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Biomedical subjects

M Kornitzer

Publications and source records attributed to M Kornitzer.

At least 55 records · Page 3Linked to original sources
PubMed1995

Ankle/arm pressure index in asymptomatic middle-aged males: an independent predictor of ten-year coronary heart disease mortality.

PURPOSE OF THE STUDY: to evaluate the predictive power of a reduced ankle/brachial pressure index (ABPI) (< or = .90) in an asymptomatic middle-aged male working population free of coronary heart disease. MATERIALS AND METHODS: 2023 subjects forty to fifty-five years old were screened at their work place. Standard techniques were used. Blood was drawn in the fasting state. Ankle and brachial blood pressures were measured by Doppler signals and all measures were done by one observer, duly trained in epidemiologic methodology. RESULTS: in univariate analysis, an ABPI < or = .90 was significantly associated with age, total serum cholesterol, body mass index, smoking, and awareness of diabetes. In multivariate analysis, it was associated with awareness of diabetes, age, Ln triglycerides (P = .073), and smoking (P = .088). Relative risks for reduced versus normal ABPI are 2.77 (P = .010), 4.16 (P = .011) and 4.97 (P = .006) for ten-year all causes, cardiovascular, and coronary mortality, respectively. In a multiple logistic regression analysis, the following variables were significant independent predictors of coronary mortality: smoking (odds ratio [OR] = 4.84), reduced ABPI (OR = 3.63), and low density lipoprotein cholesterol (OR for 1 SD = 1.69). Reduced ABPI is also an independent predictor of cardiovascular mortality. CONCLUSION: a reduced ABPI is an independent risk factor for coronary and cardiovascular mortality in asymptomatic middle-aged Belgian males.

Adult↗
PubMed1995

[Lessons from the MONICA project].

The authors review the various aspects of the MONICA project (Monitoring of Trends and Determinants in Cardiovascular Diseases) coordinated by the World Health Organization. This study comprises, in a defined geographical or administrative entity, an infarction Registry, two or three population surveys and two or three surveys concerning the treatment of the acute phase of myocardial infarction. It is a ten-year study conducted by 39 collaborative centres in 4 continents. The main hypotheses of this study have not yet been verified, as some centres have not completed the 10 years of infarction recording and/or the last population survey. However, the results collected to date and reported in about ten publications grouping all centres, and more than 500 articles published by various centres, demonstrate the wealth of precious information for clinicians provided by this public health project. For example, the infarction Registry demonstrates marked regional differences in myocardial infarction rates in the population and therefore marked differences in acute coronary bed requirements. The Registry also confirms the higher mortality rates in women and at the end of infarction compared to men. Population surveys can be used to follow the course of the main coronary risk factors and to compare the levels of risk factors in different centres. Regional differences clearly show that a more or less aggressive approach to primary prevention is required. Finally, the presence of an infarction Registry and population surveys allow the elaboration of case-control study protocols, several examples of which are mentioned by the authors. All of these techniques will be able to more clearly define the aetiology of coronary heart disease and, consequently, the reduction of this disease in the population by adequate primary and secondary prevention.

Acute Disease↗
PubMed1994

Efficacy and tolerance of 200 mg micronised fenofibrate administered over a 6-month period in hyperlipidaemic patients: an open Belgian multicenter study.

The authors report the results of a large open multicenter study using 200 mg micronised fenofibrate once a day. Among 1545 selected patients who underwent a 3-month period with nutritional advice, 1334 were included in a 6-month drug study. Inclusion criteria were total serum cholesterol equal to or above 250 mg/dl and/or serum triglycerides equal to or above 200 mg/dl. At 6 months, average changes from inclusion levels were -20.5, -26.1. -7.5 and +15.2% for total cholesterol, LDL-cholesterol > or = 160 mg/dl on inclusion, plasma fibrinogen and HDL-cholesterol, respectively. Median decrease of serum triglycerides was 46.5%. Trial discontinuation for clinical and biological adverse events were 5 and 1%, respectively. In conclusion, micronised fenofibrate at a daily dose of 200 mg had significant lipid-modifying properties but also exhibited a beneficial effect on other related risk factors such as fibrinogen reduction. The safety profile was very satisfactory providing an excellent benefit/risk ratio.

Adolescent↗
PubMed1994

Epidemiological evidence for an association between serum calcium and serum lipids.

To study the association between serum calcium and serum lipids, data from 5394 men and 4800 women in the Belgian Interuniversity Research on Nutrition and Health (25-74 years) were used. By visual inspection of the data a linear increase of both total and HDL cholesterol with serum calcium levels was observed, consistently over all age groups and both sexes. In order to adjust the measured serum calcium concentrations for total serum protein, statistical analyses were performed using Parfitt's correction formula. Multivariate analysis showed in both sexes a highly significant positive association between corrected calcium and total cholesterol independent of age, systolic blood pressure, body mass index, serum uric acid, P/S ratio of diet, cholesterol intake, smoking, educational level and geographical area. The adjusted differences in total cholesterol between the lowest and highest quartile range of the calcium distribution were about 13 mg/dl for both men and women. Protein-corrected calcium was among the strongest correlates with total cholesterol. The analysis of the relation with HDL cholesterol revealed an effect modification by gender. For men no statistically significant correlation between calcium and HDL cholesterol was observed while for women a strong increase of HDL with protein-corrected calcium was found resulting in an adjusted difference of 2.5 mg/dl between the lowest and highest calcium quartile range.

Adult↗
PubMed1994

The predictive value of electrocardiographic abnormalities for total and cardiovascular disease mortality in men and women.

The relationship between ECG abnormalities and mortality was studied in 4797 males and 4320 females aged 25 to 74 years who took part in the Belgian Inter-university Research on Nutrition and Health (The BIRNH study). At entry all were free of angina, had no history of acute myocardial infarction and showed no evidence of an old infarction on their baseline ECG. They were followed for an average of 5.6 years, and follow-up for vital status was completed satisfactorily in 99.5%. ECG abnormalities were grouped using several classifications: any abnormality, major and minor abnormalities, ischaemic changes, left ventricular hypertrophy and the separate Minnesota codes IV (ST depression), V (abnormal T-wave) and VIII (arrhythmias). Using logistic regression analysis, adjustment of odds ratios for cardiovascular disease (CVD) mortality was done for age, systolic blood pressure, serum total cholesterol and uric acid, diabetes, smoking and antihypertensive drug treatment. Men outnumbered women more than twice in total and CVD mortality. Multivariate analysis showed that the presence of major abnormalities on the ECG was significantly related to CVD mortality in both men and women (adjusted odds ratios 2.73 and 4.40 respectively). In contrast, minor abnormalities were not independently associated with CVD mortality. In men, ST depression (OR = 5.58), signs of an ischaemic ECG (OR = 3.02) and an abnormal T-wave (OR = 2.58) were independently related to CVD mortality. In women primarily a ST depression (OR = 5.87) and arrhythmias (OR = 4.22) had a significant independent effect on CVD mortality.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Twenty-five-year mortality follow-up in the Belgian Bank Study.

Two cohorts of male bank employees aged 40-59 at baseline and free of coronary heart disease were pooled and followed during 25 years for all-cause and coronary mortality. The vital status was known for all 1,227 subjects, but in both banks, 8% of all deaths occurred without any clue to a possible cause. All-cause and coronary mortality were 36.9 and 10.5 per 100 subjects, respectively. In bivariate analysis (adjusting for age), systolic blood pressure, diastolic blood pressure, serum cholesterol and cigarette smoking predicted all-cause mortality. The same variables predicted coronary mortality. Body mass index was neither a predictor of all-cause nor of coronary mortality. In multivariate analysis, age, systolic blood pressure and cigarette smoking predicted independently all-cause mortality whereas the same variables and serum cholesterol predicted coronary mortality. For coronary mortality, the odds ratio (OR) of systolic blood pressure > or = 160 against < 140 mm Hg was 2.68 (95% confidence interval, CI: 1.41-5.08). The OR for subjects with baseline serum cholesterol > or = 260 versus < 260 mg/dl was 1.68 (95% CI: 1.31-2.51). The OR for cigarette smokers versus never smokers was 2.54 (95% CI: 1.39-4.64). Age-adjusted relative risk for all-cause mortality for subjects in the highest versus the lowest quintile of a multiple logistic function was 1.72 whereas for coronary mortality the relative risk was 4.94. These results confirm the long-term predictive power of the three major modifiable coronary risk factors when measured once in middle-aged male subjects.

Adult↗
PubMed1993

[Hyperlipidemia and atherosclerosis: epidemiology, biochemistry and therapy].

Cardiovascular diseases cause 40% of deaths in Belgium. The coronary risk is more important in the Southern than in the Northern part of the country, owing probably to different levels of serum cholesterol due to different fat contents of the diet. The features of lipoprotein metabolism are mainly the permanent transfer of apoproteins and the dynamic exchange of neutral lipids. Atherogenic particles include remnants enriched in cholesterol esters and low density lipoproteins (LDL) after their oxidation. New European guidelines insist more on secondary prevention than on primary prevention.

Arteriosclerosis↗
PubMed1991

Platelet fatty acids and function in two distinct regions of Belgium: relationship to age and dietary habits.

We compared the dietary habits, fatty acid composition of plasma and platelet phospholipids, and platelet function in two groups of healthy Belgian male subjects, known to differ in their mortality rate from coronary heart disease (CHD). In the Walloon subjects, there was a larger intake of saturated and a lower intake of (n-6) polyunsaturated fats, confirmed by the fatty acid composition of plasma and platelet phospholipids. While plasma HDL and total cholesterol were similar in the present samples of the two communities, platelet aggregation to epinephrine was significantly higher in the Walloon subjects. When the two populations were divided into younger (28-54 years) and older (55-73 years) age groups, the older Walloon subjects exhibited platelet hyper-aggregability to most of the agonists, compared to the other three groups. In addition to dietary fats, alcohol and smoking habits, age was an important determinant of platelet phospholipid fatty acids and platelet reactivity. The present results reinforce those of previous studies, indicating that platelet behaviour is significantly affected by the main risk factors for CHD.

Aging↗
PubMed1990

Determinants of fat consumption in a general population.

In a random sample of the adult population (aged 25-64 years) from Ghent and Charleroi in Belgium, dietary fat consumption was estimated using both qualitative and quantitative dietary methods. A fat consumption score (FCS) was constructed from the qualitative method, and it correlated significantly with the dietary polyunsaturated/saturated fatty acids (P/S) ratio calculated from the quantitative method (r = -0.48; p less than 0.001). Differences in FCS were then studied using univariate and multivariate analyses. In both men and women, FCS was higher in Charleroi than in Ghent. In men, FCS was inversely related with educational level and with age. In women, significant correlations were observed with marital status. No differences were found in FCS by smoking behaviour. With the coronary risk factors, low-order relationships were found, but only in men. In the middle-aged group, significant correlations were found between FCS and the fatty acid composition of the serum cholesteryl esters, in particular with the linoleate/oleate ratio.

Adult↗
PubMed1989

Relationship between serum cholesteryl ester composition, dietary habits and coronary risk factors in middle-aged men.

Serum cholesteryl palmitate, oleate, linoleate and arachidonate were measured using high performance liquid chromatography in 134 men aged 45-64 years, randomly selected from the population of Ghent, Belgium. No relationship was observed between these cholesteryl esters, expressed as a percentage of their total, and age, serum cholesterol, arterial blood pressure, smoking habits and body mass index. Dietary habits were assessed using a 3-day diary method. No relationship was found between dietary habits and serum lipids. Highly significant correlations were observed between diet and the serum cholesteryl esters. In multivariate analyses dietary variables account for significant proportions of the variances of the serum cholesteryl esters. The results indicate that measurements of cholesteryl esters can be used to differentiate on the population level between subgroups with different dietary habits particularly with respect to fat consumption.

Age Factors↗
PubMed1989

Quantitation of plasma free cholesterol and cholesteryl esters by high performance liquid chromatography. Study of a normal population.

We describe a convenient method for the separation and quantitation of plasma free cholesterol and cholesteryl esters by high performance liquid chromatography (HPLC). After extraction of 100 microliters plasma with isopropanol the plasma cholesteryl esters were resolved on a Zorbax ODS reversed-phase column by isocratic elution with acetonitrile/isopropanol (50:50, v/v). Baseline separation of the plasma cholesteryl esters including the internal standard was obtained within a 25-min run. The intra- and interassay CV was less than 4%. The results obtained by HPLC show good agreement with enzymatic and gas-liquid chromatographic methods. High performance liquid chromatography provides a simple method for the quantitation of individual cholesteryl esters avoiding tedious chromatographic and derivatisation steps inherent to GLC. Our HPLC method was applied to the monitoring of plasma cholesteryl esters in a normal population and can also be used for the study of cholesteryl esters from lipid extracts of biological samples.

Adult↗
PubMed1989

[Determinants of fat consumption in a general population].

In a random sample of the adult population (aged 25-64 yr) from Ghent and Charleroi in Belgium, dietary fat consumption was estimated using both qualitative and quantitative dietary methods. A fat consumption score (FCS) was constructed from the qualitative method and correlated significantly with the dietary P/S ratio calculated from the quantitative method. Differences in FCS were then studied using univariate and multivariate analyses. In both men and women FCS was higher in Charleroi than in Ghent. In men FCS was inversely related with educational level and with age and positively related with BMI. In women no significant correlations were observed. In the middle-aged group (aged 45-64 yr) significant correlations were found between FCS and the fatty acid composition of the cholesterol-esters, in particular with the linoleate/oleate ratio.

Adult↗
PubMed1989

[The Belgian project for the prevention of cardiovascular diseases: a model of multifactorial prevention].

Résults are presented from the "belgian heart disease prevention project, part of the WHO european collaborative trial in the multifactorial prevention of coronary heart disease (CHD)". 19.409 men aged 40-59 yr took part; they were employed in thirty factories which formed the allocation units for a randomised controlled trial lasting 5-6 yr. The intervention package consisted largely of health education promoting a cholesterol-lowering diet, smoking cessation, weight control, physical activity, and treatment of arterial hypertension. A programme of information was supplemented by face-to-face counselling at the workplace by two physicians attached to the project. The coronary risk profile was reduced in the intervention group, compared with that in the control group, especially during the first 4 yr, by effects on serum cholesterol, number of cigarettes smoked daily, and arterial blood-pressure. Total mortality was 17.5% lower in the intervention group than in the control group (p = 0.038); coronary mortality was reduced by a non-significant 20.8% whereas CHD incidence (non-fatal myocardial infarction plus fatal myocardial infarction plus sudden deaths) was reduced by 24.5%, (P = 0.031). Non-fatal myocardial infarction (not a major end-point) was similarly reduced by 26.1% (p = 0.030).

Adult↗