[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.

[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.

[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.

METABOLIC SYNDROME AND RISK OF STROKE IN THE POPULATION OF NOVOSIBIRSK

Aim.To explore the association between Metabolic Syndrome (MS) and risk of stroke in Novosibirsk citizens aged 45–69 years.

Material and methods.As a part of an international prospective cohort HAPIEE study the population sample of 9363 residents of Novosibirsk aged 45–69 years were surveyed by screening method.

Results.A high prevalence of metabolic disorders in the population was revealed; the levels and distribution of cardiometabolic factors in first-ever stroke examined. It was found by the “case-control” study, that the combination of hypertension and abdominal obesity (AO) increases the odds ratio (OR) for stroke in the population studied.

Conclusion.It was shown to 2-fold increase in the risk of stroke in people with MS by 9-year prospective observation. Prognostic models of combining components of MS affecting the OR of stroke were identified in an urban population of Siberia.

WAIST CIRCUMFERENCE AS INDICATOR COMPONENTS OF METABOLIC SYNDROME IN THE SIBERIAN POPULATION

Object of research: to determine the cut-off point of waist circumference (WC) identify the components of metabolic syndrome (MS) in a large industrial center of Western Siberia.In the period from 2003 to 2005 in the screening population surveyed 9362 people, including 4268 men (45.6%) and 5094 women (54.4%).The response rate was 61%. The study protocol included a sociodemographic data, measurement of blood pressure (BP), anthropometry (height, weight, WC), the definition of biochemical parameters. Statistical analysis was performed using the package SPSS. To determine the cut-off points of the used ROC model.In the group with ≥2 components of MS cut-off point WC from the men was 93.3 cm (sensitivity 72%, specificity 83%), women – 90.2 cm (sensitivity 72%, specificity 62%).The lowest cut-off point WC marked BP ≥ 130/85 mm Hg for men – 90 cm (sensitivity 66.8%, specificity 58.1%), for women – 86.5 cm (sensitivity 71.0%, specificity 55.7%). The highest cut-off point from the defined patients with diabetes for men was 99.0 cm (sensitivity 61%, specificity 70.2%), for women – cm (sensitivity 64.1%, specificity 65.9%).Conclusions: Cut-off point from the persons with the presence of ≥2 MS components in Siberian population 45–69 years, in accordance with the ROC analysis are 93.3 cm for men and 90.2 cm for women. The lowest cut-off point WC marked BP ≥ 130/85 mm Hg for men – 90 cm, for women – 86.5 cm. The highest cut-off point from the defined patients with diabetes for men was 99.0 cm, for women – 95 cm.

Comparative assessment of cardiometabolic risk factor role in high-stress occupations

Aim. To investigate the components of metabolic syndrome (MS) and to evaluate the role of cardiometabolic risk factors (RFs) in high-stress vs. low-stress occupations, in order to enable early diagnostics of the most important factors. Material and methods. In total, 299 men were examined (mean age 43,25±7,75 years). Group I worked as train drivers (n=185), while Group II included railway track workers (n=114). All participants underwent clinical examination, measurement of body mass index, waist circumference (WC), office blood pressure (BP), blood glucose, and lipid profile. MS was diagnosed according to the criteria by IDF (2005), ATP III (2005), and the Society of Cardiology of the Russian Federation (2009). Results. Group I, compared to Group II, demonstrated higher prevalence (p<0,05) of smoking (+22%); abdominal obesity (AO), as denoted by WC ≥94 cm (+28%) or WC 94-102 cm (+16%); elevated systolic BP, SBP (+36%); total cholesterol, TCH (+12%) and very low density lipoprotein cholesterol, VLDL-CH (+16%). The most prevalent combination of MS components among individuals in a high-stress occupation was AH and AO. In Group I, MS prevalence ranged from 30% to 49% (p<0,05) and was 2,5-2,7 times higher than in Group II (p<0,001). Conclusion. Individuals in high-stress occupations demonstrated high prevalence of cardiometabolic RFs and MS. Based on strict MS criteria, early preventive measures among people in high-stress occupations should target individuals with WC 94-102 cm combined with other cardiovascular RFs.

DIABETES MELLITUS AND METABOLIC SYNDROME IN SIBERIA AND IN THE FAR EAST

In Siberia and in the Far East region overall incidence of diabetes mellitus is somewhat lower than in the European part of the country, though these indices reduplicate on average in 10-15 years. The prevalence of both diabetes (both types) and metabolic syndrome among indigenous mongoloid population is lower than among Caucasian.

[Risk of gastric cancer dependent on serological markers of atrophic gastritis: cohort study]

In a prospective study the risk of subsequent gastric cancer (GC) was assessed in persons aged 45-69 over 5 years after the initial testing with a set of serological tests (pepsinogen I, pepsinogen II, gastrin-17, antibodies to Helicobacter pylori). The presence of gastric atrophy markers was a significant predictor of GC in the forthcoming years. Non-invasive techniques may be used in the formation of high-risk groups, followed by GC active surveillance.

[Diabetes mellitus and metabolic syndrome in Siberia and in the Far East]

In Siberia and in the Far East region overall incidence of diabetes mellitus is somewhat lower than in the European part of the country, though these indices reduplicate on average in 10-15 years. The prevalence of both diabetes (both types) and metabolic syndrome among indigenous mongoloid population is lower than among Caucasian.

[Quality of life at dyspepsia and irritable bowel syndrome: population-based studies]

The aims of the study were to examine the prevalence of dyspepsia and irritable bowel syndrome (IBS) in the unselected population and to assess the quality of life (QOL) in these syndromes and their combination. The study involved 1,040 people, representing a random sample of adults aged 45-70 years (492 men, 548 women). To identify gastrointestinal symptoms using validated questionnaire, dyspepsia and IBS were diagnosed by Rome I criteria. QOL was assessed using a questionnaire SF-36. Dyspepsia was reported by 37.5% (30.1% men and 44.2% women, p < 0.001). The prevalence of IBS was 18.8% (12.0% men and 25,0% in women, p < 0.001). The combination of dyspepsia and IBS was noted in 12.0% (6.5% in men and 17.0% in women). Both dyspepsia and IBS cause significant decrease in QOL on most scales of the questionnaire SF-36 compared with those without these disorders. Their combination reduced QOL even more in comparison with isolated dyspepsia or IBS. Finally, high prevalence of dyspepsia and IBS was stated among the population, both conditions more frequently observed in women. QOL is significantly reduced in subjects with dyspepsia and IBS, especially if these syndromes combine.

[Professional stress and development of stress-induced hypertension]

to elucidate rates of development of arterial hypertension (AH) at working place (wp), risk factors of cardiovascular diseases (CVD), anxiety depressive disorders in persons with professional stress. We carried out monitoring of arterial pressure during working hours and hours of rest, assessed risk factors of CVD development, and evaluated severity of symptoms of anxiety and depression using the Hamilton scale in 138 men (mean age 40.0+/-1.2 years). Results of the study evidenced for high frequency (46.4%) of development of AHwp among representatives of stressful occupations. Patients with AHwp have risk factors of CVD development and total coronary risk comparable with those of patients with hypertensive disease. Patients with AH have more pronounced anxiety depressive disorders than healthy subjects.

Association of haplotypes of interleukin-10 gene with the risk of cancer

Polymorphisms of promotor region of IL-8, IL-10, and IL-12 genes were analyzed in cancer patients and subjects without history of cancer. The distribution of alleles of the analyzed polymorphisms in the control group coincided with that in other Caucasian populations. The incidences of three IL-10 gene polymorphisms (G-1082A, C-819T, and C-592A) significantly differed in controls and patients. Of 8 theoretically probable IL-10 gene haplotypes determined by these polymorphisms, 3 variants were revealed. Haplotype ACC was more incident in cancer patients, while ATA haplotype was rarer. The results are in line with the findings of other studies indicating the involvement of the immune system genes in the pathogenesis of cancer.

[Symptoms of gastroesophageal reflux and quality of life: population study]

AIM

To study prevalence of symptoms of gastroesophageal reflux (GER) in a free living population and to evaluate quality of life (QOL) in this disease.

MATERIAL AND METHODS

The gastroenterological symptoms and QOL were studied in a representative sample of adult population of 495 males and 548 females aged 45-70 years using a validated questionnaire, SF-36 questionnaire.

RESULTS

GER symptoms were seen in 17.0% responders, with the same frequency in men and women, in responders of different age. QOL was worse in responders with GER by 2 scales of SF-36 questionnaire: in males--"general well-being" and "viability", in females--"general well-being" and "physical functioning". In persons who had visited a doctor QOL was lower by all 8 scales than in those who had GER symptoms but had not visited a doctor. GER prevalence in Russia is similar to that in the West Europe and USA. QOL in GER patients is not low but worse in those who seek medical advice.

[Providing of adult population of Novosibirsk with iodine]

32,7% of the population of Novosibirsk consume iodine salt. The median of iodine is revealed 106,8 mkg/l. The iodine deficiency is revealed 46,3%. It is not received an authentic difference in volumes of thyroid gland and parameters of TSH at surveyed with normal parameters of excretion of iodine in urine and at a various degree of expressiveness of iodine deficiency (p>0,05). Structural pathology of thyroid gland equally frequently meets at people with iodine deficiency and without iodine deficiency (p>0,05).

[Gamma-glytamiltransferase activity and cardiovascular diseases (ischemic heart disease and cerebral stroke)]

To investigate association between gamma-glytamiltransferase levels and the development of CVD. The data were taken from materials of the epidemiological study " Determinants of cardiovascular disease in Eastern Europe " , the HAPPIE project. We investigated representative samples from non-organized population of men and women 45 - 69 years old living in Novosibirsk - 9361 subjects (4275 men and 5086 women). The program of study included: questionnaire of previous CVD, smoking status and alcohol consumption; two blood pressure measurements; anthropometry, biochemical analysis (gamma-glytamiltransferase, total cholesterol, HDL cholesterol, and triglycerides) and rest ECG. Among all subjects we distinguished three groups: first - patients with diagnosed ischemic heart disease (angina pectoris or myocardial infarction) and without previous cerebral stroke; second - patients with previous cerebral stroke (without ischemic heart disease); third - patients without previous ischemic heart disease and cerebral stroke (control group). We revealed reliable data on sex-dependent difference of gamma-glytamiltransferase activity: men have higher gamma-glytamiltransferase activity compared with women in all age groups. Subjects who didn t take alcoholic drinks during the last year have noticeably lower gamma-glytamiltransferase level than those who took alcoholic drinks during that period. Gamma-glytamiltransferase activity was higher both in men and women in group with ischemic heart disease, than in control group. We did not reveal difference in gamma-glytamiltransferase activity between groups with cerebral stroke and control group. The similar patterns were revealed in subjects who didn't take alcoholic drinks during the last year.

Risk factors for Alzheimer's disease in Russia: a case-control study

No reliable data on risk factors of Alzheimer's disease (AD) are available in Russia. We aimed to evaluate the relative importance of various putative environmental and medical risk factors of AD in a Russian population. We conducted a hospital-based case-control study. Two hundred and sixty consecutive AD patients and an equal number of cognitive impairment-free control subjects matched for sex, age, level of education and place of birth selected from nursing homes and other long-term healthcare facilities in the Novosibirsk region for the period from 1998 to 2002 were examined. A conditional logistic regression analysis was employed to calculate odds ratios (OR) and corresponding 95% confidence intervals (CI) for various putative risk factors. Of the 260 patients with AD, 187 (72%) were females. Patients' age varied from 40 to 89 years (mean +/- SD: 69.2 +/- 7.7 years). The majority of the patients (77%) had secondary education and 12% had university education. Risk factors independently associated with AD were family history of parkinsonism among first-degree relatives (OR = 4.2; 95% CI 1.2-15.1), hypothyroidism (OR = 2.7; 95% CI 1.1-6.7), and history of head trauma with loss of consciousness (OR = 1.7; 95% CI 1.0-2.8). The most important risk factors for AD in the Russian community are family history of parkinsonism, hypothyroidism and a history of head trauma with loss of consciousness. These findings have implications for developing preventive strategies of AD.

[Hyperhomocysteinemia in men of Novosibirsk]

Prevalence of hyperhomocysteinemia (HHC) in a sample of male population (n=84, age 50-64 year) of Novosibirsk assessed in the framework of the international project "Determinants of cardio-vascular diseases in the Eastern Europe: multicentral cohort research" during winter-spring period of vitamin deficiency was 50%. In 90.5% of cases HHC was moderate (15-30 micromol/l) and in 9.5% of cases -- medium (30-100 micromol/l). No correlations or independent associations were found between homocysteine blood level and CHD, as well as main risk factors (hyperlipidemia, hypertension, smoking and excessive body weight). No cases of CHD were registered among men with medium HHC. Homocysteinemia correlated positively with age, history of stroke, and negatively -- with alpha-tocopherol concentration in LDL. Men with medium HHC compared with those with normohomocysteinemia had higher systolic and diastolic blood pressure and 29% lower alpha-tocopherol concentration in LDL.

[Prognostic value of duration and variability of QT and RR intervals in general population of Novosibirsk]

Increased duration and dispersion of QT interval and lowered variability of RR interval are considered to be probable precursors of dangerous ventricular arrhythmias and sudden death. Standard epidemiological methods were used for the study of a representative sample of nonorganized male population (age 25-64 years) in Novosibirsk in a framework of the MONICA project. Database of the total mortality register was used for verification of deaths. Resting ECGs were analyzed using the Minnesota code criteria blindly relative to other data of the study. Duration and dispersion of QT and QTc intervals as well as temporal parameters of RR variability were determined manually. Assessment of significance of these factors for prognosis was made with the use of methods of survival analysis. Among all characteristics of QTc interval maximal duration and dispersion of QTc were the strongest predictors of death from any cause and cardiovascular death being independent of age, mean blood pressure, ischemic heart disease, body mass index and smoking. Predictive power of these QTc interval parameters was similar in total male population and in subpopulation of patients with cardiovascular diseases. In men without cardiovascular diseases parameters of RR variability on ECG at rest were predictors of cardiovascular death independent of age, mean blood pressure, body mass index, total cholesterol and smoking.

[Multicenter Study of Efficacy and Safety of a Preparation of Lovastatin in Patients With Ischemic Heart Disease and Mild or Moderate Hypercholesterolemia]

Ninety patients with ischemic heart disease and mild or moderate hypercholesterolemia were included in a multicenter study of efficacy and safety of a preparation of lovastatin (Holetar, KRKA). After 6 weeks of a diet period 46 patients remained on diet and in 44 patients lovastatin was added to diet for 12 weeks. All patients received 20 mg/day for 6 weeks. If after 6 weeks on lovastatin target level of low density lipoprotein cholesterol (LDL CH, 3.0 mmol/l) was not achieved the dose was doubled. Target LDL CH level was achieved in 47% and 58% of patients by the end of 6 and 12 weeks, respectively. The 20 mg dose lowered levels of LDLCH by 27% and of triglycerides by 10%. The drug was well tolerated.

Dielectrical model of cellular structures in radio frequency and microwave spectrum. Electrically interacting versus noninteracting cells

A model of dielectrical properties of cellular structures of a tissue has been proposed. Cellular structures were presented as a composition of membrane covered spheres and cylinders that do not interact with each other. No restrictions were applied to the thickness of cellular membranes. The model was further generalized into a case of electrically interacting cells. The difference in dielectrical properties calculated with the model of electrically noninteracting versus interacting cells is inversely dependent on frequency. At biological values of cellular volume fraction near 0.7 (packed configuration) the difference is about 10%-15% in resistance and in epsilon' for frequencies near 0.1 MHz. Experimental data for myocardial tissue and theoretical data, for both interacting and noninteracting models, reasonably agree at frequencies of 1-100 MHz.

Three-dimensional microwave tomography: experimental prototype of the system and vector born reconstruction method

A method of image reconstruction in three-dimensional (3-D) microwave tomography in a weak dielectric contrast case has been developed. By utilizing only one component of the vector electromagnetic field this method allows successful reconstruction of images of 3-D mathematical phantoms. A prototype of the 3-D microwave tomographic system capable of imaging 3-D objects has been constructed. The system operates at a frequency of 2.36 GHz and utilizes a code-division technique. With dimensions of the cylindrical working chamber z = 40 cm and d = 60 cm, the system allows measurement of an attenuation up to 120 dB having signal-to-noise ratio about 30 dB. The direct problem solutions for different mathematical approaches were compared with an experimentally measured field distribution inside the working chamber. The tomographic system and the reconstruction method were tested in simple experimental imaging.