Prevalence Of Elevated Levels Research Articles

Association of non-high-density lipoprotein hypercholesterol with metabolic syndrome, diabetes and arterial hypertension in the population of 45–69 years adults

Objective. To study the prevalence of non-high-density lipoprotein hypercholesterol (non-HDL–C) and the average levels of non-HDL–C in metabolic syndrome (MS), type 2 diabetes mellitus (DM2), arterial hypertension (AH) and other cardiometabolic risk factors in the Siberian population aged 45–69 years.Design and methods. The evaluation of atherogenic dyslipidemia among persons with AН, MS, T2D was based on the materials of Siberian branch of HAPIEE project in the random sample n = 9360 surveyed in 2003–2005 HAPIEE. The study program included questionnaire survey, blood pressure (BP) measurement, anthropometry, biochemical screening. The value ≥ 3,4 mmol/l was considered as hypercholesterol-non-HDL. AH was diagnosed at systolic BP levels ≥ 140 mm hg. art. or diastolic BP ≥ 90 mm hg. art. and/or taking antihypertensive drugs within the last 2 weeks. Persons with previously diagnosed AH, but with normotonia at screening in cases of taking drugs that reduce BP, were also counted as patients with AH. DM2 was diagnozed — according to WHO criteria, 1999, ADA, 2013 — at fasted plasma glucose level ≥ 7,0 mmol/l and persons with previously diagnosed DM2. MS and its components were diagnosed according to IDF criteria (2005).Results. The mean value of non-HDL cholesterol in the general population of Novosibirsk aged 45–69 were 4,7 ± 1,3 mmol/l and were higher in women than in men — 4,9 ± 1,3 mmol/l and 4,5 ± 1,2 mmol/l, (p < 0,0001). The prevalence of hypercholesterol-non-HDL in women varies from 84,7 to 94,3% — and is significantly higher than in men — 80,6 to 84,1%. The level of non-HDL cholesterol ≥ 3,4 mmol/l was observed in 86,8% of the examined, 11% — in the range of 2,6–3,39 and only 2,2% — less than 2,6 mmol/l. The average values of non-HDL–C in men and women in three cohorts (with DM2, MS and AH) were found to be the highest in DM2, lower in MS than in DM, and lower in AH than in MS and DM2. In the cohort with DM2, non-HDL–C, according to the criterion of non-HDL–C ≥ 3,4 mmol/l, was determined in 89,4% of men and 95,7% of women; in persons with MS, it was found in 92,4% of men and 95,1% of women, with AH — in 85,2% of men and 92,5% of women of the Siberian population aged 45–69 years. The frequencies of AH, MS and DM2 in the 5th quintile of the distribution of non-HDL–C are higher compared to the first quintile (p < 0,0001), with a predominance of these indicators in the female population.Conclusions. According to study, the content of non-HDL–C, and its prevalence of elevated levels in the population is high, especially in people with DM2, MS, AH. In terms of developing a platform for prevention of cardiovascular diseases, MS and DM2, the non-HDL–C ratio deserves attention as a target for further research.

PREVALENCE OF ELEVATED EXHALED NITRIC OXIDE IN PATIENTS WITH CHRONIC COUGH IN A COMMUNITY SETTING

Introduction Physicians are frequently tasked with treating chronic cough (lasting longer than 8 weeks). Among patients who do not smoke cigarettes, the three primary etiologies of chronic cough are postnasal-drip syndrome, gastroesophageal reflux disease, and atypical asthma, which combined account for 92% of chronic cough. The measurement of exhaled nitric oxide in patients with chronic cough can identify patients who will likely improve with inhaled steroids versus those who will likely not, thereby mitigating the need for a trial of corticosteroids. We evaluated 33 patients with chronic cough from our community looking at trends in their history that could possibly be associated with elevated exhaled nitric oxide and the prevalence of elevated levels among these patients. Methods Thirty-three patients who were non-smokers and complained of cough of 8 weeks duration or longer were administered a survey inquiring about the quality of their cough and previous or current steroid use. A single nitric oxide level was recorded for each patient using a NIOX Vero machine. All procedures were in accordance with the Helsinki Declaration as revised in 2013. Results Five of the thirty-three patients had an elevated exhaled nitric oxide (greater than 35 parts per billion), resulting in a 15% prevalence of elevated exhaled nitric oxide. The mean and median of nitric oxide levels were 22.3 ppb and 19 ppb, respectively. Conclusions Although eighty-five percent of our patients with chronic cough did not have elevated exhaled nitric oxide, this measurement can identify a specific pattern of inflammation and is valuable when considering corticosteroid treatment.

Alkaline Phosphatase in Healthy Children: Reference Intervals and Prevalence of Elevated Levels

Background: Transient hyperphosphatasemia (TH) is an often unnoticed benign entity, primarily affecting children below 5 years of age. However, the prevalence among healthy children is unknown. We used data from a Swedish pediatric reference interval project to estimate the prevalence of high alkaline phosphatase (ALP) among healthy children and to calculate pediatric reference intervals. Methods: Blood was collected from 699 subjectively healthy children aged 6 months to 18 years. After exclusion of subjects with high ALP, age- and gender-specific reference intervals were calculated. Results: Six children had ALP levels >16.7 µkat/l (>1,000 U/l), including 4 females and 2 males aged 7-22 months. The prevalence in the age group from 6 months to 2 years was 6.2% (6/97). None of the older children had levels of ALP >16.7 µkat/l. The study did not include the follow-up of these apparently healthy children. Consequently, conditions others than TH explaining the elevated ALP could not be excluded. However, general chemistry analyses, such as liver enzymes, calcium, intact PTH and vitamin D, were essentially normal in these children. Conclusions: The prevalence of high ALP among subjectively healthy children was approximately 2.4% below 5 years of age and 6.2% below 2 years. Reference intervals vary with age and gender.

Markers of Bone Metabolism in Obese Individuals Undergoing Laparoscopic Sleeve Gastrectomy.

Besides its advantages, bariatric surgery implicates a risk of nutritional deficiencies, which might result in impaired bone metabolism. We assessed the effect of laparoscopic sleeve gastrectomy (LSG) on blood markers of bone metabolism in obese patients during a 3-year observation period. In 39 obese patients (29 women, 10 men, mean BMI 51.8 ± 6.8 kg/m(2)) undergoing LSG, we measured blood concentrations of 25-hydroxyvitamin D (25(OH)D), calcium, parathyroid hormone (PTH), bone alkaline phosphatase (BAP), and N-telopeptides crosslinks (NTx) before LSG and up to 3 years postoperatively. Vitamin D and calcium supplementations were recorded. LSG caused an excess weight loss (EWL) of 54 ± 20 % after 3 years. Before surgery, we found decreased levels of 25(OH)D and calcium in 80 and 5 % of the subjects, respectively, while increased levels of PTH, BAP, and NTx were found in 39, 28, and 21 %, respectively. Mean levels of NTx and the prevalence of elevated levels of NTx increased within 2 years (p < 0.001 and p < 0.01). Neither mean blood concentrations of 25(OH)D, calcium, PTH, and BAP nor relative prevalence of deficiencies regarding these markers changed during the study period. The supplementation rates of calcium and vitamin D increased postoperatively. Morbid obesity is associated with pronounced changes of markers of bone metabolism; LSG did neither aggravate nor ameliorate vitamin D metabolism within a 3-year time period, but led to increased bone resorption 2 years postoperatively. Routine supplementation of calcium and vitamin D is not likely sufficient to compensate the obesity-associated deficiencies in bone metabolism.

Ground Water Conditions and Spatial Distribution of Lead and Cadmium in the Shallow Aquifer at Effurun- Warri Metropolis, Nigeria

A water table head distribution map of the shallow Benin Formation aquifer in the Effurun-Warri area has been drawn from dug well data and used to define groundwater gradients as well as identify directions of groundwater movement in this densely populated urban setting. Water samples from forty dug wells were also screened for the presence of lead and cadmium and results showed a variation in concentration from not detectable to 0.04mg/l for each metal. Iso-concentration contours for lead in groundwater suggest that enrichment may be from two sources: wastes from the refinery and petrochemical industrial complex on the northwestern edge of the city and secondly from leachates associated with the many unregulated waste dumpsites. Lead appears to be constrained from spreading eastwards from the industrial complex area by the south and westwards trending groundwater gradient. The city wide prevalence of elevated levels of cadmium is also probably due to leachates from unregulated dumpsites as well as the mixing of groundwater as suggested by existing gradients. Potential implications of the findings for public health, local and regional water quality monitoring are discussed.

Abstract P292: Severe Obesity is Associated with Dramatic Increase in Cardiovascular Disease Risk Factor Prevalence: Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Introduction: Prevalence of severe obesity is increasing, especially among the young Hispanic population. Methods: In the HCHS/SOL cohort of 18-74 year old US Hispanics, we examined gradients across BMI and age in CVD risk factors. Results: Approximately one in five males (total N = 6,547) and one in ten females (total N=9,797) met criteria for class II obesity (BMI 35 - 40 kg/m 2 ) or class III obesity (BMI ≥ 40 kg/m 2 ). The prevalence of hypertension, diabetes, and elevated C-reactive protein rose with each successive class of overweight/obesity. In contrast, the prevalence of elevated levels of total cholesterol, LDL-c and triglycerides increased across normal weight, overweight (BMI 25 - 30 kg/m 2 ), and class I obese (BMI 30 - 35 kg/m 2 ) groups, but did not increase in frequency across class I, class II, and class III obesity groups. The Figure depicts isolines that identify age- specific subgroups of the normal-weight and class II - III obese groups that had the same estimated prevalence of CVD risk factors, with 95 percent confidence intervals. Among young adults with class II or III obesity, the prevalence of hypertension, diabetes, and the combination of three or more CVD risk factors was similar to that among normal-weight individuals (BMI 18.5 - 25 kg/m 2 ) who were 15 to 30 years older. Among young obese individuals, the prevalence of low HDL-c levels and high C-reactive protein levels exceeded that among the oldest adults in the cohort. CVD risk factors had stronger, more consistent gradients across the BMI categories among men than among women. Conclusion: Class II and III obesity, defined as BMI ≥ 35 kg/m 2 , are common in the Hispanic/Latino population. Young adults with these severe forms of obesity have dramatically increased frequency of cardiometabolic risk factors. The age-related accumulation of multiple CVD risk factors, such as is typically seen in normal-weight individuals, is accelerated by 1-2 decades in severly overweight women and by 2-3 decades in severely overweight men.

Prevalence of dyslipidemia and obesity among college students in Kuwait

Objective: The purpose of this study was to determine the prevalence of elevated levels of lipids and obesity among college students in Kuwait. Subjects and Method: A sample of 484 students (35.74% male and 64.26% female), aged 20.35±1.33 years, were chosen randomly from the College of Basic Education, Kuwait, during the period between the beginning of March 2009 till mid January 2010. Data were collected, using a predesigned interviewing schedule that contained information related to age, gender, history of hypertension, family history of hypertension and diabetes and the smoking habits. Also, their weight, height and waist circumference were measured. Laboratory measurements such as impaired glucose tolerance test and lipid profile were investigated. Data analysis was done using the SPSS version 17 for Windows. The study was approved by the National Ethical Committee of health researches. Results: The overall proportion of both dyslipidemia, based on both hypercholesterolemia and hypertriglycemia, as well as hypertriglycemia were significantly higher among males above 18 years of age, when compared with their female counterparts or those less than 18 years aged-male students. Males showed higher proportions of risky HDL level ( 30, were more than those of females in both age groups. As regards waist circumference-based obesity, it was found that the proportions of females were more significantly higher than those of males in both age groups. Hypertension was more significantly noticed among males in comparison with their female counterparts in both age groups (p<0.001). There was no statistically significant difference between both sexes as regards fasting blood glucose and postprandial blood glucose. However, males had higher levels of HbA1c than had females (p=0.021). Conclusion: Prevalence of elevated levels of lipids and BMI-based obesity was higher among males than females in the college students. These results suggest the involvement of obesity and both elevated lipid levels and hypertension among males. More screening should be performed especially for overweight/obese adolescent/adult students for the risk of dyslipidemia. The research project was funded by the Public Authority of Applied Education and Training, Kuwait.

Prevalence of Elevated Alanine Aminotransferase Among US Adolescents and Associated Factors: NHANES 1999–2004

Nonalcoholic fatty liver disease (NAFLD) is a common cause of liver disease in children and adolescents. The majority of studies of NAFLD in children have been in select populations of the clinically obese. Study aims were to estimate the prevalence of elevated alanine aminotransferase (ALT, as a marker of NAFLD) in a general contemporary adolescent population and to identify leading risk factors for ALT elevation (>30 U/L). We analyzed data of adolescent participants (aged 12-19 years; N = 5586) in the National Health and Nutrition Examination Survey 1999-2004, a representative sample of the civilian noninstitutionalized US population. The prevalence of elevated ALT levels (>30 U/L) was 7.4% among white adolescents, 11.5% among Mexican American adolescents, and 6.0% among black adolescents. Elevated ALT levels were prevalent in 12.4% of male subjects compared with 3.5% of female subjects. Multivariable associations with elevated ALT levels were found for sex (odds ratio [OR] male vs female, 7.7; 95% confidence interval [CI], 3.9-15.1), ethnicity (OR black vs white, 0.6; 95% CI, 0.3-1.3; OR Mexican American vs white, 1.6; 95% CI, 1.0-2.6), waist circumference (OR per 1 SD, 1.4; 95% CI, 1.0-2.0), and fasting insulin level (OR per 1 SD, 1.6; 95% CI, 1.2-2.1). Age, C-reactive protein levels, and triglyceride levels were also positively and socioeconomic position inversely associated with elevated ALT levels. The magnitude of associations were similar across ethnic groups. ALT level is associated with waist circumference and insulin resistance even in a young population. These characteristics could be utilized to identify adolescents who may benefit from screening for NAFLD, offering an opportunity to prevent disease progression at an early age.

A modified routine analysis of arsenic content in drinking-water in Bangladesh by hydride generation-atomic absorption spectrophotometry.

The high prevalence of elevated levels of arsenic in drinking-water in many countries, including Bangladesh, has necessitated the development of reliable and rapid methods for the determination of a wide range of arsenic concentrations in water. A simple hydride generation-atomic absorption spectrometry (HG-AAS) method for the determination of arsenic in the range of microg/L to mg/L concentrations in water is reported here. The method showed linearity over concentrations ranging from 1 to 30 microg/L, but requires dilution of samples with higher concentrations. The detection limit ranged from 0.3 to 0.5 microg/L. Evaluation of the method, using internal quality-control (QC) samples (pooled water samples) and spiked internal QC samples throughout the study, and Standard Reference Material in certain lots, showed good accuracy and precision. Analysis of duplicate water samples at another laboratory also showed good agreement. In total, 13,286 tubewell water samples from Matlab, a rural area in Bangladesh, were analyzed. Thirty-seven percent of the water samples had concentrations below 50 microg/L, 29% below the WHO guideline value of 10 microg/L, and 17% below 1 microg/L. The HG-AAS was found to be a precise, sensitive, and reasonably fast and simple method for analysis of arsenic concentrations in water samples.

Elevated Serum Methylmalonic Acid Concentrations Are Common among Elderly Americans

To describe serum methylmalonic acid (MMA) concentrations of elderly Americans and examine relationships between serum MMA and other factors, we used surplus serum samples collected from elderly (n = 1145) and young-adult (n = 1026) participants in Phase 2 of the third National Health and Nutrition Examination Survey (1991-1994). In approximately 20% of participants >/=65 y old, serum MMA was >370 nmol/L, the 90th percentile of the distribution of participants aged 30-39 y. Consistent with previous reports, we observed strong, independent positive associations between serum MMA concentration and serum concentrations of creatinine and homocysteine. After controlling for demographic factors and creatinine, geometric mean MMA concentration was lower in non-Hispanic blacks [223.6 nmol/L; 95% confidence interval (CI), 198.8-251.5] than non-Hispanic whites (265.1 nmol/L; 95% CI, 240.3-292.4). However, the prevalence of elevated levels did not vary with race/ethnicity. Serum MMA concentration bore a strong inverse relation to serum vitamin B-12 concentration. Nevertheless, elevated serum MMA concentrations affected approximately 15% of those with both normal serum creatinine concentrations and serum B-12 concentrations >148 pmol/L. We conclude that many elderly Americans demonstrate metabolic evidence of low B-12 status, that elevations occur frequently in the absence of traditional deficiency indicators and that levels vary with race/ethnicity and renal function.

Prevalence of Abnormal Levels of Serum Tumour Markers in Elderly People

The study was conducted to evaluate the prevalence of abnormal levels of several serum tumour markers in an institutionalized elderly population. Serum tumour markers assay of carcinoembryonic antigen (CEA), the carbohydrate antigens CA 19-9, CA 72-4 and CA 15-3 (Enzymun-test, Boehringer Mannheim GmbH Diagnostic), alpha-fetoprotein (AFP) and prostate specific antigen (PSA) (Abbot Diagnostic Division) were performed in 228 unselected, institutionalized elderly subjects, whose mean age (SD) was 82.4 (5. 79) range (66-99 years). Patients with acute or neoplastic diseases were excluded from the study. The serum markers were also measured in 52 healthy young adults (controls). Using the established threshold values, 92 subjects (40%) were found to have at least one elevated marker. PSA was elevated in 33%, CA 19-9 in 16%, CEA in 11. 5%, CA 15-3 in 11%, CA 72-4 in 8% and AFP in 3%. We found a significant difference in the serum levels between the two groups for CEA, CA 19-9. CA 15-3, and PSA (p < 0.0001). Healthy aged people appear to have an elevated prevalence of elevated levels of serum tumour markers. The results suggest that apart from PSA, elevated antigen levels in elderly subjects are related to the ageing process itself rather than to occult pathology.

Human exposure to polychlorinated biphenyls in greater New Bedford, Massachusetts: A prevalence study

A study was conducted in the community of Greater New Bedford, Massachusetts, from 1984 through 1987 to assess the prevalence of elevated levels of polychlorinated biphenyls (PCBs) in the serum of individuals aged 18 to 64 years who had resided in the area for at least 5 years. Eight hundred and forty subjects were interviewed, examined, and tested in a cross-sectional sample of the towns of Acushnet, Dartmouth, and Fairhaven and the city of New Bedford. Serum PCBs were measured to estimate the extent of human exposure. Because of documented environmental contamination by PCBs in the New Bedford area, and the practice of recreational fishing in the harbor for food, a significant number of persons with elevated serum PCB levels were expected to be identified. Instead, the prevalence of elevated serum PCBs in the sample was found to be typical of "unexposed" urban populations in the United States. Only 1.3% of the subjects had serum PCB levels greater than 30 ppb. The same percentage was observed among males (n = 391) and females (n = 449). The geometric means of PCB levels were 4.3 ppb among males (Range = 0.50-60.9) and 4.2 ppb among females (Range = 0.38-154). We conclude that the prevalence of elevated serum PCBs is low in the population of Greater New Bedford.

National estimates of blood lead levels: United States, 1976-1980: association with selected demographic and socioeconomic factors.

Data from the second National Health Nutrition Examination Survey showed that 22 per cent of persons six months through 75 years old had blood lead levels under 10 micrograms per deciliter; 1.9 per cent had elevated levels (greater than or equal to 30 micrograms per deciliter [greater than or equal to 1.45 mumol per liter]). Among children six months through five years old the prevalence of elevated levels was significantly higher (4 per cent) than previously predicted on the basis of fewer data. The prevalence of elevated lead levels was 12.2 per cent in black children and 2.0 per cent in white children. Mean levels of blood lead were higher in blacks than white among children and adults, among young children living in urban and rural areas, and among members of low-income, moderate-income, and higher-income families. These racial contrasts may reflect different lead exposure or absorption (or both). Young children from families (both white and black) whose incomes were under $6,000 had a significantly higher prevalence of elevated lead levels than those from households with incomes of $6,000 or more.

The occupational hazards of formulating oral contraceptives--a survey of plant employees.

In May 1976 an investigation of a factory in Puerto Rico which formulates oral contraceptives revealed that during the previous 12 months five of the company's twenty-five employees (20%), and twelve of the company's thirty female employees (40%) had experienced symptoms associated with hyperestrogenism. The affected males had gynecomastia and three of them also reported a history of decreased libido or impotence. The affected females each had had at least one episode of intermenstrual bleeding during the preceding 12 months. There was an estimated relative risk of 4.3 for intermenstrual bleeding in nonclerical female employees compared with matched controls who did not work at the plant. Elevated levels of plasma ethinyl estradiol were twice as frequent in the two highest-risk job categories compared with the rest of the factory population, but the difference in prevalence of elevated levels was not statistically significant (P = 0.08). Wide variations in mestranol concentration were noted in the environmental dust samples. Prompt consideration should be given to establishing health standards for persons occupationally exposed to estrogens in view of the possible long-term sequelae of such exposure.