叶酸摄入与胰腺癌发生风险的meta分析

目的探讨叶酸摄入与胰腺癌发生风险的关系。方法计算机检索Cochrane图书馆、Pubmed、Embase、CBM-disc、CNKI数据库,手工检索相关文献,纳入关于叶酸与胰腺癌发生关系的前瞻性及病例-对照研究。评价质量及提取资料后,采用Stata version 11.0软件对胰腺癌发生风险进行合并。结果共纳入6项队列研究及3项病例-对照研究,2 209例患者。分析提示:从食物中获取叶酸的最高摄入量人群与最低者相比,前组胰腺癌罹患风险统计学上明显降低28%,在以相对危险度(RR)为效应值的队列研究中这种降低趋势更明显[合并RR=0.51,95%CI(0.29,0.89),P=0.017],在病例-对照研究中,合并优势比(OR)=0.79[95%CI(0.66,0.94),P=0.008];总叶酸摄入量(来源于食物及补充的叶酸)最高组人群与最低者相比,胰腺癌罹患风险统计学上明显降低33%,在病例-对照研究中,合并OR=0.53[95%CI(0.30,0.96),P=0.036]。结论本研究结果表明增加总叶酸摄入量(来源于食物及补充的叶酸)及食物来源叶酸摄入量是胰腺的保护因素。     

Alcohol, nutrient intake, and hypertension in US adults

Data from the first Health and Nutrition Examination Survey were analyzed with multivariate statistical techniques to determine whether there was evidence for a contributory role of alcohol in hypertension and to provide a suitable perspective on the importance of nutrient variables compared with other established risk factors for hypertension. The results of these analyses reaffirm the importance of alcohol and sodium intakes on blood pressures among US adults. Potassium (inversely) and phosphorus (directly) were also identified as important nutrient predictors of higher systolic blood pressure. Calcium intake was significantly related to systolic blood pressure only among nonwhite men and was not a significant predictor of systolic pressure overall. In addition, the results of the study reemphasized the paramount importance of age, race, and obesity in determining hypertension. Current nutrient intakes, by comparison, are relatively less important.     

高龄女性中高血压高危人群合约式干预效果观察

目的观察高龄女性中高血压高危人群合约式干预效果。方法从高龄女性中筛选出200例高血压高危人群,随机分组为合约式干预组(观察组)与非合约式干预组(对照组),每组各100例,随访1年,分别观察两组女性的生活方式改善情况与血压情况。结果观察组女性高血压的发生率(5.00%)低于对照组(20.00%),观察组女性在生活干预效果与血压控制效果均优于对照组,观察组生活方式较干预前明显改善,血压得到有效控制,差异均有统计学意义(P0.05)。结论合约式干预方法能够显著改善高龄女性中高血压高危人群不良生活方式并帮助其控制血压,降低高血压病的发生率,帮助高龄女性创造更佳的生育条件,是提高高龄妊娠成功率的可靠途径。     

Bone mineral density and the risk of incident nonspinal fractures in black and white women

Context  Black women have a lower rate of fracture than white women, but whether bone mineral density (BMD) predicts fracture risk as well in black women as it does in white women is not established. Objective  To examine the association between BMD and incident nonspinal fractures in older black and white women. Design, Setting, and Participants  Prospective cohort study of baseline data collected from 1986 through 1990 (7334 white women aged 67-99 years) and from 1996 through 1998 (636 black women aged 65-94 years) at 4 US clinical centers in the Study of Osteoporotic Fractures; mean (SD) follow-up of 6.1 (1.5) years until October 1, 2004. Main Outcome Measures  Incident nonspinal fractures were confirmed by radiograpic report. Total hip and femoral neck BMD and bone mineral content were measured by dual energy x-ray absorptiometry. Results  A total of 58 black women had a combined total of 61 fractures and 1606 white women had a combined total of 1712 fractures. In age-adjusted proportional hazard models, a 1-SD decrease in femoral neck BMD was associated with a 37% increased risk of fracture in black women (relative risk [RR], 1.37; 95% confidence interval [CI], 1.08-1.74) and a 49% increase in fracture in white women (RR, 1.49; 95% CI, 1.40-1.58). Adjustment for body weight and other risk factors for fracture weakened the association between BMD and fracture, especially among black women (multivariable adjusted RR per 1-SD decrease in femoral neck BMD for black vs white women: RR, 1.20 [95% CI, 0.93-1.55] vs RR, 1.42 [95% CI, 1.32-1.52]). The absolute incidence of fracture across the pooled BMD distribution was 30% to 40% lower among black women at every BMD tertile. The lower risk of fracture among black compared with white women was independent of BMD and other risk factors (RR, 0.48; 95% CI, 0.36-0.64). Conclusions  Decreased total hip and femoral neck BMD is associated with an increased risk of fracture in both older black and white women, but this relationship was largely explained by other risk factors in black women. Black women have a lower fracture risk than white women at every level of BMD. Race-specific normative databases may be appropriate for the densitometric definition of osteoporosis.      

Dietary intake of antioxidant nutrients and the risk of incident Alzheimer disease in a biracial community study

Context  Oxidative processes have been suggested as elements in the development of Alzheimer disease (AD), but whether dietary intake of vitamin E and other antioxidant nutrients prevents its development is unknown. Objective  To examine whether intake of antioxidant nutrients, vitamin E, vitamin C, and beta carotene is associated with incident AD. Design, Setting, and Participants  Prospective study, conducted from 1993 to 2000, of individuals selected in a stratified random sample of community-dwelling residents. The 815 residents 65 years and older were free of AD at baseline and were followed up for a mean of 3.9 years. They completed food frequency questionnaires an average of 1.7 years after baseline. Main Outcome Measure  Incident AD diagnosed in clinical evaluations with standardized criteria. Results  Increasing vitamin E intake from foods was associated with decreased risk of developing AD after adjustment for age, education, sex, race, APOE 4, and length of follow-up. Relative risks (95% confidence intervals [CIs]) from lowest to highest quintiles of intake were 1.00, 0.71 (0.24-2.07), 0.62 (0.26-1.45), 0.71 (0.27-1.88), and 0.30 (0.10-0.92) (P for trend = .05). The protective association of vitamin E was observed only among persons who were APOE 4 negative. Adjustment for other dietary factors reduced the protective association. After adjustment for baseline memory score, the risk was 0.36 (95% CI, 0.11-1.17). Intake of vitamin C, beta carotene, and vitamin E from supplements was not significantly associated with risk of AD. Conclusion  This study suggests that vitamin E from food, but not other antioxidants, may be associated with a reduced risk of AD. Unexpectedly, this association was observed only among individuals without the APOE 4 allele.      

中国上海妇女豆制品摄入量与子宫内膜癌的风险：人群病例对照研究

目的：评估富含植物雌激素的豆制品的摄入量与子宫内膜癌患病风险的关系。设计：基于人群的病例对照研究，使用食物食用频率调查表，通过面对面访谈，采集过去五年豆制品日常摄入的详细资料。     

Phytoestrogen intake and cardiovascular risk markers in Bangladeshi postmenopausal women

Menopause is the transitional event of female life creating a considerable degree of clinical and psychological as well as social problem and it is known to affect the risk markers of cardiovascular diseases. Hormone replacement therapy (HRT) was though to be a cornerstone in the management of menopause, but evidences accumulated in the recent past have raised serious questions regarding its safety and usability. In this context, phytoestrogens are getting increasingly more attention for therapeutic (as an alternate of HRT) and dietary interventions. Menopause is a special problem for women in developing countries and intake of phytoestrogens can be highly useful also from the economic point of views. The nutraceuticals of specific vitamins, minerals and especially phytoestrogens supplementations are a vital component of the strategy to reduce health problem. The present study was aimed to assess the association of phytoestrogens and risk markers of cardiovascular diseases in postmenopausal women. A total of 111 postmenopausal subjects [age, (years, M±SD) 52±5.35] were studied. The dietary intake of phytoestrogens by study subjects was calculated by a specific food frequency questionnaire (FFQ). Serum fasting homocysteine was measured by AxSYM system. Serum glucose was estimated by glucose-oxidase method. Serum total cholesterol, triglyceride and HDL-C were estimated by enzymatic-colorimetric method LDL-C was estimated by the Friedewald's formula. The intake of total phytoestrogens, isoflavones and lignans (mean±SD, mg/day) were 7.65±3.33, 0.32±0.16, 7.32±3.28 respectively in postmenopausal women. The intake of diadzein, genistein, formononetin, biochanin A (mean±SD, mg/day) were 0.085±0.035, 0.168±0.101, 0.074±0.052 and 0.001±0.0008 respectively. The intake of matairesinol and secoisolaiciresinol (SILR) (mean±SD, mg/day) were 0.022±0.006 and 7.30±3.28 respectively. The total phytoestrogens (r=-0.19, p=0.03) and SILR, one specific type of lignans (r=-0.19, p=0.04) consumption in this study were inversely significantly associated with serum glucose level. The dietary formononetin, one specific type of isoflavones was negatively significantly associated with LDL-cholesterol (r=-0.18, p=0.04). There was no significant relationship found between phytoestrogen intake and serum homocysteine level (r=-0.11, p=0.23). Phytoestrogens containing food intake should be encouraged for reducing risk markers of cardiovascular disease in postmenopausal women.     

Magnesium intake in relation to risk of colorectal cancer in women

Context  Animal studies have suggested that dietary magnesium may play a role in the prevention of colorectal cancer, but data in humans are lacking. Objective  To evaluate the hypothesis that a high magnesium intake reduces the risk of colorectal cancer in women. Design, Setting, and Participants  The Swedish Mammography Cohort, a population-based prospective cohort of 61 433 women aged 40 to 75 years without previous diagnosis of cancer at baseline from 1987 to 1990. Main Outcome Measure  Incident invasive colorectal cancer. Results  During a mean of 14.8 years (911 042 person-years) of follow-up, 805 incident colorectal cancer cases were diagnosed. After adjustment for potential confounders, we observed an inverse association of magnesium intake with the risk of colorectal cancer (P for trend = .006). Compared with women in the lowest quintile of magnesium intake, the multivariate rate ratio (RR) was 0.59 (95% confidence interval [CI], 0.40-0.87) for those in the highest quintile. The inverse association was observed for both colon (RR, 0.66; 95% CI, 0.41-1.07) and rectal cancer (RR, 0.45; 95% CI, 0.22-0.89). Conclusion  This population-based prospective study suggests that a high magnesium intake may reduce the occurrence of colorectal cancer in women.      

基层部队官兵高血压流行病学特点及危险因素分析

背景 军人作为一个特殊的群体,往往处于特殊的军事环境和压力因素中,其高血压患病率及危险因素尚不清楚.目的 分析基层某部官兵高血压流行病学特点与危险因素.方法 2019年9月对某部1634名官兵进行流行病学调查,了解部队官兵高血压患病率.对诊断为高血压的官兵进行危险因素分析,并探究体质量指数(body mass inde...     

男女教师高血压的患病特点

目的分析比较高校男女教师高血压患病特点。方法对2009年山东部分地区高校教师健康体检资料完整的1034人进行高血压患病情况统计分析。结果 1）高校教师高血压男、女患病率分别是22.9%和6.1%。2）随年龄增长男女患病率均逐渐增高,经统计学分析差异有统计学意义（P〈0.001）;3）各年龄组男性患病率明显高于女性,经统计学分析除60~69岁组可能因样本小以外,其余各年龄组差异有统计学意义（P〈0.05）;4）伴发血脂异常、尿酸高、超重等心血管危险因素男性明显高于女性,经统计学分析差异有统计学意义（P〈0.05）。结论高校教师男性高血压患病率与其他心血管危险因素的并存率均明显高于女性,因而男性有更高的发生心脑血管事件的危险,应加强对高校男性教师高血压的健康管理,包括一级和二级预防。     

Homocysteine and risk of cardiovascular disease among postmenopausal women.

CONTEXT: Individuals with elevated levels of homocysteine tend to have higher prevalence of cardiovascular disease. However, prospective studies of homocysteine are inconsistent and data among women are limited. OBJECTIVE: To determine whether elevated homocysteine levels in healthy postmenopausal women predict risk of developing cardiovascular disease. DESIGN: Prospective, nested case-control study with a mean 3-year follow-up. SETTING: The Women's Health Study, an ongoing US primary prevention trial initiated in 1993. PARTICIPANTS: From a total cohort of 28,263 postmenopausal women with no history of cardiovascular disease or cancer at baseline, 122 women who subsequently experienced cardiovascular events were defined as cases, and 244 age- and smoking status-matched women who remained free of disease during follow-up were defined as controls. MAIN OUTCOME MEASURES: Incidence of death due to cardiovascular disease, nonfatal myocardial infarction (MI), stroke, percutaneous transluminal coronary angioplasty, or coronary artery bypass graft by baseline homocysteine level. RESULTS: Of the 122 cases, there were 85 events of MI or stroke and 37 coronary revascularizations. Case subjects had significantly higher baseline homocysteine levels than controls (14.1 vs 12.4 micromol/L; P = .02). Subjects with homocysteine levels in the highest quartile had a 2-fold increase in risk of any cardiovascular event (relative risk [RR], 2.0; 95% confidence interval [CI], 1.1-3.8). This effect was largely due to an excess of cases with high levels of homocysteine; the RR for those with homocysteine levels at or higher than the 95th percentile (20.7 micromol/L) was 2.6 (95% CI, 1.1-5.7). Risk estimates were independent of traditional risk factors and were greatest for the end points of MI and stroke (RR for those with baseline homocysteine levels in the top quartile, 2.2; 95% CI, 1.1-4.6). Self-reported multivitamin supplement use at study entry was associated with significantly reduced levels of homocysteine (P<.001). However, the association between increasing quartile of homocysteine level and risk of MI or stroke remained significant in analyses controlling for baseline multivitamin supplement use (P = .003 for trend), and subgroup analyses limited to women who were (P = .02 for trend) or were not (P = .04 for trend) taking multivitamin supplements. CONCLUSIONS: Among healthy postmenopausal US women, elevated levels of homocysteine moderately increased the risk of future cardiovascular disease. Whether lowering the homocysteine level reduces risk of cardiovascular events requires testing in randomized controlled trials.     

Hormone replacement therapy, prothrombotic mutations, and the risk of incident nonfatal myocardial infarction in postmenopausal women

CONTEXT: Estrogens are known to be prothrombotic, and findings from the Heart and Estrogen/progestin Replacement Study suggest that in women with clinically recognized heart disease, hormone replacement therapy (HRT) may be associated with early harm and late benefit in terms of coronary events. OBJECTIVE: To assess whether, as hypothesized, prothrombotic mutations modify the association between HRT use and incidence of first myocardial infarction (MI). DESIGN AND SETTING: Population-based, case-control study conducted in a Seattle-based health maintenance organization. PARTICIPANTS: Cases were 232 postmenopausal women aged 30 to 79 years who had their first nonfatal MI between 1995 and 1998. Controls were a stratified random sample of 723 postmenopausal women without MI who were frequency-matched to cases by age, calendar year, and hypertension status. MAIN OUTCOME MEASURE: Risk of first nonfatal MI based on current use of HRT and the presence or absence of coagulation factor V Leiden and prothrombin 20210 G-->A variants among cases and controls, stratified by hypertension. RESULTS: One hundred eight MI cases and 387 controls had hypertension and 124 MI cases and 336 controls did not. Among hypertensive women, the prothrombin variant was a risk factor for MI (odds ratio [OR], 4.32; 95% confidence interval [CI], 1.52-12.1) and, in this stratum, there was also a significant interaction between use of HRT and presence of the prothrombin variant on risk of MI. Compared with nonusers of HRT with wild-type genotype, women who were current users and who had the prothrombin variant (n = 8) had a nearly 11-fold increase in risk of a nonfatal MI (OR, 10.9; 95% CI, 2.15-55.2). The interaction with the prothrombin variant was more pronounced in analyses assuming 100% compliance than in those assuming 80% compliance with HRT. The interaction was absent among nonhypertensive women and was less pronounced if hypertensive and nonhypertensive women were combined into 1 group. No interaction was found for factor V Leiden in either hypertensive or nonhypertensive women. Among hypertensive women, the estimates were affected only in trivial ways by adjustment, and the interaction with the prothrombin variant was specific to HRT. CONCLUSIONS: Our results suggest that among postmenopausal hypertensive women, the association between HRT use and MI risk differed between those with and without the prothrombin 20210 G-->A variant. If these findings are confirmed in other studies, screening for the prothrombin variant may permit a better assessment of the risks and benefits associated with HRT in postmenopausal women.