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Pavlovska I, Polcrova A, Mechanick JI, Brož J, Infante-Garcia MM, Nieto-Martínez R, Maranhao Neto GA, Kunzova S, Skladana M, Novotny JS, Pikhart H, Urbanová J, Stokin GB, Medina-Inojosa JR, Vysoky R, González-Rivas JP. Dysglycemia and Abnormal Adiposity Drivers of Cardiometabolic-Based Chronic Disease in the Czech Population: Biological, Behavioral, and Cultural/Social Determinants of Health. Nutrients 2021; 13:nu13072338. [PMID: 34371848 PMCID: PMC8308692 DOI: 10.3390/nu13072338] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 06/28/2021] [Accepted: 07/05/2021] [Indexed: 12/12/2022] Open
Abstract
In contrast to the decreasing burden related to cardiovascular disease (CVD), the burden related to dysglycemia and adiposity complications is increasing in Czechia, and local drivers must be identified. A comprehensive literature review was performed to evaluate biological, behavioral, and environmental drivers of dysglycemia and abnormal adiposity in Czechia. Additionally, the structure of the Czech healthcare system was described. The prevalence of obesity in men and diabetes in both sexes has been increasing over the past 30 years. Possible reasons include the Eastern European eating pattern, high prevalence of physical inactivity and health illiteracy, education, and income-related health inequalities. Despite the advanced healthcare system based on the compulsory insurance model with free-for-service healthcare and a wide range of health-promoting initiatives, more effective strategies to tackle the adiposity/dysglycemia are needed. In conclusion, the disease burden related to dysglycemia and adiposity in Czechia remains high but is not translated into greater CVD. This discordant relationship likely depends more on other factors, such as improvements in dyslipidemia and hypertension control. A reconceptualization of abnormal adiposity and dysglycemia into a more actionable cardiometabolic-based chronic disease model is needed to improve the approach to these conditions. This review can serve as a platform to investigate causal mechanisms and secure effective management of cardiometabolic-based chronic disease.
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Affiliation(s)
- Iuliia Pavlovska
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
- Department of Public Health, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic;
- Correspondence: ; Tel.: +4-207-770-90433
| | - Anna Polcrova
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
- Research Centre for Toxic Compounds in the Environment (RECETOX), Masaryk University, 62500 Brno, Czech Republic;
| | - Jeffrey I. Mechanick
- The Marie-Josée and Henry R. Kravis Center for Cardiovascular Health at Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
- Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Jan Brož
- Department of Internal Medicine, Charles University Second Faculty of Medicine, 10506 Prague, Czech Republic;
| | - Maria M. Infante-Garcia
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Barquisimeto 3001, Lara, Venezuela;
| | - Ramfis Nieto-Martínez
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Barquisimeto 3001, Lara, Venezuela;
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Harvard University, Boston, MA 02115, USA
- LifeDoc Health, Memphis, TN 38119, USA
| | - Geraldo A. Maranhao Neto
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
| | - Sarka Kunzova
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
| | - Maria Skladana
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
- Second Department of Internal Medicine, St. Anne’s University Hospital in Brno and Faculty of Medicine, Masaryk University, 65691 Brno, Czech Republic
| | - Jan S. Novotny
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
| | - Hynek Pikhart
- Research Centre for Toxic Compounds in the Environment (RECETOX), Masaryk University, 62500 Brno, Czech Republic;
- Department of Epidemiology and Public Health, University College London, London WC1E6BT, UK
| | - Jana Urbanová
- Center for Research in Diabetes, Metabolism and Nutrition, Second Department of Internal Medicine, Third Faculty of Medicine, University Hospital Královské Vinohrady, 10000 Prague, Czech Republic;
| | - Gorazd B. Stokin
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
| | - Jose R. Medina-Inojosa
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA;
- Marriott Heart Disease Research Program, Mayo Clinic, Rochester, MN 55905, USA
| | - Robert Vysoky
- Department of Public Health, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic;
- Department of Health Support, Faculty of Sport Studies, Masaryk University, 62500 Brno, Czech Republic
| | - Juan P. González-Rivas
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Barquisimeto 3001, Lara, Venezuela;
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Harvard University, Boston, MA 02115, USA
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Rambousková J, Krsková A, Slavíková M, Cejchanová M, Cerná M. Blood levels of lead, cadmium, and mercury in the elderly living in institutionalized care in the Czech Republic. Exp Gerontol 2014; 58:8-13. [PMID: 25016213 DOI: 10.1016/j.exger.2014.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Revised: 07/04/2014] [Accepted: 07/08/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND There is limited research examining the chemical load of toxic metals in the elderly. The aim of the present study was two-fold: to determine the body burden of lead, cadmium and mercury in association with age, gender, locality, lifestyle factors and potential health impacts among this population and to compare the values with blood values from the general Czech population aged 18-64 years. METHODS Lead, cadmium and mercury were examined in the blood of institutionalized senior citizens (46 males, 151 females aged 61-100 years) from two localities in the Czech Republic (Prague and Teplice) from 2009 through 2011. Measurements were made using inductively coupled plasma mass spectrometry (Pb, Cd) and a single purpose spectrometer AMA 254 (Hg). RESULTS Geometric means (GM) of whole blood lead (B-Pb), cadmium (B-Cd) and mercury (B-Hg) levels were 25.3μg/l, 0.55μg/l and 0.21μg/l, respectively. No age-related differences were found for B-Pb and B-Cd levels but a negative correlation with age was observed for B-Hg levels (p=0.04). B-Pb levels in men were significantly higher than in women (GM 29.9μg/l vs. 24.1μg/l). B-Cd was significantly higher in women (GM 0.57μg/l) than in men (0.50μg/l) (p=0.007) and in smokers (GM 1.29μg/l) than in nonsmokers (GM 0.53μg/l) (p=<0.001) and in seniors from Prague (GM 0.60μg/l) compared to those from Teplice (GM 0.43μg/l) (p=<0.001). Seniors with a history of chronic kidney disease, stroke and those using psycho-pharmaceuticals had higher B-Pb levels (p=0.008, 0.04 and 0.05, resp.), seniors diagnosed with atherosclerosis had higher B-Cd levels (p=0.002) and seniors using psycho-pharmaceuticals had higher B-Hg levels (p=0.07). B-Hg levels were also positively correlated with blood albumin levels (p=0.015). CONCLUSIONS This study provides data on levels of heavy metals in a group of elderly people. Such information is very scarce. Associations with diseases should be the subject of further investigation.
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Affiliation(s)
- Jolana Rambousková
- Centre for Research of Diabetes, Metabolism and Nutrition, Department of Nutrition, Third Faculty of Medicine, Charles University in Prague, Ruská 87, 100 00 Prague 10, Czech Republic.
| | - Andrea Krsková
- Environmental and Population Health Monitoring, National Institute of Public Health, Šrobárova 48, 100 42 Prague 10, Czech Republic
| | - Miroslava Slavíková
- Centre for Research of Diabetes, Metabolism and Nutrition, Department of Nutrition, Third Faculty of Medicine, Charles University in Prague, Ruská 87, 100 00 Prague 10, Czech Republic
| | - Mája Cejchanová
- Environmental and Population Health Monitoring, National Institute of Public Health, Šrobárova 48, 100 42 Prague 10, Czech Republic
| | - Milena Cerná
- Environmental and Population Health Monitoring, National Institute of Public Health, Šrobárova 48, 100 42 Prague 10, Czech Republic; Department of General Hygiene, Third Faculty of Medicine, Charles University in Prague, Ruská 87, 100 00 Prague 10, Czech Republic
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Trace elements in the blood of institutionalized elderly in the Czech Republic. Arch Gerontol Geriatr 2012; 56:389-94. [PMID: 23245729 DOI: 10.1016/j.archger.2012.11.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Revised: 10/31/2012] [Accepted: 11/03/2012] [Indexed: 11/23/2022]
Abstract
Whole blood selenium, copper, zinc and manganese concentrations of 197 institutionalized senior citizens (46 males, 151 females) aged 61-100 years (mean age 83.6 years) were determined using atomic absorption spectrometry and inductively coupled plasma mass spectrometry from two localities in the Czech Republic (Prague and Teplice) from 2009 through 2011. Geometric means (GM) of whole blood selenium (B-Se), copper (B-Cu), zinc (B-Zn) and manganese (B-Mn) levels were 74.0 μg/l, 941.0 μg/l, 5898.0 μg/l and 10.9 μg/l, respectively. Gender-related differences were found with significantly higher B-Cu levels in women and significantly higher B-Zn levels in men. The percentage of seniors with B-Se levels lower than 56 μg/l (which is equivalent to the critical value of 45 μg/l of Se in serum (S-Se)) was 8.6%. A negative correlation between age and B-Se levels was found. B-Zn positively correlated with serum albumin and prealbumin whereas a negative correlation between age and B-Zn was observed. Seniors with diabetes mellitus and atherosclerosis had higher B-Cu and B-Mn levels, respectively, than those without these diagnoses. The elderly from Prague had significantly higher B-Mn concentrations than those from Teplice. We found no evidence of serious essential elements deficiencies or excesses in the seniors who participated in this study.
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