The objective of the study was to determine some Cardiovascular Disease (CVD) risk factors in 174 Roma children and adolescents (88 males and 86 females) aged 7-18 in 3 Central Slovakian cities (44 from Žilina, 39 from Banská Bystrica and 91 from Rimavská Sobota). Venous blood samples were drawn in the morning, after a 12 hour overnight fast for biochemical analysis. Total cholesterol (TC) and triglycerides (TG) were determined enzymatically. HDL-cholesterol (HDL-C) after selective precipitation lipoproteins containing apolipoprotein B and LDL-cholesterol (LDL-C) was calculated by the Friedewald Formula. Serum levels of apolipoproteins (apo A, apo B) were analyzed immunochemically. Concentration of lipoprotein a [Lp(a)] was analyzed by immunonephelometric method (Beckman-Coulter System). Anthropometric measurements, including weight, height, waist and hip circumference were used to calculate the sum of the body mass index (BMI) and waist to hip ratio (WHR). Measured blood pressure (BP) was used to classify for hypertension. Significant differences were determined in serum levels of LDL-C (p<0.05; by Tukey HSD test multiple comparison more significant difference was determined between Žilina and Rimavská Sobota p<0.046), TG (p=0.008), apo A (p<0.001), Lp(a) (p=0.042), WHR (p<0.001), BMI (p<0.001), sBP (p<0.001) and dBP (p=0.012) in Roma individuals of all locality groups. The Roma population from Rimavská Sobota had (in comparison to the examined populations) statistically higher values of TC, TG, LDL-C, lower HDL-C. The population showed significant relation of TG and stress at home (p=0.03) and at school (p=0.01), HDL-C and cigarette smoking (p=0.004), apo A and cigarette smoking (p=0.02) and socioeconomic status (p=0.006), WHR and cigarette smoking (p=0.02). Risk values of WHR, apo B and Lp(a) were mostly determined in Žilina's population (WHR significantly connected with family history CVD p=0.03, cigarette smoking p=0.02 and leisure time physical activity p<0.001) and BMI, apo A and BP in Banská Bystrica. WHR was positively correlated to BP and negatively to HDL-C and TG only in Roma participants from Rimavská Sobota. BMI was positively correlated to systolic BP in populations from Banská Bystrica and Rimavská Sobota. The results of the study should improve the paediatric health treatment and prevention of CVD risk predictors for Roma from different cities.
SUMMARYThe objective of the study was to determine some Cardiovascular Disease (CVD) risk factors in relation to cigarette smoking in 174 Roma children and adolescents (88 males and 86 females) and 131 non-Roma probands (males and females) aged 7-18 in central Slovakia.In this biethnic study, 26.4% of the Roma children and adolescents (more than twice contrary to the control group) were smokers. Among the studied ethnicities, the majority of smokers was Roma (79.3%, 46 subjects). Smoking Roma have higher means of TG, Lp(a) and WHR compared with non-smoking non-Roma. The most frequent CVD risk predictors of smoking Roma probands was low serum levels HDL-C, apo A (the Fisher test confirmed a significant relationship between cigarette smoking and HDL-C, apo A; p<0.01).The results of the research should help to develop an effective preventative health education programs focused on Roma education (who live in a higher-risk environment compared to the majority population) in order to stem the spread of CVD as well as morbidity and mortality in this ethnic group living in Slovakia.
Cell adhesion molecules are thought to play a role in atherosclerosis. Several clinical trials have shown that fibrate treatment leads to a reduction in coronary events, although the mechanisms are not fully understood. Soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble intercellular adhesion molecule-1 (sICAM-1) and soluble E-selectin plasma concentrations were measured in 10 obese dyslipidemic men (group A), in 10 obese dyslipidemic type 2 diabetic men without coronary artery disease (CAD) (group B), and in 10 dyslipidemic type 2 diabetic men with angiographically documented CAD (group C) before and after 12 weeks of treatment with ciprofibrate. Compared with nondiabetic dyslipidemic men, diabetic patients with CAD or without documented CAD had significantly increased levels of sVCAM-1 (512 +/-39 versus 750 +/-139 ng/mL; p<0.0001 and 566 +/-78 ng/mL; p<0.01, respectively) and sE-selectin (54.8 +/-6.9 versus 65.9 +/-8.8 ng/mL; p<0.001 and 62.6 +/-9.4 ng/mL; p=0.056, respectively). The levels of sICAM-1 were similar in all 3 groups. Multivariate analyses showed that the higher sCAM levels in patients occurred independently of lipoprotein levels. Waist circumference as a marker of abdominal adiposity was the only independent predictor of elevated concentrations of all 3 cell adhesion molecules in multivariate analyses. sE-selectin was associated with HbA1C levels (p<0.01) in diabetic men at baseline. After 12 weeks of ciprofibrate therapy, sVCAM-1 levels were reduced by 13.5 +/-2.1%, sICAM-1 levels by 11.8 +/-2.2%, and sE-selectin levels by 17.1 +/-3.5% (p<0.01 for all) with the greatest sE-selectin reduction in the diabetic subgroups (p<0.001). There was no correlation between the lowering of soluble adhesion molecules and the magnitude of lipid-lowering effect. An increased level of circulating adhesion molecules may be a mechanism by which dyslipidemia and/or diabetes mellitus promotes atherogenesis, and treatment with ciprofibrate may alter vascular cell activation.
Hyperinsulinemia and high prevalence of various symptoms of metabolic syndrome (MS) were found in high percentage of patients with after load precordial pain who were referred to coronarography. Similarly, in several women, MIV-AP was detected and its affiliation to MS suggested.
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