bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diabetes and impaired glucose tolerance in Jordan: prevalence and associated risk factors
Authors: Ajlouni K. , Jaddou H. , Batieha A. 
Published: March 2003

Ajlouni K, Jaddou H, Batieha A (National Centre for Diabetes, Endocrine and Genetic Diseases, Amman, Jordan and the University of Science and Technology, Irbid, Jordan). Diabetes and impaired glucose tolerance in Jordan: prevalence and associated risk factors. J Intern Med 1998; 244: 317–323.ObjectivesTo study the prevalence of diabetes mellitus (DM) and impaired glucose tolerance (IGT) and their risk factors in Jordan.DesignA cross‐sectional study in four Jordanian communities was conducted: Sarih in the north, Sikhra in the middle of the country, Mazar in the south and Subha‐Subheih in the east. Within each community, a systematic sample of households was selected. All subjects ≥25 years of age within the selected households were invited to participate in the study. A total of 2836 subjects were actually included in the study with an overall response rate of 70.5% (45% in males and 86% in females). World Health Organization criteria were adopted for the diagnosis of DM (fasting plasma glucose ≥7.8 mmol L−1 or plasma glucose of ≥11.1 mmol L−1, 2 h after an oral anhydrous glucose load of 75 g) and IGT (fasting plasma glucose <7.8 mmol L−1 and plasma glucose between 7.8 mmol L−1 and 11.1 mmol L−1, 2 h after an oral glucose load of 75 g).ResultsThe overall prevalence of DM was 13.4%: 14.9% in males and 12.5% in females. IGT was found in 9.8% of the study population: 9.0% in males and 10.3% in females. Factors independently related to DM using stepwise logistic regression analysis were sex, age, family history of DM, hypertension, hypercholesterolaemia (HC), and hypertriglyceridaemia (HTG).ConclusionDiabetes mellitus and IGT are common among adult Jordanians. Considering the high prevalence of this sickness makes it imperative to formulate a national plan to face this disease and its complications.
Hypocalcaemia in HIV infection and AIDS
Authors: Kuehn E. W. , Anders H. J. , Bogner J. R. , Obermaier J. , Goebel F. D. , Schlöndorff D. 
Published: March 2003

Abstract.Objectives.  To study the prevalence and possible mechanisms of hypocalcaemia in HIV infection and AIDS.Subjects. 828 patients with HIV infection or AIDS and 549 controls.Interventions.  Measurements of total serum calcium and albumin levels. Parameters of calcium homeostatsis were determined in a subgroup of 21 hypocalcaemic AIDS patients.Results. Mean serum calcium was 2.34 ± 0.13 mmol L−1 in the HIV group vs. 2.46 ± 0.10 mmol L−1 in controls (P < 0.0001). After adjusting for serum albumin, hypocalcaemia was present in 6.5% of the HIV group vs. 1.1% of controls. Mean serum calcium was declining according to CDC groups, and differed significantly from controls in each group. Regression coefficients of cacium vs. albumin were 0.147 amongst HIV‐infected patients and 0.106 for controls. In the subgroup of hypocalcaemic patients with AIDS, 10/21 had vitamin D deficiency, six of these with low ionized calcium levels. Low serum PTH was found in 2/21 patients, Magnesium deficiency in 1/21. Of the remaining eight patients, only one had secondary hyperparathyroidism, while the other seven lacked an adequate PTH response, despite low ionized calcium levels in four subjects. Conclusions. Mean serum calcium concentrations were lower through all CDC stages, irrespective of albumin, resulting in a higher prevalence of hypocalcaemia in HIV‐positive patients compared with controls. In a considerable number, this seems to be caused by vitamin D deficiency and potentially a lack of adequate PTH secretion, but further studies are needed to confirm this.
Relationship between serum ferritin and risk factors for ischaemic heart disease in 2235 Danes aged 30–60 years
Authors: Milman N. , Kirchhoff M. 
Published: March 2003

Abstract.  Milman N, Kirchhoff M (Glostrup Hospital, University of Copenhagen and Næstved Hospital, Denmark). Relationship between serum ferritin and risk factors for ischaemic heart disease in 2235 Danes aged 30–60 years. J Intern Med 1999; 245: 423–433.Objectives.  The aim was to examine the relationships between serum ferritin and risk factors for ischaemic heart disease (physical activity, body mass index, tobacco smoking, alcohol consumption, serum total cholesterol, serum triglycerides, serum high‐density lipoprotein (HDL) cholesterol, systolic and diastolic blood pressures).Design.  Epidemiological population survey performed at the Copenhagen County Centre for Prevention of Disease in 1982–84.Subjects.  The participants were selected at random from the census register and comprised 2235 healthy Caucasian Danes, all non‐blood‐donors (1044 men and 1191 women), in cohorts of 30, 40, 50 and 60 years of age. The participants gave a detailed medical history and had a clinical examination including blood samples.Main outcome measures.  In both men and women, all risk factors displayed a significant increase with age. In men aged 40–60 years, significant positive associations were found between serum ferritin and the following risk factors: body mass index, alcohol intake, serum triglycerides, and systolic and diastolic blood pressures. There was a significant negative association between serum ferritin and tobacco smoking. There was no association between serum ferritin and physical activity, serum total cholesterol or serum HDL cholesterol. In women aged 40–60 years, significant positive associations were found between serum ferritin and the following risk factors: body mass index, alcohol intake and serum triglycerides. There was no association between serum ferritin and physical activity, tobacco smoking, serum total cholesterol, serum HDL cholesterol or blood pressure.Conclusions.  Associations were found between serum ferritin and some risk factors for ischaemic heart disease in men and women. The clinical significance of these findings remains to be clarified. One may hypothesize that the ‘missing link’ between serum ferritin and ischaemic heart disease in men is the relationship between serum ferritin, serum triglycerides and blood pressure.
Relationships between bone mineral density, serum vitamin D metabolites and calcium:phosphorus intake in healthy perimenopausal women
Authors: Brot C. , Jørgensen N. , Madsen O. R. , Jensen L. B. , Sørensen O. H. 
Published: March 2003

Abstract. Brot C, Jørgensen N, Madsen OR, Jensen LB, Sørensen OH (Copenhagen Municipal Hospital, Copenhagen, Denmark). Relationships between bone mineral density, serum vitamin D metabolites and calcium:phosphorus intake in healthy perimenopausal women. J Intern Med 1999; 245: 509–516.Objectives. To determine the relationships between serum vitamin D metabolites, bone mass, and dietary calcium and phosphorus in a cohort of 510 healthy Danish perimenopausal women.Design. A population‐based cross‐sectional study.Subjects. A total of 510 healthy women aged 45–58 years, with amenorrhoea for 3–24 months. None of the women was using hormone replacement therapy.Measurements. Measurements of total bone mineral content and regional bone mineral density were performed by dual‐energy X‐ray absorptiometry. Analyses of serum levels of 25‐OHD and 1,25‐(OH)2D, intact PTH, ionized calcium and phosphate, as well as biochemical markers of bone turnover in blood and urine. Assessment of calcium and phosphorus intake using dietary records.Results. A consistent inverse relationship between serum 1,25‐(OH)2D and bone mineral content/density was found in whole‐body mineral content (P = 0.001), spine (P = 0.005) and femoral neck (P < 0.05). There was a positive relationship between levels of 1,25‐(OH)2D and biochemical bone markers, indicating that high levels of 1,25‐(OH)2D are accompanied by increased bone turnover. The dietary calcium:phosphorus ratio was inversely related to serum 1,25‐(OH)2D (P = 0.04) and positively related to bone mineral density (P < 0.0005). No relationships could be detected between levels of PTH, serum ionized calcium and phosphate, and serum vitamin D metabolites.Conclusion. Within normal physiological range, elevated levels of 1,25‐(OH)2D were associated with decreased bone mineral density and content, reduced calcium:phosphorus ratio in the diet and increased bone turnover.
Reduced transcapillary fluid absorption from skeletal muscle and skin during hypovolaemia in insulin‐dependent diabetes mellitus
Authors: Olsen H. , Hulthén U. L. , Länne T. 
Published: March 2003

Abstract. Olsen H, Hulthén UL, Länne T (Malmö University Hospital, Malmö, Sweden). Reduced transcapillary fluid absorption from skeletal muscle and skin during hypovolaemia in insulin‐dependent diabetes mellitus. J Intern Med 1999; 246: 477–488.Objectives. Diabetes mellitus is associated with a high cardiovascular morbidity which has been linked to disturbances in microvascular function. This study was designed to examine the transcapillary fluid absorption during experimental hypovolaemia in type 1 diabetes.Subjects. Twelve males with type 1 diabetes (age 25 ± 3 years, duration 8 ± 1 years) with no clinical microangiopathy and 12 healthy males (22 ± 2 years).Interventions. As a model for hypovolaemic circulatory stress, lower body negative pressure (LBNP: 15, 30 and 60 cmH2O) was used. Transcapillary fluid absorption from tissue to blood in the upper arm, as well as forearm blood flow, was measured by volumetric technique.Results. Resting forearm blood flow, heart rate and blood pressure were similar in diabetic patients and controls. Basal plasma noradrenaline was reduced in the diabetics compared with controls (0.75 ± 0.06 vs. 1.09 ± 0.10 pmol L–1, P < 0.05), but the increase in plasma noradrenaline in response to LBNP
was similar in the two groups. The haemodynamic responses to LBNP in the two groups were equal, showing a reduction of pulse pressure, an increase in heart rate and in peripheral resistance with a concomitant blood flow reduction. The transcapillary fluid absorption (mL 100 mL–1 min–1) was significantly reduced in the diabetic patients: LBNP 15 cmH2O, 0.024 ± 0.004 vs. 0.036 ± 0.002; 30 cmH2O, 0.041 ± 0.003 vs. 0.056 ± 0.005; and 60 cmH2O, 0.057 ± 0.007 vs. 0.091 ± 0.008 (diabetic patients vs. controls, P < 0.001).Conclusions. The transcapillary fluid absorption from tissue to blood during hypovolaemic circulatory stress in type 1 diabetic patients is reduced by one‐third compared with controls, which indicates impaired plasma volume regulation. This basic mechanism for plasma volume control is affected before clinical microcirculatory complications are found and could be one of the causes of the increased cardiovascular morbidity and mortality in IDDM.
Higher relative, but lower absolute risks of myocardial infarction in women than in men: analysis of some major risk factors in the S heep study
Authors: Reuterwall C. , Hallqvist J. , Ahlbom A. , De Faire U. , Diderichsen F. , Hogstedt C. , Pershagen G. , Theorell T. , Wiman B. , Wolk A. ,   the SHEEP Study Group
Published: March 2003

Abstract. Reuterwall C, Hallqvist J, Ahlbom A, de Faire U, Diderichsen F, Hogstedt C, Pershagen G, Theorell T, Wiman B, Wolk A, the S
heep Study Group (National Institute for Working Life; Karolinska Institute; Karolinska Hospital; and National Institute for Psychosocial Factors and Health, Solna; and the Stockholm County Council, Stockholm, Sweden). Higher relative, but lower absolute risks of myocardial infarction in women than in men: analysis of some major risk factors in the S
heep study. J Intern Med 1999; 246: 161–174.Objectives. Middle‐aged men have often been the subjects of multifactorial studies of myocardial infarction (MI) risk factors. One major objective of the S
heep study was to compare the effects of different MI risk factors in women and men.Design. S
heep (Stockholm Heart Epidemiology Program) is a population‐based case‐referent study of causes of MI (first event) in Swedish women and men aged 45–70 years. During the period 1992–94, 2246 cases of MI were identified; 34% of the cases were women and 27% of the cases were fatal. One referent per case was chosen randomly from the Stockholm County population after stratification for the case’s sex and age. Logistic regression was used to estimate the relative risks associated with risk factors of primary interest (diabetes, hypercholesterolaemia, hypertriglyceridaemia , hypertension, overweight, physical inactivity, smoking and job strain).Results. The relative risk estimates ranged from 1.5 to 4.4 in women and from 1.3 to 2.9 in men (results for nonfatal cases and their referents). None of the 95% confidence intervals included 1.0. The relative risks were higher in the women than in the men (101–180%). The absolute risks, however, were all lower in the women than in the men. Estimates of Rothman’s synergy index for gender ranged from 1.0 (hypertension) to 1.8 (current smoking).Conclusions. The indications of some effect modification due to sex (stronger risks in men for certain exposures) invoke the question of possible mechanisms.
Intensive rehabilitation of emotionally distressed patients after coronary by‐pass grafting
Authors: Perski A. , Osuchowski K. , Andersson L. , Sanden Å. , Feleke E. , Anderson G. 
Published: March 2003

Abstract. Perski A, Osuchowski K, Andersson L, Sanden Å, Feleke E, Anderson G (Karolinska Institute and Hospital of the National Social Insurance Board, Nynäshamn, Sweden). Intensive rehabilitation of emotionally distressed patients after coronary by‐pass grafting. J Intern Med 1999; 246: 253–263.Objectives. To evaluate whether the status of emotionally distressed post coronary by‐pass surgery patients can be improved by a comprehensive, in‐patient rehabilitation programme.Design. Cross‐sectional.Setting. Rehabilitation hospital.Subjects. One hundred and fifty‐two post coronary by‐pass surgery patients referred to an intensive rehabilitation programme. The study group was divided into two subgroups, according to the level of emotional distress. Forty‐three (30%) out of 142 patients who completed the Nottingham Health Profile were considered to be distressed.Interventions. The comprehensive 4‐week inpatient rehabilitation programme consisted of daily physical exercise, lectures about coronary disease and risk factors, psychological support and nutrition counselling.Main outcome measures. Physical fitness, blood lipids and quality of life questionnaires.Results. The two‐way analysis of variance showed that emotionally distressed patients achieved equally good results as those obtained by nondistressed patients in performance regarding the maximal exercise stress test, maximum rate pressure product achieved, or the level of resting heart rate. Significant improvement in psychological well‐being as assessed by a seven‐point rating scale was observed in both groups. Both groups of patients were also equally successful in weight reduction and lowering of total cholesterol and triglycerides. Of all the patients who were employed at admission, twice the number of patients in the distressed group were in receipt of a permanent disability pension and half the number of patients was employed, compared to the initially nondistressed group, at 1‐year follow‐up.Conclusions. Distressed patients were very successful in improving their functional status and reducing risk factors when offered an intensive rehabilitation programme but they were much less successful in returning to work. Secondly, patients who were emotionally distressed after surgery did not differ in regard to disease status or physical capacity from nondistressed patients. They did, however, experience more angina pectoris both in daily life and when exposed to a maximal exercise stress test. Finally, the presence of emotional distress was easily detected by any measure of psychological status.
Leptin is associated with increased risk of myocardial infarction
Authors: Söderberg S. , Ahrén B. , Jansson J.‐H. , Johnson O. , Hallmans G. , Asplund K. , Olsson T. 
Published: March 2003

Abstract. Söderberg S, Ahrén B, Jansson J‐H, Johnson O, Hallmans G, Asplund K, Olsson T (Umeå University, Umeå; and Lund University, Malmö, Sweden). Leptin is associated with increased risk of myocardial infarction. J Intern Med 1999; 246: 409–418.Objectives and design. Leptin is involved in the regulation of bodyweight and metabolism in man and might also be involved in the pathophysiology of the insulin resistance syndrome, which is associated with the development of cardiovascular diseases. We tested whether leptin is a risk factor for acute myocardial infarction (AMI) in a nested case‐referent study.Subjects and methods. Sixty‐two men with first‐ever AMI were identified who, prior to AMI, had participated in population‐based health surveys in Northern Sweden. Referents were matched for sex, age, date and type of health survey, and geographical region. Blood pressure, body mass index (BMI) and the presence of smoking, diabetes and hypertension were recorded. Total cholesterol, apolipoprotein A‐1 (apo A‐1), apolipoprotein B (apo B), plasminogen activator inhibitor (PAI‐1), insulin, and leptin were analysed in stored samples. Their influences on first‐ever AMI were analysed by conditional logistic regression analysis.Results. Men with first‐ever AMI had higher BMI, plasma insulin and leptin, and diastolic blood pressure than the referents. Furthermore, they had lower plasma apo A‐1 and were more often smokers. Smoking, high leptin, PAI‐1 and cholesterol, and low apo A‐1 levels were significant risk factors for first‐ever AMI in univariate analysis. High leptin (OR 8.97; 95% CI: 1.73–46.5) and cholesterol (OR 5.18; 95% CI: 1.34–20.0) levels remained significant risk factors for AMI in a multivariate model. High apo A‐1 was protective (OR = 0.13; 95% CI: 0.03–0.55). The combination of high leptin and low apo A‐1 was associated with a particularly pronounced increased risk for AMI.Conclusion. Plasma leptin strongly predicts first‐ever AMI. Our data support the hypothesis that leptin is an important link in the development of cardiovascular disease in obesity.
The effect of various hormonal preparations and calcium supplementation on bone mass in early menopause. Is there a predictive value for the initial bone density and body weight?
Authors: Pines A. , Katchman H. , Villa Y. , Mijatovic V. , Dotan I. , Levo Y. , Ayalon D. 
Published: March 2003

Abstract. Pines A, Katchman H, Villa Y, Mijatovic V, Dotan I, Levo Y,. Ayalon D (Ichilov Hospital, Tel‐Aviv; Ramat Marpe Hospital, Ramat‐Gan, Tel‐Aviv, Israel. VU Ziekenhuis, Amsterdam, The Netherlands). The effect of various hormonal preparations and calcium supplementation on bone mass in early menopause. Is there a predictive value for the initial bone density and body weight? J Intern Med 1999; 246: 357–361.Objectives. To compare the effect of various oestrogen and oestrogen/progestin preparations on bone density over a 2‐year follow‐up period in early postmenopausal women.Setting. A retrospective study on 315 women followed in a menopause clinic.Design. Antero‐posterior lumbar spine bone densitometry was performed at baseline and between 18 and 24 months (mean 22 months) after initiation of hormone therapy. Participants were divided into six groups: women taking conjugated equine oestrogen (CEE) (n = 30); CEE plus sequential monthly medroxyprogesterone acetate (MPA) (n = 52); CEE plus sequential bimonthly MPA (n = 51); oral estradiol plus sequential monthly norethisterone acetate (n = 52); transdermal estradiol plus sequential monthly MPA (n = 30). A control group (n = 100) was composed of nonusers of hormones.Results. Hormone users, as a whole (n = 215), increased their bone mineral density (BMD) by 2.9% (4.8) as compared to the controls who lost 3.5% (3.4; P < 0.001). There were similar gains in BMD amongst the five study groups. Calcium supplementation was associated with better results in all women: users of hormones and calcium had a gain in BMD of 4.5% (4.8) compared to only 1.5% (4.5) in those on hormones but without calcium (P < 0.001); amongst the controls, women using calcium lost 1.4% (2.4), whilst nonusers of calcium lost 3.7% (2.4; P < 0.001). A dose–response curve was found between basal BMD and the effect of hormone therapy: women with osteoporosis (T‐score <75%) demonstrated the largest increase in BMD – 6.3% (4.6), osteopenia (T‐score 75–85%) was associated with a gain of 3.2% (5.6), low‐borderline values (T‐score 86–100%) gave a modest increase of 1.3% (4.3), and those with more than average BMD values (T‐score >100%) actually lost bone despite hormone treatment [–2.1% (4.1)].Conclusions. All hormone regimens had a similar bone conserving effect. Basal BMD value may serve as a predictor for the success of treatment. Calcium supplementation should be recommended in all postmenopausal women.
Musculo–skeletal pathology in patients with angina pectoris and normal coronary angiograms
Authors: Frøbert O. , Fossgreen J. , Søndergaard‐Petersen J. , Hede J. , Bagger J. P. 
Published: March 2003

Abstract. Frøbert O, Fossgreen J, Søndergaard‐Petersen J, Hede J, Bagger JP (University Hospital Aarhus, and Aarhus County Hospital, Denmark and Royal Postgraduate School, Hammersmith Hospital, London, UK). Musculo–skeletal pathology in patients with angina pectoris and normal coronary angiograms. J Intern Med 1999; 245: 237–46.Purpose. To evaluate the role of the musculo–skeletal apparatus in patients with angina pectoris despite normal coronary angiograms.Design. A survey of patients and controls investigated by blinded observers.Setting. A tertiary cardiologic referral centre.Subjects. Thirty women and 18 men (mean age 52.9 years) with chest pain of an average duration of 3 years and 11 months were investigated. All had normal resting electrocardiograms. No patients showed evidence of left ventricular hypertrophy or valvular heart disease on echocardiography and all had a normal coronary angiogram. All had left ventricular ejection fraction >50%, and none had signs of coronary vasospasm. Eighteen healthy persons (10 women and eight men, mean age 51.2 years) served as controls.Main outcome measures. The group frequency of chest wall complaints, spinal radiograph and physical examination findings; pressure pain thresholds.Results. The patients had significantly more complaints of pain from the neck, chest, and thoracic spine, and sensations and pain radiating to the arms than the controls. The patients had more degenerative findings on radiograph than the controls, mainly at levels C4–C7. Physical examination showed that abnormal findings were significantly more frequent in patients than in the control group in the anterior and posterior chest wall, in the spine at levels Th1–Th6 and in the muscles of the neck and shoulder girdle. There were no statistically significant differences in pain thresholds or in neurological examination.Conclusion. The musculo–skeletal abnormalities observed in the patients could include reflex mechanisms. Whether the abnormal findings are mainly responsible for the angina pectoris symptoms or merely epiphenomena warrants further study.