Five-year incidence of type 2 diabetes mellitus among cardiovascular disease-free Greek adults: Findings from the ATTICA study

Demosthenes B Panagiotakos1, Christos Pitsavos2, Yannis Skoumas2, Yannis Lentzas2, Christodoulos Stefanadis21Department of Nutrition Science-Dietetics, Harokopio University, Athens, Greece; 2First Cardiology Clinic, School of Medicine, University of Athens, Athens, GreeceObjective: We evaluated the 5-year incidence of diabetes in an adult population from Greece.Research design and methods: 3042 individuals (>18 years), free of cardiovascular disease, participated in the baseline examination (during 2001–2002). Of this sample, 1012 men and 1035 women were found alive at the time of follow-up, while 32 (2.1%) men and 22 (1.4%) women died during this period. The rest were lost to follow-up. Incidence of type 2 diabetes mellitus was evaluated in 1806 participants who did not have diabetes at baseline.Results: The age-adjusted 5-year incidence of diabetes was 5.5% (men, 5.8%; women, 5.2%). A linear trend was observed between diabetes incidence and age (5.6% increases in incidence per 1-year difference in age, p < 0.001). Multiple logistic regression analysis revealed that age (OR per 1 yr = 1.04, 95% CI 1.02–1.06), waist (OR per 1 cm = 1.02, 95% CI 1.01–1.003), physical activity (OR = 0.62, 95% CI 0.35–1.02) and family history of diabetes (OR = 2.65, 95% CI 1.58–4.53), as well as fasting glucose levels (OR per 1 mg/dl = 1.05, 95% CI 1.03–1.07), were the most significant baseline predictors for diabetes, after adjusting for various potential confounders. Additionally, presence of metabolic syndrome at baseline evaluation 2.95-fold the risk of diabetes (95% CI 1.89–4.61), and showed better classification ability than the model that contained the components of the syndrome (ie, correct classification rate: 94.5% vs. 92.3%).Conclusion: Our findings show that a 5.5% incidence rate of diabetes within a 5-year period, which suggests that the prevalence of this disorder in Greece is rising. Aging, heredity, and metabolic syndrome were the most significant determinants of diabetes.Keywords: diabetes, incidence, metabolic syndrom

Epidemiology of leisure-time physical activity in socio-demographic, lifestyle and psychological characteristics of men and women in Greece: the ATTICA Study

BACKGROUND: We aimed to evaluate the prevalence, frequency and type of leisure-time physical activity (LTPA) among adults in Greece, as well as its relationship with socio-demographic, lifestyle and clinical characteristics of these people. METHODS: From May 2001 to December 2002 we randomly enrolled 1514 men and 1528 women, without any evidence of cardiovascular or any other chronic disease. The sampling was stratified by the age – gender distribution of (census 2001) of the greater area of Athens. Weekly energy expenditure assessed by considering frequency, duration (in minutes) and intensity of sports related physical activity during a usual week. RESULTS: 53% of men and 48% of women were classified as physically active. Men were more likely to be active as compared to women (p < 0.05), while the lowest activity rates were observed in 40 to 49 years old participants (p < 0.01). Physically active people had higher occupation skills, were more likely to live in rural areas, to be unmarried, non smokers and they were devoted to a healthier dietary pattern, as compared to sedentary, irrespective of age and sex (all p < 0.05). In addition, the cumulative risk factors score of obesity, hypertension, hypercholesterolemia and diabetes, was inversely associated with activity status (p < 0.001). Finally, physically active men and women were less likely to report depressive symptoms (p < 0.01), after various adjustments were made. CONCLUSION: Half of the studied population reported physically inactive, indicating that sedentary lifestyle becomes a serious epidemic in Greece. High occupation skills, non-smoking, devotion to a healthier dietary pattern and a better cardiovascular risk factors profile were some of the determinants of physically active people

Abdominal obesity, blood glucose and apolipoprotein B levels are the best predictors of the incidence of hypercholesterolemia (2001–2006) among healthy adults: the ATTICA Study

<p>Abstract</p> <p>Objective</p> <p>In this work we evaluated the 5-year incidence of hypercholesterolemia, in a sample of cardiovascular disease free adult men and women from Greece. We also evaluated the association of several socio-demographic, dietary and lifestyle habits on the incidence of this disorder.</p> <p>Methods</p> <p>1514 men and 1528 women (>18 y) without any clinical evidence of cardiovascular disease, living in Attica area, Greece, were enrolled in the ATTICA study from May 2001 to December 2002. The sampling was random, multi-stage, and included information about various socio-demographic, lifestyle (diet, exercise, smoking etc), biological (lipids, and inflammatory markers), and clinical characteristics of the participants. In 2006, a group of experts performed the 5-year follow-up through telephone calls or personal visits (941 of the 3042 (31%) participants were lost to follow-up). Hypercholesterolemia, among people who had normal blood lipids at initial examination, was defined as fasting total cholesterol levels > 200 mg/dl or use of lipids lowering agents (NCEP ATPIII).</p> <p>Results</p> <p>The 5-year incidence of hypercholesterolemia was 23.7% (n = 127) in men and 17.7% (n = 110) in women (p for gender differences < 0.001). Multi-adjusted logistic regression analysis which revealed that increased age (odds ratio = 1.05, p < 0.001), waist circumference (odds ratio = 1.02, p = 0.03), fasting blood glucose (odds ratio = 1.01, p = 0.08) and apolipoprotein B (odds ratio = 1.02, p = 0.001) levels, were the most significant baseline predictors of developing hypercholesterolemia within a 5-year period.</p> <p>Conclusion</p> <p>Incidence of hypercholesterolemia was high in both genders, emphasizing the burden of this disorder at population level. Aging, increased waist circumference, fasting blood glucose and apolipoprotein B levels were the most significant baseline predictors of hypercholesterolemia.</p

The associations between physical activity and inflamatory, coagulation and oxidative stress markers the attica study

ΣΥΜΠΕΡΑΣΜΑΤΑ: Από τη μελέτη «ΑΤΤΙΚΗ» διαπιστώσαμε ότι ένα μεγάλο ποσοστό περίπου 60% των συμμετεχόντων ήταν σωματικά μη δραστήριοι που δείχνει ότι ο καθιστικός τρόπος ζωής παίρνει τη μορφή επιδημίας για την Ελλάδα. Μέσω της μελέτης «ΑΤΤΙΚΗ» εξετάσαμε τα δημογραφικά και κοινωνικά χαρακτηριστικά των συμμετεχόντων και διαπιστώσαμε τη θετική επίδραση της σωματικής δραστηριότητας στη μείωση εμφάνισης κατάθλιψης και στη μείωση του αθροιστικού αποτελέσματος των παραγόντων κινδύνου για εμφάνιση καρδιαγγειακής νόσου. Τα αποτελέσματα αυτής της μελέτης δίνουν έμφαση στην ιδιαίτερη σημασία που έχει η σωματική δραστηριότητα, στην πρωτογενή πρόληψη της καρδιαγγειακής νόσου μέσω της μείωσης των τιμών των δεικτών φλεγμονής, θρόμβωσης και οξειδωτικού stress. Ακόμα φάνηκε η ευεργετική επίδραση που έχει ο συνδυασμός της σωματικής δραστηριότητας με τη μεσογειακή διατροφή συμβάλλοντας στην ακόμα μεγαλύτερη μείωση των τιμών των δεικτών φλεγμονής, θρόμβωσης και οξειδωτικού stress. Σύμφωνα με τον Παγκόσμιο Οργανισμό Υγείας τρεις είναι οι κυριότεροι παράγοντες για την ανάπτυξη καρδιαγγειακής νόσου, η μη ύπαρξη σωματικής δραστηριότητας, το κάπνισμα και η διατροφή. Δεδομένου ότι και οι τρεις παραπάνω παράγοντες επιδέχονται παρέμβαση γίνεται κατανοητό ότι η πολιτική που θα ασκηθεί για τη δημόσια υγεία πρέπει να επικεντρωθεί στην πληροφόρηση της Ελληνικής κοινωνίας για τα οφέλη στην υγεία που μπορεί να αποκομίσει όποιος έχει καθημερινή σωματική δραστηριότητα, αφού με αυτό τον τρόπο εμποδίζει να ξεκινήσει η διαδικασία φλεγμονής και θρόμβωσης συμβάλλοντας αποφασιστικά στην πρωτογενή πρόληψη της καρδιαγγειακής νόσου

Diet, exercise, and C-reactive protein levels in people with abdominal obesity: The ATTICA epidemiological study

We evaluated the association of physical activity and diet with C-reactive protein (CRP) levels among subjects with abdominal obesity. During 2001-2002, we enrolled 625 men (18 to 87 years old) and 712 women (18 to 89 years old) with abdominal obesity (waist-to-hip ratio &gt;= 0.95 in men and &gt;= 0.8 in women) from the Attica area, Greece. The sampling was stratified by the age-gender distribution of the region (census 2001). Among several variables, we also measured plasma high-sensitivity CRP, physical activity status, dietary habits, blood lipids, and blood pressure levels. Adherence to the Mediterranean diet was evaluated through a diet score (0 to 55) that assessed the inherent characteristics of the diet. Compared with those with low CRP levels, subjects with high CRP levels (ie, &gt; 3.0 mg/L) were physically inactive (P = .01), were less likely to adopt the Mediterranean diet (P = .008), had higher glucose levels, had a higher prevalence of hypertension, had a lower high-density lipoprotein cholesterol, and had increased smoking habits and higher anthropometric indices (all P &lt; .05). Moreover, adoption of the Mediterranean diet in combination with medium physical activity seems to reduce the likelihood of having high CRP levels by 72% (P = .018), irrespective of smoking and various clinical and biological characteristics. Among subjects with abdominal obesity, low-grade systemic inflammation appears to be associated with the adoption of an unfavorable lifestyle, including physical inactivity and unhealthy dietary habits, as well as increased blood pressure levels and low high-density lipoprotein cholesterol