RESUMEN
OBJECTIVE: Although the current recommendation is to measure radiographic joint space width (JSW) to assess structural change in osteoarthritis (OA), there is increasing interest in direct measurement of cartilage volume from magnetic resonance imaging (MRI). We performed a longitudinal study to compare change in both JSW and articular cartilage volume in subjects with symptomatic knee OA. METHODS: JSW was measured in 28 subjects with knee OA (57% females, mean age 62.8+/-9.8 years) who had standing radiographs in full extension, where both radiographs had satisfactory alignment. Each subject had femoral, tibial and combined femoral and tibial cartilage volumes determined from T1-weighted fat saturated sagittal knee MRI. All subjects had a repeat of the knee radiograph and MRI 1.96+/-0.4 years later. RESULTS: At baseline there was a moderate, but statistically significant, correlation between JSW and femoral and tibial cartilage volumes in the medial tibiofemoral joint, which was strengthened by adjusting for medial tibial bone size (R=0.58-0.66, P=0.001). Although we observed a reduction in JSW and femoral and tibial cartilage volumes over the study period, there was no significant association between reduction in JSW and cartilage volume (R<0.13). There was a trend towards a significant association between change in medial tibiofemoral cartilage volume and joint replacement at 4 years (OR=9.0, P=0.07) but not change in medial tibiofemoral JSW (OR=1.1, P=0.92). CONCLUSIONS: Although there was a modest correlation between cartilage volume and JSW in the medial tibiofemoral compartment, there was no correlation between longitudinal change in these measures. Change in cartilage volume appears to be a better predictor of joint replacement. Further work in larger samples over a longer period of time will be needed to confirm these findings.
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Articulación de la Rodilla/patología , Imagen por Resonancia Magnética/métodos , Osteoartritis de la Rodilla/patología , Artroplastia de Reemplazo de Rodilla/métodos , Cartílago Articular/diagnóstico por imagen , Cartílago Articular/patología , Progresión de la Enfermedad , Femenino , Fémur , Humanos , Articulación de la Rodilla/diagnóstico por imagen , Articulación de la Rodilla/cirugía , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Osteoartritis de la Rodilla/diagnóstico por imagen , Osteoartritis de la Rodilla/cirugía , Dimensión del Dolor , Radiografía , Tibia , Resultado del TratamientoRESUMEN
OBJECTIVES: There is emerging evidence that knee alignment is associated with progression of osteoarthritis (OA). The aim of this study was to examine the relationship between baseline knee angle and the rate of cartilage loss in subjects with knee OA. METHODS: One hundred and seventeen subjects with knee OA had standing radiographs and MRI on their symptomatic knee at baseline and at the 1.9+/-0.2 yr follow-up. Knee cartilage volume was measured at baseline and follow-up. Knee angle was defined as the angle subtended by a line drawn through the mid-shaft of the femur with respect to one drawn through the mid-shaft of the tibia. RESULTS: At baseline, in the medial compartment, as the angle decreased (i.e. was less varus) the tibial and femoral cartilage volume increased. In the lateral compartment, as the angle became more valgus, there was a reduction in tibial and femoral cartilage volume. In the longitudinal study, for every 1 degrees increase in baseline varus angulation there was an average annual loss of medial femoral cartilage of 17.7 micro l [95% confidence interval (CI) 6.5-28.8]. Although not statistically significant, there was a trend for a similar relationship between loss of medial tibial cartilage volume and baseline knee angle. In the lateral compartment, there was an average loss of tibial cartilage volume of 8.0 micro l (95% CI 0.0-16.0) for every 1 degrees increase in valgus angle. CONCLUSIONS: Baseline knee angle is associated with the rate of cartilage loss in the knee. Further work will be needed to determine whether therapies aimed at modifying the knee angle will reduce the progression of knee OA.
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Cartílago Articular/patología , Articulación de la Rodilla/patología , Osteoartritis de la Rodilla/patología , Anciano , Cartílago Articular/diagnóstico por imagen , Femenino , Humanos , Articulación de la Rodilla/diagnóstico por imagen , Modelos Lineales , Estudios Longitudinales , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Osteoartritis de la Rodilla/diagnóstico por imagen , Radiografía , Factores de TiempoRESUMEN
A food frequency questionnaire (FFQ) was developed to assess long-term habitual dietary intake in a cohort of approximately 100,000 40 to 79 year-old men and women living in the Southeastern US. Using the NHANES-III database for the southem region for specific race and sex subgroups, a list of 262 food categories was developed, coded and reduced to 102 food items that could discriminate between racial groups and account for large portions of cancer-relevant nutrients. The developed FFQ was tested in a pilot study in three southeastern states involving 239 African Americans and Whites, aged 56.9 +/- 12.2 years. The frequencies of consumption and portion sizes of the 102 foods were determined and intakes of various nutrients were estimated and compared with the NHANES-III data. African Americans reported higher total energy intakes and higher consumption of macronutrients and several micronutrients, compared to Whites. Estimated nutrient indices were higher among pilot study than among NHANES-III participants, although adjustment for total energy essentially eliminated the differences. Analysis of the frequency distribution of individual foods shows that the questionnaire includes commonly eaten foods that can discriminate between African Americans and Whites. The FFQ is currently being calibrated within the cohort study population.
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Conducta Alimentaria/etnología , Encuestas y Cuestionarios/normas , Adulto , Negro o Afroamericano , Anciano , Estudios de Cohortes , Cultura , Ingestión de Energía , Femenino , Alimentos/clasificación , Humanos , Masculino , Persona de Mediana Edad , Fenómenos Fisiológicos de la Nutrición/etnología , Sudeste de Estados Unidos , Población BlancaRESUMEN
Heterocyclic amines (HAAs) are suspected carcinogens that are formed in meat when it is cooked at high temperature for long durations. These compounds require metabolic activation by CYP1A2 and N-acetyltransferase (NAT) 2 or NAT1 before they can bind to DNA. It has been hypothesized that well-done meat increases the risk of colorectal cancer (CRC), especially in individuals with the rapid phenotype for CYP1A2 and NAT2. This association may be particularly strong in smokers because smoking is known to induce CYP1A2. We conducted a population-based case-control study on Oahu, Hawaii to specifically test this hypothesis. An in-person interview assessed the diet and preference for well-done red meat of 349 patients with CRC and 467 population controls. A urine collection after caffeine challenge and a blood collection were used to assess phenotype for CYP1A2 and NAT2 and genotype for NAT2 and NAT1, respectively. No statistically significant main effect association with CRC was found for red meat intake, preference for well-done red meat, the NAT2 rapid genotype, the CYP1A2 rapid phenotype or the NAT1*10 allele. However, in ever-smokers, preference for well-done red meat was associated with an 8.8-fold increased risk of CRC (95% confidence interval, 1.7-44.9) among subjects with the NAT2 and CYP1A2 rapid phenotypes, compared with smokers with low NAT2 and CYP1A2 activities who preferred their red meat rare or medium. No similar association was found in never-smokers, and there was no increased risk for well-done meat among smokers with a rapid phenotype for only one of these enzymes or for smokers with both rapid phenotypes who did not prefer their red meat well-done. These data provide additional support to the hypothesis that exposure to carcinogens (presumably HAAs) through consumption of well-done meat increases the risk of CRC, particularly in individuals who are genetically susceptible (as determined by a rapid phenotype for both NAT2 and CYP1A2) and suggest that smoking, by inducing CYP1A2, facilitates this effect.
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Arilamina N-Acetiltransferasa/genética , Carcinógenos Ambientales/efectos adversos , Neoplasias Colorrectales/etiología , Citocromo P-450 CYP1A2/genética , Exposición a Riesgos Ambientales , Predisposición Genética a la Enfermedad , Carne , Fumar/efectos adversos , Anciano , Arilamina N-Acetiltransferasa/metabolismo , Neoplasias Colorrectales/genética , Culinaria , Citocromo P-450 CYP1A2/metabolismo , Dieta , Inducción Enzimática , Femenino , Humanos , Masculino , Persona de Mediana Edad , Fenotipo , Factores de RiesgoRESUMEN
An inflammatory response accompanies the reversible pneumotoxicity caused by butylated hydroxytoluene (BHT) administration to mice. Lung tumor formation is promoted by BHT administration following an initiating agent in BALB/cByJ mice, but not in CXB4 mice. To assess the contribution of inflammation to this differential susceptibility, we quantitatively characterized inflammation after one 150 mg/kg body weight, followed by three weekly 200 mg/kg ip injections of BHT into male mice of both strains. This examination included inflammatory cell infiltrate and protein contents in bronchoalveolar lavage (BAL) fluid, cyclooxygenase (COX)-1 and COX-2 expression in lung extracts, and PGE(2) and PGI(2) production by isolated bronchiolar Clara cells. BAL macrophage and lymphocyte numbers increased in BALB mice (P<0.0007 and 0.02, respectively), as did BAL protein content (P<0.05), COX-1 and COX-2 expression (P<0.05 for each), and PGI(2) production (P<0.05); conversely, these indices were not perturbed by BHT in CXB4 mice. BALB mice fed aspirin (400 mg/kg of chow) for two weeks prior to BHT treatment had reduced inflammatory cell infiltration. Our results support a hypothesis that resistance to BHT-induced inflammation in CXB4 mice accounts, at least in part, for the lack of effect of BHT on lung tumor multiplicity in this strain.
Asunto(s)
Antioxidantes/farmacología , Hidroxitolueno Butilado/farmacología , Carcinógenos/farmacología , Neoplasias Pulmonares/inducido químicamente , Neumonía/inducido químicamente , 6-Cetoprostaglandina F1 alfa/biosíntesis , Animales , Antiinflamatorios no Esteroideos/farmacología , Antioxidantes/toxicidad , Aspirina/farmacología , Líquido del Lavado Bronquioalveolar/química , Hidroxitolueno Butilado/toxicidad , Carcinógenos/toxicidad , Ciclooxigenasa 1 , Ciclooxigenasa 2 , Dinoprostona/biosíntesis , Immunoblotting , Técnicas para Inmunoenzimas , Inmunohistoquímica , Isoenzimas/biosíntesis , Pulmón/efectos de los fármacos , Pulmón/enzimología , Pulmón/patología , Neoplasias Pulmonares/patología , Masculino , Proteínas de la Membrana , Ratones , Ratones Endogámicos BALB C , Neumonía/metabolismo , Neumonía/patología , Prostaglandina-Endoperóxido Sintasas/biosíntesis , Estadísticas no ParamétricasRESUMEN
STUDY OBJECTIVE: In July 1998, a pilot trial which used fire fighters as medical first-responders for the first time in Australia, was implemented in Melbourne. We aimed to assess the impact of the introduction of a medical first-responder role to the fire service, on the fire fighters both professionally and personally. METHODS: Focus groups were conducted at the fire stations located in the study area. Data from the focus groups was collated and examined for themes. The issues identified as important through the focus groups were then incorporated into a questionnaire. RESULTS: The fire fighters located at the pilot stations involved in the first-responder programme appear to view their new role as first-responders as a positive addition to their emergency profession. Some areas of the programme were identified by this study as in need of improvement. Some aspects of the communication strategies utilised by the Fire Brigade were highly criticised. Some aspects of the support system offered by the Fire Brigade also appear to be regarded as unfavourable. CONCLUSION: Results from this study provide useful information on professional fire fighter first-responder programmes and their impact on participating personnel. These results can be used to improve training modules, communication strategies and support services.
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Servicios Médicos de Urgencia , Auxiliares de Urgencia , Adaptación Psicológica , Auxiliares de Urgencia/educación , Incendios , Grupos Focales , Humanos , Proyectos Piloto , VictoriaRESUMEN
This report describes the development and validation/calibration of a structured food frequency questionnaire for use in a large-scale cohort study of diet and health in Chinese men and women aged 45-74 years in Singapore, the development of a food composition database for analysis of the dietary data, and the results of the dietary validation/calibration study. The present calibration study comparing estimated intakes from 24-hour recalls with those from the food frequency questionnaires revealed correlations of 0.24-0.79 for energy and nutrients among the Singapore Chinese, which are comparable to the correlation coefficients reported in calibration studies of other populations. We also report on the nutritional profiles of Singapore Chinese on the basis of results of 1,880 24-hour dietary recalls conducted on 1,022 (425 men and 597 women) cohort subjects. Comparisons with age-adjusted corresponding values for US whites and blacks show distinct differences in dietary intakes between the Singapore and US populations. The Singapore cohort will be followed prospectively to identify dietary associations with cancer risk and other health outcomes.
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Registros de Dieta , Alimentos , Estado de Salud , Encuestas y Cuestionarios/normas , Anciano , Población Negra , Índice de Masa Corporal , China , Estudios de Cohortes , Grasas de la Dieta/administración & dosificación , Ingestión de Energía , Etnicidad , Femenino , Humanos , Masculino , Recuerdo Mental , Persona de Mediana Edad , Fenómenos Fisiológicos de la Nutrición , Estados Unidos , Población BlancaRESUMEN
BACKGROUND: This paper reviews the literature on the identification and treatment of pregnant, alcohol-abusing women, with special emphasis on poor women who have access to treatment through Medicaid. METHODS: The paper discusses the gaps and controversies in the literature and suggests five priorities for future research. RESULTS: Studies that attempt to identify pregnant women who drink conclude that heavier drinkers enter prenatal care later than other women, that many health care providers fail to recognize alcohol abuse by pregnant women, and that research on screening techniques is still in the early stages. Treatment research suggests that comprehensive, holistic treatment approaches, as well as brief interventions and case management, have been successful in reducing prenatal alcohol use. Debate continues over whether treatment should be voluntary. CONCLUSIONS: The five areas identified as priorities for future research include (1) developing reliable and valid measures to identify alcohol abuse in pregnant women, (2) creating training programs for providers, (3) generating programs to reduce barriers to care, (4) determining which treatment programs are most successful, and (5) estimating the costs and benefits of various treatment approaches.
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Alcoholismo , Complicaciones del Embarazo , Alcoholismo/diagnóstico , Alcoholismo/economía , Alcoholismo/terapia , Análisis Costo-Beneficio , Femenino , Humanos , Conocimiento , Cooperación del Paciente , Embarazo , Atención PrenatalRESUMEN
The evidence for a protective effect of vegetables, fruits, and legumes against prostate cancer is weak and inconsistent. We examined the relationship of these food groups and their constituent foods to prostate cancer risk in a multicenter case-control study of African-American, white, Japanese, and Chinese men. Cases (n = 1619) with histologically confirmed prostate cancer were identified through the population-based tumor registries of Hawaii, San Francisco, and Los Angeles in the United States and British Columbia and Ontario in Canada. Controls (n = 1618) were frequency-matched to cases on ethnicity, age, and region of residence of the case, in a ratio of approximately 1:1. Dietary and other information was collected by in-person home interview; a blood sample was obtained from control subjects for prostate-specific antigen determination. Odds ratios (OR) were estimated using logistic regression, adjusting for age, geographic location, education, calories, and when indicated, ethnicity. Intake of legumes (whether total legumes, soyfoods specifically, or other legumes) was inversely related to prostate cancer (OR for highest relative to lowest quintile for total legumes = 0.62; P for trend = 0.0002); results were similar when restricted to prostate-specific antigen-normal controls or to advanced cases. Intakes of yellow-orange and cruciferous vegetables were also inversely related to prostate cancer, especially for advanced cases, among whom the highest quintile OR for yellow-orange vegetables = 0.67 (P for trend = 0.01) and the highest quintile OR for cruciferous vegetables = 0.61 (P for trend = 0.006). Intake of tomatoes and of fruits was not related to risk. Findings were generally consistent across ethnic groups. These results suggest that legumes (not limited to soy products) and certain categories of vegetables may protect against prostate cancer.
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Anticarcinógenos/uso terapéutico , Conducta Alimentaria/etnología , Fitoterapia , Neoplasias de la Próstata/etnología , Neoplasias de la Próstata/prevención & control , Verduras/uso terapéutico , Anciano , Pueblo Asiatico , Población Negra , Colombia Británica/epidemiología , California/epidemiología , Estudios de Casos y Controles , Encuestas sobre Dietas , Fabaceae/uso terapéutico , Frutas/uso terapéutico , Hawaii/epidemiología , Humanos , Modelos Logísticos , Masculino , Oportunidad Relativa , Ontario/epidemiología , Plantas Medicinales , Antígeno Prostático Específico/sangre , Población BlancaRESUMEN
The authors describe the design and implementation of a large multiethnic cohort established to study diet and cancer in the United States. They detail the source of the subjects, sample size, questionnaire development, pilot work, and approaches to future analyses. The cohort consists of 215,251 adult men and women (age 45-75 years at baseline) living in Hawaii and in California (primarily Los Angeles County) with the following ethnic distribution: African-American (16.3%), Latino (22.0%), Japanese-American (26.4%), Native Hawaiian (6.5%), White (22.9%), and other ancestry (5.8%). From 1993 to 1996, participants entered the cohort by completing a 26-page, self-administered mail questionnaire that elicited a quantitative food frequency history, along with demographic and other information. Response rates ranged from 20% in Latinos to 49% in Japanese-Americans. As expected, both within and among ethnic groups, the questionnaire data show substantial variations in dietary intakes (nutrients as well as foods) and in the distributions of non-dietary risk factors (including smoking, alcohol consumption, obesity, and physical activity). When compared with corresponding ethnic-specific cancer incidence rates, the findings provide tentative support for several current dietary hypotheses. As sufficient numbers of cancer cases are identified through surveillance of the cohort, dietary and other hypotheses will be tested in prospective analyses.
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Encuestas sobre Dietas , Dieta , Etnicidad/estadística & datos numéricos , Neoplasias/etnología , Selección de Paciente , Negro o Afroamericano/estadística & datos numéricos , Distribución por Edad , Anciano , Asiático/estadística & datos numéricos , Estudios de Cohortes , Femenino , Hawaii/epidemiología , Hispánicos o Latinos/estadística & datos numéricos , Humanos , Los Angeles/epidemiología , Masculino , Persona de Mediana Edad , Proyectos Piloto , Estudios Prospectivos , Distribución por Sexo , Encuestas y Cuestionarios , Población Blanca/estadística & datos numéricosRESUMEN
The performance of the dietary questionnaire used in a multiethnic cohort study in Hawaii and Los Angeles was assessed in a calibration substudy that compared diet reported from the questionnaire with three 24-hour dietary recalls. For the calibration substudy, subjects from each of eight subgroups defined by sex and ethnic group (African-American, Japanese-American, Latino, and White) were chosen randomly from among the cohort members, and each participant's previous day's diet was assessed by telephone recall on three occasions over approximately 2 months. After completing the three 24-hour recalls, each calibration subject was sent a second questionnaire; 1,606 persons completed three recalls and a second questionnaire (127 to 267 per ethnic-sex group). This report describes correlation coefficients and calibration slopes for the relation between the 24-hour recalls and second questionnaire values for a selected set of macro- and micronutrients, as absolute intakes, nutrient densities, and calorie-adjusted nutrients. In all subgroups, estimates of the correlation between the questionnaire and 24-hour recalls were greater after energy adjustment (average correlations ranged from 0.57-0.74 for nutrient densities and from 0.55-0.74 for calorie-adjusted nutrients) than when absolute nutrient values were used (average range 0.26-0.57). For absolute nutrient intakes, the correlations were greatest for Whites, somewhat lower for Japanese-Americans and Latinos, and lowest for African-Americans. After energy adjustment, the difference between subgroups were diminished, and the correlations were generally highly satisfactory.
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Encuestas sobre Dietas , Dieta , Etnicidad/estadística & datos numéricos , Neoplasias/etnología , Encuestas y Cuestionarios/normas , Negro o Afroamericano/estadística & datos numéricos , Anciano , Asiático/estadística & datos numéricos , Calibración , Estudios de Cohortes , Métodos Epidemiológicos , Femenino , Hawaii/epidemiología , Hispánicos o Latinos/estadística & datos numéricos , Humanos , Los Angeles/epidemiología , Masculino , Persona de Mediana Edad , Población Blanca/estadística & datos numéricosRESUMEN
This study investigates whether alcoholism treatment costs are offset by reductions in other medical treatment costs by comparing people treated for alcoholism with a matched comparison group. The alcoholism treatment group is defined by diagnoses of alcohol dependence, abuse, or psychoses from health insurance claims field between January 1980 and June 1987. A comparison sample was matched on age, gender, and insurance coverage. In this primarily methodological study, expected costs for nonalcoholism treatments were calculated from standardized regressions. Offset effects were measured from the insurer's perspective through differences in expected total nonalcoholism treatment costs in the periods preceding and following alcoholism treatment. Members of the alcoholism treatment group were more likely than the comparison group to be hospitalized and to need other (nonalcoholism) medical treatment, thus incurring higher total costs. Offset effects emerged for patients with alcohol abuse and without mental psychosis comorbidities.
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Alcoholismo/economía , Alcoholismo/terapia , Costo de Enfermedad , Planes de Aranceles por Servicios/economía , Costos de la Atención en Salud/estadística & datos numéricos , Adulto , Alcoholismo/complicaciones , Femenino , Planes de Asistencia Médica para Empleados/economía , Investigación sobre Servicios de Salud , Humanos , Masculino , Medio Oeste de Estados Unidos , Modelos Econométricos , Análisis de Regresión , Resultado del TratamientoAsunto(s)
Leucotrieno B4/metabolismo , Neoplasias Pulmonares/metabolismo , Animales , Línea Celular , Cromatografía Líquida de Alta Presión/métodos , Cromatografía Líquida de Alta Presión/estadística & datos numéricos , Deuterio , Leucotrieno B4/análisis , Neoplasias Pulmonares/química , Espectrometría de Masas/métodos , Espectrometría de Masas/estadística & datos numéricos , Porcinos , Células Tumorales CultivadasRESUMEN
BACKGROUND: To investigate the possible relationship between intake of flavonoids-powerful dietary antioxidants that may also inhibit P450 enzymes-and lung cancer risk, we conducted a population-based, case-control study in Hawaii. METHODS: An in-person interview assessed smoking history and usual intake of 242 food items for 582 patients with incident lung cancer and 582 age-, sex-, and ethnicity-matched control subjects. Subjects who donated a blood sample were genotyped for the P450 enzyme variant allele CYP1A1*2 by use of a polymerase chain reaction-based method. Logistic regression analysis was used to compute odds ratios (ORs) and 95% confidence intervals (CIs). All P values are two-sided. RESULTS: After adjusting for smoking and intakes of saturated fat and beta-carotene, we found statistically significant inverse associations between lung cancer risk and the main food sources of the flavonoids quercetin (onions and apples) and naringin (white grapefruit). The lung cancer OR for the highest compared with the lowest quartile of intake was 0.5 (95% CI = 0.3-0.9) for onions (P for trend =.001) and 0.6 (95% CI = 0.4-1.0) for apples (P for trend =.03). The OR for the highest compared with the lowest tertile of intake for white grapefruit was 0.5 (95% CI = 0.2-0.9) (P for trend =.02). No association was found for important food sources of other flavonoids. Using published food-composition data for flavonoids, we found an inverse association between intake of quercetin and risk of lung cancer (P for trend =.07) that appears consistent with associations for its food sources. The effect of onions was particularly strong against squamous cell carcinoma (a cell type specifically associated with CYP1A1*2 in our study) and was modified by the CYP1A1 genotype, suggesting that CYP1A1 may play a role in this association. CONCLUSION: If replicated, particularly in prospective studies, these findings would suggest that foods rich in certain flavonoids may protect against certain forms of lung cancer and that decreased bioactivation of carcinogens by inhibition of CYP1A1 should be explored as underlying mechanisms.
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Citocromo P-450 CYP1A1/genética , Conducta Alimentaria , Flavanonas , Flavonoides/administración & dosificación , Neoplasias Pulmonares/prevención & control , Anciano , Antioxidantes/administración & dosificación , Estudios de Casos y Controles , Femenino , Genotipo , Hawaii , Humanos , Modelos Logísticos , Neoplasias Pulmonares/enzimología , Masculino , Persona de Mediana Edad , Evaluación Nutricional , Oportunidad Relativa , Reacción en Cadena de la Polimerasa , Polimorfismo Genético , Quercetina/administración & dosificaciónRESUMEN
Concentrations and glucosidic conjugation patterns of isoflavones were determined in soy foods consumed by multiethnic populations in Singapore and Hawaii. Six raw and 11 cooked food groups traditionally consumed in Singapore and 8 food groups consumed in Hawaii were analyzed by reversed-phase high-pressure liquid chromatography with diode array detection. Mean total isoflavone levels varied between 35 and 7500 ppm, with the lowest values found in soy milk and burgers and the highest levels observed in soybean and its seeds and in supplements. Total isoflavone levels and conjugation patterns varied as a function of soybean variety, storage conditions, and food processing. A large contribution to the differences in total isoflavone content between food groups was due to the water content in foods and to leaching of polar analytes into the water phase during boiling. Soy protein drinks and traditional soy foods were found to possess very similar isoflavone amounts considering usual serving sizes.
Asunto(s)
Dieta , Glycine max , Isoflavonas/análisis , Bebidas/análisis , Cromatografía Líquida de Alta Presión , Culinaria , Etnicidad , Manipulación de Alimentos , Hawaii , Humanos , Semillas/química , SingapurRESUMEN
It has been suggested that, for a substantial proportion of "sporadic" colorectal cancers (CRCs), inheritance determines individual susceptibility and that lifestyle determines which susceptible individuals express cancer. Because the genetic basis of this inherited susceptibility remains undefined, we used family history of the disease as a proxy for a genetic predisposition to examine its interactions with a variety of lifestyle factors in a large population-based case-control study of CRC. The subjects were 698 male and 494 female Japanese, Caucasian, Filipino, Hawaiian, and Chinese patients diagnosed with CRC in Hawaii during 1987-1991 and 1192 population controls matched to cases on age, sex, and ethnicity. Fourteen percent of the cases and 6% of the controls reported a family history of CRC among parents or siblings. After adjusting for other covariates, significant interactions with family history were found for beef and ethanol intakes in males (P = 0.03). Relative to men without a family history and whose intake fell in the lower third, odds ratios (ORs) for CRC for men with a family history and in the upper tertile of intake were 10.8 [95% confidence interval (CI), 4.2-27.6] and 7.5 (CI, 3.1-18.2) for beef and ethanol, respectively. The corresponding ORs for men without a family history and in the upper tertile were 1.5 (CI, 1.0-2.3) and 1.4 (CI, 1.0-1.9), respectively. No interactions were detected in women. Using a summary measure of lifestyle, we found that family history was not associated with CRC among men who were at the lower-risk tertile for all of the lifestyle risk factors. In contrast, the OR for men with a family history and at the higher-risk tertile for all of the lifestyle variables was 11.7 (CI, 5.8-23.9). In the absence of a family history, this OR was 4.8 (CI, 3.2-7.2). These data suggest that family history increases the risk of sporadic CRC in men mainly through its interaction with lifestyle exposures, primarily a high beef and ethanol intake, and are consistent with recent reports of effect modifications of dietary associations by metabolic genes. Computation of population attributable risks also suggested that a comprehensive reduction in exposure to lifestyle risk factors--and more specifically to ethanol and beef for individuals with a familial predisposition for the disease--may have a large beneficial effect on CRC incidence.
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Neoplasias del Colon/etiología , Predisposición Genética a la Enfermedad , Estilo de Vida , Neoplasias del Recto/etiología , Factores de Edad , Anciano , Consumo de Bebidas Alcohólicas , Animales , Pueblo Asiatico/genética , Estudios de Casos y Controles , Bovinos , Neoplasias del Colon/genética , Neoplasias del Colon/prevención & control , Intervalos de Confianza , Etnicidad/genética , Conducta Alimentaria , Femenino , Regulación Neoplásica de la Expresión Génica , Hawaii , Humanos , Incidencia , Modelos Logísticos , Masculino , Carne , Persona de Mediana Edad , Oportunidad Relativa , Neoplasias del Recto/genética , Neoplasias del Recto/prevención & control , Factores de Riesgo , Factores Sexuales , Población Blanca/genéticaRESUMEN
Leukotriene B4 (LTB4) is a potent lipid mediator of the inflammatory response whose biological half-life is believed to be mediated principally by metabolism to inactive forms either in the tissue of origin or in the liver. Pathways of metabolic degradation of LTB4 along with structural identification of metabolites have been elucidated previously in isolated rat liver cells, human keratinocytes, human polymorphonuclear leukocytes, and cultured HepG2 cells. Research advances in human liver transplantation and preservation have made isolated human hepatocytes available for studying the metabolism of LTB4 in vitro. LTB4 was added to plated human hepatocytes from three different subjects for 24-h periods whereupon the substrate was analyzed by high-performance liquid chromatography coupled with scintillation counting, UV spectroscopy, and negative ion electrospray ionization tandem mass spectrometry. Each set of hepatocytes yielded a different distribution of metabolites, but several metabolites appeared in all three sets of cells. These central metabolites included the previously identified 20-carboxy-LTB4 and 18-carboxy-LTB4, implicating the presence in the liver of specific P-450-mediated omega-oxidation as well as the enzymes involved in beta-oxidation from the omega-terminus. Each set of hepatocytes produced the metabolite 10,11-dihydro-20-COOH-LTB4, a product of the 12-hydroxyeicosanoid dehydrogenase/Delta10 reductase pathway. Glucuronides of LTB4 and several metabolites were found, which represents the first description of glucuronidation as a pathway of LTB4 metabolism. Finally, a series of novel metabolites were observed corresponding to beta-oxidation from the carboxyl terminus of LTB4.
Asunto(s)
Leucotrieno B4/metabolismo , Hígado/metabolismo , Biotransformación , Células Cultivadas , Citosol/metabolismo , Retículo Endoplásmico/metabolismo , Glucuronatos/metabolismo , Humanos , Hígado/citología , Microcuerpos/metabolismo , Mitocondrias Hepáticas/metabolismoRESUMEN
Isothiocyanates (ITCs), degradation products of glucosinolates (which occur naturally in a variety of cruciferous vegetables), have been shown to exhibit chemopreventive activity. These compounds are metabolized in vivo to form the corresponding dithiocarbamates, which are the major urinary metabolites of ITCs, by a pathway involving the glutathione S-transferase (GST) class of enzymes. Using a newly developed assay that measures total ITC (primarily ITC conjugates) in urine, we examined the relationships between cruciferous vegetable intake (obtained from a food frequency/portion size questionnaire administered in person); dietary total ITC level; GSTM1, GSTT1, and GSTP1 genotypes; and levels of total ITC in spot urine samples collected from 246 Singapore Chinese (111 men and 135 women), ages 45-74 years, who are participants of the Singapore Cohort Study on diet and cancer. Consumption level of cruciferous vegetables was high in study subjects (mean consumption = 345 times per year, mean daily intake = 40.6 g), which was >3 times the comparable level of intake in the United States. Mean daily intake of total ITC among study subjects was 9.1 micromol, and there was a 2.5-fold difference between the 25th and 75th percentile values. Seventy-three % of study subjects tested positive for ITC in urine, and there was a 4-fold difference between the 25th and 75th percentile values among the positive subjects. There was a highly significant positive association between dietary intake and urinary excretion levels of total ITC (two-sided P = 0.0003) that was stronger than the association between overall cruciferous vegetable intake and urinary ITC level, which also was statistically significant (P = 0.0004). There was no difference in urinary ITC levels between GSTM1-null and GSTM1-positive study subjects (P = 0.61) or between subjects with differing GSTP1 genotypes (P = 0.77), but urinary excretion of ITC was significantly higher among GSTT1-positive subjects, relative to GSTT1-null subjects (P = 0.006). The strength of the association between GSTT1 genotype and urinary total ITC level was highly dependent on the level of cruciferous vegetable consumption (or dietary ITC level) in study subjects. Among subjects in the lowest tertile of cruciferous vegetable intake, there was little evidence of an association between GSTT1 genotype and urinary total ITC level (P = 0.67). In contrast, there was a strong and statistically significant association between GSTT1 genotype and urinary total ITC among subjects in the highest tertile of cruciferous vegetable intake (P = 0.02), whereas those in the middle tertile of cruciferous vegetable consumption exhibited an association of intermediate strength (P = 0.04). These results suggest the presence of GSTT1 inducers in cruciferous vegetables.
Asunto(s)
Dieta , Glutatión Transferasa/genética , Isotiocianatos/orina , Verduras , Factores de Edad , Anciano , Pueblo Asiatico/genética , Biomarcadores , China/etnología , Estudios de Cohortes , Femenino , Genotipo , Gutatión-S-Transferasa pi , Glutatión Transferasa/metabolismo , Humanos , Isoenzimas/genética , Isoenzimas/metabolismo , Isotiocianatos/metabolismo , Masculino , Tasa de Depuración Metabólica , Persona de Mediana Edad , Singapur , Verduras/metabolismoRESUMEN
OBJECTIVES: This report investigates three aspects of drug abuse treatment costs, with special emphasis on systematic differences among employers: (1) predictors of drug abuse treatment costs; (2) differentials in drug abuse treatment costs across employers; and (3) differential impacts of patient and employer characteristics on drug abuse treatment costs. METHODS: The study used multiple regression analysis of behavioral cost functions. It decomposed cost differences into employer and variable effects using an algebraic method that accounted for differences in cost functions and in population characteristics. An insurance claims database was used from 10 large self-insured employers for a 3-year period starting January 1989. RESULTS: Marginal inpatient costs generally exceeded average costs, leading to slightly increasing costs per day as length of stay increased. Marginal outpatient costs were generally about the same as average costs, implying that outpatient drug treatment maintained constant unit costs as utilization increased. Decomposition of cost differences among employers suggested that observed differences among employers and/or their carriers (who administer the benefits for the self-insured employers) and providers appeared to be at least as important as differences among the characteristics or the utilization of the people that they cover. CONCLUSIONS: National health policies aimed at reducing costs are likely to have differing impacts on different employers. Employers with high costs relative to the characteristics of their covered population may be able to achieve significant cost savings. Employers serving populations with greater risk factors may find it difficult to cut costs further.