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Biomedical subjects

Christian Schwahn

Publications and source records attributed to Christian Schwahn.

At least 19 recordsLinked to original sources
PubMed2007

Comment on "A common genetic variant is associated with adult and childhood obesity".

Contrary to the findings of Herbert et al. (Reports, 14 April 2006, p. 279), homozygous carriers of the C allele of the rs7566605 variant near the INSIG2 gene did not exhibit a significantly increased risk for obesity in a large population-based cross-sectional German study. A subgroup analysis, however, revealed that this allele significantly increased the risk for obesity in already overweight individuals.

Adult↗
PubMed2006

Comparison of different biological methods for the assessment of ecotoxicological risks.

To test the effects of heavy metals in river water, we compared the sensitivity of seven different biological test methods, using bacteria (Vibrio fischeri), human FL cells, protozoans (Paramecium spp.), nematodes (Rhabditis oxycerca), aquatic plants (Lemna minor), and fishes (Leuciscus idus melanotus). As test substance we used a representative mixture of 3.0 microg/l As, 2.5 microg/l Pb, 0.8 microg/l Cd, 1.7 microg/l Cr, 3.9 microg/l Cu, 6.7 microg/l Ni, 0.4 microg/l Hg, and 23.0 microg/l Zn, imitating the detectable heavy metal contamination of the Odra estuary (NE Germany/NW Poland). This mixture was defined as normal concentration (NC). Most sensitive was the test with L. minor (exposure time 10 d). The plants already showed phytotoxic effects at the heavy metal concentration found in the Odra estuary. Test systems with human cells, protozoans, and nematodes (exposure time 1-7 d) reacted at concentrations 85-100 times above the NC. Fish toxicity (exposure time 2 d) occurred from 130-fold concentration upwards. In contrast, the standard test carried out with luminescent bacteria (exposure time 30 min) was affected only at > 1000-fold concentrations. This test is therefore not suitable as an early warning system to detect ecological risks. Even the NC of heavy metals measured in the Odra estuary inhibits cells and the growth of aquatic plants. Of the single heavy metals tested, copper produced the strongest effects. Therefore, the reduction of heavy metal emissions, especially of copper-which can amplify the toxicity of other heavy metals-should be a task of highest priority.

Aliivibrio fischeri↗
PubMed2006

Gender differences in the relation between number of teeth and systolic blood pressure.

BACKGROUND: Tooth loss predicts total and circulatory mortality. The reasons for the increased mortality in subjects with a low number of teeth may be related to enhanced atherosclerosis, elevated arterial pressure and more frequent hypertension. The present study was designed to investigate whether there is an association between the number of teeth and arterial pressure or hypertension. METHODS: We used data of 4185 adult subjects (2150 women) collected for the population-based Study of Health in Pomerania. The number of teeth was counted by trained and certified dentists. Hypertension was defined as systolic blood pressure >or= 140 mmHg or diastolic blood pressure >or= 90 mmHg or use of antihypertensive medication. Multivariable analyses were adjusted for relevant confounders. RESULTS: The adjusted mean (standard error) systolic blood pressure in men having 0-6 teeth was 149.6 mmHg (1.3 mmHg) compared to 142.6 mmHg (1.2 mmHg) in men having 27-28 teeth (P < 0.05). The adjusted odds for hypertension in men with 0-6 teeth compared to men with 27-28 teeth were 1.91 (95% confidence interval 1.21; 3.02, P < 0.05). In women no such relations were found. CONCLUSION: There is an inverse association between the number of teeth and systolic blood pressure and hypertension in men but not in women. The present findings partly explain the relation between tooth loss and mortality.

Adult↗
PubMed2006

The influence of dynamic occlusal interferences on probing depth and attachment level: results of the Study of Health in Pomerania (SHIP).

BACKGROUND: The purpose of this study was to investigate potential associations between dynamic occlusal interferences and signs of periodontal disease in posterior teeth based on dental and medical measurements obtained from a population-based sample in the cross-sectional epidemiological study entitled, "Study of Health in Pomerania" (SHIP). METHODS: Medical history and dental and sociodemographic parameters of 2,980 representatively selected dentate subjects, 20 to 79 years of age, were collected. The analysis was performed on posterior teeth only using a mixed linear model that considers the clustered structure of the data. The model also was adjusted with respect to known risk factors for periodontal disease. RESULTS: The presence of non-working side contacts only was significantly related to probing depth (P<0.0001) and attachment loss (P=0.001). The presence of non-working side contacts and working side contacts on the same tooth was significantly related to increased probing depth (P=0.004) but not attachment level. The effect magnitude was a mean increase of 0.13 mm for probing depth and 0.14 mm in attachment loss. Known risk factors for periodontal disease that also showed significant associations with probing depth and attachment loss included male gender, age, smoking, education, and plaque score. Other factors significantly related to probing depth and/or attachment loss were tilted teeth, restored occlusal surfaces versus sound surfaces, elongated teeth, and tooth type (molar versus premolar). CONCLUSION: The effect of non-working contacts on periodontal disease status was discernible, but weak in terms of magnitude and specificity.

Adult↗
PubMed2006

Partial- or full-mouth examination assessing the dental and prosthetic status among elderly individuals.

The aim of this study was to determine whether half-mouth examinations accurately reflect the dental and prosthetic status of the entire mouth. Samples of 1,830 adults aged 55- 79 years were examined. The rate of agreement between half- and full-mouth examinations was estimated using weighted and unweighted Kappa values comparing findings of each tooth bilaterally. A power analysis was performed to estimate the number of subjects representing complete dental recordings within a certain power. Subjects showed unweighted Kappa values from 0.34-0.96. Weighted Kappa values ranged from 0. 74-0.99. A power analysis for unweighted Kappa scores computed that.findings from 122-335 individuals were necessary to equal the results obtained using complete dental recordings.

Aged↗
PubMed2005

Low serum thyrotropin is associated with high plasma fibrinogen.

BACKGROUND: Elevated plasma fibrinogen levels are associated with an increased risk of cardiovascular events. Decreased serum TSH predicts vascular mortality, which hypothetically could be explained in part by alterations in the blood coagulation system. OBJECTIVE: The objective of this study was to investigate the association between thyroid function and plasma fibrinogen levels in a general population. DESIGN: The population-based Study of Health in Pomerania was performed in a previously iodine-deficient area in Germany, including 4310 subjects, aged 20-79 yr. Data for 3804 individuals without thyroid disease were analyzed. Analysis revealed an association between thyroid function status and plasma fibrinogen concentration. RESULTS: Elevated fibrinogen levels (>3.25 g/liter) were observed in 14 subjects with increased serum TSH levels (32.6%), 973 euthyroid subjects (28.9%), 158 subjects with decreased serum TSH levels (40.7%), and six individuals with overt hyperthyroidism (54.4%). Logistic regression analysis revealed decreased serum TSH as an independent risk factor for elevated fibrinogen levels (odds ratio, 1.42; 95% confidence interval, 1.12-1.80). CONCLUSIONS: Thyroid function is associated with plasma fibrinogen. Decreased serum TSH is an independent risk factor for elevated plasma fibrinogen levels as a possible explanation for the high cardiovascular mortality among affected subjects.

Adult↗
PubMed2005

Relation of parity with common carotid intima-media thickness among women of the Study of Health in Pomerania.

BACKGROUND AND PURPOSE: Metabolic and hormonal changes associated with pregnancy and childbirth are assumed to contribute to the development of cardiovascular disease among women. We analyzed the association of parity with common carotid intima-media thickness (IMT), which has a predictive value of subsequent myocardial infarction and stroke. METHODS: The Study of Health in Pomerania (SHIP), an epidemiological study of the general population in the northeast of Germany, included 1195 women aged 45 to 79 years. Mean and maximum far-wall IMT of the common carotid arteries were assessed by high-resolution ultrasound. All women were comprehensively characterized as to their reproductive history as well as to socioeconomic, behavioral, and biological risk factors. RESULTS: There was a U-shaped association between the number of children (from 0 to > or =4) and mean and maximum IMT. Nulliparous women had the highest age-adjusted mean (0.81 mm [95% CI, 0.78 to 0.84]) and maximum IMT (1.04 mm [95% CI, 1.00 to 1.09]), and women with single parity the lowest (mean IMT, 0.73 [95% CI, 0.72 to 0.74]; maximum IMT, 0.91 mm [95% CI, 0.89 to 0.93]; P<0.001 versus nulliparity for both parameters). Stepwise multivariate adjustment for socioeconomic factors, lifestyle variables, and biological variables attenuated the magnitude of this association yet significance remained. CONCLUSIONS: Nulliparity and higher number of children are associated with increased carotid IMT. These findings add support to the hypothesis of a link between the reproductive history of women and cardiovascular disease.

Aged↗
PubMed2005

Independent risk factors for gallstone formation in a region with high cholelithiasis prevalence.

BACKGROUND/AIMS: Cholelithiasis is a common disorder in north-eastern Germany. Analyses of risk factors for gallstone formation in this population may have high explanatory power. Gender-specific risk factors for gallstone formation and their interactions were investigated by using data of the population-based Study of Health in Pomerania (SHIP). METHODS: Data of 4,202 persons aged 20-79 years were available. Cholelithiasis was defined by either a prior history of cholecystectomy or the presence of gallstones on abdominal ultrasound. Multivariable analyses were performed to identify independent risk factors for gallstone formation. RESULTS: There were 468 persons (11.1%) with previous cholecystectomy and 423 persons (10.1%) with sonographic evidence of gallstones. Women had a twofold higher risk for cholelithiasis compared to men. Age, body mass index and low serum HDL cholesterol levels were independently associated with cholelithiasis in both men and women. In the male population, low alcohol and high coffee consumption and in the female population, low physical activity, were further independently related to gallstone formation. Additionally, sex-specific interactions between risk factors were found. CONCLUSIONS: Female sex, age and being overweight are major risk factors for gallstone formation in this region where cholelithiasis is a frequent disorder. Additional factors and interactions contribute to a gender-specific gallstone risk.

Adult↗
PubMed2005

Tooth loss is independently associated with the risk of acquired aortic valve sclerosis.

BACKGROUND: Several studies have shown that periodontal disease and atherosclerosis are associated. Aortic valve sclerosis (AVS) represents the sum of processes that are similar to the development of atherosclerosis. The present analysis was performed to investigate associations between periodontal disease, tooth loss, and AVS. METHODS: The population-based SHIP was conducted in northeast Germany. A study population of 2341 individuals aged > or =45 years was available for the present analysis. Aortic valve sclerosis was determined by echocardiography. Periodontal status was assessed by attachment loss and tooth loss. RESULTS: The prevalence of AVS was 29.9%. Logistic regression analyses did not reveal attachment loss as an independent risk factor for AVS. However, a reduced number of teeth was independently associated with AVS. Other risk factors for AVS were age, history of myocardial infarction, body mass index, pulse pressure, plasma fibrinogen and lipoprotein (a) levels, and the use of drugs that act on the renin-angiotensin system. CONCLUSION: A reduced number of teeth was independently associated with the risk of AVS. This finding further strengthens the link between oral health and cardiovascular disorders.

Adult↗
PubMed2005

Renin-angiotensin system and haemostasis gene polymorphisms and outcome after coronary artery bypass graft surgery.

BACKGROUND: Coronary artery bypass graft surgery is associated with a considerable 2-year mortality rate. Gene polymorphisms of the renin-angiotensin system may be associated with the risk of hypertension and cardiovascular disease. The angiotensin I-converting enzyme DD genotype has recently been identified as independent predictor of the outcome after coronary artery bypass graft surgery. Genetic factors of the clotting system may be related to the risk of myocardial infarction and restenosis after coronary interventions. The aims of the present study were to investigate whether gene polymorphisms of the renin-angiotensin system (angiotensinogen 235 M/T, angiotensin II type 1 receptor 1166 A/C) or the clotting system (glycoprotein IIIa PlA1/PlA2 and factor V Leiden 1691 G/A) are associated with the outcome after coronary artery bypass grafting. METHODS: A study population of 247 patients was followed-up 2 years after coronary artery bypass graft surgery. The primary end-point was total mortality. The secondary end-point was mortality from cardiac cause or the need for myocardial revascularization (percutaneous coronary interventions or recurrent surgery) during follow-up. Geno typing was performed by polymerase chain reaction- and restriction fragment length polymorphism-based techniques. RESULTS: An older age and the non-use of the internal mammary artery graft were identified as independent predictors of the primary end-point after coronary artery bypass grafting. A decreased left ventricular ejection fraction was an independent predictor for the secondary end-point. No association was found between any of the genetic factors and the outcomes after coronary artery bypass graft surgery in the main factor regression models. However, the angiotensin II type 1 receptor 1166 A/C gene polymorphism modulated the effects of age on the primary end-point, and the angiotensinogen 235 M/T gene polymorphism modulated the effects of age on the secondary end-point. CONCLUSION: We conclude that there are interactions between the angiotensin II type 1 receptor 1166 A/C as well as the angiotensinogen 235 M/T gene polymorphism and age with respect to the outcome after coronary artery bypass graft surgery. The glycoprotein IIIa PlA1/PlA2 and the factor V Leiden 1691 G/A gene polymorphisms were not associated with mid-term mortality or cardiac morbidity after coronary artery bypass grafting.

Adult↗
PubMed2005

Standardizing interarch tooth-size harmony in a Syrian population.

The Bolton analysis is considered to be a good indicator for evaluating the degree of intermaxillary tooth-size harmony, but the possibility of ethnic variation of these values should be examined. Thus, the aim of this study was to calculate both the anterior and overall ratios of mandibular and maxillary tooth sizes for a Syrian sample of harmonious permanent dentitions and to compare these ratios with the data from the Bolton and the Michigan studies. In plaster models of 55 Syrian patients (11-22 years) with neutral occlusion (Angle Class I), harmonious overjet and overbite, no reduction of mesiodistal tooth width or missing teeth, the mesiodistal widths of each tooth from the incisors to the first permanent molars were measured in both arches. In the statistical data analysis, the anterior and overall ratios were calculated according to Bolton. The results for the anterior ratio (78.99 +/- 2.18) and the overall ratio (92.26 +/- 2.06) showed no statistically significant differences by sex (P > .48). These values and the degree of variation were similar to the original data by Bolton. Both studies differed considerably from the values of the anterior ratio found in the Michigan University study, which also shows a higher degree of variability. Nevertheless, the overall ratios of all three studies were very similar. Therefore, the interarch tooth-size analysis and values for a harmonious dentition developed by Bolton can also be transferred to an Arabian or at least a Syrian population.

Adolescent↗
PubMed2005

Calcium antagonists and deep gingival pockets in the population-based SHIP study.

AIM: Gingival overgrowth is a common undesired side-effect in patients taking calcium channel blockers. Different reports have suggested that the drug-induced gingival hyperplasia may aggravate inflammatory periodontal disease. However, representative epidemiological data are lacking. We investigated the association between the intake of calcium antagonists and periodontitis in a population-based analysis including the most important risk factors of periodontitis. METHODS: In a cross-sectional epidemiological investigation involving 4290 subjects aged 20-80 years, we recorded periodontal risk factors and identified participants using calcium antagonists. Periodontal parameters, attachment loss, probing depth and number of teeth were assessed. In a subgroup analysis with matched pairs, 456 subjects using calcium antagonists and 456 without were compared for periodontal status. RESULTS: Subjects treated with calcium antagonistic drugs had significantly deeper gingival pockets than their drug-free counterparts. This was observed in the total population of 4290 and confirmed by logistic regression analyses (P < 0.001) controlled for the known risk factors of periodontitis (age, sex, smoking, education). In the matched-pair analysis only the probing depth was increased: extent probing depth > or = 4 mm median 23.5 vs. 17.0% (P < 0.001); mean probing depth 3.0 +/- 0.8 vs. 2.7 +/- 0.9 mm (P < 0.001). No differences were found in extent and severity of clinical attachment loss and in the number of teeth. The risk of gingival overgrowth was aggravated in smokers. CONCLUSION: In the general population, treatment with calcium antagonists leads to gingival overgrowth without an aggravation of periodontal disease. Interaction with smoking indicates the multifactorial background of the undesired effect of calcium antagonists.

Adult↗
PubMed2005

A new ultrasonic device in maintenance therapy: perception of pain and clinical efficacy.

BACKGROUND: A recently introduced piezo-driven ultrasonic device (Vector) generates longitudinal oscillations. As a result, the instrument tip moves parallel to the tooth surface. By avoiding vertical oscillations, maintenance treatment with the Vector device should be less painful than treatment with conventional systems. We investigated whether patients perceive treatment with the Vector device as less painful than with a conventional ultrasonic device, and whether the clinical efficacy of the Vector device is comparable with that of the conventional ultrasonic device in maintenance patients. MATERIAL AND METHODS: Thirty-eight maintenance patients with moderate to advanced periodontal disease took part in this prospective, randomized controlled clinical study. Each patients had to have at least two teeth with probing depths of >4 mm. They were treated either with Dentsply (n=22) at a reduced power setting or with the Vector device (n=16). The observation period was 6 months. Probing pocket depth, attachment level, and bleeding upon probing were assessed at six sites on each treated tooth by a blinded investigator Patient were asked to report perceived pain during instrumentation with a visual analog scale immediately after treatment, in the evening of the treatment day, and in the evenings 1 and 2 days after treatment. RESULTS: Bleeding on probing, probing depth, and attachment level improved in both instrumentation groups from baseline to month 6; however, there was no difference between the two instrumentation modalities. The patients perceived treatment with neither instrument as unpleasant, and their perception of pain intensity both during instrumentation and on the following days did not differ. CONCLUSION: In maintenance therapy, clinical efficacy of the vector device is comparable with that of conventional ultrasonic device. It makes no difference whether the ultrasonic device at a reduced power setting or the Vector device is used, since patients perceive both instruments as causing very little pain.

Adult↗
PubMed2005

Risk factors for headache, including TMD signs and symptoms, and their impact on quality of life. Results of the Study of Health in Pomerania (SHIP).

OBJECTIVE: The aim of this investigation was to evaluate the role of various signs and symptoms of temporomandibular disorders (TMD), among other potential risk factors, in developing frequent headache in a population-based sample of the cross-sectional epidemiologic Study of Health in Pomerania (SHIP). The impact of headache and of myogenous and arthrogenous signs of TMD on the quality of life of this sample was evaluated. METHOD AND MATERIALS: Medical history and dental and sociodemographic parameters of 4,255 subjects were checked for correlations with frequent headache using a multivariate logistic regression model. The quality of life of the headache sufferers was evaluated with a questionnaire on mental and physical health. RESULTS: Of the sample, 9% reported suffering from frequent headache. Significant values for the odds ratios for the whole sample were found for pain on palpation of the masticatory muscles; the anamnestic question on masticatory muscle pain; ear noises; lateral palpation pain of the temporomandibular joints (TMJ); several sleep disorders; psychosomatic complaints; and risk for women. Palpation pain of the muscles showed a dose/response effect. Subjects with a higher education level had a significantly reduced risk for developing frequent headache. Anamnestic questions for pain in the TMJ area, TMJ clicking, smoking, alcohol abuse, contraceptives, income, and chronic diseases did not correlate significantly with frequent headache. Subjects who reported frequent headache exhibited a significant reduction of physical and mental health scores. Pain upon muscle palpation showed significantly reduced scores on both scales for both genders. CONCLUSION: Within the limitations of this study, in addition to sensitive TMJs, mainly palpation-sensitive masticatory muscles showed a significant relation to the occurrence of frequent headache. Because of the number of tested covariates originally included in the model, this relation seems essential.

Adult↗
PubMed2004

Gender differences in the relationship between periodontal disease, tooth loss, and atherosclerosis.

BACKGROUND AND PURPOSE: Males carry a disproportionate burden of cardiovascular disease. Because males also bear a higher burden of periodontal disease, we investigated the existence of gender differences in the postulated relationship between periodontal infections, tooth loss, and subclinical atherosclerosis. METHODS: A total of 1710 randomly enrolled participants between the ages of 45 and 75 with no history of myocardial infarction or stroke received a clinical periodontal examination, carotid scan using high-resolution B-mode ultrasound, and extensive measurements for conventional cardiovascular risk factors (age, education, smoking, alcohol, body mass index, diabetes, systolic blood pressure, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, and triglycerides) as well as markers of healthy lifestyle and social network. RESULTS: In both genders, measures of current and long-term periodontitis worsened as tooth loss increased. In males but not females, an approximately 10% difference in carotid artery plaque prevalence was observed between the lowest and highest tertiles of tooth loss (P<0.05) and long-term periodontitis (P=0.05) after multivariate adjustment. Similar patterns were observed for intima-media thickness. The influence of gender on carotid artery plaque prevalence was most evident among the younger age group (<59 years). Between genders, carotid plaque prevalence differed by 10%, 15%, and 25% across increasing levels of tooth loss, and by 5%, 15%, and 25% across increasing levels of long-term periodontitis. CONCLUSIONS: Our data suggest that tooth loss and long-term periodontitis are related to subclinical atherosclerosis in men but not women. Gender variations in cardiovascular morbidity or mortality may be explained partly by the differential contributions of novel risk factors across genders.

Aged↗
PubMed2004

Hepatitis B and C virus infection and the risk of atherosclerosis in a general population.

BACKGROUND: The development of atherosclerosis has an inflammatory component. Currently it is not clear, whether hepatitis B and C virus infections are associated with the risk of atherosclerosis. The aim of the present analysis was to investigate those relationships in a population sample. METHODS AND RESULTS: The study of health in Pomerania (SHIP) is a cross-sectional study of the adult population in the northeast of Germany. HBs antigen (HBsAg) and IgG antibodies against hepatitis B and C virus (anti-HBs and anti-HCV) were determined by enzyme linked immunosorbent assays. Fifteen subjects (0.4%) were positive for HBsAg, and 21 subjects (0.5%) were positive for anti-HCV. Among the persons who had no history of anti-hepatitis B vaccination, 213 individuals (5.0%) were found to be as positive for anti-HBs. These individuals and those with prevalent anti-HCV antibodies were regarded as cases (n = 233). The control group comprised of 4033 individuals. Multivariable analyses revealed that there was no independent association between anti-HBs and anti-HCV antibody seropositivity and atherosclerotic end-points such as prevalent myocardial infarction, stroke, carotid intima-media thickness (IMT), carotid plaques and stenoses. CONCLUSION: There is no association between serological markers for hepatitis B and C virus infection and the risk of atherosclerosis in this population sample.

Adult↗
PubMed2004

Candidate genetic markers and the risk of restenosis after coronary angioplasty.

The aim of the present study was to test for possible associations between candidate gene polymorphisms and the risk of restenosis and recurrent restenosis after percutaneous transluminal coronary angioplasty (PTCA) without stenting. We followed up 511 PTCA patients, and restenosis and recurrent restenosis were defined according to angiographical criteria. Genotyping of the beta-fibrinogen -455 G/A, glycoprotein (GP) IIIa PlA1/PlA2, plasminogen activator inhibitor-1 (PAI-1) 4G/5G, factor V Leiden 1691 G/A, tumour necrosis factor alpha (TNFalpha) -238 G/A, TNFalpha -308 G/A, interleukin (IL)-1alpha -889 C/T, IL-1beta -511 C/T, methylenetetrahydrofolate reductase (MTHFR) 677 C/T and endothelial nitric oxide synthase (eNOS) 4 b/a gene polymorphisms was performed by PCR and restriction-fragment-length-polymorphism-based techniques. One hundred and sixty patients (31.3%) developed restenosis and in 130 of these patients, of whom 123 were available for analysis, a second PTCA without stenting was performed. Of these patients, 35 (28.5%) developed recurrent restenosis. None of the investigated genotypes were associated with the risk of restenosis or recurrent restenosis after PTCA. The degree of stenosis before and immediately after PTCA and the severity of the lesion were independent predictors for restenosis after PTCA. In conclusion, there was no association between the beta-fibrinogen -455 G/A, GP IIIa PlA1/A2, PAI-1 4G/5G, factor V Leiden 1691 G/A, TNFalpha -238 G/A, TNFalpha -308 G/A, IL-1alpha -889 C/T, the IL-1beta -511 C/T, MTHFR 677 C/T and eNOS 4 b/a gene polymorphisms and the risk of restenosis after PTCA as well as recurrent restenosis after repeated PTCA.

Angioplasty, Balloon, Coronary↗