During the last decade, it has been shown that the metabolic syndrome and its different components – arterial hypertension (AH), abdominal obesity (AO), diabetes mellitus (DM), atherogenic hypertriglyceridemia (HTG), and/or low concentration of high-density lipoprotein cholesterol (HDL-C)) – increase the risk of cardiovascular diseases. There is increasing evidence that the incidence of the metabolic syndrome and the distribution of its components in combinations in the general male and female population differ. The aim of our study was to determine the incidence of the metabolic syndrome in men and women with acute ischemic syndromes and to evaluate the distribution of the metabolic syndrome component combinations in the presence of the metabolic syndrome. Contingent and methods. The study included 2756 patients (1670 males and 1086 females) with acute ischemic syndromes (1997 with myocardial infarction and 759 with unstable angina pectoris), in whom all five components of the metabolic syndrome were assessed. Women were significantly older than men (68.1±9.5 vs. 60.2±11.8 years, P<0.001). The metabolic syndrome was found (according to modified NCEP III) in 1641 (59.5%) patients (in 70.2% of females and in 52.6% of males, P<0.001). The most common components in both men and women were AH andAO(94.0%vs. 95.9%and 86.4%vs. 84.5%, respectively). HTGwas significantlymore common in men than in women (80.0% vs. 73.0%, P<0.001), while decreased HDL-C concentration was more common in women (82.8% and 59.2%, P<0.001). The DM component, detected in more than one-third of patients with acute ischemic syndromes, was significantly more common in women than in men (39.2% vs. 33.1%, P<0.05). Combinations of three components were significantly more common in men than in women, while combinations of four–five components were more common in women (55.6% vs. 41.4%, P<0.001; and 58.6% vs. 44.4%, P<0.01). The most common combination of three components in men was AH+AO+HTG and in women – AH+AO+lowHDL-C; themost common combination of four components in bothmen and women was AH+AO+HTG+low HDL-C. Conclusion. In the metabolic syndrome, the differences between the components of atherogenic dyslipidemia in patients with acute ischemic syndromes were related to the patients’ gender: men significantly more frequently had increased TG concentration and women – decreased HDLC concentration; this is the problem to be addressed in further studies of dyslipidemia.

A number of studies have established the effects of solar-geomagnetic activity on the human cardio-vascular system. It is plausible that the heliophysical conditions existing during and after hospital admission may affect survival in patients with acute coronary syndromes (ACS). We analyzed data from 1,413 ACS patients who were admitted to the Hospital of Kaunas University of Medicine, Lithuania, and who survived for more than 4 days. We evaluated the associations between active-stormy geomagnetic activity (GMA), solar proton events (SPE), and solar flares (SF) that occurred 0-3 days before and after admission, and 2-year survival, based on Cox's proportional-hazards model, controlling for clinical data. After adjustment for clinical variables, active-stormy GMA on the 2nd day after admission was associated with an increased (by 1.58 times) hazard ratio (HR) of cardiovascular death (HR=1.58, 95 % CI 1.07-2.32). For women, geomagnetic storm (GS) 2 days after SPE occurred 1 day after admission increased the HR by 3.91 times (HR=3.91, 95 % CI 1.31-11.7); active-stormy GMA during the 2nd-3rd day after admission increased the HR by over 2.5 times (HR=2.66, 95 % CI 1.40-5.03). In patients aged over 70 years, GS occurring 1 day before or 2 days after admission, increased the HR by 2.5 times, compared to quiet days; GS in conjunction with SF on the previous day, nearly tripled the HR (HR=3.08, 95 % CI 1.32-7.20). These findings suggest that the heliophysical conditions before or after the admission affect the hazard ratio of lethal outcome; adjusting for clinical variables, these effects were stronger for women and older patients.

Raktažodžiai: metabolinis sindromas, komponentai, ūminiai išeminiai sindromai.Santrauka. Daugelyje darbų nurodoma, kad metabolinio sindromo komponentai (rizikos veiksniai): arterinė hipertenzija, pilvinis nutukimas, cukrinis diabetas ir aterogeninė dislipidemija -trigliceridų koncentracijos padidėjimas ir didelio tankio lipoproteinų cholesterolio koncentracijos sumažėjimas didina išeminės širdies ligos riziką ir jos progresavimą.Tyrimo tikslas. Nustatyti hospitalizuotiems ligoniams, susirgusiems ūminiais išeminiais sindromais, metabolinio sindromo komponentų ir jų derinių dažnį bei komponentų pasiskirstymą deriniuose, įvertinti hiperglikemijos (gliukozės koncentracija ³6,1 mmol/l) be cukrinio diabeto anamnezės dažnį.Tirtųjų kontingentas ir tyrimo metodai. Į tyrimą įtraukti 2756 pacientai (1670 vyrų ir 1086 moterys, kurių amžiaus vidurkis -63,3±11,3 metų), susirgę ūminiais išeminiais sindromais: Q bangos miokardo infarktas -41,8 proc., be Q bangos miokardo infarktas -30,7 proc., nestabilioji krūtinės angina -27,5 proc. Metabolinis sindromas nustatytas (NCEP, III modifikuotas) 1641 (59,6 proc.) pacientui: 52,6 proc. vyrų, 70,2 proc. moterų. Rezultatai. Nė vieno metabolinio sindromo komponento nebuvo 3,9 proc., vienas metabolinis sindromo komponentas nustatytas 13,5 proc. pacientų, du komponentai -23,0 proc., trys -29,2 proc., keturi -22,9 proc., penki -7,5 proc. pacientų. Dažniausi metabolinio sindromo komponentai buvo arterinė hipertenzija ir pilvinis nutukimas (82,2 proc. ir 65,8 proc.), beveik pusei pacientų buvo trigliceridų koncentracijos padidėjimas ir didelio tankio lipoproteinų cholesterolio koncentracijos sumažėjimas (55,0 proc. ir 51,1 proc.) ir beveik penktadaliui (23,9 proc.) -cukrinis diabetas. Hiperglikemija be cukrinio diabeto anamnezės nustatyta daugiau nei trečdaliui hospitalizuotų ligonių (38,1 proc.). Dviejų penkių metabolinio sindromo komponentų deriniuose daugiau nei pusei (57,8 proc.) atvejų pasikartojo arterinės hipertenzijos ir pilvinio nutukimo derinys.Metabolinio sindromo, nustatyto daugiau kaip pusei susirgusiųjų ūminiais išeminiais sindromais, dažniausi komponentai buvo arterinė hipertenzija ir pilvinis nutukimas.Adresas susirašinėti: B. Šlapikienė, KMU Kardiologijos institutas, Sukilėlių 17, 50161 Kaunas El. paštas: luksiene@kmu.lt ĮvadasŪminių išeminių sindromų (ŪIS) pasireiškimą lemia daugelis rizikos veiksnių, sukeliančių aterosklerozinį pažeidimą vainikinėse arterijose (VA), susijusį su endotelio uždegiminiais degeneraciniais pokyčiais, VA aterosklerozinės plokštelės susidarymu, spindžio susiaurėjimu arba plokštelės plyšimu.Literatūroje pateikiama daugiau kaip 30 rizikos veiksnių, turinčių įtakos aterosklerozės pasireiškimui, progresavimui ir jos išeminėms pasekmėms. Tačiau, kaip nurodoma, ne visų rizikos veiksnių poveikis iše-Key words: components of the metabolic syndrome; acute coronary syndromes. Summary.Objective. Many studies report that the components of the metabolic syndrome -arterial hypertension, abdominal obesity, diabetes mellitus, and atherogenic dyslipidemia -are...

Background Several lifestyle behaviours, including physical activity, smoking, alcohol consumption, nutrition habits, and social activity have been associated with psychological well-being (PWB). However, their effect on PWB prospectively has been less studied. The aim of the present study was to evaluate the influence of lifestyle factors on higher future PWB during the 10-year follow-up of middle-aged and elderly urban population. Methods In the baseline survey (2006 to 2008), 7115 men and women 45–72 years of age were examined within the framework of the international study Health, Alcohol and Psychosocial Factors in the Eastern Europe (HAPIEE). In the follow-up survey (in 2016), which was performed among all 6210 participants who survived till that year, 4266 individuals participated responding to postal questionnaires. PWB was assessed by a CASP-12 questionnaire. The lifestyle behaviours, including smoking and nutrition habits, alcohol consumption, social and physical activity, were evaluated by the questionnaire. Multivariable logistic regression models were applied for statistical data analysis. Results After accounting for several potential confounders, healthy levels of lifestyle behaviours were associated with higher PWB after 10-year follow-up. Never-smokers in men and former smokers in women had higher PWB by 43 and 67% odds respectively in comparison with smokers. Physical activity in women and high social activity both in men in women was positively related to higher PWB. More frequent fresh vegetable and fruit consumption was associated with higher odds of higher PWB (odds ratio 1.57 in men and 1.36 in women, p < 0.05) compared to less frequent consumption of such food groups. Dose-response relationship between increasing number of healthy lifestyle factors and higher PWB was determined both in men and women. Conclusions Lifestyle factors such as never smoking and former smoking, high social activity, and more frequent fresh vegetable and fruit consumption increased the odds of higher PWB over 10 years of follow-up in men and women groups. The increase of the protective health behaviour score was directly associated with the odds of higher PWB.

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