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Cardiovascular diseases (CVDs) remain the main cause of death in the WHO European Region. This systematic literature review assesses whether systematic screening programmes for CVD risk factors and preclinical CVDs across general populations can lower the CVD burden in society. Based on several high-quality randomized controlled trials with large numbers of participants, the results clearly showed that screening for CVD risk factors has no effect on lowering CVD morbidity and mortality in society. Studies showed that screening for preclinical CVDs slightly reduces mortality and negative outcomes related to abdominal aortic aneurysm; however, these results may be outdated, as smoking has declined and treatment has improved since the studies were completed. Results on screening for atrial fibrillation and other preclinical CVDs have not yet been published. In summary, the current evidence indicates that screening for CVD risk factors does not reduce the CVD burden.
- MeSH
- kardiovaskulární nemoci MeSH
- mortalita MeSH
- plošný screening MeSH
- populace MeSH
- Publikační typ
- systematický přehled MeSH
- Konspekt
- Veřejné zdraví a hygiena
- NLK Obory
- veřejné zdravotnictví
- kardiologie
- NLK Publikační typ
- publikace WHO
OBJECTIVE: To assess the seasonality of cardiovascular risk factors (CVRF) in a large set of population-based studies. METHODS: Cross-sectional data from 24 population-based studies from 15 countries, with a total sample size of 237 979 subjects. CVRFs included Body Mass Index (BMI) and waist circumference; systolic (SBP) and diastolic (DBP) blood pressure; total, high (HDL) and low (LDL) density lipoprotein cholesterol; triglycerides and glucose levels. Within each study, all data were adjusted for age, gender and current smoking. For blood pressure, lipids and glucose levels, further adjustments on BMI and drug treatment were performed. RESULTS: In the Northern and Southern Hemispheres, CVRFs levels tended to be higher in winter and lower in summer months. These patterns were observed for most studies. In the Northern Hemisphere, the estimated seasonal variations were 0.26 kg/m(2) for BMI, 0.6 cm for waist circumference, 2.9 mm Hg for SBP, 1.4 mm Hg for DBP, 0.02 mmol/L for triglycerides, 0.10 mmol/L for total cholesterol, 0.01 mmol/L for HDL cholesterol, 0.11 mmol/L for LDL cholesterol, and 0.07 mmol/L for glycaemia. Similar results were obtained when the analysis was restricted to studies collecting fasting blood samples. Similar seasonal variations were found for most CVRFs in the Southern Hemisphere, with the exception of waist circumference, HDL, and LDL cholesterol. CONCLUSIONS: CVRFs show a seasonal pattern characterised by higher levels in winter, and lower levels in summer. This pattern could contribute to the seasonality of CV mortality.
- MeSH
- dospělí MeSH
- hodnocení rizik MeSH
- index tělesné hmotnosti MeSH
- interpretace statistických dat MeSH
- kardiovaskulární nemoci * krev etiologie mortalita patofyziologie MeSH
- krevní tlak MeSH
- lidé středního věku MeSH
- lidé MeSH
- lipidy krev MeSH
- mortalita MeSH
- nízká teplota škodlivé účinky MeSH
- průřezové studie MeSH
- rizikové faktory MeSH
- roční období MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- triglyceridy krev MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
- Geografické názvy
- Evropa MeSH
- Nový Zéland MeSH
BACKGROUND: The aim of the study was to search for mutations in the NEUROD1 and IPF-1 genes in patients with clinical characteristics of maturity-onset diabetes of the young (MODY) but with no mutations in the HNF-4A (MODY1), GCK (MODY2) and TCF1 (MODY3) genes. METHODS: We studied 30 unrelated Czech probands with a clinical diagnosis of MODY (median age at testing, 18 yr; median age at the recognition of hyperglycaemia, 16 yr). The promoter, exons and exon/intron boundaries of the NEUROD1 and IPF-1 genes were examined by polymerase chain reaction-denaturing high performance liquid chromatography and direct sequencing. RESULTS: While no mutations were found in the IPF-1 gene, a novel H241Q substitution of NEUROD1 gene was identified in two unrelated families. In the first proband, the H241Q mutation led to early diagnosed (20 yr) hyperglycaemia followed by development of diabetic microvascular complications by the age of 32 yr. The second proband suffered from slowly progressing hyperglycaemia detected at the age of 30 yr. Affected members of both families were obese. The overall prevalence of the variant among the general population was 4 of 13 568 chromosomes. CONCLUSIONS: We report a novel disease-associated variant in NEUROD1 identified among a set of MODYX families. The variant seems to precipitate type-2-like diabetes in excessively obese individuals.
- MeSH
- diabetes mellitus 2. typu genetika MeSH
- dospělí MeSH
- homeodoménové proteiny genetika MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mutace MeSH
- obezita komplikace MeSH
- trans-aktivátory genetika MeSH
- transkripční faktory bHLH genetika MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- práce podpořená grantem MeSH