Waist circumference,body mass index and glycated hemoglobin in Japanese men and women

AimsTo investigate the relationship of waist circumference and body mass index (BMI) with glycated hemoglobin (HbA_1c) concentrations and to define optimal cutoffs for these indices with respect to elevated HbA_1c (>5.8%).MethodsStudy subjects were 7731 Japanese men and women aged 50–74 years in Fukuoka City who participated in the baseline survey of a cohort study on lifestyle-related diseases. Linear regression analysis and logistic regression analysis were used with and without adjustment for age, smoking, alcohol use and physical activity. Receiver operating characteristic (ROC) curve analysis was performed to determine optimal cutoffs for the obesity indices.ResultsWaist circumference and BMI were linearly related to HbA_1c concentrations in men and women with almost the same magnitude in strength. With adjustment for the covariates, mean percent changes of HbA_1c per one standard deviation (S.D.) of waist circumference and BMI were 1.6% and 1.8% respectively in men, and 1.3% and 1.4% respectively in women. Adjusted odds ratios of elevated HbA_1c per one S.D. of waist circumference and BMI also showed statistically significant increases. Optimal cutoffs for waist circumference were 89 cm for men and 85 cm for women. The area under the ROC curve was much greater in women than in men.ConclusionsIn a population of middle-aged or elderly Japanese men and women, both waist circumference and BMI were strongly, positively associated with HbA_1c concentrations. The determined optimal cutoff points for waist circumference did not support the current Japanese criterion for abdominal adiposity.     

Consumption of filtered and boiled coffee and the risk of first acute myocardial infarction; a nested case/referent study

Background and aimIn northern Sweden, consumption of both filtered and boiled coffee is common. Boiled coffee, especially popular in rural areas, is known to raise blood lipids, a risk factor for acute myocardial infarction (MI). To our knowledge, only one epidemiological study, a case-control study from Sweden, has investigated boiled coffee in MI, noting an increased risk at high consumption levels in men, and no association in women. The aim of the present nested case-referent study was to relate consumption of filtered and boiled coffee to the risk of first MI.Methods and resultsThe study subjects were 375 cases (303 men, 72 women) and 1293 matched referents from the population-based Northern Sweden Health and Disease Study. Coffee consumption was assessed by food frequency questionnaire. Risk estimates were calculated by conditional logistic regression. A statistically significant positive association was found between consumption of filtered coffee and MI risk in men [odds ratio for consumption ≥4 times/day versus ≤1 time/day 1.73 (95% CI 1.05–2.84)]. In women, a similar association was observed, but for boiled coffee [odds ratio 2.51 (95% CI 1.08–5.86)]. After adjustment for current smoking, postsecondary education, hypertension, and sedentary lifestyle, the results for women were no longer statistically significant.ConclusionConsumption of filtered coffee was positively associated with the risk of a first MI in men. A similar tendency was observed for boiled coffee in women, but the result was not statistically significant in multivariate analysis. Further investigation in a larger study is warranted.     

Genetically Predicted Adiposity,Diabetes, and Lifestyle Factors in Relation to Diverticular Disease

Background & AimsAdiposity, type 2 diabetes, alcohol and coffee consumption, and smoking have been examined in relation to diverticular disease in observational studies. We conducted a Mendelian randomization study to assess the causality of these associations.MethodsIndependent genetic instruments associated with the studied exposures at genome-wide significance were obtained from published genome-wide association studies. Summary-level data for the exposure-associated single nucleotide polymorphisms with diverticular disease were available in the FinnGen consortium (10,978 cases and 149,001 noncases) and the UK Biobank study (12,662 cases and 348,532 noncases).ResultsHigher genetically predicted body mass index and genetic liability to type 2 diabetes and smoking initiation were associated with an increased risk of diverticular disease in meta-analyses of results from the two studies. The combined odds ratio of diverticular disease was 1.23 (95% confidence interval [CI], 1.14–1.33; P < .001) for a 1-standard deviation (~4.8 kg/m²) increase in body mass index, 1.04 (95% CI, 1.01–1.07; P = .007) for a 1-unit increase in log-transformed odds ratio of type 2 diabetes, and 1.21 (95% CI, 1.12–1.30; P < .001) for a 1-standard deviation increase in prevalence of smoking initiation. Coffee consumption was not associated with diverticular disease, whereas the association for alcohol consumption largely differed between the 2 studies.ConclusionsThis study strengthens the causal associations of higher body mass index, type 2 diabetes, and smoking with an increased risk of diverticular disease. Coffee consumption is not associated with diverticular disease. Whether alcohol consumption affects the risk of diverticular disease needs further investigation.     

Associations of endogenous testosterone and SHBG with glycated haemoglobin in middle-aged and older men

Objective Low circulating levels of testosterone and sex‐hormone‐binding globulin (SHBG) are associated with increased cardiovascular risk in men. This association may be partially mediated through changes in glucose metabolism, but relatively few data are available on the relationship between sex hormones and markers of long‐term glycaemia. We assessed the associations of endogenous testosterone and SHBG with glycated haemoglobin (HbA_1c) in men. Design and subjects Cross‐sectional study of 1292 men from the Norfolk population of European Prospective Investigation into Cancer (EPIC‐Norfolk). Measurements Glycated haemoglobin, total testosterone (TT) and SHBG levels were measured, and free testosterone (FT) levels were calculated. Multiple linear regression models were used to assess the associations of TT, SHBG and FT with HbA_1c. Results Men with diabetes had lower testosterone and SHBG levels. In non‐diabetic men, HbA_1c levels were inversely associated with TT and calculated FT independently of age, body mass index, smoking, alcohol consumption and physical activity. The adjusted change in HbA_1c was 0·055 (95% CI 0·025; 0·085) per standard deviation (SD) decrease in TT and 0·041 (95% CI 0·010; 0·073) per SD decrease in calculated FT, respectively. SHBG levels were inversely associated with HbA_1c after multivariable adjustment (β = 0·038 per SD decrease (95% CI 0·004; 0·071)). Conclusions In middle‐aged and older men, low endogenous testosterone and SHBG levels are associated with glycaemia, even below the threshold for diabetes. Further studies are needed to determine the effects of interventions that raise testosterone levels in men having increased HbA_1c and subnormal testosterone levels.     

Temporal sequence of incident cigarette,coffee, and alcohol use among AA participants

Background: Cigarettes and coffee are widely used psychoactive substances among alcoholics. Due to the devastating public health impact of alcohol use disorders, it is important to determine if using cigarettes or coffee may influence alcoholism. Previous studies indicate that cigarette smoking is associated with progression of alcohol dependence, but the effects of coffee drinking have yet to be investigated. Objectives: To retrospectively determine the temporal sequence of incident cigarette, coffee, and alcohol use and attributed subjective effects in AA participants. Methods: Volunteers at all Nashville open-AA meetings (n = 289 [126 women], completion rate = 94.1%) were administered a Lifetime Drinking History modified to also include lifetime cigarette and coffee consumption, as well as coffee consumption and effects questions, the Fagerstrom Test for Nicotine Dependence, and the Smoking Effects Questionnaire. Results: Average ages (years) at first regular use of alcohol, cigarettes, and coffee were 15.4 (IQR: 13.0–18.0), 16.7 (IQR: 13.0–18.5), and 18.5 (IQR: 14.0–23.5), respectively. In a subset who used all three substances (n = 236;102 women) alcohol consumption preceded cigarette smoking (p < .001) and coffee drinking (p < .001), and cigarette smoking preceded coffee drinking (p < .001); these relationships did not differ by gender. Conclusions: Recovering alcoholics started regular alcohol consumption prior to cigarette smoking and coffee drinking. Scientific Significance: In AA participants, coffee does not precede initiation of regular smoking or alcohol drinking as might be anticipated for a gateway drug.     

Smoking and alcohol consumption influence the risk of cardiovascular diseases in Korean adults with elevated blood pressure

Background and aimsCardiovascular disease (CVD) and hypertension are the main causes of global death. We aimed to investigate the independent and combined effects of smoking and alcohol consumption on CVD risk among Koreans with elevated blood pressure (BP).Methods and resultsAdults aged 20–65 years with elevated BP and without pre-existing CVDs were selected from the National Health Insurance Service-National Sample Cohort version 2.0. We followed up 59,391 men and 35,253 women between 2009 and 2015. The association of CVD incidence with smoking pack-years and alcohol consumption was investigated using the multivariate Cox proportional hazard model. Among women, smokers (10.1–20.0 pack-years) and alcohol drinkers (≥30.0 g/day) had higher CVD risks (hazard ratio [HR] = 1.15, 95% confidence intervals [CI] 1.06–1.25, HR = 1.06, 95% CI 1.00–1.12, respectively) compared to each referent group. However, men who smoked exhibited an increased CVD risk only with pack-years >20.0 (HR = 1.09, 1.03–1.14 and HR = 1.18, 1.11–1.26 for smokers with 20.1–30.0 and ≥ 30.1 pack-years, respectively) compared to nonsmokers. In the combined groups of those smoking and consuming alcohol, only nonsmoking men consuming alcohol 1.0–29.9 g/day had a lower CVD risk than did nonsmoking, nondrinking men (HR = 0.90, 0.83–0.97). Women smoking 1.0-10.0 pack-years and consuming alcohol ≥30.0 g/day had a higher CVD risk (HR = 1.25, 1.11–1.41) than nonsmoking and nondrinking women.ConclusionSmoking and alcohol consumption, independently and jointly, were associated with CVD risk in men and women. Women had a greater CVD risk than did men among Korean adults with elevated BP.     

Blood pressure, coffee, tea and tobacco consumption: an epidemiological study in Algiers

The connections and possible interactions between coffee consumption,tobacco consumption, blood pressure (BP), age, and body massindex (BMI) were analysed in a cross-sectional epidemiologicstudy of 1098 men and 393 women of the Algiers district. Systolicblood pressure (SBP) was negatively and significatively correlatedwith cigarette smoking. Diastolic blood pressure (DBP) was positivelyand significantly associated with coffee consumption (P<0.001)and negatively and significantly with cigarette consumption(P<0.001). These associations remained significant aftermultivariate analysis including sex, age, BMI, physical exertionat work, athletic activity, rural versus urban residency, tobacco,tea and coffee consumption. Coffee consumption and cigarettesmoking were positively associated (P<0.001). In the subgroupof men, the association between coffee consumption and DBP wassignificant only after adjustment for cigarette smoking. Inthe subgroup of women, containing a low percentage of smokers,this association was significant without such adjustment. Thisfinding suggests that cigarette consumption might partly maskthe association between coffee consumption and BP. The contradictoryinteractions observed between BP, cigarette consumption andcoffee consumption might help to explain the conflicting reportsconcerning the association between coffee consumption and ischemicheart disease.     

Glycated haemoglobin and cardiovascular risk factors in Chinese subjects with normal glucose tolerance

Increased plasma glucose concentration is a predictive factor for mortality in both diabetic and non-diabetic subjects. Although glycated haemoglobin (HbA_1c) is a useful index of mean blood glucose concentrations over the preceding 1 to 3 months, there are few data regarding its relationship to cardiovascular risk. We have examined the relationship between HbA_1c and cardiovascular risk factors in 1280 subjects with normal glucose tolerance. Based on HbA_1c tertiles (tertile 1: n = 427, 262 men and 165 women, HbA_1c level: 2.9–4.7 % in men and 3.2–4.2 % in women; tertile 2: n = 426, 261 men and 165 women, HbA_1c level: 4.7–5.1 % in men and 4.2–4.6 % in women; tertile 3: n = 427, 262 men and 165 women, HbA_1c level: 5.1–6.7 % in men and 4.6–6.9 % in women), increasing HbA_1c was associated with increasing age, blood pressure, waist–hip ratio, fasting and 2-h plasma glucose, 2-h insulin, cholesterol, low-density lipoprotein cholesterol, apolipo- protein B and urate concentrations. When age and sex were included as covariates, increasing HbA_1c remained associated with increasing fasting and 2-h plasma glucose, 2-h insulin, total cholesterol, and low-density lipoprotein cholesterol concentrations. These findings emphasize the importance of hyperglycaemia, as reflected by HbA_1c, as a continuum in the evaluation of cardiovascular risk. Furthermore, these findings support the hypothesis that cardiovascular disease risk commences with rising glucose concentrations before ‘conventionally-defined’ glucose intolerance occurs. © 1998 John Wiley & Sons, Ltd.     

Coffee, tea, and caffeine consumption and risk of rheumatoid arthritis: results from the Iowa Women's Health Study

OBJECTIVE: To evaluate whether coffee, tea, and caffeine consumption are risk factors for rheumatoid arthritis (RA) onset among older women. METHODS: These factors were evaluated in a prospective cohort study that was initiated in 1986 and that included 31,336 women ages 55-69 years without a history of RA. Risk factor data were self-reported using a mailed questionnaire. Through 1997, 158 cases of RA were identified and validated against medical records. The relative risk (RR) and 95% confidence interval (95% CI) were used as the measures of association and were adjusted for age, alcohol use, smoking history, age at menopause, marital status, and the use of hormone replacement therapy. RESULTS: Compared with those reporting no use, subjects drinking > or =4 cups/day of decaffeinated coffee were at increased risk of RA (RR 2.58, 95% CI 1.63-4.06). In contrast, women consuming >3 cups/day of tea displayed a decreased risk of RA (RR 0.39, 95% CI 0.16-0.97) compared with women who never drank tea. Caffeinated coffee and daily caffeine intake were not associated with the development of RA. Multivariable adjustment for a number of potential confounders did not alter these results. The associations of RA onset with the highest categories of decaffeinated coffee consumption (RR 3.10, 95% CI 1.75-5.48) and tea consumption (RR 0.24, 95% CI 0.06-0.98) were stronger in women with seropositive disease compared with those with seronegative disease (RR 1.54, 95% CI 0.62-3.84 and RR 0.93, 95% CI 0.27-3.20, respectively). CONCLUSION: Decaffeinated coffee intake is independently and positively associated with RA onset, while tea consumption shows an inverse association with disease onset. Further investigations of decaffeinated coffee and tea intake as arthritis risk factors are needed to verify these findings and explore their biologic basis.     

Modifiable lifestyle factors in women with Takotsubo syndrome: A case-control study

BackgroundThere is limited information on the relationship between modifiable lifestyle factors and Takotsubo syndrome (TS).ObjectivesTo determine the association of physical activity, smoking, alcohol use, and caffeinated coffee consumption with TS.MethodsThis case-control study enrolled women with newly diagnosed TS (n = 45), women post-myocardial infarction (MI; n = 32), and healthy women volunteers (HC; n = 30). Information on physical activity, smoking, alcohol use, and caffeinated coffee consumption was collected 1-month post-discharge for TS and MI, and 1-month post-enrollment for HC.ResultsTS women reported a higher prevalence of lifetime smoking and cigarette packs/day, greater coffee consumption, and less physical activity than HC. Associations with cigarette and coffee use remained significant in adjusted models. Physical activity, smoking, and coffee consumption were similar in TS and MI women.ConclusionsUse of psychostimulants (caffeine and cigarettes) may play a role in TS pathophysiology. These findings need to be confirmed in larger, fully powered studies.     

Coffee and tea consumption, dietary fat intake and serum cholesterol concentration of Finnish men and women

The association between the consumption of coffee and tea and serum cholesterol concentration was studied in a population sample of 653 men and 695 women from east and south-west Finland. Cholesterol and high density lipoprotein (HDL) cholesterol were determined from fresh serum samples. Smoking and the intake of coffee, tea and alcohol were assessed by a questionnaire, and nutrient intake was determined from 3-day food records. Serum cholesterol and non-HDL cholesterol showed a positive and linear association with coffee consumption in men. In women, no such significant linear association was evident, although the highest mean serum cholesterol levels were found in subjects consuming seven to nine cups of coffee daily. Both in men and in women coffee consumption was positively associated with smoking and the intake of saturated and monounsaturated fatty acids and cholesterol. Serum cholesterol values, adjusted for age, body mass index, smoking, dietary cholesterol, fatty acids, alcohol and physical activity, showed a significant linear association with coffee consumption in men but not in women. Although coffee consumption and high intake of saturated fatty acids and cholesterol were related both in men and in women, adjustment for dietary and other confounding factors did not remove the association between coffee consumption and serum cholesterol concentration in men.     

Smoking, alcohol consumption, and Raynaud's phenomenon in middle age

Background

Data suggest Raynaud’s phenomenon shares risk factors with cardiovascular disease. Studies of smoking, alcohol consumption, and Raynaud’s have produced conflicting results and were limited by small sample size and failure to adjust for confounders. Our objective was to determine whether smoking and alcohol are independently associated with Raynaud’s in a large, community-based cohort.

Methods

By using a validated survey to classify Raynaud’s in the Framingham Heart Study Offspring Cohort, we performed sex-specific analyses of Raynaud’s status by smoking and alcohol consumption in 1840 women and 1602 men. Multivariable logistic regression analyses were used to examine the relationship of Raynaud’s to smoking and alcohol consumption.

Results

Current smoking was not associated with Raynaud’s in women but was associated with increased risk in men (adjusted odds ratio [OR] 2.59, 95% confidence interval [CI], 1.11-6.04). Heavy alcohol consumption in women was associated with increased risk of Raynaud’s (adjusted OR 1.69, 95% CI, 1.02-2.82), whereas moderate alcohol consumption in men was associated with reduced risk (adjusted OR 0.51, 95% CI, 0.29-0.89). In both genders, red wine consumption was associated with a reduced risk of Raynaud’s (adjusted OR 0.59, 95% CI, 0.36-0.96 in women and adjusted OR 0.30, 95% CI, 0.15-0.62 in men).

Conclusions

Our data suggest that middle-aged women and men may have distinct physiologic mechanisms underlying their Raynaud’s, and thus sex-specific therapeutic approaches may be appropriate. Our data also support the possibility that moderate red wine consumption may protect against Raynaud’s.     

Smoking and Asthma in Men and Women with Normal Weight,Overweight, and Obesity

Background. There is a complex interrelationship among smoking, body weight, and asthma. It needs to be clarified whether smoking is related to an increased risk of asthma after taking into account for relative body weight. Objective. To examine the association between cigarette smoking and the prevalence of asthma in Canadian men and women with normal weight, overweight, and obesity. Methods. The analysis was based on data from 112,830 Canadians aged 18 years or more who participated in a national survey in 2007–2008. A questionnaire covered the information on prevalent asthma, smoking status, height, weight, and other factors. Logistic regression analysis was used to determine the association between smoking and the prevalence of asthma stratified by sex and body mass index (BMI). Results. The crude prevalence of asthma was 6.6% for men and 9.3% for women. After adjustment for covariates, the odds ratios (ORs) for current smoking associated with asthma was 1.20 [95% confidence interval (CI): 1.01–1.43] for men with normal weight, 0.98 (95% CI: 0.81, 1.18) for overweight men, and 1.02 (95% CI: 0.80–1.30) for obese men. For women, the corresponding adjusted ORs were 1.41 (95% CI: 1.23–1.62), 1.27 (95% CI: 1.05–1.54), and 1.28 (95% CI: 1.03–1.59), respectively. Conclusion. Current smoking was significantly associated with prevalent asthma in all women regardless of their relative body weight. In men, however, the association was only observed in those with under- or normal weight.     

Arterial hypertension and glycemia in non‐diabetic subjects: is there an association independent of obesity?

Background

A possible association of glycemia with arterial hypertension has been suggested by the frequent co‐occurrence of impaired glucose tolerance or Type 2 diabetes mellitus with arterial hypertension. The objective was to examine the relationship of glycated hemoglobin (HbA_1c) concentration with arterial hypertension status in non‐diabetic subjects.

Methods

A cross‐sectional analysis of baseline data from the EPIC‐Potsdam Cohort Study, Germany, was performed. The study population comprised 1846 non‐diabetic subjects, 772 men and 1074 women, age 35–65. Blood pressure was measured three times consecutively. Level of HbA_1c was determined by an assay based on monoclonal antibodies. Body height, weight and circumferences were obtained. Arterial hypertension status was either determined through blood pressure measurement (blood pressure ≥160/95 mmHg) or based on antihypertensive drug use. HbA_1c was divided into sex‐specific quintiles and logistic regression was used to estimate the odds of being hypertensive and the corresponding confidence intervals.

Results

The highest compared to the lowest quintiles of HbA_1c were in univariate analysis associated with being hypertensive. Adjustment for age and body mass index completely removed any significant association with arterial hypertension status. The odds ratio in men was 1.1 (95% CI 0.7–1.8), and in women it was 0.9 (95% CI 0.5–1.4). Repeating the analysis with systolic and diastolic blood pressure among untreated hypertensives yielded similar results.

Conclusion

Unlike previous studies, our data do not support an association of HbA_1c with arterial hypertension that is statistically independent of age and body mass index. Whether these established arterial hypertension risk factors are truly confounders of the HbA_1c‐arterial hypertension association or rather potentially antecedent factors requires further study. Copyright © 1999 John Wiley & Sons, Ltd.

     

Dysglycaemia and the risk of acute myocardial infarction in multiple ethnic groups: an analysis of 15,780 patients from the INTERHEART study

Aims/hypothesis

Although diabetes is an established risk factor for myocardial infarction (MI), disease control may vary. HbA_1c is a reliable index of ambient glucose levels and may provide more information on MI risk than diabetes status.

Methods

The relationship between HbA_1c levels in MI patients and controls who participated in the 52 country INTERHEART study was analysed.

Results

In 15,780 participants with a HbA_1c value (1,993 of whom had diabetes), the mean (SD) levels for HbA_1c were 6.15% (1.10) in the 6,761 MI patients and 5.85% (0.80) in the control participants. After adjustment for age, sex and nine major MI risk factors (including diabetes), higher HbA_1c fifths above the lowest fifth (HbA_1c <5.4%) were associated with progressively higher OR of MI, with OR for the highest HbA_1c fifth (≥6.12%) being 1.55 (95% CI 1.37–1.75). When analysed as a continuous variable after adjustment for the same factors, every 1% higher HbA_1c value was associated with 19% (95% CI 14–23) higher odds of MI, while every 0.5% higher HbA_1c was associated with 9% higher odds of MI (95% CI 7–11). Concordant relationships were noted across subgroups, with a higher OR noted in younger people, patients without diabetes or hypertension, and those from some regions and ethnicities.

Conclusions/interpretation

The HbA_1c value provides more information on MI odds than self-reported diabetes status or many other established risk factors. Every 1% increment independently predicts a 19% higher odds of MI after accounting for other MI risk factors including diabetes.     

Cigarette smoking, alcohol consumption, and risk of ARDS: a 15-year cohort study in a managed care setting

STUDY OBJECTIVE: To examine the association of cigarette smoking and alcohol consumption with hospital presentation of ARDS in a well-defined, multiethnic population. DESIGN: Retrospective cohort study. SETTING: Health maintenance organization in Northern California. PARTICIPANTS: A total of 121,012 health plan subscribers (54.2% women), aged 25 to 89 years. OUTCOME MEASURE: Hospital presentation of ARDS (validated by medical chart review) from baseline in 1979 to 1985 through the end of 1993 (median, 9.9 years). RESULTS: There were 56 cases of ARDS (33 in men, 23 in women). The case fatality rate was 39% in both genders. ARDS was independently related to increasing age (rate ratio of 10 years, 1.38; 95% confidence interval [CI], 1.12 to 1.71), to current smoking of < 20 cigarettes/d (rate ratio vs never cigarette smokers, 2.85; 95% CI, 1. 23 to 6.60), and to current cigarette smoking of > or = 20 cigarettes/d (rate ratio vs never smokers, 4.59; 95% CI, 2.13 to 9.88). No association was observed between alcohol consumption and ARDS. CONCLUSIONS: The results of this study suggest a relationship (with evidence of dose-response effect) between cigarette smoking and ARDS. Assuming a causal relationship, approximately 50% of ARDS cases were attributable to cigarette smoking.     

Infección por Helicobacter pylori y su asociación con el consumo de alcohol. Estudio de casos y controles

IntroductionThere is a high prevalence worldwide of Helicobacter pylori (Hp) infection associated with gastritis and extending to gastric cancer. Reports have suggested that alcohol has antibacterial action and that its concentration and the amount consumed reduce the risk for Hp infection. In contrast, different studies suggest that tobacco and coffee consumption are risk factors for Hp infection, but their results are controversial.AimsTo compare the frequency of alcohol consumption in patients infected by Hp with that of non-infected subjects and, as a secondary aim, to compare the association of smoking and coffee consumption with Hp infection.Material and methodsA case-control study was conducted on Sinaloa State workers that underwent endoscopy and the Hp serology test. Cases were defined as patients with a positive Hp serology test or a positive biopsy with the rapid urease test. Alcohol consumption was categorized as: no consumption, low-risk, and at-risk. The sample included 269 subjects per group. Odds ratio (OR) and 95% confidence interval (CI) were calculated.ResultsIn both groups, the mean age of the subjects was 45.7 (SD: 9) years (P=.99), 139 of the subjects were women (51.7%) and 130 were men (48.3%); alcohol consumption was present in 108 (40.1%) and 85 (31.6%) of the cases and controls, respectively (P=.039), OR 1.45 (95%CI 1.019-2.069). The quantity of grams of alcohol in subjects with at-risk consumption was significant; However, there were no significant differences in relation to smoking and coffee consumption between the groups.ConclusionsAn association between alcohol consumption and HP infection was observed and no relation with HP infection was found with respect to smoking and coffee consumption.     

Diabetes mellitus defined by hemoglobin A1c value: Risk characterization for incidence among Japanese subjects in the JPHC Diabetes Study

Aims/Introduction: Although several risk factors for type 2 diabetes have been identified, most of them have been identified in studies on Western populations, and they should be evaluated in a Japanese population. In 2010, new diagnostic criteria for diabetes mellitus using hemoglobin A1c (HbA_1c) were released and its use in epidemiological studies has many advantages. The aim of the present study was to evaluate risk factors for type 2 diabetes defined based on HbA_1c values in a Japanese population. Materials and Methods: A total of 9223 subjects (3076 men and 6147 women) were followed up for 5 years. Diabetes was defined based on self‐report or HbA_1c value. Risk factors for diabetes were evaluated as odds ratios adjusted for potential confounding factors by logistic regression. Results: During the 5‐year follow‐up period, we documented 518 incident cases of diabetes (232 men and 286 women). Of the 518 incident cases, 310 cases were diagnosed by HbA_1c alone. Among the men, age, smoking (both past smoking and current smoking) and family history of diabetes significantly increased the risk of diabetes. Among the women, body mass index, family history of diabetes and hypertension significantly increased the risk of diabetes. These results did not change markedly after adjustment for the baseline HbA_1c values, and the baseline HbA_1c value itself was a significant risk factor for diabetes mellitus. Conclusions: Known risk factors for diabetes established in Western populations also increased the risk of diabetes in a Japanese population defined on the basis of HbA_1c values. (J Diabetes Invest, doi: 10.1111/j.2040‐1124.2011.00119.x, 2011)     

Coffee consumption and incidence of impaired fasting glucose,impaired glucose tolerance,and type 2 diabetes: the Hoorn Study

Aims/hypothesis Coffee contains several substances that may affect glucose metabolism. The aim of this study was to evaluate the relationship between habitual coffee consumption and the incidence of IFG, IGT and type 2 diabetes.Methods We used cross-sectional and prospective data from the population-based Hoorn Study, which included Dutch men and women aged 50–74 years. An OGTT was performed at baseline and after a mean follow-up period of 6.4 years. Associations were adjusted for potential confounders including BMI, cigarette smoking, physical activity, alcohol consumption and dietary factors.Results At baseline, a 5 cup per day higher coffee consumption was significantly associated with lower fasting insulin concentrations (–5.6%, 95% CI –9.3 to –1.6%) and 2-h glucose concentrations (–8.8%, 95% CI –11.8 to –5.6%), but was not associated with lower fasting glucose concentrations (–0.8%, 95% CI –2.1 to 0.6%). In the prospective analyses, the odds ratio (OR) for IGT was 0.59 (95% CI 0.36–0.97) for 3–4 cups per day, 0.46 (95% CI 0.26–0.81) for 5–6 cups per day, and 0.37 (95% CI 0.16–0.84) for 7 or more cups per day, as compared with the corresponding values for the consumption of 2 or fewer cups of coffee per day (p=0.001 for trend). Higher coffee consumption also tended to be associated with a lower incidence of type 2 diabetes (OR 0.69, CI 0.31–1.51 for 7 vs 2 cups per day, p=0.09 for trend), but was not associated with the incidence of IFG (OR 1.35, CI 0.80–2.27 for 7 vs 2 cups per day, p=0.49 for trend).Conclusions/interpretation Our findings indicate that habitual coffee consumption can reduce the risk of IGT, and affects post-load rather than fasting glucose metabolism.     

An increase in HbA1c after percutaneous coronary intervention raises the risk for restenosis in patients without Type 2 diabetes mellitus

Aims The influence of dynamic changes in glycated haemoglobin (HbA_1c) on restenosis after elective percutaneous coronary intervention (PCI) in patients without diabetes has not been analysed. Therefore, the rate of restenosis was investigated after elective PCI in 101 consecutive patients without diabetes mellitus in relation to dynamic changes of HbA_1c levels. Methods Follow‐up angiography was performed in all patients 4–6 months after intervention. Results Multivariate analysis demonstrated that the change in HbA_1c between first and second coronary angiography was the most powerful metabolic parameter for prediction of restenosis. The odds ratio for restenosis was 3.0 (95% CI 1.0–9.0) for any increase in HbA_1c and 1.9 (95% CI 1.1–3.5) for an HbA_1c increase of 0.2%. Conclusions Hence, chronic changes in the glucometabolic environment influence the incidence of restenosis after PCI in patients without diabetes.