Abstract
Data mainly from one-off surveys clearly show that the health of Roma, the largest ethnic minority of Europe, is much worse than that of the general population. However, results from comprehensive exploratory studies are missing. The aim of our study was to create a complex database for comparative and association studies to better understand the background of the very unfavourable health of Roma, especially the high burden of cardiometabolic diseases. A three-pillar (questionnaire-based, physical and laboratory examinations) health survey was carried out on randomly selected samples of the Hungarian general (HG, n = 417) and Roma (HR, n = 415) populations, and a database consisting of more than half a million datapoints was created. Using selected data, the prevalence rates of metabolic syndrome (MetS) and of its components were determined, and to estimate the risk of insulin resistance (IR), surrogate measures (the homeostasis model assessment of insulin resistance index, quantitative insulin sensitivity check index, McAuley and TyG indices and the TG/HDL-C ratio) were calculated. Receiver operating characteristic curve analysis and Youden’s method were used to define the optimal cut-off values of each IR index. The prevalence of MetS was very high in both study populations (HG: 39.8%, HR: 44.0%) with no statistically significant difference between the two groups in females or males. The prevalence of MetS showed a very marked increase in the HR 35–49 years age group. Among surrogate measures, the TyG index showed the greatest power for predicting IR/MetS at a cut-off value of 4.69 (77% sensitivity, 84% specificity) and indicated a 42.3% (HG) and 40.5% (HR) prevalence of IR. The prevalence of MetS and IR is almost equally very unfavourable in both groups; thus, the factors underlying the high premature mortality burden of Roma should be further clarified by investigating the full spectrum of risk factors available in the database, with a special focus on the access of Roma people to preventive and curative health services.
Highlights
Roma are the largest ethnic minority population in Europe, with an estimated population of10–12 million [1]
The study we present here is the most complex combined survey ever carried out using mixed methodology among Roma to determine the distribution of different health conditions, risk factors, and health determinants in comparison with those of the general population living in their neighbourhood, and to create a database that can be used for association studies to explore
Paper,ininaddition addition providing a detailed description the methodology create a complex database and to introduce its composition, we demonstrate its usefulness by first by to create a complex database and to introduce its composition, we demonstrate its usefulness describing how it can be used to examine the prevalence of cardiometabolic risk factors linked to first describing how it can be used to examine the prevalence of cardiometabolic risk factors linked insulin resistance after defining the cut-off points for different IR surrogate indices for metabolic to insulin resistance after defining the cut-off points for different IR surrogate indices for metabolic syndrome and its prevalence among Roma in comparison with the general population
Summary
Roma are the largest ethnic minority population in Europe, with an estimated population of10–12 million [1]. Restrictions exist on collecting statistical data on health and its determinants by ethnic status in the countries where Roma populations are most concentrated (Southern, Central, and Eastern European countries) [2,3], increasing amounts of data from ethically appropriate one-off surveys are available and show that the health of Roma is much worse than that of the general population [1] These studies are almost exclusively descriptive ones on the prevalence of certain diseases, especially infectious and certain genetic diseases [1,4,5], and of health determinants [6,7,8,9], especially cardiovascular risk factors [10,11,12], while comprehensive exploratory studies are missing. Recent studies on the genetic background of the increased risk of different non-communicable diseases among Roma [19,20,21] further strengthen the hypothesis that the health status of Roma is defined by a complexity of different health-related factors
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