Dietary fat and the risk of age-related maculopathy: the POLANUT study.

This study aimed at assessing the associations of dietary fat with the risk of age-related maculopathy (ARM), in the framework of a population-based study from southern France. Nutritional data were collected using a dietitian-administered food-frequency questionnaire. ARM was classified from retinal photographs using the international classification and included neovascular age-related macular degeneration, geographic atrophy, soft indistinct drusen, soft distinct drusen associated with pigmentary abnormalities. After multivariate adjustment, high total, saturated and monounsaturated fat intake were associated with increased risk for ARM (odds ratio (OR)=4.74, P=0.007; OR=2.70, P=0.04; and OR= 3.50, P=0.03, respectively). Total polyunsaturated fatty acid was not significantly associated with ARM. Total and white fish intake was not significantly associated with ARM, but fatty fish intake (more than once a month versus less than once a month) was associated with a 60% reduction in risk for ARM (OR=0.42, P=0.01).

Waist circumference adds to the variance in plasma C-reactive protein levels in elderly patients with metabolic syndrome.

BACKGROUND: C-reactive protein (CRP), a nonspecific marker of the inflammatory status, is associated with cardiovascular disease risk factors and may be an important feature of the metabolic syndrome (MSX) in middle-aged subjects. OBJECTIVES: We assessed the relationship of CRP levels to specific components of MSX and other potential determinants in apparently healthy elderly subjects living in the South of France. METHODS: In the framework of the population-based POLA (Pathologies Oculaires Liées à l'Age) Study, performed in 2,404 subjects aged 60 years or more, we measured the plasma CRP levels. All subjects with known systemic inflammatory diseases, such as chronic bronchitis, cardiovascular disease, and diabetes, and those who were on systemic steroid therapy as well as subjects with CRP levels >10 mg/l were excluded from the study, leaving 1,709 subjects for the statistical analyses. MSX was defined according to NCEP (National Cholesterol Education Program) criteria. Other potential determinants were assessed through interviewer-based questionnaire. RESULTS: We grouped the subjects into three categories based on the 75th and 25th percentiles, corresponding to 3.05 and 0.82, respectively. We compared subjects in the highest quartile, i.e., with CRP >/=3.05 mg/l, with those in the two intermediate quartiles, i.e., with 0.82 < CRP < 3.05, and those in the lowest quartile, i.e., with CRP <0.82 mg/l according to gender. MSX, which had a prevalence of 31%, was significantly associated with elevated CRP levels. Among MSX components, the strongest positive association with the highest quartile of CRP was with waist circumference in males as well as in females (age-adjusted odds ratio OR 3.06 and 95% confidence interval CI 1.82-5.14; OR 7.04 and 95% CI 4.79-10.34, respectively). Each component of the MSX, such as abnormal fasting plasma glucose (OR 2.90, 95% CI 1.69-4.99), triglycerides (OR 1.96, 95% CI 1.30-2.96), high-density lipoprotein cholesterol (OR 2.31, 95% CI 1.61-3.30), and blood pressure (OR 1.66, 95% CI 1.12-2.45), was significantly associated with high CRP values in elderly women only. In men, only current smoking was significantly associated with high CRP levels (OR 1.52, 95% CI 1.04-2.2). In multivariate analysis, the waist circumference remained significantly associated with high CRP levels, with a graded effect of CRP quartile whatever the gender. In men, current and former smoking remained significantly associated with the CRP levels. In women, the association observed in univariate analysis with fasting glucose or hypertension did not reach statistical significance in the multivariate analysis, while only a weak association could be observed with lipid parameters such as triglycerides and high-density lipoprotein cholesterol. CONCLUSIONS: Abdominal adiposity adds to the variance in plasma CRP levels in elderly patients with MSX. This suggests that weight loss or other interventions targeted at adipocyte-related inflammation may represent an important means to prevent subclinical inflammation in the elderly, bearing a high risk of cardiovascular disease.

Light exposure and the risk of age-related macular degeneration: the Pathologies Oculaires Liées à l'Age (POLA) study.

BACKGROUND: The role of light exposure in the development of age-related macular degeneration (ARMD) has been questioned. We present the relationship between lifetime light exposure and ARMD as examined in the Pathologies Oculaires Liées à l'Age (POLA) study. METHODS: The POLA study is a population-based study on cataract and ARMD and their risk factors. It included 2584 residents of the town of Sète, located in the South of France. The presence of early and late ARMD was assessed on the basis of 50 degrees color fundus photographs using an international classification system. A questionnaire about light exposure was administered. RESULTS: Late ARMD (n = 38) was not significantly associated with any light exposure variable. Subjects exposed to high ambient solar radiation and those with frequent leisure exposure to sunlight had a decreased risk of pigmentary abnormalities (odds ratio [OR] = 0.61; 95% confidence interval [CI], 0.39-0.93, and OR = 0.70; 95% CI, 0.52-0.95, respectively) and of early signs of ARMD (OR = 0.73; 95% CI, 0.54-0.98, and OR = 0.80; 95% CI, 0.64-1.00, respectively). Subjects who had used sunglasses regularly had a decreased risk of soft drusen (OR = 0.81; 95% CI, 0.66-1.00). These relationships were not modified by further adjustments for potential confounders. CONCLUSION: Our study does not support a deleterious effect of sunlight exposure in ARMD.

Light exposure and the risk of cortical, nuclear, and posterior subcapsular cataracts: the Pathologies Oculaires Liées à l'Age (POLA) study.

BACKGROUND: Exposure to light may be an important risk factor for the development of cataracts. OBJECTIVE: To present the relation of ambient solar radiation and professional and leisure exposures to light with the different types of cataracts. METHODS: Pathologies Oculaires Liées a l'Age (POLA) is a population-based study on cataract and age-related macular degeneration and their risk factors in 2584 residents of Sète (southern France). Cataract classification was based on lens examination at slitlamp according to Lens Opacities Classification System III. A questionnaire about light exposure was administered. RESULTS: After multivariate adjustment, participants who had higher ambient solar radiation had a 2.5-fold (95% confidence interval [CI], 1.2-5.0), 4.0-fold (95% CI, 2.0-8.0), and 2.9-fold (95% CI, 1.5-5.3) increased risk of cortical and mixed cataract and cataract surgery, respectively. Solar ambient radiation was not significantly associated with posterior subcapsular and nuclear cataracts. By contrast, posterior subcapsular cataracts were significantly associated with professional exposure to sunlight (odds ratio [OR], 1.63; 95% CI, 1.01-2.63) and frequent use of sunglasses (OR, 0.62; 95% CI, 0.43-0.90). Mixed cataract was also associated with professional exposure to artificial light (OR, 3.02; 95% CI, 1.03-8.82). CONCLUSION: Our study further confirms the role of sunlight exposure in the pathogenesis of cataract, in particular in its cortical localization.

Associations of cardiovascular disease and its risk factors with age-related macular degeneration: the POLA study.

The POLA study (June 1995 through July 1997) is a population-based study on cataract and age-related macular degeneration (AMD) and their risk factors in 2584 residents of Séte (South of France), aged 60--95 years. Classification of AMD was performed on 50 degrees fundus photographs, according to an international classification. The presence of cardiovascular disease and its risk factors was determined by interviewer-based questionnaire, clinical examination (anthropometry, blood pressure) and fasting plasma measurements. Using a logistic model adjusted for age and gender, late AMD was not significantly associated with a history of cardiovascular disease, diabetes, use of hypocholesterolemic drugs, hypertension, blood pressure or plasma lipids. Obese subjects (body mass index greater than 30 kg/m( 2)) had a 2.29-fold (95% confidence interval (CI): 1.00--5.23) and 1.54-fold (CI: 1.05--2.26) increased risk of late AMD and pigmentary abnormalities in comparison with lean subjects. Finally, the risk of soft drusen was decreased in those subjects with a history of cardiovascular disease (odds-ratio (OR) = 0.72, CI: 0.54--0.97), and increased with increasing levels of HDL-cholesterol (OR = 1.52, CI: 1.14--2.02). None of these results were modified by further adjustments for smoking, educational level and plasma alpha-tocopherol. These results need to be confirmed by other studies, which ideally should be longitudinal and prospective.

Anthropometric characteristics and cardiometabolic risk factors in a sample of urban-dwelling adults in Senegal.

AIM: The aim of this study was to analyze the relationship between anthropometric characteristics and cardiometabolic risk factors in urban-dwelling adults in Senegal to evaluate future threats to the public health in terms of chronic diseases. METHODS: Age- and gender-matched control subjects for a study on the prevalence of lipodystrophy in HIV+ patients were selected between June and September 2006 from the general population through systematic home visits guided by area of residence of cases. After consenting to participate, these subjects underwent anthropometric, clinical and biological examinations in their homes. RESULTS: The sample included 60 men and 106 women, mean age of 43.2 ± 9.4 years. Although the prevalence of overweight and obesity was much higher in women (30.2 and 29.2%, respectively) vs. 23.3 and 3.4%, respectively, in men (P<0.001), the women had lower waist-to-hip ratios (mean [95% CI]: 0.78 [0.77-0.80] vs. 0.86 [0.84-0.88] in men; P<10(-4)) and better systolic blood pressure, triglyceride and high-density lipoprotein (HDL)-cholesterol levels. However, their insulin levels were significantly higher (32.1 [28.2-36.5] pmol/l vs. 25.5 [21.0-30.8] in men; P<0.04). Principal component analysis showed that glucose and insulin correlated with subcutaneous fat, whereas blood pressure correlated with central fat distribution. Lipids were distributed between these two factors. CONCLUSION: Obesity still appears to be rare in Senegalese urban-dwelling men, whereas women, despite their overweight, have no untoward cardiometabolic profiles. However, the observed correlations between cardiometabolic risk factors and the amount and/or distribution of body fat suggest that obesity prevention should not be overlooked in the public health agenda for sub-Saharan Africa.

Relationships between glycaemic abnormalities, obesity and insulin resistance in nondiabetic Polynesians of New Caledonia.

OBJECTIVE: Polynesians in New Caledonia have an increased risk for developing diabetes, compared to Melanesians or Europeans. They are also more prone to obesity. The aim of this study was to analyse differences in the pre-diabetic state that may explain the varying susceptibility to diabetes between these three ethnic groups, focusing on the balance between insulin resistance and capacity of pancreatic cells to secrete insulin. DESIGN AND SUBJECTS: The CALDIA Study is a population-based cross-sectional survey of diabetes prevalence conducted in New Caledonia. All participants who did not have diabetes, according to the results of a 0-2 h oral glucose tolerance test (n=392), were selected for analysis. RESULTS: Compared to Europeans, Polynesians and Melanesians had significantly higher body mass indices (BMI) and waist-to-hip ratios (WHRs). Polynesians had higher fasting plasma glucose values than Europeans or Melanesians (6.03 mmol/l, vs 5.78 and 5.46, respectively; P<0.0001). Fasting plasma insulin level and the estimate of insulin resistance by homeostasis model assessment were not significantly different between the three ethnic groups. Homeostasis model assessment estimate of beta-cell secretory capacity was lower in Polynesians compared to the two other ethnic groups (83.1 mU/mmol, vs 119.3 and 125.2, respectively; P<0.02). CONCLUSION: Despite a high prevalence of central obesity, as judged by high BMI and WHR, in Polynesians of New Caledonia, their high risk of diabetes may be more strongly related to a defect in insulin secretion capacity than to insulin resistance.

Relationships between physical activity, obesity and diabetes mellitus in a French elderly population: the POLA study. Pathologies Oculaires lieés á l' Age.

OBJECTIVE: To analyse the relationships between body mass index, waist circumference, waist-to-hip ratio, physical activity and the risk of type 2 diabetes in a French elderly population. DESIGN AND SUBJECTS: We conducted a cross-sectional study on 1113 men and 1419 women aged 60 y or more, participating in the POLA Study. RESULTS: The prevalence of diabetes was two-fold higher in men than in women (19.1% and 9.3%, respectively). The anthropometric variables studied-body mass index (BMI), waist circumference (WC) and the waist/hip ratio (WHR)-were all positively related to the prevalence of type 2 diabetes. The strongest relationships were found for BMI in men and WHR in women. In both genders, sport activity and diabetes were inversely linked whereas no relationship was shown between the amount of household activity and diabetes mellitus. CONCLUSION: In the elderly, overall obesity in men and abdominal fat accumulation in women appeared strongly related to diabetes. Sport activity was negatively and independently associated with the prevalence of diabetes mellitus.

QT interval monitoring during clinical studies with mizolastine, a new H1 antihistamine.

BACKGROUND: Some H1 antihistamines are at risk for rare but severe dysrhythmias due to an effect on the ventricular repolarization. OBJECTIVE: To present an overview of the QT interval monitoring performed during the clinical development of mizolastine, a new selective second-generation H1 antihistamine. METHODS: The ECGs database analysis of clinical studies conducted in volunteers and patients is summarized and focused on the results of reported studies and studies specifically designed for the assessment of the effect of mizolastine on cardiac repolarization, through the QT interval measurements. Mizolastine was orally administered up to 75 mg single dose and 40 mg repeated dose in healthy volunteers (i.e. 7. 5 and 4 times the recommended dose, respectively) and at a dose of 10 or 15 mg in patients. RESULTS: In healthy volunteers, no increased incidence of QTc values >440 msec or DeltaQTc >/=40 msec were recorded compared to placebo. No dose-related increase in QTc interval was observed. The ECG parameters were not modified by the co-administration of mizolastine with digoxin, diltiazem and erythromycin, when compared to the effect of each co-administered drug alone. In patients, the mean QTc interval changes from baseline did not significantly differ from placebo. In comparative studies vs. loratadine a similar incidence of out of range values was observed with mizolastine and loratadine. CONCLUSION: ECG monitoring of volunteers and patients included in clinical studies conducted with mizolastine showed no significant effect of mizolastine on cardiac repolarization.