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BIOIMPEDANCEOMETRY IN ASSESSING THE HEALTH STATUS OF SECONDARY
SCHOOL TEACHERS: PERSPECTIVES AND OPPORTUNITIES FOR DISEASE
PREVENTION
Valiyev Ravshanbek Akhmadjonovich
Email: ravshanbekvaliev0306@gmail.com
Kosimov Islombek Ulugbekovich
Email: kosimovislom990@gmail.com
Andijan State Medical Institute.
Annotation:
The article presents a method for evaluating the effectiveness of teaching methods
in higher education institutions, with a focus on monitoring, evaluating, and preventing problems
among faculty members. The results of the pilot study on the composition of the test subjects' (n
= 87) experience are presented. The subjects' experience ranged from none to considerable. The
presence of particular anthropometric and bioimpedance indicators has been identified, which
are indicative of the specific group under investigation. Correlations have been identified
between the age of the subjects, their age, and the number of subjects in the sample. The
proposed algorithmic framework is predicated on the basis of the preceding biometric data. The
present study aims to examine the efficacy of the method in the context of programmatic
prevention of psychosocial problems among individuals engaged in psychosocial work.
Keywords:
bioimpedance, div composition, physical activity, metabolic syndrome, physical
activity, health status, and physical activity.
Introduction:
The profession of a secondary school teacher is characterised by a high level of stress, significant
emotional demands and limited opportunities for personal development. It is evident that these
factors frequently result in the onset of various somatic pathologies, including metabolic
disorders, cardiovascular diseases, and problems with the nervous and circulatory systems, as
well as orthopedic pathologies. The timely identification of risks associated with the general
condition of the population is of paramount importance in the context of public health.
As demonstrated by the findings of the following studies [1, 2, 3], the prevalence of chronic non-
infectious diseases among teaching staff exceeds that of the general population of the same age
group. In particular, the prevalence of arterial hypertension has been documented to be between
42-48% among patients over the age of 15 years. Similarly, the incidence of orthopnoea has been
reported to be between 37-40%, while that of dyslipidaemia has been documented to be between
35-39% [4]. A salient feature of professional groups is their tendency to allocate insufficient
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attention to the individuality of their members and their low level of engagement with
preventative health measures [5].
In recent years, bioimpedance analysis has become a more prevalent method of non-invasive
div composition assessment. The distinguishing features of this method include its simplicity,
cost-effectiveness and high level of functionality. It is evident that this instrument is conducive
to the monitoring of both general and specific groups, including those of a pedagogic nature.
The objective of the present study is to evaluate the potential benefits of bioimpedance analysis
in identifying risk factors. The investigation will address the prevalence of illnesses among
teaching staff in secondary schools, and the development of a programme of preventative
measures based on the data collected.
Materials and methods
Characteristics of the bioimpedanceometry method:
Bioimpedanceometry (BIA) is a method of diagnosing human div composition based on
measuring the electrical resistance of biological tissues. The method is based on the differences
in electrical conductivity of different div tissues: fatty tissue has a high resistance, while
muscle tissue and internal organs, which contain a large amount of water and electrolytes, are
good conductors of electrical current.
During the procedure, a weak electric current is passed through the div (absolutely safe for
health, with a strength of no more than 800 µA) and special equipment records the resistance of
the tissues. Based on the data obtained, the following parameters are calculated:
The following elements are of particular relevance in this study:
The total fat content of the tissue, both in absolute terms and as a percentage of the total
div fat
The fat-free mass of the div
The active cell mass
The total water content of the div
The intracellular water The following elements are of particular relevance in this context:
Intracelluar fluid
Cell mass index
Level of primary metabolism
Ratio of fat to lean div mass
Visceral fat
Visceral fat-to-total div fat ratio
The phase angle of the bi-impedance sensor is a particularly salient indicator. As such, it is
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imperative to consider the general condition of the cell membrane and its correlation with the
level of physical and biological activity [6]. The lowest values of the phase angle may be
indicative of degeneration in the tissues and the predominance of cataractous processes.
Study design
The study involved 87 teachers (78 women and 9 men) from 5 secondary general education
schools. The mean age of the participants was 42.6±8.5 years, the mean teaching experience was
18.3±9.2 years.
Inclusion criteria: age 25-65 years, teaching experience of at least 3 years, absence of acute
diseases at the time of examination, voluntary informed consent to participate in the study.
Exclusion criteria: pregnancy and lactation, presence of pacemaker or other implanted electronic
devices, oncologic diseases, acute infectious diseases, exacerbation of chronic diseases
All participants underwent anthropometric examination (measurement of height, weight, waist
and hip circumference) and bioimpedanceometry using ABC-01 analyzer “Medass” (Russia).
Measurements were performed in the morning hours, on an empty stomach, after bladder
emptying. The participants were divided into three groups depending on the length of service:
group I - work experience 3-10 years (n=23)
group II - work experience 11-20 years (n=32)
group III - work experience more than 20 years (n=32)
Statistical processing of data was performed using the SPSS 22.0 program package. Quantitative
variables are presented as mean values and standard deviations (M±SD). One-factor analysis of
variance (ANOVA) followed by Tukey's posterior tests was used to compare groups. Pearson's
correlation coefficient was used to detect correlations. Differences were considered statistically
significant at p<0.05.
Results of the study
Anthropometric and general characteristics of the surveyed teachers
The main characteristics of the surveyed teachers are presented in Table 1.
Parameter
Group
I
(experience 3–
10 years)
Group
II
(experience 11–
20 years)
Group
III
(experience >20
years)
p-value
Age, years
32.4 ± 4.2
32.4 ± 4.2
51.8 ± 6.4
<0.001
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Height, cm
166,3±6,1
165,8±5,7
164,9±5,9
0,672
Weight, kg
63,5±9,7
68,4±11,8
72,6±13,5
0,019
BMI, kg/m²
22,9±3,2
24,8±4,1
26,7±4,5
0,003
Waist
circumference,
cm
74,6±8,3
81,4±10,2
87,5±11,8
<0,001
Hip
circumference,
cm
94,8±7,2
99,3±8,5
102,7±9,1
0,002
Waist-to-hip
ratio
0,79±0,06
0,82±0,07
0,85±0,08
0,005
Statistically significant differences between the groups were revealed for the parameters
characterizing div weight and fat tissue distribution. With increasing length of service, there is
a progressive increase in BMI, waist circumference and waist/hip ratio, which indicates a
tendency towards abdominal obesity in teachers with more years of service
Results bioimpedanceometry:
The results of the bioimpedance analysis of div composition are presented in Table 2.
Parameter
Group I (3-10
years
of
experience)
Group II (11-20
years
of
experience)
Group III (>20
years
of
experience)
p-value
Fat mass, %
24,3±6,1
28,7±7,2
33,5±7,8
<0,001
Active
cell
mass, %
56,4±4,3
53,2±4,8
50,1±5,3
<0,001
Скелетно-
мышечная
масса, %
47,2±4,9
44,6±5,1
41,8±5,6
<0,001
Total
div
water, %
56,8±4,6
53,4±5,0
50,7±5,3
<0,001
Extracellular
water, %
43,2±2,8
44,9±3,1
46,7±3,5
<0,001
Phase
angle,
degrees
7,1±0,8
6,7±0,9
6,2±1,0
0,001
Visceral
fat
index
5,8±2,3
8,4±3,2
11,3±3,9
<0,001
Basic
metabolism, kcal 1456±148
1423±157
1387±165
0,193
The analysis of the obtained data showed a progressive increase in relative fat mass with
increasing length of service with a simultaneous decrease in the proportion of active cellular and
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skeletal muscle mass. Especially important is the pronounced increase in visceral fat index in the
group with more than 20 years of work experience, indicating an increased risk of metabolic
syndrome and cardiovascular diseases.
There was also a statistically significant decrease in the phase angle of bioimpedance with
increasing length of service, which may indicate progressive degenerative changes in tissues and
decreased work capacity.
Correlation analysis
Correlation analysis revealed associations between years of teaching experience and a number of
div composition indicators (Table 3).
Parameter
Correlation coefficient (r)
p-value
Body mass index
0,48
<0,001
Fat mass, %
0,57
<0,001
Visceral fat index
0,61
<0,001
Active cell mass, %
-0,52
<0,001
Phase angle
-0,47
<0,001
Waist circumference
0,54
<0,001
Waist/hip index
0,49
<0,001
Basic exchange
-0,29
0,007
The strongest correlations were found between length of service and visceral fat index (r=0.61,
p<0.001), as well as percentage of fat mass (r=0.57, p<0.001). An inverse correlation was found
between length of service and active cell mass (r=-0.52, p<0.001), reflecting a decrease in
metabolically active tissues with increasing length of teaching experience.
Disease risk assessment
Based on the obtained data, the risk of developing various diseases among the surveyed teachers
was assessed. The results are presented in Figure 1.
In the group of teachers with more than 20 years of experience, 43.8% had signs of metabolic
syndrome (according to NCEP-ATP III criteria: waist circumference >88 cm for women
and >102 cm for men, visceral fat index >9). In the group with 11-20 years of experience, this
figure was 28.1%, and in the group with 3-10 years of experience, only 8.7%.
The risk of cardiovascular diseases, calculated on the basis of impedance-sometry and
anthropometry data, also increased with increasing length of service: high risk was found in
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34.4% of teachers of the third group, in 21.9% of the second group and in 4.3% of the first group.
Discussion of results
The obtained results indicate progressive changes in the div composition of teachers with
increasing length of teaching experience. The most pronounced changes are observed in the
indicators of fat mass, especially visceral fat mass, and active cell mass.
The revealed dynamics is consistent with the data of other studies devoted to the study of
teachers' health [7, 8, 9] and may be due to a number of factors characteristic of this professional
group:
1.
High psycho-emotional load leading to chronic stress and increased cortisol levels, which
contributes to visceral fat accumulation [10];
2.
Predominantly sedentary lifestyle, characteristic for teachers in preparing for classes and
checking students' work;
3.
violation of the diet and quality of nutrition due to the specifics of the work schedule
(short breaks between lessons, forced eating “on the go”);
4.
Age-related changes in metabolic processes, aggravated by the peculiarities of
professional activity;
5.
Insufficient time for physical activity due to high workload.
The significant increase in visceral fat index in teachers with a long work experience is
particularly alarming. It is known that visceral obesity is a key risk factor for the development of
metabolic syndrome, type 2 diabetes mellitus and cardiovascular diseases [11, 12].
A decrease in the phase angle of bioimpedance with increasing length of service is also an
unfavorable sign, since this index reflects the state of cell membranes and correlates with the
general functional state of the organism. Selberg and Selberg [13] showed that low values of the
phase angle are associated with an increased risk of mortality from various causes.
The results emphasize the need to develop preventive measures aimed at correcting div
composition and preventing the development of metabolic disorders in secondary school teachers.
Algorithm of preventive measures
Based on the results of the study, an algorithm of preventive measures for secondary school
teachers using bioimpedanceometry data was developed (Fig. 2).
The algorithm includes the following steps:
1.
Conducting bioimpedanceometry as part of the annual preventive examination of teachers.
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2.
analyzing the main indicators of div composition:
Body mass index
Percentage of fat mass
Visceral fat index
Active cell mass
Bioimpedance phase angle
3.
Data-driven risk stratification of disease risk:
Low risk: normal div composition scores
Medium risk: minor deviations from normal values
High risk: severe abnormalities indicative of metabolic abnormalities
4.
Selection of preventive measures depending on the identified risk:
At low risk: general recommendations for maintaining a healthy lifestyle
At medium risk: individualized recommendations on diet and physical activity,
monitoring of the dynamics of indicators after 6 months
At high risk: endocrinologist and cardiologist consultation, laboratory examination
(lipidogram, blood glucose, insulin), development of an individual prevention program,
monitoring of the dynamics of indicators in 3 months
5.
Educational activities for educators:
Lectures and seminars on the basics of healthy nutrition
Training in stress management techniques
Development of physical activity programs adapted to teachers' professional activities
6.
Monitoring the effectiveness of preventive interventions through repeated div
composition measurements.
The effectiveness of the proposed algorithm was tested on a group of 32 teachers with identified
deviations in div composition. After 6 months of implementation of individual preventive
programs, positive dynamics of indicators was noted: decrease of div mass index by 1.8±0.5
kg/m², decrease of fat mass percentage by 2.3±0.8%, decrease of visceral fat index by 1.2±0.4
units and increase of bioimpedance phase angle by 0.4±0.1 degrees.
Conclusion
The results of the study indicate high informativeness of bioimpedanceometry method for
assessing the health status of secondary school teachers and identifying risk factors for disease
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development.
The revealed features of div composition of teachers with different length of service indicate
progressive unfavorable changes that can lead to the development of metabolic syndrome,
cardiovascular diseases and other pathologies.
The developed algorithm of preventive measures on the basis of bioimpedance symmetry data
allows individualizing the approach to disease prevention in teachers and increasing the
effectiveness of preventive measures.
It is recommended to include bioimpedanceometry in the program of preventive examinations of
secondary school teachers, which will allow to identify the risks of disease development in a
timely manner and to carry out targeted preventive measures.
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