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Biomedical subjects

M J Busby

Publications and source records attributed to M J Busby.

6 recordsLinked to original sources

Glucose tolerance in women: the effects of age, body composition, and sex hormones.

OBJECTIVE: To determine the separate and interactive effects of age, phase of the menstrual cycle, menopausal hormone status, body fat mass, and regional fat distribution on glucose tolerance in healthy women. DESIGN: Retrospective study. SETTING: The Baltimore Longitudinal Study of Aging. PATIENTS: Two hundred sixty healthy women aged 22-89 years. MEASUREMENTS: Plasma levels of estradiol and progesterone, body mass index (BMI), waist-to-hip ratio (WHR), and plasma glucose values in the fasting state (FPG) as well as 120 minutes after 40 gm/m2 of oral glucose (G120) were measured for each participant. RESULTS: We found a progressive decline in oral glucose tolerance of 0.4 mM (6.7 mg/dL)/decade at G120) in women from early to late adult years, with no relationship to phase of the menstrual cycle and no abrupt change associated with the menopause. Multiple regression analysis revealed significant, independent effects of BMI and WHR on FPG and G120. The influence of age (P less than 0.01) on G120 was stronger than that of the BMI or WHR (P less than 0.05). There was no significant relationship between the levels of endogenous sex hormones and glucose tolerance after adjustments for age, BMI, and WHR. However, women taking oral contraceptives, but not those receiving postmenopausal replacement therapy, did exhibit mildly elevated G120 values. CONCLUSIONS: Age per se, and to a lesser extent BMI and WHR, but not levels of endogenous sex steroids, contribute to the physiological decline in glucose tolerance in older women.

Activities of Daily Living

Reduced HDL2 cholesterol subspecies and elevated postheparin hepatic lipase activity in older men with abdominal obesity and asymptomatic myocardial ischemia.

Silent myocardial ischemia (SI), an asymptomatic manifestation of coronary artery disease (CAD), was identified in 10% of apparently healthy nonsmoking, nondiabetic older (60 +/- 7 years, mean +/- SD) men with normal plasma cholesterol levels. We hypothesized that in the absence of other major risk factors for CAD, the men with SI would have reduced plasma levels of high density lipoprotein (HDL) and HDL2 subspecies due to an upper-body fat distribution (waist-to-hip ratio [WHR]), hyperinsulinemia, and abnormal postheparin plasma lipoprotein lipase (LPL) and hepatic lipase (HL) activities. Compared with 47 normal control subjects of similar age, obesity, and maximal aerobic capacity, the 18 men with SI had higher plasma triglyceride (TG) (162 +/- 71 versus 102 +/- 39 mg/dl, p less than 0.001) and lower HDL-C (33 +/- 6 versus 37 +/- 7 mg/dl, p less than 0.02) levels with no difference in low density lipoprotein cholesterol level. The HDL2b and HDL2a subspecies measured by gradient gel electrophoresis were also lower in the men with SI (p less than 0.01). The plasma glucose and insulin responses during an oral glucose tolerance test were the same in both groups. Postheparin plasma HL activity was significantly higher in 12 men with SI than in 41 control subjects (34 +/- 8 versus 27 +/- 10 mumol/ml.hr-1, p less than 0.03) and was correlated with log insulin area (r = 0.36, p less than 0.05) and WHR (r = 0.32, p less than 0.05) in the control subjects but not in the men with SI. In the control group, the percent HDL2b subspecies was correlated inversely with postheparin plasma HL activity (r = -0.46, p less than 0.01, n = 41) as well as WHR (r = -0.49, p less than 0.001, n = 47) and log insulin area (r = -0.37, p less than 0.05, n = 47) but not in the men with SI. Postheparin LPL activity was the same in both groups of men and did not correlate with HDL, WHR, insulin, or plasma TG levels. As the control subjects and men with SI had comparable degrees of abdominal obesity and hyperinsulinemia, these results suggest that the reduced HDL-C levels in men with SI may be related to elevations in HL activity. Thus, abdominal obesity, hyperinsulinemia, elevated TG levels, and low HDL-C and HDL2 subspecies levels may predispose these older men to atherosclerosis.

Abdomen

Proton nuclear magnetic resonance methyl and methylene linewidths from plasma decrease during postprandial lipemia.

Narrow proton nuclear magnetic resonance (1H-NMR) linewidths from plasma have been associated with the presence of malignancy (Fossel et al., New Engl. J. Med. (1986) 315, 1369-1376). In that study, subjects and controls were not fasted. In the present study, 1H-NMR methyl and methylene linewidths were measured in plasma from normolipemic individuals without cancer both during fasting and every 90 min after eating a fat meal. Plasma lipoprotein levels were measured in order to relate results to postprandial lipemia. Methyl, methylene, and average 1H-NMR linewidths were strongly positively correlated with high-density lipoprotein levels and inversely correlated with triacylglycerol-rich lipoprotein levels in both the fasting and postprandial states. Linewidths decreased postprandially, reaching a nadir at the peak of plasma triacylglycerol levels. This study demonstrated that postprandial lipemia can lead to narrowing of plasma methyl and methylene resonances comparable to that reported for subjects with cancer.

Chylomicrons

Prevalence and long-term significance of exercise-induced frequent or repetitive ventricular ectopic beats in apparently healthy volunteers.

Frequent or repetitive exercise-induced ventricular ectopic beats are often considered a marker for serious cardiac disease or sudden death, or both. However, the prognostic value of these arrhythmias in an unreferred asymptomatic community-dwelling population over a broad age range is unknown. Of 1,160 subjects aged 21 to 96 years who underwent maximal exercise treadmill testing an average of 2.4 times, 80 (6.9%) developed frequent (greater than or equal to 10% of beats in any 1 min) or repetitive (greater than or equal to 3 beats in a row) ventricular ectopic beats on at least one test. These 80 individuals were significantly older than the group without such arrhythmia (63.8 +/- 12.5 versus 50.0 +/- 16.1 years, p less than 0.0001). A striking age-related increase in the prevalence of frequent or repetitive exercise-induced ventricular ectopic beats was seen in men (p less than 0.0001) but not in women. The prevalence of electrocardiographic abnormalities at rest, exercise-induced ST segment depression and thallium perfusion defects, duration of treadmill exercise, maximal heart rate, systolic blood pressure and rate-pressure product did not differ between these 80 study subjects with frequent exercise-induced ventricular ectopic beats and a control group matched for age and gender. Furthermore, the incidence of cardiac events (angina pectoris, nonfatal myocardial infarction, cardiac syncope or cardiac death) (10% versus 12.5%) as well as noncardiac mortality (each 7.5%) was found to be similar for the study and control groups, respectively, over a mean follow-up period of 5.6 years. No study subjects required antiarrhythmic drugs over this time interval.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult