scholarly journals γ-Glutamyltransferase Is a Predictor of Incident Diabetes and Hypertension: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

2003 ◽  
Vol 49 (8) ◽  
pp. 1358-1366 ◽  
Author(s):  
Duk-Hee Lee ◽  
David R Jacobs ◽  
Myron Gross ◽  
Catarina I Kiefe ◽  
Jeffrey Roseman ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Proportional Hazards ◽  
White Men ◽  
Incident Diabetes ◽  
Black And White ◽  
Proportional Hazards Regression ◽  
Hazard Ratios ◽  
A Prospective Study ◽  
Study Participants ◽  
Study Center

Abstract Background: γ-Glutamyltransferase (GGT), which maintains cellular concentrations of glutathione, may be a marker of oxidative stress, and GGT itself may produce oxidative stress. We performed a prospective study to examine whether serum GGT predicts diabetes and hypertension. Methods: Study participants were 4844 black and white men and women 18–30 years of age in 1985–1986; they were reexamined 2, 5, 7, 10, and 15 years later. Year 0 GGT cutpoints were 12, 17, 25, and 36 U/L (overall 25th, 50th, 75th, and 90th percentiles; the laboratory cutpoints for abnormal are 40 U/L in women and 50 U/L in men). We deleted 32 participants with prevalent diabetes and 140 participants with prevalent hypertension from the respective incidence analyses. Results: After adjustment for study center, race, sex, and age in proportional hazards regression, the hazard ratios across year 0 GGT categories were 1.0, 1.6, 1.7, 4.0 (95% confidence interval, 2.0–8.1), and 5.5 (2.7–11.1) for 15-year incident diabetes and 1.0, 1.2, 1.7 (1.2–2.2), 2.3 (1.7–3.2), and 2.3 (1.7–3.2) for hypertension. Additional adjustment for year 0 alcohol consumption, body mass index, cigarette smoking, and physical activity attenuated this relationship, but GGT remained a significant predictor. Conclusions: Serum GGT within a range regarded as physiologically normal is associated with incident diabetes and hypertension. Considering known functionality of GGT, these associations are consistent with a role for oxidative stress in risk for diabetes and hypertension.

scholarly journals Association of Serum Carotenoids and Tocopherols with γ-Glutamyltransferase: The Cardiovascular Risk Development in Young Adults (CARDIA) Study

2004 ◽  
Vol 50 (3) ◽  
pp. 582-588 ◽  
Author(s):  
Duk-Hee Lee ◽  
Myron D Gross ◽  
David R Jacobs
Keyword(s):  
Oxidative Stress ◽  
Antioxidant Properties ◽  
Experimental Studies ◽  
White Men ◽  
Geometric Means ◽  
Black And White ◽  
Serum Carotenoids ◽  
Study Participants ◽  
Β Carotene

Abstract Background: Our previous studies suggest that serum γ-glutamyltransferase (GGT) activity may be related to oxidative stress, supporting findings of experimental studies. To further examine the role of GGT in relation to oxidative stress, we investigated the association between serum carotenoids and tocopherols, which have antioxidant properties, and serum GGT. Methods: Study participants were 3128 black and white men and women 17–35 years of age in 1985–1986. Serum carotenoids and tocopherols were measured at years 0 and 7, and serum GGT was measured at years 0 and 10. Results: Circulating concentrations of α-carotene, β-carotene, and β-cryptoxanthin inversely predicted the serum GGT concentration measured 10 years later in a dose–response manner (P for trend <0.01). Year 0 zeaxanthin/lutein was weakly inversely associated with year 10 GGT (P for trend = 0.08), and year 0 lycopene was unrelated to year 10 GGT. Adjusted geometric means of serum GGT at year 10 according to quintile of the sum of four carotenoids at year 0 (α-carotene, β-carotene, β-cryptoxanthin, and zeaxanthin/lutein) were 19.9, 19.4, 18.9, 17.8, and 17.3 U/L (P for trend <0.01). Year 0 α-tocopherol was also a significant inverse predictor of year 10 serum GGT concentration (P for trend = 0.03), whereas γ-tocopherol showed an inconsistent or possibly U-shaped association. However, year 0 serum GGT did not predict serum antioxidants measured 7 years later. Conclusion: Our present findings support the contention that serum GGT concentration is a marker related with oxidative stress.

scholarly journals Sex-Specific Associations between Blood Pressure and Risk of Atrial Fibrillation Subtypes in the Tromsø Study

2021 ◽  
Vol 10 (7) ◽  
pp. 1514
Author(s):  
Hilde Espnes ◽  
Jocasta Ball ◽  
Maja-Lisa Løchen ◽  
Tom Wilsgaard ◽  
Inger Njølstad ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Pressure Management ◽  
Reference Models ◽  
Proportional Hazards Regression ◽  
Hazard Ratios ◽  
Increased Risk

The aim of this study was to explore sex-specific associations between systolic blood pressure (SBP), hypertension, and the risk of incident atrial fibrillation (AF) subtypes, including paroxysmal, persistent, and permanent AF, in a general population. A total of 13,137 women and 11,667 men who participated in the fourth survey of the Tromsø Study (1994–1995) were followed up for incident AF until the end of 2016. Cox proportional hazards regression analysis was conducted using fractional polynomials for SBP to provide sex- and AF-subtype-specific hazard ratios (HRs) for SBP. An SBP of 120 mmHg was used as the reference. Models were adjusted for other cardiovascular risk factors. Over a mean follow-up of 17.6 ± 6.6 years, incident AF occurred in 914 (7.0%) women (501 with paroxysmal/persistent AF and 413 with permanent AF) and 1104 (9.5%) men (606 with paroxysmal/persistent AF and 498 with permanent AF). In women, an SBP of 180 mmHg was associated with an HR of 2.10 (95% confidence interval [CI] 1.60–2.76) for paroxysmal/persistent AF and an HR of 1.80 (95% CI 1.33–2.44) for permanent AF. In men, an SBP of 180 mmHg was associated with an HR of 1.90 (95% CI 1.46–2.46) for paroxysmal/persistent AF, while there was no association with the risk of permanent AF. In conclusion, increasing SBP was associated with an increased risk of both paroxysmal/persistent AF and permanent AF in women, but only paroxysmal/persistent AF in men. Our findings highlight the importance of sex-specific risk stratification and optimizing blood pressure management for the prevention of AF subtypes in clinical practice.

Consumption of flavonoid-rich fruits, flavonoids from fruits, and stroke risk: a prospective cohort study

2021 ◽  
pp. 1-26
Author(s):  
Qi Gao ◽  
Jia-Yi Dong ◽  
Renzhe Cui ◽  
Isao Muraki ◽  
Kazumasa Yamagishi ◽  
...  
Keyword(s):  
Lower Risk ◽  
Stroke Risk ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Dietary Factors ◽  
Citrus Fruits ◽  
Proportional Hazards Regression ◽  
Hazard Ratios ◽  
Index Study

Abstract We sought to examine the prospective associations of specific fruit consumption, in particular flavonoid-rich fruit (FRF) consumption, with the risk of stroke and subtypes of stroke in a Japanese population. A study followed a total of 39,843 men and 47,334 women aged 44-76 years, and free of cardiovascular disease, diabetes, and cancer at baseline since 1995 and 1998 to the end of 2009 and 2012, respectively. Data on total and specific FRF consumption for each participant were obtained using a self-administrated food frequency questionnaire. The hazard ratios (HRs) of stroke in relation to total and specific FRF consumption were estimated through Cox proportional hazards regression models. During a median follow-up of 13.1 years, 4092 incident stroke cases (2557 cerebral infarctions and 1516 hemorrhagic strokes) were documented. After adjustment for age, body mass index, study area, lifestyles, dietary factors, and other risk factors, it was found that total FRF consumption was associated with a significantly lower risk of stroke in women (HR= 0.70; 95% CI, 0.58-0.84), while the association in men was not significant (HR= 0.93; 95% CI, 0.79-1.09). As for specific FRFs, consumptions of citrus fruits, strawberries, and grapes were found associated with a lower stroke risk in women. Higher consumptions of FRFs, in particular citrus fruits, strawberries, and grapes, were associated with a lower risk of developing stroke in Japanese women.

scholarly journals Supper Timing and Cardiovascular Mortality: The Japan Collaborative Cohort Study

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3389
Author(s):  
Jingyun Tang ◽  
Jia-Yi Dong ◽  
Ehab S. Eshak ◽  
Renzhe Cui ◽  
Kokoro Shirai ◽  
...  
Keyword(s):  
Hemorrhagic Stroke ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Stroke Mortality ◽  
Hazard Ratios ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Study Participants

Evidence on the role of supper timing in the development of cardiovascular disease (CVD) is limited. In this study, we examined the associations between supper timing and risks of mortality from stroke, coronary heart disease (CHD), and total CVD. A total of 28,625 males and 43,213 females, aged 40 to 79 years, free from CVD and cancers at baseline were involved in this study. Participants were divided into three groups: the early supper group (before 8:00 p.m.), the irregular supper group (time irregular), and the late supper group (after 8:00 p.m.). Cox proportional hazards regression models were used to calculate hazard ratios (HRs) for stroke, CHD, and total CVD according to the supper time groups. During the 19-year follow-up, we identified 4706 deaths from total CVD. Compared with the early supper group, the multivariable HR of hemorrhagic stroke mortality for the irregular supper group was 1.44 (95% confidence interval [CI]: 1.05–1.97). There was no significant association between supper timing and the risk of mortality from other types of stroke, CHD, and CVD. We found that adopting an irregular supper timing compared with having dinner before 8:00 p.m. was associated with an increased risk of hemorrhagic stroke mortality.

scholarly journals Twinning and Risk of Stillbirth Subtypes in Pediatric Mothers

2006 ◽  
Vol 9 (5) ◽  
pp. 673-676 ◽  
Author(s):  
Hamisu M. Salihu ◽  
Puza P. Sharma ◽  
Shillena Peters
Keyword(s):  
Adolescent Mothers ◽  
Proportional Hazards ◽  
Single Case ◽  
The United States ◽  
Cox Proportional Hazards ◽  
Adjusted Risk ◽  
Proportional Hazards Regression ◽  
Hazard Ratios ◽  
Comparison Groups ◽  
Twin Pregnancies

AbstractWe sought to estimate levels of risk for stillbirth subtypes associated with twin gestations among pediatric mothers (10–14 years). Analysis was on twin pregnancies covering the period 1989 to 2000 in the United States. We classified stillbirth as term, preterm, small-for-gestational-age (SGA) or preterm-SGA. We then assessed the risks of these stillbirth subtypes in pediatric mothers using two comparison groups consisting of women aged 15 to 19 years old (adolescent mothers) and 20 to 24 years old (mature mothers). Adjusted risk estimates were by means of hazard ratios generated from a Cox proportional hazards regression model. We adjusted for dependence of observations within twin clusters using the robust sandwich estimator. The rate of stillbirth was highest among pediatric mothers (56/1000), followed by adolescent gravidas (29/1000) and lowest in mature mothers (20/1000; p for trend < .01). Overall, preterm stillbirth was the most frequent stillbirth phenotype while term stillbirth was the least frequent. Not a single case of term stillbirth was recorded in pediatric mothers. Among pediatric gravidas, the risk for preterm stillbirth was more than tripled (adjusted hazard ratio [AHR] = 3.4; 95% confidence interval [CI] = 2.5–4.6), and that of preterm-SGA stillbirth more than doubled (AHR = 2.6; 95% CI = 1.8–3.7) that of mature mothers respectively. The 30% risk elevation for SGA stillbirth among pediatric mothers was not found to be statistically significant (AHR = 1.1; 95% CI = 0.3–4.3). Pediatric motherhood is a risk factor for stillbirth in twin gestation, especially, preterm and preterm-SGA stillbirth phenotypes. Prevention of stillbirth among this category of mothers should target the period preceding full term.

scholarly journals Factors that Influence the Duration of Symptom Resolution in COVID-19 Patients in Ethiopia: A Follow up Study Involving 60 Symptomatic Cases.

2021 ◽  
Author(s):  
Saro Abrahim ◽  
Masresha Tesema ◽  
Eshetu Ejeta ◽  
Mahammed Ahmed ◽  
Atkure Defar ◽  
...  
Keyword(s):  
Median Duration ◽  
Proportional Hazards ◽  
Statistical Significance ◽  
Signs And Symptoms ◽  
Cox Proportional Hazards ◽  
Treatment Center ◽  
Symptom Resolution ◽  
Proportional Hazards Regression ◽  
Study Participants

Abstract Background: The newly identified virus, Severe Acute Respiratory Syndrome Corona Virus-two (SARS-CoV-2) has claimed more than a million lives worldwide since it was first recognized in Wuhan, China in December 2019. Understanding the clinical features of COVID-19 and duration for resolution of symptoms is crucial for isolation of patients and tailoring public health messaging, interventions, and policy. Therefore, this study aims to assess the median duration of COVID-19 signs and symptoms resolution and explore it’s predictors among symptomatic COVID-19 patients in EthiopiaMethods: A hospital-based prospective cohort study involving 60 COVID-19 cases was conducted at Eka Kotebe General Hospital, COVID-19 Isolation and Treatment Center. The study participants were all symptomatic COVID-19 adult patients admitted to the hospital from March 18 to June 27, 2020. Physicians at the center recorded the data using a log sheet. Cox proportional-hazards regression model was conducted. Statistical significance was defined at P<0.05. All analyses were done using STATA version 16.1 software.Results: A total of 60 symptomatic COVID-19 patients with a mean age of 34.8 years (+1.8) were involved in the study. The median duration of symptom resolution of COVID-19 was seven days with a minimum of two and a maximum of 68 days. Sex and Body Mass Index (BMI) were statistically significant predictors of the symptom resolution. The hazard of having delayed sign or symptom resolution in males was 55% higher than in females (P=0.039, CI: 0.22 to 0.96) and the hazard of the delayed sign or symptom in those with BMI ≥25 was 48% higher than in those with BMI <25 (P=0.051; CI: 0.272 to 1.003). In this study, age and comorbidity had no association with the duration of sign or symptom resolution in COVID-19 patients.Conclusions: The median duration of COVID-19 symptom resolution was seven days. Being male or having a BMI ≥ 25 were predictors for having a delayed sign or symptom resolution time. Therefore, understanding the duration of COVID-19 sign or symptom resolution helps to guide the patient isolation period and prioritize COVID-19 patients to be shielded.

scholarly journals Association of Resting Heart Rate With Blood Pressure and Incident Hypertension Over 30 Years in Black and White Adults

Hypertension ◽  
2020 ◽  
Vol 76 (3) ◽  
pp. 692-698 ◽  
Author(s):  
Laura A. Colangelo ◽  
Yuichiro Yano ◽  
David R. Jacobs ◽  
Donald M. Lloyd-Jones
Keyword(s):  
Black Women ◽  
Black Men ◽  
Young Adulthood ◽  
White Women ◽  
Middle Age ◽  
White Men ◽  
Resting Heart Rate ◽  
Incident Hypertension ◽  
Black And White ◽  
Hazard Ratios

Few studies have assessed the association of resting heart rate (RHR) through young adulthood with incident hypertension by middle age. We investigated the association between RHR measured over 30 years with incident hypertension in a cohort of young Black and White men and women. A joint longitudinal time-to-event model consisting of a mixed random effects submodel, quadratic in follow-up time, and a survival submodel adjusted for confounders, was used to determine hazard ratios for a 10 bpm higher RHR. Race-sex specific effects were examined in a single joint model that included interactions of race-sex groups with longitudinal RHR. Out of 5115 participants enrolled in year 0 (1985–1986), after excluding prevalent cases of hypertension at baseline, 1615 men and 2273 women were included in the analytic cohort. Hypertension event rates per 1000 person-years were 42.5 and 25.7 in Black and White men, respectively, and 36.2 and 15.3 in Black and White women, respectively. The hazard ratios for a 10 bpm higher RHR were 1.47 (95% CI, 1.23–1.75), 1.51 (95% CI, 1.28–1.78), 1.48 (95% CI, 1.26–1.73), and 1.02, (95% CI, 0.89–1.17) for Black men, White men, White women, and Black women, respectively. Higher RHR during young adulthood is associated with a greater risk of incident hypertension by middle age. The association is similarly strong in Black men, White men, and White women, but absent in Black women, which may suggest racial differences in the effect of sympathetic nervous activity on hypertension among women.

Long-Term Exposure to Ambient Hydrocarbons Increases Dementia Risk in People Aged 50 Years and above in Taiwan

2020 ◽  
Vol 16 (14) ◽  
pp. 1276-1289
Author(s):  
Han-Wei Zhang ◽  
Victor C. Kok ◽  
Shu-Chun Chuang ◽  
Chun-Hung Tseng ◽  
Chin-Teng Lin ◽  
...  
Keyword(s):  
Air Pollutants ◽  
Proportional Hazards ◽  
The Elderly ◽  
Cox Proportional Hazards ◽  
Proportional Hazards Regression ◽  
Hazard Ratios ◽  
Dementia Risk ◽  
Disease Exposure ◽  
Total Hydrocarbons

Background: Alzheimer’s disease, the most common cause of dementia among the elderly, is a progressive and irreversible neurodegenerative disease. Exposure to air pollutants is known to have adverse effects on human health, however, little is known about hydrocarbons in the air that can trigger a dementia event. Objective: We aimed to investigate whether long-term exposure to airborne hydrocarbons increases the risk of developing dementia. Method: The present cohort study included 178,085 people aged 50 years and older in Taiwan. Cox proportional hazards regression analysis was used to fit the multiple pollutant models for two targeted pollutants, including total hydrocarbons and non-methane hydrocarbons, and estimated the risk of dementia. Results: Before controlling for multiple pollutants, hazard ratios with 95% confidence intervals for the overall population were 7.63 (7.28-7.99, p <0.001) at a 0.51-ppm increases in total hydrocarbons, and 2.94 (2.82-3.05, p <0.001) at a 0.32-ppm increases in non-methane hydrocarbons. The highest adjusted hazard ratios for different multiple-pollutant models of each targeted pollutant were statistically significant (p <0.001) for all patients: 11.52 (10.86-12.24) for total hydrocarbons and 9.73 (9.18-10.32) for non-methane hydrocarbons. Conclusion: Our findings suggest that total hydrocarbons and non-methane hydrocarbons may be contributing to dementia development.

Abstract P334: Ankle-Brachial Index and Future Diabetes: the Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Simin Hua ◽  
Laura Loehr ◽  
Hirofumi Tanaka ◽  
Gerardo Heiss ◽  
Josef Coresh ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Fasting Glucose ◽  
Ankle Brachial Index ◽  
Cox Proportional Hazards ◽  
Incident Diabetes ◽  
Atherosclerosis Risk In Communities ◽  
Black And White ◽  
Cox Proportional Hazards Models ◽  
Increased Risk ◽  
Future Diabetes

Introduction: Individuals with peripheral artery disease (PAD) often experience reduced physical function and activity, which may increase the future risk of diabetes. Although diabetes is a risk factor of PAD, whether low ankle-brachial index (ABI) predates diabetes has not been studied. Hypothesis: Low ABI is independently associated with increased risk of incident diabetes. Methods: ABI was measured on a randomly selected leg in 12,244 black and white participants without prevalent diabetes at baseline (1987-1989). Incident diabetes cases were identified by glucose measurements (fasting ≥126 mg/dl or non-fasting ≥200 mg/dl) at subsequent three visits (1990-92, 1993-95, and 1996-98) and self-reported diagnosis or medication use at those visits or during annual phone interview through 2011. We examined the association of ABI with incident diabetes after accounting for potential confounders using Cox proportional hazards models. Results: A total of 3304 participants developed diabetes during a median of 21 years of follow-up. Participants with low (<=0.9) or borderline low (0.9-1.0) ABI had 30-40% higher risk of future diabetes as compared to those with ABI of 1.1-1.2 in the demographically adjusted model (Table 1). The associations were attenuated after further adjustment for other potential confounders but remained significant for ABI 0.9-1.0 (HR=1.17, 95%CI 1.04-1.31), even after accounting for fasting glucose at baseline (P=0.046). The association were also attenuated for ABI <=0.9 (HR=1.19 [95% CI 1.00-1.43]) and remained borderline significant in model adjusting for confounders except fasting glucose. The association of low ABI with diabetes was more evident in persons with normal glucose (fasting glucose <100 mg/dl) than in those with impaired fasting glucose (100-125 mg/dl). Conclusions: Low ABI was mildly but independently associated with increased risk of incident diabetes in the general population. Attentions are needed regarding diabetes risk and glucose trajectory among people with low ABI.

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