Prevalence of metabolic syndrome and related metabolic traits in an island population of the Adriatic.

BACKGROUND: Metabolic syndrome, a constellation of risk factors associated with cardiovascular disease and Type 2 diabetes, has reached epidemic proportions worldwide. Epidemiological studies in transitional societies will provide insight into the underlying factors that interact in its manifestation. AIMS: To estimate the prevalence of metabolic syndrome, provide a comparative analysis of two metabolic syndrome definitions and assess clustering and association of metabolic traits and cardiovascular diseases in an Adriatic island population. SUBJECTS AND METHODS: In a cross-sectional study, data on four anthropometric, blood pressure and 11 biochemical traits were obtained from 1430 adults from the island of Hvar. RESULTS: Prevalence of metabolic syndrome was 25% and 38.5% based on Adult Treatment Panel III and International Diabetes Federation definitions, respectively. Rates of abdominal obesity, elevated blood glucose and hypertension were high. Among the traits not included in the definitions, levels of LDL, total cholesterol and fibrinogen were markedly elevated. The majority of the phenotypes were significantly associated with the syndrome, the strongest being waist circumference. CONCLUSION: The Croatian islanders are characterized by a high prevalence of metabolic abnormalities. Central obesity is the strongest contributor of the syndrome. With a high prevalence of dyslipidemia and pro-inflammatory factors, the population is at substantial risk for cardiovascular diseases.

Inbreeding and nephrolithiasis in Croatian island isolates.

The aim of this study was to investigate a recessive genetic component in susceptibility to nephrolithiasis (NL) by comparing its prevalence in highly inbred, moderately inbred and non-inbred villages of three Croatian islands: Brac, Hvar and Korcula. The average inbreeding coefficient of each village population (F) was estimated in a random sample of 20-30% adults from 14 villages using Wright's path method (based on genealogical information), isonymy data and average deviation from Hardy-Weinberg expectations for MN, Ss and Kk serogenetic polymorphisms. The six villages with the greatest genealogical F value (0.025-0.049; current total population N=1,401), the four with intermediate value (0.012-0.015; N=998) and the four with the smallest value (0.002-0.008; N=1,500) were chosen for this study. Medical records of entire populations were reviewed and the diagnosis of NL was established according to unified criteria, based on the information from the specialists in general hospitals and on the agreement in diagnosis between the investigators and local general practitioners. The variance in environmental and socio-cultural factors between villages was shown to be minimal. Prevalence of NL in each village was standardised by sex and age to the total population of all 14 villages. The standardized prevalence of NL was 1.5% in the group of villages with low F, 2.3% in the group with moderate F (p<0.10), and 5.4% in the group with high F (p<0.001). The correlation factor between F values by villages and the standardized prevalence of NL was 0.45 (p<0.05). The study showed that a large number of predominantly recessive genetic factors might mediate the susceptibility to formation of renal stones in humans.

Inbreeding and learning disability in Croatian island isolates.

The aim of this study was to investigate the prevalence of learning disability (LD) in isolate populations with different inbreeding coefficients (F). Prevalence of LD and F were determined in 10 villages from five Croatian islands: Brac, Hvar, Korcula, Lastovo and Susak. For the purpose of this study, LD was defined as the inability to attend the public school system. As the elementary schools (grade 1-8) in the place of the study are both public and compulsory, the assessment of child's inability to attend the school is performed at the age of six. This is required by all children in the country based on standard set of tests of cognitive performance defined by the Ministry of Education and Culture of the Republic of Croatia. The average inbreeding coefficients in each village population (F) were estimated in a random sample of 20-30% adults in each of the 10 villages based on 4 ancestral generations and using Wright's path method. Prevalence of LD ranged from 0.43% to 2.47%, and the inbreeding coefficients ranged from 0.8% to 4.9%. The Pearson's correlation coefficient between F and LD prevalence was 0.80 (p < 0.01). Although the relative risk per 5% inbreeding appeared very high (about 10), the absolute risk only increased from 0.18% to 1.77%. The genetic effect of inbreeding (GEI) was approximately 0.69% and the population-attributable fraction 76.6%. A review of the literature and the results of this study lead to a conclusion that a very large number of predominantly recessive genetic factors might mediate the genetic susceptibility to various forms of LD in these populations.

Prevalence of antibodies to IBR and BVD viruses in dairy cows with reproductive disorders.

We determined the prevalence of antibodies to infectious bovine rhinotracheitis virus (IBRV) and bovine viral diarrhea virus (BVDV) in sera of dairy cows on 4 different farms in the Republic of Croatia. A high percentage (60.8%) of cows had various reproductive disorders. The results showed that seroprevalence of infectious bovine rhinotracheitis (IBR) was 85.8% and that of bovine viral diarrhea (BVD) was 79.2% in tested cows. Antibodies to both viruses were found in 80.8% of cows with reproductive disorders but in only 46.8% of cows without reproductive disorders. This difference was statistically significant (P<0.01), and indicated a connection between reproductive disorders and simultaneous infections with IBR and BVD viruses in dairy cows.

Differences between male and female breast cancer. II. Clinicopathologic features.

The aim of this study was direct comparison of clinicopathologic features in male and female breast cancer patients. The study included 100 male and 500 female patients with pathohistologically confirmed breast cancer, who were treated at the University Hospital for Tumors in Zagreb, Croatia, between 1970 and 1990. The results revealed significant sex-related differences in the following characteristics: patients age at diagnosis (36% vs. 66% below the age of 60, respectively, p < 0.001), delay in treatment (29% vs. 58% within the first 3 months, p < 0.001), tumor size (45% vs. 58% up to 5 cm, p < 0.001), number of affected regional lymph nodes (74% vs. 87% up to 5 nodes, p < 0.01), TNM-stage distribution (49% vs. 56% in stages I-II, p < 0.001), estrogen receptor values (69% vs. 32% > 10 fmol/mg protein, p < 0.001) and progesterone receptor values (67% vs. 48% > 10 fmol/mg protein, p < 0.05). No significant sex-related differences in breast cancer patients were found regarding histologic grade of malignancy (males: grade I-36%; II-34%; III-30%; females: grade I-33%; II-36%; III-31%), affected breast (left in 58% males vs. 50% females), and type of surgical treatment (modified radical mastectomy in 64% male vs. 61% female patients). This study confirmed the well-known facts that male breast cancer develops at an older age and with a much higher proportion of positive tumor hormone receptors. Furthermore, the authors found the male patients in Croatia to be insufficiently informed about the possibility of breast cancer development in male sex, which resulted in a significantly prolonged treatment delay and, consequently, higher TNM stage of the disease, bigger tumors and more affected lymph nodes at the time of diagnosis in comparison to female patients.

Differences between male and female breast cancer. III. Prognostic features.

The aim of this study was direct comparison of prognostic features in male and female breast cancer patients. The study included 100 male and 500 female patients with pathohistologically confirmed breast cancer, who were treated at the University Hospital for Tumors in Zagreb, Croatia, between 1970 and 1990. Stage-adjusted univariate analysis of differences in five-year overall survival revealed similar prognosis in both sexes when the disease was in TNM-stages I and II (males: 95% and 80%; females: 90% and 79%, respectively). However, the study showed that in TNM stages III and IV, male patients had a significantly worse five-year overall survival (males: 39% and 5%; females: 61% and 27%, respectively; p < 0.05). The impact of ten clinicopathologic characteristics on survival in males and females was also analyzed through the multivariate statistical analysis, in this case by multiple regression. Analyzed characteristics included patient age at diagnosis, delay in treatment, tumor size, number of affected lymph nodes, TNM-stage, histologic grade, affected breast, estrogen and progesterone receptor values, and type of surgery. An extremely intriguing finding was that the percent of survival variance explained by ten selected predictors (R2) amounted to as much as 78.7% in males, in comparison to only 23.1% in females. Three predictors that explained most of the survival variance in males were TNM-stage (21.0%), number of affected lymph nodes (19.5%) and delay in treatment (16.2%). The most important corresponding prognostic factors in females were number of affected lymph nodes (12.7%), histologic grade (6.6%) and tumor size (5.9%). The authors concluded that, from the prognostic point of view, male and female breast cancer represent two quite different diseases: in males, the outcome can be very precisely predicted from the basic clinicopathologic characteristics of the disease, while in females there is probably a wide spectrum of other factors with a significant influence on the prognosis, which require additional studies.

A comparison of rectal palpation and ultrasonography for the evaluation of superovulatory response in beef heifers.

The superovulatory response was followed up in 14 beef heifers by rectal palpation and by ultrasonographic examinations of the 28 ovaries, on day 7 after superovulation induced with PMSG (ovulation = day 0). Using a B-mode ultrasound instrument (Aloka Echo Camera SSD-210-DX II) equipped with a 5 MHz linear transrectal transducer, ultrasonography was found to be more reliable than rectal palpation. A significantly higher number of follicles (P < or = 0.049) was identified by ultrasound scanning than by rectal palpation of the ovaries: follicles were more easily differentiated from cysts using ultrasonography, since each fluid-filled vesicle was accurately measured on the screen and presented on the echogram.