Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 15 de 15
Filtrar
Más filtros










Intervalo de año de publicación
1.
BMC Gastroenterol ; 19(1): 22, 2019 Feb 04.
Artículo en Inglés | MEDLINE | ID: mdl-30717703

RESUMEN

BACKGROUND: Gilbert syndrome (GS) is an autosomal recessive inherited disorder of bilirubin glucuronidation which has not been investigated in Egypt. This longitudinal study investigated the frequency, clinical course, genetic profile and health related quality of life in Egyptian adults. METHODS: An initial cross-sectional study was conducted to assess the frequency of Gilbert syndrome among Egyptian adults. Subjects fulfilling the criteria of GS were enrolled into the study and prospectively followed for the clinical features, risk factors for hyperbilirubinemia, health related quality of life [Short form-36 Health Survey version 2 (SF-36v2) and Chronic Liver Disease Questionnaire (CLDQ)], vitamins assessment and UGT1A1 polymorphisms. RESULTS: One hundred and one subjects fulfilled the criteria of GS with a prevalence of 8.016%. Recurrent jaundice was the only presentation in 47 (56.627%) GS subjects and jaundice was associated with abdominal pain, dyspepsia or loss of appetite in 54 (53.465%) subjects. A significant difference in 25-Hydroxyvitamin D3 levels was detected between GS patients and control subjects (P <  00001). Twelve subjects with GS developed significant unconjugated bilirubinemia during direct antiviral therapy (DAAs) therapy for HCV despite achieving sustained virologic response. Pregnancy was associated with significant exacerbation of unconjugated bilirubin which persisted through pregnancy. Risk factors for clinical jaundice included general anesthesia, pregnancy, fasting > 12 h, pregnancy, and low calorie weight losing plans, systemic infections, and intensive physical effort. During jaundice attacks, subjects with GS had significant differences in vitality, role emotional, social functioning, worry and general health domains of the SF-36v2 and CLDQ compared to controls. The homozygous polymorphism A(TA)7TAA was the most frequent polymorphism in Egyptians with GS. CONCLUSION: Gilbert syndrome is a frequent inherited disorder in Egypt. In a substantial percentage of subjects with GS, episodes of jaundice are associated with other symptoms and nutritional deficiencies which result in impairment of HRQOL. Screening, counseling, monitoring and individualized health care are recommended for subjects with GS in the setting of anesthesia, pregnancy, treatment with DAAs, deliveries, surgery and weight loss plans.


Asunto(s)
Enfermedad de Gilbert/complicaciones , Enfermedad de Gilbert/epidemiología , Calidad de Vida , Dolor Abdominal/etiología , Adolescente , Adulto , Estudios Transversales , Dispepsia/etiología , Egipto/epidemiología , Trastornos de Alimentación y de la Ingestión de Alimentos/etiología , Femenino , Genotipo , Enfermedad de Gilbert/genética , Enfermedad de Gilbert/psicología , Glucuronosiltransferasa/genética , Humanos , Ictericia/etiología , Estudios Longitudinales , Masculino , Polimorfismo Genético , Prevalencia , Recurrencia , Factores de Riesgo , Adulto Joven
2.
Obesity (Silver Spring) ; 21(9): E421-7, 2013 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-23404778

RESUMEN

OBJECTIVE: Obesity and diabetes are particularly high in indigenous populations exposed to a Western diet and lifestyle. The prevalence of obesity, diabetes, hyperglycemia, dyslipidemia, and hypertension in one such population, the Micronesian island of Kosrae was described. DESIGN AND METHODS: Longitudinal screenings for metabolic traits were conducted on adult Kosraens ≥ 20 years of age in 1994 and again in 2001. Data was obtained on 3,106 Kosraens, comprising ∼80% of the adult population. Diabetes was diagnosed using World Health Organization guidelines. Prevalences of obesity, hyperglycemia, dyslipidemia, and hypertension were assessed. RESULTS: The overall age-adjusted prevalence of diabetes increased from 14 to 21%. The most significant change observed in the population was increases in obesity and hyperglycemia, especially among young Kosraens and women. Obesity age-adjusted prevalence increased from 45 to 62%, and hyperglycemia age-adjusted prevalence increased from 19 to 44%. Of note, Kosraens as a group had unusually low high density lipoprotein (HDL) levels with 80% classified as low HDL by NCEP-ATPIII criteria, despite lacking the usually accompanying increase in triglycerides. Comparison to reports from other populations shows that Kosrae experiences one of the highest rates of obesity, hyperglycemia, and low HDL globally while maintaining relatively healthy levels of triglycerides. CONCLUSION: Our study shows a dramatic increase in obesity and hyperglycemia in Kosrae in just 7 years and forebodes significantly increased health risks for this part of the world.


Asunto(s)
HDL-Colesterol/sangre , Diabetes Mellitus/epidemiología , Dislipidemias/epidemiología , Hiperglucemia/epidemiología , Obesidad/epidemiología , Triglicéridos/sangre , Adulto , Anciano , Diabetes Mellitus/sangre , Dislipidemias/sangre , Dislipidemias/complicaciones , Femenino , Humanos , Hiperglucemia/sangre , Hiperglucemia/complicaciones , Hipertensión/epidemiología , Estudios Longitudinales , Masculino , Micronesia/epidemiología , Persona de Mediana Edad , Obesidad/sangre , Obesidad/complicaciones , Prevalencia , Factores Sexuales , Adulto Joven
3.
Emerg Infect Dis ; 17(7): 1202-8, 2011 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-21762573

RESUMEN

An increasing proportion of Hansen disease cases in the United States occurs among migrants from the Micronesian region, where leprosy prevalence is high. We abstracted surveillance and clinical records of the National Hansen's Disease Program to determine geographic, demographic, and clinical patterns. Since 2004, 13% of US cases have occurred in this migrant population. Although Hawaii reported the most cases, reports have increased in the central and southern states. Multibacillary disease in men predominates on the US mainland. Of 49 patients for whom clinical data were available, 37 (75%) had leprosy reaction, neuropathy, or other complications; 17 (37%) of 46 completed treatment. Comparison of data from the US mainland with Hawaii and country-of-origin suggests under-detection of cases in pediatric and female patients and with paucibacillary disease in the United States. Increased case finding and management, and avoidance of leprosy-labeled stigma, is needed for this population.


Asunto(s)
Leprostáticos/uso terapéutico , Lepra/etnología , Mycobacterium leprae/fisiología , Adolescente , Adulto , Niño , Preescolar , Demografía , Femenino , Hawaii/epidemiología , Humanos , Leprostáticos/administración & dosificación , Lepra/diagnóstico , Lepra/tratamiento farmacológico , Lepra/microbiología , Lepra/patología , Estudios Longitudinales , Masculino , Micronesia/etnología , Mycobacterium leprae/efectos de los fármacos , Prevalencia , Migrantes/estadística & datos numéricos , Estados Unidos/epidemiología
4.
Avanzada Científica ; 9(3)sept.-dic. 2006. tab, graf, ilus
Artículo en Español | CUMED | ID: cum-52703

RESUMEN

La Pitiriasis Rosada es una entidad que se puede ver en cualquier edad, pero más frecuente entre los 15 y 35 años, de etiología no precisada, aunque existen hipótesis que abogan por su posible causa viral. Se señalan diversas formas clínicas, que evolucionan aún sin tratamiento de 6 a 14 semanas, no obstante un porcentaje de las mismas presentan recidivas molestas para el paciente, que en ocasiones se convierten en causa de duda diagnóstica. Hasta hace algún tiempo esta forma clínica no era muy observada, aumentando su incidencia en la actualidad, por lo que nos decidimos a realizar un estudio descriptivo prospectivo, para evaluar la eficacia del tratamiento acupuntural, por lo que se seleccionaron diferentes puntos, aplicándose en los pacientes con diagnóstico clínico- histopatológico de la entidad. Se resalta que no se encuentran reportes de este tipo de tratamiento en la literatura revisada, lo que se estima constituye la novedad de este trabajo, además de la evolución favorable de la totalidad de los casos que se incluyeron en el estudio, por lo que se recomienda continuar esta investigación elevando la casuística(AU)


Pityriasis rosea is an entity that can be seen at any age but it is more frequently observed between 15 to 35 years of age. Although its etiology is not already established, there are hypotheses about possible viral causes. Different clinical forms may have a positive evolution without any treatment from 6 to 14 weeks, however, sometimes they can produce recurrences which cause some pain in patients and may create difficulties for diagnosis. No longer ago this clinical form was not very observed, but nowadays the number of cases has increased and for that reason, a descriptive and prospective study was carried out. It aim to evaluate the efficacy of an acupuncture treatment for patients with clinical and histopatological diagnosis of the entity. Reports of this kind of treatment were not found in a bibliographical review, so we may believe about the possible novelty of this work. The fact that the whole cases of this study had a favourable evolution may be an indication to continue the research with more cases(AU)


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Pitiriasis Rosada/terapia , Terapia por Acupuntura , Medicina China Tradicional/métodos , Pitiriasis Rosada/diagnóstico , Pitiriasis Rosada/epidemiología , Epidemiología Descriptiva , Estudios Prospectivos , Estudios Longitudinales , Resultado del Tratamiento
5.
Exp Cell Res ; 312(14): 2694-9, 2006 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-16857186

RESUMEN

We find that Rad50S mutations in yeast and mammals exhibit constitutive PIKK (PI3-kinase like kinase)-dependent signaling [T. Usui, H. Ogawa, J.H. Petrini, A DNA damage response pathway controlled by Tel1 and the Mre11 complex. Mol. Cell 7 (2001) 1255-1266.; M. Morales, J.W. Theunissen, C.F. Kim, R. Kitagawa, M.B. Kastan, J.H. Petrini, The Rad50S allele promotes ATM-dependent DNA damage responses and suppresses ATM deficiency: implications for the Mre11 complex as a DNA damage sensor. Genes Dev. 19 (2005) 3043-4354.]. The signaling depends on Mre11 complex functions, consistent with its role as a DNA damage sensor. Rad50S is distinct from hypomorphic mutations of Mre11 and Nbs1 in mammals [M. Morales, J.W. Theunissen, C.F. Kim, R. Kitagawa, M.B. Kastan, J.H. Petrini, The Rad50S allele promotes ATM-dependent DNA damage responses and suppresses ATM deficiency: implications for the Mre11 complex as a DNA damage sensor. Genes Dev. 19 (2005) 3043-3054.; J.P. Carney, R.S. Maser, H. Olivares, E.M. Davis, Le M. Beau, J.R. Yates, III, L. Hays, W.F. Morgan, J.H. Petrini, The hMre11/hRad50 protein complex and Nijmegen breakage syndrome: linkage of double-strand break repair to the cellular DNA damage response. Cell 93 (1998) 477-486.; G.S. Stewart, R.S. Maser, T. Stankovic, D.A. Bressan, M.I. Kaplan, N.G. Jaspers, A. Raams, P.J. Byrd, J.H. Petrini, A.M. Taylor, The DNA double-strand break repair gene hMRE11 is mutated in individuals with an ataxia-telangiectasia-like disorder. Cell 99 (1999) 577-587.; B.R. Williams, O.K. Mirzoeva, W.F. Morgan, J. Lin, W. Dunnick, J.H. Petrini, A murine model of nijmegen breakage syndrome. Curr. Biol. 12 (2002) 648-653.; J.W. Theunissen, M.I. Kaplan, P.A. Hunt, B.R. Williams, D.O. Ferguson, F.W. Alt, J.H. Petrini, Checkpoint failure and chromosomal instability without lymphomagenesis in Mre11(ATLD1/ATLD1) mice. Mol. Cell 12 (2003) 1511-1523.] and the Mre11 complex deficiency in yeast [T. Usui, H. Ogawa, J.H. Petrini, A DNA damage response pathway controlled by Tel1 and the Mre11 complex. Mol. Cell 7 (2001) 1255-1266.; D'D. Amours, S.P. Jackson, The yeast Xrs2 complex functions in S phase checkpoint regulation. Genes Dev. 15 (2001) 2238-49. ; M. Grenon, C. Gilbert, N.F. Lowndes, Checkpoint activation in response to double-strand breaks requires the Mre11/Rad50/Xrs2 complex. Nat. Cell Biol. 3 (2001) 844-847. ] where the signaling is compromised. Herein, we describe evidence for chronic signaling by Rad50S and discuss possible mechanisms.


Asunto(s)
Daño del ADN , Proteínas de Unión al ADN/genética , Proteínas de Saccharomyces cerevisiae/genética , Animales , Endodesoxirribonucleasas , Exodesoxirribonucleasas , Humanos , Transducción de Señal
6.
J Environ Radioact ; 88(3): 251-66, 2006.
Artículo en Inglés | MEDLINE | ID: mdl-16650918

RESUMEN

Bikini Island was contaminated on March 1, 1954 by the Bravo detonation (U.S. nuclear test series, Castle) at Bikini Atoll. About 90% of the estimated dose from nuclear fallout to potential island residents is from cesium-137 ((137)Cs) transferred from soil to plants that are consumed by residents. Thus, radioecology research efforts have been focused on removing (137)Cs from soil and/or reducing its uptake into vegetation. Most effective was addition of potassium (K) to soil that reduces (137)Cs concentration in fruits to 3-5% of pretreatment concentrations. Initial observations indicated this low concentration continued for some time after K was last applied. Long-term studies were designed to evaluate this persistence in more detail because it is very important to provide assurance to returning populations that (137)Cs concentrations in food (and, therefore, radiation dose) will remain low for extended periods, even if K is not applied annually or biennially. Potassium applied at 300, 660, 1260, and 2070 kg ha(-1) lead to a (137)Cs concentration in drinking-coconut meat that is 34, 22, 10, and about 4% of original concentration, respectively. Concentration of (137)Cs remains low 8-10 y after K is last applied. An explanation for this unexpected result is discussed.


Asunto(s)
Cocos , Productos Agrícolas , Contaminación Radiactiva de Alimentos/prevención & control , Guerra Nuclear , Potasio/química , Saneamiento , Radioisótopos de Cesio , Cocos/efectos de la radiación , Productos Agrícolas/efectos de la radiación , Estudios Longitudinales , Micronesia , Contaminantes Radiactivos , Saneamiento/métodos
7.
Nephrology (Carlton) ; 10(3): 291-5, 2005 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-15958044

RESUMEN

The number of cases of treated end-stage renal disease (ESRD) attributable to type 2 diabetes and survival after the onset of renal replacement therapy was examined in the Commonwealth of the Northern Mariana Islands (CNMI). All Chamorros and Carolinians to receive renal replacement therapy for ESRD between January 1982 and December 2002 were identified. Changes in survival over time were examined by dividing the study into three equal periods. Of 180 new cases of ESRD, 137 (76%; 101 Chamorros, 36 Carolinians) were attributed to diabetes. Ninety-nine subjects, 80% of whom had diabetic ESRD, began renal replacement therapy in the last 7 years of the study compared with 81 (72% with diabetic ESRD) in the previous 14 years. All 137 of the diabetic subjects received haemodialysis. During the 21-year study period, 79 of the diabetic subjects receiving dialysis died. The median survival after the onset of haemodialysis was 37 months in the first time period (1982-1988), 47 months in the second period (1989-1995) and 67 months in the third period (1996-2002). The death rate in the first period was 4.3 times (95% CI, 2.1-8.9) as high and the second period was 2.9 times (95% CI, 1.5-5.8) as high as the most recent period, after adjustment for age, sex and ethnicity in a proportional-hazards analysis. The number of diabetic patients in CNMI who are receiving renal replacement therapy is rising rapidly. Considerable improvement in survival after the onset of haemodialysis has occurred over the past 21 years.


Asunto(s)
Diabetes Mellitus Tipo 2/etnología , Diabetes Mellitus Tipo 2/mortalidad , Nefropatías Diabéticas/etnología , Nefropatías Diabéticas/mortalidad , Adulto , Anciano , Anciano de 80 o más Años , Nefropatías Diabéticas/terapia , Femenino , Humanos , Estudios Longitudinales , Masculino , Micronesia/epidemiología , Persona de Mediana Edad , Sistema de Registros , Terapia de Reemplazo Renal
8.
Hernia ; 9(1): 6-11, 2005 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-15517443

RESUMEN

Traditional disdain for groin repair stifled recognition of British innovations. Some, relating to modern herniology, are remembered herein. Morton (1841) and Mackay (1889) showed the epigastric artery piercing Cooper's transversalis fascia (1807). Bilaminarity (Cooper, 1807) was confirmed in 1992 (Read). Thomson's iliopubic tract (1838) became part of Nyhus' repair (1960) [derived from McEvedy's repair (1950)] and laparoscopy (Ger, 1982). Retzius' space (Edinburgh, 1858) with Lister's antisepsis (1865) enabled preperitoneal herniorrhaphy (Annandale, 1876). He participated (1873) in intraperitoneal release of incarceration and reducible protrusions (Tait 1883). Cheyne's pectineus muscle plug (1893) preceded Kelly's marble prosthesis for femoral herniation (1898). Cheatle (1920) introduced posterior preperitoneal repair-ignored, rediscovered (Henry, 1936), and adopted (1952) at the Mayo clinic. Calne (1967) pioneered retrorectus Mersilene and was followed by Stoppa (1969) and Wantz (1989). Brandon (1945) blamed failure of modified Bassini's herniorrhaphies on closure at the intermediate inguinal ring instead of the internal. A similar mechanism may explain interstitial recurrence (Gilbert, 2003) after Amid-Lichtenstein repair. Lytle (1896-1986) described a muscle shutter at the internal ring, course of genitofemoral nerve, and orifice of femoral canal. Russell's congenital saccular theory (1906) was questioned by Keith (1924). Acquired connective-tissue pathology was later shown to play a systematic role in adult groin herniation (Read, 1970), confirmed by Jackson and colleagues (1996) and others.


Asunto(s)
Cirugía General/historia , Ingle , Hernia Inguinal/historia , Ingle/cirugía , Hernia Inguinal/cirugía , Historia del Siglo XIX , Historia del Siglo XX , Humanos , Procedimientos Quirúrgicos Operativos , Reino Unido
9.
J Women Aging ; 14(1-2): 149-62, 2002.
Artículo en Inglés | MEDLINE | ID: mdl-12537285

RESUMEN

This study examines the composition of elderly population at risk of disability and speculates the impact of disability on the quality of their lives and their longevity. Using census and survey data collected in Fiji, life table estimates of unimpaired life expectancy across time are presented for older people and the potential costs of disability, in terms of productive years of life lost. From a planning perspective, the study discusses medical and support services that may be needed to support older individuals in Fiji. The study also describes policy implications of the findings, focusing on the older women, and considers the implications for older women of other developing countries.


Asunto(s)
Anciano Frágil/estadística & datos numéricos , Estado de Salud , Esperanza de Vida , Salud de la Mujer , Anciano , Anciano de 80 o más Años , Países en Desarrollo , Eficiencia , Femenino , Servicios de Salud para Ancianos , Humanos , Estudios Longitudinales , Masculino , Estado Civil , Micronesia/epidemiología , Dinámica Poblacional , Calidad de Vida , Factores Sexuales
10.
Diabetes ; 45(10): 1367-72, 1996 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-8826973

RESUMEN

Longitudinal changes in serum insulin concentrations in relation to the natural history of glucose intolerance and factors associated with the incidence of NIDDM were studied in 838 nondiabetic Micronesian Nauruans over the 5.1-year period from 1982 to 1987. In 13 individuals who had data at three time-points and who developed NIDDM only at the final test, 2-h insulin levels followed an inverted V-shaped pattern as glucose tolerance declined to NIDDM. Subjects who were normal (n = 651) or had impaired glucose tolerance (IGT) (n = 187) at the 1982 baseline survey were divided into six natural history categories depending on glucose tolerance in 1987. Changes in glucose tolerance were accompanied by changes in mean 2-h insulin concentration that paralleled the inverted V pattern seen in the 13 individuals. Longitudinal changes in fasting insulin were less consistent, but mean levels increased as subjects developed NIDDM. The 5.1-year incidence of NIDDM was strongly related to baseline fasting and 2-h glucose concentrations, but associations with insulin levels were weak and inconsistent. Neither fasting nor 2-h insulin concentrations contributed to logistic regression models predicting deterioration in glucose tolerance, whereas fasting and 2-h glucose levels were included in all models and BMI also predicted deterioration from normal. These data showing sequential changes in insulin concentrations support the beta-cell exhaustion theory of NIDDM pathogenesis. However, in contrast to glucose concentrations and obesity, insulin levels are poor predictors of NIDDM risk in Nauruans. This reflects the complexity of interactions with other metabolic markers and the inability of a single examination to characterize the point along the inverted V curve of insulin secretion that an individual has reached.


Asunto(s)
Glucemia/metabolismo , Intolerancia a la Glucosa/fisiopatología , Insulina/sangre , Factores de Edad , Estatura , Peso Corporal , Diabetes Mellitus/epidemiología , Diabetes Mellitus Tipo 2/epidemiología , Femenino , Estudios de Seguimiento , Intolerancia a la Glucosa/sangre , Prueba de Tolerancia a la Glucosa , Humanos , Incidencia , Estudios Longitudinales , Masculino , Micronesia/etnología , Obesidad/epidemiología , Islas del Pacífico/epidemiología , Valor Predictivo de las Pruebas , Análisis de Regresión , Factores de Riesgo , Factores Sexuales , Factores de Tiempo
11.
Am J Epidemiol ; 143(5): 442-55, 1996 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-8610659

RESUMEN

The association of obesity with mortality was investigated in population-based samples of Micronesian Nauruans (n = 1,400), Melanesian Fijians (n = 1,279), and Indian Fijians (n = 1,182), over 10 years from 1982 in Nauru, and 11 years from 1980 in Fiji. At the end of follow-up, vital status was known for all Nauruans and all but 3.5% of Fijians. Mortality rates were higher in Nauru than Fiji, and in Melanesians than Indians. The mean body mass index of decedents was similar to or less than (Nauruan men, p < 0.001) that of survivors in each sex-ethnic group. Crude mortality rates showed an inverse relation with body mass index in Nauruan men, with inconsistent relations in other sex-ethnic groups. After stratification by diabetes status, there was no relation between mortality and obesity in nondiabetic subjects, but an inverse relation was observed among diabetic subjects in each population. These findings persisted even after the exclusion of subjects who died within the first 2 years of follow-up. After controlling for age, smoking, and diabetes status in Cox proportional hazard models, body mass index (as a continuous variable) was not related to mortality in any sex/ethnic group and tended to be negatively associated with mortality risk. Interactions of body mass index with age, smoking, and diabetes status were not significant. Mortality risk was significantly increased in older subjects and in diabetic subjects, and cigarette smoking also increased risk in some groups. Stratification of analyses according to cigarette smoking did not alter the nature of the results. The association of mortality and body mass index categorized by quartiles was also investigated. After adjusting for age alone, or age, smoking, and diabetes status, the lower quartiles of body mass index were consistently associated with the highest relative risk for mortality. Quadratic terms for body mass index did not improve Cox models in subjects with normal glucose tolerance. Relations with cardiovascular disease mortality were also assessed and results were inconsistent, although positive trends were observed in Nauruan women (p = 0.02) and Melanesian men (p = 0.06). Overall, there was little evidence to suggest that obesity was a risk factor for total or cardiovascular mortality in these populations. However, obesity is clearly associated with a high risk of diabetes and other morbid conditions and at least on this basis it would seem desirable to prevent obesity in these and other Pacific populations.


Asunto(s)
Mortalidad , Obesidad/etnología , Obesidad/mortalidad , Adulto , Antropometría , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etnología , Intervalos de Confianza , Femenino , Humanos , Estudios Longitudinales , Masculino , Melanesia/epidemiología , Melanesia/etnología , Micronesia/epidemiología , Micronesia/etnología , Vigilancia de la Población , Modelos de Riesgos Proporcionales , Riesgo
12.
J Clin Epidemiol ; 46(12): 1373-93, 1993 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-8263565

RESUMEN

Cross-sectional associations between insulin and ECG abnormalities suggestive of 'possible' and 'probable' coronary heart disease (CHD) in the populations of Nauru (n = 568) and Mauritius (n = 3280) have been examined in both non-diabetic and diabetic subjects. Additionally, the longitudinal relationship between baseline insulin and incident ECG abnormalities has been explored in non-diabetic Nauruans (n = 177) over 5 years. Age-adjusted mean 2-hour serum insulin was generally higher in subjects with ECG abnormalities than those with a normal ECG, but the difference was significant only for non-diabetic Mauritian men (p < 0.01). There was no clear association between prevalence of ECG abnormalities and quintiles of fasting or 2-hr insulin in Mauritians, and in non-diabetic Nauruans there was a non-significant positive association between prevalence of ECG abnormalities and tertiles of 2-hr insulin. Logistic regression analyses showed a slight positive association between 2-hr insulin and ECG abnormalities in non-diabetic Mauritians (p = 0.06 in males, p = 0.09 in females), and non-diabetic male Nauruans (p = 0.054) independent of possible confounders. Fasting insulin was not associated in any group. In longitudinal analyses in Nauruans there were no significant differences in mean baseline fasting or 2-hr serum insulin between subjects who maintained a normal ECG and those who developed abnormalities consistent with 'possible CHD' (there were no changes suggestive of 'probable CHD'). The incidence of ECG changes suggesting 'possible CHD' was slightly higher in the upper tertile of baseline fasting insulin in both sexes and 2-hr insulin in females, but when other factors were accounted for, multiple logistic regression analyses did not support this finding. Data from the populations of Mauritius and Nauru do not support a major role for serum insulin in ECG abnormalities suggestive of CHD.


Asunto(s)
Enfermedad Coronaria/epidemiología , Electrocardiografía , Insulina/sangre , Adulto , Anciano , Anciano de 80 o más Años , Factores de Confusión Epidemiológicos , Enfermedad Coronaria/sangre , Enfermedad Coronaria/diagnóstico , Estudios Transversales , Diabetes Mellitus/epidemiología , Femenino , Humanos , Modelos Logísticos , Estudios Longitudinales , Masculino , Mauricio/epidemiología , Micronesia/epidemiología , Persona de Mediana Edad , Prevalencia
14.
Diabetes ; 36(2): 179-86, 1987 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-3542644

RESUMEN

A longitudinal study of 266 randomly selected nondiabetic Nauruans [215 with normal tolerance and 51 with impaired glucose tolerance (IGT)] over 6 yr showed that deterioration in glucose tolerance status had occurred in 61 subjects. Of the subjects with initially normal tolerance, 34 (16%) progressed to IGT and 14 (6.5%) progressed to diabetes. Thirteen of the subjects with IGT (25%) progressed to diabetes. Subjects were examined in 1975 through 1976, and follow-up examinations were performed in 1982. After age, a high 2-h plasma insulin response to a glucose load was the factor most predictive of progression from normal tolerance to both diabetes (P less than .001) and IGT (P less than .01). Both a high 2-h glucose level and greater obesity independently predicted progression from IGT, and a diminished 2-h insulin response just failed to significantly improve the model (P less than .06). The negative parameter of the insulin response associated with deterioration from IGT differed significantly (P less than .01) from the positive-parameter estimate of the response associated with progression to diabetes from normal tolerance (P less than .01), implying a qualitative difference between these nondiabetic subgroups. The use of a glucose-insulin interaction term to predict progression to diabetes for all nondiabetic subjects confirmed this difference; this term's addition improved the model (P less than .01), and progression to diabetes was associated with a high insulin response for 2-h glucose less than 7.8 mM but a low response for 2-h glucose greater than 7.8 mM.


Asunto(s)
Glucemia/metabolismo , Diabetes Mellitus/etnología , Insulina/sangre , Adulto , Diabetes Mellitus/epidemiología , Femenino , Prueba de Tolerancia a la Glucosa , Humanos , Estudios Longitudinales , Masculino , Micronesia , Distribución Aleatoria , Factores de Tiempo
15.
Am J Epidemiol ; 122(4): 594-605, 1985 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-3895898

RESUMEN

A longitudinal study of 266 adult residents of the Pacific Island of Nauru (1975-1976 and 1982) has shown an annual incidence of noninsulin-dependent diabetes of 1.6 per cent per annum. Factors associated with the subsequent development of glucose intolerance were determined by means of regression techniques. The two-hour, post-load plasma glucose concentration was the factor most consistently associated with subsequent glucose intolerance. Other predictors were found to vary in their importance between the sexes. In males, the fasting plasma triglyceride concentration and blood pressure showed a weaker association, and body mass index was of marginal significance. In contrast, in females, two-hour plasma insulin concentration, plasma uric acid concentration, body mass index, and fasting plasma glucose concentration showed a significant association. These findings are discussed in light of the results of similar studies in other populations.


Asunto(s)
Diabetes Mellitus Tipo 2/epidemiología , Adulto , Glucemia , Presión Sanguínea , Estatura , Peso Corporal , Creatinina/sangre , Diabetes Mellitus Tipo 2/etiología , Métodos Epidemiológicos , Femenino , Prueba de Tolerancia a la Glucosa , Humanos , Hiperglucemia/epidemiología , Insulina/sangre , Estudios Longitudinales , Masculino , Micronesia , Persona de Mediana Edad , Paridad , Factores Sexuales , Grosor de los Pliegues Cutáneos
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...