[Working conditions, work experience and subjective health].
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Biomedical subjects
Publications and source records attributed to R Gueguen.
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Familial resemblance of blood pressure (BP) was studied in 545 families of which 370 included natural children, 24 adopted children and 151 both natural and adopted children. Mean values of four automatic BP measurements (Dinamap 845) were converted into age (adult) or height (children) and sex adjusted scores. BP was compared between parents and randomly chosen index children. A significant resemblance of BP was observed between natural children and their parents: r = 0.24 for systolic BP, r = 0.29 for diastolic BP, (n = 272 p greater than 0.05). BP of adopted children did not resemble that of their foster parents except for a significant correlation to BP of the adopting mothers (n = 46). Weight, heart rate, age and time of common life shared did not influence the results. The relative contribution of genetic and common environmental factors to BP correlation between family members could not be evaluated in this study. BP of children whose parents have high BP should be monitored regularly.
Common electrocardiographic manifestations (CEM) are predictors of ischemic heart disease (IHD). If precursors of the disease, their risk factors should be similar to those of IHD. This hypothesis has been assessed on results of multiphasic screening recorded in 1976 and 1981, in 1,347 45-65 year old men. Risk factors are social class (blue collar relative risk rr = 2.3), physical activity at work (sedentariness rr = 2.4), systolic blood pressure, no beer consumption and blood urea nitrogen with an exponential risk curve. Cholesterolemia, smoking, diabetes mellitus, overweight and uricemia are not predictors of CEM incidence within 5 years. These results support the idea that CEM are partially asymptomatic expression of IHD; they also have another significance. Subgroups should be individualized and analysis yielded on larger samples. Correlation analysis has been performed between IHD mortality and beer consumption on basis of French counties. A positive correlation (r = 62, p less than 0.01) is opposed to individual results.
Factors affecting biological variation in total cholinesterase activity in plasma were studied in a population of 3372 apparently healthy subjects at least four years old. Determination of the dibucaine number, after inhibition of the activity by dibucaine, made it possible to specify the contributions of genetic and physiological characteristics to variations in the total activities by using a statistical method of segmentation. The main factors modifying plasma cholinesterase activity in males are genetic status (dibucaine number) and degree of overweight (subscapular skinfold). In females, hormonal status (puberty or menopause), genetic status (dibucaine number), and the use of oral contraceptives are the factors mainly responsible for the variations of plasma cholinesterase activity. These data allow us to propose reference limits for total plasma cholinesterase.
A study of a weight related to height index (WRH) was performed in 5,984 children and adolescents. It showed a change in the mean value of the weight index between 11 and 18 years, particularly in girls. Over a 5 years interval there was a close correlation between weight indices (r around 0.7). However, the probability of remaining in the same index class varied greatly depending on the initial value of index and sex. Occurrence of overweight, as defined by a WRH value greater than or equal to 120, was greater in girls and more frequent during the second decade. This study confirmed the variability of weight index during childhood. Half of the overweight children remained so after 5 years. It also showed a high risk of overweight after 5 years in children with an initial index between 100 and 120. The weight index does not seem to be definitely established during childhood and is therefore inadequate to alone predict overweight 5 years later.
A quality control of spirographic examinations in a health centre was carried out by repeating, after a fortnight's interval, measures of vital capacity (CV) and FEV1 (VEMS) in 629 subject of both sexes, aged 18 to 62. Water spirometers were used and their cylinders were regularly calibrated. The first series of spirographic measurements were made during a routine health check (which included other examinations) by 7 technicians who usually do the work, while the second series of measurements was made of fortnight later by the most experienced three. The overall mean values show a significant difference for vital capacity between the first and second measurement; this difference was so for young male subjects (less than 30 years). The scatter was greater for subjects over 50 years of age. The varied results observed for the same subjects obtained by two different technicians, or the same technician, underlines the fact that the scatter of the results depends largely on the technician even though spirographic tests are classically considered easy to perform.
We have studied factors affecting biological variation in total plasma alkaline phosphatase in a population of 32 329 apparently healthy subjects four years old or older. Quantification of the bone and liver isoenzymes after thermal denaturation made it possible to specify the contributions of each isoenzyme to variations in the total activities. The main factors that modify plasma alkaline phosphatase activity are age, sex, hormonal state (puberty or menopause), and morphometric parameters (height, body weight, or degree of overweight). The bone isoenzyme is mainly responsible for the variations associated with age, sex, and puberty and to some extent with the menopause. Activity of the liver isoenzyme was also altered at the menopause and by certain drugs, such as oral contraceptives and blood-lipid-lowering agents. These data allow us to propose reference limits for total plasma, bone, and liver alkaline phosphatases according to age and sex.
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Blood pressure (BP) has been measured by one observer among 837 male healthy subjects, aged 18. As it has been shown in previous studies, there is a strong correlation between BP and height, weight, overweight indices, and arm-circumference. The correlations of height and arm-circumference with BP are not fully explained by the weight. It seems to be, at this age, an association of BP with body dimensions, and not only with fatness. The strong association of BP with the lean body mass confirms this fact. It seems finally that BP level at the beginning of adulthood is, in a large extent, determined by body dimensions and the development of the osteomuscular system, and much lesser by adiposity. On the other hand, evolution during adulthood depends much more upon variation of the weight, i.e of the fatness.
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Blood pressure (BP) has been measured by one observer amond 837 male healthy subjects, aged 18. As it has been shown in previous studies, there is a strong correlation between BP and height, weight, overweight indices, and arm-circumference. The correlations of height and arm-circumference with BP are not fully explained by the weight. It seems to be, at this age, an association of BP with body dimensions, and not only with fatness. The strong association of BP with the lean body mass confirms this fact. It seems finally that BP level at the beginning of adulthood is, in a large extent, determined by body dimensions and the development of the osteomuscular system, and much lesser by adiposity. On the other hand, evolution during adulthood depends much more upon variation of the weight, i.e. of the fatness.
This is a report on blood pressure measurements of 17,067 healthy children (8,647 boys and 8,420 girls) aged between 4 and 18 years old. Blood pressure increases regularly during growth and is more closely correlated with height and weight than with age. This association increases strongly during male puberty. Correlation with height disappears after puberty while correlation with weight remains and increases. In children whose overweight reaches or exceeds 20 per cent of weight relative to height, the risk of increasing blood pressure above 20 mm Hg over the mean values for the same height is multiplied by 2.5 in boys and 2 in girls. This assertion however concerning growing children does not show to what extent blood pressure increase is due to fatness and to what extent it is due to a high level of maturity and an early development of bone and muscular mass.
The relationship between adiposity and blood pressure has been studied among 17,067 healthy children aged 4 to 18 years old. The correlation of blood pressure with fatness, expressed as non lean body mass, is smaller than the correlation with lean body mass, especially in boys. Blood pressure association with lean body mass strongly increases during puberty growth in boys. These data suggest that during adolescence blood pressure association with weight is mainly due to growth and physical-maturation and that fatness has less influence. A careful analysis of somatic features of adolescents with high blood pressure seems necessary before advocating and improved system of weight control. Preference of blood pressure reference to height is again strengthened.
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We studied factors influencing concentrations of triglycerides in the blood of a presumably healthy population of about 9000 persons. Using multi-dimensional analysis, we show, in addition to various related to sex and age, the relation between triglycerides and uric acid, overweight, arterial blood pressure, use of oral contraceptives (in women), consumption of alcohol and tobacco, and lack of physical exercise. These factors were classified as a function of their discriminative power by the statistical method of segmentation. We thus chose the following factors as criteria for exclusion from a reference population for the values of triglycerides in blood: in men 20 to 39 years old, overweight more than 90%; in men 40 to 59 years old, overweight of more than 115%, consumption of more than half a liter of wine per day or of more than 11 cigarettes, use of medicines, and a blood uric acid exceeding 420 mumol/L; in women 20 to 39 years old, contraceptives and overweight; in women 40 to 59 years old, overweight or more than 130% and the intake of medicines. At the 97.5th percentile of the reference population as compared with a non-selected population, the values were 80% less for men 20 to 39 years old, 95% less for men 40 to 59 years old, and only 26 to 30% less for women 20 to 59 years old.
We looked for variables that could serve as indexes of alcohol consumption. We tested iron, gamma-glutamyltransferase, mean erythrocyte volume, mean erythrocyte hemoglobin concentration, urea, uric acid, and alanine aminotransferase, among others, in an unselected population of men, and by principal components analysis we singled out the correlation between the two enzymes and the two hematologic values. On the other hand, calculation of the coefficients of correlation between the total amount of alcohol consumed and the 10 variables studied, together with multiple regression analysis, showed that the three variables that correlated most significantly with alcohol consumption were gamma-glutamyltransferase, mean erythrocyte volume, and the use of tobacco. Critical evaluation of the results leads us to conclude that still more discriminative biological indices msut be sought and that the use of psychosocial data is also desirable.
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