[The relationship between the relative length of leukocyte telomeres and mtDNA copy number and acute coronary syndrome in a 15-year follow-up.]

OBJECTIVE: to study the association of relative leukocyte DNA telomere length with death from natural causes during a 15-year follow-up in a middle-aged and elderly Siberian population. Study of the association of the relative length of leukocyte telomeres (LTL) with fatal outcomes during a 15-year follow-up of a random population sample formed in 2003-2005 (n=9 360, 45-69 years old, Novosibirsk, HAPIEE project). The main group included the persons died from natural causes (except external) without a previous history of CVD and cancer (n=609); controls were stratified by sex and age (n=799). The analysis of relative LTL at baseline was performed using quantitative real-time PCR. We estimated the odds ratio of all-cause death per 1 decile shortening of LTD as a continuous variable in a multivariable-adjusted logistic regression. The carriers of shorter telomere carriers had an increased risk of death from natural causes over the next 15 years (OR=1,37, 95% CI 1,31-1,44) per decile of LTL decrease, regardless of other factors. The risk coefficients were similar for death from CVD (1,39), cancer (1,42), and other non-external causes (1,51). In studied middle-aged and elderly Siberian (Caucasoid) population cohort the LTL was an independent inverse predictor of the 15-year risk of death from natural causes.

[Cognitive functions and modifiable risk factors for chronic non-communicable diseases in ageing in a Russian population sample.]

We aimed to investigate the relationship between the indicators of cognitive functions (CF) and modifiable risk factors for chronic non-communicable diseases (NCD) in a cross-sectional analysis in the urban Russian population sample aged 55-84 years. The study investigated a random sample of 3 153 people (men and women 55-84 years old) from a general population cohort of Novosibirsk residents; a sample was examined within the international project HAPIEE. The study protocol included standardized neuropsychological tests (quantitative assessment of memory, semantic verbal fluency, attention and processing speed) and standardized assessment of risk factors, history and treatment of cardiovascular disease and NCD. In cross-sectional analysis we observed a positive relationship of CF indices with level of education and an inverse relationship with metabolic risk factors and smoking in both sexes. The level of total cholesterol and moderate alcohol consumption had positive relationship with CF indices in women. These associations were independent from age and other factors.

[The relationship between the relative length of leukocyte telomeres and mtDNA copy number and acute coronary syndrome in a 15-year follow-up.]

We studied the relationship between the leucocyte telomere length (LTL) and the copy number of mitochondrial DNA (CNmtDNA) and the development of acute coronary syndrome during 15 years of follow-up. A random population sample was examined at baseline in 2003-2005 (n=9 360, men and women 45-69 years old, Novosibirsk, the HAPIEE project) and followed-up for 15 years. In the frame of nested case-control design, we selected cases - incident myocardial infarction/acute coronary syndrome (MI/ACS) among those free from baseline CVD (n=256) and sex- and age-stratified control among those free from baseline CVD and cancer and alive by the end of follow-up (n=799). The relative LTL and CNmtDNA were assessed using quantitative real-time PCR. Results. The carriers of shorter telomeres had increased 15-year risk of MI/ACS with adjusted OR=1,87 (95% CI 1,70-2,06) per 1 LTL decile independent of other factors. Fewer CNmtDNA was associated with increased risk of MI/ACS with adjusted OR=1,19 (95% CI 1,12-1,26) per 1 CNmtDNA decile. The identified associations were confirmed in tertile analysis and in stepwise analysis with continuous variables of both biomarkers. All associations persisted after adjusting for gender, age, and traditional CVD risk factors. Conclusion. The LTL and CNmtDNA were independent predictors of the 15-year risk of MI/ACS in the middle- and elderly Siberian (Caucasoid) population cohort. These findings highlight the need for further research to elucidate the mechanisms by which LTL and mtDNA copy number may affect human health.

[Relationship of retinal vascular caliber with age and cardiometabolic diseases in the population over 50 years of age]. / Svyaz' kalibra retinal'nykh sosudov s vozrastom i kardiometabolicheskimi zabolevaniyami v populyatsii starshe 50 let.

In an aging society, age-dependent diseases with high mortality, including cardiovascular diseases (CVD) and type 2 diabetes mellitus (DM2), occupy a special place. There is only limited population-based data on the relationship between cardiometabolic diseases and target-organ damage, including ocular microvasculature. PURPOSE: To explore the associations between the caliber of retinal vessels and cardiometabolic diseases in a population sample of men and women from middle-aged to elderly (Novosibirsk). MATERIAL AND METHODS: The subjects were participants of the Russian cohort - part of the international project HAPIEE, and were initially examined in 2003-2005 (n=9360, aged 45-69 years, Novosibirsk). At the third survey in 2015-2017, a random sub-sample of men and women (n=1011) was formed for an in-depth evaluation. We performed a calibrometric analysis involving measurement of central retinal artery equivalent (CRAE), central retinal vein equivalent (CRVE), and CRAE-to-CRVE ratio (AVR). RESULTS: In a population sample of men and women aged 55-84 years, age increment is accompanied by a decrease in the calibers of retinal arterioles and venules (p<0.001). Arterial hypertension (AH) was accompanied by a decrease in CRAE, CRVE (p=0.001) and AVR (p<0.001); the associations between AH, CRAE and AVR were independent from other factors. Multivariate analysis showed that CRAE and CRVE were inversely associated with the presence of DM2 (p=0.026). Carotid atherosclerosis was accompanied by an increase in CRVE (p<0.002); this relationship was mainly attributed to age and metabolic factors. There were no associations between carotid atherosclerosis and either CRAE or AVR. The multivariate analysis identified the weak positive associations of CRAE and AVR with the presence of ischemic heart disease and CVD. CONCLUSION: In the examined population sample aged 55-84 years, a number of associations were detected between retinal vascular caliber and cardiometabolic diseases. The observed changes in the microvascular bed of the retina may be important for prognosis of the course of common cardiometabolic diseases.

[Age-related characteristics of retinal vessels in aging (literature review).]

The changes of retinal vascular caliber and microvascular topography reflect the cumulative response to ageing, the influence of cardiovascular risk factors, inflammation, endothelial dysfunction. With objective to perform a systematic review of the studies which evaluate retinal vessels in ageing, we conducted the search of published reports (2003-2020). The review provided the evidence of narrowing of the caliber of retinal arterioles and venules in ageing; inverse relationship has been found in ethnically heterogeneous populations in a wide age range from 4th to 9th decade. The age dynamics of arteriovenous ratio (AVR) is evaluated less consistently. The available data showed the loss of complexity of the retinal microcirculatory bloodstream in elderly age, which might lead to a decrease in functional activity of microcirculation; however the studies are limited for systematic conclusions. The large population studies in Russia on this topic are practically absent. The researches of the microvascular retinal bloodstream in aging using the automatic analysis of the modern range of indicators, are relevant in the Russian population and will provide new data.

[The frequency and profile of drug treatment in subjects with dyslipidemias and cardimetabolic diseases in an urban russian population older then 55 years].

Aim      To analyze frequency and profile of the lipid-lowering therapy (LLT) in patients with dyslipidemia (DLP) and cardiometabolic diseases (CMD) in a population sample aged 55-84 years at the current time (2015-2017).Material and methods  Despite guidelines on DLP treatment and the availability of effective and safe lipid-lowering drugs, control of DPL in primary and secondary prevention of cardiovascular diseases (CVD) is insufficient. Knowledge of the level of pharmaceutical correction of DLP in the Russian population is limited; it requires an LLT assessment in various regions and in a wide age range, and a regular monitoring taking into account changing approaches to the correction of DLP. A random population of men and women aged 55-84 years (n=3 896) was evaluated in Novosibirsk in 2015-2017 (project HAPIEE). A joint DLP category was established as low-density lipoprotein cholesterol (LDL-C) ≥3.0 mmol/l, or total cholesterol (TC) ≥5.0 mmol/l, or triglycerides (TG) ≥1.7 mmol/l, or LLT. The combined group of DLP and CMD included ischemic heart disease (IHD), type 2 diabetes mellitus (DM2), and DLP. Regular LLD treatment for the recent 12 months, excluding the dosage of medicines, was assessed using the Anatomic Therapeutic Chemical (ATC) classification. The conditional control of serum lipids was taken as the achievement of LDL-C <3.0 mmol/l, TC <5.0 mmol/l, and TG <1.7 mmol/l.Results In the study sample, the total prevalence of DLP and CMD was 88 % (82.8 % for men and 91.3 % for women, p<0.001). 48.3% of patients in the IHD group, 35.0% in the DM2 group, 29.4% in the DLP group, and 32.8% in the CMD group took LLT. Control of serum lipids was achieved in 18.3% (37.9 % of patients on LLT) of patients with IHD; 9 % (25.6 % of patients on LLT) of patients with DM2; 7.3 % (24.8 % of patients on LLT) of patients with DLP; and 9.0 % (27.6 % of patients on LLTсреди) in the DLP and CMD group. Women with DM2 and DLP more frequently achieved lipid control than men (p<0.001). 98.7 % of study participants took statins as LLT.Conclusion      In the sample of urban population aged 55-84 years in 2015-2017, 90 % of patients had DLP or CMD, and at least ¾ of them required blood lipid control. The lipid control was achieved in every fifth IHD patient and in approximately 40% of those who took LLT. For DM2 or DLP patients, the lipid control was achieved in every tenth patient and in approximately 25% of those receiving LLT. Frequency of lipid control in IHD patients was comparable for men and women; in DM2 and DLP, men less frequently achieved the lipid control than women. About 70% of patients in the combined DLP and CMD group and more than 50% of IHD patients did not take LLT, which considerably contributed to the insufficient lipid control in primary and secondary prevention of atherosclerotic CVDs in this population.

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.

[The changes of left ventricular longitudinal systolic function depending on hypertension and its control: analysis in a population].

Aim To evaluate changes in left ventricular (LV) systolic function by LV myocardial global longitudinal strain (GLS) and global strain rate (GSR) in patients with arterial hypertension (AH) and based on the effectiveness of blood pressure (BP) control in a Russian population sample of individuals older than 55 years.Materials and methods This cross-sectional study was a population-based cohort study (HAPIEE, Novosibirsk). LV myocardial GLS and GSR were studied by echocardiography in a random sample (n=1004, 55-84 years). Statistical analysis was performed with multivariate models of logistic regression.Results AH prevalence in the study sample was 78.4 %. Mean GLS was 19.1 % (SD, 4.07), which was less for men than for women (p=0.001). Mean GSR was 0.86 s-1 (SD, 0.19) and was not different between men and women. In individuals with AH, the GLS absolute value was lower than in normotensive people (18.8 %; SD, 4.04 vs. 20.2 %; SD, 4.03, p˂0.001); these differences remained irrespective of the age, gender, body weight index (BWI) (p=0.027), and LV mass index (p=0.05). When people with AH were divided into groups, the lowest GLS absolute values were observed among "ineffectively treated" or not receiving any therapy individuals (p<0.001 vs. normotensive group). AH 1.6 times increased the risk of LV GLS decrease. In individuals with AH, the GSR absolute value was lower than in normotensive people (- 0.85 s-1 (SD, 0.19) vs.- 0.92 s-1 (SD, 0.18), p<0.001); this difference remained in multivariate models. The lowest GSR absolute values were observed in the "ineffectively treated" group irrespective of the gender, age, and BWI (p=0.036 vs. normotensive group). AH doubled the risk of LV GSR decrease, which could be partially explained by the contribution of BWI and myocardial mass index.Conclusion In this population sample, LV GLS and GSR were independently associated with AH. The lowest GLS and GSR values were observed for ineffectively treated" individuals with AH, which may reflect an early decline of LV systolic function with inadequate control of AH.

[C-reactive protein and its associations with сardiometabolic risk factors and echocardiographic indicators of heart failure: results of "Know your heart" study in Arkhangelsk].

Aim To evaluate the relationship between high-sensitivity C-reactive protein (hsCRP) and echocardiographic (EchoCG) indicators of heart failure (HF) among adult population of the North region of Russia.Material and methods The Know Your Heart transversal study was performed in 2015-2017 on a random sample of adult population of Arkhangelsk aged 35-69 years (n=2381). The exclusion criterion for this study was a concentration of hsCRP >10 mg/l. The group of subclinical inflammation included 686 participants with hsCRP ≥2.0 mg/l; the comparison group consisted of 1158 participants with hsCRP <2.0 mg/l. Analysis included cardiometabolic risk factors, EchoCG indexes of left ventricular (LV) systolic and diastolic function and biomarkers (NT-proBNP, hsTroponin Т, cystatin С). Linear and logistic regressions were used.Results The group with hsCRP ≥2.0 mg/l had higher rates of arterial hypertension, diabetes mellitus, HF, and myocardial infarction in history than the comparison group. The hsCRP level was independently associated with waist circumference (ß=0.379, p <0.001), male gender (ß=-0.135, p<0.001), smoking (ß=0.109, p<0.001), triglycerides (ß=0.083, p<0.001), diastolic blood pressure (ß=0.082, p<0.001), cystatin C (ß=0.082, p<0.001), glycated hemoglobin (ß=0.064, p=0.003), and low-density lipoproteins (LDL) (ß=0.049, p=0.025). Independent predictors of subclinical inflammation included older age, smoking, abdominal obesity, elevated values of LDL (>3.0 mmol/l), triglycerides (>1.7 mmol/l), and cystatin C (>1.2 mg/l). hsCRP was independently negatively associated with LV ejection fraction, left atrial volume index, ratio of early to late LV diastolic filling velocity (p=0.003, p=0.002, p=0.005, respectively), which reflected the relationship of the increased content of hsCRP with impairment of LV systolic and diastolic function. A relationship between heart remodeling indexes and hsCRP concentration was shown.Conclusion In a sample of adult population from the North region of Russia, the hsCRP concentration was independently associated with cardiometabolic risk factors and structural and functional changes in the heart detected by EchoCG, which reflects a potential contribution of inflammation to heart remodeling and development of HF.

[The profile of drug treatment in subjects aged over 50 years with hypertension in an urban russian population].

Objective To analyze a profile of hypotensive drug therapy in patients with arterial hypertension (АH) aged 55-84 in a sample of urban population at a current period of time (2015-2017).Materials and Methods AH is a leader among risk factors of cardiovascular diseases (CVD) due to its high prevalence and serious prognosis. Despite the availability of effective hypotensive drugs and guidelines on AH treatment, 50% of patients do not achieve blood pressure (BP) goals. Knowledge about drug correction of AH in the Russian population is limited to clinical studies. Taking into account changing approaches in management of patients with AH, the population-based evaluation of hypotensive treatment if relevant. A random population sample of males and females aged 55-84 (n=3.898) was evaluated in Novosibirsk in 2015-2017 (international project, Health, Alcohol and Psychosocial Factors in Eastern Europe (HAPIEE)). AH was diagnosed in presence of systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg and/or treatment with hypotensive drugs within the recent two weeks. Regular intake of medication for 12 months was evaluated with coding according to the Anatomic Therapeutic Chemical Classification System (АТХ / АТС).Results In the population sample aged 55-84, AH prevalence was 80.9 %, and 21.1 % of persons with AH did not receive drug therapy. Hypotensive medicines included (total/as a part of combination therapy) angiotensin-converting enzyme (ACE) inhibitors (42.3 % / 25.3 %), angiotensin II receptor blockers (ARBs) (30.3 % / 18.9 %), diuretics (22.6 % / 20.4 %), calcium channel blockers (20.2 % / 16.1 %), and beta-blockers (34.7 % / 27.6 %). 45.7 % of people with AH received a combination therapy. Effective BP control was achieved in 23.4 % of AH patients and in 29.6 % of patients receiving a hypotensive therapy. In the group of ineffective BP control, the proportion of females was lower, AH duration was longer, and blood glucose was higher than in the group of effective control.Conclusion In the sample of urban population aged 55-84 in 2015-2017, each fourth participant with AH and each third participant using hypotensive drugs achieved effective BP control. The therapy profile in AH patients included recommended drug classes. However, combination therapy was used insufficiently (50% of AH patients). By frequency of use, ACE inhibitors were on the first place, beta-blockers were on the second place, ARBs were on the third place, diuretics were on the fourth place, and calcium channel blockers were on the fifth place, which differed from the guidelines (the difference from the recommended priority ranking is that the drugs taking the first places in the guidelines were in fact on the 3rd and 4th places in their actual frequency of use). 20% of persons with AH did not receive hypotensive therapy, which significantly contributed to the insufficient BP control in the population.

[Prevalence of ophthalmic diseases in the population older than 50 years]. / Rasprostranennost' oftal'mologicheskikh zabolevanii v populyatsionnoi vyborke starshe 50 let.

The ageing of population is accompanied by an increase in the frequency of chronic diseases, including ophthalmic. The progression of ophthalmologic disturbances has population specificity and its analysis in Russian population is relevant. PURPOSE: To study the prevalence and age- and gender-related gradient of ophthalmic diseases (cataract, glaucoma, age-related macular degeneration, diabetic and hypertensive retinopathy) in the Russian population older than 50 years. MATERIAL AND METHODS: A random population cohort (9360, aged 45-69 years) was examined in Novosibirsk in 2003/05 and re-examined in 2015/17 (the HAPIEE project). Ophthalmological parameters were studied in a random subsample (324 m/f, aged 55-84, 2015/17). Clinical and instrumental methods were applied to assess eye diseases: cataract, glaucoma, age-related macular degeneration (AMD), diabetic retinopathy (DR), hypertensive retinopathy (HR) and other ophthalmic diseases. RESULTS: In the studied sample of men and women aged 55-84 years, the prevalence of cataract was 72.8%, AMD - 25.7%, glaucoma - 6.2%, DR - 2.1%, HR - 79.6%. The prevalence of other ophthalmic diseases (myopia, hyperopia, astigmatism, pterygium, pinguecula, dystrophy of cornea and retina, tumors and inflammatory diseases) was 13.5%. The frequency of cataract (p<0.001) and AMD (p=0.003) significantly increased with age. The frequency of glaucoma did not change substantially in the studied age range with insignificant increase in those older than 80 years (14.3%). The frequency of DR and HR were not consistently related to age. CONCLUSIONS: In the studied population sample of men and women aged 55-84 years (Novosibirsk), the prevalence of cataract and HR is high; the prevalence of AMD is similar to populations with moderate frequency of diseases; the frequency of glaucoma is close to populations with high prevalence of this disease. The frequency of cataract and AMD increased with age. There was no consistent age gradient of the frequency of glaucoma, DR and HR in the age range of 55-84 years.

[Mitochondrial DNA copy number of leucocytes as ageing marker and risk factors for age-related diseases in human.]

We used quantitative real-time PCR method to analyse mtDNA copy number in a random subsample (n=996; 358 men aged 66,31±7,24 years; 468 women aged 67,62±7,1 years) selected from a population cohort (n=9 630) examined at baseline in international project HAPIEE in Novosibirsk, Russia, in 2003-2005. The participants were re-examined after 12 years in 2015-2017. The average relative number of mtDNA copies in peripheral blood leukocytes was greater in women than in men, independently of age and smoking (p=0,001). mtDNA copy number was inversely correlated with age both in men (p=0,005) and women (p<0,001). In age adjusted analysis, mtDNA copy number was inversely associated with waist, hip and heart rate in both sexes. In addition, mtDNA copy number in women was inversely associated with triglycerides and glucose, aterogenity index and positively with HDL cholesterol. In men, mtDNA copy number was positively associated with physical activity. The age-adjusted mean of mtDNA copy number among male never-smokers was greater than in smokers (p=0,003), and the mean mtDNA copy number was lower in women with diabetes than in women without diabetes (p=0,005). In both sexes, subjects with baseline history of hypertension had lower mtDNA copy number after 12-year follow-up than those without hypertension (p=0,05). This broadly supports the hypothesis that mtDNA copy number may act as biomarker of ageing.

[Length telomere leukocytes as ageing markers and risk factors for age-related diseases in humans].

The purpose of the research was studying of leukocyte telomere length association with age, sex, risk factors for age-related diseases in Russian people of pre-retirement and retirement age. By quantitative real-time PCR method we studied the leukocyte telomere length in 398 men (56,3±7,2 years) and 365 women (56,6±7,1 years) selected from a population sample of 45-69 year-old residents of the Oktyabrsky and Kirovsky districts of Novosibirsk (9 400 people). The selection was formed in the course of work on the international project HAPIEE. As a result, an inverse correlation of telomere length with age (r=-0,159, р<0,001), with the ratio waist / hips (r=-0,107, p=0,003) was found out. The average length of telomeres in women significantly more than in men, p=0,031.The correlation of telomere length in males with weight (r=0,140, p=0,005), waist size (r=0,111, p=0,027) was found out. In women, there is an inverse correlation of telomere length with a waist size (r=-0,127, p=0,015), the ratio of waist / hips (r=-0,141, p=0,007). The length of telomeres is an inverse correlation with correlation with quantity of the cigarettes smoked (r=-0,121, р=0,024). The length of telomeres leukocytes correlates with age, smoking, and a number of phenotypical signs. In men with the family anamnesis burdened by malignancies leucocytes telomere length was found to be greater than in men without such anamnesis.

[Effects of DNA quality on the measurement of telomere length].

Existing evidence on the association of telomere length with life expectancy and the risk of various age related diseases is discordant. This inconsistency in the data may be due to methodological factors, e.g., the differences in the techniques for measuring telomere length, cell harvesting, DNA isolation, and material. One of the general requirements to experiments concerned with the measurement of telomere length is the high quality of DNA samples under study. The current review considers the most common errors during the measurement of telomere length associated with the improper quality of the biological material.

[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.

[Population-level changes to promote cardiovascular health]. / Zmeny na úrovni populace zamerené na podporu kardiovaskulárního zdraví

BACKGROUND: Cardiovascular diseases (CVD) cause 1.8 million premature (<75 years) death annually in Europe. The majority of these deaths are preventable with the most efficient and cost-effective approach being on the population level. The aim of this position paper is to assist authorities in selecting the most adequate management strategies to prevent CVD. DESIGN AND METHODS: Experts reviewed and summarized the published evidence on the major modifiable CVD risk factors: food, physical inactivity, smoking, and alcohol. Population-based preventive strategies focus on fiscal measures (e.g. taxation), national and regional policies (e.g. smoke-free legislation), and environmental changes (e.g. availability of alcohol). RESULTS: Food is a complex area, but several strategies can be effective in increasing fruit and vegetables and lowering intake of salt, saturated fat, trans-fats, and free sugars. Tobacco and alcohol can be regulated mainly by fiscal measures and national policies, but local availability also plays a role. Changes in national policies and the built environment will integrate physical activity into daily life. CONCLUSION: Societal changes and commercial influences have led to the present unhealthy environment, in which default option in life style increases CVD risk. A challenge for both central and local authorities is, therefore, to ensure healthier defaults. This position paper summarizes the evidence and recommends a number of structural strategies at international, national, and regional levels that in combination can substantially reduce CVD.

Verification of Single Nucleotide Polymorphisms rs34554140, rs6670279, and rs6874185 as Novel Molecular Genetic Markers of Sudden Cardiac Death.

The aim of the study was to explore the association between sudden cardiac death (SCD) and single nucleotide polymorphisms (SNPs) rs34554140, rs6670279, and rs6874185 from the list of potential molecular genetic markers of SCD, obtained in our earlier genome-wide allelotyping on pooled DNA samples. Materials and Methods: The study is based on the case-control principle. The SCD group included 438 deceased residents of Novosibirsk (average age - 53.2±9.1 years; men - 72.7%, women - 28.3%) with the main postmortem diagnoses of acute circulatory failure or acute coronary failure, which met the criteria of SCD established by the European Society of Cardiology. The control group included 435 live subjects enrolled in the international projects HAPIEE and MONICA (average age - 53.2±8.9 years; men - 70.0%, women - 30.0%). DNA was isolated by phenol-chloroform extraction from the myocardial tissue in the SCD group and from the venous blood in the control group. Genotyping was performed by polymerase chain reaction with subsequent analysis of restriction fragment length polymorphism in a polyacrylamide gel. Results: The frequencies of the genotypes of SNPs rs34554140, rs6670279, and rs6874185 in the control group correspond to those predicted by the Hardy-Weinberg equilibrium (c2=0.98, 0.009, 3.39, respectively). The AA genotype of rs34554140 is associated with an increased risk of SCD (p=0.002; OR=1.85; 95% CI 1.26-2.71). The AT genotype has a protective effect against SCD (p=0.001; OR=0.53; 95% CI 0.36-0.78). In subgroups separated by gender and age, the differences persist in the subgroups of men, women, and individuals under 50 years old (p<0.05). The AA genotype of rs6670279 is associated with an increased risk of SCD (p=0.005; OR=1.54; 95% CI 1.15-2.06). The AT genotype has a protective effect against SCD (p=0.047; OR=0.73; 95% CI 0.54-0.98). When distributed by sex and age, the differences persist in the subgroups of men, individuals above 50 years old, and men above 50 years old (p<0.05). There were no significant differences in the frequencies of genotypes and alleles of rs6874185 between the SCD and control groups, even after the subgroups specified by gender and age were compared (p>0.05). Conclusion: The association of single nucleotide polymorphisms rs34554140 and rs6670279 with SCD was confirmed. In contrast, no association of rs6874185 with SCD was detected.

[Erratum: The forearm fractures in patients with diabetes and without diabetes in population sample aged over 50 years (Novosibirsk) (Problems of Endocrinology (2019) 65(2) DOI: 10.14341/probl9799)].

A corrigendum on the article The forearm fractures in patients with diabetes and without diabetes in population sample aged over 50 years (Novosibirsk) by E.S. Mazurenko, S.K. Malyutina, L.V. Shcherbakova, S.V. Mustafina, T.M. Nikitenko, M. Bobak, O.D. Rymar (2018). Problems of Endocrinology 65(2). doi: 10.14341/probl9799 There was an error on the page 84 in the Table 4: symbol greater than or equal to was confuse with lower than in the table raw for menopause; symbol lower than or equal to was confuse with greater than in the table raw for total cholesterol level. The authors and editors apologize for this error. The original article has been updated.

[The forearm fractures in patients with diabetes and without diabetes in population sample aged over 50 years (Novosibirsk)].

BACKGROUND: The attention to the forearm fractures, as to osteoporotic fractures, is important for ensuring early detection of individuals at increased risk of future fractures and taking preventive measures. AIMS: To determine the frequency of a history of forearm fractures in patients with type 2 diabetes mellitus (DM2) and without diabetes, and their association with risk factors for chronic non-communicable diseases (NCD). MATERIAL AND METHODS: In 2015-2017, in Novosibirsk, a random urban population sample of males and females, 58-84 years old (n=3878), was surveyed. The study included persons who signed the informed consent to conduct the study, excluded individuals who wrote a waiver of taking blood to determine biochemical parameters. In total, the analysis included n=3393 people, 718 of them with DM2 (21.2%). Work design is cross-sectional research. The collection of information on fractures during for the last 3 years, the registration of socio-demographic data; and risk factors for NCD, a study of biochemical blood parameters. The analysis of the association of DM2 and a complex of risk factors for NCD with a chance of a forearm fracture. RESULTS: The prevalence of forearm fractures in the last 3 years did not differ in patients with DM2 compared with those examined without diabetes and was 2.4% and 2.8%, respectively (p=0.557). Men with fractures had higher cholesterol and HDL values, women had lower body mass index (BMI), compared with people without fractures. According to the results of a multivariate analysis in women, the chance of a forearm fracture is directly associated with smoking in the past, a total cholesterol level of more than 200 mg/dl and inversely associated with a BMI. In men, associations were found of the chance of a forearm fracture with an increase in the level of cholesterol. There was no evidence of DM2 with forearm fracture. CONCLUSION: The obtained data on the incidence of fractures and their association with risk factors for chronic low risk infections suggest the need for preventive measures for osteoporotic fractures, both in people with and without DM2.

The Relationship between Body Mass Index and 10-Year Trajectories of Physical Functioning in Middle-Aged and Older Russians: Prospective Results of the Russian HAPIEE Study.

OBJECTIVE: To investigate the associations of overweight and obesity with longitudinal decline in physical functioning (PF) among middle-aged and older Russians. DESIGN: Prospective cohort study. SETTING: Four rounds of data collection in the Russian Health, Alcohol and Psychosocial factors In Eastern Europe study with up to 10 years of follow-up. PARTICIPANTS: 9,222 men and women aged 45-69 years randomly selected from the population of two districts of Novosibirsk, Russia. MEASUREMENTS: PF score (range 0-100) was measured by the Physical Functioning Subscale (PF-10) of the 36-item Short Form Health Survey (SF-36) at baseline and three subsequent occasions. Body mass index (BMI), derived from objectively measured body height and weight at baseline, was classified into normal weight (BMI 18.5-24.9), overweight (BMI 25.0-29.9), obesity class I (BMI 30.0-34.9), and obesity class II+ (BMI≥35.0). RESULTS: The mean annual decline in the PF score during the follow-up was -1.92 (95% confidence interval -2.17; -1.68) in men and -1.91 (-2.13; -1.68) in women. At baseline, compared with normal weight, obesity classes I and II+ (but not overweight) were associated with significantly lower PF in both sexes. In prospective analyses, the decline in PF was faster in overweight men (difference from normal weight subjects -0.38 [-0.63; -0.14]), class I obese men and women (-0.49 [-0.82; -0.17] and -0.44 [-0.73; -0.15] respectively) and class II+ obese men and women (-1.13 [-1.73; -0.53] and -0.43 [-0.77; -0.09] respectively). Adjustment for physical activity and other covariates did not materially change the results. CONCLUSIONS: PF decreased more rapidly in obese men and women than among those with normal weight. The adverse effect of high BMI on PF trajectories appeared to be more pronounced in men than in women, making more extremely obese Russian men an important target population to prevent/slow down the process of decline in PF.