The ß(2)-adrenergic receptor (ADRB2) influences regulation of energy balance by stimulating catecholamine-induced lipolysis in adipose tissue. The rare functional ADRB2rs1800888(Thr164Ile) polymorphism could therefore influence risk of obesity and subsequently diabetes.
We tested the hypothesis that the ADRB2rs1800888(Thr164Ile) polymorphism associates with risk of obesity and diabetes and compared effect sizes with those of FTO(rs9939609), MC4R(rs17782313), and TMEM18(rs6548238).
We conducted a population-based cohort study in Copenhagen, Denmark.
We genotyped more than 64,000 individuals from the Danish general population.
We evaluated body mass index (BMI), obesity (BMI =30 kg/m(2)), and diabetes.
Rare allele frequencies were 0.02 for T for ADRB2rs1800888(Thr164Ile), 0.40 for A for FTOrs9939609, 0.25 for C for MC4Rrs17782313, and 0.20 for T for TMEM18rs6548238. For rare vs. common homozygotes, odds ratio for obesity was 3.32 (95% confidence interval = 1.08-10.19) for ADRB2rs1800888(Thr164Ile), 1.42 (1.35-1.52) for FTOrs9939609, 1.18 (1.06-1.30) for MC4Rrs17782313, and 1.28 (1.10-1.50) for TMEM18rs6548238 (common vs. rare). Corresponding odds ratios for diabetes were 1.85 (0.24-14.29), 1.22 (1.07-1.39), 0.96 (0.80-1.16), and 1.61 (1.17-2.22), respectively. After adjustment for BMI, only TMEM18rs6548238 remained associated with diabetes. BMI was increased in rare vs. common homozygotes in FTOrs9939609, MC4Rrs17782313, and TMEM18rs6548238 (common vs. rare) but not in ADRB2rs1800888(Thr164Ile).
Our results suggest that ADRB2rs1800888(Thr164Ile) rare vs. common homozygotes are not significantly associated with an increase in BMI measured continuously but may be associated with an increased risk of obesity. Also, TMEM18rs6548238 associated with risk of diabetes after adjustment for BMI. These findings need confirmation in other studies.
OBJECTIVE: To investigate the longitudinal relationship between body mass index (BMI), a major vascular risk factor, and cerebral atrophy, a marker of neurodegeneration, in a population-based sample of middle-aged women. METHODS: A representative sample of 290 women born in 1908, 1914, 1918, and 1922 was examined in 1968 to 1969, 1974 to 1975, 1980 to 1981, and 1992 to 1993 as part of the Population Study of Women in Göteborg, Sweden. At each examination, women completed a survey on a variety of health and lifestyle factors and underwent anthropometric, clinical, and neuropsychiatric assessments and blood collection. Atrophy of the temporal, frontal, occipital, and parietal lobes was measured on CT in 1992 when participants were age 70 to 84. Univariate and multivariate regression analyses were used to assess the relationship between BMI and brain measures. RESULTS: Women with atrophy of the temporal lobe were, on average, 1.1 to 1.5 kg/m2 higher in BMI at all examinations than women without temporal atrophy (p
Comment In: Neurology. 2005 Jun 14;64(11):1990-1; author reply 1990-115955971
SummaryForPatientsIn: Neurology. 2004 Nov 23;63(10):E19-2015557485
To assess associations between the intake of different types of alcoholic beverages and the 32-year incidence of myocardial infarction, stroke, diabetes, and cancer, as well as mortality, in a middle-aged female population.
Gothenburg, Sweden, population about 430 000.
Representative sample of a general population of women (1462 in total) aged 38 to 60 years in 1968-1969, followed up to the ages of 70 to 92 years in 2000-2001.
Associations between alcohol intake and later risk of mortality and morbidity from myocardial infarction, stroke, diabetes, and cancer, studied longitudinally.
During the follow-up period, 185 women developed myocardial infarction, 162 developed stroke, 160 women became diabetic, and 345 developed cancer. Women who drank beer had a 30% lower risk (hazards ratio (HR) 0.70, 95% confidence interval (CI) 0.50-0.95) of developing myocardial infarcion and almost half the risk (HR 0.51 CI 0.33-0.80). A significant association between increased risk of death from cancer and high spirits consumption was also shown (hazards ratio [HR] 1.47, CI 1.06-2.05).
Women with moderate consumption of beer had a reduced risk of developing myocardial infarction. High spirits consumption was associated with increased risk of cancer mortality.
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We describe the 40-year weight history and adult morbidity and mortality in a cohort of 504 overweight children, aged 2 months to 16 years, who were admitted for investigation of their overweight to four children's hospitals in Stockholm between 1921 and 1947. Follow-up information was gathered by questionnaire at 10-year intervals, most recently in 1980-1983 (n = 458), on weight history (based on the body mass index (BMI = kg/m2)), as well as prevalence of cardiovascular disease (n = 143), diabetes (n = 39), and cancer (all types (n = 20)), reported during the 40 years of follow-up, and mortality from all causes (n = 55), determined from death certificate. The sample of overweight children remained overweight as adults; after age 55 years, the BMI began to decline for both genders. Female subjects were heavier than their male counterparts from postpuberty onward. Subjects who died by the 40-year follow-up and those reporting cardiovascular disease were significantly (P
Myasthenia gravis (MG) may be associated with the presence of acetylcholine receptor antibodies (AChRAb) [seropositive MG (SPMG)] or their absence [seronegative MG (SNMG)]. Along with features of MG, the presence of the AChRAb may relate to the existence of other immune-mediated diseases. We sought to determine the association of SPMG with other potential autoimmune diseases.
A retrospective evaluation of prospectively identified MG patients at a tertiary care center was performed, with patients separated into SPMG and SNMG. Prevalence of other immune-mediated disorders, as well as the epidemiology, sensitivity of diagnostic testing, and thymic pathology, was contrasted between both patient groups.
Of the 109 MG patients identified, 66% were SPMG. SPMG was associated with a greater likelihood of significant repetitive stimulation decrement, the presence of either thymoma or thymic hyperplasia, and the presence of thyroid disease. In addition, all patients with a diagnosis of diabetes, concurrent with MG, were found to be SPMG.
AChRAb and SPMG impart not only a distinctive clinical and electrophysiological phenotype of MG, but are also associated with the heightened presence of endocrinological disease.
Valid data on acromegaly incidence, complications and mortality are scarce. The Danish Health Care System enables nationwide studies with complete follow-up and linkage among health-related databases to assess acromegaly incidence, prevalence, complications and mortality in a population-based cohort study.
All incident cases of acromegaly in Denmark (1991-2010) were identified from health registries and validated by chart review. We estimated the annual incidence rate of acromegaly per 10(6) person-years (py) with 95% confidence intervals (95% CIs). For every patient, 10 persons were sampled from the general population as a comparison cohort. Cox regression and hazard ratios (HRs) with 95% confidence intervals (95% CIs) were used.
Mean age at diagnosis (48.7 years (CI: 95%: 47.2-50.1)) and annual incidence rate (3.8 cases/10(6) persons (95% CI: 3.6-4.1)) among the 405 cases remained stable. The prevalence in 2010 was 85 cases/10(6) persons. The patients were at increased risk of diabetes mellitus (HR: 4.0 (95% CI: 2.7-5.8)), heart failure (HR: 2.5 (95% CI: 1.4-4.5)), venous thromboembolism (HR: 2.3 (95% CI: 1.1-5.0)), sleep apnoea (HR: 11.7 (95% CI: 7.0-19.4)) and arthropathy (HR: 2.1 (95% CI: 1.6-2.6)). The complication risk was also increased before the diagnosis of acromegaly. Overall mortality risk was elevated (HR: 1.3 (95% CI: 1.0-1.7)) but uninfluenced by treatment modality.
(i) The incidence rate and age at diagnosis of acromegaly have been stable over decades, and the prevalence is higher than previously reported. (ii) The risk of complications is very high even before the diagnosis. (iii) Mortality risk remains elevated but uninfluenced by mode of treatment.
Compare the prevalence of comorbidities in adults with and without asthma in Canada and investigate the association between comorbidities in patients with asthma and the occurrence of asthma symptoms or attacks.
Survey data from the 2005 Canadian Community Health Survey (CCHS) were analyzed. A total of 132,221 Canadians participated in the national survey; 10,089 adult respondents from 10 Canadian provinces and 3 territories reported having asthma. Analyses focused on 11 major chronic comorbidities.
Respondents with asthma were more likely to have comorbidities except cancer; 31% of respondents with asthma and comorbidities reported their health status to be fair or poor. For respondents with asthma, non-asthma chronic respiratory disease, mental illness, and allergy were significantly associated with having asthma symptoms or attacks.
Many Canadians with asthma report a high comorbidity burden. These patients will likely require more health services and more complex health management strategies. Comorbid conditions should be clearly identified with particular emphasis on management of mood disorders and anxiety because these conditions are likely to increase asthma symptomatology and may be unrecognized by clinicians.
We sought to measure the prevalence of inadequate glycemic control in prevalent hemodialysis patients with diabetes and to examine independent predictors of inadequate glycemic control in these patients.
This is a cross-sectional study of prevalent hemodialysis patients with diabetes in southeastern Ontario (n = 100). Data were collected by chart review and interview. The outcome variable was inadequate glycemic control defined as HbA1c (A1C) >0.07. Other measured variables were diabetes type, diabetes duration, diabetes physician, blood glucose monitoring, diabetes medications, BMI, time on dialysis, and other demographic, clinical, and laboratory variables.
Fifty-four patients had A1C >0.07. In bivariate analysis, these patients had a longer diabetes duration (23.6 vs. 14.7 years, P 0.07.
A high proportion of hemodialysis patients with diabetes had inadequate glycemic control, particularly those with longstanding disease. Patients with inadequate glycemic control had a significantly higher burden of microvascular complications.
The results refer to a 12-year longitudinal population study of women in Gothenburg, Sweden. Correlations were studied between initial adipose tissue amount and adipose tissue distribution on the one hand and incidence of diabetes and change in serum blood glucose concentration on the other. Body mass index, sum of two skinfolds and waist-to-hip circumference ratio were significantly associated with incidence of diabetes. The waist-to-hip ratio was also positively associated with an increase of serum glucose concentration in the fasting state during the followup period. The significant correlations remained in multivariate analysis and were independent of age, initial smoking habits, systolic blood pressure, intake of antihypertensive drugs and serum cholesterol, triglyceride and glucose concentrations. The correlations between the separate anthropometric variables and incidence of diabetes remained when the other anthropometric variables were considered as background factors. The distribution of fat to the abdominal region as well as the total amount of fat per se seem to be important risk factors for diabetes and the effect of one of these factors seems to add to the other.
Physical activity may counteract the adverse effects of adiposity on cardiovascular mortality; however, the evidence of a similar effect on diabetes is sparse. This study examines whether physical activity may compensate for the adverse effect of adiposity on diabetes risk.
The study population consisted of 38 231 individuals aged 20 years or more who participated in two consecutive waves of the prospective longitudinal Nord-Trøndelag Health Study in Norway: in 1984-1986 and in 1995-1997. A Poisson regression model with SEs derived from robust variance was used to estimate adjusted risk ratios of diabetes between categories of body mass index and physical activity.
Risk of diabetes increased both with increasing body mass (Ptrend