and leisure-time activities across both genders and all age groups. Public health policies and programmes should focus on substantial differences between various sociodemographic groups.

Childhood socioeconomic circumstances and adult height and leg length in central and eastern Europe.

BACKGROUND: Adult height and leg length have been shown to be positively associated with childhood socioeconomic circumstances in several studies in western populations. This study will determine whether similar associations are observable in settings with different social histories, and will assess whether adult leg length is more strongly associated than adult height. METHODS: Random samples of men and women aged 45-69 years were taken from population registers in Novosibirsk (Russia), Krakow (Poland) and six towns of the Czech Republic, recruiting nearly 29,000 people. Participants completed a questionnaire that included questions regarding their mother's and father's education (not available in the Czech Republic) and ownership of several household items when they were 10 years old. Participants' standing and sitting heights were measured and from these an estimate of leg length was derived. Associations between indicators of childhood socioeconomic circumstances and anthropometric measures were analysed using linear regression. RESULTS: Russian individuals were shorter and reported fewer household assets at the age of 10 years than Czech and Polish individuals. Parental education and household assets were strongly associated with each other and both were independently associated with height, leg length and trunk length. Height was associated with childhood circumstances more strongly than leg length. The associations of childhood circumstances with the leg/trunk ratio were weak and inconsistent. CONCLUSION: In these urban populations in eastern Europe, adult height is associated with childhood conditions at least as strongly as leg length.

Regional variability in the prevalence of cerebral white matter lesions: an MRI study in 9 European countries (CASCADE).

White matter lesions (WML) on MRI of the brain are common in both demented and nondemented older persons. They may be due to ischemic events and are associated with cognitive and physical impairments. It is not known whether the prevalence of these WML in the general population differs across European countries in a pattern similar to that seen for coronary heart disease. Here we report the prevalence of WML in 1,805 men and women drawn from population-based samples of 65- to 75-year-olds in ten European cohorts. Data were collected using standardized methods as a part of the multicenter study CASCADE (Cardiovascular Determinants of Dementia). Centers were grouped by region: south (Italy, Spain, France), north (Netherlands, UK, Sweden), and central (Austria, Germany, Poland). In this 10-year age stratum, 92% of the sample had some lesions, and the prevalence increased with age. The prevalence of WML was highest in the southern region, even after adjusting for differences in demographic and selected cardiovascular risk factors. Brain aging leading to disabilities will increase in the future. As a means of hypothesis generation and for health planning, further research on the geographic distribution of WML may lead to the identification of new risk factors for these lesions.

The association between psychosocial characteristics at work and problem drinking: a cross-sectional study of men in three Eastern European urban populations.

BACKGROUND: Psychosocial factors at work are thought to influence health partly through health behaviours. AIMS: To examine the association between effort-reward imbalance and job control and several alcohol related measures in three eastern European populations. METHODS: A cross-sectional study was conducted in Novosibirsk (Russia), Krakow (Poland), and Karvina (Czech Republic). The participants completed a questionnaire that included effort-reward at work, job control, and a number of sociodemographic variables. Annual alcohol intake, annual number of drinking sessions, the mean dose of alcohol per drinking session, and binge drinking (> or =80 g of ethanol in one session at least once a week) were based on graduated frequencies in the questionnaire. Data were also available on problem drinking (> or =2 positive answers on CAGE questionnaire) and negative social consequences of drinking. All male participants in full employment (n = 694) were included in the present analyses. RESULTS: After controlling for age and centre, all indices of alcohol consumption and problem drinking were associated with the effort-reward ratio. Adjustment for material deprivation did not change the results but adjustment for depressive symptoms reduced the estimated effects. Job control was not associated with any of the alcohol related outcomes. CONCLUSIONS: The imbalance of effort-reward at work is associated with increased alcohol intake and problem drinking. The association appears to be partly mediated by depressive symptoms, which might be either an antecedent or a consequence of men's drinking behaviour.

alpha-Ketoglutarate (AKG) absorption from pig intestine and plasma pharmacokinetics.

To study the absorption, metabolism and kinetics, the AKG (in different concentrations) was administered intravenously, intra-portally, orally and directly into the ileum or duodenum of pigs, chronically fitted with portal and jugular catheters and T-shaped cannula at the duodenum and ileum. Additionally, this study was conducted to determine the influence of low pH, Fe(2+) or/and SO on AKG gut absorption and conversely FeSO(4) and FeSO(4)/AKG on Fe(2+) gut absorption. It is concluded that AKG was significantly better absorbed from the upper small intestine than from the distal sections. Furthermore, low pH, Fe(2+) and/or SO ions enhanced AKG absorption. The AKG administered to the portal vein was rapidly eliminated from the blood (half-life less than 5 min). The short lifetime for AKG is probably dependent on quick metabolism in the enteorcyetes and liver. However, the prolonged half-life can be related to its low AKG blood concentration. The Fe(2+) concentrations in blood increased after FeSO(4) and FeSO(4)/AKG duodenal infusion. The implication of above observations is important for practical application of the AKG in animal and human nutrition as well in medicine.

Analysis of the relationship between total cholesterol, age, body mass index among males and females in the WHO MONICA Project.

OBJECTIVE: To explore the relationship between hypercholesterolaemia, age and BMI among females and males. DESIGN: Population-based cross-sectional survey. SUBJECTS: The data came from the initial surveys of the WHO MONICA Project. In all, 27 populations with 48 283 subjects (24 017 males and 24 266 females) aged 25-64 y were used for the analysis. MEASUREMENTS: Total cholesterol, weight, height, BMI, prevalence of hypercholesterolaemia (PHC) defined as cholesterol >/=6.5 mmol/l, and the prevalence of obesity (POB) defined as BMI >/=30 kg/m(2). RESULTS: PHC increased with age, with PHC in males being significantly higher than in females at age range 25-49 y and significantly lower than in females at age range 50-64 y. Age-related increase in hypercholesterolaemia was steeper in females than in males. There was a statistically significant positive association between hypercholesterolaemia and BMI. Multiple logistic regression analysis revealed a negative statistically significant (P<0.001) effect modification involving age and BMI on the risk of having hypercholesterolaemia both in females and males. The relation between PHC and BMI became weaker in higher age groups, with no statistically significant association in females aged 50-64 y. CONCLUSION: Public health measures should be directed at the prevention of obesity in young adults since the strongest effect of obesity on the risk of hypercholesterolaemia has been found in subjects aged 25-39 y.

Arterial hypertension in Poland in 2002.

Arterial hypertension represents a serious medical, social and economic problem in Poland. Owing to a small number of studies concerning HT epidemiology in Poland and large differences in methodology, it is difficult to make an objective verification of the changes regarding principal parameters in our country within the last decade. Important programme for the assessment of the situation in our country is NATPOL PLUS, carried out in the year 2002 on a representative sample of 3051 adult Polish residents aged between 18 and 93 years, using the current diagnostic criteria for arterial hypertension (blood pressure readings obtained at three separate visits in cases of newly detected HT, different cuff sizes for different arm circumference, age range 18-93 years, rejection of first measurement during initial screening visit). Prevalence of HT in Poland is 29%, awareness-67%, and effectiveness of treatment-12%. This means that while HT affects about 8.4 million adult Poles, only 1 million of them get effective treatment. Moreover, as much as 8.7 million Poles have high normal blood pressure and they should apply active prevention. The awareness, detection and control of hypertension is much worse in men than in women. A series of NATPOL studies indicated over the period 1994-2002 a significant and rapid decrease in the awareness of one's own blood pressure among the adult Polish population, especially in small towns and villages, among less educated people, and in males.

Contribution of drinking patterns to differences in rates of alcohol related problems between three urban populations.

OBJECTIVES: To examine, on empirical data, whether drinking patterns, in addition to overall alcohol consumption, contribute to differences in rates of alcohol related problems between populations. DESIGN: Cross sectional survey. SETTINGS: One Russian, one Polish, and one Czech city. PARTICIPANTS: 1118 men and 1125 women randomly selected from population registers. MAIN OUTCOME MEASURES: Problem drinking; negative social consequences of drinking; alcohol consumption and drinking pattern. RESULTS: Rates of problem drinking and of negative consequences of drinking were much higher in Russian men (35% and 18%, respectively) than in Czechs (19% and 10%) or Poles (14% and 8%). This contrasts with substantially lower mean annual intake of alcohol reported by Russian men (4.6 litres) than by Czech men (8.5 litres), and with low mean drinking frequency in Russia (67 drinking sessions per year, compared with 179 sessions among Czech men). However, Russians consumed the highest dose of alcohol per drinking session (means 71 g in Russians, 46 g in Czechs, and 45 g in Poles), and had the highest prevalence of binge drinking. In women, the levels of alcohol related problems and of drinking were low in all countries. In ecological and individual level analyses, indicators of binge drinking explained a substantial part of differences in rates of problem drinking and negative consequences of drinking between the three countries. CONCLUSIONS: These empirical data confirm high levels of alcohol related problems in Russia despite low volume of drinking. The binge drinking pattern partly explains this paradoxical finding. Overall alcohol consumption does not suffice as an estimate of alcohol related problems at the population level.