[Prevalence of obstructive sleep apnea symptoms in a rural population]. / Prevalenta simptomelor de apnee obstructiva în somn într-o populatie rurala.

AIM: Obstructive Sleep Apnea Syndrome (OSAS) is an under diagnosed condition with significant consequences on health. The aim of this study is to estimate the prevalence of symptoms and key features of OSAS in a rural population. MATERIAL AND METHODS: 254 subjects were enrolled. We measured height (H) and weight (W), calculated body mass index (BMI) and determined glycated hemoglobin (HbA1c). Information about age, gender, medical history (diabetes, hypertension) was collected. All the participants filled in the Berlin questionnaire, which has separate questions regarding the symptoms of OSAS. RESULTS: Snoring was reported by 44.1% of the subjects, observed apneas by 6.7% and excessive daytime sleepiness by 36.6%. All symptoms were more frequently reported by women. A higher percentage of obese, hypertensive and diabetics reported snoring (p < 0.001). When analyzing gender differences, the significance was maintained, except for diabetic men. Witnessed apneas were more prevalent in hypertensive subjects (p = 0.034), but were significantly associated with hypertension only in (p = 0.003). No correlation was found regarding excessive daytime sleepiness and the risk factors studied. CONCLUSIONS: Prevalence of OSAS symptoms and risk factors in this rural population was noticeable and efforts for early diagnosis and treatment are recommended.

The central role of the non alcoholic fatty liver disease in metabolic syndrome.

Non-alcoholic fatty liver disease (NAFLD) covers a spectrum of liver disease from steatosis to non-alcoholic steatohepatitis (NASH) and cirrhosis. Most NAFLD patients are hyperinsulinaemic and more insulin resistant compared with nonsteatotic healthy subjects, and there is a near universal association between NAFLD and insulinresistance (IR) irrespective of obesity. The metabolic syndrome (MS) is highly prevalent in the general adult population (approximatively 22%) and it carries an increased cardiovascular morbidity and mortality. Pathophysiologic considerations, clinical associations, and laboratory investigations support that IR and hyperinsulinaemia have a central role in pathogenesis of both MS and NAFLD. The fatty liver is resistant to the action of insulin to suppress hepatic glucose production, which results in hyperglycaemia and, further, in hyperinsulinemia. The MS is associated with maldistribution of body fat, increased free fatty acids (FFAs) and IR, leading to type 2 diabetes, hypertension, dyslipidemia. Visceral fat is an important clinical marker of metabolic cardiovascular risk and a marker of IR in multiple tissues, independent of body mass index (BMI). NAFLD and atherosclerosis share common molecular mediators and NAFLD itself might play an early role in the development and progression of atherosclerosis. These data suggest that NAFLD should be considered part of a multi-organ system derangement in insulin sensitivity, and help explain why NAFLD is so closely linked with diabetes, MS and is an important risk factor for coronary heart disease. NAFLD may be the hepatic manifestation of the MS and raises the possibility that it may play an early role in the etiology of MS.

Non-alcoholic fatty liver disease is associated with cardiovascular risk factors of metabolic syndrome.

AIM: To evaluate the prevalence of steatosis and to assess its correlations with the classical cardiovascular (CV) risk factors, components of metabolic syndrome (MS) in a rural population. MATERIAL AND METHODS: A sample of 254 subjects was enrolled in the study. Collected data included: age, gender, complete medical history, anthropometric and blood pressure (BP) measurements. The biological evaluation included metabolic and hepatic parameters. Ultrasound evaluation of steatosis relied on the criteria of the National Health and Nutrition Examination Survey (NHANES) III. RESULTS: Two thirds of the study population were obese or overweight (64.96%); 32.66% had systolic BP and 27.16% diastolic BP levels higher than normal. 38% of the subjects had abnormal fasting blood glucose levels, 14.56% having glycated hemoglobin (HbA1c) values corresponding to pre-diabetes, and 9.84% to overt diabetes; 8% had low HDL-cholesterol and 14.96% high triglycerides (Tg) levels. MS was present in 50.8% of individuals. Only 10.8% of all subjects did not have an ultrasound appearance of steatosis; 28.8% had moderate and 32% severe steatosis. There were statistically significant differences in subjects with steatosis vs. subjects without steatosis with regard to body mass index (BMI), WC, presence of MS, and BP and Tg levels, but not to ALAT, ASAT and GGT values. CONCLUSIONS: The important prevalence of obesity, fasting hyperglycamia, steatosis and MS shows a particularly metabolic fragile population; early diagnosis and interventional strategies are mandatory.

Anthropometric parameters--predictive factors for cardio-metabolic diseases.

UNLABELLED: The aim of this study was to evaluate comparatively the predictive power of body mass index (BMI) and waist circumference (WC), two anthropometric parameters used in daily practice, for detecting cardio-metabolic diseases, in a rural community in north-east Romania. MATERIAL AND METHODS: We evaluated 3248 persons, aged 19 or over, for whom we collected the following data: medical history, anthropometric parameters, blood pressure value and biochemical parameters. RESULTS AND CONCLUSIONS: Both WC and BMI help correctly determine the presence of arterial hypertension, diabetes and dislipidemia. However, the cut-off value of each of these parameters differs for each pathology. The predictive value of WC for different cardio-metabolic diseases is maintained even at normal or borderline overweight values of BMI.

Socio-demographic and lifestyle characteristics associated with the risk for obstructive sleep apnea syndrome in a rural population.

AIM: To evaluate socio-demographic and lifestyle characteristics in relationship to the risk for obstructive sleep apnea syndrome (OSAS). MATERIAL AND METHODS: The study was carried out on 254 subjects. Socio-demographic data (age, gender, occupation, education level, and economic status), smoking status, alcohol consumption, and hours/day spent watching TV were recorded. For physical activity assessment the international physical activity questionnaire and for identifying the risk for OSAS Berlin Questionnaire were used. RESULTS: Of the 254 subjects, 29.4% of men and 36.8% of women were at high risk for OSAS (p=0.22). Age was higher in the group at high risk for OSAS (p=0.002) and in women (p<0.001). The highest percentage (47.5%) of participants at high risk for OSAS was found among retired people, whereas farmers generated the lowest percentage (18.6 %) (p<0.001). 57.1% of retired women were at high risk for OSAS as compared to 5.6% of the farmers (p<0.001). Education level and monthly income did not influence the risk of OSAS (p=0.172, p=0.113, respectively). No differences in the risk of OSAS were found in relation with smoking (p=0.887), alcohol consumption (p=0.688), and sedentary lifestyle. We found that individuals at low risk for OSAS performed more physical activity at work (p=0.053) and significantly more vigorous physical activity (p=0.036). CONCLUSIONS: In the study rural population, age, occupation and physical activity are related to the risk for OSAS.

[Correlations between anthropometric parameters and cardio-vascular risk factors related to lifestyle in a rural population]. / Corelatii între indicii antropometrici si factorii de risc cardiovascular legati de stilul de viata într-o populatie rurala (nota I).

BACKGROUND AND AIMS: Prevention and reduction of cardio-vascular mortality are in relationship with understanding and being able to modify risk factors, among which overweight and obesity become the most significant. The aim of this paper is to define cardio-metabolic risk factors which are specific to the studied population, and also to find elements of lifestyle that lead to overweight. We targeted smoking, alcohol consumption, stress, physical exercise, income and educational level. MATERIAL AND METHODS: We studied a sample of 172 subjects, representative for the population of Deleni, a rural community in Iasi County; among these subjects, 67 were men, 105 were women, with an average age of 54. For each a chart was filled, containing demographic data, socio-economic status, personal and family medical history. We measured anthropometric parameters: weight (W), height (H), waist circumference (WC) and we calculated body mass index (BMI), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). We performed interviews to fill in a food frequency questionnaire, the Perceived Stress Scale and the International Physical Activity Questionnaire. RESULTS: In the lot studied, 44.2% are overweight and 18.6% are obese, the majority of these being women. Regarding WC, among normal weight, 52.4% have large WC (> or = 94cm for men and > or = 80cm for women). Obesity markers positively correlate with increase in age and decrease in income (p=0.024), with low educational level, regular consumption of coffee (p=0.093), and negatively correlate with excessive alcohol consumption (p=0.049) and smoking (p=0.003). As expected, there is an inverse relationship between increased physical exercise and BMI (p=0.015) and a direct relationship between increased stress level and WC. CONCLUSIONS: Anthropometric parameters are sensible markers in evaluating the influence of lifestyle on cardio-metabolic risk.