Purpose of the study: based on a longitudinal study, to assess the contribution of psychosocial factors to survival and the risk of developing cardiovascular diseases (CVD) among people 25–64 years old in Siberia (Novosibirsk, Tyumen, Tomsk). Materials and methods. On the basis of Research Institute of Therapy and Preventive Medicine – branch of the Federal State Budgetary Scientific Institution «Federal Research Center Institute of Cytology and Genetics of the Siberian Branch of the Russian Academy of Sciences», Tyumen Cardiology Research Center – branch of the Federal State Budgetary Scientific Institution «Tomsk National Research Medical Center of the Russian Academy of Sciences», Research Institute of Cardiology – branch of the Federal State Budgetary Scientific Institution «Tomsk National Research Medical Center of the Russian Academy of Sciences» using the standard protocol for cardiac screening programs: «Study of the prevalence of coronary artery disease, risk factors for coronary artery disease in various regions of the country»; WHO «MONICA», which did not differ significantly, as well as the «MONICA-psychosocial» subprogram to identify psychosocial risk factors for cardiovascular diseases, cross-sectional studies were conducted on random representative samples of people 25-64 years old: Tomsk – 1981–1982 (n = 738 men); 1985–1986 (n = 1148 men); 1994–1995 (n = 637 men – postal survey and n = 450 men – cardiac screening); Tyumen – 1996 (795 men and 813 women); Novosibirsk – 1994 (657 men and 870 women). The cohort in Tyumen was observed for 12 years, in Tomsk for 19 years, and in Novosibirsk for 16 years. The following «end points» were recorded: death from ischemic heart disease (IHD), CVD, new-onset acute myocardial infarction (AMI) using the WHO program «Acute Myocardial Infarction Registry». Results. Among men and women 25-64 years old in Tyumen, a high 12-year relative risk of cardiovascular death was established in persons with a low level of education, in the professional group of heavy physical labor; in the male cohort – among single, widowed and divorced men. An assessment of the attributable risk of the social gradient in the male cohort showed the greatest contribution to cardiovascular death from the group of widows – 69.2 %, in the female cohort – from the group of people with a low level of education – 84.0 %. For men 25–64 years old in Tomsk, prognostically significant parameters of the social gradient of attributable risk are ranked as follows: 1) for mortality from IHD – working professions, lack of a permanent life partner, low level of education; 2) for mortality from CVD – working professions, average level of education, lack of a permanent life partner, low level of education. Among men and women aged 25–64 years in Novosibirsk, high levels of anxiety, depression and low levels of social support became prognostically significant risk factors for AMI for men and women; among men there is a high level of vital exhaustion. Conclusions. It was established that in the high: 12-year relative risk, 19-year attributable risk of cardiovascular death, the social gradient is prognostically significant. Anxiety, depression, vital exhaustion, social support play a leading role in predicting CVD in the Siberian region among the active working population.

The APOE gene polymorphism is associated with the risk of the development of several neurological disorders. The aim of the study was to investigate the association of the APOE gene polymorphism with depression in the white adult population aged 25–64 years in Novosibirsk (Western Siberia). The third screening of the WHO program “MONICA-psychosocial” was conducted in 1994–1995. In total, 403 men (the average age was 34 ± 0.4 years, the response was 71%) and 531 women (the average age was 35 ± 0.4 years, the response was 72%) of the open population of residents aged 25–64 years of the Oktyabrsky district of Novosibirsk were examined. The “MONICA-MOPSY” psychosocial questionnaire was used to assess depression. A high level of depression was found in 12.8% of the population: in 8.9% of men and in 15.8% of women. The frequencies of APOE gene polymorphism genotypes ε2/3, ε2/4, ε3/3, ε3/4, and ε4/4 were 14.9%, 3.1%, 61.6%, 17.5%, and 2.9%, respectively. Carrying the ε3/4 genotype of the APOE gene increased the odds of developing major depression by 2.167 times (95% CI 1.100–4.266) compared to carrying the ε3/3 genotype of the APOE gene in people without depression (χ² = 5.120 df = 1 p = 0.024). Carriers of the ε4 allele were 2.089 times (95% CI 1.160–3.761) more likely to have a high level of depression than those without this allele and no depression (χ² = 6.148 df = 1 p = 0.013), and 2.049 times (95% CI 1.117–3.758) more likely to have a moderate level of depression than those without this allele (χ² = 5.470 df = 1 p < 0.019). The ε4 allele of the APOE gene is associated with a high level of depression.

Aim. To determine the dynamics and impact of sleep duration in 2003-2018 on the risk of myocardial infarction (MI) in an open population aged 45-64 years in Novosibirsk.Material and methods. The study included representative samples of the population aged 45-64 years, obtained as part of the screening IV in 2003-2005 (men, 576; mean age, 54,23±0,2 years; response rate, 61%; women, 1074; mean age, 54,27+0,2 years; response rate, 72%) and screening VI in 2015-2018 (men, n=275; mean age, 49±0,4 years; response, 72%; women, n=390; mean age, 45±0,4 years; response rate, 75%). Screenings were carried out according to the standard protocol of the WHO MONICA-psychosocial Program (MOPSY). The Jenkins Questionnaire was used to assess sleep duration and disturbances.Results. For the period from 2003-2005 to 2015-2018, we revealed decrease in the number of following people: with 7 hours of sleep at night from 44,9% to 31,9%; with 8 hours of sleep from 28,5% to 24,4%. In addition, the number of participants with ≤5 hours of sleep increased from 4,9% to 9,9%, while those with ≤6 hours — from 16,2% to 27,2%, as well as the number of people sleeping 9 hours a day (from 3,7% to 5,4%). In 2003-2005, among the population in the age group of 55- 64 years, 7-hour sleep was observed more often (45б1%); 6-hour sleep prevailed in the group of people aged 45-54 (18,9%). There were no significant differences between the duration of sleep and the age group according to screening VI in 2015- 2018. Among men, 6-hour sleep were observed more often (38.4%), and among women — 7 hours (37,3%). Those who sleep 7 hours a night were more likely to consider their sleep “good” (35,3%) in 2015-2018. In a population of 45-64 years old, over a 14-year period, the risk of MI was higher as follows: 1. in men with 5-6 hours of sleep than with 7-8 hours of sleep at night by 1,689 times (95% confidence interval (CI), 1,124-2,537 p<0,012); in men aged 45-54 years by 2,416 times (95% CI, 1,311-4,452; p<0,005), respectively; 2. in women with 5-6 hours of sleep by 1,591 times (95% CI, 1,058-2,392; p<0,026) compared with 7-8-hour duration of sleep. In the 45-54 year group, the risk of MI was higher among women with 9-10 hours of sleep a night by 4,44 times (95% CI, 2,726-20,309; p<0,0001) compared with women who had 7-8 hours of sleep at night.Conclusion. We revealed that over the period of 2003-2018, the duration of night sleep of 7-8 hours among the population aged 45-64 years (without cardiovascular diseases) decreased both among men and women. At the same time, the “good” quality of sleep was more often found in people with 7-hour sleep. It was determined that short sleep duration was associated with MI among men and women, and long sleep duration turned out to be a risk factor for MI for women in the group of 45-54 years.

Objective: to determine the main psychosocial factors associated with sleep disorders in an open population aged 25–64 years in Novosibirsk.Material and methods. Screening studies were conducted on representative samples of the population aged 25–64 years: in 2013–2016. (V screening: 427 men, mean age 34±0.4 years, response rate 71%; 548 women, mean age 35±0.4 years, response rate 72%); in 2015–2018 (VI screening: 275 men, mean age – 49±0.4 years, response rate – 72%; 390 women, mean age – 45±0.4 years, response rate – 75%) (budget topic No. АААА-А17-117112850280-2) using the protocol of the WHO international program “MONICA-psychosocial”. The Jenkins questionnaire was used in the population survey to investigate sleep disorders. To examine personal anxiety, a form of the Spielberger Self-Assessment Scale was used; to determine depression, life exhaustion, and hostility, the MOPSY-test was used; and to examine social support, the Berkman-Syme test was used.Results. In the open population aged 25 to 64 years, sleep disorders were found in 47.6% of men and 51.2% of women. Among those with sleep disorders, we found high levels of: anxiety (HLA) in 61.8% of men (χ²=56.169; df=4; p<0.001) and 68.1% of women (χ²=36.535; df=4; p<0.001); depression (HLD) – in 18.2% of men (χ²=26.609; df=4; p<0.001) and 20% of women (χ²=41.041; df=4; p<0.001); vital exhaustion (VE) – in 63.6% of men (χ²=93.378; df=4; p<0.001) and 59.3% of women (χ²=124.115; df=4; p<0.001); hostility (HLH) – in 52.7% of men (χ²=17.598; df=4; p<0.001) and 39.3% of women (χ²=13.139; df=4; p<0.01).We found no statistically significant differences between groups of men and women, who differed in sleep self-essessment and indicators of the index of close contacts and the index of social ties.Sleep disturbances increased the likelihood of developing of VE (OR 2.301; 95% СI 1.774–2.984; p<0.0001), HLA (OR 1.882; 95% CI 1.199–2.955; p<0.006), depression (OR 1.423; 95% CI 1.099–1.842; p<0.007). In men, sleep disturbances contributed to: HLA (OR 2.477; 95% CI 1.303–4.709; p<0.006), VE (OR 2.282; 95% CI 1.529–3.404; p<0.0001). In the group of women with sleep problems, the probability of VE increased (OR 2.37; 95% CI 1.669–3.366; p<0.0001).Conclusion. The study found that in an open population aged 25–64 years with sleep disorders, there was a high level of psychosocial factors and that the presence of sleep disorders increased the likelihood of developing psychosocial factors.

Фенотипы ожирения и риск развития инфаркта миокарда, по данным проспективного когортного исследования

Цель. Исследовать распространенность жизненного истощения, его влияния на 14-летний риск развития сердечно-сосудистых заболеваний (ССЗ) (артериальной гипертонии (АГ), инфаркта миокарда (ИМ) и инсульта), а так же генетических особенностей жизненного истощения в открытой популяции среди мужчин 25-64 лет в России/Сибири (г.Новосибирск, мегаполис Западной Сибири). Материал и методы. Была обследована случайная репрезентативная выборка мужчин 25-64 лет в рамках программы ВОЗ “МONICA-психосоциальная (MOPSY)” в 1994г. Маастрихтский опросник (ОМ) использовался для оценки жизненного истощения. Генотипирование было выполнено для переменного числа тандемных повторов (VNTR) полиморфизмов генов DRD4 и DAT. Все новые случаи АГ, ИМ и инсульта были зарегистрированы у лиц без ССЗ в течение 14 лет (с 1994 по 2008гг). Статистический анализ проводился с помощью пакета программ SPSS 11.5. Кокс-пропорциональная регрессионная модель была использована для оценки риска развития (Hazard ratio — HR) с учетом временного интервала. Тест Х2 был использован для оценки статистической значимости различий между группами. Результаты. В исследованной популяции уровень жизненного истощения составил 66,8%. HR был значительно увеличен (АГ: HR=3,2; ИМ: HR=2,7; инсульт: HR=3,2) у мужчин с жизненным истощением, по сравнению с лицами без жизненного истощения в открытой популяции в течение первых пяти лет наблюдения. Многофакторное моделирование показало, что жизненное истощение вместе с сопутствующим социальным градиентом определяет развитие АГ, ИМ и инсульта в открытой популяции среди мужчин 25-64 лет. 7 аллель DRD4 и генотип 9/9 гена DAT были связаны с высоким уровнем жизненного истощения. Заключение. В открытой популяции среди мужчин 25-64 лет (Россия/ Сибирь, г.Новосибирск) определен высокий уровень жизненного истощения, как предиктор риска развития ССЗ. Жизненное истощение существенно связано с определенными VNTRr-полиморфизмами генов DRD4 и DAT.