Biomedical subjects

Maurizio Trevisan

Publications and source records attributed to Maurizio Trevisan.

11 recordsLinked to original sources

PubMed2003

Estrogen plus progestin and the risk of coronary heart disease.

BACKGROUND: Recent randomized clinical trials have suggested that estrogen plus progestin does not confer cardiac protection and may increase the risk of coronary heart disease (CHD). In this report, we provide the final results with regard to estrogen plus progestin and CHD from the Women's Health Initiative (WHI). METHODS: The WHI included a randomized primary-prevention trial of estrogen plus progestin in 16,608 postmenopausal women who were 50 to 79 years of age at base line. Participants were randomly assigned to receive conjugated equine estrogens (0.625 mg per day) plus medroxyprogesterone acetate (2.5 mg per day) or placebo. The primary efficacy outcome of the trial was CHD (nonfatal myocardial infarction or death due to CHD). RESULTS: After a mean follow-up of 5.2 years (planned duration, 8.5 years), the data and safety monitoring board recommended terminating the estrogen-plus-progestin trial because the overall risks exceeded the benefits. Combined hormone therapy was associated with a hazard ratio for CHD of 1.24 (nominal 95 percent confidence interval, 1.00 to 1.54; 95 percent confidence interval after adjustment for sequential monitoring, 0.97 to 1.60). The elevation in risk was most apparent at one year (hazard ratio, 1.81 [95 percent confidence interval, 1.09 to 3.01]). Although higher base-line levels of low-density lipoprotein cholesterol were associated with an excess risk of CHD among women who received hormone therapy, higher base-line levels of C-reactive protein, other biomarkers, and other clinical characteristics did not significantly modify the treatment-related risk of CHD. CONCLUSIONS: Estrogen plus progestin does not confer cardiac protection and may increase the risk of CHD among generally healthy postmenopausal women, especially during the first year after the initiation of hormone use. This treatment should not be prescribed for the prevention of cardiovascular disease.

Aged↗

PubMed2003

Alcohol drinking patterns differentially affect central adiposity as measured by abdominal height in women and men.

Alcohol drinking in light-to-moderate amounts has been associated with reduced coronary heart disease (CHD) risk. However, there is evidence that the way people consume alcohol (drinking pattern) may affect risk. Central adiposity, a known CHD risk factor may be one mechanism in the pathway between alcohol consumption and CHD risk. Our study examined whether various drinking patterns differentially affect fat distribution, particularly abdominal fat in women and men. In a randomly selected population-based cohort (n = 2343), 35-79 y old, we assessed drinking pattern as reported for the past 30 d, including beverage type and amount, frequency of consumption, percentage of time drinking while eating and number of drinks consumed/drinking day. Central adiposity was determined using an abdominal caliper to measure supine height of the abdomen. Current drinkers tended to have smaller abdominal heights than nondrinkers (women, P < 0.0001; men, P = 0.0559). For drinking pattern, frequency was inversely associated, but drinking intensity (drinks/drinking day) was positively associated with central adiposity in women (P trend for frequency, 0.0007; intensity, 0.0010) and men (P trend for frequency, 0.0005; intensity, 0.0004), even when age, education, physical activity, smoking status and amount of alcohol (g) were included in the models. When frequency and intensity were considered together, daily drinkers of <1 drink/drinking day had the smallest mean abdominal height measures with the largest measures in less than weekly drinkers who consumed 4 or more drinks/drinking day. These results support the hypothesis that drinking pattern affects the distribution of body fat, an important CHD risk factor.

Abdomen↗

PubMed2003

Average volume of alcohol consumption and all-cause mortality in African Americans: the NHEFS cohort.

AIM: To analyze the relationship between average volume of alcohol consumption and all-cause mortality in African Americans. DESIGN: Prospective cohort study--the NHANES Epidemiologic Follow-Up Study (NHEFS)--with baseline data collected 1971 through 1975 as part of the first National Health and Nutrition Examination Survey (NHANES I) and follow-up through 1992. PARTICIPANTS: The analytic data set consisted of 2054 African American men (n = 768) and women (n = 1,286), 25 to 75 years of age, who were followed for approximately 19 years. MEASUREMENT: Alcohol was measured with a quantity-frequency measure at baseline. OUTCOME: All-cause mortality. RESULTS: No J-shaped curve was found in the relationship between average volume of alcohol consumption and mortality for male or female African Americans. Instead, no beneficial effect appeared and mortality increased with increasing average consumption for more than one drink a day. The reason for not finding the J-shape in African Americans may be the result of the more detrimental drinking patterns in this ethnicity and consequently the lack of protective effects of alcohol on coronary heart disease. Taking into account sampling design did not substantially change the results from the models, which assumed a simple random sample. CONCLUSIONS: If this result can be confirmed in other samples, alcohol policy, especially prevention, should better incorporate patterns of drinking into programs.

Adult↗

PubMed2003

Relation between lung function and RBC distribution width in a population-based study.

STUDY OBJECTIVES: Pulmonary function is dependent not only on smoking, but also on nutritional status. Since an increased RBC distribution width (RDW) has been associated with nutritional deficiencies, we postulated that RDW has an inverse relation to pulmonary function. The purpose of this study was to test this hypothesis. DESIGN AND SETTING: A cross-sectional study was conducted of a random sample of the general population in western New York. PARTICIPANTS: A total of 1,616 subjects of both genders who were aged 35 to 79 years and were free of respiratory disease. INTERVENTIONS: None. MEASUREMENTS: Pulmonary function was assessed from FEV(1), FVC, height, body weight, total pack-years of smoking, smoking status, hemoglobin concentration, and hematologic indexes, eosinophil count, education, and blood levels of retinol, beta-cryptoxanthin, and vitamin E. RESULTS: We found a direct relation between RDW and the number of pack-years of smoking and smoking status, and an inverse relation between FEV(1) and FVC with RDW, even when potentially confounding variables such as smoking were taken into account. When the variability of FEV(1) due to smoking was used for comparison, an additional 27% of that variability in FEV(1) was explained by variations in antioxidant vitamin levels, and another 24% by RDW. CONCLUSIONS: The results confirmed our hypothesis that there is an inverse relation between RDW and pulmonary function, and raise the possibility that RDW may be a biomarker for as-yet unidentified nutrients that affect pulmonary function.

Adult↗

PubMed2002

Beverage specific alcohol intake in a population-based study: evidence for a positive association between pulmonary function and wine intake.

BACKGROUND: Lung function is a strong predictor of cardiovascular and all-cause mortality. Previous studies suggest that alcohol exposure may be linked to impaired pulmonary function through oxidant-antioxidant mechanisms. Alcohol may be an important source of oxidants; however, wine contains several antioxidants. In this study we analyzed the relation of beverage specific alcohol intake with forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) in a random sample of 1555 residents of Western New York, USA. METHODS: We expressed pulmonary function as percent of predicted normal FEV1 (FEV1%) and FVC (FVC%) after adjustment for height, age, gender and race. To obtain information on alcohol intake we used a questionnaire that reliably queries total alcohol and beverage specific recent (past 30 days) and lifetime alcohol consumption. RESULTS: Using multiple linear regression analysis after adjustment for covariates (pack-years of smoking, weight, smoking status, education, nutritional factors and for FEV1%, in addition, eosinophil count), we observed no significant correlation between total alcohol intake and lung function. However, we found positive associations of recent and lifetime wine intake with FEV1% and FVC%. When we analyzed white and red wine intake separately, the association of lung function with red wine was weaker than for white wine. CONCLUSION: While total alcohol intake was not related to lung function, wine intake showed a positive association with lung function. Although we cannot exclude residual confounding by healthier lifestyle in wine drinkers, differential effects of alcoholic beverages on lung health may exist.

Journal Article↗

PubMed2002

Lung function in relation to intake of carotenoids and other antioxidant vitamins in a population-based study.

Accumulating evidence suggests that dietary antioxidant vitamins are positively associated with lung function. No evidence exists regarding whether dietary carotenoids other than beta-carotene are related to pulmonary function. In 1995--1998 the authors studied the association of forced expiratory volume in 1 second and forced vital capacity as the percentage of the predicted value (FEV(1)% and FVC%, respectively) after adjustment for height, age, gender, and race with the intakes of several carotenoids (alpha-carotene, beta-carotene, beta-cryptoxanthin, lutein/zeaxanthin, and lycopene) in a random sample of 1,616 men and women who were residents of western New York State, aged 35--79 years, and free from respiratory disease. They observed significant associations of lutein/zeaxanthin and vitamins C and E with FEV(1)% and FVC% using multiple linear regression after adjustment for total energy intake, smoking, and other covariates. When they analyzed all of these antioxidant vitamins simultaneously, they observed the strongest association of vitamin E with FEV(1)% and of lutein/zeaxanthin with FVC%. The differences in forced expiratory volume in 1 second and forced vital capacity associated with a decrease of 1 standard deviation of dietary vitamin E or lutein/zeaxanthin were equivalent to the influence of approximately 1--2 years of aging. Their findings support the hypothesis that carotenoids, vitamin C, and vitamin E may play a role in respiratory health and that carotenoids other than beta-carotene may be involved.

Adult↗

PubMed2002

Associations of serum C-reactive protein with fasting insulin, glucose, and glycosylated hemoglobin: the Third National Health and Nutrition Examination Survey, 1988-1994.

This study investigated the associations between serum C-reactive protein and fasting blood levels of insulin, glucose, and hemoglobin A1c (HbA1c). Data from the Third National Health and Nutrition Examination Survey (1998-1994) were used. Study subjects included 2,466 men and 2,876 women who were > or = 17 years and nondiabetics with an overnight fast for blood draw. C-reactive protein was categorized into low (<0.3 mg/dl), moderate (0.3-0.9 mg/dl), and high (> or = 1.0 mg/dl) levels. Mean levels of insulin, glucose, and HbA1c were compared across C-reactive protein levels after adjustment for age, ethnicity, education, poverty index, cigarette smoking, alcohol use, and leisure time physical activity. For men with low (n = 1,818), moderate (n = 493), and high (n = 155) C-reactive protein, the adjusted means of insulin were 9.4, 11.7, and 10.5 microunits/ml (p < 0.01); glucose, 99.8, 101.6, and 100.6 mg/dl (p > 0.05); and HbA1c, 5.4%, 5.5%, and 5.5% (p < 0.05). For women with low (n = 1,816), moderate (n = 776), and high (n = 282) C-reactive protein, the adjusted means of insulin were 8.7, 11.2, and 13.7 microunits/ml (p < 0.01); glucose, 95.3, 97.9, and 105.2 mg/dl (p < 0.01); and HbA1c, 5.3%, 5.4%, and 5.6% (p < 0.01). In conclusion, elevated C-reactive protein was associated with higher insulin and HbA1c among men and women and with higher glucose levels among women only. These results suggest a possible role of inflammation in insulin resistance and glucose intolerance.

Adolescent↗

PubMed2002

Evidence for a positive association between pulmonary function and wine intake in a population-based study.

BACKGROUND: Lung function is a strong predictor of cardiovascular and all-cause mortality. Previous studies suggest that alcohol exposure may be linked to impaired pulmonary function through oxidant-antioxidant mechanisms. Alcoholic beverages may be an important source of oxidants and antioxidants. We analyzed the relation of beverage-specific alcohol intake with forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) in a random sample of 1555 residents of Western New York, USA. METHODS: We expressed pulmonary function as percent of predicted normal FEV1 (FEV1%) and FVC (FVC%) after adjustment for height, age, gender, and race. To obtain information on alcohol intake we used a questionnaire that reliably queries total alcohol and beverage-specific recent (past 30 days) and lifetime alcohol consumption. RESULTS: Using multiple linear regression analysis after adjustment for covariates (pack-years of smoking, weight, smoking status, education, nutritional factors, and for FEV1%, in addition, eosinophil count), we observed no significant correlation between total alcohol intake and lung function. However, we found positive associations of recent and lifetime wine intake with FEV1% and FVC%. When we analyzed white and red wine intake separately, the association of lung function with red wine was weaker than with white wine. CONCLUSION: While total alcohol intake was not related to lung function, wine intake showed a positive association with lung function. Although we cannot exclude residual confounding by healthier lifestyle in wine drinkers, differential effects of alcoholic beverages on lung health may exist.

Adult↗

PubMed2002

The relationship of waist circumference to blood pressure: the Olivetti Heart Study.

BACKGROUND: The association between overweight, high blood pressure (BP), and insulin resistance is well established, but the role of body fat distribution in this association has yet to be fully elucidated. The aim of this study was to investigate the role of central adiposity in the association between overweight, high BP, and insulin resistance. METHODS: A total of 1,079 men participated in the follow-up of the Olivetti Heart Study from 1994 to 1995. The present analysis includes 768 men, after the exclusion of 184 participants on pharmacological treatment for hypertension. In 65 men fasting blood glucose was >7 mmol/L; in 48, age was below or above 2 standard deviations from the mean of the population; and in 14 the data set was incomplete. Anthropometric indices of adiposity, metabolic variables (including fasting serum insulin and homeostasis model assessment [HOMA] index of insulin sensitivity), and BP were measured. RESULTS: In univariate analysis, waist circumference was the anthropometric index that best correlated with BP (P < .001). In multiple regression analysis, waist circumference remained the strongest independent predictor of BP after adjustment for confounders. Significant increase of systolic (P value for trend analysis < .001) and diastolic (P < .001) pressure, heart rate (P = .003), fasting and postload serum insulin (P < .001), and HOMA index of insulin sensitivity (P < .001) were observed across age-adjusted quintiles of waist circumference. Greater degrees of central adiposity were associated with higher prevalence of elevated BP values and insulin resistance (P value < .001, chi2 for linear trend). CONCLUSIONS: In middle-aged men, a central distribution of body fat is associated with increased BP, independently of body mass index and insulin resistance, thus suggesting a key role of central adiposity in the full expression of the "metabolic syndrome."

Abdomen↗

PubMed2002

One drink to a lifetime of drinking: temporal structures of drinking patterns.

This article presents the proceedings of a symposium at the 2001 Research Society on Alcoholism Meeting in Montreal, Canada. The cochairs were Paul J. Gruenewald and Marcia Russell. The focus of the symposium was on mathematical, methodological, and statistical approaches to the assessment of drinking patterns from short (daily and monthly) to very long periods (the life course) of time. The research presented in the symposium argues that (1) model-based approaches to analyzing drinking patterns can provide comprehensive bases for assessing drinking risks, (2) data acquisition technologies that track daily drinking over long periods of time can illuminate unique features of drinking associated with abuse and dependence, and (3) retrospective data can be used to assess life-course trajectories of drinking associated with chronic problem outcomes. Each of the presentations points toward an integrated approach to understanding acute and chronic risks related to alcohol use. The presentations were (1) Mathematical models of current drinking, by Paul J. Gruenewald and Fred Johnson; (2) Mathematical models of drinking problems, by John Light and Rob Lipton; (3) Patterns of drinking ascertained from daily data aggregated across 24 months, by John Searles; and (4) Cognitive lifetime drinking histories and natural histories of drinking, by Marcia Russell, Paul J. Gruenewald, Fred Johnson, Maurizio Trevisan, Jo Freudenheim, Paola Muti, Ann Marie Carosella, and Thomas H. Nochajski.

Alcohol Drinking↗

PubMed2002

Fasting glucose is a risk factor for breast cancer: a prospective study.

There is some evidence that glucose and other factors related to glucose metabolism, such as insulin and insulin-like growth-factors (IGFs) may contribute to breast cancer development. The present study analyzed the hypothesis that serum glucose, insulin levels, and IGF-I pattern are associated with breast cancer using a nested case-control study. Between 1987 and 1992, 10,786 women ages 35-69 were recruited in a prospective study in Italy. Women with history of cancer and on hormone therapy were excluded at baseline. At recruitment, blood samples were collected after a 12-h fast between 7:30 and 9:00 a.m. from all of the study participants. After 5.5 years, 144 breast cancer cases were identified among the participants of the cohort. Four matched controls were chosen for each breast cancer case from members of the cohort who did not develop breast cancer during the follow-up period. In premenopausal women, glucose was associated with breast cancer risk: the age, body mass index, and reproductive variable adjusted relative risk (RR) for the highest quartile of serum glucose versus the lowest was 2.8 [95% confidence interval (CI), 1.2-6.5], and P for trend was 0.02. Insulin showed a weaker association with breast cancer, the adjusted RR of the highest quartile versus the lowest was 1.7 (95% CI, 0.7-4.1), and P for trend was 0.14, whereas the adjusted RR of the highest quartile of IGF-I was 3.1 (95% CI, 1.1-8.6), and P for trend was 0.01. Increased levels of insulin-like growth factor binding protein-3 (IGFBP)-3 were related to breast cancer risk: the adjusted RR for the highest quartile was 2.1 (95% CI, 0.95-4.75), and P for trend was 0.02. In postmenopausal women, the associations of glucose, insulin, and IGF-1 pattern were associated with breast cancer risk in heavier subjects characterized by a body mass index higher than 26. These results indicate that chronic alteration of glucose metabolism is related to breast cancer development.

Adult↗