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Biomedical subjects

Christina Chrysohoou

Publications and source records attributed to Christina Chrysohoou.

At least 37 records · Page 2Linked to original sources
PubMed2005

Fish consumption among healthy adults is associated with decreased levels of inflammatory markers related to cardiovascular disease: the ATTICA study.

OBJECTIVES: The aim of this work was to investigate the association between fish consumption and levels of various inflammatory markers among adults without any evidence of cardiovascular disease. BACKGROUND: Fish consumption has been associated with reduced risk of coronary heart disease, but the mechanisms have not been well understood or appreciated. METHODS: The ATTICA study is a cross-sectional survey that enrolled 1,514 men (age 18 to 87 years) and 1,528 women (age 18 to 89 years) from the Attica region, Greece. Of them, 5% of men and 3% of women were excluded due to a history of cardiovascular disease. Among others, C-reactive protein (CRP), interleukin (IL)-6, tumor necrosis factor (TNF)-alpha, serum amyloid A (SAA), and white blood cells (WBC) were measured, and dietary habits (including fish consumption) were evaluated using a validated food frequency questionnaire. RESULTS: A total of 88% of men and 91% of women reported fish consumption at least once a month. Compared to non-fish consumers, those who consumed >300 g of fish per week had on average 33% lower CRP, 33% lower IL-6, 21% lower TNF-alpha, 28% lower SAA levels, and 4% lower WBC counts (all p < 0.05). Significant results were also observed when lower quantities (150 to 300 g/week) of fish were consumed. All associations remained significant after various adjustments were made. CONCLUSIONS: Fish consumption was independently associated with lower inflammatory markers levels, among healthy adults. The strength and consistency of this finding has implications for public health and should be explored further.

Adult↗
PubMed2005

An association between the methylenetetrahydrofolate reductase (MTHFR) C677T mutation and inflammation markers related to cardiovascular disease.

BACKGROUND: Prospective studies have identified many markers of systemic inflammation that are powerful predictors of future cardiovascular events. The methylenetetrahydrofolate reductase (MTHFR) C677T genotype, a common polymorphism that induces hyperhomocysteinaemia, has been proposed as a genetic risk factor for cardiovascular disease. In this work, we evaluated the relationship between the levels of inflammation markers and MTHFR genotype among cardiovascular disease free subjects of the ATTICA study. METHODS: During 2001-2002, we randomly enrolled for genetic evaluation 574 subjects from Attica region, Greece. In this work, we investigated demographic, lifestyle, clinical, biochemical and genetic information from 322 men (46+/-13 years) and 252 women (45+/-14 years). Among other characteristics, we measured various inflammatory markers levels in relation to C677T MTHFR genotype distribution. RESULTS: The MTHFR genotypes distribution was: homozygous normal (CC) genotype, 41%; heterozygous (CT), 48%; and homozygous mutant (TT) genotype, 11%. C-reactive protein (CRA), fibrinogen, white blood cell (WBC) counts and amyloid-a levels were higher in TT compared to CC and CT genotypes (p<0.01), in both genders, even after controlling for various potential confounders. CONCLUSION: The observed association between markers of systemic inflammation with MTHFR genotype may state a hypothesis for a common pathobiological mechanism between inflammation process and MTHFR, which is a key enzyme in homocysteine (Hcy) metabolism.

C-Reactive Protein↗
PubMed2005

The implication of obesity and central fat on markers of chronic inflammation: The ATTICA study.

OBJECTIVE: We evaluated the association of obesity with various markers of chronic inflammation, in a population-based sample of 3,042 adults. METHODS: During 2001-2002, we randomly enrolled 1,514 men (18-87 years old) and 1,528 women (18-89 years old), from the Attica area, Greece; the sampling was stratified by the age-sex distribution of the region (census 2001). Among several variables, we also measured various inflammatory markers (C-reactive protein, tumor necrosis factor alpha, amyloid A, white blood cells and interleukin-6) and anthropometric variables (weight, height, waist and hip circumferences). Central fat was defined as waist-to-hip ratio>or=0.95 in men and>or=0.8 in women, while obesity as body mass index (BMI)>29.9 kg/m(2). RESULTS: Central fat prevailed in 36% of men and 43% of women (p<0.001), while obesity prevailed in 20% of men and 15% of women, respectively. Compared to participants with normal body fat distribution, those with central fat exhibited 53% higher C-reactive protein levels, 30% higher tumor necrosis factor, alpha levels, 26% higher amyloid A levels, 17% higher white blood cell counts and 42% higher interleukin-6 levels (all p<0.05). We observed that all inflammation markers were related to BMI (index for obesity), waist and to waist-to-hip ratio (indices for central fat), in both genders. Moreover, the models that included waist or waist-to-hip ratio as independent variable had higher explanatory ability (i.e. R(2)) than the models included BMI, especially in women, even after adjusting for age and various other potential confounders. CONCLUSION: Our results suggest a relationship between central adiposity and inflammation process, irrespective of age and other potential confounders. This association was more prominent than the relationship between total obesity and inflammation. It could be hypothesized that a disproportionate accumulation of visceral fat mass could be partially associated with increased coronary risk, through inflammation process.

Adolescent↗
PubMed2005

The association between lifestyle-related factors and plasma homocysteine levels in healthy individuals from the "ATTICA" Study.

OBJECTIVE: The aim of this work was to investigate the associations between homocysteine levels and several lifestyle-related factors, in a population-based sample of Greek adults. METHODS: During 2001-2002, we randomly enrolled 1128 men and 1154 women, from Athens area. The sampling was stratified by the age-gender distribution of the underlying population. Among several demographic, lifestyle, clinical and biochemical factors, we measured plasma total homocysteine levels. For the present analysis, we excluded people who had a history of cardiovascular disease. RESULTS: Homocysteine values were higher in men as compared to women (14.5+/-6 vs. 10.8+/-3.5 micromol/l, p<0.001). Twenty-five percent of men and 15% of women had plasma homocysteine levels >14 micromol/l. Postmenopausal women had higher homocysteine levels (12.0+/-5.2 vs. 9.9+/-2.9 micromol/l, p<0.001). The lifestyle factors most strongly associated with plasma total homocysteine were number of cigarettes smoked (r=0.12, p=0.004), fruits (r=-0.12, p=0.006) and vegetables consumption (r=-0.15, p=0.02), alcohol (r=0.11, p=0.04) and coffee drinking (r=0.10, p=0.03). Additionally, aerobic exercise was related with lower homocysteine levels as compared to anaerobic or sedentary life (11.0+/-2.6 vs. 12.4+/-2.5 vs. 12.5+/-2.3 micromol/l, respectively, p=0.04). Multivariate analysis after adjusting for several potential confounders confirmed the previous associations. No relationship was observed of homocysteine with the Mediterranean diet score (r=0.02, p=0.85). CONCLUSIONS: Several lifestyle-related factors were associated with homocysteine levels. Identifying and understanding modifiable factors related to homocysteine, a possible risk factor for vascular disease, might be especially important for the public health.

Aged↗
PubMed2005

The associations between leisure-time physical activity and inflammatory and coagulation markers related to cardiovascular disease: the ATTICA Study.

BACKGROUND: As coronary heart disease is increasingly seen as an inflammation process, we evaluated the hypothesis whether physical activity reduces coronary heart disease risk by modifying the levels of inflammatory and coagulation markers. METHODS: From May 2001 to December 2002, we randomly enrolled 1524 adult men and 1518 women, without any evidence of cardiovascular disease, stratified by age-gender (census 2001), from the greater area of Athens, Greece. We assessed the relationship between self-reported physical activity status and inflammation markers (high sensitivity C-reactive protein, serum amyloid-A, fibrinogen, interleukin-6, tumor necrosis factor-alpha, and white blood cell counts), after taking into account the effect of several confounders. RESULTS: Eight hundred seventy-four (57%) of men and 903 (59%) of women were classified as sedentary. Multivariate statistical analysis after adjustment for gender, age, smoking habits, body mass index, total cholesterol, blood glucose, and systolic and diastolic blood pressure levels showed that participants devoted to high physical activity (>7 kcal/min expended) had 29% lower levels of C-reactive protein, 19% of white blood cell counts, 22% lower concentrations of amyloid-A, 20% lower levels of tumor necrosis factor-alpha, 32% of interleukin-6, and 11% of fibrinogen (all P<0.05) as compared to those who were devoted to sedentary life. CONCLUSIONS: Our findings suggest that the adoption of a physically active lifestyle modifies the inflammation process in healthy individuals.

Adult↗
PubMed2005

Adherence to the Mediterranean diet is associated with total antioxidant capacity in healthy adults: the ATTICA study.

BACKGROUND: Greater adherence to the Mediterranean diet has been associated with a lower incidence of cardiovascular disease and cancer. OBJECTIVE: We studied the effect of the Mediterranean diet on total antioxidant capacity (TAC) in 3042 participants who had no clinical evidence of cardiovascular disease. DESIGN: During 2001-2002, a random sample of 1514 men and 1528 women aged 18-89 y from the Attica area of Greece was selected. TAC was measured with an immune-diagnostic assay. Food consumption was evaluated with a validated food-frequency questionnaire, and adherence to the Mediterranean diet was assessed on the basis of a diet score that incorporated the inherent characteristics of this diet. RESULTS: TAC was positively correlated with diet score. The participants in the highest tertile of the diet score had, on average, 11% higher TAC levels than did the participants in the lowest tertile, even after adjustment for relevant confounders (P < 0.01). On the other hand, the participants in the highest tertile of the diet score had, on average, 19% lower oxidized LDL-cholesterol concentrations than did the participants in the lowest tertile (P < 0.01). An additional analysis showed that TAC was positively correlated with the consumption of olive oil (rho = 0.54, P = 0.002) and of fruit and vegetables (rho = 0.34 and rho = 0.31, respectively; P < 0.001 for both), whereas it was inversely associated with the consumption of red meat (rho = -0.35, P = 0.02). CONCLUSION: Greater adherence to the Mediterranean diet is associated with elevated TAC levels and low oxidized LDL-cholesterol concentrations, which may explain the beneficial role of this diet on the cardiovascular system.

Adolescent↗
PubMed2005

The associations between physical activity, inflammation, and coagulation markers, in people with metabolic syndrome: the ATTICA study.

OBJECTIVE: Metabolic syndrome is a condition that promotes atherosclerosis and increases the risk of cardiovascular mortality and morbidity. We evaluated whether leisure time physical activity is associated with the levels of inflammatory and coagulation markers, in people with metabolic syndrome. METHODS: From May 2001 to December 2002 we randomly enrolled 1514 men and 1528 women (>18 years old), without any clinical evidence of cardiovascular disease, stratified by age-gender (census 2001). The population of the study was divided into those who fulfilled the NCEP ATP III criteria for the metabolic syndrome (n=701 or 33% men and 13% women) and the rest of the participants (n=2341). We assessed the relationship between self-reported physical activity status and inflammatory, and coagulation markers [i.e., C-reactive protein (CRP), serum amyloid-A (SAA), interleukin (IL)-6, tumour necrosis factor (TNF)-alpha, white blood cell (WBC) counts, and fibrinogen (FIB)], after taking into account the effect of several confounders. RESULTS: Of the non-metabolic syndrome group, 56% of men and 58% of women were classified as sedentary, while of the metabolic syndrome group 58% men and 72% women were sedentary. After controlling for various potential confounders we found that physically active individuals with the metabolic syndrome had 36% lower levels of CRP, 15% lower levels of WBC, 19% lower levels of SAA, 15% lower levels of TNF-alpha, 30% lower levels of IL-6 and 15% lower levels of FIB, compared to sedentary (all P<0.05). Similar results were observed in the non-metabolic syndrome group. CONCLUSIONS: The adoption of a physically active lifestyle is independently associated with lower levels of the investigated biomarkers in individuals with the metabolic syndrome. The latter may suggest a pathway for reducing cardiovascular events, even in high-risk people.

Adult↗
PubMed2005

Total cholesterol and body mass index in relation to 40-year cancer mortality (the Corfu cohort of the seven countries study).

PURPOSE: We evaluated risk factors of cancer mortality based on a 40-year follow-up of the Corfu cohort (Seven Countries Study). MATERIAL AND METHODS: The population studied in this analysis consisted of 529 rural men (49 +/- 6 years old) enrolled in 1961. Since then, periodic visits every 5 years were made to define the causes of death of the participants. Cox proportional hazards models evaluated various risk factors in relation to cancer mortality. RESULTS: The death rate at the end of the follow-up was 87.1% (i.e., 461 deaths in 529 participants). Of those deaths, 118 (25.6%) were because of cancer (30 deaths were due to cancer of trachea, bronchus, and lung, and the rest were due to other malignant neoplasms). Cancer was the second cause of death in this cohort, after coronary heart disease. Age (hazard ratio, 1.05 per year; P < 0.05), smoking (hazard ratio, 1.97; P < 0.01), total serum cholesterol levels (hazard ratio, 0.95 per 10 mg/dL; P < 0.05), and body mass index (hazard ratio, 0.93 per 1 kg/m2; P < 0.05) showed a significant association with cancer deaths after controlling for physical activity status and anthropometric indices. It should be noted that the protective effect of total cholesterol on cancer mortality was observed only between 183 and 218 mg/dL baseline levels. CONCLUSION: Cancer was one of the leading causes of death in this cohort. Smoking was associated with increased risk of cancer, whereas moderate total serum cholesterol and increased body and mass index seemed to have a protective effect on 40-year cancer mortality.

Adult↗
PubMed2004

The J-shape association of ethanol intake with total homocysteine concentrations: the ATTICA study.

BACKGROUND: Epidemiological studies suggest a non-monotonic effect of alcohol consumption on cardiovascular risk, while there is strong evidence concerning the involvement of homocysteine levels on thrombosis. The aim of this work was to evaluate the association between usual ethanol consumption and homocysteine levels, in cardiovascular disease free adults. METHODS: From May 2001 to December 2002 we randomly enrolled 1514 adult men and 1528 women, without any evidence of cardiovascular disease, stratified by age - gender (census 2001), from the greater area of Athens, Greece. Among the variables ascertained we measured the daily ethanol consumption and plasma homocysteine concentrations. RESULTS: Data analysis revealed a J-shape association between ethanol intake (none, <12 gr, 12 - 24 gr, 25 - 48 gr, >48 gr per day) and total homocysteine levels (mean +/- standard deviation) among males (13 +/- 3 vs. 11 +/- 3 vs. 14 +/- 4 vs. 18 +/- 5 vs. 19 +/- 3 mumol/L, respectively, p < 0.01) and females (10 +/- 4 vs. 9 +/- 3 vs. 11 +/- 3 vs. 15 +/- 4 vs. 17 +/- 3 mumol/L, respectively, p < 0.01), after controlling for several potential confounders. The lowest homocysteine concentrations were observed with ethanol intake of < 12 gr/day (Bonferroni alpha* < 0.05). No differences were observed when we stratified our analysis by type of alcoholic beverage consumed. CONCLUSION: We observed a J-shape relationship between homocysteine concentrations and the amount of ethanol usually consumed.

Journal Article↗
PubMed2004

Adherence to the Mediterranean diet attenuates inflammation and coagulation process in healthy adults: The ATTICA Study.

OBJECTIVES: We studied the effect of the Mediterranean diet on plasma levels of C-reactive protein (CRP), white blood cell counts, interleukin (IL)-6, tumor necrosis factor (TNF)-alpha, amyloid A, fibrinogen, and homocysteine. BACKGROUND: To the best of our knowledge, the mechanism(s) by which the Mediterranean diet reduces cardiovascular risk are not well understood. METHODS: During the 2001 to 2002 period, we randomly enrolled 1,514 men (18 to 87 years old) and 1,528 women (18 to 89 years old) from the Attica area of Greece (of these, 5% of men and 3% of women were excluded because of a history of cardiovascular disease). Among several factors, adherence to the Mediterranean diet was assessed by a diet score that incorporated the inherent characteristics of this diet. Higher values of the score meant closer adherence to the Mediterranean diet. RESULTS: Participants who were in the highest tertile of the diet score had, on average, 20% lower CRP levels (p = 0.015), 17% lower IL-6 levels (p = 0.025), 15% lower homocysteine levels (p = 0.031), 14% lower white blood cell counts (p = 0.001), and 6% lower fibrinogen levels (p = 0.025), as compared with those in the lowest tertile. The findings remained significant even after various adjustments were made. Borderline associations were found regarding TNF-alpha (p = 0.076), amyloid A levels (p = 0.19), and diet score. CONCLUSIONS: Adherence to the traditional Mediterranean diet was associated with a reduction in the concentrations of inflammation and coagulation markers. This may partly explain the beneficial actions of this diet on the cardiovascular system.

Adolescent↗
PubMed2004

Distribution of serum lipids and lipoproteins in patients with beta thalassaemia major; an epidemiological study in young adults from Greece.

BACKGROUND: Beta-thalassaemia major (b-TM) has been defined as a combination of chronic hemolytic anemia, iron storage disease and myocarditis, and it has been associated with premature death especially due to heart failure. To the best of our knowledge the status of blood lipids in these patients has rarely been investigated. Thus, we assessed the levels of lipids and lipoproteins in a sample of cardiovascular disease free adult men and women with b-TM. METHODS: During 2003 we enrolled 192 consecutive patients with b-TM that visited our Institution for routine examinations. The Institution is considered the major reference center for b-TM in Greece. Of the 192 patients, 88 were men (25 +/- 6 years old) and 104 women (26 +/- 6 years old). Fasting blood lipid levels were measured in all participants. RESULTS: Data analysis revealed that 4% of men and 2% of women had total serum cholesterol levels > 200 mg/dl, and 11% of men and 17% of women had triglyceride levels > 150 mg/dl. In addition, mean HDL cholesterol levels were 32 +/- 11 mg/dl in men and 38 +/- 10 mg/dl in women, lipoprotein-a levels were 8.3 +/- 9 mg/dl in men and 8.8 +/- 9 mg/dl in women, apolipoprotein-A1 levels were 111 +/- 17 mg/dl in men and 123 +/- 29 mg/dl in women, and apolipoprotein-B levels were 60 +/- 20 mg/dl in men and 59 +/- 14 mg/dl in women. Total-to-HDL cholesterol ratios were 3.7 +/- 1.2 and 3.8 +/- 1.5 in men and women, respectively. CONCLUSIONS: The majority of the patients had blood lipid levels (by the exception of HDL-cholesterol) within the normal range, and consequently the prevalence of lipid and lipoprotein abnormalities was much lower as compared to the general population of the same age. Interestingly, is that the total-to HDL cholesterol ratio was high in our patients, and may underline the importance of this index for the prognosis of future cardiac events in these patients.

Journal Article↗
PubMed2004

Effect of exposure to secondhand smoke on markers of inflammation: the ATTICA study.

PURPOSE: We sought to investigate the effect of secondhand smoke exposure on inflammatory markers related to cardiovascular disease. METHODS: During 2001 to 2002, we randomly selected a stratified (age-sex) sample of adults without clinical evidence of cardiovascular disease. Exposure to secondhand smoke (>30 minutes per day and > or =1 day per week) was recorded. Multivariate regression analysis was used to evaluate the effects of exposure to secondhand smoke on levels of C-reactive protein, fibrinogen, homocysteine, and oxidized low-density lipoprotein (LDL) cholesterol, and on white blood cell count. RESULTS: One hundred and thirty-seven (38%) of the 357 men who had never smoked and 211 (33%) of the 638 never-smoking women reported current exposure to secondhand smoke. Compared with those who were not exposed to secondhand smoke, those exposed more than 3 days per week had higher white blood cell counts (by 600 cells per microL; P = 0.02), as well as higher levels of C-reactive protein (by 0.08 mg/dL; P = 0.03), homocysteine (by 0.4 micromol/L; P = 0.002), fibrinogen (by 5.2 mg/dL; P = 0.4), and oxidized LDL cholesterol (by 3.3 mg/dL; P = 0.03), after adjusting for several potential confounders. CONCLUSION: Our findings suggest another pathophysiological mechanism by which exposure to secondhand smoke is associated with the development of atherosclerosis.

Adult↗
PubMed2004

The association between coffee consumption and plasma total homocysteine levels: the "ATTICA" study.

The aim of this work was to investigate the association between homocysteine levels and coffee consumption in a sample of cardiovascular disease-free men and women. From May 2001 to December 2002, we randomly enrolled 1514 men and 1528 women, stratified by age and gender, from the greater area of Athens. Blood samples were collected in the fasting state. Among other investigated factors, dietary habits (including coffee consumption in ml per day, adjusted for 28% caffeine containment) were evaluated using a validated food frequency questionnaire. Men consumed higher quantities of coffee compared with women (250 +/- 55 vs 150 +/- 60 ml/day, P = 0.001), while homocysteine values were also higher in men than in women (14.5 +/- 6 vs 10.8 +/- 3.5 micromol/l, P = 0.001). A dose-response relationship of homocysteine levels with coffee consumption was observed (r = 0.10, P = 0.034). In particular, we found that homocysteine levels were 11.2 +/- 5 micromol/l for no consumption, 11.7 +/- 7 micromol/l for <100 ml/day, 12.5 +/- 7 micromol/l for 200-400 ml/day, and 12.7 +/- 4 micromol/l for >500 ml/day consumption (P = 0.018). The observed trend remained significant even after controlling for the interactions between coffee consumption with gender, smoking habits, physical activity status, and eating habits. However, the sole effect of the consumption of filtered coffee on homocysteine levels was significant only in those who consumed more than 500 ml/day (P = 0.043). Although our findings cannot be evidence for causality, they can be the basis for hypotheses about the relation between homocysteine and coffee that can partially explain the mechanisms by which elevated homocysteine levels may influence coronary risk.

Adult↗
PubMed2004

Association between prehypertension status and inflammatory markers related to atherosclerotic disease: The ATTICA Study.

BACKGROUND: We sought to evaluate the association between prehypertension status and inflammatory markers (C-reactive protein, white blood cells, interleukin-6, tumor necrosis factor-alpha, amyloid-a, homocysteine, and fibrinogen), in a random sample of cardiovascular disease-free adults. METHODS: The ATTICA study is a cross-sectional population-based survey conducted in the Attica region during 2001 to 2002. Based on a multistage and stratified random sampling, 1514 men and 1528 women (18 to 89 years old) were enrolled. The survey included a detailed interview, blood samples collected after 12 h of fasting, and, among other clinical measurements, status of blood pressure levels. RESULTS: The prehypertensive population included 653 men (43%) and 535 women (35%). Compared to normotensives, prehypertensive men and women had 31% higher C-reactive protein (P <.01), 32% higher tumor necrosis factor-alpha (P <.05), 9% higher amyloid-a (P <.05), 6% higher homocysteine levels (P <.01), and a 10% higher white blood cell counts (P <.05), after correcting for multiple comparisons and adjusting for age, body mass index, blood lipids, glucose, food groups consumed, and other potential confounders. CONCLUSIONS: Studying a large sample of cardiovascular disease-free adults, we revealed an association between prehypertension and inflammatory markers linked to the atherosclerotic process, independently of other coexisting risk factors or unhealthy lifestyle behaviors. Our findings may be of clinical importance, as they suggest that prehypertension might be a pro-inflammatory condition.

Adolescent↗
PubMed2004

Exercise capacity and heart rate recovery as predictors of coronary heart disease events, in patients with heterozygous Familial Hypercholesterolemia.

BACKGROUND: Several clinical and observational studies have established that exercise capacity and activity status are strong predictors of cardiovascular and overall mortality. We aimed to evaluate the relationship between exercise tolerance test (ETT) indices and occurrence of coronary heart disease (CHD), in patients with heterozygous Familial Hypercholesterolemia (eFH). METHODS: During 1987-1997, we enrolled 639 cardiovascular disease-free patients with heterozygous eFH; 58 (9%) patients were excluded since they had a positive ETT. A fatal or non-fatal CHD event was the end point. Cox proportional hazards models were applied to evaluate the association between the investigated outcome and ETT indices. RESULTS: During the follow-up (1987-2002), 53 (18%) men and 34 (10%) women developed a CHD event (11 were fatal). The age-adjusted event rate was 87 events per 2915 person-years (3%). Statistical analysis revealed that exercise capacity (hazard ratio = 0.82, P < 0.001), heart rate recovery at 1 min (hazard ratio = 0.91, P < 0.05), and peak pulse pressure levels (hazard ratio = 1.03, P < 0.001), were predictors of CHD, after controlling for several potential confounders. CONCLUSION: Decreased exercise capacity, a delayed decrease in heart rate during the first minute of graded exercise, and increased peak pulse pressure are strong predictors of coronary events in patients with eFH. Physical activity should be strongly recommended in these patients.

Adult↗
PubMed2004

Status and management of blood lipids in Greek adults and their relation to socio-demographic, lifestyle and dietary factors: the ATTICA Study. Blood lipids distribution in Greece.

OBJECTIVE: In this work, we assessed the status and management of blood lipids in a sample of cardiovascular disease free adult men and women from Greece. We also evaluated the effect of several socio-demographic, dietary and lifestyle habits on lipid levels. METHODS: The ATTICA Study is a population-based cohort that has randomly enrolled 1128 men and 1154 women (aged >18 years old), stratified by age-gender, from the greater area of Athens, during 2001-2002. Adherence to Mediterranean diet was assessed through a diet score that was based on a validated food-frequency questionnaire. RESULTS: Forty-six percent of men and 40% of women had total serum cholesterol levels >200mg/dl. Of them, 40% of men and 30% of women were unaware of their condition. Twenty-one percent of men and 7% of women had HDL-cholesterol levels <35 mg/dl. Twenty-eight percent of men and 13% of women had triglyceride levels >150 mg/dl. Fifteen percent of men and 12% of women had LDL-cholesterol levels >160 mg/dl and 52% of men and 48% of women had LDL >130 mg/dl. Of those who had known blood lipid abnormalities, 36% of men and 33% of women followed a dietary medication, 31% of men and 20% of women were receiving a pharmaceutical treatment (mainly statin) and the rest were untreated. Participants who adopted the Mediterranean diet and received statin, had on average 9% lower total cholesterol (P = 0.04), 19% lower LDL-cholesterol levels (P = 0.02) and 32% lower oxidized LDL-cholesterol levels (P < 0.001) compared to those who were untreated and adopted a Westernized diet. CONCLUSIONS: We could speculate that about 3 million Greek adults had high total cholesterol levels. Adverse findings were also observed regarding the other investigated blood lipids. Mediterranean diet could be a complimentary mean to pharmaceutical treatment in reducing blood lipids.

Adult↗
PubMed2004

Inflammation, coagulation, and depressive symptomatology in cardiovascular disease-free people; the ATTICA study.

BACKGROUND: Depression is associated with an increase in cardiovascular disease, but the underlying mechanisms are not well understood. The aim of this study was to examine the associations of depressive symptoms with inflammation and coagulation factors related to cardiovascular risk in persons free of cardiovascular disease. METHODS: A random algorithm was developed and stratified by gender-age and multistage sampling was performed during 2001-2002. In this study, we analysed data from 453 men (19-89 years old) and 400 women (18-84 years old). Inflammation markers were C-reactive protein (CRP), serum amyloid A, white blood cell (WBC) and total platelet counts; and coagulation factors including homocysteine and fibrinogen. Depression was assessed with the Zung Self-Rating Depression Scale (ZDRS range 0-100) after validation for the study population. A ZDRS score of 50 or more classified a person as mildly depressive. Statistical adjustments were made for risk factors (age, gender, smoking, diabetes mellitus, and physical activity level). RESULTS: Women had significantly higher scores on the Zung depression scale than men (47 +/- 9 vs. 43 +/- 10, p<0.001). Thus, 21% of men and 27% of women had mild depression, while 4% of men and 6% of women had severe depressive symptomatology. The depression scale correlated positively with C-reactive protein levels (p<0.05), white blood cell count (p<0.05), and fibrinogen (p<0.05) in both genders after adjustment for control variables. CONCLUSION: This study revealed that depression was associated with inflammation and coagulation factors in cardiovascular disease-free people, suggesting a possible pathway leading to an increased frequency of events of coronary heart disease in depressive individuals.

Adolescent↗