Positive Association In Women Research Articles

Alcohol Intake and Risk of Hypertension: A Systematic Review and Dose-Response Meta-Analysis of Nonexperimental Cohort Studies.

Alcohol consumption has been associated with higher blood pressure and an increased risk of hypertension. However, the possible exposure thresholds and effect-modifiers are uncertain. We assessed the dose-response relationship between usual alcohol intake and hypertension incidence in nonexperimental cohort studies. After performing a systematic literature search through February 20, 2024, we retrieved 23 eligible studies. We computed risk ratios and 95% CI of hypertension incidence using a nonlinear meta-analytic model based on restricted cubic splines, to assess the dose-response association with alcohol consumption. We observed a positive and almost linear association between alcohol intake and hypertension risk with risk ratios of 0.89 (0.84-0.94), 1.11 (1.07-1.15), 1.22 (1.14-1.30), and 1.33 (1.18-1.49) for 0, 24, 36 and 48 g/d, respectively, using 12 g alcohol/d as the reference value. In sex-specific analyses, the association was almost linear in men over the entire range of exposure but only observed above 12 g/d in women, although with a steeper association at high levels of consumption compared with men. The increased risk of hypertension above 12 to 24 g alcohol/d was similar in Western and Asian populations and considerably greater in White than in Black populations, mainly due to the positive association in women at moderate-to-high intake. Overall, our results lend support to a causal association between alcohol consumption and risk of hypertension, especially above an alcohol intake of 12 g/d, and are consistent with recommendations to avoid or limit alcohol intake. Sex and ethnicity appear to be major effect-modifiers of such association.

Prospective and Mendelian randomization analyses on the association of circulating fatty acid binding protein 4 (FABP-4) and risk of colorectal cancer

BackgroundFatty acid binding protein 4 (FABP-4) is a lipid-binding adipokine upregulated in obesity, which may facilitate fatty acid supply for tumor growth and promote insulin resistance and inflammation and may thus play a role in colorectal cancer (CRC) development. We aimed to investigate the association between circulating FABP-4 and CRC and to assess potential causality using a Mendelian randomization (MR) approach.MethodsThe association between pre-diagnostic plasma measurements of FABP-4 and CRC risk was investigated in a nested case-control study in 1324 CRC cases and the same number of matched controls within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. A two-sample Mendelian randomization study was conducted based on three genetic variants (1 cis, 2 trans) associated with circulating FABP-4 identified in a published genome-wide association study (discovery n = 20,436) and data from 58,131 CRC cases and 67,347 controls in the Genetics and Epidemiology of Colorectal Cancer Consortium, Colorectal Cancer Transdisciplinary Study, and Colon Cancer Family Registry.ResultsIn conditional logistic regression models adjusted for potential confounders including body size, the estimated relative risk, RR (95% confidence interval, CI) per one standard deviation, SD (8.9 ng/mL) higher FABP-4 concentration was 1.01 (0.92, 1.12) overall, 0.95 (0.80, 1.13) in men and 1.09 (0.95, 1.25) in women. Genetically determined higher FABP-4 was not associated with colorectal cancer risk (RR per FABP-4 SD was 1.10 (0.95, 1.27) overall, 1.03 (0.84, 1.26) in men and 1.21 (0.98, 1.48) in women). However, in a cis-MR approach, a statistically significant association was observed in women (RR 1.56, 1.09, 2.23) but not overall (RR 1.23, 0.97, 1.57) or in men (0.99, 0.71, 1.37).ConclusionsTaken together, these analyses provide no support for a causal role of circulating FABP-4 in the development of CRC, although the cis-MR provides some evidence for a positive association in women, which may deserve to be investigated further.

Saudi Community-Based Screening Study on Genetic Variants in β-Cell Dysfunction and Its Role in Women with Gestational Diabetes Mellitus.

Diabetes (hyperglycemia) is defined as a multifactorial metabolic disorder in which insulin resistance and defects in pancreatic β-cell dysfunction are two major pathophysiologic abnormalities that underpin towards gestational diabetes mellitus (GDM). TCF7L2, KCNQ1, and KCNJ11 genes are connected to the mechanism of β-cell dysfunction. The purpose of this study was to investigate the genes associated with β-cell dysfunction and their genetic roles in the rs7903146, rs2237892, and rs5219 variants in Saudi women diagnosed with type 2 diabetes mellitus and GDM. In this case-control study, 100 women with GDM and 100 healthy volunteers (non-GDM) were recruited. Genotyping was performed using polymerase chain reaction (PCR), followed by restriction fragment length analysis. Validation was performed using Sanger sequencing. Statistical analyses were performed using multiple software packages. Clinical studies showed a β-cell dysfunction positive association in women with GDM when compared to non-GDM women (p < 0.05). Both rs7903146 (CT vs. CC: OR-2.12 [95%CI: 1.13-3.96]; p = 0.01 & T vs. C: (OR-2.03 [95%CI: 1.32-3.11]; p = 0.001) and rs5219 SNPs (AG vs. AA: OR-3.37 [95%CI: 1.63-6.95]; p = 0.0006 & G vs. A: OR-3.03 [95%CI: 1.66-5.52]; p = 0.0001) showed a positive association with genotype and allele frequencies in women with GDM. ANOVA analysis confirmed that weight (p = 0.02), BMI (p = 0.01), and PPBG (p = 0.003) were associated with rs7903146 and BMI (p = 0.03) was associated with rs2237892 SNPs. This study confirms that the SNPs rs7903146 (TCF7L2) and rs5219 (KCNJ11) are strongly associated with GDM in the Saudi population. Future studies should address the limitations of this study.

The visceral fat area to leg muscle mass ratio is significantly associated with the risk of hyperuricemia among women: a cross-sectional study

BackgroundA significant positive association was found in previous studies among obesity, visceral fat accumulation, and hyperuricemia. The purpose of this study was to explore the association between the ratio of visceral fat area to leg muscle mass (VFA-to-LMM) and hyperuricemia, and verify the role of gender differences in the association.MethodsA total of 3393 (43.3% are men) participants from Tianjin Union Medical Center-Health Management Center were recruited for this cross-sectional study. The VFA-to-LMM ratio was used as the independent variable. Hyperuricemia, a serum uric acid level ≥ 416 μmol/L in men and in menopausal women and ≥ 357 μmol/L in premenopausal women, was used as the dependent variable. Multiple logistic regression analysis was used to estimate the odds ratio and the 95% confidence interval between the VFA-to-LMM ratio and hyperuricemia.ResultsThe overall prevalence of hyperuricemia was 14.8% (8.9% in women, and 22.5% in men). After adjustment by age, smoking status (for males), menopause status (for females), drinking status, exercise frequency, blood pressure, alanine aminotransferase, fasting plasma glucose, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, creatinine, and history of diseases, a strong positive association was found between the VFA-to-LMM ratio and hyperuricemia in both men (4th vs. 1st quartile 1.60, 95%CI: 1.03–2.49) and women (4th vs. 1st quartile 5.22, 95%CI: 2.44–12.56). After additional adjustment by BMI, there was still a significant positive association in women (4th vs. 1st quartile 2.57, 95%CI: 1.06–6.77). The results of subgroup analysis showed that pre-menopausal women (4th vs. 1st quartile OR: 3.61) have a higher risk of hyperuricemia than postmenopausal women (4th vs. 1st quartile OR: 1.94) with the increase of the VFA-to-LMM ratio. Besides, the interaction analysis results showed the highest risk of hyperuricemia when VFA and LMM were both in the highest quantile (OR: 11.50; 95% CI: 4.86–31.98).ConclusionThe VFA-to-LMM ratio was positively associated with the risk of hyperuricemia in women after adjustment by confounders. Pre-menopausal women have a higher risk of hyperuricemia than postmenopausal women with the increase of the VFA-to-LMM ratio. In addition, the highest risk of hyperuricemia was demonstrated when both VFA and LMM were at the highest quartile.

High-coverage plasma lipidomics reveals novel sex-specific lipidomic fingerprints of age and BMI: Evidence from two large population cohort studies.

Obesity and related metabolic diseases show clear sex-related differences. The growing burden of these diseases calls for better understanding of the age- and sex-related metabolic consequences. High-throughput lipidomic analyses of population-based cohorts offer an opportunity to identify disease-risk–associated biomarkers and to improve our understanding of lipid metabolism and biology at a population level. Here, we comprehensively examined the relationship between lipid classes/subclasses and molecular species with age, sex, and body mass index (BMI). Furthermore, we evaluated sex specificity in the association of the plasma lipidome with age and BMI. Some 747 targeted lipid measures, representing 706 molecular lipid species across 36 classes/subclasses, were measured using a high-performance liquid chromatography coupled mass spectrometer on a total of 10,339 participants from the Australian Diabetes, Obesity and Lifestyle Study (AusDiab), with 563 lipid species being validated externally on 4,207 participants of the Busselton Health Study (BHS). Heat maps were constructed to visualise the relative differences in lipidomic profile between men and women. Multivariable linear regression analyses, including sex-interaction terms, were performed to assess the associations of lipid species with cardiometabolic phenotypes. Associations with age and sex were found for 472 (66.9%) and 583 (82.6%) lipid species, respectively. We further demonstrated that age-associated lipidomic fingerprints differed by sex. Specific classes of ether-phospholipids and lysophospholipids (calculated as the sum composition of the species within the class) were inversely associated with age in men only. In analyses with women alone, higher triacylglycerol and lower lysoalkylphosphatidylcholine species were observed among postmenopausal women compared with premenopausal women. We also identified sex-specific associations of lipid species with obesity. Lysophospholipids were negatively associated with BMI in both sexes (with a larger effect size in men), whilst acylcarnitine species showed opposing associations based on sex (positive association in women and negative association in men). Finally, by utilising specific lipid ratios as a proxy for enzymatic activity, we identified stearoyl CoA desaturase (SCD-1), fatty acid desaturase 3 (FADS3), and plasmanylethanolamine Δ1-desaturase activities, as well as the sphingolipid metabolic pathway, as constituent perturbations of cardiometabolic phenotypes. Our analyses elucidate the effect of age and sex on lipid metabolism by offering a comprehensive view of the lipidomic profiles associated with common cardiometabolic risk factors. These findings have implications for age- and sex-dependent lipid metabolism in health and disease and suggest the need for sex stratification during lipid biomarker discovery, establishing biological reference intervals for assessment of disease risk.

Investigating the Relationship between Personality and Technology Acceptance with a Focus on the Smartphone from a Gender Perspective: Results of an Exploratory Survey Study

Prior research found that user personality significantly affects technology acceptance perceptions and decisions. Yet, evidence on the moderating influence of user gender on the relationship between personality and technology acceptance is barely existent despite theoretical consideration. Considering this research gap, the present study reports the results of a survey in which we examined the relationships between personality and technology acceptance from a gender perspective. This study draws upon a sample of N = 686 participants (n = 209 men, n = 477 women) and applied the HEXACO Personality Inventory—Revised along with established technology acceptance measures. The major result of this study is that we do not find significant influence of user gender on the relationship between personality and technology acceptance, except for one aspect of personality, namely altruism. We found a negative association between altruism and intention to use the smartphone in men, but a positive association in women. Consistent with this finding, we also found the same association pattern for altruism and predicted usage: a negative one in men and a positive one in women. Implications for research and practice are discussed, along with limitations of the present study and possible avenues for future research.

Serum uric acid and risk of stroke and its types: the Circulatory Risk in Communities Study (CIRCS).

The role of serum uric acid as a predictor of stroke among the general Japanese population remains controversial. We conducted a prospective cohort study of 5235 men and 8185 women aged 40-79 years at baseline between 1985 and 1994 in four Japanese communities, who were initially free from stroke, coronary heart disease, and medication for hyperuricemia or gout. Cox proportional hazards models were used to estimate sex-specific hazard ratios of stroke and its types in relation to serum uric acid level. During a median follow-up of 23.1 years, we recorded 1018 (488 men and 530 women) incident strokes, including 222 (99 and 123) intraparenchymal hemorrhages, 113 (33 and 80) subarachnoid hemorrhages and 667 (347 and 320) ischemic strokes. After adjustment for age, community and known cardiovascular risk factors, the multivariable hazard ratios (95% CIs) in the highest vs. lowest quintile of serum uric acid were 1.45 (1.07-1.96) for total stroke, 1.20 (0.65-2.20) for intraparenchymal hemorrhage, 1.46 (0.69-3.09) for subarachnoid hemorrhage and 1.61 (1.07-2.41) for ischemic stroke in women. The corresponding multivariable hazard ratios (95% CIs) in men were 1.02 (0.74-1.35), 0.83 (0.40-1.72), 1.19 (0.38-3.75) and 1.00 (0.70-1.41). Furthermore, those positive associations with risks of total and ischemic strokes in women were more evident in nonusers of antihypertensive medication than the users. In conclusion, elevated serum uric acid level is an independent predictor of total stroke in women but not in men. The positive association in women was mostly attributable to ischemic stroke and was more pronounced among nonusers of antihypertensive medication.

Association between Family History of Cancer and Lung Cancer Risk among Japanese Men and Women.

Although cigarette smoking is a major risk factor for lung cancer, genetic susceptibility may also affect lung cancer risk. To explore the role of genetic risk, this case-control study investigated the association between family history of cancer at several sites and lung cancer risk. A total of 1,733 lung cancer cases and 6,643 controls were selected from patients aged 30 years and over admitted to a single hospital in Japan between 1997 and 2009. Information on family history of cancer was collected using a self-administered questionnaire and odds ratios (ORs) were estimated by unconditional logistic regression. Family history of lung cancer in first-degree relatives was associated with an increased risk of lung cancer among both sexes. According to histology and type of relatives, a parental history of lung cancer was significantly associated with an increased risk of female adenocarcinoma (OR = 1.72). Stratification by smoking status revealed that this significant positive association in women was limited to ever-smokers (OR = 4.13). In men, a history of lung cancer in siblings was significantly associated with an increased risk of small cell carcinoma (OR = 2.28) and adenocarcinoma (OR = 2.25). Otherwise, positive associations between history of breast (OR = 1.99) and total (OR = 1.71) cancers in siblings and the risk of male adenocarcinoma were observed. These results suggest that inherited genetic susceptibility may contribute to the development of lung cancer. In men, shared exposure to environmental factors among siblings may also be responsible for the increase in lung cancer risk.

The Prevalence of Anticardiolipin Antibodies in women with Bad Obstetric History

Background: Bad obstetric history (BOH) implies previous unfavorable fetal outcome in terms of two or more consecutive spontaneous abortions, early neonatal deaths, stillbirths, intrauterine fetal deaths, intrauterine growth retardation and congenital anomalies. The immune factors associated with pregnancy loss are classified as autoimmune and alloimmune factors. The autoimmune factors include the synthesis of autoantibodies (anti-phospholipid antibodies, anti-nuclear antibodies, anti-thyroid antibodies). The main types of antiphospholipid antibodies are Lupus Anticoagulant (LA) and Anticardiolipin (aCL) antibodies (IgG &amp; IgM).Objective: To measure the level of anticardiolipin antibodies in the sera of women with bad obstetric history.Patients &amp; method: the study was conducted from October 2009 till June 2011 including 117 patients who attended private clinic &amp; laboratory. Patients included in the sudy were those with history of two or more recurrent miscarriages, intrauterine fetal death &amp; stillbirth. Fetal losses due to diabetes or congenital anomalies were excluded.Serum levels of anticardiolipin IgM &amp; IgG antibodies were measured using AESKULISA phospholipid-Screen-GM (Germany) which is a solid phase enzyme immunassay for the separate qualitative &amp; quantitative detection of IgG and /or IgM antibodies in human sera.Results: from the total of 117 patients with BOH fourteen (11.96%) had positive anticardiolipin antibodies in their sera. When comparing between the different groups of patient who were classified according to the type of fetal loss the highest number &amp; percentage of positive anticardiolipin antibody were found in those with three &amp; more recurrent miscarriages (4 cases, 57.14%). When comparing the IgM &amp; IgG levels in different patients groups, the highest levels were found in those with three &amp; more recurrent miscarriages.Conclusion: Anticardiolipin antibodies can have a positive association in women with bad obstetric history especially those with three &amp; more recurrent miscarrigages. The level of IgM &amp; IgG is highest in this group however these antibodies should be looked for in other patients with BOH

Rice consumption, incidence of chronic diseases and risk of mortality: meta-analysis of cohort studies.

Findings from cohort studies investigating the association between rice consumption and risk of chronic diseases or mortality have been inconsistent. We performed a comprehensive systematic review and meta-analysis on all published cohort studies examining white rice consumption in relation to incidence of chronic diseases or risk of mortality. A systematic literature search of MEDLINE, Embase, Cochrane review, Google Scholar and Scopus databases for relevant cohort studies published until July 2014. For systematic review, we found nineteen studies examining the association between rice intake and risk of chronic diseases (obesity, hypertension, metabolic syndrome, diabetes, CVD and cancers) or mortality. Cohort studies which reported relative risk (RR) or odds ratio for highest v. lowest intake of rice and chronic diseases or mortality were included in the meta-analysis. In a meta-analysis on seventeen risk estimates for highest v. lowest category of rice intake, provided from twelve studies, we found a trend towards a positive association (RR; 95 % CI) between rice consumption and risk of all chronic diseases (1·11; 0·96, 1·29); however, significant between-study heterogeneity was found (I 2=70·3 %, P<0·001). Stratified analysis by gender showed a significant positive association between rice consumption and risk of chronic diseases in women (1·40; 1·13, 1·73), but not in men (0·95; 0·72, 1·24). Combining ten effect sizes from five studies showed that high consumption of rice was not significantly associated with mortality (0·97; 0·88, 1·06). Subgroup analysis by gender indicated an inverse association between rice consumption and mortality in men (0·87; 0·81, 0·94), but a trend towards a positive association in women (1·08; 0·97, 1·19). Although white rice consumption was not found to be associated with individual chronic conditions, we observed a positive association between white rice intake and risk of all overall chronic diseases in women. High rice consumption was related to a modest reduction in risk of mortality in men but not in women. Further studies of these relationships, in different populations, are needed.

A repeated cross-sectional study of socio-economic inequities in dietary sodium consumption among Canadian adults: implications for national sodium reduction strategies.

IntroductionIn many countries including Canada, excess consumption of dietary sodium is common, and this has adverse implications for population health. Socio-economic inequities in sodium consumption seem likely, but research is limited. Knowledge of socio-economic inequities in sodium consumption is important for informing population-level sodium reduction strategies, to ensure that they are both impactful and equitable.MethodsWe examined the association between socio-economic indicators (income and education) and sodium, using two outcome variables: 1) sodium consumption in mg/day, and 2) reported use of table salt, in two national surveys: the 1970/72 Nutrition Canada Survey and the 2004 Canadian Community Health Survey, Cycle 2.2. This permitted us to explore whether there were any changes in socio-economic patterning in dietary sodium during a time period characterized by modest, information-based national sodium reduction efforts, as well as to provide baseline information against which to examine the impact (equitable or not) of future sodium reduction strategies in Canada.ResultsThere was no evidence of a socio-economic inequity in sodium consumption (mg/day) in 2004. In fact findings pointed to a positive association in women, whereby women of higher education consumed more sodium than women of lower education in 2004. For men, income was positively associated with reported use of table salt in 1970/72, but negatively associated in 2004.ConclusionsAn emerging inequity in reported use of table salt among men could reflect the modest, information-based sodium reduction efforts that were implemented during the time frame considered. However, for sodium consumption in mg/day, we found no evidence of a contemporary inequity, and in fact observed the opposite effect among women. Our findings could reflect data limitations, or they could signal that sodium differs from some other nutrients in terms of its socio-economic patterning, perhaps reflecting very high prevalence of excess consumption. It is possible that socio-economic inequities in sodium consumption will emerge as excess consumption declines, consistent with fundamental cause theory. It is important that national sodium reduction strategies are both impactful and equitable.

Plant and Animal Protein Intakes Are Differently Associated with Nutrient Adequacy of the Diet of French Adults

The sustainability of dietary plant and animal protein consumption is an important issue, but few data are available to ascertain the health-related impact of animal and plant protein intake. The objective was to study the relationships between animal and plant protein intake and diet quality, as reflected by an integrated index of nutrient adequacy. Using data on 1912 adults from the French Individual and National Consumption Survey 2 (2006–2007), we assessed diet quality by using the PANDiet, a unique score combining 35 probabilities of having an adequate nutrient intake, and used multiple regression analysis to study the relationship with intakes of plant, animal, and related food source proteins. After adjustments for intakes of energy, alcohol, and protein from other sources and sociodemographic factors, plant protein intake was positively associated with the PANDiet, irrespective of sex (β = 0.50, P < 0.0001). By contrast, total and animal protein intakes were differently associated with the PANDiet according to sex, with a positive association in women (β = 0.07 and β = 0.08, respectively; P < 0.01) and an inverse association in men (β = −0.07 and β = −0.05, respectively; P < 0.01). The relationships between the PANDiet and intakes of protein from animal food sources varied: for instance, associations were inverse for red meat and poultry in men but not in women, whereas irrespective of sex, they were positive for fish, milk, and yogurt and inverse for processed meat, cheese, and eggs. These findings show that plant protein is a robust marker of a healthy diet, whereas total animal protein includes different subtypes of animal protein that largely vary in their relationship with diet quality. These data could help refine protein recommendations from a qualitative and dietary standpoint.

Plasma 25‐hydroxyvitamin D and the risk of breast cancer in the European prospective investigation into cancer and nutrition: A nested case–control study

Experimental evidence suggests that vitamin D might play a role in the development of breast cancer. Although the results of case-control studies indicate that circulating 25-hydroxyvitamin D [25(OH)D] is inversely associated with the risk of breast cancer, the results of prospective studies are inconsistent. A case-control study embedded in the European Prospective Investigation into Cancer and Nutrition (EPIC) was carried out comprising 1,391 incident breast cancer cases and 1,391 controls. Multivariable conditional logistic regression models did not reveal a significant overall association between season-standardized 25(OH)D levels and the risk of breast cancer (ORQ4-Q1 [95% CI]: 1.07 [0.85-1.36], ptrend = 0.67). Moreover, 25(OH)D levels were not related to the risks of estrogen receptor positive tumors (ORQ4-Q1 [95% CI]: 0.97 [0.67-1.38], ptrend = 0.90) and estrogen receptor negative tumors (ORQ4-Q1 [95% CI]: 0.97 [0.66-1.42], ptrend = 0.98). In hormone replacement therapy (HRT) users, 25(OH)D was significantly inversely associated with incident breast cancer (ORlog2 [95% CI]: 0.62 [0.42-0.90], p = 0.01), whereas no significant association was found in HRT nonusers (ORlog2 [95% CI]: 1.14 [0.80-1.62], p = 0.48). Further, a nonsignificant inverse association was found in women with body mass indices (BMI) < 25 kg/m(2) (ORlog2 [95% CI]: 0.83 [0.67-1.03], p = 0.09), as opposed to a borderline significant positive association in women with BMI ≥ 25 kg/m(2) (ORlog2 [95% CI]: 1.30 [1.0-1.69], p = 0.05). Overall, prediagnostic levels of circulating 25(OH)D were not related to the risk of breast cancer in the EPIC study. This result is in line with findings in the majority of prospective studies and does not support a role of vitamin D in the development of breast cancer.

Abstract LB-19: Plasma levels of pre-diagnostic sex hormones and mortality among patients with colorectal cancer - Results from four cohort studies.

Abstract Background: Although increasing evidence suggests a role of sex hormones in colorectal cancer development, no previous studies, to our knowledge, have examined the influence of sex hormones on the outcome of patients with colorectal cancer. Methods: We conducted the first study to evaluate whether pre-diagnostic sex hormones including testosterone, estradiol, estrone, and sex hormone binding globulin(SHBG) were associated with mortality among 561 patients with pathologically confirmed colorectal adenocarcinoma (338 in men and 213 in women) diagnosed from 1990 to 2009 in four US cohorts: the Physicians' Health Study II(PHS II), the Health Professionals Follow-up Study(HPFS), the Nurses' Health Study(NHS), and the Women's Health Study(WHS). Participants were followed up until date of death, or end of the follow up [June 2010(PHS II), January 2012(HPFS), June 2009(NHS), or November 2011(WHS)], whichever occurred first. Cox proportional hazard regression models were used to calculate hazard ratios (HR) adjusted for other risk factors for cancer survival including age at diagnosis, grade of tumor differentiation, primary location of the tumor, status of tumor metastasis, as well as pre-diagnostic measures of body mass index and physical activity. Results: We identified 221 deaths(132 in men and 89 in women). Testosterone, estradiol, and SHBG were not associated with mortality in both male and female patients. However, there was an association of borderline significance between free (or bioavailable) testosterone and mortality among patients of both genders. Specifically, in men, higher levels of free testosterone were associated with a lower risk of overall mortality (top vs. bottom tertile HR=0.65, 95%CIs: 0.41-1.04, p-trend=0.07) and colorectal cancer-specific mortality (HR=0.61, 95%CIs: 0.31-1.19, p-trend=0.14). In contrast, there was a positive association in women between free testosterone and overall mortality (HR=1.66, 95%CIs: 0.90-3.06, p-trend=0.13, p-value for interaction by gender=0.02) and colorectal cancer-specific mortality (HR=1.92, 95%CIs: 0.93-3.98, p-trend=0.07, p-value for interaction by gender=0.02). Results remained essentially unchanged after further adjustment for plasma pre-diagnostic C-peptide levels. Moreover, higher estrone levels were associated with an elevated risk of overall mortality (HR=2.06, 95%CIs: 1.14-3.72, p-trend=0.02) and colorectal cancer-specific mortality (HR=2.73, 95%CIs: 1.25-5.93, p-trend=0.02) in women. Conclusion: Findings from our study suggest that higher pre-diagnostic free testosterone level may be associated with lower mortality for men but higher mortality in women in colorectal cancer patients. The observed positive association between estrone and mortality in women likely reflected the adverse effects of adiposity, which warrants further investigation. Citation Format: Xuehong Zhang, Edward L. Giovannucci, Andrew T. Chan, Kana Wu, Charles S. Fuchs, I-Min Lee, Julie E. Buring, J. Michael Gaziano, Howard D. Sesso, Jennifer H. Lin. Plasma levels of pre-diagnostic sex hormones and mortality among patients with colorectal cancer - Results from four cohort studies. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr LB-19. doi:10.1158/1538-7445.AM2013-LB-19

Relationship Between Uric Acid and Vascular Structure and Function in Hypertensive Patients and Sex-Related Differences

We sought to analyze the relationship between uric acid (UA) and vascular structure and function based on the carotid intima-media thickness, the pulse-wave velocity (PWV), the central arterial pressure, and the augmentation index in hypertensive patients and to evaluate the sex-related differences. A cross-sectional study was performed with 366 hypertensive individuals aged 34-75 years (men = 61.74%). The vascular structure was assessed based on the carotid intima-media thickness, the arterial stiffness was assessed by PWV, and the vascular function was assessed using hemodynamic parameters such as the central and peripheral augmentation index and the ambulatory arterial stiffness index (AASI). In the bivariable analysis, the PWV (r = 0.28; P < 0.01) and AASI (r = 0.25; P < 0.01) were positively correlated with UA in women. The central augmentation index (r = -0.16; P < 0.05) and peripheral augmentation index (r = -0.18; P < 0.05) were negatively correlated with UA, whereas the maximum carotid intima-media thickness (r = 0.11; P < 0.05) was positively correlated with UA in the global analysis. In the multiple linear regression analysis, a positive association between PWV and UA was observed after adjusting for classical risk factors (β = 0.27; P = 0.01) in women only. In turn, a negative association was observed between the AASI and UA after adjusting for confounders in men (β = -0.06; P = 0.04), with a positive association in women (β = 0.11; P = 0.03). Serum UA showed a positive correlation with the mean maximum intima-media thickness and PWV, and this parameter showed a negative correlation with the central and peripheral augmentation indices, although this relationship was lost after adjusting for confounding factors. AASI showed a positive association in women and a negative association in men after adjusting for confounding factors. Clinical Trials.gov Identifier: NCT01325064.

Lipoprotein subfractions and dietary intake of n-3 fatty acid: the Genetics of Coronary Artery Disease in Alaska Natives study

Few studies have compared lipoprotein composition with dietary intake. The lipoprotein subfraction profile was evaluated in relation to diet in Alaska Eskimos at high cardiovascular risk but with a low frequency of hyperlipidemia and high intake of n-3 (omega-3) fatty acids. A population-based sample (n = 1214) from the Norton Sound Region of Alaska underwent a physical examination and blood sampling. Analyses were from 977 individuals who did not have diabetes or use lipid-lowering medications and had complete dietary information (food-frequency questionnaire) and a lipoprotein subfraction profile (nuclear magnetic resonance spectroscopy). After adjustment for age, BMI, total energy intake, and percentage of energy from fat, the intake of n-3 fatty acids was significantly associated with fewer large VLDLs (P = 0.022 in women, P = 0.064 in men), a smaller VLDL size (P = 0.018 and P = 0.036), more large HDLs (P = 0.179 and P = 0.021), and a larger HDL size (P = 0.004 and P = 0.001). After adjustment for carbohydrate and sugar intakes, large VLDLs (P = 0.042 and 0.018) and VLDL size (P = 0.011 and 0.025) remained negatively associated with n-3 fatty acid intake in women and men, and large HDLs (P = 0.067 and 0.005) and HDL size (P = 0.001 in both) remained positively associated with n-3 fatty acid intake in women and men. In addition, large LDLs (P = 0.040 and P = 0.025) were positively associated in both sexes, and LDL size (P = 0.006) showed a positive association in women. There were no significant relations with total LDL particles in either model. Dietary n-3 fatty acids, independent of the reciprocal changes in carbohydrate and sugar intakes, are associated with an overall favorable lipoprotein profile in terms of cardiovascular risk. Because there are no relations with total LDL particles, the benefit may be related to cardiovascular processes other than atherosclerosis.

Abstract 947: The association between diabetes and cancer incidence and mortality in the NIH-AARP study

Abstract Objective: Incidence rates for diabetes and cancer are increasing globally. Epidemiologic studies have observed increased risk between diabetes and several cancers, including breast, colorectal, liver, and pancreatic. Yet, the association between diabetes and other cancers remains unclear. Thus, we evaluated the association between diabetes and cancer incidence and mortality in the prospective NIH-AARP Diet and Health Study. Methods: Our analysis included 295,287 men and 199,665 women who resided in one of eight states (CA, FL, GA, LA, MI, NC, NJ, and PA) at baseline (1995-1996). Diabetes was assessed by self-report. Hazard ratios and 95% confidence intervals were estimated from Cox proportional hazards models adjusted for age, education, BMI, smoking status, self-reported health status, physical activity, vitamin supplement use, intake of alcohol, fruits, vegetables and meat, family history of cancer, and among women, menopausal hormonal therapy. Results: After 11 years of follow-up, 55,888 men and 26,364 women were diagnosed with incident cancer; 13,037 men and 6,474 women died of cancer. We observed a modest inverse association between diabetes and total incident cancer in men (HR=0.96, 95% CI: 0.93-0.99) and a modest positive association in women (1.06, 1.02-1.12). Inverse associations in men stemmed from prostate cancer (n=23,483 cases, 42% of incident cancers; 0.75, 0.71-0.79). After excluding prostate cancer, diabetes became positively associated with cancer in men (1.08, 1.05-1.12). For total cancer mortality, we observed a positive association in men (1.20, 1.14-1.27) and women (1.15, 1.05-1.26). Associations were similar for cancers occurring during the first year, years 1 to 5, and years 5 to 11 of follow-up. When evaluated by site, diabetes was positively associated with cancers of the colon (1.15, 1.04-1.28; 1.33, 1.13-1.55), rectum (1.28, 1.08-1.51; 1.45, 1.10-1.91), and liver (2.40, 1.90-3.02; 1.90, 1.16-3.10) in both men and women. In men, diabetes was positively associated with cancers of the pancreas (1.47, 1.24-1.75) and urinary bladder (1.10, 1.01-1.20); risk estimates for these cancers were similar in women but not statistically significant. In women, diabetes was positively associated with cancers of the stomach (1.74, 1.14-2.67), anus (2.44, 1.18-5.02), and corpus and uterus (1.20, 1.01-1.41); the risk estimate for stomach cancer was similar in men but not statistically significant. We observed no association between diabetes and lung (1.02, 0.94-1.10; 0.97, 0.85-1.10), skin (0.99, 0.88-1.11; 0.97, 0.76-1.24), or other cancers. Discussion: Diabetes was associated with lower rates of incident prostate cancer in men, but with higher incidence rates for a number of other cancers in both sexes. Diabetes was also associated with higher cancer mortality rates. Our results suggest that preventing or controlling diabetes may contribute to decreased cancer incidence and mortality. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 947. doi:10.1158/1538-7445.AM2011-947

Screening statins for possible carcinogenic risk: up to 9 years of follow-up of 361,859 recipients.

Determine the risk of cancer in statin users. Risk of cancer in up to 9.4 years after first recorded receipt of statins was evaluated in subscribers of an integrated health care program in northern California. Statin use and cancer development were ascertained from the program's pharmacy records and cancer registry from August 1994 to December 2003. Most of the 361,859 statin users received lovastatin, simvastatin or both. Results are presented from analyses with 2-year lag and use for over 5 years. Most of the observed associations were likely due to chance or confounding. The few associations that seemed less readily explainable were increased risk of cancers of the thyroid, esophagus and urinary tract and decreased risk of colon cancer in men. Increased risk of lung cancer was the only nominally statistically significant positive association in women and could be partially attributable to their smoking habits. Overall this study provided no strong evidence of either causation or prevention of cancer by statins.

A prospective study of body size and colon cancer mortality in Japan: The JACC Study.

To determine whether body size measurements are risk factors for colon cancer death among the Japanese. A nationwide prospective study, the Japan Collaborative Cohort (JACC) Study from 1988 to 1999. The present analysis included 43 171 men and 58 775 women aged 40-79 y who respond to a questionnaire on current weight and height, weight around 20 y of age, and other lifestyle factors. Body mass index (BMI) at baseline and 20 y of age (B-BMI and 20-BMI, respectively) were calculated. We identified 127 deaths from colon cancer during the follow-up of 424 698 person-years among men and 122 deaths during the follow-up of 591 787 person-years among women. After adjustments for the lifestyle factors known to modify the risk of colon cancer, weight at baseline showed a significant positive association in women, while no such association was seen in men. There was also a significant trend of increasing risk with the increase in B-BMI among women. Women with B-BMI >/=28 kg/m(2) had a relative risk (RR) of 3.41 (95% confidence interval (CI): 1.44-8.06) compared with those with BMI of 20-<22 kg/m(2). 20-BMI also presented the same trend of increasing risk as B-BMI. Women with 20-BMI of <22 and B-BMI of >26 kg/m(2), that is, excessive BMI gain, had a high RR of 3.41 (95% CI 1.29-9.02) compared with those with 20-BMI of <22 and B-BMI of <22 kg/m(2). There were no corresponding trends of colon cancer risk for B-BMI, 20-BMI, or BMI change among men. These study data suggest that obesity and excessive weight gain are associated with the risk of colon cancer death in Japanese women but no such relationship was found in Japanese men.

Relationship between depression and body dissatisfaction in women diagnosed with bulimia nervosa.

Body dissatisfaction and depression have consistently demonstrated a positive association in women. This study sought to determine the independence of this association from bulimic symptomatology among women diagnosed with bulimia nervosa. Participants were 101 women who completed a controlled treatment study of bulimia nervosa and participated in follow-up assessments 10 years later. Findings indicated that baseline levels of depression were independent of and superior to bulimic symptoms in prospectively predicting body dissatisfaction at follow-up assessment. Findings suggest that depression may be a better prognostic indicator of body dissatisfaction than bulimic symptoms in women diagnosed with bulimia nervosa. A model in which depression represents a contributing factor for the maintenance of body dissatisfaction is discussed.