We examined the severity of airway obstruction and the occurrence of respiratory symptoms in a large, nationally representative population sample and in a subgroup of subjects with chronic bronchitis and/or emphysema to obtain information for developing national prevention and treatment strategies for these diseases. The study population comprised of 7217 randomly selected subjects (aged 30 years and older) who participated in a comprehensive health examination survey. The 'cases' were subjects diagnosed as having chronic bronchitis and/or emphysema. The survey methods comprised of questionnaires, interviews, physical measurements, including spirometry, and clinical examinations. In the whole study population, the age-adjusted prevalence of chronic bronchitis and/or emphysema was 22% among men and 7% among women, whilst clinically relevant airways obstruction (FEV1/FVC%
The association between consumption of alcoholic beverages (spirits, beer and wine) and coronary heart disease (CHD) mortality, especially the incidence of sudden coronary death (SCD), was investigated in a 5-year prospective population study comprising 4,532 men aged 40-64 years. The amount of alcohol used was estimated on the basis of answers to a self-filled structured questionnaire. The incidence of SCD was statistically significantly lower among abstainers than among alcohol consumers. The relative risk of SCD of alcohol consumers in comparison with abstainers was largest in the oldest age group and it became more apparent after a follow-up of a couple of years. Only the consumption of spirits was positively associated with the incidence of SCD. Among non-smokers the incidence of SCD was statistically significantly higher in consumers than in abstainers, a similar but not significant trend was observed among current smokers. The positive association between alcohol consumption and incidence of SCD was detected both in CHD-free men and in men with prior CHD. Consumption of alcoholic beverages, and in particular of spirits, is associated with an increased risk of SCD in Finnish men.
The study aimed to reveal associations between dietary antioxidant vitamins and other personal characteristics.
Population based, cross sectional survey.
Twenty seven rural, industrial, and semiurban communities in six different regions of Finland.
Subjects included 5304 men and 4750 women aged 15 years or older, who were interviewed about their dietary habits at the baseline study of the Finnish Mobile Clinic Health Examination Survey, 1967-72.
Intakes of carotenoids and vitamins A, E, and C were estimated from dietary history interviews covering the subjects' food consumption in the preceding year. In older age groups intakes of all the vitamins studied were low. Occupation had a profound effect on dietary antioxidant vitamins: intakes were highest in white collar workers and lowest in farmers; those classified as service workers, industrial workers, or housewives came in between. Current smoking was inversely associated with dietary carotenoids and vitamin C, especially in men. The vitamin intakes of ex-smokers were equal to or even slightly higher than those of never smokers. Married men had higher intakes of carotenoids and vitamin C than men living alone. Body mass index was not an important determinant of the intake of antioxidant vitamins.
The associations of dietary antioxidant vitamins with sociodemographic characteristics and smoking were strong enough to exert a confounding or modifying effect in studies on diet and diseases.
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Apolipoprotein E (apoE) has an essential role in lipoprotein metabolism, but recent studies have also revealed other functions associated with it, eg, neurologic and malignant diseases. We studied the association between apoE phenotypes E2/3, E3/3, and E4/3 and blood pressure after adjustment for covariates, as well as the association between phenotypes and adjusted plasma glucose and insulin levels in the standard oral glucose tolerance test in a random middle-aged population-based cohort of 259 men and 267 women. Systolic blood pressure was associated with apoE phenotype in the men with moderate or heavy alcohol consumption (>115 g/week), the mean systolic blood pressure value being 16 mm Hg higher in the E2/3 and 11 mm Hg higher in the E3/3 phenotypes than in the E4/3 phenotype, P = .04. No association was seen in occasional drinkers or teetotalers (lowest tertile
Comment In: Am J Hypertens. 1999 Sep;12(9 Pt 1):946-710509555
Comment In: Am J Hypertens. 1999 Sep;12(9 Pt 1):949-5010509558
OBJECTIVE: Variations in the angiotensin converting enzyme (ACE) gene have been implicated in cardiovascular pathology. Therefore, the association between the intima-media thickness (IMT) of the carotid artery and the insertion/ deletion (I/D) polymorphism of the ACE gene was investigated. SUBJECTS: Three hundred men and 300 women were selected randomly from the middle-aged population living in the town Oulu, Finland, of whom 515 subjects (85.8%) participated. METHODS: The IMT of the carotid arteries was determined by bilateral B-mode ultrasonography. IMT values were adjusted for gender, age, height, plasma low-density lipoprotein cholesterol level, smoking and systolic blood pressure. The I/D polymorphism of the ACE gene was determined by polymerase chain reaction. RESULTS: Among non-smokers, the subjects with the DD genotype had significantly higher carotid IMT than did those with II or ID. The association was found also in combined IMT plaque values. In the total population the association was weaker and it was absent in current smokers. Genotype could explain 1.3-2.7% of the variance of carotid IMT in non-smokers. No association between the amount or size of carotid plaques and genotype was observed. CONCLUSIONS: Variations at the ACE gene locus contribute to the degree of the early changes in carotid atherosclerosis in the population. The gene effect is, however, masked by stronger effects of environmental factors such as smoking. The lack of association between atherosclerotic plaques and genotypes may reflect different mechanisms being involved in plaque development and early arterial wall thickening.
A high level of available tissue iron may increase the risk of cancer through its contribution to the production of free oxygen radicals. Serum iron, total iron-binding capacity (TIBC) and transferrin saturation levels were studied for their prediction of different cancers in a cohort of 41,276 men and women aged 20-74 years and initially free from cancer. During a mean follow-up of 14 years, 2,469 primary cancer cases were diagnosed. Excess risks of colorectal and lung cancers were found in subjects with transferrin saturation level exceeding 60%. The relative risks, adjusted for age, sex and smoking, were 3.04 for colorectal cancer and 1.51 for lung cancer, in comparison with subjects having lower levels. The risk of lung cancer was inversely related to serum TIBC, with a relative risk between the highest and lowest quartiles of 0.69 for men and 0.19 for women. For the risk of stomach cancer, we detected inverse relationships with serum iron and with transferrin saturation and a positive relationship with TIBC, but these associations weakened when the cancer cases occurring during the 5 first years of follow-up were excluded. High iron stores may increase the risk of colorectal cancer, whereas low iron stores may be an early sign of occult stomach cancer.
To assess whether increased body iron stores and dietary iron intake are associated with an increased risk of coronary heart disease mortality.
A prospective population study with a mean mortality follow-up time of 14 years.
Participants attending a health screening examination carried out in several localities in Finland.
All 6086 men and 6102 women aged from 45 to 64 years at the baseline examination without known heart disease, who had had serum iron and total iron binding capacity (TIBC) assessed. In a random fifth of these people, dietary iron intake was assessed by a dietary history.
The study was observational without any interventions.
Mortality from coronary heart disease.
Altogether, 739 of the men and 245 of the women died from coronary heart disease. No relationship between TIBC and coronary mortality was observed in the men; in the women, an inverse although not significant association was found. Transferrin saturation was inversely but not significantly associated with coronary mortality in men; in women, the relationship was U-formed with a higher mortality at both the lower and higher ends of the distribution. Adjustment for other risk factors did not alter the results. No association was found with dietary iron intake and coronary mortality.
The results do not corroborate earlier findings that excess body iron stores and increased iron intake are associated with an elevated risk of coronary heart disease.
Prevalence and incidence of known diabetes mellitus in Finnish subjects aged 30 years or over in 1970-1987 were investigated using a nationwide register of drug recipients and four population surveys. On the basis of the drug-register data, the prevalence of drug-treated diabetes in men increased from 1.5% in 1970 to 2.8% in 1987. In women, the prevalence increased from 2.1% in 1970 to 3.0% in 1979 and declined thereafter slightly to 2.7% in 1987. The increase in the prevalence of drug-treated diabetes was mainly due to the increase of diabetes in the age groups 60 years and older. The prevalence of all known diabetic subjects in the population studies increased from 2.1% in the health examination survey of 1966-1972 (n = 38,676) to 3.5% in the interview survey of 1976 (n = 10,657) and to 4.5% in the health examination survey of 1979-1980 (n = 7,217) but decreased to 3.3% in the interview survey in 1987 (n = 9,522). The increased prevalence of obesity in men and better survival may be important factors contributing to the increasing prevalence rates of diabetes in Finnish subjects aged 30 years and over.
BACKGROUND: The cholesteryl ester transfer protein (CETP) is involved in the reverse cholesterol transport and is therefore a candidate gene for atherosclerosis. DESIGN: The prevalences of the I405V and the R451Q polymorphisms were studied in a population sample of 515 men and women. Genotypes were determined by PCR and carotid atherosclerosis by ultrasonography as the mean intima-media thickness (IMT) of the carotid arteries. RESULTS: The Q451 allele was associated with significantly lower intima media thickness in men (P = 0.001). The Q451 allele was, in our earlier study, associated with high plasma CETP activity in men. The VV405 genotype was associated with lower plasma CETP activity compared with the II405 genotype (P