US assessment of estrogen-responsive organ growth among healthy term infants: piloting methods for assessing estrogenic activity.

BACKGROUND: A mother's circulating estrogen increases over the third trimester, producing physiological effects on her newborn that wane postnatally. Estrogenization might be prolonged in newborns exposed to exogenous estrogens, such as isoflavones in soy formula. OBJECTIVE: We evaluated ultrasonography for monitoring growth of multiple estrogen-responsive organs in healthy infants and developed organ-growth trajectories. MATERIALS AND METHODS: We studied 38 boys (61 visits) from birth to age 6 months and 41 girls (96 visits) from birth to age 1 year using a partly cross-sectional, partly longitudinal design. We measured uterus and ovaries in girls, testes and prostate in boys, and kidneys, breasts, thymus, and thyroid in all children. We imaged all organs from the body surface in one session of < 1 h. RESULTS: Uterine volume decreased from birth (P < 0.0001), whereas ovarian volume increased sharply until age 2 months and then decreased (P < 0.001). Testicular volume increased with age (P < 0.0001), but prostatic volume showed minimal age trend. Breast bud diameter showed no age trend in girls but declined from birth in boys (P = 0.03). CONCLUSION: US examination of multiple estrogen-responsive organs in infants in a single session is feasible and yields volume estimates useful for assessing potential endocrine disruptor effects on organ growth.

Dietary sources of nutrients among rural Native American and white children.

OBJECTIVE: To identify important food sources of energy, fiber, and major macro- and micronutrients among rural Native American and white children. DESIGN: In a 1997 cross-sectional study, food frequency questionnaire data were collected during in-person interviews with caregivers of young children. SUBJECTS/SETTING: Participants included a representative sample of 329 rural Native American and non-Hispanic white children aged 1 through 6 years living in northeastern Oklahoma. STATISTICAL ANALYSES: The percentage that each of 85 food items contributed to the population intake of 10 dietary constituents was calculated for the total sample and by age and race/ethnicity. Percentages are presented in descending rank order for foods providing at least 2% of the total sample intake. Z scores were used to assess age and racial/ethnic differences in food sources. RESULTS: Primary energy sources among study children were milk, cheese, white breads, salty snacks, nondiet soft drinks, hot dogs, candy, and sweetened fruit drinks. Diets showed poor food variety. With few exceptions (eg, milk, cheese, 100% orange juice, ready-to-eat cereals, peanuts/peanut butter, and dried beans), top sources of most dietary constituents were low-nutrient-dense high-fat foods and refined carbohydrates. Solid fruits and vegetables contributed minimally to nutrient and fiber intake. There were few differences in food sources by age or race/ethnicity. CONCLUSIONS: Among rural Native American and white children in northeastern Oklahoma, food sources of nutrients appear less healthful than found in national samples. Sugar-sweetened beverages, high-fat foods, and refined carbohydrates are displacing more nutrient-dense alternatives, increasing children's risk for childhood obesity, type 2 diabetes, and adult chronic disease.

The epidemiology of autoimmune diseases.

Autoimmune diseases are among the leading causes of death among young and middle-aged women in the United States. Incidence rates vary among the autoimmune diseases, with estimates ranging from less than one newly-diagnosed case of systemic sclerosis to more than 20 cases of adult-onset rheumatoid arthritis per 100,000 person-years. Prevalence rates range from less than 5 per 100,000 (e.g. chronic active hepatitis, uveitis) to more than 500 per 100,000 (Grave disease, rheumatoid arthritis, thyroiditis). At least 85% of thyroiditis, systemic sclerosis, systemic lupus erythematosus, and Sjögren disease patients are female. Although most diseases can occur at any age, some diseases primarily occur in childhood and adolescence (e.g. type 1 diabetes), in the mid-adult years (e.g. myasthenia gravis, multiple sclerosis), or among older adults (e.g. rheumatoid arthritis, primary systemic vasculitis). Ethnic and geographic differences in incidence of specific autoimmune diseases have been documented, but specific groups may be at higher risk for some diseases and lower risk for other diseases. The incidence of type 1 diabetes increased but the rates of rheumatoid arthritis declined over the past 40 years. Thus although there are commonalities, there are also important demographic differences between diseases. Disease-specific research, as well as studies that focus on potentially related diseases, needs to be conducted.

Apolipoprotein E polymorphism and cardiovascular disease: a HuGE review.

This review examines the association between the apolipoprotein (apo) var epsilon gene polymorphism (or its protein product (apo E)), metabolic regulation of cholesterol, and cardiovascular disease. The apo var epsilon gene is located at chromosome 19q13.2. Among the variants of this gene, alleles (*) epsilon2, (*) epsilon3, and (*) epsilon4 constitute the common polymorphism found in most populations. Of these variants, apo (*) epsilon3 is the most frequent (>60%) in all populations studied. The polymorphism has functional effects on lipoprotein metabolism mediated through the hepatic binding, uptake, and catabolism of chylomicrons, chylomicron remnants, very low density lipoprotein (VLDL), and high density lipoprotein subspecies. Apo E is the primary ligand for two receptors, the low density lipoprotein (LDL) receptor (also known as the B/E receptor) found on the liver and other tissues and an apo E-specific receptor found on the liver. The coordinate interaction of these lipoprotein complexes with their receptors forms the basis for the metabolic regulation of cholesterol. Allelic variation in apo var epsilon is consistently associated with plasma concentrations of total cholesterol, LDL cholesterol, and apo B (the major protein of LDL, VLDL, and chylomicrons). Apo var epsilon has been studied in disorders associated with elevated cholesterol levels or lipid derangements (i.e., hyperlipoproteinemia type III, coronary heart disease, strokes, peripheral artery disease, and diabetes mellitus). The apo var epsilon genotype yields poor predictive values when screening for clinically defined atherosclerosis despite positive, but modest associations with plaque and coronary heart disease outcomes. In addition to genotype-phenotype associations with vascular disease, the alleles and isoforms of apo var epsilon have been related to dementias, most commonly Alzheimer's disease.