Another Risk Factor For Stroke
There are several well-known risk factors for stroke, including high cholesterol, high blood pressure, cigarette smoking, and diabetes. A new study shows that an additional risk factor is that of high blood levels of triglycerides.
The study was conducted by doctors at the stroke unit at Sheba Medical Center in Tel Hashomer, Israel. Over 11,000 people were included in the study, none of whom had a history of stroke or transient ischemic attacks (TIA), which are temporary interruptions in blood flow that are similar to strokes but don't have lasting damage. The participants were followed for six to eight years, and 941 of them had TIAs or ischemic strokes, which are the result of a blocked artery. These participants all had in common that they had higher than normal levels of triglycerides.
Triglycerides are a type of fat that contain acids that are metabolized in order to provide energy. High blood levels of LDL ("bad") cholesterol has already been determined to be a risk factor for stroke, as it leads to fatty deposits in the arteries. With this recent study, researchers are now aware that triglycerides are an independent risk factor for stroke.
Results of the study were published in Circulation: Journal of the American Heart Association (volume 104; pages 2892-2897; December 11, 2001). The researchers found that those who had blood levels of triglycerides that were over 200 milligrams per deciliter had a 30% greater risk of stroke than those who had normal levels, which are less than 150 milligrams, according to the American Heart Association. However, participants who had high levels of HDL ("good") cholesterol had a decreased risk of stroke, as this kind of cholesterol helps the body metabolize fat.
Doctors are already aware that triglyceride levels can be decreased with fibrate drugs such as gemfibrozil. However, it is more important that people who have high triglyceride levels eat a low-fat diet and get regular exercise.
  
Obesity May Be Caused By Enzyme
There appear to be a variety of risk factors that cause people to become obese, and doctors now believe that the cause of one particular form of obesity may be an enzyme.
Researchers from Harvard Medical School in Boston, Massachusetts recently studied "apple-shaped" obesity. In this form of obesity, people tend to gain weight primarily around their waist and torso. This condition has been linked to a variety of health problems, including high blood pressure and insulin resistance. People who have this form of obesity are more likely to have elevated levels of glucocorticoid hormones, which are formed by the enzyme 11-beta HSD-1.
In the study, the researchers bred mice that produced excess amounts of 11-beta HSD-1. These mice ate more than normal mice, and developed abdominal obesity. They also developed diabetes, high cholesterol, and high blood pressure.
The results of the study have been published in the journal Science (volume 294; pages 2166-2170; December 7, 2001). Pharmaceutical companies are already looking into developing anti-obesity drugs that would work by stopping the effects of the enzyme.
Weight As Child May Affect Health As Adult
Because obesity is becoming a predominant health problem of people all over the world, more and more research is being conducted to determine its causes and risk factors. Two of the more recent of these sought to determine whether weight and socioeconomic status in childhood played a part in becoming obese and having health risks as an adult.
The first study, in a recent issue of the British Medical Journal (volume 323; pages 1280-4; December 1, 2001) was conducted by researchers at the University of Glasgow, in Scotland. The researchers used information from a 50-year-long study that tracked everyone born in the city of Newcastle in England in 1947. They compared the body mass index (BMI) measurements of 412 people at the ages of 9 and 13 with BMI measurements and actual percentages of body fat at the age of 50. The researchers also measured the people's blood pressure, artery thickness, cholesterol and triglyceride levels, and blood sugars.
The researchers found that the participants' BMI at age 9 was a strong indicator of the person's BMI at age 50, but that the numbers differed in terms of percentage of body fat. In addition, being overweight at the age of 13 was indicative that the person would be overweight at the age of 50. The researchers also found that being overweight in childhood meant that the participants had a lower risk for high triglyceride and cholesterol levels as an adult. Those who had been thin as a child and then became overweight as an adult had an increased risk for disease as an adult. These results may be skewed by the way the fat in the body was measured and where the fat was deposited.
In another study, researchers from the Helsinki University Central Hospital in Finland studied the health records of 3,676 men who had been born there between the years of 1934 and 1944. By the year 1971, 234 of the men had been hospitalized with coronary heart disease (CHD), which is a narrowing of the arteries around the heart. Fifty-one of the participants had died of CHD.
These researchers, who also published their findings in the British Medical Journal (volume 323; page 1273; December 1, 2001), found that the men who had had a low birth weight and were born into a lower socioeconomic class had a higher risk of CHD. Those who were born in lower social classes had slow growth in infancy, and possibly had abnormalities in liver growth which led to CHD.
The researchers also found that the men who were at the greatest risk for CHD were those that had been born into low-income families and had low birth weights. Those who weighed less than 7.4 pounds at birth, were born into lower class families, and experienced rapid weight gain in childhood had a 3.78 greater risk of CHD. The study authors postulate that poor living conditions triggered an increased cortisol response to stress in the children.
Both studies highlight the importance of weight awareness, and the need for prevention tactics.
Does Low Birth Weight Lead To Type 2?
One of the precursors to Type 2 diabetes is insulin resistance syndrome (IRS), which results in high levels of insulin in the blood, low HDL ("good") cholesterol, obesity, and high levels of blood fats. A new study shows that one of the causes of IRS is low birth weight.
The study focused on 139 children between the ages of 8 and 12, who had had low birth weights. These children had measurements taken of their blood fats, blood sugar, and insulin levels after fasting overnight on four different occasions. Researchers from the University of Southern California in Los Angeles found that children of low birth weight had higher levels of fasting insulin, lower HDL ("good") cholesterol, and increased abdominal fat. This was particularly true for African American children.
The researchers, who published their findings in the journal Diabetes Care (volume 24, pages 2035-2042, December 2001), believe that health risks of low birth weight may lead to IRS in childhood. These risks include hyprinsulinemia, decreased beta-cell function, high levels of blood fats, and central obesity. The researchers are not sure why low birth weight in African American children was more likely to lead to insulin resistance in childhood, but postulate that there is a mixture of genetic and environmental factors.
Study authors highlight the importance of proper nutrition during pregnancy, as fetal malnutrition may lead to insulin resistance in childhood.
Antipsychotic Drugs May Raise Blood Sugar
For people who have serious mental health issues like schizophrenia, antipsychotic drugs like clozapine and olanzapine may be the only way to keep their illness under control. However, there have been many reports lately about the negative side effects of these drugs, including poor blood sugar control.
Researchers from Duke University and the Food and Drug Administration (FDA) recently released a statement in the Journal of the American Medical Association (November 28, 2001) in which they warn of the risk of hyperglycemia associated with these antipsychotic drugs.
In addition, a paper in a supplement to the Journal of Clinical Psychiatry reported that the FDA has been told of over 140 cases of newly-diagnosed diabetes in people taking clozapine. Thirty-six of these involved ketoacidosis, which elevates blood sugar to potentially deadly levels.
Recently, doctors from the FDA used information from their MedWatch database to determine that there had been 11 reports of uncontrollable blood sugar levels in people aged 13 to 18 who were taking clozapine between January 1993 and March 2000. There were similar problems with teens taking olanzapine. People taking the drugs often developed hyperglycemia and even diabetes within days of beginning their prescription. Sugar control was often regained once the person stopped taking the medicine.
Another noted side effect of clozapine is that of agranulocytosis, which is a decrease in white blood cells. People taking the drug must be monitored for this condition. The drug has also been linked to heart complications. Warning labels on the drug do not currently highlight any of these problems in particular.
Dialysis In Morning May Be More Effective
For people who must undergo daily dialysis due to kidney failure, the time of day in which they have this treatment may make a difference in terms of their survival.
Recently, researchers from Emory University in Atlanta, Georgia studied 242 people aged 60 or older who were on dialysis. The study continued for 11 years, and included 167 people who had dialysis in the mornin, and 75 people who had dialysis in the afternoon.
Results of the study, which were published in The Journal of the American Medical Association (volume 286; page 2690; December 5, 2001), indicate that people who had dialysis in the morning lived an average of one year and three months longer than those who had the treatment in the afternoon. The researchers found that morning dialysis cut the risk of death by 30%.
More research needs to be done to determine why morning dialysis may help people live longer, but researchers believe that the fact that people are more likely to sleep during morning dialysis plays a part. Other studies have shown that dialysis may be more effective if the person is sleeping.
Lifescan Settles Suit
Recently, Lifescan Inc, which makes diabetes blood sugar monitors, settled a class-action suit that claimed its products were defective. The company agreed to pay $45 million to people with diabetes in the United States who had purchased the SureStep glucose meter before August 1997.
Last year, the company had to pay $60 million after it pled guilty to charges that it had marketed the glucose meter even though it knew of dangerous defects in the product. Court documents in last year's case indicated that at least 61 customers became ill or had to be hospitalized due to the malfunctioning meters.
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