Increased prevalence of the CVD-associated ANRIL allele in the Roma/Gypsy population in comparison with the majority Czech population

Cardiovascular disease (CVD) is a major cause of death around the world, with highest prevalence reported in minority Roma/Gypsy populations living in developed countries. Whether these differences are caused by unhealthy lifestyles or genetic factors remain unknown. The aim of our study was to examine the genotype frequencies of the rs10757274 polymorphism in the 9p.21 locus within ANRIL (antisense non-coding RNA in the INK4 locus), a long non-coding RNA located in the vicinity of the CDKN2A/2B inhibitors loci. ANRIL is understood to be the strongest genetic determinant of CVD in Caucasians. Using PCR-RFLP, we analysed the ANRIL rs10757274 polymorphism in 298 non-Roma (50% male) and 302 Roma/Gypsy (50% male) adult (39.5 ± 15.1 years and 39.2 ± 12.8 years, respectively) subjects. We found that frequencies of the ANRIL GG, GA and AA genotypes were 20.1%, 52.4% and 27.5% in the majority population and 32.9%, 47.9% and 19.2% in Roma/Gypsy subjects, respectively. The distribution of genotypes was deemed significantly different at P < 0.001. Within the Roma/Gypsy population, we detected increased prevalence of the CVD-associated GG genotype. Increased prevalence of CVD among Roma/Gypsies subjects may be significantly linked to genetic background.

Five genetic polymorphisms of cytochrome P450 enzymes in the Czech non-Roma and Czech Roma population samples

Objectives Cytochromes P450 play a role in human drugs metabolic pathways and their genes are among the most variable in humans. The aim of this study was to analyze genotype frequencies of five common polymorphisms of cytochromes P450 in Roma/Gypsy and Czech (non-Roma) population samples with Czech origin. Methods Roma/Gypsy (n=302) and Czech subjects (n=298) were genotyped for CYP1A2 (rs762551), CYP2A6 (rs4105144), CYP2B6 (rs3745274) and CYP2D6 (rs3892097; rs1065852) polymorphisms using PCR-RFLP or Taqman assay. Results We found significant allelic/genotype differences between ethnics in three genes. For rs3745274 polymorphism, there was increased frequency of T allele carriers in Roma in comparison with Czech population (53.1 vs. 43.7%; p=0.02). For rs4105144 (CYP2A6) there was higher frequency of T allele carriers in Roma in comparison with Czech population (68.7 vs. 49.8%; p<0.0001). For rs3892097 (CYP2D6) there was more carriers of the A allele between Roma in comparison with Czech population (39.2 vs. 38.2%; p=0.048). Genotype/allelic frequencies of CYP2D6 (rs1065852) and CYP1A2 (rs762551) variants did not significantly differ between the ethnics. Conclusions There were significant differences in allelic/genotype frequencies of some, but not all cytochromes P450 polymorphisms between the Czech Roma/Gypsies and Czech non-Roma subjects.

Five genetic polymorphisms of cytochrome P450 enzymes in the Czech non-Roma and Czech Roma population samples

Objectives Cytochromes P450 play a role in human drugs metabolic pathways and their genes are among the most variable in humans. The aim of this study was to analyze genotype frequencies of five common polymorphisms of cytochromes P450 in Roma/Gypsy and Czech (non-Roma) population samples with Czech origin. Methods Roma/Gypsy (n=302) and Czech subjects (n=298) were genotyped for CYP1A2 (rs762551), CYP2A6 (rs4105144), CYP2B6 (rs3745274) and CYP2D6 (rs3892097; rs1065852) polymorphisms using PCR-RFLP or Taqman assay. Results We found significant allelic/genotype differences between ethnics in three genes. For rs3745274 polymorphism, there was increased frequency of T allele carriers in Roma in comparison with Czech population (53.1 vs. 43.7%; p=0.02). For rs4105144 (CYP2A6) there was higher frequency of T allele carriers in Roma in comparison with Czech population (68.7 vs. 49.8%; p<0.0001). For rs3892097 (CYP2D6) there was more carriers of the A allele between Roma in comparison with Czech population (39.2 vs. 38.2%; p=0.048). Genotype/allelic frequencies of CYP2D6 (rs1065852) and CYP1A2 (rs762551) variants did not significantly differ between the ethnics. Conclusions There were significant differences in allelic/genotype frequencies of some, but not all cytochromes P450 polymorphisms between the Czech Roma/Gypsies and Czech non-Roma subjects.

Different prevalence of T2DM risk alleles in Roma population in comparison with the majority Czech population

Background

The Czech governmental study suggests up to a 25% higher prevalence of type 2 diabetes mellitus (T2DM) in the Roma population than within the majority population. It is not known whether and to what extent these differences have a genetic background.

Methods

To analyze whether the frequencies of the alleles/genotypes of the FTO, TCF7L2, CDKN2A/2B, MAEA, TLE4, IGF2BP2, ARAP1, and KCNJ11 genes differ between the two major ethnic groups in the Czech Republic, we examined them in DNA samples from 302 Roma individuals and 298 Czech individuals.

Results

Compared to the majority population, Roma are more likely to carry risk alleles in the FTO (26% vs. 16% GG homozygotes, p < .01), IGF2BP2 (22% vs. 10% TT homozygotes, p < .0001), ARAP1 (98% vs. 95% of A allele carriers, p < .005), and CDKN2A/2B (81% vs. 66% of TT homozygotes, p < .001) genes; however, less frequently they are carriers of the TCF7L2 risk allele (34% vs. 48% of the T allele p < .0005). Finally, we found significant accumulation of T2DM‐associated alleles between the Roma population in comparison with the majority population (25.4% vs. 15.2% of the carriers of at least 12 risk alleles; p < .0001).

Conclusion

The increased prevalence of T2DM in the Roma population may have a background in different frequencies of the risk alleles of genes associated with T2DM development.

Distribution of ADH1B genotypes predisposed to enhanced alcohol consumption in the Czech Roma/Gypsy population

OBJECTIVE

The aim of the study was to analyse the frequencies of rs1229984 genotypes within the alcohol dehydrogenase (ADH1B) gene in a Gypsies/Roma population and compare them with other populations and with ethanol consumption.

METHODS

We analysed the ADH1B (rs1229984; Arg47→His; c.143G>A) genotype using the Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) in two ethnically different groups - Gypsies/Roma (N = 301) and Czechs (N = 300) where one day alcohol consumption was recorded.

RESULTS

ADH1B genotype/allelic frequencies did not significantly differ between the populations (p = 0.32). The frequency of minor A allele carriers was slightly higher in Gypsies/Roma (14.7%) than in Czechs (11.9%). The prevalence of subjects reporting alcohol intake on the previous day was non-significantly lower in Gypsies/Roma (10.5% vs. 16.4%), as was the amount of alcohol consumed the day before the examination in ethanol consumers (36.1 ± 18.3 g vs. 43.0 ± 27.2 g).

CONCLUSIONS

The frequency of rs1229984 genotypes in the ADH1B gene within the Gypsies/Roma population corresponds with frequencies obtained in North India/Central Asia, the putative country of this ethnic origin. Our results suggest that the minority Gypsies/Roma population consume slightly less alcohol than the Czech majority population.

Stress within preventive cardiology

INTRODUCTION

The mental, physical and social stress and pressure of present day influences the incidence of cardiovascular diseases (CVD). Studies suggest that some psycho-social factors significantly increase the risk of CVD. But they are not paid the necessary attention. The goal of the study consisted in ascertaining how citizens assess their own mental health, how they perceive the influence of stress on CVD, how physicians and nurses work with them in the area of stress and how efficient their activity is. Research set and methods: The data ware collected via a non-standardized questionnaire leaded with face-to-face controlled interviews face-to-face. The analysis was carried out by the SASD 1.4 program with 1st degree and 2nd degree sorting. The goodness-of-fit &#967;2 was applied. The independence test at the level of significance &#945; = 0.05, &#945; = 0.01, &#945; = 0.001 was calculated. We approached 2&#8239;306 randomly chosen citizens by quota selection. 314 citizens (13.6 %) refused the participation. The set consisted of 1&#8239;992 citizens (86.4 %) aged from 40 to 80 and more years, including 937 (47 %) men and 1055 (53 %) women. The relation of selected sociometric parameters was observed.

RESULTS

The citizens aged 40 and more years assess their mental status as good (85 %), at the scale from 6 to 10, (1 the worst, 10 the best mental status). With increasing age, the mental status is assessed as worse at a significantly higher degree (p &lt; 0.001). The mental status is assessed worse as the physical condition, with values 9 and 10. Out of the total number of the citizens approached, 87.9 % agree that stress influences the origination of CVD. Citizens from lower age groups (40-59 years) tend to think it (p.

Assessing the awareness of Czechs, age 40+, on the link between lifestyle choices and risk factors for cardiovascular diseases

OBJECTIVES

Cardiovascular diseases constitute the main cause of disability and premature death worldwide. Those diseases will continue to endanger health unless the public understands clearly and completely which risk factors contribute to the development of these diseases and what they can do to avoid these risks. This article assesses the understanding of risk factors that can lead to the development of heart and vessel diseases.

METHODS

A non-standardized questionnaire was used for data collection. The respondents expressed their opinions on influenceable factors using a five-degree Likert scale. The research set included 1,992 respondents. Data were statistically analyzed using the SASD program, version 1.4.12. To calculate the level of dependence of the selected characteristics, the Wallis, and Spearman correlation coefficients were calculated. The goodness-of-fit χ2 was applied as well.

RESULTS

The results show that 66.8% of respondents go walking for at least 30 minutes on 5 or more days per week. Respondents from lower age groups reported significantly more (p < 0.001) walking. The comparison of mean values showed that Czech citizens aged 40 or more years express the highest agreement with the statement that they could prevent heart and vessel diseases by modifying their eating habits. The results further showed that 25.8% of Czech citizens smoked and that men smoked significantly more (29.6%) than women (22.5%). More than one-half (60.1%) reported drinking alcohol occasionally; the remaining respondents reported drinking alcohol 3-4 times a month or more often. Men reported drinking beer significantly more often (p < 0.001) than women, while women reported drinking wine significantly more often (p < 0.001) than men.

CONCLUSIONS

Respondents aged 40 or more years were aware of some, but not all, of the risk factors that can influence the development of cardiovascular diseases. They accepted that they could prevent heart and vessel diseases by modifying their eating habits, however, their opinions regarding exercise differed from professional recommendations. Two-thirds of the respondents stated that smoking could also influence heart and vessel diseases. The study suggests that primary care providers need to put more effort into educating their patients regarding steps that can be to influence their own health.

Cultural Features Influencing Eating, Overweight, and Obesity in the Roma People of South Bohemia

This article describes the important cultural specifics that impact on treatment of overweight and obesity for the Roma people of South Bohemia. Methods: Data on health and nutrition were collected using a semi-structured interview of 302 Roma adults (quantitative phase). A further 25 participants received in-depth interviews regarding their eating and lifestyle habits and perceptions about obesity and overweight (qualitative phase). Height and weight were measured with calibrated scales and stadiometer. Qualitative data were analyzed with the “grounded theory” method. Results: The participants reported a relatively high consumption of high-sugar drinks and foods compared to fruits and vegetables. Lifestyle factors increasing risk of overweight identified from the qualitative interview included unemployment, socially isolating housing, poor transport, poverty, inactivity, tobacco smoking, and for women weight gain after childbirth. Also identified was the need for better health literacy. Conclusions: Effective health education may help to address risk factors for overweight and obesity in Roma peoples. Other measures include improved socioeconomic status and housing security, and improved health literacy of the Roma people.

Frequency of adult type-associated lactase persistence LCT-13910C/T genotypes in the Czech/Slav and Czech Roma/Gypsy populations

Lactase non-persistence (leading to primary lactose intolerance) is a genetically dependent inability to digest lactose in adulthood. As part of the human adaptation to dairying, the human lactase LCT-13910C/T mutation (which propagates adult expression of lactase) developed, spread and participated in the adaptation to dairying. This variant is associated with lactase activity persistence, and its carriers are able to digest lactose. We compared the frequencies of lactase 13910C/T (rs4988235) genotypes in Czechs/Slavs (N = 288) and Czech Gypsies/Roma (N = 300), two ethnically different groups where this polymorphism has not yet been analysed. Allelic frequencies significantly differed between the populations (p < 0.0001). In Czechs/Slavs, the lactase persistence T allele was present in 76% of the individuals, which is in agreement with frequencies among geographically neighbouring populations. In the Czech Gypsy/Roma population, only 27% of the adults were carriers of at least one lactase persistence allele, similar to the Indian population. In agreement with this result, dairy product consumption was reported by 70.5% of Czechs/Slavs and 39.0% of the Czech Gypsy/Roma population. Both in the Czech Gypsy/Roma and in the Czech/Slavs populations, the presence of carriers of the lactase persistence allele was similar in subjects self-reporting the consumption of unfermented/fresh milk, in comparison to the others.

Participation of adult patients in healthcare

In this study, the question of health literacy in adult patient population in the Czech Republic is explored in the context of healthcare, particularly in the South Bohemian Region. The study is based on the analysis of qualitative data which were collected during the first half of 2016. The study included 34 adult participants at the age range between 18 and 64 years. The study is focused on the involvement of adult patients in the process of decision making concerning the healthcare provided. The views of this sort of problems were recorded by the technique of semi-structured dialogues. The study results have suggested that adult individuals accept the healthcare provided by doctors or nurses prevailingly with trust. In addition, they have shown that in the sphere of health education, the adults lack the knowledge of the right for information about the individual's health condition and information about the service provided by the health insurance agency. It is regarded as desirable to deal with the topic of health literacy of adult population, particularly in the area of internet counselling and telemedicine, and to develop the space for information sharing between the doctor and nurse on one side and the patient on the other.

Approach to prevention of obesity of Roma population in the Region of South Bohemia with focus on selected eating behaviors

OBJECTIVE

To survey obesity prevention methods for use in the Roma population with a focus on eating behaviors.

METHODS

A semi-structured interview was used to identify potentially useful obesity prevention methods. Basic anthropometric measurements were also gathered at the same time. This study was part of the "Obesity and overweight in the Roma minority in the Region of South Bohemia" research project (grant project 280-COST-LD14114). Participants consisted of members of the Roma minority (302 respondents) as well as the majority (Czech) population for comparisons.

RESULTS

Differences in eating behaviors like irregular eating schedules and excessive consumption of fast food were observed. Statistically significant differences between the Roma minority and the majority (Czech/non-Roma) population were found in this area with the help of statistical significance tests. The Chi-square characteristic of independence (χ2) was, in case of this distribution, valued at 30.815 with 5 degrees of freedom, P < 0.001. The analyses, based on the second degree of classification, identified statistically significant differences between the Roma minority and the majority population. Members of the Roma minority attended preventive health check-ups statistically less often than members of the majority population. Differences between the majority and the Roma population were also found in the degree of patient cooperation with general practitioners.

CONCLUSION

The results show that the Roma population is more likely to engage in eating behaviors that can contribute to overweight and obesity than the majority population. Based on the results of a semi-structured interview and on the results of anthropometric measurements, we can say that the Roma population is at a greater health risk, relative to overweight and obesity, than the majority population.

Opinions regarding the effectiveness of non-pharmacological measures in prevention of cardiovascular disease in the Czech Republic

OBJECTIVE

Cardiovascular diseases are the most common cause of deaths. Cardiovascular mortality is influenced by several factors that can be changed by our behaviour. The goal of this study was to survey the opinions of physicians and nurses on the topic of preventative cardiovascular risk factors.

METHODS

The inquiry was carried out using a standardized structured interviewer-respondent interview (face-to-face). The final form of the interview was based on the results of a pre-investigation. The study was anonymous, participation was voluntary, and the actual interview did not contain any controversial ethical questions. To meet these goals, a non-standardized questionnaire for nurses and physicians was developed. The questions evaluated the interest, coping difficulties, and efficiency of multimodal interventions in practice. The study sample included 1000 physicians and 1000 nurses. The results were statistically evaluated.

RESULTS

The survey of physician and nurse opinions showed that patients were primarily interested in interventions in the area of nutrition, weight loss, and coping with pharmacotherapy; however, the overall lack of interest in smoking cessation was a surprising result. Physicians and nurses viewed smoking cessation as the most difficult risk factors to influence, followed by nutrition changes, and weight loss. It was noteworthy that more than half of the interviewed physicians and nurses were of the opinion that behavioral interventions were only sometimes or rarely effective.

CONCLUSION

The results of our study show that nurses and physicians largely agree on behavioral risk factors and how to influence them. Nurses and physicians in Czech health care generally agree that patients are interested in influencing the above risk factors, being least interested in exercise and smoking cessation. Nurses and physicians also consider smoking reduction and weight loss as particularly difficult risk factors to manage. Results from this study will contributed to the overall goal of preparing and implementing short-term and long-term interventions in preventive cardiology.

Areas of health-education of physicians and nurses in care for cardiac patients from the perspective of citizens of the Czech Republic

OBJECTIVES

The goal of this article was to assess the delivery of patient health-education, relative to cardiovascular disease from the perspective of physicians and nurses, as well as from the perspective of citizens living in the Czech Republic.

METHODS

The article is based on data acquired from the "Intervention procedures in preventive cardiology" grant project. To evaluate patient health education, non-standardized questionnaires intended for physicians (n = 1000) and nurses (n = 1000) were used. A combination of a non-standardized questionnaire and a standardized questionnaire (SF-36) was used to assess citizen (n = 1992) viewpoints. The actual investigation took place from April 1 to April 20, 2016 and was implemented over the entirety of the Czech Republic. Data were analyzed using the SASD v. 1.4.12 program. Both first and second degree sorting was used. The degree of dependence of selected characteristics was established based on the Chi-square test and the T-test.

RESULTS

A bit more than half (53.1%) of the physicians indicated that nurses carried out patient education regarding influenceable risk factors associated with cardiovascular diseases, while 71.6% of nurses reported carrying out this duty. The overwhelming majority of physicians (97.1%) and nurses (92.3%) report informing patients about how to improve their health condition. Citizen respondents reported that topics such as nutrition, exercise, smoking cessation, stress reduction, and the drug side effects use were discussed with them more frequently by physicians than by nurses. Citizen respondents reported that nutrition was discussed most frequently with them, while the issue of smoking cessation was discussed the least frequently.

CONCLUSION

Our analysis showed that physicians engage in patient education more frequently than nurses. At the same time, results suggest that a relatively significant number of physicians and nurses rarely or never educate regarding risk factors associated with cardiovascular diseases.

Evaluation of selected indicators of overweight and obesity of Roma minority in the region of South Bohemia

OBJECTIVES

The objective of our correlation study was to compare selected indicators of overweight and obesity of Roma and non-Roma (majority) populations in the South Bohemia Region or the Czech Republic.

METHODS

The following indicators were chosen for evaluation of overweight and obesity: body height and weight, waistline measurement, waist/height index, waist/hips index, BMI, total fat and blood pressure. 600 participants were examined and interviewed in total, including 302 Roma and 298 non-Roma participants. Each of the participants had a personal examination performed by a general nurse, under hygienic-epidemiological conditions. The criteria for inclusion of participants into the study were consent with examination and age greater than 18 years.

RESULTS

The statistical analysis showed that, at a level of significance of p < 0.001, the following values differed between the Roma and non-Roma population of the South Bohemia Region: waist/height index, waistline, total fat, body mass index (BMI), systolic and diastolic blood pressure. Differences in the incidence of the waist/hips index were significant at p < 0.01. Correlations of incidence with indicators of overweight and obesity in Roma were registered in relation to both age and gender of participants. The results show that overweight and obesity indicators were recorded more frequently in Roma female respondents. Although the results are unique, the conclusions cannot be generalized for Roma throughout the Czech Republic.

CONCLUSION

The conclusions of the above findings will be implemented in strategic materials for community planning in the South Bohemia Region. The goal will be to offer services aimed at supporting a healthy life style for Roma living in the South Bohemia Region of the Czech Republic.

The importance of self-management in the prevention and treatment of excessive weight and obesity

OBJECTIVES

The aim of this research into 'self-management' was to determine to what extent respondents were aware of their status as overweight or obese. For respondents who indicated that they were overweight or obese, the goal was to determine whether they tried to lose weight, what steps they took to control their, and what specific methods they used.

METHODS

Information was collected using semi-structured interviews from May 31, 2014, to January 30, 2015. Data processing was performed using statistical analysis of the social data SASDM 01/04/10 software. The total study group consisted of 600 respondents, including 302 from the Roma minority, and 298 from the non-Roma majority population (control group). Respondents were selected specifically from South Bohemia Region of the Czech Republic. The sample from the Roma minority was constructed using the snowball method (Snowball Sampling). The control sample of non-Roma was selected through quota sampling.

RESULTS

The results indicate that the respondents from both the Roma minority and the non-Roma control group generally recognized when they were overweight or obese, or they were aware of it to a much lesser extent than objective indicators revealed. More than two thirds of the respondents who admitted they were overweight or obese (N = 143) reported that they had suffered from overweight or obesity since they were young adults. Significantly more members of the majority population had tried to lose weight using self-management, whereas the level of effort was significantly less among members of the Roma minority (P = 0). Nevertheless, Roma respondents significantly more often reported (P < 0.01) that they had agreed on a specific weight loss plan with a doctor.

CONCLUSION

The results of our research show that in the context of prevention, it is important to promote self-managed skills, habits and other characteristics that can play an important role in the prevention and treatment of obesity and overweight.

The reflection of the quality of life of people with Crohn's disease in nursing

OBJECTIVES

To determine the quality of life of patients with Crohn's disease and to determine if this is reflected by the quality of nursing care.

METHODS

For the purpose of this research, we used a generic standardized questionnaire of the quality of life, published by the World Health Organization (WHOQOL-100). The questionnaire was distributed among 100 patients with Crohn's disease and among 1456 and members of healthy population. To analyze the results, we used the SPSS program and appropriate statistical methods.

RESULTS

The comparison of the domain scores of population standards in the Czech Republic and the respondents with Crohn's disease revealed a difference in the domain "physical condition", where the mean value was at the limit of the lower interval of the standard, and in the domain of "independence".

CONCLUSION

The results given in this study define the possibilities of nurses and their functioning associated with altered quality of life. An evaluation of the most affected areas allows nurses to determine an appropriate intervention. Providing nursing care, in accordance with the latest knowledge, must be based on the quality of life. This newly incorporated area offers healthcare professionals a new dimension for assessing and determining subsequent interventions.

Quality of life in patients with chronic diseases

OBJECTIVES

A quality of life assessment is of great importance for patients with chronic diseases, because problems caused by specific diseases impact specific areas of their lives. The goal of this work was to determine, in which areas select diseases (rheumatoid arthritis, Crohn's disease, ischemic disease of the lower extremities and chronic obstructive pulmonary disease) affect patients' quality of life.

METHODS

The Czech version of the WHOQOL-100 instrument and specific standardized questionnaires for individual diseases: EuroQol, EQ-5D-5L, IBDQ, PAQ were used to assess quality of life. This paper presents the results of the WHOQOL-100 questionnaire. In total, 5 research samples were put together. The first sample consisted of 200 respondents with rheumatoid arthritis (RA); the second sample included 100 respondents with inflammatory bowel disease (IBD); the third sample was comprised of 404 respondents with ischemic disease of the lower extremities (IDLE); the fourth sample consisted of 449 respondents with chronic obstructive pulmonary disease (COPD); and the fifth sample was represented by 1,456 healthy respondents. The acquired data were then statistically analyzed. A statistical data analysis was performed in two steps. In the first step descriptive statistical analyses were performed in the SASD program (absolute and relative frequencies of respondents' answers, median values and variability characteristics). In the second step differences in means of the subjectively-perceived quality of life in patients with individual diseases and in control group were tested using the Mann-Whitney U test and the non-parametric Wilcoxon pair test. These analyses were computed in the SPSS (Statistical Package for the Social Sciences) program.

RESULTS

The results show that a statistically significant difference in average domain score values was found between the healthy population and patients diagnosed with RA in the domains of "physical health", "level of independence", "environment", and "spirituality/religion/personal beliefs". A statistically significant difference was found in all domains for patients with IDLE and COPD. A statistically significant difference was found in four domains for patients with IBD, namely those of "physical health", "level of independence", "social relationships" and "spirituality/religion/personal beliefs".

CONCLUSION

All therapeutic and nursing interventions that can contribute to improving QoL in poorly performing domains should be utilized.