Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Longitudinal analysis”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,657 records · Page 92Linked to original sources
PubMed2004

Longitudinal study of the inception of perimenopause in relation to lifetime history of sexual or physical violence.

STUDY OBJECTIVE: To investigate of the extent to which violence over the life course accelerates the onset of perimenopause, as measured by menstrual changes. DESIGN: Prospective cohort study. SETTING: Boston, Massachusetts. PARTICIPANTS: 603 premenopausal women aged 36-45 years at baseline who completed a cross sectional survey on childhood and adult violence history. MAIN OUTCOME MEASURE: Time to perimenopause, defined as time in months from baseline interview to a woman's report of (1) an absolute change of at least seven days in menstrual cycle length from baseline or subjective report of menstrual irregularity; (2) a change in menstrual flow amount or duration; or (3) cessation of periods for at least three months, whichever came first. MAIN RESULTS: Experience of abuse was associated with delayed onset of menstrual changes indicative of onset of perimenopause. Women reporting childhood or adolescent abuse entered perimenopause about 35% slower than women who reported no abuse (IRR(adj) = 0.65, 95% CI 0.45 to 0.95) after adjusting for age, age at menarche, ever live birth, ability to maintain living standard, smoking, BMI, and depression. There was a similar association among women who reported first abuse during adulthood (IRR(adj) = 0.72, 95% CI 0.28 to 1.80). These findings persisted when the cohort was restricted to non-depressed women (childhood/adolescent IRR(adj) = 0.57, 95% CI 0.36 to 0.90; adulthood IRR(adj) = 0.63, 95% CI 0.23 to 1.77). CONCLUSIONS: This study is the first longitudinal analysis of the timing of perimenopause to show an association with a history of physical or sexual abuse. Further study of the relation between violence and reproductive aging is needed.

Adult↗
PubMed2002

Highly active antiretroviral treatment does not increase sexual risk behaviour among French HIV infected injecting drug users.

STUDY OBJECTIVE: This study examined the impact of highly active antiretroviral therapies (HAART) on sexual risk behaviours of HIV infected injecting drug users (IDUs) included in the French MANIF 2000 cohort study. DESIGN: Longitudinal analysis including baseline and last follow up characteristics using generalised estimating equations (GEE). SETTING: Hospital departments for specialist AIDS care in south eastern France and inner suburbs of Paris. PATIENTS: All patients antiretrovial treatment naive, who reported being sexually active at enrollment, and who had at least one follow up visit in the cohort between October 1996 and May 1998 (n=188). MAIN RESULTS: Of the 188 HIV infected IDUs who were antiretroviral treatment naive at enrollment, 34 were prescribed HAART during follow up. Proportion of patients who reported at least one episode of unprotected sexual intercourse in the previous six months only significantly decreased in the HAART treated group (from 47.1% to 23.5%, p=0.008, compared with 43.5% to 35.7% in the rest of the sample, p=0.10). GEE multivariate model confirmed that prescription of HAART was associated with reduced sexual risk. CONCLUSIONS: The concern that HAART might result in clinical improvement leading to resumption of high risk activities that could inadvertently result in HIV transmission was not supported by these data. Reasons for further reductions in HIV risk with taking HAART remain to be clarified.

Adult↗
PubMed2002

Transitions to informal care in Great Britain during the 1990s.

OBJECTIVES: To estimate annual changes and trends in the population of informal carers and to investigate transitions to caregiving by age, gender, locus of care, and level of involvement. DESIGN: Longitudinal analysis of data from the British household panel survey, 1991 to 1998, an annual prospective survey of a nationally representative sample of more than 5000 private households in England, Scotland, and Wales. SUBJECTS: Over 9000 adults over 16 years interviewed personally in successive waves of the survey, including around 1300 informal carers each year. RESULTS: One third of co-resident carers and 40% of extra-resident carers start caregiving each year and similar proportions cease to provide care. Five year period rates are at least 75% higher than the one year prevalence estimates. Almost everyone is involved in caregiving at one time or another and over half are likely to provide 20 hours or more care per week at some point in their lives. Recent trends indicate that more adults are becoming heavily involved in providing longer episodes of care. Although the onset of caregiving peaks in late middle and early older age, above average incidences span three decades or more of adult life. Age variations in the start of caring relationships are driven by the changing demands for care within and between generations over the life course. There is no firm evidence that carers increase their involvement in caring activities over the first three years of a caring episode. CONCLUSIONS: The population of carers is constantly changing as some people stop providing care and others take on a caring role or vary their level of involvement. Policy measures responsive to the diversity of caring roles, and geared around key transitions, are likely to be most effective in supporting carers through changing circumstances. Recognition and support for carers who are heavily involved in caring activities from the outset should be a priority.

Adolescent↗
PubMed2006

Increasing cord atrophy in early relapsing-remitting multiple sclerosis: a 3 year study.

OBJECTIVES: Previous studies have shown that upper cervical cord atrophy (UCCA) occurs in multiple sclerosis (MS), particularly in those disabled and with primary or secondary progressive disease. It is less clear how early it can be detected in relapsing-remitting (RR) MS, and whether early cord atrophy relates to the concurrent or future clinical course. METHODS: Twenty seven RR MS patients (median disease duration 1.7 years, in all cases <3 years from onset) were recruited along with 20 controls. They were followed for up to 3 years with a yearly assessment of UCCA and clinical function measured by the Expanded Disability Status Scale (EDSS) and MS Functional Composite Score (MSFC). Clinical and MRI correlations were investigated. Statistical models adjusted for covariates including total intracranial volume. RESULTS: Longitudinal analysis showed a significant decrease in UCCA in patients both within the patient cohort (p < 0.001) and in comparison with controls (p = 0.001). There was a significant increase in EDSS (p = 0.008) but no significant change in MSFC. The rate of UCCA loss did not correlate with clinical change or with change in brain volume. CONCLUSIONS: In summary, serial UCCA measurement detects the development of spinal cord atrophy in clinically early RR MS.

Adult↗
PubMed2002

Progressive sudomotor dysfunction in amyotrophic lateral sclerosis.

Autonomic dysregulation is part of the complex degenerative process in amyotrophic lateral sclerosis (ALS). To investigate this, sweating was examined at rest in 39 patients with ALS in comparison with a control group. Sweat was collected over a 30 second period over the thenar and hypothenar eminences and on the sole of the foot, using a commercial device based on vapour pressure gradient. The measurements were repeated after three and six months in 10 patients for longitudinal analysis. In early ALS, patients had significantly higher skin water loss than control subjects over the thenar and the hypothenar eminences. In advanced disease stages, sweating was decreased at all sites compared with controls. A significant decline in sweat secretion of about 40% was found over a six month period. The findings suggest an abnormal sympathetic activity with hyperhidrosis in early ALS and a reduction in sweat production as the disease progresses.

Adult↗
PubMed2000

Diet, lung function, and lung function decline in a cohort of 2512 middle aged men.

BACKGROUND: A prospective cohort study of 2512 Welshmen aged 45-59 living in Caerphilly in 1979-1983 was used to investigate associations between diet and lung function. METHODS: At baseline (phase I) and at five year follow up (phase II), forced expiratory volume in one second (FEV(1)) was measured using a McDermott spirometer and dietary data were obtained using a semi-quantitative food frequency questionnaire. RESULTS: Good lung function, indicated by high maximum FEV(1) given age and height, was associated with high intakes of vitamin C, vitamin E, beta-carotene, citrus fruit, apples, and the frequent consumption of fruit juices/squashes. Lung function was inversely associated with magnesium intake but there was no evidence of an association with fatty fish. Following adjustment for confounders including body mass index, smoking history, social class, exercise, and total energy intake, only the associations with vitamin E and apples persisted, with lung function estimated to be 39 ml (95% confidence interval (CI) 9 to 69) higher for vitamin E intakes one standard deviation (SD) apart and 138 ml higher (95% CI 58 to 218) for those eating five or more apples per week compared with non-consumers. Decline in lung function between phases was not significantly associated with the changing intakes of apples or vitamin E. An association between high average apple consumption and slow decline in lung function lost significance after adjustment for confounders. CONCLUSIONS: A strong positive association is seen between lung function and the number of apples eaten per week cross sectionally, consistent with a protective effect of hard fruit rather than soft/citrus fruit. The recent suggestion that such effects are reversible was not supported by our longitudinal analysis.

Ascorbic Acid↗
PubMed1996

Effects of bilateral lesions of the dorsolateral funiculi and dorsal columns at the level of the low thoracic spinal cord on the control of locomotion in the adult cat. I. Treadmill walking.

1. A quantitative and longitudinal analysis of locomotion was made after bilateral lesions of the dorsolateral funiculi (DLF) and/or the dorsal columns (DC) in the lower thoracic cord (T12 or T13) in five adult cats. All cats were chronically implanted several weeks before the spinal cord lesion to permit the recording of electromyographic (EMG) activity from selected flexor and extensor muscles of the fore- and hindlimbs of each side. This allowed each cat to act as its own control when comparing the pattern and amplitude of EMG activity before and after the lesion. All experiments were also videotaped to allow an analysis of the kinematic changes before and after the lesions. Kinematic data were only analyzed for the side of the cat facing the camera; for all cats this was the left side. 2. After recovery periods of 2-5 mo, wheat-germ-agglutinated horseradish peroxidase (WGA-HRP) was injected caudal to the lesion site (normally at L2). The extent of the lesion was verified both histologically and by evaluating the number of HRP-labeled neurons in different supraspinal structures. These analyses showed that the cortico- and rubrospinal tracts (CST and RST, respectively) were completely interrupted, bilaterally, in two of five of the cats; in one of these cats the DCs were also interrupted. In the other three cats there was more variable damage, and the CST and RST were only completely interrupted on the right side of one of these animals. The DCs were completely sectioned in two of these cats. 3. During the 1st wk subsequent to the lesion, most cats had difficulty in supporting their weight and in walking. However, within 10 days all were able to walk, unaided, for extended periods on the treadmill at speeds of at least 0.35 m/s. In the two cats with the complete, bilateral DLF lesions, the animals dragged both their left and right hindpaws along the treadmill belt during the swing phase of the step cycle (paw drag) throughout the testing period of 3-5 mo. In the other three cats, paw drag in either hindlimb was only seen in the 1st 2-3 wk after the lesions, with the exception of the cat with the complete lesion of the DLF on the right side, which showed sustained paw drag in the right hindlimb throughout the testing period. 4. Significant increases in step cycle and swing duration following the lesion were observed only in the two cats with the largest lesions. In all five cats, statistical comparisons of the slopes from a linear regression analysis showed that the relationship between swing and step cycle duration was unchanged by the lesions. 5. Joint angles in the left hindlimb of the two cats with the largest lesions were generally smaller (more flexed) than in the prelesion controls. This was particularly true for the knee and ankle joints. The other three cats showed changed joint angle values for the hip, knee, and ankle only in the 1st 2-3 wk after the lesions. All of the cats, except the one with the least damage to the left DLF, exhibited increased joint excursions at the metatarsophalangeal (MTP) joint of the left limb throughout the recovery period. 6. There were sustained changes in the coupling between the hip and the knee of the left limb, together with smaller changes in the coupling of the knee and ankle in the two cats with the complete lesions of the DLF. In contrast to the prelesion controls, flexion at the ankle occurred before swing onset in these same two cats. The changes in the coordination between the hip and the knee were associated with changes in the temporal coupling between the hip flexor, sartorius (Srt), and the knee flexor, semitendinosus (St). Despite some improvement, the coupling between these two muscles never fully recovered to the prelesion values. Similar, but smaller, changes in the delay between Srt and St were also seen in two of the other three cats. (ABSTRACT TRUNCATED)

Animals↗
PubMed2006

Carcinoembryonic antigen messenger RNA expression in blood predicts recurrence in esophageal cancer.

PURPOSE: The clinical significance of isolated tumor cells (ITC) in blood has not been clearly established, particularly during follow-up in cancer patients. We conducted a longitudinal analysis of the relationship between ITC in blood during follow-up and clinicopathologic findings in patients with esophageal squamous cell carcinoma. EXPERIMENTAL DESIGN: Blood samples obtained from 106 patients were examined by real-time RT-PCR assay targeting carcinoembryonic antigen (CEA) mRNA. Follow-up examination every 3 months after surgery included testing for CEA mRNA and tumor markers, as well as imaging. RESULTS: Thirty-nine (36.8%) patients were positive for CEA mRNA expression. CEA mRNA positivity significantly correlated with tumor depth, lymph node metastasis, stage, and venous invasion. Recurrent disease was found in 34 of 106 (32.1%) cases. CEA mRNA was found in 28 (76.5%) patients experiencing relapse. Of these 28 patients, the number positive of CEA mRNA before detection by imaging, at the same time of detection by imaging, and after detection by imaging was 18 (52.9%), 8 (23.5%), and 2 (5.9%), respectively. The sensitivity, specificity, positive predictive value, and negative predictive value for CEA mRNA were higher than those for serum CEA or squamous cell carcinoma. Patients positive for CEA mRNA experienced significantly shorter disease-free interval than those with negative CEA mRNA (P < 0.001). According to multivariate analysis, CEA mRNA positivity was an independent factor for disease-free interval. CONCLUSIONS: Examination of CEA mRNA in peripheral blood during follow-up is useful for early detection of occult recurrence. We believe that CEA mRNA in blood will be a new marker for recurrence in esophageal squamous cell carcinoma.

Adult↗
PubMed2002

Congenital adrenal hyperplasia: lessons from a multinational study.

A study group of paediatric endocrinologists was established in Austria, Czech Republic, Hungary, Slovenia and Slovakia in order to investigate various aspects in children with congenital adrenal hyperplasia (CAH). Five hundred and ninety-eight patients with CAH who were diagnosed between 1969 and 1998 were included in order to analyze the following questions. Epidemiological data: There were significantly fewer males (43%) than females (57%), and the percentage of males did not increase during the observation period. Salt wasters (SW) totalled 64.7%, whereas 35.3% had simple virilizing (SV) CAH. Diagnosis was established significantly later in boys than in girls (median of 26 vs. 13 days for SW, p < 0.0001; 1,817 vs. 1,010 days for SV, p < 0.03). Mortality in the general population was significantly lower than in CAH siblings (1.8% vs. 7.0%, p < 0.0001) or in SW children (2.2% vs. 11.3%, p < 0.0001). According to our calculation with the present clinical diagnostic criteria in Central Europe, from 40 expected CAH patients/year, 2-2.5 SW, and one female and four male SV patients will not be diagnosed. Auxological data: Growth data from 341 patients were analyzed retrospectively. Percentiles were constructed in a longitudinal/cross-sectional study and pubertal growth was described in a longitudinal analysis. Growth of SW patients was impaired in early childhood (0-3 years), but followed a normal course until puberty. In contrast, SV children had a normal growth pattern during early childhood, but were above the standard thereafter. The pubertal growth spurt was of normal magnitude in boys and girls, but started too early. Final height was reduced compared with both standard and target heights. There was no correlation between final height and age of starting treatment or the year of birth. Bone age was accelerated in both CAH types, but more so in SV patients. Molecular genetics: Three hundred and fifty-six patients were investigated for 11-14 of the most frequent mutations by direct allele-specific polymerase chain reaction (PCR) and/or PCR followed by sequence-specific oligonucleotide, single strand chain polymorphism and restriction fragment length polymorphism. In the group as a whole, we most frequently found the Intron 2 splice mutation (30.8%) or a deletion/conversion (28.5%). The Intron 2 mutation was most frequent in the Hungarian population, whereas deletions/conversions were found more frequently in Slovenians. The other mutations had a similar distribution to those seen in other populations. Genotype-phenotype correlation confirms previous reports.

Adolescent↗
PubMed2004

Stability of the ECG features of complete right bundle branch block over time: a methodological study for implementation in research and clinical practice.

Since research is concentrated to a large extent on patients with left bundle branch block, we aimed at evaluating the hypothesis that measurements of certain intervals and other characteristics of the ECG may change over time in patients with right bundle branch block (RBBB), and to design a model, which could be implemented in research and clinical practice, irrespective of the specific ECG features present. The duration of the QRS complex, QT, QTc, and PR intervals, the frontal QRS axis, the heart rate and the presence of hemiblocks, atrioventricular blocks, and atrial fibrillation were compared in the 1st and last of all available ECGs for each patient. Also, a subgroup of patients who had a ventricular aneurysm (VA) was compared with the remaining patients, with respect to the above variables. This longitudinal analysis included all of the patients with RBBB followed in our Cardiology Clinic. There were no significant changes in the ECG variables from the two ECGs recorded 487.6 +/- 410.1 (range 0-1,476) days apart, in the two comparisons carried out in 151 patients with RBBB. Comparison of the above-described ECG intervals and characteristics of patients with RBBB were found to be stable over the time course of the investigation. This methodological study is presented as a model to be used serially and prospectively in research and clinical practice for the follow-up of patients with bundle branch block, VA, dilated cardiomyopathy, congestive heart failure, or those considered for cardiac resynchronization therapy.

Adolescent↗
PubMed1975

Weight growth of colony-reared chimpanzees.

Body weight data, collected routinely from the US Air Force chimpanzee colony at Holloman AFB, was used for a longitudinal analysis of growth. Data were fitted to a model based on human growth patterns, which is described and compared to other treatments applied to growth data. Results are compared to other observations of chimpanzee and of human growth.

Age Factors↗
PubMed1993

Syndrome X.

Using cross-sectional and longitudinal analysis of data from the San Antonio Heart Study, syndrome X (primary insulin resistance syndrome) has been redefined in terms of hyperinsulinaemia combined with changes in glucose tolerance, lipid pattern, blood pressure and body fat distribution. Syndrome X is itself an atherogenic cardiovascular risk factor, which interacts with environmental and genetic factors to lead to the eventual development of the endpoint of cardiovascular disease.

Adipose Tissue↗
PubMed1997

Effect of single-drug therapy on reduction of left ventricular mass in mild to moderate hypertension: comparison of six antihypertensive agents. The Department of Veterans Affairs Cooperative Study Group on Antihypertensive Agents.

BACKGROUND: Antihypertensive drugs may differ in their ability to reduce LV mass. Covariates other than drug selection, such as pretreatment LV mass, body weight, the magnitude of blood pressure reduction, race, and age may modify the response of LV mass to therapy. METHODS AND RESULTS: Patients with mild to moderate hypertension (diastolic blood pressure, 95 to 109 mm Hg) were randomly allocated to treatment with atenolol, captopril, clonidine, diltiazem, hydrochlorothiazide, or prazosin in a double-masked trial. Patients achieving the goal diastolic blood pressure of <90 mm Hg during drug titration entered a 1-year maintenance period. Longitudinal analysis examined changes from baseline echocardiogram in LV mass at 8 weeks and at 1 year, statistically adjusted for pretreatment LV mass, systolic blood pressure, body weight, sodium excretion, physical activity, race, and age. Significant reductions at 1 year in adjusted LV mass were seen for patients in the highest tertile of pretreatment LV mass treated with hydrochlorothiazide (mean, -42.9; 95% confidence limits, -65.5, -20.2 g), captopril (mean, -38.7; 95% confidence limits, -61.0, -16.4 g), and atenolol (mean, -28.1; 95% confidence limits, -50.9, -5.3 g). These treatment effects differed from those of prazosin, diltiazem, or clonidine. CONCLUSIONS: Antihypertensive drugs have disparate effects on LV mass independent of the magnitude of blood pressure reduction. Patients with adequate blood pressure control on captopril, hydrochlorothiazide, and atenolol show a reduction of LV mass after 1 year of treatment, whereas patients on diltiazem, clonidine, or prazosin do not.

Adrenergic alpha-Antagonists↗
PubMed1999

Markers of impaired growth of pulmonary function in children and adolescents.

Our knowledge about the age-related growth of pulmonary function is incomplete. The purpose of this study was to describe the relation of various factors to the growth of pulmonary function in children and adolescents. A population sample comprising 408 children and adolescents (7-17 yr of age at enrollment) was reexamined after a 6-yr interval. Case history was obtained by interview and questionnaire. Pulmonary function, skin prick test reactivity to common allergens, and airway responsiveness (AR) were measured using standard techniques; airway hyperresponsiveness (AHR) was defined as a concentration of histamine causing a 20% decline in FEV1 < 8 mg/ml. The cross-sectional analyses of data from the two surveys showed that the presence of asthma (p < 0.02), atopy to house dust mite (HDM) (p = 0.03), and increasing degree of AR (p < 0.002) were associated with a lower level of FEV1 %pred. The longitudinal analysis revealed that asthma (p = 0.0001) and a lower level of FEV1 (p < 0.0001) at enrollment were associated with a lower level of FEV1 at follow-up. Further, an increase in the degree of AR (p = 0. 0001), new asthma (p = 0.0002), and new atopy to HDM (p = 0.03) also predicted a lower level of FEV1 at the end of the observation period. Confining the analysis to subjects without asthma and without evidence of AHR (n = 271) showed that both persistent (p = 0.04) and new (p = 0.03) atopy to HDM predicted a lower level of FEV1 at follow-up; compared with subjects with a negative skin reaction to HDM, those subjects who were sensitized to HDM had on average a 5%pred lower level of FEV1. The growth of FEV1 in children and adolescents appears to be impaired not only by symptomatic asthma but also by an increase in the degree of AR and atopy to HDM; sensitization to HDM appears to have a negative impact on the age-related growth in FEV1 even in nonasthmatic subjects without evidence of AHR.

Adolescent↗
PubMed1989

The epidemiology of pulmonary function and COPD mortality in the multiple risk factor intervention trial.

The potential determinants of the changes in chronic obstructive pulmonary disease (COPD) mortality were evaluated using both the Multiple Risk Factor Intervention Trial (MRFIT) screenees, the longitudinal analysis of the participants, and the differences in special intervention (SI) and usual care (UC) groups. COPD was the underlying cause for only one third of all death certificates listing COPD. Small changes in classification will have a major impact on reported COPD death rates. Cigarette smoking is clearly the primary determinant of COPD mortality. Decreased pulmonary function is an independent risk factor for coronary heart disease (CHD) mortality. Smoking cessation results in a slower rate of decline in pulmonary function over time, especially among heavy smokers. Careful evaluation of smoking cessation, including repeat chemical measures, suggest that the percentage of long-term quitters, especially among heavy smokers has been overestimated. The low percentage of quitters substantially reduced the power to detect an intervention effect. The increased cigarette smoking among recent older cohorts, and failure to substantially reduce smoking, especially among heavy smokers, may be an important factor accounting for the failure to note a decline in COPD mortality among older persons.

Adult↗
PubMed2004

The evolution of airway function in early childhood following clinical diagnosis of cystic fibrosis.

This study aimed to investigate the evolution of airway function in infants newly diagnosed with cystic fibrosis (CF). FEV(0.5) was measured soon after diagnosis (median age of 28 weeks) and 6 months later in subjects with CF and on two occasions 6 months apart (median ages of 7.4 and 33.7 weeks) in healthy infants, using the raised-volume technique. Repeated measurements were successful in 34 CF and 32 healthy subjects. After adjustment for age, length, sex, and exposure to maternal smoking, mean FEV(0.5) was significantly lower in infants with CF both shortly after diagnosis and at the second test, with no significant difference in rate of increase in FEV(0.5) with growth between the two groups. When compared with published reference data, FEV(0.5) was reduced by an average of two z scores on both test occasions in those with CF, with 72% of individuals having an FEV(0.5) of less than 1.64 z-scores (i.e., less than the fifth percentile) on one or both test occasions. On longitudinal analysis, subjects with CF experienced a mean (95% confidence interval) reduction in FEV(0.5) of 20% (11, 28). Airway function is diminished soon after diagnosis in infants with CF and does not catch up during infancy and early childhood. These findings have important implications for early interventions in CF.

Body Height↗
PubMed2005

Association of sleep apnea and type II diabetes: a population-based study.

RATIONALE: Cross-sectional association has been reported between sleep-disordered breathing (SDB) and insulin resistance, but no prospective studies have been performed to determine whether SDB is causal in the development of diabetes. OBJECTIVES: The purpose of our study was to investigate the prevalence and incidence of type II diabetes in subjects with SDB and whether an independent relationship exists between them. METHODS: A cross-sectional and longitudinal analysis was performed in 1,387 participants of the Wisconsin Sleep Cohort. Full polysomnography was used to characterize SDB. Diabetes was defined in two ways: (1) physician-diagnosis alone or (2) for those with glucose measurements, either fasting glucose > or = 126 mg/dl or physician diagnosis. MEASUREMENTS AND MAIN RESULTS: There was a greater prevalence of diabetes in subjects with increasing levels of SDB. A total of 14.7% of subjects with an apnea-hypopnea index (AHI) of 15 or more had a diagnosis of diabetes compared with 2.8% of subjects with an AHI of less than 5. The odds ratio for having a physician diagnoses of diabetes mellitus with an AHI of 15 or greater versus an AHI of less than 5 was 2.30 (95% confidence interval, 1.28-4.11; p = 0.005) after adjustment for age, sex, and body habitus. The odds ratio for developing diabetes mellitus within 4 yr with an AHI of 15 or more compared with an AHI of less than 5 was 1.62 (95% confidence interval, 0.67-3.65; p = 0.24) when adjusting for age, sex, and body habitus. CONCLUSIONS: Diabetes is more prevalent in SDB and this relationship is independent of other risk factors. However, it is not clear that SDB is causal in the development of diabetes.

Adult↗
PubMed2005

Preinfection systemic inflammatory markers and risk of hospitalization due to pneumonia.

RATIONALE: Elevated proinflammatory cytokines are associated with severity of pneumonia, but the role of preinfection cytokine levels in the predisposition to pneumonia in humans is less clear. OBJECTIVE: To ascertain role of preinfection inflammatory markers on susceptibility to community-acquired pneumonia (CAP). METHODS: Longitudinal analysis over 6.5 yr of a cohort that consisted of 70- to 79-yr-old well-functioning elderly individuals. MEASUREMENTS: Association between preinfection tumor necrosis factor (TNF), interleukin 6 (IL-6), and C-reactive protein (CRP) levels and CAP requiring hospitalization. RESULTS: Of the 3,075 participants, 161 (5.2%) developed at least one episode of CAP requiring hospitalization over a median duration of 3.3 yr. The highest tertiles of TNF (> 3.7 pg/ml) and IL-6 (> 2.4 pg/ml) were associated with increased risk of CAP, and the adjusted odds ratios were 1.6 (95% confidence interval [CI], 1.02-2.7) and 1.7 (95% CI, 1.1-2.8), respectively. The adjusted risk of CAP with at least one of these markers in the highest tertile was 1.6 (95% CI, 1.1-2.3). TNF and IL-6 levels in the highest tertile had a synergistic effect (p = 0.01 for interaction), and risk of CAP for both markers in the highest tertile was 2.8 (95% CI, 1.8-4.3). An FEV(1) of 50% or less of predicted was associated with the highest risk of CAP (adjusted odds ratio, 3.6; 95% CI, 2.3-5.6). Furthermore, TNF and IL-6 levels modified risk of CAP in participants with coexisting medical conditions and history of smoking. CONCLUSION: In the well-functioning elderly subjects, preinfection systemic levels of TNF and IL-6 were associated with higher risk of CAP requiring hospitalization in smokers and those with coexisting medical conditions.

Aged↗