Hungarian General Population Research Articles

Cardiovascular risk factors among Roma and non-Roma populations in underprivileged settlements.

The 'Taking the screening tests close to the people' program offers cardiovascular screening to the inhabitants of underprivileged settlements. This study aimed to evaluate the cardiovascular risk factors of underprivileged populations, including individuals who described themselves as belonging to the Roma population. During the program, we collected information about demographic features, lifestyle and current illnesses. A general health assessment (body weight, height, blood pressure and fasting blood glucose) and cardiovascular examination were performed. We analysed data on both Roma and non-Roma groups and used Pearson's chi-squared test and multiple logistic regression models to analyse the factors that contribute to the onset of comorbidities, with a special focus on ethnicity. Data from 6211 participants were processed. Based on self-reports, the non-Roma population consisted of 5352 respondents (1364 men (25.5%) and 3988 women (74.5%)), and the Roma population comprised 859 respondents (200 men (23.3%) and 659 women (76.7%)). A total of 91.2% (4849) of the non-Roma population and 92.5% (788) of the Roma population exercised less than 3h per week (p < 0.001). Of the non-Roma population, 71.7% (3512) had a body mass index above 25kg/m2, while the corresponding figure was 72.4% (609) in the Roma population (p = 0.709). The median body mass index was 28.0 (24.6-31.9) in the non-Roma population and 28.8 (24.5-33.0) in the Roma population (p < 0.001). The prevalence of active smokers was 28.7% (1531) in the non-Roma population and 60.3% (516) in the Roma population (p < 0.001). The prevalence of hypertension was 54.9% (2824) in the non-Roma population and 49.8% (412) in the Roma population (p < 0.001). The prevalence of diabetes was 11.5% (95) in the Roma population and 12.2% (619) in the non-Roma population (p < 0.001). We found a high prevalence of overweight and obesity, a lack of physical activity and an remarkably high smoking rate in the studied underprivileged population. Both type 2 diabetes and hypertension were more common among people living in underprivileged settlements than in the general Hungarian population. People living in underprivileged settlements need more attention in primary care.

Sociodemographic determinants of vaccination and willingness to pay for COVID-19 vaccines in Hungary, results of a cross-sectional online questionnaire

BackgroundSeveral different coronavirus disease (COVID-19) vaccines were authorized and distributed all over the world, including Hungary, but vaccination rates and acceptance of the different vaccines varied through 2021 and subsequent years. In Hungary Western vaccines and the Chinese and Russian vaccines were available in early 2021. Understanding preference and willingness to pay (WTP) for the COVID-19 vaccine could provide information for policy decision making to control the COVID-19 pandemic. We aimed to assess the socio-demographic factors influencing the COVID-19 vaccination and to analyse individual preferences for the available COVID-19 vaccines in Hungary.MethodsA cross-sectional online questionnaire survey was conducted between 25–05-2021 and 08–06-2021 exploring the vaccine acceptance and WTP for vaccination in the Hungarian general population. To assess the preferences towards the different vaccines available in Hungary at the time of the study, we used a multi-step WTP task.ResultsAltogether 2,000 respondents filled out our survey, with the average age of 49.1 (SD = 15.3), out of whom 370 respondents (18.5%) stated that they already had a COVID-19 infection. Age above 65 years, male gender, higher level of education, higher income and residence in the capital or county seats were associated with a higher probability of vaccination. The average WTP ranged from 14.2 to 30.3 EUR for the different vaccine types.ConclusionsMales, respondents with higher education and income stated a higher WTP value for all vaccines. Better socioeconomic status increased both vaccination coverage and willingness to pay for vaccines.

Relationship between Social Networks, Support Patterns, and Health Problems among the General Hungarian Population during the Last Phase of the COVID-19 Pandemic

Numerous research works prove that social relationships and the support they provide have particular importance in maintaining both mental and physical health: they help to deal with stressful life situations, overcome diseases, and maintain health. It is also known that certain periods of life and life events can be critical in terms of social support, as they involve the narrowing of possible sources of support, so the lack of a network of contacts and social support increases not only the risk of becoming lonely but also the occurrence or worsening of diseases. This study investigates the relationship between social network factors and support provided through networks and health problems, taking into account the perceived personal and general impact of COVID-19. The data came from a cross-sectional study, a representative sample of 5000 Hungarian participants was conducted during the dwindling period of the pandemic. We used a latent profile analysis to separate the different groups of respondents based on the support received from different sources of relationships, aiming at capturing the diversity of supported support combinations based on the type of relationships in the network, the form of support, and frequency. Multilevel regression was used to examine the impact of social connectivity factors, emerging patterns, and COVID-19-related perceived consequences on health conditions. Our results confirm that the “poorly supported network” plays a key role in the occurrence of chronic diseases and depression. It seems interesting, however, that the probability of poor physical and mental health was higher in the group of those receiving financial and in-kind support mainly from family compared to the group of those receiving support from multiple sources of relationships. The models also suggest that network integration plays a major role in maintaining mental and physical health during an epidemic crisis.

Association of HDL subfraction profile with the progression of insulin resistance

Abstract Background Type 2 diabetes mellitus (T2D) is a major global public health problem, as it is associated with increased morbidity, mortality, and healthcare costs. Insulin resistance (IR) is considered to be a condition characterized by disturbances in carbohydrate and lipid metabolisms that precede T2D. The correlation between IR and high-density lipoprotein cholesterol (HDL-C) levels is known, but the underlying mechanisms are not fully understood. The present study aimed to investigate the association between HDL subfraction profile and the development of IR. Methods The progression of IR was assessed using the Homeostatic Model Assessment for IR index (HOMA-IR), and IR was defined as those with a HOMA-IR greater than 3.63. The HDL-C was separated using the Lipoprint system, which identifies ten subfractions (HDL-1-10) and three classes: large- (HDL-L), intermediate- (HDL-I), and small-HDL (HDL-S). All analyses were performed on samples of 240 control subjects and 137 individuals with IR from the Hungarian general and Roma populations. Results The HDL-1 to -6 and the HDL-L and -I showed a significant negative association with elevated HOMA-IR and the presence of IR. Among them, HDL-2 (β = 42.2, p = 4.1 × 10-12) and HDL-L (β = 15.5, p = 2.2 × 10-10) showed the strongest correlation with the IR progression. The optimal cut-off value was found to be 0.264 mmol/L for HDL-L and 0.102 mmol/L and above for HDL-2. The risk of IR is 5.1 times higher for HDL-L levels below the cut-off (p = 2.2 × 10-7), and 4.2 times higher for HDL-2 (p = 3.0 × 10-6). Furthermore, the risk of early manifestation of IR are significantly higher in individuals with both HDL-L (HR = 3.5, p = 3.2 × 10-7) and HDL-2 (HR = 3.19, p = 2.0 × 10-6) levels below the cut-off. Key messages • HDL-2 and -L levels are strongly associated with the development of insulin resistance. • Elevated risk of early onset of insulin resistance is associated with HDL subfraction profile.

Hungarian population norms for the 15D generic preference-accompanied health status measure

Objectives15D is a generic preference-accompanied health status measure covering a wide range of health areas, including sensory functions. The aim of this study was to establish population norms for the 15D instrument in Hungary.Methods2000 members of the Hungarian adult general population participated in an online cross-sectional survey in August 2021. The sample was broadly representative in terms of gender, age groups, highest level of education, geographical region, and settlement type. Index values were derived using the Norwegian 15D value set. In addition to providing population norms, mean index values were computed for 32 physical and 24 mental health condition groups.ResultsMost respondents (78.7%) reported problems in at least one 15D domain. The most problems were reported with sleeping (50.7%), followed by vitality (49.2%), distress (43.6%), discomfort and symptoms (31.2%), depression (31.1%), sexual activities (29.6%), breathing (28.1%), and vision (27.8%). The mean 15D index value was 0.810. With advancing age categories, the 15D index values showed an inverse U-shaped curve. Generally, mean index values in respondents with mental health conditions were lower [range 0.299 (post-traumatic stress disorder) to 0.757 (smoking addiction)] than those of respondents with physical conditions [range 0.557 (liver cirrhosis) to 0.764 (allergies)].ConclusionsThis study provided 15D population norms of the Hungarian general population; furthermore, this is the first study to provide population norms for the 15D in any country. The values established in this study can serve as benchmarks for evaluating efficacy outcomes in clinical trials, quantifying disease burden and identifying unmet needs.

Association of HDL Subfraction Profile with the Progression of Insulin Resistance.

Type 2 diabetes mellitus (T2DM) is a major global public health problem, as it is associated with increased morbidity, mortality, and healthcare costs. Insulin resistance (IR) is a condition characterized by disturbances in carbohydrate and lipid metabolism that precedes T2DM. The aim of the present study was to investigate the association between HDL and its subfraction profile and the progression of IR, as assessed by the Homeostatic Model Assessment for IR (HOMA-IR) index, and to define cut-off values to identify an increased risk of IR. Individuals with a HOMA-IR greater than 3.63 were considered to have IR. The HDL subfractions were separated using the Lipoprint system, which identifies ten subfractions (HDL-1-10) in three subclasses as large (HDL-L), intermediate (HDL-I) and small (HDL-S). Analyses were performed on samples from 240 individuals without IR and 137 with IR from the Hungarian general and Roma populations. The HDL-1 to -6 subfractions and the HDL-L and -I classes showed a significant negative association with the progression and existence of IR. Among them, HDL-2 (B = -40.37, p = 2.08 × 10-11) and HDL-L (B = -14.85, p = 9.52 × 10-10) showed the strongest correlation. The optimal threshold was found to be 0.264 mmol/L for HDL-L and 0.102 mmol/L and above for HDL-2. Individuals with HDL-L levels below the reference value had a 5.1-fold higher risk of IR (p = 2.2 × 10-7), while those with HDL-2 levels had a 4.2-fold higher risk (p = 3.0 × 10-6). This study demonstrates that the HDL subfraction profile (especially the decrease in HDL-2 and -L) may be a useful marker for the early detection and intervention of atherogenic dyslipidemia in subjects with impaired glucose and insulin metabolism.

Association of CETP Gene Polymorphisms and Haplotypes with Cardiovascular Risk.

Cholesteryl ester transfer protein (CETP) is known to influence HDL-C levels, potentially altering the profile of HDL subfractions and consequently cardiovascular risk (CVR). This study aimed to investigate the effect of five single-nucleotide polymorphisms (SNPs; rs1532624, rs5882, rs708272, rs7499892, and rs9989419) and their haplotypes (H) in the CETP gene on 10-year CVR estimated by the Systematic Coronary Risk Evaluation (SCORE), the Framingham Risk Score for Coronary Heart Disease (FRSCHD) and Cardiovascular Disease (FRSCVD) algorithms. Adjusted linear and logistic regression analyses were used to investigate the association of SNPs and 10 haplotypes (H1-H10) on 368 samples from the Hungarian general and Roma populations. The T allele of rs7499892 showed a significant association with increased CVR estimated by FRS. H5, H7, and H8 showed a significant association with increased CVR based on at least one of the algorithms. The impact of H5 was due to its effect on TG and HDL-C levels, while H7 showed a significant association with FRSCHD and H8 with FRSCVD mediated by a mechanism affecting neither TG nor HDL-C levels. Our results suggest that polymorphisms in the CETP gene may have a significant effect on CVR and that this is not mediated exclusively by their effect on TG and HDL-C levels but also by presently unknown mechanisms.

Genetic susceptibility to Insulin resistance and its association with estimated longevity in the hungarian general and roma populations

Genetic susceptibility to Insulin resistance and its association with estimated longevity in the hungarian general and roma populations

Taste Preference-Related Genetic Polymorphisms Modify Alcohol Consumption Behavior of the Hungarian General and Roma Populations.

Harmful alcohol consumption has been considered a major public health issue globally, with the amounts of alcohol drunk being highest in the WHO European Region including Hungary. Alcohol consumption behaviors are complex human traits influenced by environmental factors and numerous genes. Beyond alcohol metabolization and neurotransmitter gene polymorphisms, taste preference-related genetic variants may also mediate alcohol consumption behaviors. Applying the Alcohol Use Disorders Identification Test (AUDIT) we aimed to elucidate the underlying genetic determinants of alcohol consumption patterns considering taste preference gene polymorphisms (TAS1R3 rs307355, TAS2R38 rs713598, TAS2R19 rs10772420 and CA6 rs2274333) in the Hungarian general (HG) and Roma (HR) populations. Alcohol consumption assessment was available for 410 HG and 387 HR individuals with 405 HG and 364 HR DNA samples being obtained for genotyping. No significant associations were found between TAS1R3 rs307355, TAS2R19 rs10772420, and CA6 rs2274333 polymorphisms and alcohol consumption phenotypes. Significant associations were identified between TAS2R38 rs713598 and the number of standard drinks consumed in the HG sample (genotype GG negatively correlated with the number of standard drinks; coef: -0.136, p = 0.028) and the prevalence of having six or more drinks among Roma (a negative correlation was identified in the recessive model; genotype GG, coef: -0.170, p = 0.049), although, none of these findings passed the Bonferroni-corrected probability criterion (p > 0.05). Nevertheless, our findings may suggest that alcohol consumption is partially driven by genetically determined taste preferences in our study populations. Further studies are required to strengthen the findings and to understand the drivers of alcohol consumption behavior in more depth.

Genetic Determinants of Leisure-Time Physical Activity in the Hungarian General and Roma Populations.

Leisure-time physical activity (LTPA) is one of the modifiable lifestyle factors that play an important role in the prevention of non-communicable (especially cardiovascular) diseases. Certain genetic factors predisposing to LTPA have been previously described, but their effects and applicability on different ethnicities are unknown. Our present study aims to investigate the genetic background of LTPA using seven single nucleotide polymorphisms (SNPs) in a sample of 330 individuals from the Hungarian general (HG) and 314 from the Roma population. The LTPA in general and three intensity categories of it (vigorous, moderate, and walking) were examined as binary outcome variables. Allele frequencies were determined, individual correlations of SNPs to LTPA, in general, were determined, and an optimized polygenetic score (oPGS) was created. Our results showed that the allele frequencies of four SNPs differed significantly between the two study groups. The C allele of rs10887741 showed a significant positive correlation with LTPA in general (OR = 1.48, 95% CI: 1.12-1.97; p = 0.006). Three SNPs (rs10887741, rs6022999, and rs7023003) were identified by the process of PGS optimization, whose cumulative effect shows a strong significant positive association with LTPA in general (OR = 1.40, 95% CI: 1.16-1.70; p < 0.001). The oPGS showed a significantly lower value in the Roma population compared with the HG population (oPGSRoma: 2.19 ± SD: 0.99 vs. oPGSHG: 2.70 ± SD: 1.06; p < 0.001). In conclusion, the coexistence of genetic factors that encourage leisure-time physical activity shows a more unfavorable picture among Roma, which may indirectly contribute to their poor health status.

Alcohol consumption patterns of the Hungarian general and Roma populations.

Harmful alcohol use is a significant public health problem worldwide, though the alcohol-related burden affects disproportionately certain populations and ethnic minorities, with the WHO European Region being the most heavily affected and putting an increased risk on Roma populations. This ethnic minority group is the largest and most vulnerable ethnic minority in Europe and Hungary as well. The present study aims to describe and compare the alcohol consumption behaviors of the Hungarian general and Roma populations using the Alcohol Use Disorders Identification Test (AUDIT), which provides a comprehensive view of alcohol consumption behavior. In addition, a decomposition analysis was performed when the multivariate logistic or Poisson regression model showed significant differences between the two samples. Our findings suggest that Roma people in our study sample experience more alcohol-related harm, even when considering past problems. The decomposition analysis revealed that gender and relationship status differences act more intensely among Roma than non-Roma when considering alcohol-related harm. Equalizing these differences would be expected to reduce the Hungarian general and Roma populations' alcohol-related harm frequency gap. Investigating alcohol-attributed harms at the ethnicity level provides important information to identify high-risk groups and, thus, to design and implement more targeted and accessible interventions for alcohol problems.

Association of HDL subfractions with cardiovascular risk in Hungarian general and Roma populations

Abstract Background High-density lipoprotein (HDL) cholesterol levels are inversely associated with cardiovascular risk (CVR). However, HDL cholesterol is not a homogeneous lipid and can be subdivided into subfractions, which are not uniformly associated with CVR. Among Roma populations, the prevalence of reduced HDL cholesterol levels and, consequently, that of cardiovascular diseases is very high. However, it is not known how this reduction affects the different HDL subfractions and whether changes in their representation are associated with changes in CVR. Methods The study aimed to investigate whether there is a difference in the HDL subfraction profile between the Hungarian general (HG) and Roma populations and to determine the association of the different subfractions with the CVR estimated by the Framingham Risk Score (FRS) and the Systematic COronary Risk Evaluation (SCORE) algorithms. HDL cholesterol was separated using the Lipoprint system, which separates 10 subfractions into three classes: large HDL (HDL-L), medium HDL (HDL-I), and small HDL (HDL-S). Analyses were carried out on samples of 100 control subjects (50 Hungarian general and 50 Roma individuals with normal lipid profiles) and 277 individuals with reduced HDL-C levels. Results Our results show that Roma has reduced levels of the overall HDL subfraction profile, with significant decreases in HDL-6, and -7. Regardless of the estimation method, elevated levels (in mmol/L) of HDL-1 to 3 and HDL-L were significantly associated with reduced risk. A higher representation (in %) of HDL-1 to 3 subfractions have a significant risk-reducing, while HDL-8 to 10 have a risk-increasing effect estimated by FRS. Conclusions The results of our study show that levels of CVR protective HDL subfractions are significantly lower in Roma individuals and their reduced levels are associated with increased CVR, suggesting that the distribution of HDL subfractions contributes to the overall unfavourable CVR profile of Roma. Key messages • Levels of HDL-6 and -7 subfractions were significantly lower in the Roma population than in the Hungarian general one. • The HDL subfraction profile of the Roma population is associated with a higher cardiovascular risk among them.

Higher VTE in a Roma population attributed to raised genetic risk and gene-environmental interaction

Abstract Background Interactions between genetic and environmental risk factors (GxE) contribute to an increased risk of venous thromboembolism (VTE). Understanding how these factors interact provides insight for the early identification of at-risk groups within a population and creates an opportunity to apply appropriate preventive and curative measures. Objective To estimate and compare GxE for VTE risk in the general Hungarian and Roma populations. Methods The study was based on data extracted from a database consisting the results obtained previously in a three pillars complex health survey. DNA was genotyped for rs121909567 (SERPINC1), rs1799963 (F2), rs2036914 (F11), rs2066865 (FGG), rs6025 (F5), and rs8176719 (ABO) polymorphisms. Multivariable linear regression analysis was applied to test the impact of GxE on VTE risk. Results Interestingly, the rs121909567 (SERPINC1) SNP was not present in the general population, however the risk allele frequency was 1.4% among Roma, which might suggest a founder effect in this minority. The risk of VTE was higher among depressive Roma subjects who carried the risk variant of rs2036914 (β = 0.819, p = 0.02); however, not for the general subjects. The joint presence of high level of LDL-C and rs2066865 increased the VTE risk only among Roma (β = 0.389, p = 0.002). A multiplicative interaction between rs8176719 and cancer was identified and higher for the Roma population (β = 0.370, p &amp;lt; 0.001). The VTE risk increased in the Roma population (β = 0.280, p = 0.001) but was higher in the general population (β = 0.423, p = 0.001) as a result of the multiplicative interaction between CAD and rs2036914 (F11). Conclusions rs121909567 (SERPINC1) was confirmed as a founder mutation in the Roma population. As a result of higher genetic load and GxE interactions, the minority Roma population is at higher risk of VTE than the general Hungarian population. Key messages • Our study revealed some evidence on the burden of the joint presence of genetic and environmental risk factors on VTE. • A marginalized and segregated Roma community could need due attention for the prevention and control of CVDs.

Value Set for the EQ-5D-Y-3L in Hungary.

BackgroundThe Hungarian health technology assessment guidelines recommend the use of the EuroQol instrument family in quality-adjusted life-year calculations. However, no national value set exists for the EQ-5D-Y-3L or any other youth-specific instrument.ObjectiveThis study aims to develop a national value set of the EQ-5D-Y-3L for Hungary based on preferences of the general adult population.MethodsThis study followed the international valuation protocol for the EQ-5D-Y-3L. Two independent samples, representative of the Hungarian general adult population in terms of age and sex were recruited to complete online discrete choice experiment (DCE) tasks and composite time trade-off (cTTO) tasks by computer-assisted personal interviews. Adults valued hypothetical EQ-5D-Y-3L health states considering the health of a 10-year-old child. DCE data were modelled using a mixed logit model with random-correlated coefficients. Latent DCE utility estimates were mapped onto mean observed cTTO utilities using ordinary least squares regression.ResultsOverall, 996 and 200 respondents completed the DCE and cTTO surveys, respectively. For each domain, the value set resulted in larger utility decrements with more severe response levels. The relative importance of domains by level 3 coefficients was as follows: having pain or discomfort > feeling worried, sad or unhappy > mobility > doing usual activities > looking after myself. Overall, 12.3% of all health states had negative utilities in the value set, with the worst health state having the lowest predicted utility of − 0.485.ConclusionThis study developed a national value set of the EQ-5D-Y-3L for Hungary. The value set enables to evaluate the cost utility of health technologies for children and adolescents based on societal preferences in Hungary.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40273-022-01190-2.

SNPs and haplotypes in the CETP gene and their effects on cardiovascular risk estimated by FRS and score in the Hungarian general and Roma populations

Background and Aims : Cholesteryl ester transfer protein (CETP) is known to reduce high-density lipoprotein cholesterol (HDL-C) levels and, as a result, increase cardiovascular risk. Serum levels of CETP are genetically determined, therefore the polymorphisms influencing it are also suspected to influence cardiovascular risk. This study aims to explore the association between 5 single nucleotide polymorphisms (SNPs) and their haplotypes (H) in CETP genes and the 10-year cardiovascular risk estimated by the Framingham Risk Score for hard coronary heart disease (FRSCHD) and for cardiovascular disease in general (FRSCVD), and the Systematic Coronary Risk Evaluation (SCORE) among the Hungarian general (HG) and Roma populations.

Parallel exploratory and confirmatory factor analysis of the Hungarian Fear of COVID-19 Scale in a large general population sample: a psychometric and dimensionality evaluation

BackgroundThis study aims to confirm validity and reliability of the Hungarian version of Fear of COVID-19 Scale (FCV-19S) and evaluate its dimensional structure.MethodsCross-sectional survey was carried out in 2021 among Hungarian general population. In addition to classical test theory methods, construct dimensionality of FCV-19S was assessed using EFA with principal axis factoring method and CFA with diagonally-weighted least squares estimation. Fear score was compared in age, gender, educational level, vaccination and infection subgroups.ResultsSignificant differences in FCV-19S mean scores were observed between three subgroups (age, gender, vaccination). Items showed good internal consistency (Cronbach α = 0.88). EFA identified two latent factors (eig = 4.2 and 1.02), though parallel analysis supports the one-factor model. The two-dimensional structure was confirmed by CFA, items 3,4,6,7 correlated with Factor 1 (physiological fear), items 1,2,5 with Factor 2 (emotional fear).ConclusionThe Hungarian version of FCV-19S seems valid and reliable. The EFA identified two-latent factors (emotional and physiological fear), that was confirmed by CFA. The two-factor structure had better model fit, though its’ acceptance is limited.

Genetic Susceptibility to Insulin Resistance and Its Association with Estimated Longevity in the Hungarian General and Roma Populations.

Diabetes mellitus is a major public health problem with a wide range of prevalence among different ethnic groups. Early recognition of pre-diabetes is important to prevent the development of the disease, its complications, co-morbidities, and consequently early death. Insulin resistance (IR) is considered a condition that precedes type 2 diabetes; thus, understanding its underlying causes (genetic and non-genetic factors) will bring us closer to preventing it. The present study aimed to investigate the genetic susceptibility to IR and its impact on estimated longevity in populations with different ethnic origins using randomly selected samples of 372 Hungarian general (HG, as a reference with Caucasian origin) and 334 Roma participants (largest ethnic minority in Europe, with a northern India origin). In the present study, we used the Homeostasis Model Assessment—Insulin Resistance (HOMA—IR) to identify people with IR (>3.63) at the population level. To investigate the genetic predisposition to IR, 29 single nucleotide polymorphisms (SNPs) identified in a systematic literature search were selected and genotyped in sample populations. In the analyses, the adjusted p < 0.0033 was considered significant. Of these 29 SNPs, the commutative effects of 15 SNPs showing the strongest association with HOMA—IR were used to calculate an optimized genetic risk score (oGRS). The oGRS was found nominally significantly (p = 0.019) higher in the Roma population compared to HG one, and it was more strongly correlated with HOMA—IR. Therefore, it can be considered as a stronger predictor of the presence of IR among the Roma (AUCRoma = 0.673 vs. AUCHG = 0.528). Furthermore, oGRS also showed a significant correlation with reduced estimated longevity in the Roma population (β = −0.724, 95% CI: −1.230–−0.218; p = 0.005), but not in the HG one (β = 0.065, 95% CI: −0.388–0.518; p = 0.779). Overall, IR shows a strong correlation with a genetic predisposition among Roma, but not in the HG population. Furthermore, the increased genetic risk of Roma is associated with shorter estimated longevity, whereas this association is not observed in the HG one. Increased genetic susceptibility of Roma to IR should be considered in preventive programs targeting the development of type 2 diabetes, which may also reduce the risk of preventable premature death among them.

The profile of HDL-C subfractions and their association with cardiovascular risk in the Hungarian general and Roma populations

High-density lipoprotein cholesterol (HDL-C) is not a homogenous lipid fraction, but it can be further divided into subfractions. It is well-known that the Roma population has a high prevalence of reduced HDL-C levels and cardiovascular diseases (CVDs). However, it is unknown how this reduction affects different HDL subfractions, and whether changes in their quantity/representation are associated with an increased cardiovascular risk among them. In the present study, the HDL subfraction profile of the Hungarian general (HG) and the Roma populations were compared, and the subfractions showing a significant difference between the two populations were identified. The association of HDL subfractions with CVD risk estimated by the Framingham risk score (FRS) and the Systematic COronary Risk Evaluation (SCORE) algorithms were also defined. The present study is the first to find a significant association between HDL subfractions and cardiovascular risk estimated by FRS and SCORE. Ten HDL subfractions were investigated on small but carefully selected samples comprising 100 control subjects (with normal lipid profile) and 277 case subjects (with reduced HDL-C levels) from HG and Roma populations of a complex health survey. The level of HDL-1 to 3 subfractions and HDL-L showed a significant inverse association with cardiovascular risk estimated by both SCORE and FRS algorithms, whereas HDL-4 to 6 and HDL-I only for FRS. A higher representation (in %) of HDL-1 to 3 has a significant risk-reducing effect, while HDL-8 to 10 has a risk-increasing effect estimated by FRS. Our results confirmed that reduced levels of HDL-6 and -7 expressed in mmol/L were significantly associated with Roma ethnicity.

Development the societal preference-based utility value set for the Patient Health Questionnaire depression scale in Hungary

IntroductionDepression is associated with high impact on health-related quality of life (HRQoL). Health state valuations are used for cost-effectiveness analysis to provide results for health-policy interventions.ObjectivesThe study aims to estimate a population-based value set of depression described by Patient Health Questionnaire (PHQ-9). We intend to assess vignettes describing PHQ-9 health states to estimate utility valuesMethodsCurrent research elicited direct utility scores using time trade-off (TTO) method obtained from the Hungarian general population (N=2,000). TTO vignettes were created to describe hypothetical health states of depression based on the nine items of PHQ-9. The hypothetical health states were sorted orthogonally in 11 blocks, each containing 4 vignettes (combinations of no; mild; moderate; severe depression). All respondents valued the four health states of one randomly given block. Conventional TTO method was applied, using a 10-year timeframe, while the first iteration step was randomized to 1,3 and 5 year. Preference weights were estimated using regression model fitted to TTO utility results.ResultsAltogether 1,999 respondents valued overall 34 different health states. The mean age was 47.3 (16.9) years, the majority was female (57.2%). Nearly half of the respondents were secondary educated 45.4%, 27.3% higher educated and 27.2% completed primary school. The mean TTO utility of selected mild, moderate and severe depression was: 0.83; 0.82 and 0.77 respectively.ConclusionsOur results constitute the first population-based value set for PHQ-9. Utility scores give useful information for cost-effectiveness assessments. Estimates provide preference-based quality of life weights for the Hungarian population.DisclosureNo significant relationships.

Physical Activity Pattern Characterized by Domains and Dimensions of the Roma Population in Comparison with That of the General Population in Northeast Hungary.

Our study focuses on examining physical activity, as one of the most influential health determinants by domains and dimensions among Roma, the largest vulnerable ethnic minority in Europe. The study was carried out on a sample representative of the Hungarian Roma (HR) population (n = 350) living in segregated colonies in Northeast Hungary in comparison with the Hungarian general (HG) population sample (n = 343) from the same region. Data were collected using the International Physical Activity Questionnaire (IPAQ) long-form and physical activity was quantified as MET-min/week. Scores were calculated for walking, moderate and vigorous-intensity activities for each domain (work, transport, domestic and gardening, leisure) and as an overall total. The HR population—similarly to the HG—is characterized by moderate or high physical activity; however, this level is achieved by work and housework/gardening instead of leisure time activities, which is worryingly low among HR females, but its prevalence is significantly (p < 0.001) lower in both sexes than among the HG population in the vigorous activity category. HR men move (walk and cycle) significantly more during transport than HG men. Our results may direct the attention of decision-makers to improve the health of Roma by increasing leisure-time physical activity.