What factors explain the much higher diabetes prevalence in Russia compared with Norway? Major sex differences in the contribution of adiposity

Iakunchykova, Olena; Averina, Maria; Wilsgaard, Tom; Malyutina, Sofia; Kudryavtsev, Alexander; Cook, Sarah; Wild, Sarah; Eggen, Anne Elise; Hopstock, Laila Arnesdatter; Leon, David A.

doi:10.1136/bmjdrc-2020-002021

Cited by 5 publications

(3 citation statements)

References 46 publications

(60 reference statements)

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“…This study con rms the previously described unfavourable risk pro le of the Russian population. The Russian participants had higher diastolic and systolic BP, high-sensitivity C-reactive protein levels, BMI, prevalence of diabetes, active smoking, and renal failure (4,6,23,24). Only serum cholesterol levels were similar in both populations; however, triglyceride levels were higher in the Russian population, possibly due to the higher incidence of diabetes.…”

Section: Differences In Cardiovascular Risk Factors and Diseasesmentioning

confidence: 85%

Cardiac systolic and diastolic function in relation to cardiovascular risk factor distribution: a comparison of strain-rate imaging in Russian and Norwegian populations

Kornev,

Caglayan,

Schirmer

et al. 2023

Preprint

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Background:Cardiovascular morbidity and mortality rates are high in Russia and it is likely that this reflects a similar impact on the general cardiac health of the population. The current study seeks to compare standard echocardiography and strain-based measurements between Russian and Norwegian populations, while also exploring their links to hemodynamic and risk factors. Methods: This study included echocardiographic measurements of 1,192 participants from Arkhangelsk and Novosibirsk, Russia, and 917 from the Tromsø Study population, Norway. The sample included men and women aged 40–69 years. Normalcy, defined as the absence of hypertension or indicators of CVD, was observed in 840 individuals. We performed conventional echocardiography and analysed two-dimensional speckle-tracking longitudinal strains, including systolic, early-, and late-diastolic SR values. The study population was divided into four groups: normal, controlled hypertension, hypertensive blood pressure, and cardiac disease. Echocardiographic parameters were compared between the Russian and Norwegian populations,adjusted for age, sex, height, body mass index, blood pressure, heart rate (HR), atrial fibrillation, smoking, pulmonary hypertension, and serum values for total, LDL (low density lipoprotein), and HDL (high density lipoprotein) cholesterol; triglycerides; creatinine; high-sensitivity C-reactive protein; and HbA1C. Results: Russians showed a tendency towards lower longitudinal systolic functional parameters, which were most prominent in the normotensive group. However, these differences became insignificant after adjusting for parameters that influence pre- and after-loads. Russians also had a lower stroke volume, higher HR, higher left atrial volume, lower A, and higher E/A ratio, indicating a higher incidence of diastolic dysfunction in the Russian population that persisted after adjustments. Conclusion: After adjusting for factors that influence cardiac function, there were no differences in systolic functional parameters betweenthe Norwegian and Russian populations. However, differences in diastolic parameters, which persisted after adjusting for conventionally influential factors, indicated unexplained underlying causes of diastolic dysfunction in the Russian population.

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Section: Differences In Cardiovascular Risk Factors and Diseasesmentioning

confidence: 85%

Cardiac systolic and diastolic function in relation to cardiovascular risk factor distribution: a comparison of strain-rate imaging in Russian and Norwegian populations

Kornev,

Caglayan,

Schirmer

et al. 2023

Preprint

Self Cite

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“…In parallel, the comparisons showed higher levels of hs-CRP in the Russian study, along with elevated population levels of biomarkers of heart damage (cardiac troponin T and N-terminal pro-b-type natriuretic peptide) [10]. The finding of different hs-CRP levels but almost the same cholesterol fractions also challenged the existing knowledge of metabolic syndrome, which is a known associate of both dyslipidemia and chronic inflammation [11][12][13]. The explanations might be in comparisons of population levels of remnant cholesterol and oxidized LDL-C, which were not performed.…”

Section: Introductionmentioning

confidence: 91%

Socio-Demographic, Lifestyle, and Cardiometabolic Characteristics Associated with Low-Grade Systemic Inflammation in Russian Adult Population

et al. 2023

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Mortality from cardiovascular diseases (CVDs) is higher in Russia compared to other European countries. High-sensitivity C-reactive protein (hs-CRP) is a biomarker of inflammation, and its elevated levels indicate increased CVD risks. We aim to describe the prevalence of low-grade systemic inflammation (LGSI) and the associated factors in a Russian population. The Know Your Heart cross-sectional study was conducted in Arkhangelsk, Russia in 2015–2017 with a population sample aged 35–69 years (n = 2380). LGSI was defined as hs-CRP ≥ 2 and < 10 mg/L, and its associations with socio-demographic, lifestyle, and cardiometabolic characteristics were analyzed. The prevalence of LGSI (age-standardized to European Standard Population 2013) was 34.1% (33.5% in men and 36.1% in women). In the total sample, the increased odds ratios (ORs) of LGSI were associated with abdominal obesity (2.1), smoking (1.9), dyslipidemia (1.5), pulmonary diseases (1.4), and hypertension (1.3); the decreased ORs were in women (0.6) and in married participants (0.6). In men, the ORs were higher with abdominal obesity (2.1), smoking (2.0), CVDs (1.5), and hazardous drinking (1.5); in women—with abdominal obesity (4.4) and pulmonary diseases (1.5). In conclusion, one-third of the adult population in Arkhangelsk had LGSI. Abdominal obesity was the strongest LGSI correlate in both sexes, while the profiles of other associated factors were different between men and women.

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“…Furthermore, evidence for sex differences in the education–diabetes association has been indicated in several studies, where the link between education and diabetes seemed stronger among women than men, 18,19 or even in the opposite direction 3,20 . Therefore, it might be necessary to separate the discussion by gender.…”

Section: Introductionmentioning

confidence: 99%

Obesity mediates the opposite association of education and diabetes in Chinese men and women: Results from the REACTION study

Zhu

Lin

et al. 2022

Journal of Diabetes

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Background Evidence regarding the impact of education on diabetes risk is scarce in developing countries. We aimed to explore the association between education and diabetes within a large population in China and to identify the possible mediators between them. Methods Information on educational level and lifestyle factors was collected through questionnaires. Diabetes was diagnosed from self‐report and biochemical measurements. A structural equation model was constructed to quantify the mediation effect of each mediator. Results Compared with their least educated counterparts, men with college education had a higher risk of diabetes (odds ratio [OR] 1.19; 95% confidence interval [CI], 1.12–1.27), while college‐educated women were less likely to have diabetes (OR 0.77; 95% CI, 0.73–0.82). Obesity was the strongest mediator in both genders (proportion of mediation: 11.6% in men and 23.9% in women), and its association with education was positive in men (β[SE] 0.0387 [0.0037]) and negative in women (β[SE] −0.0824 [0.0030]). Taken together, all behavioral factors explained 12.4% of the excess risk of diabetes in men and 33.3% in women. Conclusions In a general Chinese population, the association between education level and diabetes was positive in men but negative in women. Obesity was the major mediator underlying the education disparities of diabetes risk, with a stronger mediation effect among women.

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What factors explain the much higher diabetes prevalence in Russia compared with Norway? Major sex differences in the contribution of adiposity

Cited by 5 publications

References 46 publications

Cardiac systolic and diastolic function in relation to cardiovascular risk factor distribution: a comparison of strain-rate imaging in Russian and Norwegian populations

Cardiac systolic and diastolic function in relation to cardiovascular risk factor distribution: a comparison of strain-rate imaging in Russian and Norwegian populations

Socio-Demographic, Lifestyle, and Cardiometabolic Characteristics Associated with Low-Grade Systemic Inflammation in Russian Adult Population

Obesity mediates the opposite association of education and diabetes in Chinese men and women: Results from the REACTION study

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