Ethnic differences in management of anxiety and depression in general practice in urban areas in the Netherlands in 2007.

Background: A substantial part of the population in western countries has a non-western ethnic background, and there is widespread concern that access to and quality of care (QoC) for mental health problems for ethnic minority groups are lower in comparison to the host populations. Health services in The Netherlands are generally well accessible as a consequence of mandatory basic health insurances for all citizens, which provide an interesting setting for the study of ethnic disparities in care for anxiety and depression (CMD) in general practice. Methods: Data from The Netherlands Information Network of General Practice in 2007 (89 practices, 340 000 patients) and population registries were collected. Prevalence of CMD in general practice, based on the International Classification of Primary Care was compared with the prevalence in the general population (indication for CMD detection). QoC was indicated by at least five general practice consultations, prescription of psychotropics for at most six weeks or at least 5 months, and/or referral to a mental health care specialist. Data were analysed using multilevel multiple regression techniques. Results: CMD were prevalent among 6413 patients (4.43%), and more often registered among Turkish patients than among ethnic Dutch. Detection of CMD by GPs was less adequate among Turkish patients. Of patients diagnosed with CMD, 42.9% received guideline-concordant treatments. Guideline adherence was lower among Surinamese/Antillean patients (odds ratio = 0.70, 95% confidence interval = 0.51–0.96). No disparities regarding QoC were observed for Turkish and Moroccan patients compared with ethnic Dutch. Conclusions: The quality of treatment among subjects diagnosed with CMD in Dutch general practice was comparable between ethnic groups. However, there were some unfavourable results among Turkish and Surinamese/Antillean patients, which underline the importance of continuing efforts to make GPs aware of the higher prevalence of CMD in some ethnic minority groups, and to further improve the accessibility to good quality care in general practice. (aut. ref.

Biomolecular building blocks for well-defined polymer architectures

Cancer Signaling networks and Molecular Therapeutic

Polymorphisms in glyoxalase 1 gene are not associated with vascular complications: the Hoorn and CoDAM studies

. CONCLUSION: Polymorphisms in the GLO1 gene are not associated with the prevalence of hypertension, markers of atherosclerosis, renal function and AGEs and are weakly associated with pulse pressure and systolic blood pressure (possibly due to chance) in two Dutch cohorts of patients with normal glucose metabolism, impaired glucose metabolism and type 2 diabetes mellitu

BclI glucocorticoid receptor polymorphism in relation to cardiovascular variables: the Hoorn and CODAM studies

Cancer Signaling networks and Molecular Therapeutic

The association between the-374T/A polymorphism of the receptor for advanced glycation endproducts gene and blood pressure and arterial stiffness is modified by glucose metabolism status: the Hoorn and CoDAM studies

Objectives: Receptor for advanced glycation endproducts (RAGE)–ligand interaction may lead to vascular complications. Genetic variation in RAGE has been shown to alter expression, activity of RAGE or both. We, therefore, investigated whether RAGE single-nucleotide polymorphisms (SNPs) and haplotypes were associated with vascular disease. Methods: Nine tag SNPs that cover the common RAGE gene variation were genotyped in 1291 individuals from two Dutch population-based cohort studies, aged 64.5 ± 8.6 years, with normal glucose metabolism (44%), impaired glucose metabolism (23%) or type 2 diabetes mellitus (33%). We used multiple regression analyses to compare prevalent cardiovascular disease and markers of atherosclerosis, blood pressure and arterial stiffness across genotypes, and examine effect modification by glucose metabolism status. Results: In unstratified analyses, no consistent associations between RAGE SNPs and prevalent cardiovascular disease and markers of atherosclerosis were found. However, the AA genotype of SNP rs1800624 (-374T/A) was consistently associated with lower SBP [-5.0 mmHg (95% confidence interval -10.4 to 0.3)] and DBP [-4.2 (-7.2 to -1.3)], pulse pressure [-0.8 (-5.0 to 3.4)] as well as with less arterial stiffness [-0.56 SD (-1.04 to -0.09)] in individuals with normal glucose metabolism, but with higher SBP [6.2 (0.9–11.5)], DBP [2.1 (-0.7 to 5.0)] and pulse pressure [4.1 (-0.2 to 8.4)] in individuals with impaired glucose metabolism or type 2 diabetes mellitus (P for interactio

The association between the-374T/A polymorphism of the receptor for advanced glycation endproducts gene and blood pressure and arterial stiffness is modified by glucose metabolism status: the Hoorn and CoDAM studies

Objectives Receptor for advanced glycation endproducts (RAGE)-ligand interaction may lead to vascular complications. Genetic variation in RAGE has been shown to alter expression, activity of RAGE or both. We, therefore, investigated whether RAGE single-nucleotide polymorphisms (SNPs) and haplotypes were associated with vascular disease. Methods Nine tag SNPs that cover the common RAGE gene variation were genotyped in 1291 individuals from two Dutch population-based cohort studies, aged 64.5 +/- 8.6 years, with normal glucose metabolism (44%), impaired glucose metabolism (23%) or type 2 diabetes mellitus (33%). We used multiple regression analyses to compare prevalent cardiovascular disease and markers of atherosclerosis, blood pressure and arterial stiffness across genotypes, and examine effect modification by glucose metabolism status. Results In unstratified analyses, no consistent associations between RAGE SNPs and prevalent cardiovascular disease and markers of atherosclerosis were found. However, the AA genotype of SNP rs1800624 (-374T/A) was consistently associated with lower SBP [-5.0 mmHg (95% confidence interval -10.4 to 0.3)] and DBP [-4.2 (-7.2 to -1.3)], pulse pressure [-0.8 (-5.0 to 3.4)] as well as with less arterial stiffness [-0.56 SD (-1.04 to -0.09)] in individuals with normal glucose metabolism, but with higher SBP [6.2 (0.9-11.5)], DBP [2.1 (-0.7 to 5.0)] and pulse pressure [4.1 (-0.2 to 8.4)] in individuals with impaired glucose metabolism or type 2 diabetes mellitus (P for interaction <= 0.05 in all analyses). Similar results were found for a haplotype that includes the -374A allele. Conclusion In individuals with normal glucose metabolism, the -374A allele of the RAGE gene is protectively associated with blood pressure and arterial stiffness, whereas in individuals with impaired glucose metabolism or type 2 diabetes mellitus, it is adversely associated with these variables. J Hypertens 28: 285-293 (C) 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.Signal transduction in aging related disease

Blood metabolomic measures associate with present and future glycemic control in type 2 diabetes.

Objective: We studied whether blood metabolomic measures in people with type 2 diabetes (T2D) are associated with insufficient glycemic control and whether this association is influenced differentially by various diabetes drugs. We then tested whether the same metabolomic profiles were associated with the initiation of insulin therapy.Methods: A total of 162 metabolomic measures were analyzed using a nuclear magnetic resonance-based method in people with T2D from four cohort studies (n = 2641) and one replication cohort (n = 395). Linear and logistic regression analyses with adjustment for potential confounders, followed by meta-analyses, were performed to analyze associations with hemoglobin A1c levels, six glucose-lowering drug categories, and insulin initiation during a 7-year follow-up period (n = 698).Results: After Bonferroni correction, 26 measures were associated with insufficient glycemic control (HbA1c &gt;53 mmol/mol). The strongest association was with glutamine (OR, 0.66; 95% CI, 0.61 to 0.73; P = 7.6 x 10(-19)). In addition, compared with treatment-naive patients, 31 metabolomic measures were associated with glucose-lowering drug use (representing various metabolite categories; P &lt;= 3.1 x 10(-4) for all). In drug-stratified analyses, associations with insufficient glycemic control were only mildly affected by different glucose-lowering drugs. Five of the 26 metabolomic measures (apolipoprotein A1 and medium high-density lipoprotein subclasses) were also associated with insulin initiation during follow-up in both discovery and replication. The strongest association was observed for medium high-density lipoprotein cholesteryl ester (OR, 0.54; 95% CI, 0.42 to 0.71; P = 4.5 x 10(-6)).Conclusion: Blood metabolomic measures were associated with present and future glycemic control and might thus provide relevant cues to identify those at increased risk of treatment failure