The Relationship between Dioxin-Like Polychlorobiphenyls and IGF-I Serum Levels in Healthy Adults: Evidence from a Cross-Sectional Study

OBJECTIVE: Insulin-like growth factor I (IGF-I) and dioxin-like polychlorobiphenyls (DL-PCBs) have been associated with the pathogenesis of several diseases like cancer, diabetes and growth disorders. Because it has been suggested that organohalogenated contaminants could influence IGF-I levels in adults, the potential relationship between DL-PCBs and IGF-I serum levels was studied in 456 healthy adults from a representative sample of the general population of the Canary Islands (Spain). DESIGN: Free circulating serum levels of IGF-I and IGFBP-3 were measured through an ELISA methodology, while the serum levels of the 12 DL-PCBs congeners (IUPAC numbers # 77, 81, 105, 114, 118, 123, 126, 156, 157, 167, 169, and 189) were measured by gas chromatography/mass spectrometry (GC-MS). RESULTS: DL-PCBs 156 and 167, Total DL-PCBs body burden (∑PCBs: sum over the 12 measured DL-PCBs), and Total toxic burden (in terms of toxic equivalence to dioxins: ∑TEQs) showed a trend of inverse association with IGF-I serum levels in the whole studied population. After adjusting for potential confounders, including gender, body mass index (BMI), age, and IGF-binding protein-3 (IGFBP-3), younger (18-45 years) women with lower BMI (<27 kg/m(2)) and detectable levels of DL-PCB-156 showed significantly lower IGF-I levels than those in the same age and BMI subgroup with non-detectable levels of DL-PCB-156 (p<0.001). Similarly, ∑PCBs and ∑TEQs showed a tendency to an inverse association with IGF-I levels in the same group of women (p=0.017 and p=0.019 respectively). CONCLUSIONS: These findings suggest that DL-PCBs could be involved in the regulation of the IGF-system in a way possibly influenced by gender, age and BMI. Although these results should be interpreted with caution, such circumstances could contribute to explain the development of diseases associated to the IGF system

Residence in mountainous compared with lowland areas in relation to total and coronary mortality. A study in rural Greece

Study objective: To investigate the association of residence in mountainous or lowland areas with total and coronary mortality, in a cohort with 15 years of follow up. Design and setting: Prospective study, based on the adult population of two lowland and one mountainous village in rural Greece. Baseline measurements on sociodemographic, lifestyle, somatometric, clinical, and biochemical variables were recorded in 1981 during a health survey and total and coronary deaths were ascertained on the basis of death certificates up to 1996. Participants: 1198 men and women, who had participated in the 1981 survey. Analyses are based on 504 men and 646 women with complete data. Main results: There were 150 deaths among men and 140 among women (coronary deaths: 34 and 33 respectively). In multivariate analysis with Cox regression, after adjustment for age, education, body weight, smoking, alcohol consumption, systolic blood pressure, serum total cholesterol, blood glucose, serum triglycerides, and serum uric acid, total and coronary mortality were lower for residents of the mountainous village in comparison with residents of the lowland villages (hazard ratios (95% confidence intervals) for men and women, respectively: total mortality, 0.57 (0.38 to 0.84) and 0.69 (0.47 to 1.02); coronary mortality, 0.39 (0.16 to 0.98) and 0.46 (0.20 to 1.05)). Conclusions: Residence in mountainous areas seems to have a "protective effect" from total and coronary mortality. Increased physical activity from walking on rugged terrains under conditions of moderate hypoxia among the mountain residents could explain these findings

Residence in mountainous compared with lowland areas in relation to total and coronary mortality. A study in rural Greece

Study objective: To investigate the association of residence in mountainous or lowland areas with total and coronary mortality, in a cohort with 15 years of follow up. Design and setting: Prospective study, based on the adult population of two lowland and one mountainous village in rural Greece. Baseline measurements on sociodemographic, lifestyle, somatometric, clinical, and biochemical variables were recorded in 1981 during a health survey and total and coronary deaths were ascertained on the basis of death certificates up to 1996. Participants: 1198 men and women, who had participated in the 1981 survey. Analyses are based on 504 men and 646 women with complete data. Main results: There were 150 deaths among men and 140 among women ( coronary deaths: 34 and 33 respectively). In multivariate analysis with Cox regression, after adjustment for age, education, body weight, smoking, alcohol consumption, systolic blood pressure, serum total cholesterol, blood glucose, serum triglycerides, and serum uric acid, total and coronary mortality were lower for residents of the mountainous village in comparison with residents of the lowland villages ( hazard ratios (95% confidence intervals) for men and women, respectively: total mortality, 0.57 (0.38 to 0.84) and 0.69 ( 0.47 to 1.02); coronary mortality, 0.39 (0.16 to 0.98) and 0.46 (0.20 to 1.05)). Conclusions: Residence in mountainous areas seems to have a “protective effect” from total and coronary mortality. Increased physical activity from walking on rugged terrains under conditions of moderate hypoxia among the mountain residents could explain these findings

The optimal home blood pressure monitoring schedule based on the Didima outcome study

This study investigated the optimal schedule for home blood pressure (HBP) monitoring that has the greatest prognostic ability and provides the most reliable assessment of HBP. The Didima study assessed the value of HBP (duplicate morning and evening measurements, 3 days) in predicting cardiovascular events in the general population (662 adults, 8.2±0.2 years follow-up). Criteria for the optimal monitoring schedule were stabilization of mean HBP, its variability (standard deviation (s.d.)) and hazard ratios (HRs) of cardiovascular events per 1 mm Hg HBP increase. By averaging more readings (1-12), there was a progressive decline in average HBP and its s.d. and increase in HR, with most of these benefits achieved on the second day (8 readings) and little additional benefit obtained on the third day (12 readings). The first day gave higher and more unstable HBP values (higher s.d.) with less prognostic ability (lower HR). The first HBP readings per occasion gave higher values but with similar prognostic ability as the second readings taken 1 min later. There was little difference in average HBP between morning and evening readings with no prognostic superiority of morning readings. In conclusion, by averaging more readings the average HBP and its variability are reduced and the prognostic ability improved. Any aspect of HBP monitoring (first or second readings, morning or evening) has similar prognostic ability. The first day gives higher and unstable values with lower prognostic ability and should be better discarded. These data validate the HBP monitoring schedule proposed by the European Society of Hypertension. © 2010 Macmillan Publishers Limited All rights reserved

Clinical significance of preoperative serum vascular endothelial growth factor levels in patients with colorectal cancer and the effect of tumor surgery

Background. Vascular endothelial growth factor (VEGF) is an angiogenic cytokine involved in the progression of solid tum ors. In this study we evaluated the clinical usefulness of preoperative serum VEGF Concentrations in patients with colorectal cancer The changes in serum VEGF levels after tumor surgery zoo-e also evaluated. Methods. Serum VEGF levels were determined by an enzyme-linked immunosorbent assay in the sera of 61 healthy control subjects and 67 patients with colorectal cancer preopetatively and 7 and 30 days after surgery. Results. Serum VEGF levels in patients with colorectal cancer (median, 492 pg/mL; interquartile range, 281 to 737 pg/mL) were higher (P &lt; .0001) than in control subjects (median, 186 pg/mL; interquartile range, 100 to 273 pg/mL). There was a significant association between serum VEGF levels and disease stage, invasion depth of the tumor the presence of lymph node and distant metastases, and the degree of diffetentiation. Curative but not palliative resection of the primary tumor resulted in a significant decrease of preoperative serum VEGF levels but normalized in only 72% of patients. Failure of a return of VEGF to normal after resection for cure was associated with (in increased although not statistically significant risk of metastasis during follow-up. Univariate analysis showed a lower survival rate jot patients with increased preoperative serum VEGF levels (P &lt; .002). Multivariate regression analysis showed that the prognostic value of serum VEGF level was not independent of tumor stage. Conclusions. These findings suggest that VEGF plays an important role in tumor progression and the formation of distant metastases in colorectal cancer. It is at present unclear whether serial estimation of serum VEGF is clinically useful it the prediction of tumor relapse

Clinical significance of serum and urinary c-erbB-2 levels in colorectal cancer

In this study we measured serum and urinary c-erbB-2 levels in 63 patients with colorectal cancer and 29 healthy controls, assessing their role in cancer-specific survival and the effects of resectional surgery. Serum and urinary c-erbB-2 levels were measured by an enzyme-linked immunosorbent assay, preoperatively and 7 days following tumor resection. Preoperative serum c-erbB-2 concentrations were significantly higher in the cancer patients and correlated with disease stage and the presence of liver metastases. Urinary c-erbB-2 was detected more often in cancer patients, although levels did not differ from controls and there was no association with any clinicopathological variable. Serum c-erbB-2 levels decreased significantly in those patients resected for cure and were an independent prognostic factor for cancer-specific survival with higher preoperative concentrations correlating with worse overall survival. These findings suggest that serum assessment of c-erbB-2 concentration may be valuable in defining colorectal cancer prognosis. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved

Efficacy and safety of mometasone furoate vs nedocromil sodium as prophylactic treatment for moderate/severe seasonal allergic rhinitis

Background: The preventive use of medications has been proposed to be effective in the treatment of seasonal rhinitis. Objective: To evaluate the efficacy and safety of mometasone furoate and nedocromil sodium nasal sprays as prophylactic treatment for moderate to severe seasonal allergic rhinitis (SAR). Patients: Sixty-one patients were recruited from 3 referral allergy centers. Inclusion criteria were history of SAR for 2 years or longer, sensitization to relevant local pollen (grasses, Parietaria, and olive), and age older than 12 years. Methods: An open-label, randomized, parallel-group, &quot;real-life&quot; study design was used. Patients received mometasone furoate nasal spray once daily or nedocromil sodium nasal spray 3 times daily starting 2 to 4 weeks before the pollen season and continuing for up to 4 months. Instructions regarding the use of additional medications were given. Diary cards recording symptoms, use of medication, and adverse events were kept by the patients. Results: All 61 patients completed the study. The prophylactic use of mometasone furoate vs nedocromil sodium led to significantly more days without symptoms (75.1% vs 54.5%; P &lt; .001). The mometasone furoate group also had lower nasal symptom scores (mean, 1.4 vs 2.9; median, 0 vs 2; P &lt; .001) and was more satisfied (93.1% vs 43.5%; P &lt; .001). No serious adverse event was recorded, and there was no difference between the treatments in any adverse event. Conclusions: Prophylactic administration of mometasone furoate before the pollen season is safe and may lead to improved control of SAR compared with the use of nedocromil sodium

Associations between dietary pattern and lifestyle, anthropometry and other health indicators in the elderly participants of the EPIC-Italy cohort

Introduction: Epidemiological studies have shown that dietary behaviour is an important aetiological factor in various chronic diseases. We used principal component factor analysis to identify dietary patterns and to examine the associations of these patterns with health-related variables in a sample of elderly (≥60 years) Italians participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). Methods and results: Exploratory factor analysis was applied to the intake of food groups as estimated by semi-quantitative food questionnaires. Individual participants were assigned factor scores, indicating the extent to which their diet conformed to each of the four dietary patterns identified: prudent (cooked vegetables, pulses, cabbage, seed oil and fish); pasta &amp; meat (pasta, tomato sauce, red meat, processed meat, bread and wine); olive oil &amp; salad (raw vegetables, olive oil, soup and chicken); and sweet &amp; dairy (sugar, cakes, ice cream, coffee and dairy). Highly educated people had high scores on prudent and low scores on pasta &amp; meat. The pasta &amp; meat and prudent patterns were strongly positively associated with body mass index (BMI) and waist-to-hip ratio (WHR) in men and women. Hyperlipidaemic men and women consumed more of the prudent and olive oil &amp; salad patterns and less of the sweet &amp; dairy pattern than those with normal lipids. The olive oil &amp; salad was significantly higher and the pasta &amp; meat and sweet &amp; dairy patterns significantly lower in men and women who had dieted over the previous year, suggesting awareness of the health consequences of these patterns. Conclusions: Dietary pattern analysis provides a characterization of recurrent dietary behaviour in elderly people, and can be used to provide tangible dietary advice to elderly people. © 2005 Elsevier B.V. All rights reserved