Screening of the most common cardiometabolic diseases based on risk factor assessment among military personnel
Authors: Kolesnikova O. V. , Kyrychenko I. I. , Radchenko A. O. , Zaprovalna O. Y. , Yemelianova N. Y. 
Published: October 2024

Objective — to assess the prevalence of major cardiometabolic diseases by identifying their risk factors and comparing them with metabolic disorders and stress indicators in military personnel.
Materials and methods. The study included 74 male military personnel with an average age of 43.4 [31.4; 50.6] years. Among all the participants, the proportion of individuals with hypertension (HTN) was 51.4%, with dyslipidemia (DLP) — 75.7%, with metabolic­associated steatotic liver disease (MASLD) — 48.6%, and with overweight or obesity — 51.4%. The participants were divided into groups based on the number of cardiometabolic diseases: group 1 (comparison) consisted of military personnel without HTN, DLP, or MASLD (n=14, 18.9%), group 2 — personnel with 1—2 of the above­mentioned cardiometabolic diseases (n=32, 43.2%), and group 3 — military personnel with comorbid pathology, including HTN, DLP, and MASLD (n=28, 37.8%). All participants were assessed for anthropometric profile, traditional clinical and biochemical indicators. Stress indicators included dehydroepiandrosterone sulfate (DHEA­S), cortisol, and oxidative stress marker 8­OH­deoxyguanosine (8­OH­DG), which were measured in the blood using immunoassay methods.
Results. Among military personnel with HTN, overweight/obesity was twice as common (p=0.003, χ2=9.110), MASLD was 3.3 times more frequent (p=0.0001, χ2=19.598), and DLP was 1.7 times more frequent (p=0.0001, χ2=15.418). Among military personnel with MASLD, overweight/obesity was observed three times more frequently (p=0.0001, χ2=19.598), and dyslipidemia was 1.6 times more common (p=0.0001, χ2=13.416). Personnel with more cardiometabolic diseases were significantly older (p=0.003). In group 3, 21.4% had a normal BMI, while in group 1, 28.6% were overweight or had obesity (p=0.001). The increase in the number of cardiometabolic diseases between groups was accompanied by a significant reduction in skeletal muscle percentage (p=0.039 for group 1 vs group 2; p=0.001 for group 1 vs group 3; p=0.001 for group 2 vs group 3). Military personnel in group 3 had significantly higher BMI, waist circumference (WC), total fat percentage, and lower skeletal muscle percentage compared to groups 1 and 2 (p=0.001 for all comparisons). The highest levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), uric acid (UA), and the lowest AST/ALT ratio were observed in group 3 compared to group 1 (p=0.002; p=0.0001; p=0.001; p=0.0001) and group 2 (p=0.0001; p=0.0001; p=0.0001; p=0.0001), respectively. Alkaline phosphatase levels were significantly lower in group 3 compared to group 1 (p=0.048). Lipid profile deterioration was observed with an increase in the number of cardiometabolic diseases: total cholesterol (TC), triglycerides (TG), very low­density lipoprotein cholesterol (VLDL­C), and low­density lipoprotein cholesterol (LDL­C) levels were significantly higher in group 3 compared to group 1 (p=0.0001; p=0.0001; p=0.0001; p=0.007) and group 2 (p=0.0001; p=0.024; p=0.002; p=0.005), respectively. In group 2, only TG (p=0.0001) and VLDL­C (p=0.0001) levels were higher compared to group 1. DHEA­S levels were significantly lower in group 3 compared to group 1 (p=0.019), but no differences in cortisol levels were found. 8­OH­DG levels were significantly lower in groups 2 (p=0.003) and 3 (p=0.019) compared to group 1. Correlation analysis revealed that stress hormone levels were inversely associated with WC (p=0.016), AST (p=0.004), ALT (p=0.021), total bilirubin (p=0.033), UA (p=0.002), glycated haemoglobin (HbA1с) (p=0.024), TC (p=0.002), TG (p=0.001), and VLDL­C (p=0.001).
Conclusions. Cardiometabolic diseases are highly prevalent among military personnel, and comorbidity is a frequent phenomenon that contributes to a significant increase in cardiovascular risk and highlights the need for optimized preventive and therapeutic strategies. The increase in the number of cardiometabolic diseases is associated with older age, worsened anthropometric status, liver function tests, increased uric acid levels, and deteriorating lipid profile. DHEA­S can be considered a marker of chronic stress in individuals with cardiometabolic comorbidity. Monitoring and timely correction of WC, AST, ALT, total bilirubin, UA, HbA1с, TC, TG, and VLDL­C levels among military personnel are necessary, as these indicators are related to stress and can improve cardiometabolic disease prevention.