Objectives, design and recruitment of a familial and longitudinal cohort for studying gene-environment interactions in the field of cardiovascular risk: the Stanislas cohort.

The main objective of the Stanislas cohort is to study the role and the contribution of genetic and environmental factors to cardiovascular status. We plan: a) to describe the degree of association of a large number of cardiovascular risk indicators with cardiovascular endpoints, b) to evaluate the contribution of genetic and that of environmental factors to this association, c) to follow the evolution of these risk indicators during a period of at least ten years, d) to search for the determinants influencing this evolution. The principal variables studied are: a) blood pressure, cardiac mass, and wall thickness of carotid and femoral arteries, b) obesity and fat mass, c) indicators of lipid metabolism, d) genetic polymorphisms of several cardiovascular risk candidate genes, e) food, tobacco and alcohol consumption, f) consumption of drugs and anti-oxidant vitamins. Between September 1993 and August 1995, 1006 families consisting of the two biological parents with at least two children were recruited totalling 4295 individuals. This cohort will be followed up until 2004. There will be two health examinations five and ten years after the initial examination. A bank of blood samples (serum and plasma) in liquid nitrogen and DNA (-80 degrees C) has been established.

Determinants of alveolar nitrogen slope and closing volumes in healthy adolescents.

The alveolar nitrogen slope (PIII), closing volume (CV), and closing capacity (CC) were measured by the single-breath nitrogen washout method (SBN2) in a group of 187 healthy children and adolescents (92 boys, 95 girls), 10 to 16 yr old, from the general population of Lorraine, France. The test was performed using a computerized system, which also made the calculations. About one out of five healthy subjects in this population were unable to satisfactorily perform the test; the failure rate was the same for the two sexes (20% in boys, 21.5% in girls) and significantly higher in younger children (26.6 and 14.5% for children under and over the age of 13, respectively; p = 0.03). The distribution of results was skewed for PIII and practically normal for log PIII, CV, VC, and CV/VC or CC/TLC ratios. PIII was highly significantly, inversely related to anthropometric variables; the highest coefficient was that for the age-weight interaction term in boys (= r -0.57 for PIII, -0.62 for log PIII) and for weight in girls (r = -0.57 for both PIII and log PIII). Because the anthropometric variables were strongly interrelated (r between 0.45 and 0.79), multiple regressions did not materially improve the prediction of PIII. In simple regression, weight alone explained 36% of the variability of log PIII in boys and 32% in girls. The mean PIII was significantly higher in girls as compared to boys (1.14 +/- 0.38 versus 0.98 +/- 0.17% N2/L, p = 0.02); CV and CC in milliliters were related to body build as other lung volumes; the CV/VC in girls and CC/TLC ratio in both sexes were not related to anthropometric variables. In boys, CV/VC decreased significantly with height (p = 0.035 for CV/VC versus height3).

[Thoracic radiography in detecting heart diseases]. / Etude de la valeur de la radiographie thoracique dans la détection des cardiopathies.

Within the scope of a physical examination, more than 147,000 patients from the Eastern part of France, were examined and had a chest X-ray, between 1982 and 1987. Seven physicians read those radiographs and reported their findings. After discussion of an interindividual variation noted between the seven physicians, the authors present the major findings of this study: relation between a cardiovascular anomaly discovered on the radiographs and a high blood pressure; relation between a cardiovascular anomaly discovered on the radiographs and one or several electrocardiographic anomalies; relation between anomaly of the cardiovascular silhouette as seen on the radiographs and increased levels of triglycerides and cholesterol in young adults.

Lung function in adolescents after uncomplicated whooping cough in childhood.

Ventilatory function (forced vital capacity, forced expiratory volume in one second, forced expiratory flows), static lung volumes, phase III slope and closing volume (single-breath nitrogen washout test) were measured in 499 children and adolescents aged 10-16 yrs from a general population sample in North-East France. A history of whooping cough was given by 44 children (22 of each sex); their results were compared to those of the 455 children (215 girls) with a negative history. The only difference between the two groups was a minimal increase in the residual volume/total lung capacity ratio in cases (19.2 +/- 3.1 vs 18.0 +/- 2.9%). We conclude that uncomplicated whooping cough in early childhood did not lead to significant pulmonary function abnormality in this population of children born after 1967.

Respiratory symptoms or signs on the day of the study alter pulmonary function in teenagers.

Pulmonary function variables (forced expiratory flows and vital capacity, static lung volume, alveolar N2 slope, closing volume and closing capacity) were compared in a group of 10-16 year old children with (n = 65) and without (n = 440) symptoms or signs of mild acute respiratory infection ('common cold'). Symptomatic children had a significant impairment of forced expiratory vital capacity and flows, with no change in static volumes, alveolar N2 slopes and closing volumes. The effect was present only in boys (in whom RV/TLC and phase III slope were borderline abnormal), was more evident in older children (13 to 16 years) and was independent of the smoking habits or the presence of chronic respiratory symptoms. The results are in favour of a predominant involvement of upper airways, but signs of lower airways dysfunction are present in boys and in children 13 to 16 years old.

[Epidemiologic study of atopic environment in Lorraine]. / Etude épidémiologique du terrain atopique en Lorraine.

An epidemiology study on atopy was performed in a Center of Preventive Medicine, in 505 children aged from 4 to 14 years old, in good health, in consultation with their parents. The clinical atopy was evaluated by a questionnaire inquiring about atopic dermatitis, hay fever, infantile asthma, previous recurrent infections, breast or bottle feeding. Total serum IgE were dosed (Phadezym) and pricks performed to mites and pollens. The clinical atopy is diagnosed in 14.46% of cases (atopic dermatitis: 10.28%--asthma: 3.76%--hay fever: 2/98%). Pricks are positive in 14.85% of cases (mites: 11.48%--pollen: 99.11%--both: 5.74%). The cutaneous sensibility is observed in 32.8% of cases with clinical atopy, 12.5% of other children. The total IgE are very variable and does not correlate with a normal distribution. This allows definition of the quartile below which 90% of the sample is to be found: 474 kUI/l. There is a highly significant relation (p 0.001) between clinical atopy and positive pricks to airborne allergens, clinical atopy and raised alone 474 kUI/l, positive pricks and IgE of more than 474 kUI/l. There is a close relation between atopy and recurrent infections, raised IgE in children and paternal atopy, specific IgE in children and maternal atopy. It appears also that breast feeding is a risk factor for raised IgE in children when the mothers are not atopic, which is somewhat unexpected. Investigation of an atopic terrain may be performed through skin tests or an assay of seric IgE, which seem to be closely comparable.

[Quality control of spirographic examinations in a health center]. / Contrôle de qualité de l'examen spirographique dans un centre d'examens de santé.

A quality control of spirographic examinations in a health centre was carried out by repeating, after a fortnight's interval, measures of vital capacity (CV) and FEV1 (VEMS) in 629 subject of both sexes, aged 18 to 62. Water spirometers were used and their cylinders were regularly calibrated. The first series of spirographic measurements were made during a routine health check (which included other examinations) by 7 technicians who usually do the work, while the second series of measurements was made of fortnight later by the most experienced three. The overall mean values show a significant difference for vital capacity between the first and second measurement; this difference was so for young male subjects (less than 30 years). The scatter was greater for subjects over 50 years of age. The varied results observed for the same subjects obtained by two different technicians, or the same technician, underlines the fact that the scatter of the results depends largely on the technician even though spirographic tests are classically considered easy to perform.