Determination of RBC membrane and serum lipid composition in trinidadian type II diabetics with and without nephropathy

Aim:

The rheological properties of erythrocytes are impaired in diabetes mellitus, especially because of changes in their membrane lipid composition.The aim of this study was to determine and examine the relationship between red blood cell (RBC) membrane and serum lipid composition in type II diabetes subjects with and without nephropathy.

Methods:

Trinidadian subjects aged 18–65 years were recruited for the study regardless of gender and ethnicity. Fasting blood samples were collected from 60 subjects of whom 20 were healthy individuals, 20 had type II diabetes without complications, and 20 were type II diabetics with nephropathy. Weight, height, waist/hip ratio, and blood pressure were recorded. All the blood samples were analysed to determine the serum lipid concentration, membrane lipid composition and plasma glucose concentration.

Results:

The body mass index and the systolic blood pressure of the diabetics (28.17 ± 4.98 kg/m², 153.21 ± 22.10 mmHg) and those with nephropathy (25.87 ± 4.68, 158.60 ± 22.49 mmHg) were higher when compared with controls (24.67 ± 5.18, 119.15 ± 13.03 mmHg). The diabetic (175.89 ± 102.73 μg/mgprotein) and diabetic nephropathy (358.80 ± 262.66) subjects showed significantly higher levels of RBC membrane cholesterol compared with controls (132.27 ± 66.47). The membrane phospholipids, protein and Na⁺/K⁺ATPase concentrations were altered in diabetics and diabetic nephropathy patients when compared with controls. The trends of increased serum cholesterol and decreased high-density lipoprotein in diabetics and diabetic nephropathy patients were noted as compared with controls but they are not significant as expected. The low-density lipoprotein cholesterol was significantly higher in diabetics when compared with diabetic nephropathy and control subjects.

Conclusions:

Our data suggest that there is a relationship between RBC membrane and serum lipid composition in subjects with type II diabetes with and without nephropathy. This relationship shows that diet and lifestyle plays a significant role in the alterations of the lipids both in serum and RBC membrane. The membrane and serum lipid composition may be used as possible indicators for type II diabetic patients with and without nephropathy to control their diet in the beginning stages to prevent them from further complications.     

Effect of recovery from obesity on cardiovascular risk factors among Japanese schoolchildren: the Iwata population-based follow-up study

Background

The effect of recovery from obesity on cardiovascular risk factors is not well understood in Japanese children.

Methods

We analyzed follow-up data from the Iwata city population-based study of schoolchildren in Japan. The Iwata Board of Education conducted health screenings of children aged 10 and 14 years. A total of 914 children aged 10 years (451 boys and 463 girls, 87.1% of all children in the city in 1997) were followed until 14 years of age and classified by pattern of obesity as Normal, Recovered, Worsened, or Persistent.

Results

Of the 914 children, 111 (12%) were obese at 10 years of age. Of those children, 44 (40%) were no longer obese at 14 years (ie, Recovered). At follow-up, Recovered boys had the greatest decrease in non-HDL cholesterol (mean ± SE, −21.3 ± 3.6 mg/dL) among the 4 groups, and Recovered girls had a significantly lower level of non-HDL cholesterol (Recovered, 107.1 ± 5.4 mg/dL vs. Persistent, 126.1 ± 4.5 mg/dL). The Recovered boys also had a significantly higher level of HDL cholesterol at age 14 (Recovered, 67.2 ± 2.7 mg/dL vs. Persistent, 53.3 ± 2.1 mg/dL). In the Recovered group, 68% of children who were dyslipidemic at baseline had normal cholesterol levels at age 14. The recovery rate from dyslipidemia was significantly higher in the Recovered group (cumulative incidence rate ratio, 2.5; 95% confidence interval, 1.4–4.7) as compared with the Persistent group.

Conclusions

Dyslipidemia was reversed in children who recovered from obesity. Our findings suggest that reducing obesity is beneficial to the health of Japanese schoolchildren.Key words: blood pressure, child, cholesterol, cohort studies, obesity     

唾液酸和微量白蛋白尿与2型糖尿病合并症的关系

目的研究唾液酸、尿微量白蛋白与2型糖尿病合并症的关系。方法健康对照组44例，2型糖尿病无合并症组44例，2型糖尿病合并肾病组44例，2型糖尿病合并视网膜病变组30例。采集静脉血样和随机尿样。血样检测唾液酸和血脂谱、血糖、HbA1C、C-反应蛋白，随机尿样检测尿微量白蛋白和唾液酸。并测量各组体质量指数（BMI）、血压、腰围比。结果各糖尿病组血和尿唾液酸含量比对照组显著增高（P〈0．01）。血清唾液酸含量明显增加的趋势显示合并肾病的严重性和尿白蛋白排出的程度（P〈0．01）。糖尿病。肾病患者的血清唾液酸含量和尿白蛋白含量明显高于其他患者（P〈0．01）。血清唾液酸含量与尿微量白蛋白明显正相关（r=0．263，P〈0．01），与腰围比明显正相关（r=0．226，P〈0．05），与收缩压明显正相关（r=0．263，P〈0．01），与C反应蛋白和血脂没有相关性。尿微量白蛋白含量与腰围比成正相关（r=0．301，P〈0．05），与收缩压成正相关（r=0．633，P〈0．01）。结论血清唾液酸含量的增加和尿微量白蛋白与2型糖尿病合并肾病、糖尿病合并视网膜病以及糖尿病心血管病的危险因子如高血压、高腰围比密切相关，两者可以作为2型糖尿病微血管合并症的检查指标。     

Intraocular pressure and its determinants in subjects with type 2 diabetes mellitus in India

Objectives

This study was conducted to show the intraocular pressure (IOP) distribution and the factors affecting IOP in subjects with type 2 diabetes mellitus (DM) in India.

Methods

We measured the anthropometric and biochemical parameters for confirmed type 2 DM patients. A comprehensive ocular examination was performed for 1377 subjects aged > 40 years and residing in Chennai.

Results

A significant difference in IOP (mean ± standard deviation) was found between men and women (14.6±2.9 and 15.0±2.8 mmHg, p = 0.005). A significantly elevated IOP was observed among smokers, subjects with systemic hypertension and women with clinically significant macular edema (CSME). After a univariate analysis, factors associated significantly with higher IOP were elevated systolic blood pressure, elevated resting pulse rate and thicker central corneal thickness (CCT). In women, elevated glycosylated hemoglobin was associated with a higher IOP. After adjusting for all variables, the elevated resting pulse rate and CCT were found to be associated with a higher IOP.

Conclusions

Systemic hypertension, smoking, pulse rate and CCT were associated with elevated intraocular pressure in type 2 DM. Women with type 2 DM, especially those with CSME, were more prone to have an elevated IOP.     

Serum vaspin levels are associated with physical activity or physical fitness in Japanese: a pilot study

Aim

To investigate the link between serum vaspin levels and physical activity and/or physical fitness in Japanese.

Methods

A total of 156 subjects (81 men and 75 women) was enrolled in this cross-sectional study. Serum vaspin levels, physical activity by uniaxial accelerometers, peak oxygen uptake, and metabolic risk parameters were evaluated. We also assessed anthropometric and body composition parameters.

Results

Serum vaspin levels were over the level of 10 ng/mL in 15 subjects (9.6 %: Vaspin High group). In Vaspin Low group (<5 ng/mL: 74 men and 67 women), serum vaspin levels were 0.12 ± 0.18 ng/mL in men and 0.39 ± 0.70 ng/mL in women. Peak oxygen uptake was significantly and positively correlated with serum vaspin levels even after adjusting for age, physical activity evaluated by Σ[metabolic equivalents × h per week (METs⋅h/w)], BMI, and other confounding factors in men. In turn, physical activity was significantly and positively correlated with serum vaspin levels even after adjusting for confounding factors in women.

Conclusion

Serum vaspin levels were closely associated with physical fitness in men and physical activity in women independent of body composition in this Japanese cohort.     

Cigarette smoking leads to reduced relaxant responses of the cutaneous microcirculation

Background

Smoking is a major risk factor for cardiovascular disease. The present study was undertaken to examine if cigarette smoking translates into reduced relaxant responses of the peripheral microcirculation.

Methods

The cutaneous forearm blood flow was measured by laser Doppler flowmetry. The vasodilator response to the iontophorectic administration of acetylcholine (ACh), acting via an endothelial mechanism, and sodium nitroprusside (SNP), and acting via a smooth muscle mechanism were studied. The study population consisted of 17 nonsmokers and 17 current smokers (mean age 64 ± 2 years, 13 females and 4 males) in each matched group.

Results

There was no difference between the groups in baseline characteristics or in basal flow. Smokers showed however significantly reduced responses to both ACh (mean ± SEM, from 973 ± 137% in nonsmokers to 651 ± 114% in smokers, p < 0.05) and SNP (from 575 ± 111% in nonsmokers to 355 ± 83% in smokers, p < 0.05). The response to the local heating (44 °C) was reduced in smokers (from 1188 ± 215% in nonsmokers to 714 ± 107% in smokers, p < 0.01). In addition, there was no difference between men and women within the groups.

Conclusions

The data show that cigarette smoking results in reduced peripheral microvascular responses to both endothelial and smooth muscle cell stimulation in healthy subjects, suggesting a generalized microvascular vasomotor function.     

Compliance, clinical outcome, and quality of life of patients with stable angina pectoris receiving once-daily betaxolol versus twice daily metoprolol: a randomized controlled trial

Background

A randomized, controlled trial was conducted in an outpatient setting to examine the effect of beta-blocker dosing frequency on patient compliance, clinical outcome, and health-related quality of life in patients with stable angina pectoris.

Methods

One hundred and twelve beta-blockers-naive outpatients with stable angina pectoris were randomized to receive betaxolol, 20 mg once daily or metoprolol tartrate, 50 mg twice daily for 8 weeks. The principal outcome measure was overall compliance measured electronically, whereas secondary outcome measures were drug effectiveness and health-related quality of life.

Results

The overall compliance was 86.5 ± 21.3% in the betaxolol group versus 76.1 ± 26.3% in the metoprolol group (p < 0.01), and the correct number of doses was taken on 84.4 ± 21.6% and 64.0 ± 31.7% of treatment days, respectively (p < 0.0001). The percentage of missed doses was 14.5 ± 21.5% in the once-daily group and 24.8 ± 26.4% in the twice-daily group (p < 0.01). The percentage of doses taken in the correct time window (58.6% vs 42.0%, p = 0.01), correct interdose intervals (77.4% v 53.1%, p < 0.0001), and therapeutic coverage (85.6% vs 73.7%, p < 0.001) were significantly higher in the once-daily group. Both studied drugs had similar antianginal effectiveness. Health-related quality of life improved in both groups, but this increase was more pronounced in the betaxolol arm in some dimensions.

Conclusions

The study demonstrates that patient compliance with once-daily betaxolol is significantly better than with twice daily metoprolol. Similarly, this treatment provides better quality of life. These results demonstrate possible therapeutic advantages of once-daily over twice-daily beta-blockers in the treatment of stable angina pectoris.     

Asian ethnicity is associated with a higher trunk/peripheral fat ratio in women and adolescent girls

Background

Ethnic differences in body fat mass and distribution may develop in childhood and contribute to increased obesity-related disease risk among Asians. We used dual-energy X-ray absorptiometry (DXA) to evaluate adiposity measures among adult women and their adolescent daughters, who were of predominantly Japanese and white ethnicity.

Methods

We obtained DXA whole body scans for 101 mothers aged 30 years or older and 112 daughters aged 10 to 16 years. The participants were classified as Asian, part-Asian, mixed/other, or white. As a measure of central adiposity, we calculated the trunk/peripheral fat ratio (TPFR). General linear models were used to evaluate differences in adiposity measures by ethnic category.

Results

In mothers, TPFR was significantly higher (P_trend < 0.01) in Asians and part-Asians (1.38 ± 0.42 and 1.32 ± 0.51) than in mixed/others and whites (1.18 ± 0.27 and 1.09 ± 0.21). The trend was similar among daughters (P_trend < 0.001), with respective values of 1.09 ± 0.18, 0.97 ± 0.17, 0.99 ± 0.16, and 0.87 ± 0.11. Among mothers, gynoid fat mass and peripheral fat mass were significantly lower in Asians than in whites, whereas none of the regional DXA adiposity measures differed by ethnicity in daughters.

Conclusions

These results confirm previous reports of greater central adiposity in women of Asian ancestry and indicate that ethnic differences in adiposity are already present in adolescence.Key words: DXA, trunk/peripheral fat ratio, central adiposity, ethnicity     

Daily magnesium intake and serum magnesium concentration among Japanese people

Background

The vitamins and minerals that are deficient in the daily diet of a normal adult remain unknown. To answer this question, we conducted a population survey focusing on the relationship between dietary magnesium intake and serum magnesium level.

Methods

The subjects were 62 individuals from Fukui Prefecture who participated in the 1998 National Nutrition Survey. The survey investigated the physical status, nutritional status, and dietary data of the subjects. Holidays and special occasions were avoided, and a day when people are most likely to be on an ordinary diet was selected as the survey date.

Results

The mean (±standard deviation) daily magnesium intake was 322 (±132), 323 (±163), and 322 (±147) mg/day for men, women, and the entire group, respectively. The mean (±standard deviation) serum magnesium concentration was 20.69 (±2.83), 20.69 (±2.88), and 20.69 (±2.83) ppm for men, women, and the entire group, respectively. The distribution of serum magnesium concentration was normal. Dietary magnesium intake showed a log-normal distribution, which was then transformed by logarithmic conversion for examining the regression coefficients. The slope of the regression line between the serum magnesium concentration (Y ppm) and daily magnesium intake (X mg) was determined using the formula Y = 4.93 (log₁₀X) + 8.49. The coefficient of correlation (r) was 0.29. A regression line (Y = 14.65X + 19.31) was observed between the daily intake of magnesium (Y mg) and serum magnesium concentration (X ppm). The coefficient of correlation was 0.28.

Conclusion

The daily magnesium intake correlated with serum magnesium concentration, and a linear regression model between them was proposed.Key words: Random Sampling, National Nutrition Survey, Daily Magnesium Intake, Serum Magnesium Concentration, Spectrum Analysis     

Magnetic resonance imaging in coronary artery bypass surgery--improvement of global and segmental function in patients with severely compromized left ventricular function

Objectives

In the present study, patients with severely compromized left ventricular function underwent magnetic resonance imaging (MRI) before and after coronary artery bypass grafting (CABG). Although improvement of global myocardial contractile function has been shown before, we sought to evaluate whether a functional contractile improvement may be determinable on a myocardial segmental basis after CABG surgery.

Methods

Thirty-three CABG patients with left ventricular ejection fraction (LVEF) ≤30% prospectively underwent MRI to compare pre- and postoperative functional data. At follow-up, all survivors underwent clinical assessment. In 16 patients (three patients died perioperatively, 13 could were lost to MRI follow-up because of cardiac resynchronization therapy and other reasons) postoperative MRI scanning was performed.

Results

In-hospital mortality was 9%. At 20 ± 2 months after surgery, New York Heart Association class improved from 3.0 ± 0.1 to 2.2 ± 0.2 (p < 0.01). Left ventricular end-diastolic volumes decreased significantly from 229 ± 14 mL to 189 ± 19 mL (p < 0.05). LV end-systolic volumes decreased significantly from 163 ± 13 mL to 126 ± 17 mL (p < 0.05). LVEF improved from 30 ± 2% to 36 ± 3% (p < 0.05). On a segmental basis, 42 out of 875 segments (4.8%) had normal function before surgery, at follow-up, 177 segments (20.4%) had normal regional function (p < 0.05).

Conclusions

Patients who undergo CABG surgery with severely compromized left ventricular function, postoperative MRI shows improved global and segmental cardiac function at mid-term follow-up. At the same time there is considerable clinical improvement.     

Simultaneous changes in high-fat and high-cholesterol diet-induced steatohepatitis and severe fibrosis and those underlying molecular mechanisms in novel SHRSP5/Dmcr rat

Objectives

The aim of this study was to identify the molecular mechanisms underlying high-fat and high-cholesterol (HFC) diet-induced steatohepatitis and associated liver fibrosis progression in a novel stroke-prone, spontaneously hypertensive 5/Dmcr (SHRSP5/Dmcr) rat model.

Methods

SHRSP5/Dmcr rats were given the control or HFC-diet for 2, 8, and 16 weeks. Plasma and hepatic gene expression of key molecules involved in fatty acid oxidation, inflammation, oxidative stress, and fibrosis were subsequently analyzed.

Results

Rats fed the HFC-diet showed increased plasma tumor necrosis factor-α (TNF-α) and hepatic p50/p65 signals, but reduced hepatic Cu²⁺/Zn²⁺-superoxide dismutase across the treatment period and reduced plasma total adiponectin at 8 weeks. In HFC-diet-fed rats, transforming growth factor-β1 (TGF-β1) was elevated prior to the appearance of obvious liver fibrosis pathology at 2 weeks, followed by elevations in platelet-derived growth factor-B (PDGF-B) and α-smooth muscle actin (α-SMA), corresponding to evident liver fibrosis, at 8 weeks and by α₁ type I collagen production at 16 weeks. The HFC-diet increased hepatic total cholesterol accumulation, although hepatic triglyceride declined by 0.3-fold from 2 to 16 weeks due to reduced hepatic triglyceride synthesis, as suggested by the diacylglycerol acyltransferase 1 and 2 measurements.

Conclusions

TNF-α and p50/p65 molecular signals appeared to be major factors for HFC-diet-induced hepatic inflammation and oxidative stress facilitating liver disease progression. While the up-regulation of TGF-β1 prior to the appearance of any evident liver fibrosis could be an early signal for progressive liver fibrosis, elevated PDGF-B and α-SMA levels signified evident liver fibrosis at 8 weeks, and subsequent increased α₁ type I collagen production and reduced triglyceride synthesis indicated extensive liver fibrosis at 16 weeks in this novel SHRSP5/Dmcr model.

Electronic supplementary material

The online version of this article (doi:10.1007/s12199-012-0273-y) contains supplementary material, which is available to authorized users.     

Changes in mental health and quality of life with dental implants as evaluated by General Health Questionnaire (GHQ) and Health Utilities Index (HUI)

Objectives

The purpose of this study was to assess and compare the improvement in oral and systemic conditions and health-related quality of life in patients with missing teeth receiving dental implants and conventional treatment.

Methods

A total of 97 patients with missing teeth, of whom 59 received dental implants and 38 received conventional treatment, were included in this study. The patients were divided into two age groups for a more detailed analysis: a 30- to 59-year age group (young) and a >60-year age group. The changes in oral condition, mental health, and health utility level before and after (pre- and post-, respectively) the procedures were assessed using an original questionnaire, the General Health Questionnaire 12 (GHQ12), and Health Utilities Index Mark 3.

Results

Responses to the GHQ12 indicated that treatment with implants significantly improved the oral health of patients in all treatment groups, except for the young group receiving partial dentures (PD). The mental state improved with a lower GHQ score; in terms of pre- versus post-procedure, mental state improved after the procedure in the young group receiving full dentures (FD) (1.75 ± 2.12 vs. 0.88 ± 2.10, p < 0.05), in the old group receiving PD (2.61 ± 3.91 vs. 0.72 ± 1.71, p < 0.05), and in the old group receiving FD (2.63 ± 3.12 vs. 0.44 ± 0.27, p < 0.05). The sleep score also improved by implant in FD of the old group (2.00 vs. 1.00, p < 0.05); it also is better with a lower score.

Conclusions

Recovery of oral function and oral stability in middle-aged people who did not receive implants was possible with PD. However, the results suggest that implant treatment in edentulous denture cases and particularly in elderly people with dentures has a certain efficacy on the physical condition mediated through an improvement in aspects of the mental state.     

Peer Reviewed: Objective Physical Activity Accumulation in Bouts and Nonbouts and Relation to Markers of Obesity in US Adults

Introduction

Little is known about the relation between duration of physical activity and obesity. The objective of this study was to compare the effects of physical activity in bouts (≥10 minutes) to the effects of physical activity in nonbouts (<10 minutes) on markers of obesity.

Methods

We used data from the 2003-2004 National Health and Nutrition Examination Survey on body mass index, waist circumference, and objectively determined physical activity levels for 3,250 adults aged 18 years or older. After controlling for relevant confounding variables, we performed multiple linear regression analyses to predict body mass index and waist circumference for bout and nonbout minutes of moderate- to vigorous-intensity physical activity (MVPA) and for bout and nonbout accelerometer counts of physical activity.

Results

MVPA bout minutes and MVPA nonbout minutes are independently associated with body mass index and waist circumference, after controlling for confounding variables. The strength of the association between lower body mass index and MVPA bout minutes (β = −0.04, P <.001) was nearly 4 times greater than for MVPA nonbout minutes (β = −0.01, P = .06). For smaller waist circumference the association was nearly 3 times greater for MVPA bout minutes (β = −0.09, P <.001) than for MVPA nonbout minutes (β = −0.03, P = .01). Bout minutes of physical activity were at a higher intensity of activity compared with nonbout minutes of physical activity.

Conclusion

Accumulating MVPA in nonbouts may be a beneficial starting point for individuals to increase physical activity levels and decrease body mass index and waist circumference. However, bouts of physical activity lasting ≥10 minutes may be a more time-efficient strategy to decrease body mass index and waist circumference.     

Noninvasive measurements of arterial stiffness: repeatability and interrelationships with endothelial function and arterial morphology measures

Background

Many noninvasive arterial assessment techniques have been developed, measuring different parameters of arterial stiffness and endothelial function. However, there is little data available comparing different devices within the same subject. Therefore, the purpose of this study was to examine the repeatability and interrelationships between 3 different techniques to measure arterial stiffness and to compare this with forearm-mediated dilation.

Methods

Carotid-radial pulse wave velocity was measured by the Sphygmocor (SPWV) and Complior (CPWV) devices, cardio-ankle vascular index (CAVI) was measured by the VaSera device, vascular structure and function was assessed using ultrasonography and evaluated for reliability and compared in 20 apparently healthy, college-aged men and women.

Results

The intraclass correlation coefficient and standard error of the mean for the Sphygmocor (R = 0.56, SEM = 0.69), Complior (R = 0.62, SEM = 0.69), and VaSera (R = 0.60, SEM = 0.56), indicated moderate repeatability. Bland-Altman plots indicated a mean difference of 0.11 ± 0.84 for SPWV, 0.13 ± 1.15 for CPWV, and −0.43 ± 0.90 for CAVI. No significant interrelationships were found among the ultrasound measures and SPWV, CPWV, and CAVI.

Conclusions

The three noninvasive modalities to study arterial stiffness reliably measures arterial stiffness however, they do not correlate with ultrasound measures of vascular function and structure in young and apparently healthy subjects.     

Effect of candesartan cilexetil on diabetic and non-diabetic hypertensive patients: meta-analysis of five randomized double-blind clinical trials

Objective

To study the effect of candesartan cilexetil (CC) in the management of blood pressure (BP) in diabetic and non-diabetic hypertensive patients.

Methods

A selection of five randomized double-blind clinical trials in which patients were treated for hypertension with CC was analyzed. All of these were similar in design: i) a 4-week placebo run-in period, ii) a 4-to 6-week period (V1) with CC 8 mg once daily (od), after which the dosage was doubled if BP was not normalized (BP >140/90 or BP >130/80 mmHg in diabetes), and iii) a 4- to 6-week period (V2) with CC 8 or 16 mg od. Efficacy was measured at V1 and V2.

Results

702 patients were screened. The population consisted of 397 males (56.6%) with a mean age of 60 ± 11 years, with 153 diabetic (21.8%) and 549 non-diabetic (78.2%) patients. At baseline, mean BP values were 160/94/65 mmHg for SPB, DBP, and pulse pressure (PP) respectively, with differences between diabetic and non-diabetic patients. SBP, DBP, and PP values showed a significant reduction at V1 (p < 0.001) and V2 (p < 0.001) compared with baseline for all hypertensive patients. Mean changes at V2 in SBP and PP values were higher in diabetic than non-diabetic patients (p < 0.001), and to a lesser degree on DBP values (p = 0.034).

Conclusions

CC was effective in lowering BP in diabetic and non-diabetic hypertensive patients. CC is a promising therapy to manage hypertensive diabetic patients, as demonstrated by the significant BP reduction.

Short abstract

The effect of candesartan cilexetil (CC) on controlling blood pressure (BP) in hypertensive diabetic and non-diabetic patients was analyzed. Five randomized double-blind trials were pooled treating hypertension by CC (n = 702), including 153 diabetic (21.8%) and 549 non-diabetic (78.2%) patients. After treatment with CC (8–16 mg), significant reductions in SBP, DBP, and pulse pressure (PP) values were observed after 4–6 weeks (p < 0.001) and after 8–12 weeks (p < 0.001) compared with baseline for all hypertensive patients. Mean BP reductions after 8–12 weeks were higher in diabetic patients than non-diabetic (p < 0.001). CC is a promising therapy to treat hypertensive patients, both diabetic and non-diabetic.     

Relationship between blood mercury concentration and waist-to-hip ratio in elderly Korean individuals living in coastal areas

Objectives

This study investigated the relationship between the blood mercury concentration and cardiovascular risk factors in elderly Korean individuals living in coastal areas.

Methods

The sample consisted of 477 adults (164 males, 313 females) aged 40 to 65 years who visited a Busan health promotion center from June to September in 2009. The relationship between blood mercury concentration and cardiovascular risk factors including metabolic syndrome, cholesterol profiles, blood pressure, body mass index (BMI), waist circumference and waist-to-hip ratio (WHR), was investigated. Variables related to blood mercury concentration were further evaluated using multiple regression analysis.

Results

The blood mercury concentration of the study population was 7.99 (range, 7.60 to 8.40) µg/L. In males, the blood mercury concentration was 9.74 (8.92 to 10.63) µg/L, which was significantly higher than that in females (7.21, [6.80 to 7.64] µg/L). The blood mercury concentration of the study population was related to several cardiovascular risk factors including low-density lipoprotein (LDL) cholesterol (p=0.044), high-density lipoprotein (HDL) cholesterol (p=0.034), BMI (p = 0.006), waist circumference (p = 0.031), and WHR (p < 0.001). In males, the blood mercury concentration was significantly correlated with WHR in the multiple regression analysis.

Conclusions

In males, the blood mercury concentration was related to waist-to-hip ratio, which is a central obesity index and cardiovascular risk factor. Our finding suggests that cardiovascular disease risk in males was increased by mercury exposure via an obesity-related mechanism.     

Maternal body mass index and gestational weight gain and their association with perinatal outcomes in Viet Nam

Objective

To examine the association between gestational weight gain and maternal body mass index (BMI) among Vietnamese women and the risk of delivering an infant too small or too large for gestational age.

Methods

A prospective health-facility-based study of 2989 pregnant Vietnamese women was conducted in the city of Nha Trang in 2007–2008. Cubic logistic regression was used to investigate the association of interest. Infants were classified into weight-for-gestational-age categories according to weight centiles for the Asian population. Gestational age was based on the date of last menstrual period and adjusted by the results of first-trimester ultrasound.

Findings

BMI was low (< 18.5), normal (18.5–22.9) and high (≥ 23.0) in 26.1%, 65.4% and 8.5% of the women, respectively. In each of these BMI categories, the percentage of women who delivered infants too small for gestational age was 18.1, 10.0 and 9.4, respectively, and the mean gestational weight gain was 12.5 kg (standard deviation, SD: ± 3.6), 12.2 kg (SD: ± 3.8) and 11.5 kg (SD: ± 4.7), respectively. Among women with low BMI, the risk of delivering an infant too small for gestational age ranged from approximately 40% if the gestational weight gain was < 5 kg to 20% if it was 5–10 kg.

Conclusion

Having a low BMI, commonly found in Viet Nam, puts women at risk of delivering an infant too small for gestational age, especially when total maternal gestational weight gain is < 10 kg.     

Increased levels of serum uric acid among ex-smokers

Background

It remains unclear whether serum uric acid level increases after the cessation of smoking.

Methods

In 2000, we conducted a cross-sectional study on the effects of smoking cessation on serum uric acid levels by analyzing the results of annual health check-ups in the Japanese male working population (n = 16,642).

Results

The serum uric acid level (6.18 mg/dL) was the highest in ex-smokers, followed by that in never-smokers (6.10 mg/dL) and that in current smokers (5.98 mg/dL). Ex-smokers weighed 0.6 kg more than the never-smokers and 1.5 kg more than the current smokers. The frequency of alcohol intake was closely correlated to the smoking habits. The serum uric acid levels declined in all groups, after adjustments for age, body mass index, and alcohol intake, though the levels in ex-smokers were 0.2 mg/dL higher than those in current smokers.

Conclusion

The results suggested that alcohol intake contributed considerably to the serum uric acid levels and that smoking itself may have suppressed these levels via metabolic effects or the action of superoxides.Key words: Smoking Cessation, Uric Acid, Body Mass Index, Alcohol Drinking     

Arsenic speciation analysis of urine samples from individuals living in an arsenic-contaminated area in Bangladesh

Objectives

Chronic inorganic arsenic (iAs) exposure currently affects tens of millions of people worldwide. To accurately determine the proportion of urinary arsenic metabolites in residents continuously exposed to iAs, we performed arsenic speciation analysis of the urine of these individuals and determined whether a correlation exists between the concentration of iAs in drinking water and the urinary arsenic species content.

Methods

The subjects were 165 married couples who had lived in the Pabna District in Bangladesh for more than 5 years. Arsenic species were measured using high-performance liquid chromatography and inductively coupled plasma mass spectrometry.

Results

The median iAs concentration in drinking water was 55 μgAs/L (range <0.5–332 μgAs/L). Speciation analysis revealed the presence of arsenite, arsenate, monomethylarsonic acid (MMA), and dimethylarsinic acid in urine samples with medians (range) of 16.8 (7.7–32.3), 1.8 (<0.5–3.3), 13.7 (5.6–25.0), and 88.6 μgAs/L (47.9–153.4 μgAs/L), respectively. No arsenobetaine or arsenocholine was detected. The concentrations of the 4 urinary arsenic species were significantly and linearly related to each other. The urinary concentrations of total arsenic and each species were significantly correlated with the iAs concentration of drinking water.

Conclusions

All urinary arsenic species are well correlated with each other and with iAs in drinking water. The most significant linear relationship existed between the iAs concentration in drinking water and urinary iAs + MMA concentration. From these results, combined with the effects of seafood ingestion, the best biomarker of iAs exposure is urinary iAs + MMA concentration.