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Biomedical subjects

B Gutin

Publications and source records attributed to B Gutin.

At least 19 recordsLinked to original sources
PubMed1995

Fasting insulin concentration is related to cardiovascular reactivity to exercise in children.

OBJECTIVE: One mechanism through which hyperinsulinemia is linked to hypertension is through its stimulation of sympathetic nervous activity. Thus, insulin concentration may be correlated with indices of sympathetic activity before it is associated with resting blood pressure. We tested this hypothesis by determining the relationship of insulin concentration and sympathetically mediated cardiovascular reactivity to exercise in children. DESIGN: Survey. SETTING: General community. PARTICIPANTS: Volunteer sample of 46 black and white boys and girls, 9 to 11 years of age. INTERVENTIONS: None. Fasting insulin concentration was the main independent variable. MAIN OUTCOME MEASURES: Systolic blood pressure and heart rate during a standard submaximal bout of treadmill exercise, and systolic blood pressure at peak effort. RESULTS: The hypothesis was tested by multiple regression analyses controlled for resting values. Insulin contributed significantly to the regression models for submaximal heart rate (P < .001), submaximal systolic blood pressure (P = .001), and peak systolic blood pressure (P = .006). CONCLUSIONS: Fasting insulin concentration is associated with cardiovascular reactivity to exercise in young children. This supports the hypothesis that the relationship between hyperinsulinemia and hypertension is mediated by sympathetic nervous tone and that the process begins in childhood. Because percent body fat was positively associated with both insulin and cardiovascular reactivity to exercise, prevention of childhood obesity may be a valuable prophylactic measure for these health problems.

Analysis of Variance↗
PubMed1994

Knowledge, beliefs, and behaviors among college women concerning the prevention of osteoporosis.

OBJECTIVE: To assess the knowledge of osteoporosis risk factors among young women, their beliefs about the disease, and to what extent they practice preventive behaviors, such as adequate calcium intake and physical activity. DESIGN: Cross-sectional survey. SETTING/PARTICIPANTS: One hundred twenty-seven women (mean age, 19.6 years; 92% were white) enrolled in a required undergraduate health course at a midwestern state university. RESULTS: One hundred fourteen (90%) of the survey respondents had heard about osteoporosis, but only 49 (43%) of the 114 had received information from either a health care provider or a school. There was a significant relationship between receiving osteoporosis information and the ability to correctly identify risk factors (P < or = .006). Only 6.7% of the women reported getting both adequate "osteoprotective" exercise per week and the recommended 1200 mg of calcium per day. Respondents believed that it was unlikely that osteoporosis would develop in them. They also expressed less responsibility and concern about osteoporosis and believed that it is less serious than other common causes of morbidity and mortality in women, such as heart disease and breast cancer (P < or = .02). There was no significant relationship between risk-factor identification and exercise habits, calcium intake, or beliefs about osteoporosis. CONCLUSIONS: The majority of young women are not consuming the recommended daily amount of calcium and are lacking sufficient osteoprotective exercise for building healthy bone. Health care providers and educational institutions either have missed opportunities to educate young women about osteoporosis or such information has not been received and retained. Increasing levels of osteoporosis awareness may not be associated with influencing beliefs or behaviors. However, because of the importance of building an adequate bone mass in early life, our data suggest that the development and evaluation of comprehensive osteoporosis educational interventions targeted at younger women are warranted.

Adolescent↗
PubMed1994

Relation of percentage of body fat and maximal aerobic capacity to risk factors for atherosclerosis and diabetes in black and white seven- to eleven-year-old children.

OBJECTIVE: To determine whether body fatness, aerobic capacity, and fat distribution are associated with levels of cardiovascular risk factors in children. METHODS: Subjects (N = 57) were 7 to 11 years of age; their percentage of body fat ranged from 10% to 58%. The percentage of fat was measured with dual-energy x-ray absorptiometry, maximal aerobic capacity was measured on a treadmill, fat distribution was expressed as the waist/hip circumference ratio, and blood pressures were measured with an automated monitor. Measurements of several lipoproteins and apoproteins were combined into one atherogenic index. RESULTS: The percentage of fat was related to the atherogenic index (p = 0.38; p > 0.01) and insulin level (p = 0.78; p > 0.001). Aerobic capacity was inversely related to the atherogenic index (p = -0.27; p > 0.05) and insulin level (p = -0.72; p > 0.001). The waist/hip ratio was not related to the risk factors, and blood pressures were not related to fatness or aerobic capacity. In multiple regression analyses, only fatness explained significant independent proportions of the variance in the atherogenic index and insulin level. After control for fatness, the black children had higher insulin levels (p > 0.05). CONCLUSION: At early ages (7- to 11-year-old children), fatness was related to risk factors for cardiovascular disease and diabetes.

Absorptiometry, Photon↗
PubMed1994

Association of apolipoprotein(a) phenotypes in children with family history of premature coronary artery disease.

Although blacks have higher plasma levels of lipoprotein(a) [Lp(a)] than whites, the Lp(a) levels are not associated with clinical coronary artery disease (CAD) or parental history of myocardial infarction in blacks. To explore whether ethnic differences in the pathogenicity of Lp(a) are related to the thrombogenic component of Lp(a), this study investigated in children the associations of apolipoprotein(a) [apo(a)] phenotypes and Lp(a) levels with family history of premature CAD. Subjects were 46 children aged 7 to 11 years divided according to family history of premature CAD and assessed for Lp(a), apo(a) phenotypes, and other lipids and lipoproteins. The prevalence of small isoforms was higher in children with positive family history of premature CAD than in children with negative family history of premature CAD (32% versus 10%). Large isoforms were more prevalent in whites (24% versus 6%), and medium-sized isoforms were more prevalent in blacks (75% versus 52%). The black/white difference was smaller (19% versus 24%) in regard to small isoforms. Lp(a) levels were inversely related to apo(a) size in both blacks and whites (P = .084 and P = .049, respectively). Single-banded small apo(a) isoforms predicted positive family history of premature CAD, independent of ethnicity and Lp(a) levels. Small apo(a) isoforms in children were independent predictors of family history of premature CAD. Unlike Lp(a), they appear to be equally pathogenic for blacks and whites.

Age of Onset↗
PubMed1994

The rate of increase in blood pressure in children 5 years of age is related to changes in aerobic fitness and body mass index.

OBJECTIVE: To determine whether changes in aerobic fitness and body mass index are related to the age-related rise in blood pressure in healthy preschool children. STUDY DESIGN: Longitudinal analyses of 196 free-living children aged 5 years at baseline who were followed over a mean of 19.7 months. Aerobic fitness was assessed using a treadmill. All measures were obtained on multiple occasions at scheduled visits as part of a longitudinal cohort study. SETTING: An inner-city medical center. OUTCOME MEASURES: Blood pressure was measured using an automated Dinamap device. RESULTS: Mean systolic blood pressure was 95.3 mmHg (SD 8.38) at baseline and increased by 4.46 mmHg per year. Mean diastolic blood pressure was 53.9 mmHg (SD 5.81) at baseline and did not change significantly. Children in the highest quintile of increase in fitness had a significantly smaller increase in systolic blood pressure compared to children in the lowest quintile (2.92 vs 5.10 mmHg/year; P = .03). Children in the lowest quintile of increase in body mass index did not differ significantly in rate of increase in systolic blood pressure compared to children in the highest quintile (3.92 vs 4.96 mmHg/year). In a multiple regression model including baseline systolic blood pressure, fitness, height, body mass index, and other covariates, greater increase in fitness (P = .03) and lesser increase in body mass index (P < .01) were associated with lower rates of increase in systolic blood pressure. In a similar multivariate analysis, an increase in fitness was also associated with a lower rate of increase in diastolic blood pressure (P = .02). CONCLUSION: Young children who increase their aerobic fitness or decrease their body mass index reduce the rate of the age-related increase in blood pressure. These observations may have implications for development of interventions directed at the primary prevention of hypertension.

Age Factors↗
PubMed1994

Low density lipoprotein cholesterol/apolipoprotein B-100 ratio: interaction of family history of premature atherosclerotic coronary artery disease with race and gender in 7 to 11 year olds.

BACKGROUND: In adults, a low density lipoprotein cholesterol (LDL-C)/apolipoprotein B-100 (ApoB) ratio is an indicator of ApoB-enriched small dense LDL, which is associated with premature coronary artery disease (CAD). Since this LDL subclass may be inherited, we investigated whether a low LDL-C/ApoB ratio was associated with a positive family history of premature CAD in young children. METHODS: Subjects were 66 children aged 7 to 11 years who were recruited through a school-based family history survey, flyers, and hospital newspaper advertisements. They were divided according to family history and assessed for fatness, blood pressure, lipids, lipoproteins, and apoproteins. RESULTS: Family history interacted with gender such that girls with a positive family history had a lower LDL-C/ApoB ratio than girls with a negative family history, while the opposite was true in boys; ie, family history-positive boys had a higher ratio than family history-negative boys. The association of a low ratio with a positive family history was seen most clearly in white girls. Family history-positive whites had higher ApoB than family history-negative whites, whereas the pattern was reversed in the blacks. The LDL-C/ApoB ratio and ApoB were not related to other CAD risk factors such as fatness, blood pressure, or other lipids and lipoproteins. CONCLUSION: In young children, a low LDL-C/ApoB ratio and high ApoB levels were associated with a positive family history of CAD only in the white girls, suggesting that this group is at increased risk of genetically mediated CAD.

Apolipoprotein B-100↗
PubMed1992

Supervised fitness walking in patients with osteoarthritis of the knee. A randomized, controlled trial.

OBJECTIVE: To assess the effect of a program of supervised fitness walking and patient education on functional status, pain, and use of medication in patients with osteoarthritis of the knee. DESIGN: An 8-week randomized, controlled trial. SETTING: Inpatient and outpatient services of an orthopedic hospital in an academic medical center. PATIENTS: A total of 102 patients with a documented diagnosis of primary osteoarthritis of one or both knees participated in the study. Data were obtained on 47 of 51 intervention patients and 45 of 51 control patients. INTERVENTIONS: An 8-week program of supervised fitness walking and patient education or standard routine medical care. MEASUREMENTS: Patients were evaluated and outcomes assessed before and after the intervention using a 6-minute test of walking distance and scores on the physical activity, arthritis impact, pain, and medication subscales of the Arthritis Impact Measurement Scale (AIMS). RESULTS: Patients randomly assigned to the walking program had a 70-meter increase in walking distance relative to their baseline assessment, which represents an improvement of 18.4% (95% Cl, 9.8% to 27.0%). In contrast, controls showed a 17-meter decrease in walking distance relative to their baseline assessment (P less than 0.001). Improvements in functional status as measured by the AIMS physical activity subscale were also observed in the walking group but not in the control group (P less than 0.001); patients assigned to the walking program improved 39% (Cl, 15.6% to 60.4%). Although changes in scores on the arthritis impact subscale were similar in the two groups (P = 0.093), the walking group experienced a decrease in arthritis pain of 27% (Cl, 9.6% to 41.4%) (P = 0.003). Medication use was less frequent in the walking group than in the control group at the post-test (P = 0.08). CONCLUSIONS: A program of supervised fitness walking and patient education can improve functional status without worsening pain or exacerbating arthritis-related symptoms in patients with osteoarthritis of the knee.

Adult↗
PubMed1992

Can vigorous exercise play a role in osteoporosis prevention? A review.

Part of the reduction in bone density observed in older people is due to disuse rather than the aging process itself. While some mechanical stress is needed to maintain optimal bone density, it is not clear just which types of exercise are most valuable or whether appropriate exercise might reduce the need for estrogen therapy in postmenopausal women. Cross-sectional studies. Physical activity, aerobic fitness, and strength have all been correlated with bone density. Young people who use a specific part of the body in vigorous exercise exhibit enhanced bone density in that part of the body, but not necessarily in other regions. Older people who have been active for many years seem to exhibit generally enhanced bone density. Prospective studies. Most regimens which used vigorous aerobic and strength training enhanced bone density, but walking is relatively ineffective for prevention of postmenopausal bone loss. Most studies using specific bone-loading exercise have shown substantial increases in bone density at the specific sites loaded. Elderly people seem capable of responding favorably to vigorous exercise. No direct comparisons of exercise and estrogen therapy have been reported. Excessive exercise. Extremely high volumes of exercise may overwhelm a person's adaptive capacity, leading to stress fractures. For example, young women athletes who suffer from menstrual dysfunction exhibit reduced bone density and musculoskeletal disorders. Clinical implication. Although the evidence is far from conclusive, an exercise regimen should probably include vigorous total body exercise, including strength and aerobic training.

Animals↗
PubMed1992

A screening and counseling program for prevention of osteoporosis.

Prevention of osteoporosis is an increasingly salient public health concern as our society ages. This report describes the procedures used at an osteoporosis center to which people come for screening and counseling. The patients on whom this report is based were 53 non-smoking women, 1-10 years postmenopausal at the time of their first visit to the center, who chose not to undertake estrogen therapy, and who returned for a second visit in 12-18 months. They were classified as to adequacy of calcium intake (at least 750 mg/day) and exercise (at least 3 h/week of weight-bearing exercise) at both visits; complete data on calcium intake and exercise were available on 46 of the women. Bone densities were measured at the femoral neck and lumbar spine with dual energy X-ray absorptiometry, and at the distal radius with single photon absorptiometry. At the first visit, 67% of the women reported adequate exercise and 43% reported adequate calcium intake. At the second visit, the percentages in the adequate categories had increased to 74% for exercise (p = 0.06) and 70% for calcium intake (p = 0.02). Age at the first visit was inversely correlated with femoral (r = -0.40, p = 0.003) and spinal (r = -0.36, p = 0.009) bone densities; the correlation with radial bone density did not achieve significance (r = -0.27, p = 0.55). Rather than declining, as would be expected in early postmenopausal women, bone density rose slightly, but not significantly, between visits for all three sites.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMed1992

Total body bone density in amenorrheic runners.

Many studies have suggested that the positive effect of running on bone mass does not fully compensate for the negative effects of athletic amenorrhea. These studies have made this conclusion based on measurements of bone at a limited number of sites. This study used dual-photon absorptiometry to measure bone mineral content and bone mineral density in the total body as well as in several regions in amenorrheic runners (N = 13), eumenorrheic runners (N = 13), and sedentary controls (N = 12). The subjects were 21-35 years old. Runners had run at least 40 km/week for at least the past 3 years. Controls had body mass indices similar to those of the runners. The amenorrheic women had significantly lower values for total bone mineral content (P = .01), total bone mineral density (P = .04), and total bone mineral content as a percent of normal values (P = .04) than eumenorrheic women, but they were not significantly different from the controls. When total bone mineral content and total bone mineral density were adjusted for body weight, there were no significant differences among the groups. The eumenorrheic subjects had significantly greater bone mineral density in the trunk than the amenorrheic women; eumenorrheics and controls had significantly greater bone mineral density in the spine compared with amenorrheics. Lumbar spine bone mineral density showed a trend toward greatest values for controls and lowest for amenorrheic women (P = .069), although this measurement is relatively imprecise. Arms and legs showed no significant differences among the groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗
PubMed1991

Relationships of dietary fat consumption to serum total and low-density lipoprotein cholesterol in hispanic preschool children.

BACKGROUND: Studies of the relationship between dietary fat intake and serum lipids in young children have yielded inconclusive results. We studied this relationship in 108 Hispanic children ages 4-5 years. METHODS: Four 24-hr recalls approximately 3 months apart and two Willett semiquantitative food frequency questionnaires approximately 6 months apart were obtained by interviewing the children's mothers. Diet measures were averaged for the multiple administrations of each of these instruments. RESULTS: Based on the 24-hr recalls, children in the highest tertile of total fat consumption (36.2% of total calories) compared with the lowest tertile (30.2% of total calories) had mean total serum cholesterol of 4.32 mmol/liter (167 mg/dl) vs 3.91 mmol/liter (151 mg/d) (test for linear trend across tertiles, P less than 0.05) and mean low-density lipoprotein cholesterol of 2.74 mmol/liter (106 mg/dl) vs 2.29 mmol/liter (89 mg/dl) (test for linear trend, P less than 0.01). Children in the highest tertile of saturated fat consumption (14.6% of total calories) compared with the lowest tertile (11.2% of total calories) had mean total serum cholesterol of 4.39 mmol/liter (170 mg/dl) vs 3.97 mmol/liter (154 mg/dl) (test for linear trend, P less than 0.05) and mean low-density lipoprotein cholesterol of 2.80 mmol/liter (108 mg/dl) vs 2.35 mmol/liter (91 mg/dl) (test for linear trend, P less than 0.01). These relationships remained significant when calorie-adjusted nutrient intakes were examined and after adjustment in multiple linear regression models for age, sex, and body mass index, with the exception of the association of calorie-adjusted total fat with total serum cholesterol level (P = 0.07). Similar results were obtained using the Willett questionnaires. CONCLUSIONS: These findings indicate that dietary fat, particularly saturated fat consumption, is an important correlate of blood lipid levels in preschool children. These are also the first reported data indicating that the Willett questionnaire, as a method for measuring the atherogenic components of diet, has criterion-related validity in young children.

Child, Preschool↗
PubMed1991

Does tourniquet use during anterior cruciate ligament surgery interfere with postsurgical recovery of function? A review of the literature.

This article explores the issue of whether use of a tourniquet during arthroscopically assisted repair of the anterior cruciate ligament (ACL) slows the postoperative recovery of function. A tourniquet is customarily used to provide a bloodless field, thus enabling the surgeon to visualize the joint clearly. However, there is increasing evidence that tourniquets cause muscle and nerve damage that can have long-term consequences for the recovery of function following surgery. The two randomized trials that investigated tourniquet use during meniscectomy reached contradictory conclusions about the effects of the tourniquet. There have been no randomized trials of tourniquet use during the longer and more complex ACL surgery. This article reviews the pertinent literature and suggests some clinical implications of the available information.

Anterior Cruciate Ligament↗
PubMed1991

Resting metabolic rate and energy balance in amenorrheic and eumenorrheic runners.

This study investigated metabolic and nutritional factors in association with athletic menstrual dysfunction (AMD). Three groups of women were studied: amenorrheic runners (amenorrheic), eumenorrheic runners (eumenorrheic), and eumenorrheic sedentary controls (sedentary). Amenorrheic and eumenorrheic were similar in age, weight, percent body fat by hydrodensitometry, training pace and mileage, best 10 km race time, years running, and maximal oxygen consumption. When adjusted for body weight or for fat-free mass by analysis of covariance, RMR was significantly lower in amenorrheic than in eumenorrheic and sedentary. The daily caloric intakes of the groups did not differ significantly, but the amenorrheic scored significantly higher than the eumenorrheic and sedentary on a scale of aberrant eating patterns. Amenorrheic high mileage runners seem to have a less adequate diet than eumenorrheic runners but appear to maintain energy balance and stable weight through a reduction in RMR.

Adaptation, Physiological↗
PubMed1990

Blood pressure, fitness, and fatness in 5- and 6-year-old children.

Cross-sectional relations among blood pressure (BP), aerobic fitness, body fatness, and fat patterning were studied in 216 primarily Hispanic inner-city 5- and 6-year-olds. Fitness was measured with a submaximal treadmill test, and fatness was measured with five skin folds. Diastolic BP was inversely related to fitness in the boys and girls, and positively related to fatness for the boys. Systolic BP was positively related to fatness for the boys and girls. Using multiple regression and including parental BPs, fatness explained significant proportions of the variance in systolic BP for both the boys and girls and in diastolic BP for the boys. There were tendencies for central skin folds to explain more of the variation in BP than peripheral skin folds only for the boys. Fitness and fatness were inversely related for the boys and girls. Thus, at 5 and 6 years of age children exhibit some of the same risk factors for cardiovascular disease seen in adults.

Blood Pressure↗
PubMed1990

Survey of cardiac rehabilitation centers in New York City.

Out-patient cardiac rehabilitation centers in New York City were surveyed in order to determine current practices. All 24 centers operating as of May, 1987 were sent questionnaires; 16 responded for a return rate of 67 percent. In general, practices of the centers were in accord with guidelines of the American Heart Association (AHA) and the American College of Sports Medicine. The incidence of medical complications in the centers was quite rare, perhaps accounting for the failure of centers to follow all emergency guidelines of the AHA, such as daily testing of the defibrillator. The major aim of the centers was to enhance physiological status, rather narrowly defined as aerobic fitness and cardiovascular function. Little attention was paid to nutrition, body composition and strength, despite the fact that the value of broadening the concept of fitness to include these parameters is becoming evident. Lifestyle counseling to help in long-term rehabilitation was also rare. Third party payers should be encouraged to support such components of a rehabilitation program so that centers would be more likely to incorporate them.

Ambulatory Care↗