Macronutrient intakes of elderly in the Lipid Research Clinics Program Prevalence Study

As part of the Lipid Research Clinics (LRC) Program Prevalence Study of coronary heart disease risk factors, nutrient intakes of two US populations over 59 years of age were determined by 24-hour recalls in the 1970s. Characteristics of the populations were (1) California: suburban, upper-middle class, 95% high school graduates, 10% blue collar occupations; (2) Oklahoma: rural lower-middle class, 75% high school graduates, and 40% blue-collar occupations. Macronutrients consumed by both populations were similar, except for alcohol. For both men and women, energy intake was approximately 25 kcal/kg/day (body weight) sources of energy were approximately 40% from carbohydrate, 16% from protein, 37% from fat, and 4% from alcohol. The Oklahoma population, however, consumed significantly less alcohol than did Californians. Percentages of calories from fatty acids were approximately 14% from saturated and 6% from polyunsaturated, which yielded a polyunsaturated: saturated ratio of 0.48. The intake of cholesterol for women was 190 mg/1000 kcal and for men, 210 mg/1000 kcal. Between the ages of 60 and 69, the Oklahoma men consumed more energy than did the California men. Both sexes demonstrated lower energy intakes with advancing age and with increasing body mass index. The higher energy intake of the Oklahoma cohort aged 60-69 was attributed to the greater physical demands of their occupations, but this difference disappeared after age 70. The California and Oklahoma women had similar caloric intakes beyond age 60. In summary, the LRC findings suggest that geographically diverse American populations consumed in the late 1970s remarkably similar intakes of macronutients and cholesterol, with the only major exception being energy from alcoholic beverages.     

The prevalence and correlates of Rose Questionnaire angina among women and men in the Lipid Research Clinics Program Prevalence Study population

The prevalence and correlates of Rose Questionnaire angina were investigated in a sample of 4,661 white woman and men aged 30 years and above who participated in the Lipid Research Clinics Program Prevalence Study 1972-1976. Among men, the prevalence of Rose angina increased with age from about 1% to 12%, while the prevalence among women ranged from about 3% to 6%. Young women compared with men also had a relatively high prevalence of dyspnea, which was strongly correlated with Rose angina in both sexes. For women and men younger than 50 years, the dyspnea-Rose angina odds ratio was about 6 (p less than 0.001), while older women and men had somewhat lower sand higher odds ratios, respectively. Major and minor resting electrocardiographic abnormalities and self-reported history of a heart attack were not significantly associated with Rose angina among young participants of either sex, but they did show positive associations among older participants with the exception of minor electrocardiographic abnormalities in men. A logistic regression analysis revealed a strong inverse association between high density lipoprotein cholesterol and Rose angina in both sexes. Because mortality studies consistently show an excess of coronary heart disease death among young men compared with women, the female excess of Rose angina at young ages suggests that the grouping of angina and myocardial infarction into a single endpoint in cardiovascular disease studies may be more appropriate for young men than for young women.     

Effect of estrogen/progestin potency on clinical chemistry measures. The Lipid Research Clinics Program Prevalence Study

The effects of oral contraceptives of varied estrogen/progestin composition on clinical measurements of hepatic, thyroid, and renal function and carbohydrate metabolism were examined in 1,355 women in the Lipid Research Clinics Program Prevalence Study. In general, bilirubin and alkaline phosphatase levels are lower with both oral contraceptives and postmenopausal estrogen use, suggesting an estrogen effect. The least bilirubin reduction is seen with a progestin dominant oral contraceptive. A significant decrement in aspartate aminotransferase is observed in users of one high estrogen dose oral contraceptive and in postmenopausal Premarin users, while aspartate aminotransferase is higher in postmenopausal users of higher dose ethinyl estradiol. Globulins are slightly higher in all hormone use categories, suggesting an estrogen effect on hepatic secretion of this protein class into the circulation. Fasting glucose concentrations are generally slightly lower even in the progestin dominant oral contraceptives, where glucose intolerance has been described. Thyroxine concentrations are generally elevated in all women using oral contraceptives. A relationship to estrogen dose is seen in women with thyroxine concentrations greater than the 99th percentile and in postmenopausal estrogen users. Creatinine concentration is greater with the use of Ovral, a progestin dominant oral contraceptive, and lower with two estrogen dominant oral contraceptives and Premarin, suggesting a competitive effect of estrogen and progestin. Among the clinical laboratory tests considered here, oral contraceptive effects seem to be largely estrogen mediated with a suggestion of competitive effect of estrogen versus progestin only on bilirubin and creatinine levels. These observations differ from lipoproteins where opposing hormonal effects are more clearly reflected in changing lipoprotein concentrations.     

Cancer mortality and lipid and lipoprotein levels. Lipid Research Clinics Program Mortality Follow-up Study

The associations of serum lipid and lipoprotein levels with the risk of cancer mortality were assessed in 2,753 men and 2,476 women aged 40-79 years at baseline (1972-1976) who participated in the Lipid Research Clinics Program Mortality Follow-up Study through 1984. Seventy-nine cancer deaths occurred in men and 65 occurred in women during an average follow-up time of 8.4 years. Total cholesterol and low-density lipoprotein (LDL) cholesterol were significantly inversely associated with overall cancer mortality in men, but no relation was observed in women. Neither high-density lipoprotein (HDL) cholesterol nor triglycerides were significantly related to total cancer mortality in either sex, although in women. HDL cholesterol was positively associated with risk of death from gynecologic cancers. Compared with men with higher cholesterol levels, the relative risk of death from colon cancer, adjusted for age, body mass, cigarette smoking, and alcohol consumption, was 5.20 (95 percent confidence interval (Cl) 1.61-16.8) in men with total cholesterol levels less than or equal to 187 mg/dl and 4.79 (95 percent CI 1.37-16.8) in those with LDL cholesterol levels less than or equal to 119 mg/dl. Death from smoking-related cancers was inversely related to baseline total cholesterol but not to LDL cholesterol. The absence of an association with HDL cholesterol, which has been shown to be lower in persons with clinically manifest malignancy, and evidence from survival curves suggest that the inverse relation in men is not due to preexisting disease.     

Parent-offspring aggregation of plasma lipids in selected populations in North America and Israel. The Lipid Research Clinics Prevalence Study

Parent-offspring associations of total cholesterol and triglycerides were compared between family dyads in six North American populations examined between 1972 and 1976 as part of the North American Lipid Research Clinics Prevalence Study and those from families examined between 1976 and 1979 at the Lipid Research Clinic located in Jerusalem. Common study design, protocol, and laboratory techniques were used by all Lipid Research Clinics. The authors first examined homogeneity of familial correlations across clinics in the North American population and across origin groups in the Israeli sample. In general, correlations were homogeneous across clinics and origin groups, except for parent-daughter pairs for triglycerides in North America. The pooled familial correlations were similar in the two study populations. There was no asymmetry in parent-offspring correlations by the sex of the offspring. The pooled mother-child correlations were significantly higher than father-child values in the North American sample only. The strength of parent-offspring similarity showed no consistent pattern of change with level of education of parents in either study group. Patterns of familial similarity are discussed in relation to genetic, cultural, and environmental differences between the two study populations.     

The relation of drinking and smoking habits to diet: the Lipid Research Clinics Prevalence Study

The relation of cigarette smoking and alcohol use to diet was examined in a general population of adults ages 20-59 years enrolled in the Lipid Research Clinics (LRC) Prevalence Study. There was a positive association between cigarette and alcohol use, but little relation between these habits and the nutrient intake. The total energy from food was about the same whether or not a person drank or smoked; alcohol was simply added to food intake. However, persons who drank received slightly less of their food energy from carbohydrate than persons who did not drink and persons who smoked received slightly more of their food energy from fat than did nonsmokers. Both persons who drank and persons who smoked weighed less than would be expected from their total energy intake. While these relationships were similar for men and women, among women they were stronger for those using gonadal hormones than among those not using these hormones.     

Contrasting diet and body mass among users and nonusers of oral contraceptives and exogenous estrogens: the Lipid Research Clinics Program Prevalence Study

Mean dietary constituent levels using the 24-hour recall method and body mass measures were examined among oral contraceptive and exogenous estrogen users and nonusers in the Lipid Research Clinics Program Prevalence Study. Among women aged 20-44 years, oral contraceptive users had a significantly lower mean Quetelet index of body mass and triceps skinfold thickness and a significantly higher total caloric intake. Among women aged 45-69 years, those taking exogenous estrogens had a significantly lower mean Quetelet index. No significant differences between hormone users and nonusers were seen for per cent of calories from fat (saturated or unsaturated), protein, carbohydrates, starch, sucrose, or alcohol. The higher total caloric intake in oral contraceptive users in contrast to nonusers and the lower body mass in both groups of gonadal hormone users may in part be indicative of other differences in life-style and behavior between the study groups. Further documentation of specific eating patterns, nutrient intake, and energy metabolism in women consuming gonadal hormones and in suitable control subjects seems to be indicated.     

High density lipoprotein cholesterol as a predictor of cardiovascular disease mortality in men and women: the follow-up study of the Lipid Research Clinics Prevalence Study

With data from the Lipid Research Clinics Prevalence Study used as a baseline, an average of 8.4 years of mortality follow-up has been completed for 8,825 male and female participants who were at least 30 years of age at the time of the study. The participants were examined at 10 North American sites during 1972-1976. Univariate findings for high density lipoprotein (HDL) cholesterol in the 7,569 persons initially free of coronary heart disease indicate an inverse relation with cardiovascular disease mortality for men and women. Controlling for age, low density lipoprotein (LDL) cholesterol, triglycerides, body mass index, systolic blood pressure, and smoking, multivariate analysis results indicate inverse relations between HDL cholesterol and cardiovascular disease mortality. In men, the cardiovascular disease mortality rate ratio for HDL cholesterol increments of 10 mg/dl was similar to the cardiovascular disease mortality rate ratio for LDL cholesterol increments of 30 mg/dl. In women, HDL cholesterol is more closely related to cardiovascular disease than is LDL cholesterol. HDL cholesterol is inversely related to both coronary heart disease and other cardiovascular disease mortality in both sexes, though the relation of HDL cholesterol with coronary heart disease mortality in women approached statistical significance only for the combined end point of suspect and definite cases. No relation was observed in either sex group between HDL cholesterol and noncardiovascular disease mortality. This study, only the second large prospective study evaluating the role of HDL cholesterol in women, confirms both the importance and the independence in both men and women of HDL cholesterol in the epidemiology of coronary heart disease and other cardiovascular disease mortality.     

Nutrient intake, lipids, and lipoprotein cholesterols in black and white children: the Lipid Research Clinics Prevalence Study

Our specific aim was to assess differences in nutrient intake and in lipids and lipoprotein cholesterols between blacks and whites in 259 black children (129 boys, 130 girls) and in 811 white children (424 boys, 387 girls) ages 5-19. The nutrient intake data were obtained by 24-hr recall from the Houston and Cincinnati Lipid Research Clinics. The fundamental nutrient differences between blacks and whites were in total calories and in calories per kilogram of body weight, both of which were uniformly and significantly lower among black than white boys and generally, but less consistently and significantly, lower among black than white girls. No racial differences in total cholesterol or cholesterol intake per kilogram body weight were observed. After statistically controlling for education of the head of household, there were no consistent significant racial differences in Quetelet index. There was no significant independent effect of education of head of household on the children's caloric intake and racial differences in socioeconomic status did not appear to systematically account for differences in total energy intake. In aggregate, black children had lower triglyceride and very-low-density lipoprotein cholesterol levels, and higher levels of high-density lipoprotein cholesterol than whites; there were no significant differences by race in low-density lipoprotein cholesterol levels. Race was a significant independent explanatory variable for high-density lipoprotein cholesterol levels (higher in blacks) and for very-low-density lipoprotein and triglyceride levels (higher in whites) (P less than 0.005), after covariance adjusting for education of head of household, sex, age, Quetelet index, calories, saturated fat (g/day/kg body wt), and clinic. Lower caloric intake among blacks compared with whites, the major nutrient difference in the current study, did not account for differences in lipoprotein cholesterol levels between the two groups.     

Nutrient intakes among selected North American populations in the Lipid Research Clinics Prevalence Study: composition of energy intake

Mean energy intake and its components are presented for 4,568 white adults, 20-59 years, who participated in a population survey at nine North American Lipid Research Clinics (LRC). Nutrient intake was evaluated by a 24-hour dietary recall. Mean energy intakes ranged from 3200 kcal at age 20 to 2400 kcal at age 59 for men (2150-1650 for women). Protein intake, about 15% of energy intake, exceeded 1 g/kg body weight at all ages. Carbohydrate intake was about 40-45% of kcal, starch provided 14-20%, and estimated sucrose intake provided about 6-14%. Sex- and age-related differences varied for each macronutrient. Mean alcohol intake, for those reporting alcohol consumption, contributed 6-18% of energy for women, and 8-15% for men. Comparisons are made with data from the Health and Nutrition Examination Survey I and from the USDA Nationwide Food Consumption Survey, with the Recommended Dietary Dietary Allowances, and with the Dietary Goals.     

Nutrient intakes among selected North American populations in the Lipid Research Clinics Prevalence Study: composition of fat intake

Components of fat and their relationship to total energy are described for 2,368 white male and 2,200 white female adults, aged 20-59 years, for whom 24-hour dietary recalls were completed between 1972 and 1975 in nine North American populations as a part of the Lipid Research Clinics (LRC) Program Prevalence Study. Men had higher absolute intakes of total fat and cholesterol than women, although both sexes consumed diets similar in relative composition of polyunsaturated, saturated, and monounsaturated fatty acids. Marked geographical differences in intakes of energy, total fat, and dietary cholesterol were observed. Compared with data from dietary surveys conducted in the 1960's the LRC data showed that consumption of cholesterol had decreased by the early 1970's, whereas consumption of polyunsaturated fatty acids appears to have increased, resulting in a higher ratio of polyunsaturated to saturated fatty acids. However, comparison of current dietary guidelines with these data, which are based on a single dietary recall, showed that few LRC participants met the recommendations of the Senate Select Committee on Nutrition and Human needs for dietary fat intake.     

The association of corneal arcus with coronary heart disease and cardiovascular disease mortality in the Lipid Research Clinics Mortality Follow-up Study.

The relationship between corneal arcus (arcus senilis) and mortality from coronary heart disease (CHD) and cardiovascular disease (CVD) is examined in a prospective study of White men (n = 3,930) and women non-hormone users (n = 2,139), ages 30-69, followed for an average of 8.4 years as part of the Lipid Research Clinics Mortality Follow-up Study. After excluding those with clinically manifest CHD at baseline, corneal arcus was strongly associated with CHD and CVD mortality only in hyperlipidemic men ages 30-49 years, for whom the relative risk for CHD and CVD death was 3.7 and 4.0, respectively, after adjusting for age, total cholesterol, HDL cholesterol, and smoking status using a Cox proportional hazards model. Among 30-49 year old males, corneal arcus appears to be a prognostic factor for CHD, independent of its association with hyperlipidemia in this age-group, of about the same magnitude as other common risk factors, underscoring the usefulness of corneal arcus as a prognostic factor to the practicing clinician.     

广州市男男性行为者rush poppers使用情况及影响因素研究

目的 了解广州市男男性行为者（men who have sex with men, MSM）rush poppers使用情况及影响因素,为制定相关防控措施提供依据。方法 采用现况研究方法,于2017年5 - 11月通过非概率抽样招募广州市MSM进行匿名电子问卷调查,获取社会人口学特征、近6个月性伴和性行为特征、发生性行为前rush poppers使用情况等信息。使用χ2检验和非条件logistic回归分析rush poppers使用的影响因素。结果 近6个月,广州市MSM rush poppers使用率为34.84%（340/976）。多因素logistic回归分析结果显示,近6个月,有同性多性伴（aOR = 1.72, 95%CI:1.24～2.38）、有同性临时性伴（aOR = 2.05, 95%CI:1.49～2.82）、发生性行为前饮酒（aOR = 1.87, 95%CI:1.40～2.50）及近一年曾被诊断患有性病（aOR = 1.78, 95%CI:1.08～2.94）的MSM使用rush poppers的可能性较大。结论 广州市MSM rush poppers使用比例高,应开展针对性的干预措施,特别加强对有多性伴、有临时性伴、性行为前饮酒及近一年曾被诊断患过性病者的宣教,以降低该人群的使用率。     

The Collaborative Lipid Research Clinics Program Family Study: detection of major genes influencing lipid levels by examination of heterogeneity of familial variances

Age, sex-adjusted, and transformed lipid and lipoprotein data on over 1,200 white North American sibships in the Collaborative Lipid Research Clinics Family Study were analyzed for possible major genes causing high or low levels of these traits. The sibships were stratified on the basis of parents' trait values, and within-sibship variance in the high (or low) families was compared to that in the normal families via an F-test. The null hypothesis of multifactorial transmission was strongly rejected for low LDL, low total cholesterol, and high HDL families. An analysis of spouse-pair variance gave similar results. This may reflect the presence of dominant genes for hyperalpha- and hypobetalipoproteinemia. There was weaker evidence for single genes causing hyperbetalipoproteinemia. There was no evidence for major genes influencing triglyceride levels. Methodological issues with significant bearing on these results and those of other studies are discussed.     

Comparing mean levels of total cholesterol from visit 2 of the Lipid Research Clinics Prevalence Study with the second National Health and Nutrition Examination Survey

Mean levels of total cholesterol by sex and age were compared between groups of whites in visit 2 of the Lipid Research Clinics Program Prevalence Study and in the second National Health and Nutrition Examination Survey (NHANES II). NHANES II estimates were found to be higher than comparable visit 2 estimates by 3-14 mg/dl for males and by 11-21 mg/dl for females. Adjustment for the use of differing components of blood in making the lipid determinations in the two studies (plasma in visit 2 and serum in NHANES II) reduced the original differences by roughly one half. Other adjustments--for operational differences among laboratories that performed the blood sample analysis in the two studies, for educational differences in the study populations, and for inclusion of data from a Toronto clinic in the visit 2 data--were collectively found to explain most of the remaining differences between visit 2 and NHANES II, especially for males.     

Prevalence and risk factors associated with syphilis in women]

INTRODUCTION: Although the incidence of syphilis is generally low, it remains an important global public health problem, given its interaction with other sexually transmitted diseases (STDs). It has been shown that syphilis, due to the genital ulcers it produces, is a co-factor for acquiring other STDs, principally those of viral origin such as herpes simples type 2, hepatitis B and HIV. Many female commercial sex workers (FCSW) in Mexico have been found to have acquired good levels of knowledge about STD prevention. Nevertheless, they constitute a heterogeneous group in terms of socio-economic level, health status and type of work site; these factors in turn appear to determine their attitudes, knowledge and behavior related to acquiring and transmitting STDs, including syphilis. This study, therefore, focused on the factors associated with Treponema pallidum infection in this group of women. METHOD: Based on a sample frame of sites where female commercial sex work takes place within Mexico City, a sample of 807 FCSWs was selected; after providing informed consent, they completed a structured questionnaire. A blood sample for identifying serologic markers for STDs was collected and analyzed according to a procedure manual for STD diagnosis. Treponema pallidum was diagnosed using the RPR (Bigaux Diagnostica) screening test, and FTA-ABS (Pasteur Diagnostics) for confirmation. RESULTS: The prevalence of syphilis in this sample of FCSWs was 6.4% (52/807), and was higher among women who worked at street sites than among those who worked in massage parlors. The age of the women interviewed ranged from 17 to 58 years, with a mean of 29.2 years (SD 7.3 years); syphilis was more prevalent among women over 30 years of age. Age at first sexual intercourse ranged from 11 to 30 years, with a mean of 16 years (SD 3.1 years), which is similar to that of the general female population in Mexico. Predictive factors for T. pallidum infection, determined adjusted logistic regression, included: tupe of by work site (bar and street sites); socio-economic level (middle and low); age (over 30 years); duration of involvement in sex work (> 5 years) and number of clients per week (> 10). CONCLUSION: In spite of some limitations regarding statistical precision, this study shows that FCSWs are heterogeneous in terms of risk of acquiring STDs, including syphilis; the principal differentiating factor was shown to be the type of work site. Given that it is not belonging to a risk group but rather participating in risky practices that leads to acquiring STDs, situations that facilitate riskier or safer practices (such as type of sex work site, for sex workers) should be taken into account when studying people's risk level. STD prevention campaigns must also consider these factors, in addition to focusing on FCSWs and their clients and personal partners, so that all involved assume their responsibility for safer sex.     

The use of telemedicine in primary care for women with cervical cytological abnormalities

Telemedicine can be used in two different ways in the context of the National Health Service Cervical Screening Programme. The first method allows primary health-care providers to offer direct online booking of clinic appointments according to predefined algorithms based on the woman's cytological abnormality. The second method is telecolposcopy, which is designed to be used by nurses in primary care. Preliminary data confirm that such a system can be used reliably to make diagnoses. The technology is easily adaptable for realtime teleconsultation.