The genetic risk for hypertension is lower among the Hungarian Roma population compared to the general population

Soltész, Beáta; Pikó, Péter; Sándor, János; Kósa, Zsigmond; Ádány, Róza; Fiatal, Szilvia

doi:10.1371/journal.pone.0234547

Cited by 17 publications

(10 citation statements)

References 53 publications

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“…Table 3 shows that regarding data defined by the questionnaire-based survey, as well as by laboratory and physical examinations and used in IR and MetS calculations, significant differences were observed in the average HDL-C concentration and systolic blood pressure; both values were significantly lower in the HR population than in the HG population (1.26 mmol/L vs. 1.37 mmol/L, 123.7 mmHg vs. 126.8 mmHg, respectively). In the case of these two parameters, significant differences were observed in subgroups without and with MetS in harmony with our previous findings on the genetic background of the high prevalence of low HDL-C concentration [ 20 ] and low prevalence of hypertension [ 60 ] among Roma in comparison with the HG population. The prevalence rates of antidiabetic and lipid-lowering therapies were significantly higher among the HR population (11.1% vs. 6.1%, 11.7% vs. 6.8%, respectively), while no significant difference was found in any of the other parameters between the study groups.…”

Section: Resultssupporting

confidence: 89%

Prevalence of Insulin Resistance in the Hungarian General and Roma Populations as Defined by Using Data Generated in a Complex Health (Interview and Examination) Survey

Ádány

Pikó

Fiatal

et al. 2020

IJERPH

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Data mainly from one-off surveys clearly show that the health of Roma, the largest ethnic minority of Europe, is much worse than that of the general population. However, results from comprehensive exploratory studies are missing. The aim of our study was to create a complex database for comparative and association studies to better understand the background of the very unfavourable health of Roma, especially the high burden of cardiometabolic diseases. A three-pillar (questionnaire-based, physical and laboratory examinations) health survey was carried out on randomly selected samples of the Hungarian general (HG, n = 417) and Roma (HR, n = 415) populations, and a database consisting of more than half a million datapoints was created. Using selected data, the prevalence rates of metabolic syndrome (MetS) and of its components were determined, and to estimate the risk of insulin resistance (IR), surrogate measures (the homeostasis model assessment of insulin resistance index, quantitative insulin sensitivity check index, McAuley and TyG indices and the TG/HDL-C ratio) were calculated. Receiver operating characteristic curve analysis and Youden’s method were used to define the optimal cut-off values of each IR index. The prevalence of MetS was very high in both study populations (HG: 39.8%, HR: 44.0%) with no statistically significant difference between the two groups in females or males. The prevalence of MetS showed a very marked increase in the HR 35–49 years age group. Among surrogate measures, the TyG index showed the greatest power for predicting IR/MetS at a cut-off value of 4.69 (77% sensitivity, 84% specificity) and indicated a 42.3% (HG) and 40.5% (HR) prevalence of IR. The prevalence of MetS and IR is almost equally very unfavourable in both groups; thus, the factors underlying the high premature mortality burden of Roma should be further clarified by investigating the full spectrum of risk factors available in the database, with a special focus on the access of Roma people to preventive and curative health services.

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Section: Resultssupporting

confidence: 89%

Prevalence of Insulin Resistance in the Hungarian General and Roma Populations as Defined by Using Data Generated in a Complex Health (Interview and Examination) Survey

Ádány

Pikó

Fiatal

et al. 2020

IJERPH

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“…Moreover, previous studies provided robust evidence that the high prevalence of smoking behaviours and nicotine dependence was related to genetic susceptibility [ 20 , 21 , 22 ]. Recent studies have shown that the majority of risk alleles of selected non-communicable diseases have been accumulated in the Roma population [ 18 , 23 ], which support the hypothesis that the health status of Roma is determined by a complex set of inheritable factors.…”

Section: Introductionmentioning

confidence: 78%

“…A study, conducted on UK individuals aimed to determine the influences of Body Mass Index (BMI) on smoking habits and intensity, suggests that higher adiposity has a strong influence on smoking behaviours and also associated with smoking initiation at younger ages [ 17 ]. Among Roma population, a shift from traditional lifestyles characterized by higher caloric intakes and more sedentary lifestyle could lead change in BMI distribution, with obesity becoming significantly more common in the younger Roma population [ 12 , 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

Roma Socioeconomic Status Has a Higher Impact on Smoking Behaviour than Genetic Susceptibility

Merzah

Kósa

Sándor

et al. 2021

IJERPH

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It is a matter of speculation whether the high prevalence of smoking among Hungarian Roma (HR) is related to genetic, gene-environmental interactions or cultural factors. Our aim is to compare the genetic susceptibility and possible effects of determinants associated with smoking behaviours in the Hungarian general (HG) and Roma populations. A complex health survey including three pillars (questionnaire, physical and laboratory examinations) was carried out (NHG = 412 and NHR = 402). Risk allele frequencies of ten single-nucleotide polymorphisms (SNPs) were compared, and their combined effect was estimated by computing unweighted and weighted genetic risk scores (GRS, wGRS). The effects of genetic and environmental factors were investigated in regression analyses after confounders were introduced. Socio-economic status (SES) was calculated based on the Kuppuswamy scale 2019. Risk allele frequencies of only four SNPs were found to be different between populations (p < 0.01). Median values of GRS did not differ, while the wGRS median was slightly higher among Roma individuals (5.2 vs. 4.9; p = 0.02). Roma individuals were more likely to be heavy smokers (ORmales = 2.05, 95% CI [1.47–2.86]; ORfemales = 1.89, 95% CI [1.58–2.25]. Smokers have lower SES compared to never smokers (SES βHR = −0.039, p = 0.023; βHG = −0.010, p = 0.049). An inverse relationship was found between SES and smoking behaviours (p < 0.0001) and was found to be a better predictor of smoking behaviours than genetic susceptibility. Our study findings suggest that the high prevalence of smoking behaviours and nicotine-dependence were not revealed to have a genetic susceptibility among HR individuals; therefore, the highest efforts should be focused on targeting SES-related factors in the Roma population. Strengths of the study: This is the first study carried out to investigate and detect the most relevant factors and the possible genetic background of the extremely high prevalence of smoking based in the Roma population. Limitations of the study: No standard instrument has been used to assess the intensity of addiction to nicotine. Because of some participants’ unwillingness to define themselves as Roma, the overall HR population was not represented by the sample of this study.

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“…Previous studies have shown that obesity [ 12 , 13 ] and T2DM [ 14 ] are mainly determined by the environment and not by genetic factors, while there are clearly genetic reasons behind the prevalence of elevated blood pressure [ 15 ], low HDL-C levels [ 16 , 17 , 18 ] and age of onset for T2DM [ 19 ] in the Hungarian general population.…”

Section: Introductionmentioning

confidence: 99%

Changes in the Prevalence of Metabolic Syndrome and Its Components as Well as in Relevant Preventive Medication between 2006 and 2018 in the Northeast Hungarian Population

Pikó

Diószegi

Sándor

et al. 2021

JPM

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Metabolic syndrome (MetS) is a worldwide problem with severe health consequences. In this study, we examine the changes in the prevalence of MetS and its components in two disadvantaged counties of Northeastern Hungary. Two health examination surveys were performed in the Hungarian population aged 20–64 years in 2006 (n = 450) and 2018 (n = 397) and the data were compared to each other. It was found that the prevalence of MetS increased significantly in the period examined (from 34.9% to 42.2%, p = 0.035) due to the increased prevalence of raised blood pressure (from 45.6% to 57.0%, p = 0.002) and raised fasting glucose concentration (13.2% vs. 24.8%, p < 0.001). The increase mainly affects the younger (20–34 years old) age group (12.1% in 2006 vs. 31.6% in 2018, p = 0.001). It is quite alarming that the prevalence of MetS and its components has increased significantly in the last decade, while the prevalence of preventive medication is unchanged (antihypertensive and antidiabetic treatments) or even significantly decreased (lipid-lowering medication). Consequently, the number of individuals untreated for hypertension and metabolic disturbances is severely increased. A targeted public health strategy is desperately needed to prevent further worsening the situation.

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The genetic risk for hypertension is lower among the Hungarian Roma population compared to the general population

Cited by 17 publications

References 53 publications

Prevalence of Insulin Resistance in the Hungarian General and Roma Populations as Defined by Using Data Generated in a Complex Health (Interview and Examination) Survey

Prevalence of Insulin Resistance in the Hungarian General and Roma Populations as Defined by Using Data Generated in a Complex Health (Interview and Examination) Survey

Roma Socioeconomic Status Has a Higher Impact on Smoking Behaviour than Genetic Susceptibility

Changes in the Prevalence of Metabolic Syndrome and Its Components as Well as in Relevant Preventive Medication between 2006 and 2018 in the Northeast Hungarian Population

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