Gender Differences in the Relationship Between Age-Related Carotid Intima-media Thickness and Cardiac Diastolic Function in a Healthy Chinese Population

BackgroundVentricular-arterial coupling is a key determinant of cardiovascular performance. However, little is known about the gender differences in ventricular-arterial interactions in the healthy Chinese population.ObjectiveTo identify gender differences in the association between carotid intima-media thickness (CIMT) and cardiac diastolic function in healthy Chinese individuals.Methods and ResultsWe examined 852 healthy participants (aged 30–98 years, 46% men) in 3 northern China cities with the use of M-mode ultrasonography to analyze CIMT and cardiac structure and function. Cardiac function was measured by determining the ratio of early-diastolic peak flow velocity (E) and late-diastolic peak flow velocity (A), as well as the deceleration time of the early mitral velocity (MV-DT). Cardiac dysfunction was defined as E/A values <25th percentile (E/A <0.78 for men and <0.79 for women), left atrial volume (LAV) values >75th percentile (LAV >34.9 mL for men and >32.2 mL for women), and MV-DT values >75th percentile (MV-DT >210 ms for men and >195 ms for women). CIMT, E/A, LAV, and MV-DT were significantly correlated with age in both men (CIMT: r = 0.418, P < .01; E/A: r = ?0.325, P < .01, LAV: r = 0.123, P < .05; MV-DT: r = 0.175, P < .01) and women (CIMT: r = 0.429, P < .01; E/A: r = ?0.423, P < .01; LAV: r = 0.180, P < .01; MV-DT: r = 0.174, P < .01). Interestingly, left ventricular ejection fraction (LVEF) was not significantly correlated with age in either gender. CIMT was significantly associated with a lower E/A in an unadjusted model in tertiles II and III. The odds ratios (95% confidence interval [CI]) for men were 2.428 (1.36–4.335) and 3.017 (1.674–5.437), respectively. However, this association disappeared with age adjustment. The odds ratios (95% CI) for women were 3.298 (1.742–6.246) and 6.002 (3.202–11.251), respectively, and these were still significant after adjustments for all other variables, including age, blood pressure, blood lipid, and inflammatory markers (tertile II: 3.031, 95% CI 1.228–7.48; tertile III: 3.224, 95% CI 1.308–7.946). A higher MV-DT was significantly correlated with higher CIMT only in an unadjusted model for women, and this association was lost with age adjustment. There was no significant association between CIMT and higher LAV values.ConclusionsAge-related increases in CIMT were correlated with a decline in cardiac diastolic function only in women, which may contribute to the higher incidence of heart failure with preserved ejection fraction.     

The Association of Airflow Obstruction with Occupational Exposures in a Sample of Rural Adults in Iowa

Abstract

A recent article reported that occupational exposure to vapor-gas, dust, and fumes (VGDF) was more common in a sample of rural adults than in a sample of adults in urban settings. In another study of the same urban adults, airflow obstruction (AO) was associated with occupational VGDF and the combination of smoking and occupational exposure. The goal of the current study was to determine if similar associations were evident in the sample of rural adults. We analyzed enrollment data from the Keokuk County Rural Health Study (KCRHS), which investigated the health of rural residents in Iowa. We used the same methods as the study of urban adults. A job-exposure matrix (JEM) assigned an occupational VGDF exposure level based on each participants’ last reported job. The health outcome was AO, defined as both the forced expiratory volume in one second (FEV1) and the FEV1/forced vital capacity (FVC) ratio?<?lower limit of normal. Of the 1699 KCRHS participants, 436 (25.7%) had high total VGDF occupational exposure, 661 (38.9%) had ever smoked cigarettes, and 110 (6.5%) had AO. The crude frequency of AO increased across the joint categories of smoking (never, ever) and high exposure (no, yes) (p?<?0.05 for linear trend). After adjusting for potential confounders, AO was associated with high total occupational VGDF exposure only among smokers (OR = 1.81, 95% CI 1.002 to 3.26). In conclusion, the association of AO with occupational exposure in the current study of rural adults was similar to what was previously observed among urban adults.     

Association of Cognitive Function with Albuminuria and eGFR in the General Population

Summary

Background and objectives

Recent studies found different associations of cognitive function with albuminuria or estimated GFR (eGFR). Most studies were limited to the elderly or did not take both renal variables into account. Therefore, this study analyzed the association of cognitive function with albuminuria and eGFR in community-dwelling persons aged 35 to 82 years.

Design, setting, participants, & measurements

This was a cross-sectional study comprising 4095 participants of the Prevention of Renal and Vascular End-Stage Disease (PREVEND) study. Cognitive function, measured with the Ruff Figural Fluency Test (RFFT), was treated as the dependent variable, and albuminuria and eGFR were treated as independent variables.

Results

The prevalence of albuminuria <10, 10 to 29, and ≥30 mg/24 h was 54%, 31%, and 15%, respectively. Mean eGFR (± SD) was 79 ± 15 ml/min per 1.73 m². Because of interaction between albuminuria and age, analyses were performed per age tertile. After multivariate adjustment, albuminuria ≥ 30 mg/24 h, but not eGFR, was associated with lower RFFT score in the youngest tertile (B −5.3; 95% CI, −0.6 to −9.2; P = 0.05), but not in older tertiles. Moreover, subjects in the youngest tertile with increasing albuminuria (5–15 and >15 mg/24 h) before RFFT measurement had lower mean RFFT scores than subjects with stable albuminuria: mean difference −4.9 (P = 0.3) and −6.7 (P = 0.03), respectively.

Conclusions

In this community-based cohort, elevated albuminuria was associated with worse cognitive function in young but not in old persons. There was no association of eGFR with cognitive function.     

Association of Lung Function Genes with Chronic Obstructive Pulmonary Disease

Background

Spirometric measurements of pulmonary function are important in diagnosing and determining the severity of chronic obstructive pulmonary disease (COPD). We performed this study to determine whether candidate genes identified in genome-wide association studies of spirometric measurements were associated with COPD and if they interacted with smoking intensity.

Methods

The current analysis included 1,000 COPD subjects and 1,000 controls recruited from 24 hospital-based pulmonary clinics. Thirteen SNPs, chosen based on genome-wide association studies of spirometric measurements in the Korean population cohorts, were genotyped. Genetic association tests were performed, adjusting for age, sex, and smoking intensity, using models including a SNP-by-smoking interaction term.

Results

PID1 and FAM13A were significantly associated with COPD susceptibility. There were also significant interactions between SNPs in ACN9 and FAM13A and smoking pack-years, and an association of ACN9 with COPD in the lowest smoking tertile. The risk allele of FAM13A was associated with increased expression of FAM13A in the lung.

Conclusions

We have validated associations of FAM13A and PID1 with COPD. ACN9 showed significant interaction with smoking and is a potential candidate gene for COPD. Significant associations of genetic variants of FAM13A with gene expression levels suggest that the associated loci may act as genetic regulatory elements for FAM13A gene expression.     

Lung Function and Respiratory Symptoms in Association with Mortality: The HUNT Study

Whether respiratory symptoms are associated with mortality independent of lung function is unclear. The authors explored the association of the exposures i) lung function, ii) respiratory symptoms, and iii) lung function and respiratory symptoms combined, with the outcomes all-cause and cardiovascular mortality. The study included 10,491 adults who participated in the Nord-Trøndelag Health Study (HUNT) Lung Study in 1995–1997 and were followed through 2009. Cox regression was used to calculate adjusted hazard ratios (HRs) with 95% confidence intervals for all-cause and cardiovascular mortality associated with pre-bronchodilator% predicted forced expiratory volume in 1 second (ppFEV₁), chronic obstructive pulmonary disease (COPD) grades, and respiratory symptoms (chronic bronchitis, wheeze, and levels of dyspnoea). Lung function was inversely associated with all-cause mortality. Compared to ppFEV₁ ≥100, ppFEV₁ <50 increased the HR to 6.85 (4.46–10.52) in women and 3.88 (2.60–5.79) in men. Correspondingly, compared to normal airflow, COPD grade 3 or 4 increased the HR to 6.50 (4.33–9.75) in women and 3.57 (2.60–4.91) in men. Of the respiratory symptoms, only dyspnoea when walking remained associated with all-cause mortality after controlling for lung function (HR 1.73 [1.04–2.89] in women and 1.57 [1.04–2.36] in men). Analyses of lung function and dyspnoea when walking as a combined exposure further supported this finding. Overall, associations between lung function and cardiovascular mortality were weaker, and respiratory symptoms were not associated with cardiovascular mortality. In conclusion, lung function was inversely associated with all-cause and cardiovascular mortality, and dyspnoea when walking was associated with all-cause mortality independent of lung function.     

Diurnal Variability of Lung Function and Its Association with Sleep among Patients with Asthma

This prospective exploratory story examined diurnal variations in pulmonary function and their association with sleep and quality of life (QOL) in 20 adult asthmatics. Peak expiratory flow (PEF) was assessed for 7 days, before bedtime and upon awakening. There was no association between PEF variability and QOL. Six of 13 polysomnographic measures were significantly correlated with overnight decline in PEF. Individuals with greatest decline took longer to fall asleep and enter Stage 1 sleep, spent less time asleep, and experienced poorer sleep efficiency. Diurnal variations in PEF reflect adverse sleep quality, yet impact on QOL is often unnoticed.     

Diurnal Variability of Lung Function and Its Association with Sleep among Patients with Asthma

This prospective exploratory story examined diurnal variations in pulmonary function and their association with sleep and quality of life (QOL) in 20 adult asthmatics. Peak expiratory flow (PEF) was assessed for 7 days, before bedtime and upon awakening. There was no association between PEF variability and QOL. Six of 13 polysomnographic measures were significantly correlated with overnight decline in PEF. Individuals with greatest decline took longer to fall asleep and enter Stage 1 sleep, spent less time asleep, and experienced poorer sleep efficiency. Diurnal variations in PEF reflect adverse sleep quality, yet impact on QOL is often unnoticed.     

Association of Variants in IL6-Related Genes with Lung Cancer Risk in Moroccan Population

Purpose

Lung cancer is known to be a complex multifactorial disease, involving both genetic and environmental factors. The study of the different signaling pathways and the identification of the genes involved, will contribute to further understanding the pathogenesis of the disease, thus allowing the development of appropriate targeted treatments. Recently, the link between cancer and inflammation has become more evident and inflammation has been proposed as the seventh hallmark of cancer. Previous studies have suggested that key cytokines involved in inflammation may have an important role in the etiology of lung cancer. The aim of this study was to investigate whether common variants in inflammation-related genes: IL-6, IL6-R, and IL6-ST, influence lung cancer risk in Moroccan population.

Materials and Methods

Single nucleotide polymorphisms (SNPs) in IL-6, IL6-R, and IL6-ST genes were assessed in 120 controls and 120 patients with confirmed lung cancer diagnosis. Genotyping analysis was performed with the TaqMan® allelic discrimination technology. The results were analyzed using SPSS 24.0 software.

Results

Among the studied SNPs, we found a significant association for the IL-6 (rs2069840) (OR = 1.63; 95% confidence interval 1.08–2.47; p = 0.01). No significant association was observed for the remaining SNPs of IL-6R (rs2228145) and IL-6ST (rs2228044) genes.

Conclusion

Our results suggest the IL-6 (rs2069840) polymorphism may influence the occurrence of lung cancer in Moroccan patients.

     

Elderly First Time Admitted Alcoholics: A Descriptive Study on Gender Differences in a Clinical Population

All patients ≥60 years of age who were first-time admitted to the Department of Alcohol Diseases in Malmö during 1988–1992 were investigated, a total of 218 men and 64 women. Several clinical variables were assessed addressing gender differences. The sex ratio (female:male) in this elderly population was compared with the corresponding ratio of one decade previously (1978-1982). The main findings were that similarities were more common than dissimilarities, except age of onset problem drinking that occurred significantly later in the female patients ( p < 0.05). Sex ratios indicated a significant convergence of female patients to that of males during 1988–1992, compared with one decade earlier (1:3.4 and 1:7.8, respectively; p < 0.01). The former ratio resembled the one found in the younger age groups. Conceivable explanations of the convergence are discussed herein.     

不同性别和年龄的非心肌损伤人群血清高敏心肌肌钙蛋白T水平差异

目的:研究非心肌损伤人群中血清高敏心肌肌钙蛋白T(hs-cTnT)水平是否有年龄和性别差异,为hs-cTnT在临床的更好应用提供理论基础。方法:回顾性分析2017年1月至2018年9月来我院因胸痛需检测血清hs-cTnT的就诊者资料。根据临床检查基本排除引起血清hs-cTnT水平升高的非心脏因素;根据临床症状和体征、心电图、血清hs-cTnT和N末端B型利钠肽原水平,初步排除心肌受损的因素。结果:共纳入29114例患者,其中男性占53.0%。分析结果显示,血清hs-cTnT水平整体呈偏态分布,中位数(四分位数间距)为7(4~19)ng/L。男性的血清hs-cTnT水平高于女性,差异有统计学意义(P<0.05)。不论男性还是女性,随着年龄增长,血清hs-cTnT水平逐渐升高,各年龄段之间的差异均有统计学意义(P均<0.05);随着年龄增长,血清hs-cTnT水平低于检测限的比例逐渐变低,女性中最高比例达37.10%,而男性中最高比例为20.36%。7岁以下儿童中,不同年龄段的血清hs-cTnT水平存在差异:1岁前较高,此后逐渐下降,6岁左右达到成年人水平。结论:在非心肌受损人群中,血清hs-cTnT水平随着年龄增长而升高;男性血清hs-cTnT水平高于同年龄的女性。随着年龄增长,血清hs-cTnT水平低于检测限的比例逐渐降低;与同年龄段男性相比,女性更不容易检测出hs�cTnT。7岁以下儿童不同年龄段的血清hs-cTnT水平有差异,1岁前较高,随着年龄增长逐渐下降,6岁达到成年人水平。     

Association of Psychiatric Disorders,Asthma and Lung Function in Early Adulthood

Objective. To examine the association between psychiatric disorders, asthma, and lung function in young adults. Study Design. Data were from the Mater–University of Queensland Study of Pregnancy (MUSP). The study was based on 2443 young adults (1193 male and 1250 female) for whom data were available on psychiatric disorders, asthma, and respiratory function. Life time and last 12 months’ generalized anxiety, panic, posttraumatic stress disorder (PTSD), and depressive disorders were assessed using a computerised version of the Composite International Diagnostic Interview (CIDI-Auto). A Spirobank G spirometer system was used to measure forced vital capacity (FVC), forced expiratory volume in one second (FEV₁), and forced expiratory flow between 25% and 75% of forced vital capacity (FEF_25–75%). Results. Participants with mental health disorders were more likely to have experienced asthma before or to use asthma medication at 21 years. However, for both males and females, life time and last 12 months’ experience of generalized anxiety, panic, PTSD, and depressive disorders were not statistically significantly associated with FVC, FEV₁, and FEF_25–75%, except a modest association with major depressive disorders for males. Conclusion. There is an association between mental health and asthma, but the relationship between mental health and lung function appeared to be confounded by the respondent's gender. More narrowly based prospective studies are required to determine the causal pathway between mental disorders and asthma.     

Gender and Age Impacts on the Association Between Thyroid Function and Metabolic Syndrome in Chinese

The relationship between thyroid dysfunction and metabolic syndrome (MS) is complex. We aimed to explore the impact of gender and age on their association in a large Chinese cohort.This cross-sectional study enrolled 13,855 participants (8532 male, 5323 female), who self-reported as healthy without any known previous diseases. Clinical data including anthropometric measurements, thyroid function, and serum metabolic parameters were collected. The associations between thyroid function and MS of both genders were analyzed separately after dividing thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and age into subgroups. MS risks were calculated by binary logistic regression models.Young males had significantly higher MS prevalence than females, yet after menopause, females had higher prevalence than males. Females had higher incidence of thyroid dysfunction than males. By using TSH quartiles as the categorical variables and the lowest quartile as reference, significantly increased MS risk was demonstrated in quartile 4 for males, yet quartiles 3 and 4 for females. By using FT3 quartiles as the categorical variables, significantly increased MS risk was demonstrated in quartile 2 to 4 for females only. By using age subgroups as the categorical variables, significantly increased MS risk was shown in both genders, with females (4.408–58.455) higher than males (2.588–4.943).Gender and age had substantial influence on thyroid function and MS. Females with high TSH and high FT3 had higher MS risks than males. Aging was a risk for MS, especially for females. Urgent need is necessary to initiate interventional programs.     

Gender Differences in the Association Between Romantic Relationships and Relapse Among Individuals in Early Recovery in Oxford House

Although clear gender differences exist in the effect of romantic relationships on substance use, little empirical evidence is available about whether romantic relationships affect recovery differently for men and women. To test potential gender differences in associations of romantic partner relationships with relapse among Oxford House residents. Self-reported presence or absence of a romantic relationship among Oxford House residents ages 18–59 (N = 306) in early recovery was assessed at baseline and 4 months later, beginning in 2001. Odds of relapse over 8 months was assessed by the interaction of presence of romantic relationship at each occasion and gender. Relapse was most common among men in a relationship at baseline and follow-up and women not in a relationship at either occasion, occurring with significantly greater odds than women in a relationship at both times, after adjusting for days of sobriety at baseline (adjusted odds ratio [OR_adjusted] = 3.50; 95% confidence interval [CI] [1.29, 9.51]; OR_adjusted: 3.35; 95% CI [1.24, 9.10]). These findings provide initial empirical understanding of gender differences in the influence of romantic relationships in early recovery.     

The Association Between Gastric Endoscopic Findings and Histologic Premalignant Lesions in the Iranian Rural Population

Atrophic gastritis, intestinal metaplasia, and gastric dysplasia are histologic premalignant lesions (PMLs). Correlation between the gastric endoscopic findings and histologic PMLs is not clear. This study was designed to determine the possible association of endoscopic findings and histologic PMLs.Over 28 months gastric endoscopic findings of consecutive rural patients with dyspepsia were categorized into 3 groups: 1—normal, 2—ulcerative with or without concurrent abnormality, 3—abnormal non-ulcerative. Biopsies of antrum and body were taken from all included patients and examined for the presence of histologic PMLs. Any mucosal abnormality was also biopsied.From 7340 evaluated patients, an overall of 1973 patients were included. 55.7% of patients were in group 1; 3.8% in group 2 and 40.5% in group 3. A within sex analysis showed that the majority of male patients were in PMLs subgroup (P < 0.001) likewise in groups 2 and 3 (P < 0.001). The prevalence of histologic PMLs in groups 2 and 3 was significantly higher than group 1 (P < 0:001) but the difference was not significant between groups 2 and 3 (P = 0.484). Mean (±SD) age of patient with PMLs was 50.25 ± 17.71 whereas in patients without PMLs was 41.16 ± 16.48 (P < 0.001).This study has showed that abnormal gastric endoscopic findings, male sex and increased age can be considered as risk factors of the formation of histologic PMLs. Until further investigations we propose that any abnormality on gastric mucosa (ulcerative or non-ulcerative) could be biopsied for the evaluation of probable histologic PMLs especially in old men.     

Individual Differences in the Biphasic Effects of Ethanol

Ethanol exerts both stimulant-like and sedative-like subjective and behavioral effects in humans depending on the dose, the time after ingestion and, we will argue, also on the individual taking the drug. This study assessed stimulant-like and sedative-like subjective and behavioral effects of ethanol during the ascending and descending limbs of the blood alcohol curve across a range of doses in nonproblem social drinkers. Forty-nine healthy men and women, 21 to 35 years old, consumed a beverage containing placebo or ethanol (0.2, 0.4, or 0.8 g/kg) on four separate laboratory sessions, in randomized order and under double-blind conditions. Subjective and behavioral responses were assessed before and at regular intervals for 3 hr after ingestion of the beverage. The lowest dose of ethanol (0.2 g/kg) only produced negligible subjective effects compared to placebo. The moderate dose (0.4 g/kg) increased sedative-like effects 90 min after ethanol ingestion but did not increase ratings of stimulant effects at any time. The highest dose (0.8 g/kg) increased ratings of both stimulant- and sedative-like effects during the ascending limb and produced only sedative-like effects during the descending limb. Closer examination of the data revealed that individual differences in response to the highest dose of ethanol accounted for this unexpected pattern of results: about half of the subjects reported stimulant-like effects on the ascending limb and sedative-like effects on the descending limb after 0.8 g/kg ethanol, whereas the other half did not report stimulant-like effects at any time after administration of ethanol. These results challenge the simple assumption that ethanol has biphasic subjective effects across both dose and time, and extend previous findings demonstrating individual differences in response to ethanol.     

Individual Differences in the Sedating Effects of Ethanol

Twenty-four healthy, normal-sleeping, males aged 21-35 were screened for basal levels of sleepiness using the Multiple Sleep Latency Test (MSLT). Twelve subjects had basal average daily sleep latencies of less than or equal to 6 min (sleepy) and 12 had latencies of greater than or equal to 16 min (alert) on the MSLT. Subjects consumed either ethanol (0.75 mg/kg) or placebo at 0900-0930 after spending 8 hr time in bed (TIB) the previous night. Sleep latency was measured at 1000, 1200, 1400, and 1600 hr. Divided attention performance and the Stanford Sleepiness Scale (SSS) were assessed at 1100 hr. Breath ethanol concentration (BEC) was determined prior to each latency test. Ethanol decreased average daily sleep latency, divided attention scores and SSS ratings. There were individual differences in the sedating and impairing effects of ethanol, related to subjects' basal level of sleepiness/alertness. The alert subjects exhibited longer sleep latencies and higher performance scores after ethanol administration than the sleepy subjects after placebo. Subjectively the groups had a similar level of sleepiness on placebo and were similarly sedated with ethanol.