Biological mechanisms of disease and death in Moscow: rationale and design of the survey on Stress Aging and Health in Russia (SAHR)

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THE ASSOCIATION OF DEPRESSION WITH C-REACTIVE PROTEIN (THE DATA OF ESSE-RF EPIDEMIOLOGICAL STUDY)

Aim. To study the association of depression with a high-sensitivity C-reactive protein (hsCRP) level, taking into account the main risk factors and noncommunicable diseases in Russia residents.Material and methods. The data of ESSE-RF multicenter study (a representative sample of the unorganized male and female population aged 25-64 years from 8 regions surveyed in 2012-2014) were used in the work. A total 11884 people were involved into the study including 35.9% men. The examination included a survey on the standard questionnaire containing data on disease history, etc. The level of depression was assessed by the validated in Russian Hospital Anxiety and Depression Scale (HADS, 1983). hsCRP level was determined in all patients.Results. The continuing association between elevated levels of depression (HADS-D ≥8+) and high level of hsCRP ≥3.0 mg/l (odds ratio [OR] 1.15; 95% confidence interval [CI] 1.03-1.27; p=0.009) was found in the multivariate model, after adjustment for sex, age, education, and risk factors. Reducing of the relationship of elevated levels of depression with a high level of hsCRP (OR 1.11; 95% CI 1.00-1.24; p=0.048) was found with the additional introduction of diseases in the model. This relationship was reduced to not statistically significant level (OR 1.08; 95% CI 0.98-1.20; p=0.134) in the full model adjusted for regions.Conclusion. The reduced association of depression with hsCRP ajusted for aggregate risk factors was found in the study. This suggests about multifactor affecting on this relationship

Non-High Density Lipoprotein Cholesterol: A Modern Benchmark for Assessing Lipid Metabolism Disorders

Aim. To perform a population analysis of Non-High Density Lipoprotein Cholesterol level (non-HDL-c) in Russian population and to evaluate its association with cardiovascular events.Material and Methods. The material consisted of results obtained from 11 regions of the ESSE-RF1 Study and from 4 regions of the ESSE-RF2 Study. Study protocols were identical. The studies were performed in 2012-2014 and 2017, respectively. Endpoints were assessed in 19041 people aged 35-64 years. The median follow-up was 6.5 years in ESSE RF (1) and 3.8 years in ESSE RF(2). Analysis was performed for three lipid variables: total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and non-HDLC in two samples: the general population sample and the same sample without individuals with coronary heart disease (CHD), myocardial infarction (MI) and/or stroke history and not taking statins (the population sample of "without a history of cardiovascular diseases [CVD]". The analysis of nonlinear associations was performed using the generalized additive Cox model. The combined cardiovascular endpoint was represented by cardiovascular death and nonfatal MI and stroke. Traditional and laboratory FRs, socio-demographic parameters were analyzed. The significance level for all tested hypotheses was set to be 0.05.Results. The prevalence of elevated non-HDL-C level (>3.7 mmol/l) was found to be 74.6%. No gender differences were found: there was 74.6% for men and 74.5% for women. Both mean values and prevalence of elevated non-HDL-C were increased with age in women, and its level was slightly decreased in men after 55 years old. Almost all analyzed RFs were significantly associated with elevated non-HDL-C in these two population samples. In both samples elevated total CH and elevated LDL-C were associated with all-cause mortality after correction for all RFs. On the contrary, the non-HDL-C was associated with CVD combined end pints. It has been shown that the risk of these end points increases uniformly with increase in levels of non HDL cholesterol, no nonlinear associations were found.Conclusion. The results of a population-based analysis of non-HDL-C performed in the Russian population for the first time confirmed that elevated non-HDL-C levels contribute significantly to determining the risk of cardiovascular events in the medium term. It can be assumed that the new risk scales (SCORE2 and SCORE OP) proposed by the European Society of Cardiology and the European Society of Preventive Cardiology, which include non-HDL C instead of TC, will allow adequate assessment of 10-year cardiovascular risk for Russians. However, continued monitoring of endpoints in order to obtain stable associations is required

Management accounting Techniques in the hospitality industry

Факультет международных отношенийThis article represents an overview of the management accounting techniques used in the Hospitality Industry. The main differences between financial and management accounting are explained. Much attention is given to the Uniform System of Accounts for the Lodging Industry (USALI) and principles of its operation. The Key Performance Indicators used in the Hospitality Industry are analysed. Advantages and disadvantages of the USALI standards are assessed during the practical research. The article is focused on models of USALI implementation. The recommendations for the improvement of management accounting system in the Belarusian hotels are given

Management accounting Techniques in the hospitality industry

Факультет международных отношенийThis article represents an overview of the management accounting techniques used in the Hospitality Industry. The main differences between financial and management accounting are explained. Much attention is given to the Uniform System of Accounts for the Lodging Industry (USALI) and principles of its operation. The Key Performance Indicators used in the Hospitality Industry are analysed. Advantages and disadvantages of the USALI standards are assessed during the practical research. The article is focused on models of USALI implementation. The recommendations for the improvement of management accounting system in the Belarusian hotels are given

Gender specifics of the association between blood fibrinolytic activity and cardiovascular disease or diabetes mellitus in a cohort of Muscovites aged 55 years or older

Aim. To investigate potential gender differences in the association between plasma fibrinolytic activity (FLA) and atherosclerotic pathology in elderly people. Material and methods. This analysis was performed as a part of the prospective population-based cohort study “Stress, Ageing, and Health in Russia”. The study included randomly selected Moscow residents of both genders and age of ≥55 years (n=1863; 889 men and 974 women). Based on the levels of blood FLA (time of spontaneous lysis of euglobin blood fraction, or euglobin lysis time, ELT), all participants were divided into three groups: with normofibrinolysis (ELT 180-260 minutes), hypofibrinolysis (ELT >260 minutes), and hyperfibrinolysis (ELT <180 minutes). Results. In this cohort of elderly Muscovites, the association between FLA and the presence of cardiovascular disease (CVD) or Type 2 diabetes mellitus (DM-2) differed in men and women. The link between hypofibrinolysis, atherogenic changes in lipid profile, or high fasting levels of insulin and arterial hypertension (AH), myocardial infarction (MI), or DM-2 was present only in men. In women, either reduced or increased FLA was not related to DM-2. Men with hyperfibrinolysis demonstrated lower odds of AH and DM-2, while women with hyperfibrinolysis had lower odds of AH, coronary heart disease, or angina. Conclusion. In elderly people, high FLA appears to provide protection against atherothrombotic pathology, regardless of gender. Low FLA was associated with higher odds of CVD and DM-2 in men only

SERUM LIPOPROTEIN(a) LEVEL IN SUBJECTS FREE OF CLINICAL MANIFESTATIONS OF ATHEROSCLEROSIS-RELATED DISEASES: THE RELATIONSHIP WITH LIPID AND GLUCOSE METABOLISM PARAMETERS AND ARTERIAL STIFFNESS

Aim of the study – in subjects without any signs of atherosclerosis to study the associations between blood serum level of lipoprotein(a) (Lp(a)) from one hand, and lipoprotein profile, insulinmediated glucose utilization parameters and pulse wave velocity (PWV), from the other. Material and methods. Totally 202 subjects (68 men, 134 women) aged 25–75 years without clinical manifestations of atherosclerosis-related diseases but with cardiovascular disease risk factors were included into the study. Blood lipid and carbohydrate parameters were measured by standard methods, serum concentration of Lp(a), apolipoproteins (apo) AI, AII, and B – immunoturbidimetrically. PWV was used as a measure of arterial stiffness. Results. Serum level of Lp(a) positively correlated with apo B concentration (R=0,143; p=0,043) and negatively with apo АII content (R=–0,286; p<0,0001). No associations between Lp(a) level and glucose metabolism parameters were found. At the same time, the comparison in groups differed by Lp(a) level according to the highest quintile of its distribution, showed that in subjects with elevated Lp(a) (≥ 50 mg/dl), PWV, apo AII concentration, and postprandial glycemia were lower, while apo B concentration and apo B/apo AI ratio were higher, than in those with Lp(a) < 50 mg/dl. Subjects with high Lp(a) level have upward trend to increased frequency of atherosclerotic plaques presence in carotid arteries. Conclusions. The relationship between elevated Lp(a) level with the initial stages of atherosclerosis was found; however, this association wasn’t coupled with increased arterial stiffness. Higher Lp(a) level positively correlated with apo B concentration and negatively with apo AII content. The relationship between Lp(a) and glucose level was observed only after glucose load in glucose tolerance test and might be explained by more favorable glycemic control in subjects with increased Lp(a) level

DISORDERS OF PLASMA AND PLATELET PATHWAYS OF HEMOSTASIS IN PATIENTS WITH ARTERIAL HYPERTENSION COMBINED WITH DISLIPOPROTEINEMIA

Parameters of lipid transport system as well as that of haemostasis have been studied in coronary heart disease (CHD) patients (n = 70) having at least one of two major CHD risk factors - arterial hypertension (AH) and dyslipoproteinemia (DLP). Patients with combination of AH and DLP significantly differed from those with isolated DLP by higher levels of total and low density lipoprotein cholesterol, triglycerides and apolipoprotein B. As compared with patients with isolated AH they differed by elevated systolic and diastolic blood pressure. The increased blood thrombogenicity (combination of disturbances in haemostasis resulted in enhanced thrombosis) was high both in hypertensive and dyslipidemic subjects. However, while in group with isolated DLP there was a predominance of decreased anticoagulation and fibrinolysis, in patients with isolated AH the major impact was related to elevated platelet aggregation. Thus, unfavorable shifts in lipoprotein and haemostasis parameters found in patients with AH and DLP could be regarded as markers of their atherothrombogenicity

DISTRIBUTION OF LIPID PROFILE VALUES IN ECONOMICALLY ACTIVE MEN AND WOMEN IN RUSSIAN FEDERATION: RESULTS OF THE ESSE-RF STUDY FOR THE YEARS 2012-2014

Elevated level of plasma cholesterol, together with arterial hypertension, is the main modifiable factor of cardiovascular diseases (CVD) development. Monitoring of lipid levels at populational level is an important instrument of the prevention medicine, applied for CVD populational risk assessment.Aim. Blood lipid levels assessment, with the data obatined during epidemiological study “ESSE-RF” (Epidemiology of cardiovascular diseases in various regions of Russian Federation) in 13 regions of Russia.Material and methods. In the study, the patients were included, of 25-64 y.o. All participants underwent specimens collection for total cholesterol (TC), triglycerides (TG), high density lipoproteides cholesterol (HDL-C) and low density lipoproteides cholesterol (LDL-C) by enzymatic methods on automatic analyzer Abbott Architect 8000. Also, in all the participants, hypolipidemic therapy was evaluated.Results. Totally, 21167 persons included into analysis, 7937 males and 13230 females. 807 (3,81%) had been taking hypolipidemic therapy and were ruled out from further analysis. Mean age 44±12 and 47±11 y.o., respectively. Mean values for men were TC 5,31±1,15 mM/L, TG 1,58±1,24 mM/L, HDL-C 1,30±0,33 mM/L and LDL-C 3,38±0,99 mM/L (7643 persons), for women — 5,48±1,18 mM/L, 1,36±0,85 mM/L, 1,47±0,35 mM/L and 3,42±1,04 mM/L, respectively (12717 persons). In the study we present percentile variations of the studied groups by the measured levels of TC, TG, HDL-C, LDL-C according to the age and sex. There were moderate correlations found of HDL-C with age and sex (r=0,34, p=0,000) and LDL-C (r=0,33, p=0,000). Correlation of TG with age and sex was low, but significant (r=0,18, p=0,000). There was no correlation of HDL-C with age and sex (r=-0,002, p=0,740). Also, a high prevalence is shown for severe lipid disorders. 23% of the participants had severely increased TC level (&gt;6,2 mM/L), and 20,6% — of LDL-C (&gt;4,2 mM/L). Severe increase of TG (&gt;5,0 mM/L) was found much more rarely (1,1%).Conclusion. In the ESSE-RF study the prevalence of significant lipid disorders was shown as high, that demands respective prevention and management. This study might be a starting point for lipids populational dynamics analysis in Russia