Epidemiologic aspects of tobacco smoking in connection with its clinical course among men aged 20-69 years living in Kiev

An epidemiological study was carried out among 1500 men aged 20-69 years in order to study the prevalence of risk factors of coronary heart disease. 51.1% of the men turned out to be tobacco-smokers. Every tenth man smoked up over 20 cigarettes, every fourth man smoked up from 10 to 20 cigarettes a day. The number of tobacco-smokers decreased with age, namely from 61% at an age of 20-29 years to 33% at an age of 60-69 years. The structure of tobacco-smoking was found to change with age. This is related to the fact that the age-associated dynamics of its prevalence and intensity correlates with the dynamics of formation and course of the toxicomanic dependence on tobacco smoke. The data obtained are important for the planning of measures aimed at tobacco-smoking control among the population in cases where it is necessary to estimate whether carrying out of the sanitary instructive measures alone is sufficient.     

The potentialities of capnography in the early diagnosis of obstructive ventilatory disorders

A total of 52 subjects (27 normal persons not abusing tobacco-smoking and 25 tobacco-smokers without respiratory disorders) were examined for external respiration function. A study was also made of the capnography data. It has been demonstrated that the classical criteria of the functional disorders of ventilation (FVC, RFV1, RFV1/FVC, MPV) do not enable one to make an early diagnosis of the ventilatory alterations in subjects with a risk of the development of CNPD (in tobacco-smokers). Analysis of the last third of the forced expiration curve flow-volume appeared to be of great informative value. There was a marked correlation between the capnogram characteristics and external respiration function characterizing patency of the small bronchi. It is concluded that capnography can be used as a method for assessing bronchial patency. The most informative criteria of the capnogram are provided.     

The effect of smoking on the composition of the peripheral blood in normal subjects]

The peripheral blood erythrocytic and leukocytic status was studied in 60 healthy young tobacco-smokers and in 30 non-smokers. The smokers were divided into two subgroups, each with 30 members: those smoking for not more than 5 years and those smoking for 6 to 10 years. A trend to inhibition of erythro- and leukocytopoiesis was detected in Subgroup 1 tobacco smokers: reticulocyte maturation rate was reduced, as was bone marrow production and the level of circulating red cells, macrocyte count was increased and planocytosis was likely to develop, leukocyte counts were decreased at the expense of the neutrophils, eosinophils, and monocytes; basophil count was growing. Subgroup 2 tobacco-smokers presented with normalization of erythro- and leukocytopoiesis: reticulocyte maturation rate was growing, as was bone marrow production and the count of circulating red cells, erythrocytogram normalized, leukocyte count was increasing at the expense of the neutrophils, eosinophils, and lymphocytes; basophil count has decreased. The detected changes in the peripheral blood erythro- and leukocytic composition, related to the duration of tobacco-smoking, appear to reflect different phases of tobacco smoke toxic product effects on the bone marrow and the formation of the defense, adaptive, allergic, and immunologic reactions of the body in conditions of prolonged tobacco antigenemia.     

The incidence of ischemic heart disease and its risk factors in 20- to 54-year-old male workers in physical and intellectual jobs]

The low incidence of coronary heart disease (CHD) was established in the course of a one-stage epidemiological examination of 2562 men aged 20-54 years (a random sample from an open city population). It was found to be associated with an insignificant prevalence of lipid metabolism abnormalities (excluding hypoalphacholesterolemia) and did not depend on the nature of labour (4.3% among white collars and 4.4% among blue collars). The incidence of overweight and high AP turned out approximately identical, whereas tobacco-smoking, hypercholesterolemia and hypertriglyceridemia were mostly recorded in blue collars. The prevalence of CHD and its risk factors increased with age, excluding tobacco-smoking. In the latter case, it reduced with age.     

Epidemiology of ischemic heart disease as related to the main risk factors among the male population in various Soviet cities (a cooperative study)

A study was made of the prevalence of coronary heart disease, risk factors (arterial hypertension, hypercholesterolemia, hypertriglyceridemia, hypo-alpha-cholesterolemia, overweight, tobacco-smoking) and of the relation of coronary heart disease to the risk factors in men aged 20 to 39 years and 40 to 54 years, living in 8 cities of the USSR. The study was carried out on material of random representative samples. It has been established that the prevalence of coronary heart disease and risk factors is bigger among the populations living in the European part of the USSR and Siberia, being lower among the populations of Central Asia. The relationship between coronary heart disease and the risk factors is pronounced to a greater measure in arterial hypertension and overweight and to a less degree in other conditions. Besides, the relation of coronary heart disease to the risk factors is marked to a much greater measure among men belonging to the senior age groups.     

Mean values of risk factors for ischemic heart disease and their percentile distributions in the Alma-Ata population of men aged 20-54]

The authors analyze the results of a one-stage epidemiological study of the open population of men aged 20-54 years (n-2886), carried out with a purpose of revealing coronary heart disease (CHD) and its risk factors (RF). The study was performed with the aid of the standard WHO methods of epidemiological investigations. The prevalence of the main CHD RF (arterial and borderline hypertension, overweight, tobacco-smoking, dyslipoproteinemias) was established. The mean values of RF in different age groups were calculated. The regional 90% cut-off points of RF distributions were defined: the body weight index (30.0), systolic arterial pressure (141 mm Hg), diastolic arterial pressure (95 mm Hg), cholesterol level (6.50 mmol/l, triglycerides (2.15 mmol/l). The 10% cut-off point for alpha-cholesterol amounted to 0.98 mmol/l. The regional values obtained can be used in prophylactic screenings when making up groups to be placed under dispensary observation.     

Reference values for the physical work capacity on a bicycle ergometer for men -- a comparison with a previous study on women

The aim of the study was to collect new reference values for the clinical ramp exercise test on bicycle, because in our experience, the commonly used values were too low. A group of healthy men (n = 81, 20-80 years) was randomly selected from the local municipal register to achieve an even distribution in age. Data were compared with those obtained in a similar, previous study on women (n = 87). The subjects were encouraged to cycle until exhaustion (19 on the Borg scale) when maximal load, heart rate and systolic blood pressure were recorded. Maximal load (W(max)) was related to age (years) and height (m) using a non-linear function: W(max) = (244.6 x height - 92.1)/[1 + exp[0.038 x (age - 77.3)]]. Maximal heart rate (HRmax) was described by a similar function: HRmax = 203.7/[1 + exp[0.033 x (age - 104.3)]]. The maximal systolic blood pressure (BP(max)) was described by a linear function based on age: BP(max) = 0.505 x age + 192. Similar functions for the women are also given. It is suggested that 80-120% of the predicted maximal load can be taken as a reference interval for both men and women and similarly 90-110% of the maximal heart rate. In this study, 84% of the men reached a maximal load within the reference interval and 93% maximal heart rate within the reference interval. The reported values for maximal load were 104-132% of the reference values published by others.     

Study of myocardial infarction risk factors within the framework of the WHO Monica-psychosocial program

Three screening population studies were carried out within the framework of the WHO MONICA-psychosocial program in 1984, 1988, and 1994. The subjects of the study were male inhabitants of one of Novosibirsk districts aged 25 to 64 years. The cohort was studied during 18 years, from 1984 to 2002, using the WHO Acute Myocardial Infarction Register program. The statistical analysis was performed using SPSS-10 software package. The relative risk (RR) of myocardial infarction (MI) was estimated using Cox proportional regressive model. The greatest proportion (38.9%) of patients with MI was among men aged 45 to 54 years. Among men with MI, 58.7% had a high personal anxiety (PA) level. RR of MI was high among widowers, divorced and single men with a high PA level, in men with incomplete secondary or primary education, and men of hard or moderate physical labor. In the age group of 24 to 44, RR of MI during the first 5 and 10 years was 7.5 times higher in men with a high PA level vs. men with a medium PA level (p < 0.01). This explains the bigger number of men with MI in the group of 45 to 54 years of age.     

四川省遂宁地区表观健康成年人群血浆FMN,FMN/TP比值及FMN/ALB比值参考区间的建立

目的 建立四川省遂宁地区表观健康成年人群血浆果糖胺(fructosamine,FMN)、果糖胺/总蛋白比值(fructosamine to total protein ratio,FMN/TP)及果糖胺/清蛋白比值(fructosamine to albumin ratio,FMN/ALB)的参考区间。方法 选取2017年1～12月遂宁市中心医院健康管理中心14 639例20～79岁的表观健康成年人作为研究对象,其中男性4 811例,女性9 828例,通过问卷调查、体格检查、超声及实验室检查排除呼吸系统、血液系统、内分泌系统、炎症和肿瘤等疾病,检测其血浆FMN、总蛋白(total protein,TP)和清蛋白(albumin,ALB)的浓度并计算该人群FMN/TP及FMN/ALB的浓度水平。根据性别和年龄将研究对象分组(男女各6组:20～29岁组,30～39岁组,40～49岁组,50～59岁组,60～69岁组和70～79岁组),对各组检测结果进行统计学分析,浓度水平差异无统计学意义的各组数据进行合并后,呈正态分布则以均值±1.96标准差((-overx)&#177;1.96s)建立该地区表观健康人群血浆中FMN,FMN/TP及FMN/ALB的参考区间; 呈偏态分布以百分位数法(P_2.5～P_97.5)建立其参考区间。结果 男性血浆FMN,FMN/TP及FMN/ALB浓度水平依次为1.7(1.6～1.8)mmol/L,22.0(20.7～23.5)μmol/g和37.1(34.5～39.8)μmol/g; 女性则依次为1.7(1.6～1.8)mmol/L,22.4(21.1～23.9)μmol/g和38.5(36.2～41.2)μmol/g。男性和女性血浆FMN,FMN/TP及FMN/ALB浓度水平均呈偏态分布(P<0.05),且两组间比较差异均具有统计学意义(P<0.01)。进一步分析,男性和女性各年龄组血浆FMN,FMN/TP及FMN/ALB浓度水平的中位数与其总体区间中位数的差异均<25%,故不建议按年龄段分组建立参考区间,可仅按性别分组建立其参考区间。 FMN的参考区间:男性为1.4～2.0 mmol/L,女性为1.5～2.0 mmol/L; FMN/TP的参考区间:男性为18.2～26.4 μmol/g,女性为18.9～26.8 μmol/g; FMN/ALB的参考区间:男性为30.4～46.1 μmol/g,女性为32.1～46.9 μmol/g。结论 初步建立了遂宁地区20～79岁表观健康人群血浆FMN,FMN/TP及FMN/ALB的参考区间,为临床应用其作为糖尿病患者的诊断及疗效评估指标提供依据。     

Study of arterial pressure, body weight, motor activity and prevalence of smoking in two independent samples of Moscow schoolchildren 11 and 14 years of age

The paper treats the results of a comparative 6-year study of arterial blood pressure, body weight, motor activity, and tobacco-smoking prevalence with respect to two representative samples of schoolchildren aged 11 and 14 years living in one of the districts of Moscow. A total of 1999 and 1219 persons were examined. The scope of examination amounted to 88 to 93 percent. From 1978-1980 to 1985-1986 the levels of systolic and diastolic arterial blood pressure increased whereas the physical activity of the schoolchildren of the same age declined. The situation with tobacco-smoking changed towards better. Thus the number of tobacco-smoking boys aged 14 years reduced almost 2-fold in spite of the lack of any prophylactic interventions in that population.     

Soluble transferrin receptor (sTfR): biological variations and reference limits.

The aim of this study was to establish soluble serum transferrin receptor (sTfR) reference limits. sTfR was measured in 885 healthy subjects from 3 to 91 years old (433 men, 409 women), without hematological abnormalities, using an immunonephelometric assay. The sTfR median concentrations in our population decreased gradually from the group aged 3-10 years to the group aged 21-40 years, then there were no changes in the older groups except for the females >60 years of age. The interindividual variability ranged from 12.6% to 30.3% among different age groups, and the analytical variability was 5%. Biological factors and other factors associated with sTfR concentration variation were examined and accounted for 35% of the sTfR variability in men aged 20 years or less, and 18% in those older than 20 years. Also, they accounted for 45% of the variability in women aged 20 years or less and 14% in those older than 20 years. The main factors statistically associated with sTfR concentration in males were ferritin, orosomucoid, hemoglobin, and tobacco in all age groups and only mean corpuscular volume (MCV) in males less than 20 years old. In the females the main factors were age, orosomucoid, and hemoglobin in all age groups, MCV and tobacco in females less than 20 years old, and ferritin and physical activity in females more than 20 years old. These factors were used to define the exclusion and partition criteria for obtaining the reference samples. Medians for reference values were: 1.60 mg/l in the 3-10-year old group (males and females); 1.42 mg/l in males between 11 and 20 years of age, and 1.33 mg/l in females of the same age. In the other age groups, the median of the reference values was 1.16 mg/l, except in females over 60 years old, for whom it was 1.26 mg/l.     

Universal definition of MI: Above 99 percentile of upper reference limit (URL) for hs-cTn: Yes,but which URL?

The definition of myocardial infarction (MI) is based on the detection of high-sensitive cardiac troponin (hs-cTn) levels above the 99th percentile of upper reference limit (URL) value for a healthy reference population. In the era of hs-cTn assay and the 4th definition for MI, the distinction between the injury and infarction is crucial for the clinician. Measurable troponin is present in the blood of healthy adult subjects. Thus, the calculation of the 99th percentile URL depends on the selected reference population. There is no consensus in the definition of ‘reference population’ among hs-cTn manufacturing companies. For example, gender, age, ethnic and populational differences affect the URL for hs-cTn assay. The URL level is substantially higher in elderly as compared with younger patients. Elevated levels of cTn are found in up to 22% of persons living in the community who are 70?years of age or older. Similarly, men have significantly higher URL levels compared to women. Using the same URL for men and women causes underdiagnosis of MI in women. Finally, the definition of MI covers a wide variety of systemic conditions that can affect the myocardium through injury or infarction. Professional societies have published their recommendations to solve the pre-analytic and analytic contraversies in hs-cTn assay. In conclusion, hs-cTn assays have revolutionized the practice of cardiology. Universal healthy normal pool and consideration of different cut off levels for different populations (i.e. elderly) can potentially help to standardize the interpretation of the hs-cTn test.     

邯郸市健康献血人群丙氨酸氨基转移酶参考值范围调查

目的 调查邯郸市健康献血人群丙氨酸氨基转移酶(ALT)的参考值范围.方法 采用速率法检测ALT值,对邯郸市2010-01-2010-02 10844名18～55周岁健康献血者的ALT检测结果进行统计学分析.结果 ALT水平为对数正态分布,本地区健康献血者95％参考值范围是小于51.7 U/L,其中男7512例,女3332例,几何均数分别为21.5 U/L、13.8 U/L,认为男女间有差异(P＜0.0001),男性高于女性,95％参考值范围分别为小于:57.1、34.3 U/L.各年龄分组中,18～岁人群的ALT值低于其他年龄组(每5岁一组,最后一组为48～55岁),各年龄组几何均数分别为:14.9、17.9、20.9、20.4、20.4、18.8、19.6 U/L,95％参考值范围分别小于:40.1、51.0、58.9、52.8、55.1、50.7、44.9 U/L.结论 该调查反映了邯郸地区健康献血人群的ALT平均水平,男性95％参考值范围高出国家规定≤40 U/L的标准,女性95％参考值范围低于国家规定≤40 U/L的标准;各年龄组的ALT值95％参考值范围均＞40 U/L,18～岁年龄组最低.供有关单位参考.     

中国正常成人步行时空参数分析

目的:探讨中国正常成人的步行特征,为临床步态分析提供科学参考依据。方法:365名正常受试者,按性别、年龄分为20—29岁组、30—39岁组、40—49岁组、50—59岁组、60—75岁组共10组。应用人体步态垫测量与分析系统,测试受试者自由行走时的步速、步长、步幅、步长时间、摆动时间、支撑时间、单足支撑时间、双足支撑时间等时空参数,并对每位受试者的身高、体重进行测试。结果:年龄组内平均步速,除30—39岁组、60—75岁组外,男性均大于女性(P<0.05),50岁以后,男、女步速均减慢,与50岁以前相比差异具有显著性(P<0.01);各年龄组步长,男性均大于女性(P<0.05),女性步长在50岁以后减小,与50岁以前相比差异具有显著性(P<0.01),男性步长在60岁以后减小,明显小于60岁以前步长(P<0.01)。结论:应用人体步态垫测量与分析系统,首次建立中国正常成人步行时空参数值参考范围,初步揭示中国正常成人的步行时空特征。     

Reference distributions for apolipoproteins AI and B and B/AI ratios: comparison of a large cohort to the world's literature

Limiting the clinical utility of apolipoproteins AI (apo AI) and B (apo B) and the apo B/AI ratios until the last decade has been the lack of satisfactory methods for quantifying serum levels and credible reference materials. Great technological strides have been made in the last few years. The remaining barrier to more relevant and cost-effective use of serum protein data for diagnosis and prognosis has been the availability of widely recognized reliable reference intervals from birth to old age for both males and females. A total of 82 publications reporting reference intervals have been identified that meet most of the same inclusion criteria used in our prior six studies. These have been analyzed statistically and compared to similar studies, i.e., sufficient number, listed subject criteria, method, and reference material, in general terms. Published smaller studies with constrained age ranges, agree on average with our large series of life-long reference intervals that range from less than one year to over 80 years. This study was performed to assess the degree of agreement between smaller reference interval studies to our large population analysis. This meta-analysis provides support and reassurance that many of the smaller reference intervals published previously fall within reasonable limits of out large population.     

Bone mineral density of vertebrae,proximal femur and os calcis in normal Greek subjects as assessed by dual-energy X-ray absorptiometry: comparison with other populations

Dual energy X-ray absorptiometry (DXA) is an established method for the detection of even small changes in bone mineral density (BMD). It thus allows the earliest possible diagnosis of osteopenia, with consequent prompt estimation of fracture risk. However, for proper evaluation of densitometry results it is essential that a comparison with reference BMD values of normal age- and sex-matched persons from the same population be performed. For this purpose we determined bone density of the L2–L4 vertebrae, the L3 vertebra in the lateral projection, the proximal femur and the os calcis in a cross-sectional study of 168 men and 244 women from the Greek population. The age range of the subjects was 20–80 years. Peak bone mass for both sexes was attained in the 30–35 year age group for the vertebrae and in the 25–30 year age group for the proximal femur and os calcis. Mean annual vertebral bone loss calculated on cross-sectional data ranged from 0.1% to 0.22% for women <50 years and from 1.3% to 1.6% for those >50 years, whereas in men the range was from 0.36% to 0.64% for the whole age spectrum. Regarding femoral neck, the values were 0.3% (women <50 years), 1.2–1.5% (>50 years) and 0.6–0.8% for men. Total bone loss between ages 20 and 70 was 29.5% for the vertebrae and 32% for the femoral neck in women, whereas the values for men were 19.5% and 29% respectively. A positive correlation was observed between bone density, body weight and body height in both sexes. Body mass index correlated significantly with density only in postmenopausal women. Compared with North American, Finnish and German populations, Greek men presented with lower BMD values in the decades above 40 years. Greek women exhibited lower vertebral BMD values than those from the USA, Germany and Japan (50–60 age group), whereas they did not differ from those of Finnish women. However, femoral neck BMD in Greek women was higher than in Japanese women in all age groups.     

Factors affecting the concentration of triacylglycerols (triglycerides in plasma: reference values for adults.

We studied factors influencing concentrations of triglycerides in the blood of a presumably healthy population of about 9000 persons. Using multi-dimensional analysis, we show, in addition to various related to sex and age, the relation between triglycerides and uric acid, overweight, arterial blood pressure, use of oral contraceptives (in women), consumption of alcohol and tobacco, and lack of physical exercise. These factors were classified as a function of their discriminative power by the statistical method of segmentation. We thus chose the following factors as criteria for exclusion from a reference population for the values of triglycerides in blood: in men 20 to 39 years old, overweight more than 90%; in men 40 to 59 years old, overweight of more than 115%, consumption of more than half a liter of wine per day or of more than 11 cigarettes, use of medicines, and a blood uric acid exceeding 420 mumol/L; in women 20 to 39 years old, contraceptives and overweight; in women 40 to 59 years old, overweight or more than 130% and the intake of medicines. At the 97.5th percentile of the reference population as compared with a non-selected population, the values were 80% less for men 20 to 39 years old, 95% less for men 40 to 59 years old, and only 26 to 30% less for women 20 to 59 years old.     

Health status of the aged: medical profile of a group of functional elderly.

By studying a group of very elderly but generally functional people, we have compiled a medical profile that helps describe health-related characteristics of effective aging. We obtained functional, nutritional, and biochemical information regarding 61 men and women (mean age 86.8 years) attending a veterans' convention. Twenty-three out of 60 (38%) reported a fall in the previous year, with those who were less physically active falling more than the most active. Many of the men were thin or had lost weight, but at most 3 of the 25 male subjects were clinically malnourished. Many of the women were heavy but were otherwise healthy. Of the 36 women, 6 (17%) had an elevated level of thyroid-stimulating hormone (TSH). Five of 58 (9%) had low vitamin B12 levels. Even in the older old who seem to be aging well, falling is relatively common, and screening for certain laboratory abnormalities has a reasonably high yield.     

Biochemical reference intervals for sex hormones with a new AutoDelfia method in aged men.

BACKGROUND: Our aim was to establish sex hormone reference intervals measured with a new AutoDelfia immunoassay method for aged men free of medication and/or conditions known to influence sex hormone levels. METHODS: The reference population consisted of 466 individuals between 64 and 97 years (mean 72 years) and a mean body mass index (BMI) of 26.9 kg/m(2). RESULTS AND CONCLUSIONS: Because age correlated significantly with most sex hormones studied, we calculated reference intervals for three age groups (64-69, 70-74 and > or =75 years). In clinical practice, single ranges can be used for men aged 64 years or over for testosterone, estradiol and follicle-stimulating hormone (FSH) with the AutoDelfia method. For free testosterone and luteinizing hormone (LH), separate reference intervals should be used for men aged 64-74 years and those aged 75 years or over. For sex hormone-binding globulin, two separate reference intervals by age (64-69 and > or =70 years) are also needed for aged men. LH and FSH reference ranges should be judged with caution, because they may be too high due to cases of subclinical hypogonadism included in the reference population.     

Reference ranges for neuroprotein S-100B: from infants to adolescents

Abstract Background: Diagnosis and treatment of mild traumatic brain injuries in children are especially problematic. At present, computed tomography (CT) is the standard method to identify if patients with intracranial lesions require inpatient monitoring. CT, however, involves exposure to high doses of X-rays, which should be avoided if possible. In adults, the serum level of neuroprotein S-100B has already been proven to be effective for the selection of patients requiring CT. The aim of the present study was to determine reference ranges for serum S-100B in a large number of healthy children. Methods: All patients younger than 18 years with no recent history of head injuries presenting for routine operations were included in the study. Results: A total of 394 patients were evaluated. In children from 3 to 18 years an upper reference level of 0.16 mug/L was determined. There was a strong inverse relation between age and S-100B in patients younger than 3 years. As the values in this age group were scattered and the number of cases limited (n=65), no reference range could be calculated. Conclusions: This study provides S-100B reference ranges for pediatric patients based on the largest group of healthy pediatric patients yet analyzed. Clin Chem Lab Med 2008;46:1296-9.