Maria Kaczmarek

Blood pressure references for Polish children and adolescents

The objective of this study was to develop age- and gender-specific reference ranges for blood pressure in a large national database on blood pressure levels throughout childhood and adolescence in young Poles. A prospective cross-sectional study was performed in 2002−2005 in the representative sampling sites, selected randomly from the entire Poland. Altogether, 6,447 school pupils, aged 7−18 years, were involved in the study of which 3,176 were boys and 3,271 were girls. Statistical analysis was performed using STATISTICA for Windows 7.1. The normal range of blood pressure, determined by age and the category of body height percentiles, revealed percentiles values which might serve as reference values to identify cases of high normal blood pressure (the mean blood pressure between 90th and 95th percentiles for age and gender) and hypertension (the mean blood pressure equals or exceeds the 95th percentiles on at least three occasions).

Who is at higher risk of hypertension? Socioeconomic status differences in blood pressure among Polish adolescents: a population-based ADOPOLNOR study

AbstractIn Poland, there is no data on parental socioeconomic status (SES) as a potent risk factor in adolescent elevated blood pressure, although social differences in somatic growth and maturation of children and adolescents have been recorded since the 1980s. This study aimed to evaluate the association between parental SES and blood pressure levels of their adolescent offspring. A cross-sectional survey was carried out between 2009 and 2010 on a sample of 4941 students (2451 boys and 2490 girls) aged 10–18, participants in the ADOPOLNOR study. The depended outcome variable was the level of blood pressure (optimal, pre- and hypertension) and explanatory variables included place of residence and indicators of parental SES: family size, parental educational attainments and occupation status, income adequacy and family wealth. The final selected model of the multiple multinomial logistic regression analysis (MLRA) with backward elimination procedure revealed the multifactorial dependency of blood pressure levels on maternal educational attainment, paternal occupation and income adequacy interrelated to urbanization category of the place of residence after controlling for family history of hypertension, an adolescent’s sex, age and weight status. Consistent rural-to-urban and socioeconomic gradients were found in prevalence of elevated blood pressure, which increased with continuous lines from large cities through small- to medium-sized cities to villages and from high-SES to low-SES familial environments. The adjusted likelihood of developing systolic and diastolic hypertension decreased with each step increase in maternal educational attainment and increased urbanization category. The likelihood of developing prehypertension decreased with increased urbanization category, maternal education, paternal employment status and income adequacy. Weight status appeared to be the strongest confounder of adolescent blood pressure level and, at the same time, a mediator between their blood pressure and parental SES. Conclusion: The findings of the present study confirmed socioeconomic disparities in blood pressure levels among adolescents. This calls for regularly performed blood pressure assessment and monitoring in the adolescent population. It is recommended to focus on obesity prevention and socioeconomic health inequalities by further trying to improve living and working conditions in adverse rural environments.What is known:• Socioeconomic gradient exists in adolescent blood pressure levels.• Adolescents from lower SES families are at greater risk of hypertension.What is new:• Urbanization levels of residence area affect adolescent blood pressure by parental socioeconomic status.• Socioeconomic inequalities in adolescent hypertension may be modulated through effects of body weight.

The association between menstrual cycle characteristics and perceived body image: A cross-sectional survey of polish female adolescents

The increasing prevalence of negative body perceptions among adolescent girls and the tendency towards wishing to be thinner have become a cultural norm in Western culture. Adolescent girls are particularly vulnerable to developing a negative body image due to physical and sexual changes occurring during puberty. This study aimed to evaluate the association between different measures of body image perceptions and different phases of the menstrual cycle after controlling for weight status and other potential confounders in Polish adolescent girls aged 12-18 years. Three-hundred and thirty participants of a cross-sectional survey conducted in 2009, normally cycling and with no eating disorders, completed a background questionnaire and the Stunkard Figure Rating Scale, and their anthropometric measurements were collected. The dependent outcome variables were measures of body image (actual body image, ideal body image and ideal-self discrepancy) and dichotomous body image perception (satisfied versus dissatisfied) adjusted for other predictor factors: socio-demographic variables, menstrual history and cycle phases, and weight status. One-way ANOVA indicated that weight status, age at menarche and menstrual cycle phase were associated with actual body image and rate of ideal-self discrepancy. Ideal body image was associated with weight status and menstrual cycle phase. General logistic regression models were constructed to evaluate associations of body dissatisfaction and all potential predictor variables. The final selected model of the multiple logistic regression analysis using the backward elimination procedure revealed that adjusted for other factors, negative body image was significantly associated with different phases of the menstrual cycle (p trend=0.033) and increasing body weight status (p trend=0.0007). The likelihood of body dissatisfaction was greatest during the premenstrual phase of the menstrual cycle (OR=2.38; 95% CI 1.06, 5.32) and among girls in obesity class I (OR=8.04; 95% CI 2.37, 27.26). The study confirmed the association between body image dissatisfaction in adolescent girls and different phases of the menstrual cycle after controlling for weight status. The issue of negative body self-image is not only of cognitive, but also of practical value as understanding better the factors contributing to the formation of a negative body image may be instrumental in developing preventive health programmes targeted at young people.

Perceived health status among middle-aged Polish people in relation to selected demographic and social factors

Abstract Self-rated health is an important measure of health status and outcomes and plays a significant role in the quality of life. The main purpose of the study was to estimate selected demographic and socio-economic factors associated with perceived health status among middle-aged Polish people. The sample being studied consisted of 5,776 women and 2,191 men aged 35-65 years, participants of two nation-wide cross-sectional surveys: the survey on middle-aged women’s health and quality of life (WOMID) and the survey on men’s health and quality of life, both conducted in 2000-2004. Participants were administered a gender-specific questionnaire on demographic, socio-economic status, lifestyle behaviours and self-rated health. The subjectively evaluated health status was then correlated with sex, age, marital status, place of residence, education level, financial situation, types of leisure time and the tobacco use. Data were processed using uni- and multivariate statistical procedures including the logistic regression models LOGITs and multiple correspondence analysis (MCA). It was found that the perceived health status was associated with women’s and men’s age, and in women with their menopausal status. Women were likely to evaluate their health significantly worse than men. It was found that marital status, educational attainment and financial well-off were the factors significantly associated with perceived health status in both women and men. In concluding remarks it should be stated that the health perception of women and men in mid-life is significantly related to their socio-economic status.

Multiplex PCR for identification of herpes virus infections in adolescents.

The aim of the study was to develop a multiplex PCR (mPCR) for a rapid and simultaneous detection of herpes simplex 1 (HSV‐1), herpes simplex 2 (HSV‐2), and human cytomegalovirus (HCMV) DNA in squamous oral cells obtained from adolescents. Accuracy of the method was tested in a group of 513 adolescents, almost 11% of subjects were positive for infection with herpes viruses. Correlations with gender, age, and place of residence were sought. A similar incidence of HSV‐2 and HCMV was found (4.3% and 5.4%, respectively) and the incidence of HSV‐1 was the lowest (1%) in the study group. Conversely to HSV‐2, HCMV was detected mostly in the youngest individuals. The same occurrence of all viruses was observed in boys and girls. The mPCR method described is suggested as a useful tool for epidemiologic studies of active herpes infections. J. Med. Virol. 83:267–271, 2011.

REPRODUCTIVE HEALTH AND PSYCHOLOGICAL WELL-BEING OF SURGICALLY MENOPAUSAL POLISH WOMEN

Backgroud. Every year, thousands of women experience premature menopause induced through a medical intervention and the dramatic effect of sudden oestrogen failure. The aim of the study was to describe reproductive health and psychological well-being of women who ceased menses due to surgical interventions. Materials and methods. The sample consisted of 628 women with surgical menopause who were examined in a cross-sectional survey (WOMID) carried out across Poland between 2000 and 2004. The data came from a 51-item Menopause Specific Questionnaire completed by every woman participating in the survey. The prevalence of menopausal symptoms was assessed using the MRS scale. Life Satisfaction Index was employed for the evaluation of the global satisfaction with life and with particular life domains. The ANCOVA models and Multiple Correspondence Analysis (MCA) were run to evaluate predictive factors for variation in subjective well-being of the study women and the association between the degrees of satisfaction with particular life domains. Statistical computations were run using Statistica 7.1 programme. Results. The findings of uni- and multivariate ANCOVA models with calendar age as a cov ariate revealed that menopausal symptoms, educational attainment and marital status were the main predictors of subjective well-being among women with surgical menopause. The results of MCA revealed a negative association between the degree of severity of menopausal complaints reported by the study women and the degree of satisfaction with life domains. Conclusion. The present estimate of the reproductive pattern, menopausal symptoms and psychological well-being of women with surgical menopause provides some insight into the growing process of medicalization of the menopause among Polish women.

A microsatellite polymorphism in IGF1 gene promoter and timing of natural menopause in Caucasian women.

Background: Genes involved in the IGF-1 aging pathways in the human ovary can be considered strong candidates for predictors of the natural menopause timing. This study evaluates the association between a cytosine-adenine (CA) microsatellite polymorphism in the IGF1 gene promoter P1 and age at natural menopause. Methods: Genomic DNA was extracted from the peripheral blood, PCR was performed using primers designed to amplify the polymorphic (CA)n repeat of the human IGF1 gene, an allele dose effect for the most common (CA)19 repeats allele, Cox proportional hazard regression models and the Kaplan-Meier cumulative survivorship method with the log-rank test were used to determine statistical significance of studied associations in a sample of 257 Polish women aged 40-58 years. Results: Crude Cox proportional hazard regression analysis confirmed the association between the IGF1 gene polymorphism and the menopause timing (p=0.038). This relationship remained statistically significant after controlling for other menopause confounders in multivariate modelling. Out of the input variables, the (CA)n polymorphism in the IGF1 gene promoter, age at menarche and smoking status were independent covariates of the natural menopause timing (χ2 =12.845; df=3; p=0.034). The onset of menopause at a younger age was likely associated with the IGF1 genotype variant not carrying the (CA)19 repeats allele, menarche before the age of 12 and a current cigarette smoker status (HR=1.6). Conclusion: This study provides evidence that a common cytosine-adenine (CA) microsatellite repeat polymorphism in the P1 promoter region of the IGF1 gene is an independent predictive factor for age at natural menopause in Caucasian women also after adjusting for other menopause covariates.

The association between socioeconomic status and health-related quality of life among Polish postmenopausal women from urban and rural communities

In recent years, more scholarly attention has been paid to a growing range of geographic characteristics as antecedents of inequalities in womens health and well-being. The purpose of this study was to evaluate differences in health-related quality of life between rural and urban Polish postmenopausal women. Using a data set from a reproductive health preventive screening of 660 postmenopausal women aged 48-60 years, inhabitants of Wielkopolska and Lublin provinces, the association of place of residence, socioeconomic status and lifestyle factors with health-related quality of life (the SF-36 instrument) was evaluated using ANCOVA models and multiple logistic regression analysis with backward elimination steps. A consistent rural-to-urban gradient was found in all indices of physical health functioning and well-being but not in vitality, social functioning, emotional role and mental health scales with women in large cities being likely to enjoy the highest and those in villages the lowest quality of life. The rural-urban disparities in health-related quality of life were mediated by womens socioeconomic status. The likelihood of worse physical and mental functioning and well-being was 2-3 times greater for the low socioeconomic status rural women than their counterparts from more affluent urban areas. The educational attainment and employment status were the most powerful independent risk factors for health-related quality of life in both rural and urban women. Better understanding of the role of socioeconomic status that acts as a mediator in the association between area of residence and health-related quality of life may be useful in developing public health policies on health inequalities among women at midlife.

Variation in biological status among Polish males and underlying socio-economic factors

Variation in biological status among Polish males and underlying socio-economic factors The main purpose of this study was to evaluate the socio-economic and lifestyle factors associated with biological status of Polish men. Data were collected during a cross-sectional survey carried out in Poznań and several localities in Western Poland, between 2000 and 2002. The sample consisted of 2509 men ranging from 30 to 90 years of age. Biological status was expressed in terms of functional-biological age (BA) computed as a composite z-score of 11 biomarkers according to the method proposed by Borkan and Norris [1980a], and physiological reserve index (PR) developed by Goffaux et al. [2005]. The average biological age profiles (BAP) were compared in several subgroups of participants. The subgroups were categorized based on demographic, socio-economic and lifestyle characteristics. It was found that values of systolic and diastolic blood pressure, BMI, physical and emotional aging indicators and perceived satisfaction with life were significantly associated with most of the study factors, except for smoking habit and education level. The multivariate logistic regression models revealed that two factors, financial situation and physical activity, were significantly associated with the physiological reserve index estimation. The study confirmed the role of the socio-economic and lifestyle factors likely to play in mens biological status and aging rates. Celem pracy była ocena wybranych czynników społeczno-ekonomicznych oraz elementów stylu życia wywierających wpływ na stan biologiczny mężczyzn. Badaną grupę stanowiło 2509 mężczyzn w wieku od 30 do 90 lat, pochodzących z różnych warstw społeczno-ekonomicznych. Badania, przeprowadzone w latach 2000-2002 na terenie Poznania oraz zachodniej Polski, miały charakter przekrojowy. Stan biologiczny określano posługując się koncepcją wieku biologicznego zaproponowaną przez Borkana i Norrisa [1980a] oraz metodą wyznaczania wskaźnika rezerwy fizjologicznej (PR) opracowaną przez Goffaux et al. [2005] (ryc. 1). Wiek biologiczny określano na podstawie 11 biomarkerów obejmujących pomiary antropometryczne, charakterystyki układu krążenia i biochemiczne, jakość życia oraz emocjonalne i fizyczne objawy towarzyszące starzeniu się mężczyzn (ryc. 2). Posługując się formułą [(wartość obserwowana - mediana)/odległość kwartylowa], uzyskiwano wartości z, które przypisywano do kategorii wieku biologicznego: młodszy (ujemne wartości) i starszy (dodatnie wartości) od przeciętnego. Następnie wykreślano profile wieku biologicznego, odrębnie w grupie mężczyzn młodszych (mniej niż 50 lat) oraz starszych (50 lat i więcej), kategoryzowanych w zależności od czynników społeczno-ekonomicznych oraz określających styl życia. Wartość wskaźnika PR uzyskano sumując wszystkie wartości z dla każdego osobnika. Charakterystykę próby przedstawiono w tabeli 1. Wykazano, że mężczyźni chronologicznie młodsi byli również biologicznie młodsi w porównaniu z mężczyznami chronologicznie starszymi (ryc. 3). Stwierdzono, że w obu grupach wieku parametrami najczęściej istotnie różniącymi się pomiędzy grupami o odmiennym statusie społecznym oraz stylu życia były parametry określające ciśnienie krwi, BMI, fizyczne i emocjonalne objawy towarzyszące starzeniu się oraz jakość życia. Poziom wykształcenia oraz palenie papierosów najsłabiej różnicowały wiek biologiczny mężczyzn w obu grupach wieku (tab. 2). Na ryc. 4 przedstawiono profile wieku biologicznego wyznaczone dla mężczyzn kategoryzowanych w zależności od stanu cywilnego, poziomu wykształcenia, miejsca zamieszkania, sytuacji finansowej, aktywności fizycznej oraz palenia papierosów. Analiza regresji logistycznej wykazała, że sytuacja finansowa oraz aktywność fizyczna, były istotnie powiązane z wskaźnikiem rezerwy fizjologicznej PR, kompleksowo oceniającym wiek biologiczny badanych mężczyzn (tab. 3). Wyniki uzyskane w pracy potwierdzają wpływ czynników społeczno-ekonomicznych oraz stylu życia na zróżnicowanie stanu biologicznego oraz wskaźników starzenia się mężczyzn.

Environmental variation in the prevalence of hypertension in children and adolescents – is blood pressure higher in children and adolescents living in rural areas?

INTRODUCTION Despite considerable progress in diagnostic methods and treatment options, cardiovascular diseases constitute a serious health issue in Poland, and hypertension is considered one of the main risk factors in the incidence of the diseases. OBJECTIVES The aim of this study is to assess the values of arterial blood pressure among adolescents in the context of urban and rural environments. MATERIALS AND METHOD The study was carried out on a representative, randomly selected group of youths aged 10-18 years, participating in the ADOPOLNOR project. Prior to blood pressure measurement, each pupil was assessed according to anthropomorphic principles. The BP measurements strictly followed the guidelines of the Fourth Protocol of the American Working Group of High Blood pressure in Children and Adolescents. RESULTS Mean values of systolic blood pressure (SBP) in boys in rural areas were higher in every age group than in the boys in urban areas. Higher values of systolic and diastolic blood pressure were observed also in girls in rural areas. BP values sufficiently high for the diagnosis of hypertension were observed in 12.8% of the rural boy population but only in 6.7% of the boys from the urban environment. The difference is statistically significant. The girls in rural areas (13.3%) had twice the incidence of elevated BP values in comparison with the girls in urban areas (7.2%) and, as in boys, the difference is statistically significant. CONCLUSIONS The high proportion of pupils with elevated arterial blood pressure observed in the rural areas of Wielkopolska calls for regularly performed BP assessment and monitoring in this populatio.