Many incident cases of type 2 diabetes do not
fulfill the metabolic syndrome, which accordingly has been questioned both as a research and clinical tool. The aim of this study was to determine differences in risk factors for type 2 diabetes between groups with high or low metabolic
score. The study population were 26,093 men and women attending the Tromsø Study in 1994, followed through 2005, and who did not have diabetes when entering the study. A total of 492 incident cases of type 2 diabetes were registered. A metabolic score was defined according to a modified version of the National Cholesterol Education Program Adult Treatment Panel III. For those fulfilling C 3 metabolic score criteria, increasing age, body mass index (BMI), triglycerides and a family history of diabetes were independent predictors. Age, BMI, and triglycerides predicted type 2 diabetes more strongly in subjects with low metabolic score, whereas high HDL cholesterol was not protective in this low risk group. The risk associated with a positive family history was unaffected by level of metabolic score. In addition smoking, low education and in men also physical inactivity were independent risk factors only in those with low metabolic score. Adding these nonmetabolic
risk factors increased correct classification from
an ROC area of 77.2 to 87.1% (P value\0.0001). One
half of the incident cases of type 2 diabetes were missed by using high metabolic score for risk prediction
Objectives. To examine whether enculturation factors, like cultural activities, ethnic pride, and native language competence, are related to decreasing internalizing and externalizing symptoms in indigenous Sami youth from Arctic Norway. The impact of self-efficacy on the relationship between enculturation factors and mental health problems was also examined.
Study design. Population-based, cross-sectional questionnaire study.
Methods. The Norwegian Arctic Adolescent Health Study was conducted among 10th graders in junior high schools in North Norway during 2003-2005. The study sample consisted of 450 indigenous Sami youth, aged 15-16 years. Internalizing symptoms were measured with the
Hopkins Symptom Check List-10 (HSCL-10), while externalizing symptoms were measured by two subscales of the Strengths and Difficulties Questionnaire (SDQ).
Results. For boys, participating in cultural activities and self-efficacy were associated with decreasing internalizing symptoms. Additionally, self-efficacy interacted with Sami language competence and cultural activities: when self-efficacy increased, these enculturation factors were related to symptom reduction. For girls, self-efficacy had an independent effect on internalizing symptoms and self-efficacy also strengthened the relationship between participation in cultural activities and reduced externalizing symptoms. Sami language
competence was related to reduction of both internalizing and externalizing symptoms in
girls.
Conclusions. In the present study, several enculturation factors and self-efficacy were identified as potential protective factors against mental health problems. In order to develop theoretical models that explain the mechanisms between cultural resilience and mental health, there is a need for both qualitative studies and longitudinal studies.
Martiushov, Sergey; Sidorenkov, Oleg; Arkhipovsky, Vadim L.; Nilssen, Odd; Grjibovski, Andrej M.; Brenn, Tormod(Journal article; Tidsskriftartikkel; Peer reviewed, 19-Jan-2010)
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Abstract:
Background: The metabolic syndrome (MetS) is a cluster of risk factors associated
with morbidity from cardiovascular disease (CVD) and associated mortality. Russia has one of the highest CVD mortality rates in the world. However, the prevalence of MetS in Russia remains largely unknown. The aim of this study is to estimate the prevalence of MetS and its components in an urban Russian setting.
Methods: Altogether, 3705 Russian adults aged 18-90 years were enrolled in a
cross-sectional study in Arkhangelsk (Northwest Russia). All subjects completed a
questionnaire and underwent a physical examination. Blood samples were taken and
analyzed in Tromsø, Norway. Three separate modified definitions of MetS were
used, namely, the National Education Cholesterol Education Program Adult
Treatment Panel III (NCEP), the American Heart Association / National Heart, Lung
and Blood Institute (AHA/NHLBI) and the International Diabetes Federation (IDF).
To ensure comparability of the findings, the prevalence data were standardized using
world and European standard populations and Russian population.
Results: The age-standardized (Segi’s world standard population) prevalence rates
of the MetS among women were 19.8% (95% CI: 18.1-21.5), 20.6% (95% CI: 18.9-
22.3) and 23.1% (95% CI: 21.3-24.9) by the NCEP, AHA/NHLBI and IDF criteria,
respectively. The corresponding rates for men were 11.5% (95% CI: 10.1-12.9),
13.7% (95% CI: 12.2-15.2) and 11.0% (95% CI: 9.7-12.4). Among subjects with
MetS, central obesity was more common among women, while elevated triglycerides
and blood glucose were more common among men. Almost perfect agreement was
found between the NCEP and AHA/NHLBI criteria (ĸ=0.94). There was less
agreement between the used definitions of MetS in men than in women. Conclusions: While the prevalence of MetS among Russian women is comparable
to the data for Europe and the U.S., the prevalence among Russian men is
considerably lower than among their European and North-American counterparts. Our
results suggest that MetS is unlikely to be a major contributor to the high
cardiovascular mortality among Russian men. Further studies of MetS determinants
and associated cardiovascular risk are needed for a better understanding of the
mechanisms leading to the exceptionally high cardiovascular mortality in Russia.