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Biomedical subjects

H King

Publications and source records attributed to H King.

At least 127 records · Page 7Linked to original sources
PubMed1985

Non-insulin-dependent diabetes in Nauruans: a comparison of newly and previously diagnosed cases.

A comparison of 148 newly diagnosed ('incident') and 202 previously diagnosed ('prevalent') Nauruan diabetics, examined during a population survey in 1982, has permitted cautious inference regarding the natural history of non-insulin-dependent diabetes (NIDDM) in this Micronesian population. As might be expected the results of the comparison do suggest that Nauruan diabetics undergo further deterioration in glucose tolerance, subsequent to diagnosis of the disease. Plasma glucose concentration is higher in prevalent than incident cases (males: fasting--12.2 versus 10.4 mmol/l; 2 h--18.9 versus 16.3 mmol/l; and females: fasting--13.1 versus 9.3 mmol/l; 2 h--20.3 versus 15.8 mmol/l) suggesting that present treatment measures may not be effective in this population. There was also some evidence that the metabolic consequences of NIDDM may be greater in female than in male Nauruans. Apart from plasma glucose concentration, of 8 other biological variables examined by univariate and multiple logistic regression analysis, three showed consistent differences between incident and prevalent cases in females, but none were consistently different in males. A relatively small difference in estimates of obesity was observed between incident and prevalent cases, and this was particularly notable in males. A number of potential sources of bias in this study are highlighted, and definitive, longitudinal studies will be required to corroborate these findings.

Adult↗
PubMed1985

Mortality and health service utilization amongst Melanesian and Indian diabetics in Fiji.

A population-based survey of the biracial population of Fiji conducted in 1980 showed non-insulin dependent diabetes (NIDDM) prevalence to be high amongst urban Melanesians and Asian Indians. Follow-up of the cohort of urban residents has been conducted at the major sites of health service delivery in Suva, and surveillance now encompasses 4 years of such attendances. Age-adjusted mortality rates for diabetic subjects were increased compared with normal subjects (relative risks for 4 year mortality being 4.6 for Indians, P less than 0.01, and 1.5 for Melanesians, P greater than 0.1). Inpatient admission rates were also increased amongst diabetic subjects, but only significantly for the females. The relative risk of admission was 3.1 for Melanesian and 2.6 for Indian females (both significant at P less than 0.05). These results suggest that NIDDM in these populations is associated with several adverse health outcomes, and confirms for developing country populations the association of NIDDM with excess mortality noted amongst developed country populations.

Adult↗
PubMed1985

Factors associated with the development of diabetes in the Micronesian population of Nauru.

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.

Adult↗
PubMed1985

Patterns of site-specific displacement in cancer mortality among migrants: the Chinese in the United States.

Taking advantage of the information gathered for the 1975 National Mortality Survey in China, this paper compares the levels of cancer mortality among foreign-born and United States-born Chinese around 1970 with those of the communities of origin of the majority of Chinese migrants to the US. Age-adjusted rates indicate two distinctive site-specific patterns among US Chinese: a downward trend for cancers of high risk among Guangdong and Hong Kong Chinese (nasopharynx, esophagus, liver, uterus, and perhaps stomach) and an upward trend for those sites of low risk among Chinese in Guangdong and Hong Kong (colon, lung, leukemia, and female breast). Further field studies are needed with emphasis on the birthplace of migrants and environmental changes in host countries.

Adolescent↗
PubMed1985

Glucose tolerance in Papua New Guinea: past and future studies.

The ethnic and geographic diversity to be found in Papua New Guinea provide unique opportunities for the study of the epidemiology of glucose intolerance and diabetes. Whereas coastal populations have been influenced by successive waves of migrants of Austronesian origin, the Papua New Guinea highlanders were not influenced genetically by these people, and now represent one of the few non-Austronesian populations in the Pacific. Early studies in Papua New Guinea suggested that diabetes was not uncommon in coastal communities. Austronesian populations in other regions of the Pacific are also susceptible to glucose intolerance. Of particular interest, however, were the results of a diabetes survey conducted in a highland population in 1983. No diabetic subjects were discovered among over 300 examined. Further studies have now been planned, which aim to determine whether the apparent resistance of Papua New Guinea highlanders to glucose intolerance is genetically determined, or whether modernization of lifestyle will lead to the emergence of diabetes as a health problem in this region, as it already is in other areas of the Pacific. The future studies have been carefully designed, so as to define the relative importance of genetic and environmental components in the variability of glucose tolerance.

Acculturation↗
PubMed1985

Lower-extremity rotational problems in children. Normal values to guide management.

We studied 1,000 normal lower extremities of children and adults in order to establish normal values for the rotational profile. The intrauterine position of the fetus molds the femur by rotating it laterally and molds the tibia by rotating it medially. These molding effects usually resolve spontaneously during infancy, and then genetically determined individual differences are unmasked. Rotational problems should be clinically evaluated and the findings compared with the normal values provided by this study. Out-toeing in infants, medial tibial torsion in toddlers, and medial femoral torsion in young children are extremes of a normal developmental pattern. In the vast majority, these rotational variations fall within the broad range of normal and require no treatment.

Adolescent↗
PubMed1985

Genetic and environmental influence in the epidemiology of noninsulin-dependent diabetes mellitus: a global perspective.

Refinement of the classification of diabetes mellitus to include two major categories, insulin dependent (IDDM) and noninsulin-dependent (NIDDM) and the recent attention paid to the standardization of epidemiological techniques have led to much new information on the epidemiology of the disease. Support for the notion of genetic influence in the development of NIDDM has come from twin studies, but the search for specific genetic markers for NIDDM has been largely unproductive to date. There is increasing scepticism as to the utility of the chlorpropamide-alcohol flush as a genetic marker for NIDDM. The large disparity in the frequency of NIDDM between populations provides indirect support for the genetic hypothesis, as do recent studies of the association between NIDDM and ancestral genetic admixture. Obesity has long been considered a causal factor in the aetiology of NIDDM, though the strength and consistency of this relationship is now being questioned. The strength of the association between obesity and NIDDM has been shown to vary depending on the presence or absence of a family history of the disease. There is further preliminary evidence to suggest that association between obesity and NIDDM may vary in strength between populations, and between the sexes. Little evidence has so far emerged for a role of quantitative or qualitative aspects of diet in the aetiology of NIDDM. This may be due, in part, to the imprecision of current techniques for dietary estimation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Blood pressure in Papua New Guinea: a survey of two highland villages in the Asaro Valley.

The results of a population survey of blood pressure in the adult residents of two highland villages in the Asaro Valley, Papua New Guinea are reported. The survey was conducted in 1983 as part of a wider epidemiological investigation of non-communicable disease in Papua New Guinea. Response to the survey was 95%, and 308 subjects were examined. Population estimates of both systolic and diastolic blood pressures were low and there was a virtual absence of hypertension, as defined by internationally recommended criteria. There was no evidence of a rise in blood pressure with age, and the association between blood pressure and indices of obesity was weak. These findings are consistent with previous studies of blood pressure in traditional Papua New Guinean societies. The two villages differed with respect to their degree of modernisation. An unexpected finding was that in both sexes, both systolic and diastolic blood pressures were higher in the more traditional village. In each case, these differences were consistent across the three age groups examined, and they could not be explained by differences between the villages with respect to the indices of obesity. Analysis of variance showed that the higher blood pressures in the more traditional village were most unlikely to be due to chance (p less than 0.001). The explanation for this finding remains obscure.

Adult↗
PubMed1984

Impaired glucose tolerance in Kiribati.

Subjects with impaired glucose tolerance have been shown to have a higher risk for subsequent diabetes and increased susceptibility to atherosclerosis. Data obtained from a cross-sectional medical survey in Kiribati in 1981 have been studied for evidence as to whether impaired glucose tolerance is a truly separate category of glucose intolerance. Subjects in the impaired glucose tolerance category were compared to both normal and diabetic subjects with respect to the mean values of certain variables including plasma glucose, body mass index, plasma cholesterol, plasma triglycerides, and systolic blood pressure. Differences between impaired glucose tolerant and normal subjects, and between impaired glucose tolerant and diabetic subjects were assessed. The most important differences between groups occurred with respect to plasma glucose concentration, body mass index, and plasma lipids. The results of this study provide further support for the validity of the impaired glucose tolerance category.

Adult↗
PubMed1984

Kaposi's sarcoma, tuberculosis and Hodgkin's lymphoma in a lymph node--possible acquired immunodeficiency syndrome. A case report.

A patient in whom a single lymph node contained Kaposi's sarcoma, tuberculosis and Hodgkin's lymphoma is reported on. Kaposi's sarcoma was also present in the skin of the legs, and serum antibody titres to cytomegalovirus were elevated. This case may represent acquired immunodeficiency syndrome in a Black South African male.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Glucose tolerance and ancestral genetic admixture in six semitraditional Pacific populations.

Population-based data on 1,842 subjects from six semitraditional Pacific communities, collected in the years 1978-1983, have been compared in order to examine the hypotheses that differences in the distribution of plasma glucose concentration between populations are to some extent genetically determined, and that non-Austronesian (NAN) Melanesians are relatively resistant to glucose intolerance. Semitraditional communities were chosen for study so that the comparison would be minimally confounded by either known or as yet undetermined environmental factors associated with nontraditional living, the effects of which may vary between populations. The samples were also selected so as to provide a gradient of proportional NAN and AN admixture. They were drawn from the following regions: the highlands of Papua New Guinea, New Caledonia, Fiji, the Wallis Islands, Western Samoa, and Kiribati (formerly the Gilbert Islands). The Papua New Guinea highlanders, of entirely NAN ancestry, were regarded as the baseline population. A gradient of increasing mean 2-hr plasma glucose concentration was observed across the six populations and differences persisted between populations, after controlling for age and obesity. Variations in diet, physical activity, and degree of sociocultural modernization were not considered a sufficient or consistent explanation of these findings and they therefore lend tentative support to the hypothesis of a genetic component to variability in glucose tolerance. The relationship between population estimates of glucose tolerance and estimates of the genetic distance from the baseline NAN Melanesian sample was examined. With the notable exception of Fiji, there was evidence of a linear correlation between the two parameters.

Female↗
PubMed1984

The natural history of impaired glucose tolerance in the Micronesian population of Nauru: a six-year follow-up study.

A longitudinal study of 266 randomly selected non-diabetic Nauruans (215 normal subjects, 51 with impaired glucose tolerance) has permitted the natural history of impaired glucose tolerance to be studied in this Micronesian population. Nauruans are known to suffer from a very high prevalence of abnormal glucose tolerance. The subjects were first examined in 1975-1976, and a follow-up examination was performed in 1982. Of the subjects with impaired glucose tolerance, 26% developed diabetes during the study period (4% per annum) compared with 7% of normal subjects (1% per annum). After controlling for the effects of both age and obesity, the risk of subsequent diabetes for subjects with impaired glucose tolerance remained significantly higher than for normal subjects (odds ratio 3.6, 95% confidence interval 1.4-9.1). Of those with impaired glucose tolerance on initial examination, 39% were normoglycaemic at follow-up. In subjects with impaired glucose tolerance, of nine factors examined only plasma glucose concentration at the time of the initial examination was consistent in predicting progression to diabetes, when the data were examined by both univariate and multivariate methods. Both 2-h and fasting plasma glucose values were useful predictors. Thus, Nauruans with impaired glucose tolerance have a higher risk of subsequent diabetes than their normoglycaemic counterparts, after controlling for age and obesity. Nevertheless, the prognosis of impaired glucose tolerance is unpredictable as a substantial proportion of such subjects return to normality.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

Factors affecting fasting serum C-peptide levels in Micronesians: comparison with a Caucasoid population.

Fasting serum C-peptide immunoreactivity was determined on Nauruans, a Micronesian population with a high prevalence of diabetes. In Micronesian subjects neither age nor gender had a significant effect on fasting serum C-peptide. In non-diabetic subjects, as has been shown previously for Caucasiod subjects, both obesity and fasting plasma glucose levels were determinants of fasting serum C-peptide. Obesity was the major determinant. Taken overall, mean fasting serum C-peptide increased then possibly fell in subjects grouped by increasing 2-h post-glucose plasma glucose levels. Mean fasting serum C-peptide in newly-diagnosed diabetic subjects was greater than that in non-diabetic subjects with a similar degree of obesity, supporting the concept that the transition to diabetes may be associated with an increase in insulin resistance. The data for non-diabetic subjects were compared with serum C-peptide measured in the same laboratory on samples from a Caucasoid population in Busselton, Western Australia. There was no difference in fasting serum C-peptide level between Micronesian and Caucasoid subjects approximately matched for obesity and fasting plasma glucose levels.

Adult↗
PubMed1984

Venous prostheses: improved patency with external stents.

A uniformly successful prosthesis for replacement in the venous system has not been developed. This study assesses the effect of external stents on the patency of polytetrafluoroethylene (PTFE) grafts in the infrarenal vena cava. Under general anesthesia, 21 mongrel dogs underwent midline laparotomy. The infrarenal vena cava was resected and replaced by a standard segment (8 cm X 10 mm) of stented PTFE (12 dogs) and nonstented PTFE (9 dogs). Patency was assessed by contrast venography and the results compared between the two groups. The 7-, 30-, and 90-day patency was 12/12, 10/12, and 9/12, respectively, for stented PTFE and 6/9, 2/9, and 2/9, respectively, for nonstented PTFE. The patency of externally stented PTFE at 30 and 90 days was significantly better than grafts fashioned from PTFE alone (P less than 0.05 by chi-square analysis). These data demonstrate that external stenting improves the early patency of PTFE prostheses in the infrarenal vena cava. Consideration should be given to the clinical use of externally stented PTFE when prosthetic replacement in the venous system is required.

Animals↗