dc.contributor.advisor | Nikolić, Maja | |
dc.contributor.other | Stojanović, Dušica | |
dc.contributor.other | Deljanin-Ilić, Marina | |
dc.contributor.other | Todorović, Lazar | |
dc.contributor.other | Živković, Nenad | |
dc.creator | Stevanović, Slavica D. | |
dc.date.accessioned | 2016-03-20T17:05:27Z | |
dc.date.available | 2016-03-20T17:05:27Z | |
dc.date.available | 2020-07-03T16:06:59Z | |
dc.date.issued | 2015-04-17 | |
dc.identifier.uri | http://eteze.ni.ac.rs/application/showtheses?thesesId=2506 | |
dc.identifier.uri | https://nardus.mpn.gov.rs/handle/123456789/4985 | |
dc.identifier.uri | https://fedorani.ni.ac.rs/fedora/get/o:1024/bdef:Content/download | |
dc.identifier.uri | http://vbs.rs/scripts/cobiss?command=DISPLAY&base=70052&RID=1025243117 | |
dc.description.abstract | Prevalence of the ischemic heart disease (IHD) differs between populations of
different countries. Also, amongst the population in a single country there are geographical
variations in the incidence of IHD.
If we exclude the unchanging risk factors for cardiovascular disease, a major
changeable risk factors such a smoking, high blood pressure, increased cholesterol levels
(total and LDL), diabetes mellitus, have so far not adequately explained the geographical
variation in incidence of IHD. The existence of areas with high risk for IHD, especially for
acute myocardial infarction, indicate that is very likely that environmental factors are also
involved in the pathogenesis of the cardiovascular disease, and it is necessary to consider
them carefully. In the last five decades epidemiological data have been accumulating on the
protective effect of high values of hardness and Ca and Mg from drinking water on morbidity
and mortality from cardiovascular disease.
The aim of the study was to determine the interdependence between of hardness of
drinking water, as well the risk factor and morbidity from ischemic heart disease.
The study presents an epidemiological and ecological (correlation) study, within
which a prospective analytical (anamnestic) small-scale study was performed.
The research is based on the analyses of water hardness and the content of Ca and Mg
in the drinking water of the Nis water supply system (NIVOS). As a source of data for IHD in
the territory of Nis district, the relevant section of the National population register of acute
coronary syndrome (REAKS) referring to the Nis district was used. The crude and
standardized incidence rates (per specific gender and age) in the territorial units of Nis district
formed on the basis of different hardness values of drinking water were calculated. A spatial
distribution (map) of the average total crude incidence rate of IHD in the reporting period
2010-2012 was produced as well.
As part of the anamnestic study, through interviews and using the original structured
epidemiological questionnaire, information has been collected on how to enter drinking water
and risk factors for IHD (smoking, physical activity, hereditary burden of heart disease and
diabetes) in 200 subjects with territorial units in which the highest and lowest values of the
hardness of drinking water and the contents of Ca and Mg. To determine the average daily
energy intake (which includes the daily intake of fat, protein and carbohydrates), as well as
the intake of Mg and Ca in patients, we used the validated semi-quantitative questionnaire on
the frequency of food intake in the previous year, Food Frequency Questionnaire (FFQ).
Testing of the nutritional status of subjects was carried out by measuring the anthropometric
parameters (height, weight) using standard procedures to determine body mass index (BMI)
as the ratio of body weight in kilograms by height squared in meters (kg / m2).
Having reviewed the medical records of patients, data was collected on blood
cholesterol, triglycerides and LDL cholesterol levels, and systolic and diastolic blood
pressure.
Research has shown that subjects who consumed soft and medium soft water for
drinking (area Niska Banja) for over 10 years had a significantly higher incidence rate of IHD
compared to people of the same sex and age who consume hard drinking water (villagers
connected to the Moravian-part of the water supply system NIVOS).
Although the daily intake of drinking water in the subjects was on average less than 2
l, using an amnestic study it was found that a negative correlation between Ca and Mg from
drinking water and its hardness with IHD and risk factors for IHD existed: elevated
triglycerides, total and LDL cholesterol, systolic and diastolic blood pressure.
This survey also confirmed low intake of Ca and Mg in the food as risk factors for
IHD as well as known risk factors for cardiovascular disease: a hereditary predisposition to
heart disease, smoking and fat intake. Using a binary logistic regression analysis it was
shown that the greatest influence on the occurrence of IHD, out of all investigated risk
factors, is due to the magnesium from water (equivalent to Ca from the water - a protective
factor, p = 0.000), magnesium from food (protective factor, p = 0.000) and fat (factor risk, p
= 0.000).
From the aspect of prevention of IHD, the ROC analysis determined that it is
necessary to add per day for at least 75 mg of Ca and Mg 7 mg though drinking water and
802 mg of calcium and 260 mg of Mg though food intake.
The results of this study suggest that the degree of hardness of drinking water in the
central water supply systems should increase to the optimal 180dH- 200dH. Legislating water
hardness, Ca and Mg in the regular assessments of drinking water would lead to an overall
reduction of morbidity and mortality from cardiovascular disease. | en |
dc.format | application/pdf | |
dc.language | sr | |
dc.publisher | Универзитет у Нишу, Медицински факултет | sr |
dc.rights | openAccess | en |
dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/4.0/ | |
dc.source | Универзитет у Нишу | sr |
dc.subject | tvrdoća vode za piće | sr |
dc.subject | hardness of drinking water | en |
dc.subject | calcium | en |
dc.subject | magnesium | en |
dc.subject | ischemic heart disease | en |
dc.subject | kalcijum | sr |
dc.subject | magnezijum | sr |
dc.subject | ishemijska bolest srca | sr |
dc.title | Tvrdoća vode za piće kao faktor rizika za ishemijsku bolest srca | sr |
dc.type | doctoralThesis | en |
dc.rights.license | BY-NC-ND | |
dcterms.abstract | Николић, Маја; Тодоровић, Лазар; Живковић, Ненад; Стојановић, Душица; Дељанин-Илић, Марина; Стевановић, Славица Д.; Тврдоћа воде за пиће као фактор ризика за исхемијску болест срца; Тврдоћа воде за пиће као фактор ризика за исхемијску болест срца; | |
dc.identifier.fulltext | https://nardus.mpn.gov.rs/bitstream/id/53089/Disertacija617.pdf | |
dc.identifier.fulltext | https://nardus.mpn.gov.rs/bitstream/id/53090/Stevanovic_Slavica_D.pdf | |
dc.identifier.fulltext | http://nardus.mpn.gov.rs/bitstream/id/53089/Disertacija617.pdf | |
dc.identifier.fulltext | http://nardus.mpn.gov.rs/bitstream/id/53090/Stevanovic_Slavica_D.pdf | |
dc.identifier.rcub | https://hdl.handle.net/21.15107/rcub_nardus_4985 | |