Reduced lung function is independently associated with increased risk of type 2 diabetes in Korean men

<p>Abstract</p> <p>Background</p> <p>Reduced lung function is associated with incident insulin resistance and diabetes. The aim of this study was to assess the relationship between lung function and incident type 2 diabetes in Korean men.</p> <p>Methods</p> <p>This study included 9,220 men (mean age: 41.4 years) without type 2 diabetes at baseline who were followed for five years. Subjects were divided into four groups according to baseline forced vital capacity (FVC) (% predicted) and forced expiratory volume in one second (FEV₁) (% predicted) quartiles. The incidence of type 2 diabetes at follow-up was compared according to FVC and FEV₁ quartiles.</p> <p>Results</p> <p>The overall incidence of type 2 diabetes was 2.2%. Reduced lung function was significantly associated with the incidence of type 2 diabetes after adjusting for age, BMI, education, smoking, exercise, alcohol, and HOMA-IR. Both FVC and FEV₁ were negatively associated with type 2 diabetes (<it>P</it> < 0.05). In non-obese subjects with BMI < 25, the lowest quartile of FVC and FEV₁ had a significantly higher odds ratio for type 2 diabetes compared with the highest quartile after adjusting for age and BMI (2.15 [95% CI 1.02-4.57] and 2.19 [95% CI 1.09-4.42]).</p> <p>Conclusions</p> <p>Reduced lung function is independently associated with the incidence of type 2 diabetes in Korean men.</p

Relationship between insulin resistance and coronary artery calcium in young men and women.

The gender disparity in cardiovascular disease (CVD) risk is greatest between young men and women. However, the causes of that are not fully understood. The objective of this study was to evaluate the relationship between insulin resistance and the presence of coronary artery calcium (CAC) to identify risk factors that may predispose young men and women to CVD.Insulin resistance and CVD risk factors were examined in 8682 Korean men and 1829 women aged 30-45 years old. Insulin resistance was estimated using the homeostasis model assessment of insulin resistance (HOMA-IR), and CAC was measured using computed tomography. Women were less likely to be insulin resistant (upper quartile of HOMA-IR, 18% vs. 27%, p<0.001) and had a lower prevalence of CAC (1.6% vs. 6.4%, p<0.001). Even when equally insulin resistant men and women were compared, women continued to have lower prevalence of CAC (3.1% vs. 7.2%, p = 0.004) and a more favorable CVD risk profile. Finally, after adjustment for traditional CVD risk factors, insulin resistance remained an independent predictor of CAC only in men (p = 0.03).Young women have a lower risk for CVD and a lower CAC prevalence compared with men. This favorable CVD risk profile in women appears to occur regardless of insulin sensitivity. Unlike men, insulin resistance was not a predictor of CAC in women in this cohort. Therefore, insulin resistance has less impact on CVD risk and CAC in young women compared with men, and insulin resistance alone does not explain the gender disparity in CVD risk that is observed at an early age

Hypertrophic Cardiomyopathy: Assessment with MR Imaging and Multidetector CT

Hypertrophic cardiomyopathy (HCM) is a genetic cardiac disease. Its early detection is important because it is the most common cause of sudden cardiac death among young people. However, HCM is often a dilemma for clinicians because it manifests with diverse phenotypic expressions and clinical courses. With the advances in imaging technology, magnetic resonance (MR) imaging and multidetector computed tomography (CT) serve as suitable modalities for detecting and characterizing HCM and obtaining information for appropriate management of cases of HCM, although echocardiography is currently the most widely used modality. This article is an overview of the definition of HCM, its various phenotypes, risk stratification of HCM, and the potential application of cardiac MR imaging and multidetector CT for the assessment of HCM.Maron MS, 2009, J AM COLL CARDIOL, V54, P220, DOI 10.1016/j.jacc.2009.05.006Kwon DH, 2009, J AM COLL CARDIOL, V54, P242, DOI 10.1016/j.jacc.2009.04.026Soor GS, 2009, J CLIN PATHOL, V62, P226, DOI 10.1136/jcp.2008.061655Strijack B, 2008, J CARDIOVASC MAGN R, V10, DOI 10.1186/1532-429X-10-58Luckie M, 2008, HEART, V94, P1383, DOI 10.1136/hrt.2007.122069Shah JS, 2008, HEART, V94, P1288, DOI 10.1136/hrt.2007.126003Williams TJ, 2008, CLIN RADIOL, V63, P464, DOI 10.1016/j.crad.2007.07.024Vogelsberg H, 2008, J AM COLL CARDIOL, V51, P1022, DOI 10.1016/j.jacc.2007.10.049Germans T, 2008, AM J ROENTGENOL, V190, pW169HALPERN EJ, 2008, CLIN CARDIAC CT ANAT, P166Hansen MW, 2007, AM J ROENTGENOL, V189, P1335, DOI 10.2214/AJR.07.2286Hansen MW, 2007, AM J ROENTGENOL, V189, P1344, DOI 10.2214/AJR.07.2287Srichai MB, 2007, AM J ROENTGENOL, V189, P204, DOI 10.2214/AJR.06.1223OHANLON R, 2007, CURR CARDIOL REP, V9, P51Nagueh SF, 2006, J AM COLL CARDIOL, V48, P2410, DOI 10.1016/j.jacc.2006.07.065Germans T, 2006, J AM COLL CARDIOL, V48, P2518, DOI 10.1016/j.jacc.2006.08.036Maron MS, 2006, CIRCULATION, V114, P2232, DOI 10.1161/CIRCULATIONAHA.106.644682Harris KM, 2006, CIRCULATION, V114, P216, DOI 10.1161/CIRCULATIONAHA.105.583500Spirito P, 2006, BRIT MED J, V332, P1251Binder J, 2006, MAYO CLIN PROC, V81, P459GHERSIN E, 2006, BRIT J RADIOL, V79, pE200Biagini E, 2005, J AM COLL CARDIOL, V46, P1543, DOI 10.1016/j.jacc.2005.04.062Rickers C, 2005, CIRCULATION, V112, P855, DOI 10.1161/CIRCULATIONAHA.104.507723Vignaux O, 2005, AM J ROENTGENOL, V184, P249Petersen SE, 2005, J CARDIOV MAGN RESON, V7, P551, DOI 10.1081/JCMR-200060631Kato TS, 2004, CIRCULATION, V110, P3808, DOI 10.1161/01.CIR.0000150334.69355.00Pennell DJ, 2004, EUR HEART J, V25, P1940, DOI 10.1016/j.ehj.2004.06.040Lima JAC, 2004, J AM COLL CARDIOL, V44, P1164, DOI 10.1016/j.jacc.2004.06.033Moon JCC, 2004, J AM COLL CARDIOL, V43, P2260, DOI 10.1016/j.jacc.2004.03.035Elliott P, 2004, LANCET, V363, P1881Moon JCC, 2004, HEART, V90, P645, DOI 10.1136/hrt.2003.014969Hughes SE, 2004, HISTOPATHOLOGY, V44, P412Teraoka K, 2004, MAGN RESON IMAGING, V22, P155, DOI 10.1016/j.mri.2003.08.009Amano Y, 2004, AM J ROENTGENOL, V182, P523Moon JCC, 2003, EUR HEART J, V24, P2151, DOI 10.1016/j.ehj.2003.09.017Matsubara K, 2003, J AM COLL CARDIOL, V42, P288, DOI 10.1016/S0735-1097(03)00576-XMoon JCC, 2003, J AM COLL CARDIOL, V41, P1561, DOI 10.1016/S0735-1097(03)00189-XKofflard MJM, 2003, J AM COLL CARDIOL, V41, P987, DOI 10.1016/S0735-1097(02)03004-8Maron MS, 2003, NEW ENGL J MED, V348, P295MARON BJ, 2003, J AM COLL CARDIOL, V42, P1687Sipola P, 2003, RADIOLOGY, V226, P129, DOI 10.1148/radiol.2261011874Choudhury L, 2002, J AM COLL CARDIOL, V40, P2156Grothues F, 2002, AM J CARDIOL, V90, P29Maron BJ, 2002, JAMA-J AM MED ASSOC, V287, P1308Eriksson MJ, 2002, J AM COLL CARDIOL, V39, P638Wigle ED, 2001, HEART, V86, P709Juergens KU, 2000, J COMPUT ASSIST TOMO, V24, P688Spirito P, 2000, NEW ENGL J MED, V342, P1778Cooke JC, 2000, HEART, V83, P517Bergey PD, 2000, AM J ROENTGENOL, V174, P242Prasad K, 1999, HEART, V82, P8Devlin AM, 1999, BRIT J RADIOL, V72, P258Suzuki J, 1999, J AM COLL CARDIOL, V33, P146Fattori R, 1998, AM HEART J, V136, P824Yoshida M, 1997, INTERNAL MED, V36, P263Kim RJ, 1996, CIRCULATION, V94, P3318White E, 1996, GENE DEV, V10, P1MARIAN AJ, 1995, CIRCULATION, V92, P1336MARON BJ, 1995, CIRCULATION, V91, P1596PARK JH, 1992, RADIOLOGY, V185, P441CAMICI P, 1991, J AM COLL CARDIOL, V17, P879WEBB JG, 1990, J AM COLL CARDIOL, V15, P83OGARA PT, 1987, CIRCULATION, V76, P1214FIGHALI S, 1987, J AM COLL CARDIOL, V9, P288YAMAGUCHI H, 1979, AM J CARDIOL, V44, P401KANSAL S, 1979, CIRCULATION, V60, P1058SAKAMOTO T, 1976, JPN HEART J, V17, P611

Proportion with detectable CAC by insulin resistance and diabetes status in young women and men.

<p>Regardless of the classification, men were significantly more likely to have CAC. P refers to difference in proportion between genders. Error bars represent standard error.</p

Characteristics of the study population by gender.

<p>Data are mean ± SD or median [interquartile range] unless otherwise noted. LDL-C, low density lipoprotein cholesterol; HDL-C, high density lipoprotein cholesterol; CAC, coronary artery calcium.</p

Odds ratio (OR) for coronary artery calcium by insulin resistance and diabetes status in young men and women.

*<p>Model 1 is adjusted for age, smoking status, hypertension, LDL-C, HDL-C;</p>**<p>Model 2 is adjusted for variables in Model 1 and BMI.</p

A Case of Metachronous Metastasis to the Breast from Non-Small Cell Lung Carcinoma

Breast metastases from an extramammary primary tumor are very rare and the prognosis for such patients is generally poor. We report here on a case of a 42-year-old female with metastasis of non-small cell lung cancer to the breast, and she is now being followed up on an outpatient basis. In 2004, she presented with a solitary pulmonary nodule in the left lung, and this lesion had been noted to have gradually increased in size over time. The final pathological diagnosis was adenocarcinoma, and the diagnosis was made by performing percutaneous needle aspiration and lobectomy of the left upper lobe. Adjuvant chemotherapy and radiotherapy were given. Unfortunately, a nodule in the left breast was noted three years later, and metastatic non-small-cell lung cancer to the breast was diagnosed by excisional biopsy. Making the correct diagnosis to distinguish a primary breast carcinoma from a metastatic one is important, because the therapeutic plan and outcome for these two types of cancer are quite different