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    Abstract: OBJECTIVES: Aim was to examine the relationship between individually perceived changes in psychosocial stressors associated with German reunification and cardiovascular effects. We hypothesised that higher levels of psychosocial stress related to German reunification were associated with an increase in cardiovascular risk factors and cardiovascular diseases (CVDs). DESIGN: Cross-sectional data from 2 cohort studies in East Germany were used: Cardiovascular Disease, Living and Ageing in Halle Study (CARLA), and Study of Health in Pomerania (SHIP). SETTING: 2 populations in East Germany. PARTICIPANTS: CARLA study: 1779 participants, aged 45-83 years at baseline (812 women), SHIP study: 4308 participants, aged 20-79 years at baseline (2193 women). PRIMARY AND SECONDARY OUTCOME MEASURES: Psychosocial stressors related to reunification were operationalised by the Reunification Stress Index (RSI; scale from 0 to 10). This index was composed of questions that were related to individually perceived changes in psychosocial stressors (occupational, financial and personal) after reunification. To examine the associations between the RSI and each stressor separately with cardiovascular risk factors and CVD, regression models were used. RESULTS: RSI was associated with CVD in women (RR=1.15, 95% CI 1.00 to 1.33). Cardiovascular risk factors were associated with RSI for both men and women, with strongest associations between RSI and diabetes in women (RR=1.10, 95% CI 1.01 to 1.20) and depressive disorders in men (RR=1.15, 95% CI 1.07 to 2.77). The change in occupational situation related to reunification was the major contributing psychosocial stressor. We observed a strong association with CVD in women who experienced occupational deterioration after reunification (RR=4.04, 95% CI 1.21 to 13.43). CONCLUSIONS: Individually perceived deterioration of psychosocial stressors (occupational, financial and personal) related to German reunification was associated with cardiovascular risk factors and CVD. The associations were stronger for women than for men. An explanation for these findings could be that women were more often affected by unemployment after reunification. Morbidity and mortality follow-up of both cohorts could enhance the results.
    Type of Publication: Journal article published
    PubMed ID: 26729378
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  • 2
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  GMDS 2013; 58. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e.V. (GMDS); 20130901-20130905; Lübeck; DOCAbstr.142 /20130827/
    Publication Date: 2013-08-28
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 3
    Abstract: CONTEXT: Except from associations study with body weight, there are few longitudinal data regarding the association between thyroid function and anthropometric such as waist circumference, waist-to-hip-ratio or waist-to height-ratio. OBJECTIVE: We aimed at investigating the association of thyroid stimulating hormone (TSH) at baseline with changes in different anthropometric markers between baseline and follow-up in the general population. DESIGN AND SETTING: We used data from four population-based longitudinal cohort studies and one population-based cross-sectional study. SUBJECTS: We studied 16,902 (8,204 males and 8,698 females) subjects aged 20 to 95 years from the general population. MAIN OUTCOME MEASURES: We measured body mass index, waist-circumference, waist-to-hip- ratio and waist-to-height-ratio. Multivariable median regression models were calculated adjusting for the following covariates: age, sex, baseline value of the respective anthropometric marker, smoking status, follow-up-time period and study site. RESULTS: In cross-sectional analyses, serum TSH within the reference range was positively associated with waist circumference (beta 0.94 cm (95%CL 0.56; 1.32)) and waist-to-height-ratio (beta 0.029 (95%CL 0.017; 0.042)). These associations were also present for the full range of TSH. In the longitudinal analyses, serum TSH at baseline was inversely associated with 5-year change of all considered anthropometric measures within the prior defined study-specific reference range, as well as in the full range of serum TSH. CONCLUSION: High TSH serum levels were positively associated with current anthropometric markers even in the study-specific reference ranges. In contrast, high TSH serum levels were associated with decreased anthropometric markers over a time span of approximately 5 years. Further research is needed to determine possible clinical implications as well as public health consequences of these findings.
    Type of Publication: Journal article published
    PubMed ID: 27393002
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