Clinical and laboratory characteristics of hepatitis d in Republic of Sakha (Yakutia).

OBJECTIVE: Inrtroduction: The epidemiological situation for hepatitis D has changed significantly. Reduced population authors infection due to a sharp decline in hospitalizations from Central Asia regions, the Caucasus and Moldova, which are known to be endemic for hepatitis D. Currently, the incidence of chronic hepatitis D (HGD) in Russia is 1%, while in the countries of Central Asia, and in particular in Turkmenistan, the share of HGD among chronic viral hepatitis is 8%. The aim of research was to establish the clinical features, depending on the activity of the replication of hepatitis viruses B and D. PATIENTS AND METHODS: Materials and Methods: We studied 26 patients with viral hepatitis D with a determined activity replicative virus by PCR (polymerase chain reaction). The age of patients ranged from 28 to 78 years. The patients performed the ELISA (enzyme-linked immunosorbent assay) study for the presence of markers of parenteral viral hepatitis (HBsAg, a-HCV and a-HDV), the standard general clinical biochemical blood tests. of the instrumental methods survey used ultrasonography (ultrasound), EGD (fibrogastroduodenoscopy). Grading the severity of liver cirrhosis established by Child-Pugh (eng. Child-Pugh, Child-Turcotte, Child-Turcotte-Pugh, sometimes Child-Paquet) is designed to assess the severity of cirrhosis. The severity of liver cirrhosis is assessed on a point system, which are calculated from 5 or 6 parameters. RESULTS: Results: It is established that most HGD more prevalent among young people bodied (69%) and occurs mainly in severe symptoms and portal hypertension leading to the rapid development of liver cirrhosis (53%). It showed that hyperenzymemia reaches high levels of ALT to 1715 U / L. with a high viral DNA load virus (HBV) 2648226,0 ± 953892,7 copies / ml in the presence of an RNA virus D (HDV +). CONCLUSION: Conclusion: Thus, the main feature of chronic hepatitis D is its predominant tsirrogennost.

Lipid metabolism and feeding habits of indigenous peoples of the sakha republic (yakutia) in today's socio-economic development.

INTRODUCTION: By results of a single-step epidemiological research indicators of a lipid range at 355 Evenks of the Olenyoksky District of the Republic of Sakha (Yakutia) are estimated. The aim of this research was assessment of lipid exchange and character of a delivery of Evenks of the item of Zhilinda. MATERIAL AND METHODS: 355 evenks aged over 20 years (170 men, women-185). Total cholesterol (OCHS), cholesterol (low-density lipoproteins (LDL-CHOLESTEROL), highdensity lipoprotein cholesterol ((XC-LVNP), triglycerides (TG), the calculated coefficient of haemoglobin (Ka). The measurement is taken at biochemical autoanalyzer Architest 80000 model Systems, firm Abbot (United States) generally accepted method. Food has been studied using questionnaire CYNDI. Results of the Lipid profile compared to the Evenks of Yakut and Russian population of the Republic's population has a high concentration of CS LPHD, low content of TG and haemoglobin index. Food Evenks is characterized by significant disbalance-» surveyed every day consume meat and fish every day consumes but 1/5 surveyed. the shortage of basic products is replaced with bread, pasta and sweets. CONCLUSION: The identified indicators of lipid range Evenks have more healthy than the Yakut. Nutrition Evenks departs from the traditional protein-lipid in carbohydrate-protein.

Adiponectin, hemoglobin, and cardiovascular risk in an indigenous siberian population.

OBJECTIVES: Adipose tissue hypoxia appears to play a role in promoting chronic inflammation and the development of obesity-related cardiovascular and metabolic diseases, yet the underlying mechanisms are not well understood. The aim of the present research is to examine whether adiponectin levels (an adipocyte-derived hormone with anti-inflammatory properties) are inversely correlated with hemoglobin levels in an indigenous Siberian population. METHODS: The study was conducted among 252 Yakut adults (≥18 years; 135 females) from Berdygestiakh, Sakha Republic, Russia. Measurements included anthropometric dimensions (body mass index [BMI], waist circumference [WC], and percent body fat) and blood levels of hemoglobin and adiponectin. RESULTS: Yakut females had higher adiponectin concentrations than males (15.1 ± 9.8 vs. 11.7 ± 10.6 µg/ml; P < 0.001), whereas males had higher hemoglobin levels (14.4 ± 1.4 vs. 12.6 ± 1.5 g/dL; P < 0.001). Body composition measures in both sexes were negatively associated with adiponectin and positively associated with hemoglobin. After adjusting for central adiposity and smoking, adiponectin levels were negatively correlated with hemoglobin levels in men (P < 0.05), but not in women (P = 0.511). CONCLUSIONS: This investigation provides some support for the involvement of hypoxia-related dysregulation of adiponectin associated with obesity and potentially cardiovascular disease. Am. J. Hum. Biol. 28:580-583, 2016. © 2015 Wiley Periodicals, Inc.

Do physical activity and sedentary behavior relate to cardio-metabolic risk factor clustering in indigenous Siberian adults?

OBJECTIVES: To investigate whether having multiple risk factors for cardio-metabolic disease is associated with objectively measured physical activity or sedentary behavior within a sample of Yakut (Sakha) of Siberia. METHODS: This cross sectional study involved 63 Yakut adults (32 men) who were measured for cardio-metabolic risk factors. Free living physical activity and sedentary behavior were calculated from waist accelerometry. Correlations and t-tests were used to assess the relationship between moderate-vigorous physical activity (MVPA), sedentary behavior (SB), and individual risk factors and clustering of risk factors. RESULTS: These Yakut were physically active, with 54.4% spending at least 30 min in MVPA, with men being more active than women and women having less favorable cardio-metabolic profiles. These Yakut spent about 7.5 h in SB a day. SB was not related to cardio-metabolic risk factors. MVPA was significantly and negatively related to waist circumference and risk factor clustering in men and the total sample. MVPA was not related to women's risk factors. CONCLUSIONS: Objectively measured physical activity was related to lower risk of cardio-metabolic risk factor clustering within this sample of Yakut men, but not women. SB was not related to cardio-metabolic indicators. Physical activity may contribute to a reduction in clustering of metabolic risk factors within indigenous circumpolar populations.

Communicating hydrocephalus following eosinophilic meningitis is pathogenic for chronic Viliuisk encephalomyelitis in Northeastern Siberia.

BACKGROUND: Viliuisk encephalomyelitis (VE) is an endemic neurological disease in Northeast Siberia and generally considered to be a chronic encephalomyelitis of unknown origin actually spreading in the Sakha (Yakutian) Republic. METHODOLOGY AND PRINCIPLE FINDINGS: In search for the pathophysiology and causative agent of VE, we performed a cross-sectional study on clinical, serological and neuroimaging data on chronic VE patients during two medical expeditions to three villages within the Viliuiski river basin in the Republic of Sakha in 2000 and to the capital Yakutsk in 2006. The severity of the core clinical picture with predominant sensory ataxia, gait apraxia, lower limb spasticity, cognitive impairment and bladder dysfunction correlated with the degree of MRI findings showing enlargement of inner ventricular spaces as in communicating hydrocephalus. Laboratory studies revealed transient eosinophilia during the preceding acute meningitis-like phase, but no ongoing inflammatory process in the CSF. We found immune reactions against Toxocara canis in the majority of chronic VE patients but rarely in controls (P = 0.025; Fisher's exact test). Histological analysis of subacute to subchronic VE brain samples showed eosinophilic infiltrations with no signs of persistent Toxocara canis infection. CONCLUSIONS AND SIGNIFICANCE: Our data showed that pressure by the communicating hydrocephalus as a mechanical factor is the major pathogenic mechanism in chronic VE, most likely triggered by eosinophilic meningitis. There are no signs for an ongoing inflammatory process in chronic VE. The past eosinophilic reaction in VE might be caused by Toxocara ssp. infection and might therefore represent the first hint for an initial cause leading to the development of chronic VE. Our data provide a framework for future studies and potential therapeutic interventions for this enigmatic epidemic neurological disease potentially spreading in Sakha Republic.

Objectively measured physical activity and sedentary behaviour of Yakut (Sakha) adults.

BACKGROUND: Circumpolar regions are undergoing social and economic transition, which often corresponds to a behavioural transition. Yet, physical activity and sedentary behaviour are rarely objectively measured within these groups. AIM: This study aimed to characterize objectively measured physical activity and sedentary behaviour in a sample of indigenous Siberians. SUBJECTS AND METHODS: Yakut (Sakha) adults (n = 68, 32 men) underwent anthropometry, interviews and wore a triaxial accelerometer for two days. Time spent in moderate-to-vigorous physical activity (MVPA) or sedentary behaviour was calculated using a single axis and also all three axes. RESULTS: Men spent significantly more time in MVPA than women, although no sex difference was found in sedentary behaviour. Participants were far more active and less sedentary when classified using all three axes (vector magnitude) than a single axis. Television viewing time significantly related to sedentary behaviour in men only. CONCLUSION: The Yakut have gender differences in amount and predictors of physical activity and sedentary behaviour. Triaxial accelerometry is more sensitive to daily physical activity in free living populations than single axis.

Seasonal and socioeconomic influences on thyroid function among the Yakut (Sakha) of Eastern Siberia.

OBJECTIVES: Previous research has shown that the extreme cold and short day lengths of polar winters promote increased production and uptake of thyroid hormones, resulting in marked declines in free triiodothyronine (fT3). However, this "polar T3 syndrome" has been documented almost exclusively on small samples of male sojourners and little is known about seasonal changes in thyroid function among indigenous circumpolar groups. The present study addresses this gap by examining seasonal changes in thyroid hormone levels among the indigenous Yakut (Sakha) of northeastern Siberia. METHODS: Anthropometric dimensions and thyroid measures (fT3, free thyroxine [fT4], thyroid-stimulating hormone [TSH]) were obtained on two occasions (July/August, 2009 and January 2011) on a sample of 134 Yakut adults (51 men, 83 women) from the village of Berdygestiakh, Sakha Republic/Yakutia, Russia. RESULTS: Yakut men and women both displayed significant declines in fT3 and fT4, and significant increases in TSH from summer to winter despite showing only modest seasonal changes in body mass and composition. Among men, gains in fat-free mass (FFM) were associated with larger reductions in fT3 and greater increases in TSH. Men living more traditional lifeways showed larger winter declines in fT4 and greater increases in TSH. CONCLUSIONS: The Yakut exhibited significant winter declines in fT3 levels similar to other circumpolar groups studied. However, the magnitude of seasonal change was greater in the Yakut, perhaps reflecting their distinctive metabolic physiology. Lifestyle factors play a mediating role in thyroid responses, such that men with more traditional lifeways had more exaggerated seasonal changes.

Circumpolar adaptation, social change, and the development of autoimmune thyroid disorders among the Yakut (Sakha) of Siberia.

OBJECTIVES: Alterations in thyroid function appear to play a central role in adaptation to Arctic environments. Increased thyroid activity in indigenous circumpolar populations is associated with upregulated metabolism, including elevated basal metabolic rate (BMR); however, little is known about the possible health consequences of these climate-induced changes on thyroid function. The focus of the present study is to determine the prevalence of autoimmune thyroid disorders and their lifestyle and metabolic correlates among a sample of indigenous Yakut adults from northeastern Siberia. METHODS: Anthropometric dimensions, health data, and plasma samples were collected among 281 adults (143 women, 138 men; ≥18 years old) from the rural community of Berdygestiakh (62°N, 127°E; pop. 4,900), Sakha Republic (Yakutia), Russia. BMR measurements were available for 96 women and 98 men. Free triiodothyronine (T(3) ), free thyroxine (T(4) ), thyroid stimulating hormone (TSH), and anti-thyroid peroxidase antibody (TPOAb) levels were determined using enzyme immunoassay. RESULTS: Twenty-two percent of women and 6% of men had clinically elevated (>30 IU/ml) TPOAb. TPOAb was positively correlated with TSH (P < 0.01), T(3) (P < 0.05), and T(4) (P < 0.05) in women and showed a positive trend with T(4) (P = 0.06) in men. Monthly household income was significantly positively correlated with TPOAb in men (P < 0.01) and showed a trend among women (P = 0.06). CONCLUSIONS: Although preliminary, these findings document higher than expected TPOAb levels among Yakut women and suggest possible consequences of increased thyroid activity associated with circumpolar adaptation and social change.

Epidemiology of Viliuisk encephalomyelitis in Eastern Siberia.

BACKGROUND: Viliuisk encephalomyelitis is a disorder that starts, in most cases, as an acute meningoencephalitis. Survivors of the acute phase develop a slowly progressing neurologic syndrome characterized by dementia, dysarthria, and spasticity. An epidemic of this disease has been spreading throughout the Yakut Republic of the Russian Federation. Although clinical, neuropathologic, and epidemiologic data suggest infectious etiology, multiple attempts at pathogen isolation have been unsuccessful. METHODS: Detailed clinical, pathologic, laboratory, and epidemiologic studies have identified 414 patients with definite Viliuisk encephalomyelitis in 15 of 33 administrative regions of the Yakut Republic between 1940 and 1999. All data are documented in a Registry. RESULTS: The average annual Viliuisk encephalomyelitis incidence rate at the height of the epidemic reached 8.8 per 100,000 population and affected predominantly young adults. The initial outbreak occurred in a remote isolated area of the middle reaches of Viliui River; the disease spread to adjacent areas and further in the direction of more densely populated regions. The results suggest that intensified human migration from endemic villages led to the emergence of this disease in new communities. Recent social and demographic changes have presumably contributed to a subsequent decline in disease incidence. CONCLUSIONS: Based on the largest known set of diagnostically verified Viliuisk encephalomyelitis cases, we demonstrate how a previously little-known disease that was endemic in a small indigenous population subsequently reached densely populated areas and produced an epidemic involving hundreds of persons.

Lifestyle incongruity, stress and immune function in indigenous Siberians: the health impacts of rapid social and economic change.

The purpose of this study was to investigate the impact of economic and cultural change on immune function and psychosocial stress in an indigenous Siberian population. We examined Epstein-Barr virus antibodies (EBV), an indirect biomarker of cell-mediated immune function, in venous whole blood samples collected from 143 Yakut (Sakha) herders (45 men and 98 women) in six communities using a cross-sectional study design. We modeled economic change through the analysis of lifestyle incongruity (LI), calculated as the disparity between socioeconomic status and material lifestyle, computed with two orthogonal scales: market and subsistence lifestyle. EBV antibody level was significantly negatively associated with both a market and a subsistence lifestyle, indicating higher cell-mediated immune function associated with higher material lifestyle scores. In contrast, LI was significantly positively associated with EBV antibodies indicating lower immune function, and suggesting higher psychosocial stress, among individuals with economic status in excess of material lifestyle. Individuals with lower incongruity scores (i.e., economic status at parity with material resources, or with material resources in excess of economic status) had significantly lower EBV antibodies. The findings suggest significant health impacts of changes in material well-being and shifting status and prestige markers on health during the transition to a market economy in Siberia. The findings also suggest that relative, as opposed to absolute, level of economic status or material wealth is more strongly related to stress in the Siberian context.

Viliuisk encephalomyelitis in Northeastern Siberia is not caused by Borrelia burgdorferi infection.

Viliuisk encephalomyelitis (VE) is an endemic neurological disease in Northeastern Siberia and generally believed to be a chronic encephalomyelitis of unknown origin. We investigated 17 patients with a clinical diagnosis of VE within the Viliuiski region of Sakha (Yakutian) Republic to explore the core clinical syndrome of chronic VE and subsequently whether VE is caused by Borrelia burgdorferi infection. We found a chronic myelopathy as the core of the syndrome, often following an acute phase with a meningo-radiculo-neuropathy, suggestive of chronic neuroborreliosis. A search for inflammatory parameters in a larger cohort in blood (39 VE patients and 41 controls) and CSF samples (10 VE patients and 7 controls) excluded an ongoing chronic infection, but revealed evidence for an immunological scar or a chronic inflammatory ("autoimmune") response in the CSF. In addition, we detected signs of a previous exposure to Borrelia burgdorferi antigens in a subset of chronic VE patients with positive serological results using ELISA/immunoblot in 54/10% and 22/0% of VE patients and controls, respectively (p values of 0.003/0.034; Fisher's exact test). However, CSF analyses did not show a link between exposure or at least immunological reaction against Borrelia and the risk of suffering from VE. Our data provide the first evidence of the presence of Borrelia burgdorferi or similar pathogens in Northeastern Siberia, but do not support a causative role of these pathogens in the aetiopathogenesis of VE.

Anthropometric correlates of C-reactive protein among indigenous Siberians.

C-reactive protein (CRP) is an inflammatory marker, which at low-level elevations is associated with increased cardiovascular risk. Although CRP has been extensively investigated in North American and European settings, few studies have measured CRP among non-Western groups. The present study used dried whole blood spot samples to examine high-sensitivity CRP concentrations among the Yakut (Sakha) of Siberia (85 females, 56 males; 18-58 years old). Our goals were: (1) to compare Yakut CRP concentrations with other populations; (2) to investigate sex differences; and (3) to explore anthropometric correlates of CRP. Results indicate that serum equivalent CRP concentrations are similar to those from industrializing nations, lower than US and European values, and greater than Japanese concentrations. Yakut men and women display similar CRP concentrations; however, CRP was significantly higher among men after adjustment for body fat, age, and smoking. Positive associations were documented between CRP and BMI, body fat, and central adiposity.

Family clustering of Viliuisk encephalomyelitis in traditional and new geographic regions.

Viliuisk encephalomyelitis is an acute, often fatal, meningoencephalitis that tends to develop into a prolonged chronically progressive panencephalitis. Clinical, neuropathologic, and epidemiologic data argue for an infectious cause, although multiple attempts at pathogen isolation have been unsuccessful. To assess mechanisms of disease transmission and spread, we studied 6 multiplex families. Secondary cases occurred among genetically related and unrelated persons in a setting of prolonged intrahousehold contact with a patient manifesting the disease. Transmission to unrelated persons was documented in a densely populated region around the city of Yakutsk in which Viliuisk encephalomyelitis had not been previously known. Initially identified in a small Yakut-Evenk population on the Viliui River of eastern Siberia, the disease subsequently spread through human contacts to new geographic areas, thus characterizing Viliuisk encephalomyelitis as an emerging infectious disease.

Basal metabolic rate in the Yakut (Sakha) of Siberia.

Human indigenous circumpolar populations have elevated basal metabolic rates (BMRs) relative to predicted values; this metabolic elevation has been postulated to be a physiological adaptation to chronic and severe cold stress. The present study examines BMR in the Yakut, an indigenous high-latitude population from the Sakha Republic of Russia to determine (1) whether the Yakut show evidence of an elevated BMR, (2) if the Yakut display evidence of age-related changes in BMR, and (3) whether lifestyle differences influence BMR. BMR was measured during the late summer in 75 women and 50 men (ages 18-56 years) from the Siberian village of Berdygestiakh. Measured BMR (+/- SEM) of the entire sample was significantly elevated (+6.5%) compared to predictions based on body mass (6,623.7 +/- 94.9 vs. 6,218.2 +/- 84.7 kJ/day; P < 0.001). Additionally, measured BMR for the entire sample was significantly higher than predictions based on fat-free mass (+20.8%) and surface area (+8.9%). Males and females both showed significant elevations relative to all three standards. The elevated BMR of the Yakut does not appear to be attributable to extreme levels of protein, since the Yakut consume a mixed diet with a substantial proportion of carbohydrates. No significant age-related changes in BMR were found when controlled for body composition. No significant relationship was found between lifestyle variables and BMR, suggesting the possibility of a genetic or developmental mechanism. This study provides additional evidence of metabolic elevation in indigenous circumpolar groups and has important implications for estimating the nutritional requirements of these populations.

Viliuisk encephalomyelitis: intrathecal synthesis of oligoclonal IgG.

Viliuisk encephalomyelitis (VE) is a neurodegenerative disorder expressed as subacute meningo-encephalitis progressing to a more prolonged pan-encephalitic syndrome with a fatal outcome within 1 to 10 years. Some patients survive to a steady state of global dementia and severe spasticity that may last for over 20 years. Multiple micronecrotic foci surrounded by inflammatory infiltrates are observed throughout the cerebral cortex and other gray matter areas. Infectious etiology of VE is strongly suspected, but the causative agent has not been identified. We conducted a search for assays that might be helpful for VE diagnosis and established for the first time that the majority of patients with definite VE show evidence for intrathecal IgG synthesis correlating with the clinical manifestations of the disease. This indicates that the detection of oligoclonal IgG banding in the cerebrospinal fluid is a valuable diagnostic assay for VE. Implications of these findings for a possible etiology of VE are discussed.