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Tytuł:
Association of body mass index and long-term mortality in patients from nationwide LIPIDOGRAM 2004–2015 cohort studies : no obesity paradox?
Autorzy:
Tomasik, Tomasz
Lip, Gregory Y.H.
Łabuz-Roszak, Beata
Osadnik, Tadeusz
Goławski, Marcin
Gierlotka, Marek
Sattar, Naveed
Windak, Adam
Mastej, Mirosław
Jóźwiak, Kacper
Jóźwiak, Jacek
Mikhailidis, Dimitri P.
Banach, Maciej
Osadnik, Kamila
Nowak, Dariusz
Toth, Peter P.
Opis:
Background An obesity paradox has been described in relation to adverse clinical outcomes (e.g., mortality) with lower body mass index (BMI). Aims We sought to evaluate the association between BMI and weight loss with long-term all-cause mortality in adult populations under the care of family physicians. Methods LIPIDOGRAM studies were conducted in primary care in Poland in 2004, 2006, and 2015 and enrolled a total of 45,615 patients. The LIPIDOGRAM Plus study included 1627 patients recruited in the LIPIDOGRAM 2004 and repeated measurements in 2006 edition. Patients were classified by BMI categories as underweight, normal weight, overweight and class I, II, or III (obesity). Follow-up data up to December 2021 were obtained from the Central Statistical Office. Differences in all-cause mortality were analyzed using Kaplan‒Meier and Cox regression analyses. Results Of 45,615 patients, 10,987 (24.1%) were normal weight, 320 (0.7%) were underweight, 19,134 (41.9%) were overweight, and 15,174 (33.2%) lived with obesity. Follow-up was available for 44,620 patients (97.8%, median duration 15.3 years, 61.7% females). In the crude analysis, long-term all-cause mortality was lowest for the normal-weight group (14%) compared with other categories. After adjusting for comorbidities, the highest risk of death was observed for the class III obesity and underweight categories (hazard ratio, HR 1.79, 95% CI [1.55–2.05] and HR 1.57, 95% CI [1.22–2.04]), respectively. The LIPIDOGRAM Plus analysis revealed that a decrease in body weight (by 5 and 10%) over 2 years was associated with a significantly increased risk of death during long-term follow-up—HR 1.45 (95% CI 1.05–2.02, p = 0.03) and HR 1.67 (95% CI 1.02–2.74, p < 0.001). Patients who experienced weight loss were older and more burdened with comorbidities. Conclusions Being underweight, overweight or obese is associated with a higher mortality risk in a population of patients in primary care. Patients who lost weight were older and more burdened with cardiometabolic diseases, which may suggest unintentional weight loss, and were at higher risk of death in the long-term follow-up. In nonsmoking patients without comorbidities, the lowest mortality was observed in those with a BMI < 25 kg/m2, and no U-curve relationship was observed.
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł
Tytuł:
The differences in the prevalence of cardiovascular disease, its risk factors, and achievement of therapeutic goals among urban and rural primary care patients in Poland : results from the LIPIDOGRAM 2015 study
Autorzy:
Tomasik, Tomasz
Studziński, Krzysztof
Ray, Kausik K.
Williams, Bryan
Charchar, Fadi J.
Tomaszewski, Maciej
Lip, Gregory Y.H.
Penson, Peter E.
Catapano, Alberico
Sattar, Naveed
Mastej, Mirosław
Wójtowicz, Ewa
Banach, Maciej
Mikhailidis, Dimitri P.
Toth, Peter P.
MacDonald, Thomas M.
Windak, Adam
Jóźwiak, Jacek J.
Howard, George
Opis:
A nationwide cross-sectional study, LIPIDOGRAM2015, was carried out in Poland in the years 2015 and 2016. A total of 438 primary care physicians enrolled 13,724 adult patients that sought medical care in primary health care practices. The prevalence of hypertension, diabetes mellitus, dyslipidaemia, and CVD were similar in urban and rural areas (49.5 vs. 49.4%; 13.7 vs. 13.1%; 84.2 vs. 85.2%; 14.4 vs. 14.2%, respectively). The prevalence of obesity (32.3 vs. 37.5%, p < 0.01) and excessive waist circumference (77.5 vs. 80.7%, p < 0.01), as well as abdominal obesity (43.2 vs. 46.4%, p < 0.01), were higher in rural areas in both genders. Mean levels of LDL-C (128 vs. 130 mg/dL, p = 0.04) and non-HDL-C (147 vs. 148 mg/dL, p = 0.03) were slightly higher in rural populations. Altogether, 14.3% of patients with CVD from urban areas and 11.3% from rural areas reached LDL <70 mg/dL (p = 0.04). There were no important differences in the prevalence of hypertension, diabetes, dyslipidaemia, and CVD, or in mean levels of blood pressure, cholesterol fractions, glucose, and HbA1c between Polish urban and rural primary care patient populations. A high proportion of patients in cities and an even-higher proportion in rural areas did not reach the recommended targets for blood pressure, LDL-C, and HbA1c, indicating the need for novel CVD-prevention programs.
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł
Tytuł:
Secondary stroke prevention in polish adults : results from the LIPIDOGRAM2015 study
Autorzy:
Tomasik, Tomasz
Charchar, Fadi J.
Howard, George
MacDonald, Thomas M.
Mastej, Miroslaw
Labuz-Roszak, Beata
Banach, Maciej
Lip, Gregory Y. H.
Windak, Adam
Catapano, Alberico
Tomaszewski, Maciej
Toth, Peter P.
Sattar, Naveed
Williams, Bryan
Mikhailidis, Dimitri P.
Penson, Peter
Skrzypek, Michal
Jozwiak, Jacek J.
Ray, Kausik K.
Opis:
Background: The purpose of the study was to evaluate secondary stroke prevention in Poland and its association with sociodemographic factors, place of residence, and concomitant cardiovascular risk factors. Material and methods: From all patients in LIPIDOGRAM2015 Study (n = 13,724), 268 subjects had a history of ischaemic stroke and were included. Results: 165 subjects (61.6%) used at least one preventive medication. Oral antiplatelet and anticoagulation agents were used by 116 (43.3%) and 70 (26.1%) patients, respectively. Only 157 (58.6%) participants used lipid-lowering drugs, and 205 (76.5%) were treated with antihypertensive drugs. Coronary heart disease (CHD) and dyslipidaemia were associated with antiplatelet treatment (p = 0.047 and p = 0.012, respectively). A history of atrial fibrillation, CHD, and previous myocardial infarction correlated with anticoagulant treatment (p = 0.001, p = 0.011, and p < 0.0001, respectively). Age, gender, time from stroke onset, place of residence, and level of education were not associated with antiplatelet or anticoagulant treatment. Only 31.7% of patients were engaged in regular physical activity, 62% used appropriate diet, and 13.6% were current smokers. Conclusions: In Poland drugs and lifestyle modification for secondary stroke prevention are not commonly adhered to. Educational programmes for physicians and patients should be developed to improve application of effective secondary prevention of stroke.
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł
Tytuł:
Analysis of the impact of sex and age on the variation in the prevalence of antinuclear autoantibodies in Polish population : a nationwide observational, cross-sectional study
Autorzy:
Mikhailidis, Dimitri P.
Catapano, Alberico
Mastej, Mirosław
Toth, Peter P.
Lip, Gregory Y.H.
Banach, Maciej
Krzemien, Paweł
Charchar, Fadi J.
Windak, Adam
Tomasik, Tomasz
Howard, George
Penson, Peter E.
MacDonald, Thomas M.
Sattar, Naveed
Tomaszewski, Maciej
Kasperczyk, Sławomir
Kasperczyk, Aleksandra
Ray, Kausik K.
Williams, Bryan
Jóźwiak, Jacek J.
Dobrakowski, Michał
Opis:
The detection of antinuclear autoantibody (ANA) is dependent on many factors and varies between the populations. The aim of the study was first to assess the prevalence of ANA in the Polish adult population depending on age, sex and the cutoff threshold used for the results obtained. Second, we estimated the occurrence of individual types of ANA-staining patterns. We tested 1731 patient samples using commercially available IIFA using two cutoff thresholds of 1:100 and 1:160. We found ANA in 260 participants (15.0%), but the percentage of positive results strongly depended on the cutoff level. For a cutoff threshold 1:100, the positive population was 19.5% and for the 1:160 cutoff threshold, it was 11.7%. The most prevalent ANA-staining pattern was AC-2 Dense Fine speckled (50%), followed by AC-21 Reticular/AMA (14.38%) ANA more common in women (72%); 64% of ANA-positive patients were over 50 years of age. ANA prevalence in the Polish population is at a level observed in other highly developed countries and is more prevalent in women and elderly individuals. To reduce the number of positive results released, we suggest that Polish laboratories should set 1:160 as the cutoff threshold.
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł
Wyświetlanie 1-10 z 20

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