To evaluate the impact on lipid and carbohydrate variables of a combined one-third ethinyl estradiol (EE)/levonorgestrel (LNG) dose reduction in oral contraceptives.
In an open-label, randomized study, a dose-reduced oral contraceptive containing 20 microg EE and 100 microg LNG (20 EE/100 LNG) was compared with a reference preparation containing 30 microg EE and 150 microg LNG (30 EE/150 LNG). One-year data from 48 volunteers were obtained.
We found a decrease of HDL2 cholesterol and increases of low-density lipoprotein cholesterol, very low-density lipoprotein cholesterol and total triglycerides in both treatment groups from baseline to the 13th treatment cycle. Although for four of six variables, the changes in the 20 EE group were lower compared with the 30 EE group, none of the differences between the two treatments were statistically significant. The median values for the fasting levels of insulin, C-peptide and free fatty acids slightly increased or remained unchanged while the fasting glucose levels slightly decreased after 13 treatment cycles. While the glucose area under the curve (AUC) (0-3 h) was similar in both groups during the OGTT, the insulin AUC(0-3 h) was less increased in the 20 EE/100 LNG group compared with the 30 EE/150 LNG group. None of the differences between the treatment groups for any of the carbohydrate metabolism variables were statistically significant at any time point. Both study treatments were safe and well tolerated by the volunteers.
Similar effects on the lipid and carbohydrate profiles were found for both preparations. The balanced one-third EE dose reduction in this new oral contraceptive caused slightly lower, but insignificant, changes in the lipid and carbohydrate variables compared with the reference treatment.
Haplotype analysis of the low density lipoprotein receptor (LDLR) gene was performed in Norwegian subjects heterozygous for familial hypercholesterolemia (FH). Southern blot analysis of genomic DNA, using an exon 18 specific probe and the restriction enzyme NcoI, showed that two out of 57 unrelated FH subjects had an abnormal 3.6 kb band. Further analyses revealed that this abnormal band was due to a 9.6 kb deletion that included exons 16 and 17. The 5' deletion breakpoint was after 245 bp of intron 15, and the 3' deletion breakpoint was in exon 18 after nucleotide 3390 of cDNA. Thus, both the membrane-spanning and cytoplasmatic domains of the receptor had been deleted. A polymerase chain reaction (PCR) method was developed to identify this deletion among other Norwegian FH subjects. As a result of this screening one additional subject was found out of 124 subjects screened. Thus, three out of 181 (1.7%) unrelated Norwegian FH subject possessed this deletion. The deletion was found on the same haplotype in the three unrelated subjects, suggesting a common mutagenic event. The deletion is identical to a deletion (FH-Helsinki) that is very common among Finnish FH subjects. However, it is not yet known whether the mutations evolved separately in the two countries.
The Cardiovascular Risk in Young Finns Study is an on-going multicentre study of atherosclerosis precursors in Finnish children and young adults. We have collected risk factor data in the 21-year follow-up performed in 2001. The aims of this analysis were to examine the levels, secular trends and east-west difference in risk factors amongst young adults.
Population based follow-up study.
A total of 2283 participants aged 24-39 years in 2001 (63.5% of the original cohort).
Levels of serum lipids, apolipoproteins, blood pressure and smoking.
The mean serum total cholesterol, low density lipoprotein cholesterol, high density lipoprotein (HDL) cholesterol and triglyceride concentrations in 24-39-year-old adults were 5.16, 3.27, 1.29 and 1.34 mmol L(-1), respectively. Total cholesterol (5.21 vs. 5.12 mmol L(-1), P = 0.046), HDL cholesterol (1.31 vs. 1.28 mmol L(-1), P = 0.027), systolic blood pressure (118 vs. 115 mmHg, P
The aim of this study is to describe the 21 year trends in myocardial infarction among middle-aged inhabitants in the city of Turku, in southwestern Finland. Since 1972 the coronary register in Turku has monitored acute coronary events leading to hospital admission or death, first according to the methods of the World Health Organization Heart Attack Register Study, and since 1982 according to the methods of the WHO MONICA. From 1972 to 1992 we registered 7374 events of suspected myocardial infarction, of which 6045 events occurring in inhabitants of Turku aged 35-64 years, fulfilled the criteria for myocardial infarction. Within 28 days, 2266 coronary events proved fatal. During the 21-year period, the incidence of definite myocardial infarction fell by 55% in men and by 62% in women, and coronary mortality fell by 66 and 81%, respectively. From 1972 to 1982, total mortality and coronary mortality decreased in parallel. Later on, the decrease in total mortality levelled off, even though coronary mortality fell still steeper, because mortality from external causes of death increased. The favourable long-term trends reflect favourable changes in total cholesterol and blood pressure in the middle-aged population, and the improvement in the treatment of myocardial infarction. Further efforts are needed to enhance this trend, but also to reduce total mortality among middle-aged people.
Comment In: Eur Heart J. 1996 Oct;17(10):1455-68909894
The -250G>A promoter variant in hepatic lipase associates with elevated fasting serum high-density lipoprotein cholesterol modulated by interaction with physical activity in a study of 16,156 Danish subjects.
CONTEXT: Hepatic lipase plays a pivotal role in the metabolism of high-density lipoprotein (HDL) and low-density lipoprotein by involvement in reverse cholesterol transport and the formation of atherogenic small dense low-density lipoprotein. OBJECTIVES: The objective was to investigate the impact of variants in LIPC on metabolic traits and type 2 diabetes in a large sample of Danes. Because behavioral factors influence hepatic lipase activity, we furthermore examined possible gene-environment interactions in the population-based Inter99 study. DESIGN: The LIPC -250G>A (rs2070895) variant was genotyped in the Inter99 study (n = 6070), the Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen Detected Diabetes in Primary Care Denmark screening cohort of individuals with risk factors for undiagnosed type 2 diabetes (n = 8662), and in additional type 2 diabetic patients (n = 1,064) and glucose-tolerant control subjects (n = 360). RESULTS: In the Inter99 study, the A allele of rs2070895 associated with a 0.057 mmol/liter [95% confidence interval (CI) 0.039-0.075] increase in fasting serum HDL-cholesterol (HDL-c) (P = 8 x 10(-10)) supported by association in the Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen Detected Diabetes in Primary Care study [0.038 mmol/liter per allele (95% CI 0.024-0.053); P = 2 x 10(-7)). The allelic effect on HDL-c was modulated by interaction with self-reported physical activity (P(interaction) = 0.002) because vigorous physically active homozygous A-allele carriers had a 0.30 mmol/liter (95% CI 0.22-0.37) increase in HDL-c compared with homozygous G-allele carriers. CONCLUSIONS: We validate the association of LIPC promoter variation with fasting serum HDL-c and present data supporting an interaction with physical activity implying an increased effect on HDL-c in vigorous physically active subjects carrying the -250 A allele. This interaction may have potential implications for public health and disease prevention.
The aim of this study was to examine whether the well-established effect of the common TaqIB polymorphism in intron 1 of the gene for cholesterol ester transfer protein (CETP) on high density lipoprotein cholesterol (HDL-C) concentration and increased risk of myocardial infarction (MI), could be explained by the recently identified -629C>A functional polymorphism in the promoter. Non-fatal MI cases (388 male) and a control group of 794 healthy men were recruited from the 30 year long prospective Reykjavik Study. In the healthy men the frequency of the TaqIB B2 allele was 0.47 (95% CI: 0.44-0.50) and there was a strong allelic association with the -629A allele (D=-0.21, P
Risk factors for the development of stroke was studied in a prospective long-term investigation of 855 male in a random population sampled of the same age. After 13 years of follow-up 25 participants had suffered from stroke, which gives an incidence of 19/10,000 annually. At the 1963 year investigation several parametras were studied. The stroke-prone person had higher values of systolic and diastolic blood pressure and had a significant greater total heart volume. Blood parametras as the fasting of serum cholesterole, triglyceride and erytrocyte sedimentation rate were significantly elevated in those who developed stroke. They also tended to consume more coffee and showed a higher tobacco consumption. By applying the multiple regression model it was disclosed that the most predective risk-variables were diastolic blood pressure, erytrocyte sedimentation rate and smoking habits.
The Alaska Department of Health and Social Services implemented the Behavioral Risk Factor Surveillance System (BRFSS) in 1990 incooperation with the federal Centers for Disease Control and Prevention. The system gathers information about the health-related lifestyle choices of Alaskan adults related to leading causes of death such as heart disease, cancer and injury. The program is part of an ongoing national data collection system. Results are analyzed each year to improve our understanding of Alaskanhealth habits and to measure progress toward national and state health objectives. This report summarizes survey findings from1991 to 1996 and compares the results to selected national health objectives presented in the Healthy People 2000 publication.
Behavior and lifestyle play an important part in determining ourhealth status and lifespan. Every day Alaskans make lifestyle choices that profoundly affect their health. Although heredity and environment play a part, the leading causes of death in Alaska (heart disease, cancer and unintentional injuries) are closely related to lifestyle factors. Lifestyle and behavioral factors that affect health include such things as diet, exercise, use of alcohol andtobacco, and preventive health practices. Many premature deathsand disabilities could be prevented through better control of thesebehavioral risk factors.