STAR PAPER
Prevalence of hypovitaminosis D in cardiovascular diseases (from the National Health and Nutrition Examination Survey 2001–2004)
Kim DH, Sabour S, Sagar UN, Adams S, Whellan DJ
Am J Cardiol 2008;102:1540–4
Study. The burden of cardiovascular diseases (CVDs) and measurement of serum 25-hydroxyvitamin D (25[OH]D) and prevalence of hypovitaminosis D in adults with CVDs from 2001 to 2004 were studied. Serum (25[OH]D) levels were divided into three categories ≥30, 20–29 and <20 ng/mL, and hypovitaminosis D was defined as vitamin D <30 ng/mL.
Results. In more than 8000 adults, the prevalence of hypovitaminosis D was 74%. The burden of CVDs increased with lower 25[OH]D categories, with 5.3%, 6.7% and 7.3% of coronary heart disease; 1.5%, 2.4% and 3.2% heart failure; 2.5%, 2.0% and 3.2% stroke and 3.6%, 5.0% and 7.7% peripheral arterial disease. Across all CVDs, hypovitaminosis D was more common in blacks than in Hispanics or Whites.
Conclusion. Hypovitaminosis D was highly prevalent in US adults with CVDs, particularly those with both coronary heart disease and heart failure.
Menstrual and reproductive factors in association with lung cancer in female lifetime non-smokers
Weiss JM, Lacey JV Jr, Shu XO, Ji BT, Hou L, Yang G, Li H, Rothman N, Blair A, Gao YT, Chow WH, Zheng W
Am J Epidemiol 2008;168:1319–25
Objective. The strongest risk factor for lung cancer is cigarette smoking. However, 25% of cases occur in non-smokers. This study looks at hormonal factors in women who were lifetime non-smokers.
Study. A total of 71,312 women aged 40–70 years between 1996 and 2000 were observed. There were 220 cases of lung cancer.
Result. Those having later age of menopause, a longer reproductive period, higher parity and used intrauterine devices had a decreased risk of lung cancer.
Conclusion. This study suggests a potential role for hormonal factors in the aetiology of lung cancer among non-smoking women.
Leg strength or velocity of movement: which is more influential on the balance of mobility-limited elders?
Mayson DJ, Kiely DK, Larose SI, Bean JF
Am J Phys Med Rehabil 2008;87:969–76
Objective. To determine which component of leg power (maximum limb strength or limb velocity) is more influential on balance performance in mobility-limited elders?
Study. A total of 138 community-dwelling older adults with mobility limitations were studied. Balance was measured using recognized mobility assessment tests. Velocity was calculated with one repetition maximum strength and power at 40% (see original paper).
Results. Strength was found to be associated with performance using the Stance test, whereas velocity showed no significant association. In contrast, velocity was consistently associated with performance on all measures of balance.
Conclusion. Higher leg velocity is associated with better performance by mobility assessment, whereas greater leg strength is associated with better performance by the Stance test. These tests emphasize the importance and relevance of limb velocity.
Increased energy density of the home-delivered lunch meal improves 24-hour nutrient intakes in older adults
Silver HJ, Dietrich MS, Castellanos VH
J Am Diet Assoc 2008;108:2084–9
Objective. As food intake declines with ageing, older adults develop energy and nutrient inadequacies. By manipulating the energy density of meals in institutions, the energy intakes of meals has seen improvement. The effects on community-residing older adults who are at nutrition risk have not been investigated.
Study. To determine whether enhancing the energy density of food served in a home-delivered meals programme would increase 24-hour energy and nutrient intakes. There were 45 subjects studied in a randomized trial.
Results. Consumption of the enhanced meal increased average lunch energy intakes by 86% and 24-hour energy intakes by 453 kcal. The intake of several key macronutrients and micronutrients also improved.
Conclusion. Altering the energy density of regularly served menu items is an effective strategy to improve dietary intakes of free-living older adults.
A retrospective study of cholinesterase inhibitors for Alzheimer's disease: cerebrovascular disease as a predictor of patient outcomes
Charbonneau C, Massoud F, Dorais M, Lelorier J
Curr Med Res Opin 2008;24:3287–94
Background. Dementia may be due to Alzheimer's disease (AD), cerebrovascular disease (CVD) or both. When CVD is associated with dementia, survival is thought to be reduced. Cholinesterase inhibitors (ChEls) slow disease progression in AD, but does it have similar benefits in dementia caused by CVD?
Study. The time taken to Nursing Home Placement (NHP) or death for AD patients aged >66 years with or without CVD treated with ChEls was examined.
Results. More than 4000 patients had AD and CVD and more than 13,000 had AD alone. For the endpoints of NHP or death, 1000 day survival rates were lower among AD patients with or without CVD. However, differences were small.
Conclusion. Association between coexisting CVD and time to NHP or death appears to be of little clinical relevance among AD patients treated with ChEls. The lack of difference between AD patients with and without CVD suggests that CVD should not be used as a reason to deny AD patients' access to ChEls treatment.
Antihistamine therapy and bone mineral density: analysis in a population-based US sample
Kinjo M, Setoguchi S, Solomon DH
Am J Med 2008;121:1085–91
Background. Histamine may play an important part in bone turnover.
Study. Histamine 1 receptor antagonist (H1RA) and histamine 2 receptor antagonist (H2RA) and bone mineral density were studied.
Methods. Subjects >60 years and using H1RA and H2RA had femoral neck bone density measured in users and non-users.
Results. Femoral neck bone density was slightly higher in H1RA users versus non-users and in H2RA users and non-users when daily calcium intake exceeded 800 mg/day.
Conclusion. Femoral neck bone mineral density may be higher in H1RA users than non-users among older adults. H2RA users with reduced calcium intake had lower bone mineral density than non-users.
Strontium ranelate reduces the risk of vertebral fracture in young postmenopausal women with severe osteoporosis
Roux C, Fechtenbaum J, Kolta S, Isaia G, Andia JB, Devogelaer JP
Ann Rheum Dis 2008;67:1736–8
Objective. Early osteoporotic fractures are a major risk factor for further fractures. This study looks at the effectiveness of strontium ranelate in preventing vertebral fractures in women aged 50–65 years.
Methods. Strontium ranelate 2 g/day given in a double-blind, placebo-controlled trial was studied at the incidence of repeat vertebral fractures in postmenopausal women with osteoporosis.
Results. Over four years, strontium ranelate significantly reduced the risk of vertebral fracture by 35% and bone mineral density increased in the lumbar spine and femoral neck.
Conclusion. Strontium ranelate is an effective osteoporotic treatment for preventing vertebral fractures.
Proteins, dietary acid load and calcium, and risk of postmenopausal fractures in the E3N French Women Prospective Study
Dargent-Molina P, Sabia S, Touvier M, Kesse E, Bréart G, Clavel-Chapelon F, Boutron-Ruault MC
J Bone Miner Res 2008;23:1915–22
Objective. Excess dietary protein and acidic diets may increase the risk of osteoporosis. This study aims to find out if there is an association between protein intake and overall acid–base equilibrium of the diet (as renal net acid excretion [RNAE] estimate) and fracture risk vary according to calcium intake.
Study. More than 2000 women over 8.5 years reported a fracture (excluding high-impact trauma) among 36,000 women who were looked at. Calcium, protein and RNAE measured were using questionnaires.
Results. There was an overall association between fracture risk and total protein and RNAE. However, in the lowest quartile of calcium (<400 mg, 1000 kcal), high protein intake was associated with a significantly increased fracture risk for the highest versus lowest quartile.
Conclusions. An increasing fracture risk with increasing protein intake was also observed. There was some evidence that high protein and high acid ash diets were associated with an increased risk of fracture when calcium intake was low.
Efficacy of bazedoxifene in reducing new vertebral fracture risk in postmenopausal women with osteoporosis: results from a three-year, randomized-, placebo-, and active-controlled clinical trial
Silverman SL, Christiansen C, Genant HK, Vukicevic S, Zanchetta JR, de Villiers TJ, Constantine GD, Chines AA
J Bone Miner Res 2008;23:1923–34
Study. A three-year double-blind trial was performed on healthy women with osteoporosis (55–85 years) who were treated with bazedoxifene 20 or 40 mg, raloxifene 60 mg or placebo. The primary endpoint was new vertebral fractures after 36 months; secondary endpoints included non-vertebral fractures, bone mineral density (BMD) and bone turnover markers.
Results. Among nearly 7000 subjects, the incidence of new vertebral fractures was lower with bazedoxifene 20 + 40 mg and raloxifene 60 mg compared with placebo. Bazedoxifene significantly improved BMD. The incidence of vasodilations, leg cramps and venous thrombosis was higher with both drugs versus placebo.
Conclusion. Bazedoxifene reduced the risk of new vertebral fractures in women with osteoporosis.
