Association between community noise and adiposity in patients with cardiovascular disease

INTRODUCTION

This study aimed to explore the effect of community noise on body mass index (BMI) and waist circumference (WC) in patients with cardiovascular disease (CVD).

MATERIALS AND METHODS

A representative sample of 132 patients from three tertiary hospitals in the city of Plovdiv, Bulgaria was collected. Anthropometric measurements were linked to global noise annoyance (GNA) based on different residential noise annoyances, day-evening-night (Lden), and nighttime (Lnight) road traffic noise exposure. Noise map Lden and Lnight were determined at the living room and bedroom façades, respectively, and further corrected to indoor exposure based on the window-opening frequency and soundproofing insulation.

RESULTS AND DISCUSSION

Results showed that BMI and WC increased (non-significantly) per 5 dB. The effect of indoor noise was stronger in comparison with that of outdoor noise. For indoor Lden, the effect was more pronounced in men, those with diabetes, family history of diabetes, high noise sensitivity, using solid fuel/gas for domestic heating/cooking, and living on the first floor. As regards indoor Lnight, its effect was more pronounced in those with low socioeconomic status, hearing loss, and using solid fuel/gas for domestic heating/cooking. GNA was associated with lower BMI and WC.

CONCLUSION

Road traffic noise was associated with an increase in adiposity in some potentially vulnerable patients with CVD.

Community Noise Exposure and its Effect on Blood Pressure and Renal Function in Patients with Hypertension and Cardiovascular Disease

BACKGROUND

Road traffic noise (RTN) is a risk factor for cardiovascular disease (CVD) and hypertension; however, few studies have looked into its association with blood pressure (BP) and renal function in patients with prior CVD.

AIM

This study aimed to explore the effect of residential RTN exposure on BP and renal function in patients with CVD from Plovdiv Province.

MATERIALS AND METHODS

We included 217 patients with ischemic heart disease and/or hypertension from three tertiary hospitals in the city of Plovdiv (March - May 2016). Patients' medical history, medical documentation, and medication regimen were reviewed, and blood pressure and anthropometric measurements were taken. Blood samples were analyzed for creatinine, total cholesterol, and blood glucose. Participants also filled a questionnaire. Glomerular filtration rate was estimated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. All participants were asked about their annoyance by different noise sources at home, and those living in the city of Plovdiv (n = 132) were assigned noise map Lden and Lnight exposure. The effects of noise exposure on systolic blood pressure (SBP), diastolic blood pressure (DBP), and estimated glomerular filtration rate (eGFR) were explored using mixed linear models.

RESULTS

Traffic noise annoyance was associated with higher SBP in the total sample. The other noise indicators were associated with non-significant elevation in SBP and reduction in eGFR. The effect of Lden was more pronounced in patients with prior ischemic heart disease/stroke, diabetes, obesity, not taking Ca-channel blockers, and using solid fuel/gas at home. Lnight had stronger effect among those not taking statins, sleeping in a bedroom with noisy façade, having a living room with quiet façade, and spending more time at home. The increase in Lden was associated with a significant decrease in eGFR among men, patients with ischemic heart disease/stroke, and those exposed to lower air pollution. Regarding Lnight, there was significant effect modification by gender, diabetes, obesity, and time spent at home. In some subgroups, the effect of RTN was statistically significant.

CONCLUSIONS

Given that generic risk factors for poor progression of cardiovascular diseases cannot be controlled sufficiently at individual level, environmental interventions to reduce residential noise exposure might result in some improvement in the management of blood pressure and kidney function in patients with CVD.

Effect of Nitrates, Thiocyanates and Selenium on the Iron and Iodine Status of Postpartum Women

AIM

To find correlations between high thiocyanate and nitrate levels and low selenium levels and the indicators of the iodine and iron status of postpartum women.

MATERIALS AND METHODS

The study included 41 mothers aged 26.4±5.9 yrs from Asenovgrad and nearby villages. Urinary iodine was determined by the Sandell-Kolthoff reaction and thiocyanate - by the interaction of these ions with acidic solution of KMnO4; for serum nitrates we used the colorimetric method; serum selenium was assessed by electro-thermal atomic-absorption spectrophotometry; thyroxin (FT4), the thyroid stimulating hormone (TSH), serum ferritin (SF), and serum transferrin receptor (sTfR) were determined using ELISA; Hb levels were determined by hematology analyzer.

RESULTS

Assessing the iodine status, we found a negative correlation between the levels of iodine and thiocyanates in urine (R=-0.717, р<0.0001), a positive correlation between nitrates and TSH (R=0.487, р=0.003) and a negative correlation between nitrates and FT4 (R=-0.312, р=0.06). For the iron status, we found a negative correlation between nitrates and SF (R=-0.429, р=0.009) and between nitrates and Hb (R=-0.383, р=0.021). The Mann-Whitney U-test showed that in women with nitrate levels higher than the mean value there was low FT4 level (р=0.06), high TSH level (р=0.013), low Hb concentration (р=0.061) and low SF concentration (р=0.005). The combined effects of environmental factors (elevated nitrate levels and low selenium level) on the iodine and iron status are manifested by low concentrations of FT4 (р=0.033), Hb (р=0.06) and SF (р=0.05) and high level of TSH (р=0.05). In conclusion, we found that environmental factors, especially when combined, have a negative impact on the iron and iodine status of females.

The Role of Eating Habits on the Iron Status of Pregnant Women

OBJECTIVE

This study highlights the relationship between some eating habits and iron status during pregnancy.

SUBJECTS

The study included 219 healthy pregnant women aged 27.6 ± 5.7 years from southern Bulgaria.

METHODS

Subjects' iron status was assessed on the basis of the following iron indicators: hemoglobin (Hb), serum ferritin (SF), serum transferrin receptor (sTfR), and body iron index (mg/kg).

RESULTS

Severe anemia among the women from southern Bulgaria was not observed. Advanced pregnancy and some eating habits are factors that deteriorate iron status. Women who had consumed fish at least 3 times a week had lower levels of sTfR (р = 0.008), higher levels of SF (р = 0.05), and lower levels of body iron (р = 0.018). Frequent legume consumption was related to increased levels of sTfR (р = 0.036). Pregnant women with a high frequency of coffee consumption had lower values of body iron (р < 0.0001). Women who had consumed cow's milk at least 3 times a week had lower levels of SF (р = 0.026) and body iron (р = 0.042).

CONCLUSIONS

Regular consumption of fish and legumes, rarely drinking coffee, and milk consumption during the intervals between food intake are conditions for optimization of iron status during pregnancy.

Benefits and risks from the national strategy for improvement of iodine nutrition in Bulgaria: study on schoolchildren living in a rural area

OBJECTIVES

To assess the effectiveness of iodine prophylaxis in schoolchildren, living in a rural area in South Bulgaria, after the introduction of salt iodization.

STUDY DESIGN

The study subjects were 114 schoolchildren (59 boys and 55 girls), aged 11-14 years, living in a rural area in Bulgaria. Urinary iodine concentration was used as an index of iodine intake. The iodine level in table salt used in the children's households was also monitored.

METHODS

Iodine concentration was measured by the Sandell-Kolthoff reaction. The iodine content of samples of table salt was determined by redox titration.

RESULTS

The median urinary iodine concentration of the inspected schoolchildren was >200 microg/l, which indicates that iodine intake is more than adequate. An unfavourable result of the study was that 52.6% of the schoolchildren had more than adequate or excessive iodine intake. The hypothesis that this iodine overload may be due to poorly controlled salt iodization was confirmed by monitoring the iodine content in samples of table salt; three of six specimens contained iodine above the recommended level.

DISCUSSION

Although the results indicated that the national strategy has had a positive effect on iodine-deficiency disorders, excessive iodization during the production of table salt and excessive consumption may be potential risks for the development of thyroid-related diseases.

Iodine status of children living in areas with high nitrate levels in water

Several researchers have suggested a possible relationship between nitrate intake and the development of goiter in children. The present cross-sectional study included schoolchildren between the ages of 11 and 14 years from 2 villages in Bulgaria with high and low nitrate levels in drinking water. The comparison between the median urinary iodine levels of the total number of exposed (179.0 microg/l) and nonexposed (202.50 microg/l) children showed statistically significant differences. The relative risk for the children exposed to high nitrate levels in drinking water, expressed as the odds ratio, was 8.145 (95% confidence interval = 1.67-39.67). The authors considered this to be very significant. They found a statistically significant difference for the prevalence of goiter among the exposed and nonexposed children. The results of the study confirmed the role of high nitrate levels in drinking water as a health risk factor for thyroid dysfunction.

Evaluation of health hazards in children from regions with nitrate pollution

Nitrate pollution of drinking water can be potentially hazardous with health risks for considerable groups of people. Methemoglobin in blood and concentration of nitrates and nitrites in morning saliva, urine, and plasma as sensitive indicators of nitrate accumulation in the body were analysed in 12-14-year-old children living in villages with nitrate pollution of the drinking water. The children were distributed in two experimental groups of 18-21 children each. Nitrates and nitrites were analysed in biological fluids by a modified cadmium-reduction method. Nitrate accumulation in the body was significantly higher in the nitrate pollution exposed children than in the unexposed children which correlated with greater health hazards.