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Biomedical subjects

D De Bacquer

Publications and source records attributed to D De Bacquer.

At least 73 records · Page 4Linked to original sources
PubMed1997

[Hypercholesterolemia in Belgium in 1996: an epidemiological viewpoint].

The authors review the epidemiological evidence linking causally the level of blood cholesterol to coronary heart disease. The evidence is based both on analytical and experimental epidemiology. They review also the two strategies of prevention: the strategy of screening for the detection of "high risk" subjects and the "population" or mass approach. The distribution of blood cholesterol in Belgium according to the Belgian Interuniversity Research on Nutrition and Health (BIRNH) data is presented. Finally, blood cholesterol is placed within a multifactorial prevention perspective using the Framingham equations. The multifactorial approach is now based on different instruments among which the graphs published by the European Society of Cardiology which are "user friendly".

Adult↗
PubMed1996

Apolipoprotein E polymorphism in middle-aged Belgian men: phenotype distribution and relation to serum lipids and lipoproteins.

Apo E phenotype was determined in 760 Belgian men, aged 35 to 59 years. Serum lipids and lipoproteins were related to the apo E polymorphism in 734 participants. By comparison with the most frequent apo E3/3 phenotype, the presence of the epsilon2 allele was associated with a lower serum total and non-HDL cholesterol, and with a lower apo B and a higher HDL cholesterol, independently of age, lifestyle factors and apo E concentration. In contrast, the presence of the epsilon4 allele was associated with a higher serum total and non-HDL cholesterol, and with a lower HDL cholesterol and a lower apo AI. The apo E phenotype explained 17.4% of the variance in apo E concentration; the proportion of the variance in total cholesterol, HDL cholesterol, apo AI and apo B levels explained by the apo E polymorphism was low but statistically significant. Among the lifestyle factors, waist to hip ratio was the only variable significantly associated with apo E concentration. The data suggest that besides the well-documented increasing effect on non-HDL cholesterol, the epsilon4 allele could further predispose to coronary heart disease through a decreasing effect on HDL while the epsilon2 allele could exert a protective influence through both a decreasing effect on non-HDL cholesterol and an increasing effect on HDL cholesterol.

Adult↗
PubMed1996

Determinants of lipoprotein(a) levels in a middle-aged working population.

BACKGROUND: The association between blood lipids, apolipoproteins, fibrinogen, life-style-related factors and lipoprotein(a) was assessed in a cohort of middle-aged men. METHODS: Male employees, working in local industry, were invited to participate in a health survey at their worksite. After exclusion of nine persons with prevalent diabetes and 14 subjects with a history of myocardial infarction or angina, data were available on 720 healthy Caucasian men. RESULTS: Lipoprotein(a) concentration was measured using an enzyme-linked immunosorbent assay (ELISA), and distribution was found to be highly skewed with a median level of 9 mg.dl-1 (mean level 23.1 mg.dl-1). The percentage of subjects with lipoprotein(a) levels higher than 30 mg.dl-1 was 23.6%. Univariate analysis showed a significant association between lipoprotein(a) and age, total cholesterol, apolipoprotein B and fibrinogen. However, no relationship was found with body mass index, waist to hip ratio, smoking, blood pressure, alcohol consumption, diet, HDL cholesterol, apolipoprotein AI and apolipoprotein E concentration or apolipoprotein E polymorphism. In multivariate analysis, In-transformed lipoprotein(a) correlated positively with apolipoprotein B (P < 0.0001) and fibrinogen (P = 0.004). Proportional changes in lipoprotein(a) concentration were predicted in relation to specified changes in biochemical and lifestyle variables. A 20 mg.dl-1 increase in apolipoprotein B and a 75 mg.dl-1 increase in fibrinogen levels were estimated to increase lipoprotein(a) concentration by 29.4% and 21.5% respectively. CONCLUSIONS: Our data confirm the existence of an independent association between lipoprotein(a) and fibrinogen and give evidence for correlation with apolipoprotein B.

Adult↗
PubMed1995

Accuracy of aortic stenosis severity assessment by Doppler echocardiography: importance of image quality.

UNLABELLED: The aim of the present study was to investigate which factors could influence the accuracy of aortic stenosis severity assessment by Doppler echocardiography in an unselected population. Doppler echocardiographic determination of mean transvalvular pressure gradient and aortic valve area by continuity equation was performed in 101 patients before catheterization. According to the catheterization data, aortic stenosis was classified into 2 categories: mild to moderate (orifice area [Gorlin formula] > 0.75 cm2, mean transvalvular gradient < 50 mmHg) and severe (orifice area < or = 0.75 cm2, mean transvalvular gradient > or = 50 mmHg). The influence of eight factors on the absolute difference in aortic valve area and mean transvalvular pressure gradient and on the concordant classification in the same category by both methods was investigated. RESULTS: By multivariate analysis, the absolute difference in aortic valve area by both methods was significantly associated with poor image quality, absolute difference between mean catheterization and Doppler transvalvular gradient and inversely related to body mass index. Absolute difference in mean transvalvular gradients by both methods was significantly associated only with image quality. Poor image quality emerged as the only significant factor influencing the concordant classification between invasive and noninvasive studies according to orifice area (but not according to transvalvular pressure gradient). CONCLUSION: Echographic image quality significantly influences the accuracy of Doppler echocardiographic determination of aortic valve area and, to a lesser extent, of transvalvular pressure gradient. Therefore, the mere noninvasive approach is not suitable to every consecutive patient with aortic stenosis. Qualifications concerning overall image quality should identify patients most likely to benefit from catheterization.

Adolescent↗
PubMed1995

Prevalences and correlates of ECG abnormalities in the adult Belgian population.

Data from 5,817 men and 5,215 women (age range, 25-74 years) who participated in the Belgian Interuniversity Research on Nutrition and Health were used to determine prevalences and associated variables of different abnormalities on the resting electrocardiogram. Electrocardiographic abnormalities were coded according to the Minnesota classification system. About one third of the subjects showed one or more abnormalities on their electrocardiogram. Major abnormalities occurred in 7.3% of the men and in 4.6% of the women. The prevalence of minor abnormalities was twice as high. Minnesota codes 4 (ST abnormalities) and 5 (T wave changes) were found to be the most prevalent in both sexes (9.6 and 10.5% respectively in women and 8.4 and 9.1% respectively in men), while code 2 (QRS axis deviation, 7.9%) and code 7 (ventricular conduction defect, 8.7%) were quite common in men. Most prevalences were rather log-linearly related with age, except codes 6 (atrioventricular conduction defect) and 9 (miscellaneous items). In the asymptomatic subjects, blood pressure showed the strongest positive correlation with minor ST-T abnormalities in both men and women independent of other factors. Other correlates identified by multivariate analyses were serum potassium, serum phosphor, and serum uric acid levels, as well as the intake of diuretics. However, any major, minor, and ST-T abnormalities were, according to sex, differently related to those correlates.

Adult↗
PubMed1995

Tricuspid valve replacement: postoperative and long-term results.

A series of 146 consecutive patients who underwent tricuspid valve replacement at the University Brugmann Hospital between 1967 and 1987 was reviewed. Mean age at operation was 51.4 years (+/- 12.1 years). Different types of prostheses were implanted including porcine and bovine pericardial bioprostheses and older and bileaflet mechanical valves. Most patients were severely disabled by their cardiac disease before operation, with 30.1% in New York Heart Association functional class III and 69.9% in class IV. Operative mortality and hospital mortality rates (30 days) were high (16.4%). Incremental risk factors for hospital death included icterus (p < 0.005), preoperative hepatomegaly (p = 0.012), and New York Heart Association functional class IV (p = 0.013). Multivariate analysis only selected preoperative icterus (p < 0.01) as being independently significantly related to hospital mortality. The hospital survivors were followed up for a median of 94 months. A complete follow-up was available for all patients except two for 30 months or more. At 30 months the only two significant parameters were the type of myocardial protection (p = 0.024) and the year of operation (before 1977 or after [precardioplegia era or after], p = 0.011). There were 70 late deaths during the entire follow-up period. The univariate (log-rank statistics) incremental risk factor for late death was the type of tricuspid prosthesis (Smeloff-Cutter and Kay-Shiley versus St. Jude Medical versus bioprosthesis) (p = 0.04). A trend was observed for the type of operative myocardial protection (normothermia and coronary perfusion) (p = 0.06) and preoperative New York Heart Association functional class IV (p = 0.055). Actuarial survival was 74% at 60 months and 23.4% at 180 months. Cumulative follow-up added up to 1015 patient-years. In a more detailed analysis of the effect on survival of the type of tricuspid prosthesis, a significant difference was observed between the bioprostheses and some older mechanical prostheses (Smeloff-Cutter and Kay-Shiley) (p = 0.04) but not between the bioprostheses and the bileaflet valves (p = 0.15). When the follow-up period was stratified according to less than 7 years and more than 7 years of follow-up, no difference was observed for the first period, but for the late follow-up the new mechanical prostheses did better than the bioprostheses (p = 0.05), suggesting a degradation of the bioprostheses after 7 years and favoring mechanical prostheses for those patients with a good long-term prognosis.

Actuarial Analysis↗
PubMed1995

The management of non-compliance with referral to out-patient after-care among attempted suicide patients: a controlled intervention study.

The failure to comply with referral for out-patient after-care is a well-documented problem among attempted suicide patients. The present study aimed at the investigation of an experimental referral procedure by means of a randomized controlled study. Non-compliant patients in the experimental group were visited in their homes by a community nurse in order to assess reasons for non-compliance and to motivate patients to comply with referral. One year after their suicide attempt patients were visited in their homes in order to assess repetition of suicidal behaviour. Uni- and multi-variate analyses showed a significant beneficial effect of the experimental procedure on compliance with referral. A near-significant effect of the experimental procedure on the rate of repetition of suicidal behaviour was found.

Adolescent↗
PubMed1995

Relation of fibrinogen to lifestyles and to cardiovascular risk factors in a working population.

BACKGROUND: The association between fibrinogen and smoking behaviour, age, body mass index, blood pressure, heart rate and plasma lipid profile, was assessed in a cohort of middle-aged working men. METHODS: Seven hundred and forty five subjects were examined as part of a health intervention programme at the work-site. Nine subjects were excluded from the study because of prevalent diabetes. Correlates of plasma fibrinogen concentrations were evaluated through univariate and multivariate methods. RESULTS: In multiple regression analysis fibrinogen correlated with age, smoking behaviour, apolipoprotein B (apo B) apolipoprotein A-I (apo A-I) and lipoprotein (a) (Lp(a)) levels, which together explained 11% of the variation in fibrinogen concentration. From this model, fibrinogen concentration was associated with an increase of 13.6 mg/dl for every 10 years' increase in age, 28.2 mg/dl if a person smoked, and 4.6 mg/dl and 3.8 mg/dl with a 20 mg/dl rise in respectively apo B and Lp(a). A 20 mg/dl increase in apo A-I concentrations was estimated to be associated with a 6.0 mg/dl lower fibrinogen level. CONCLUSION: The data indicate that both biochemical and lifestyle factors are related to the plasma fibrinogen concentration; these interactions may explain partly the relationship between fibrinogen and cardiovascular disease.

Adult↗
PubMed1994

Epidemiological evidence for an association between serum calcium and serum lipids.

To study the association between serum calcium and serum lipids, data from 5394 men and 4800 women in the Belgian Interuniversity Research on Nutrition and Health (25-74 years) were used. By visual inspection of the data a linear increase of both total and HDL cholesterol with serum calcium levels was observed, consistently over all age groups and both sexes. In order to adjust the measured serum calcium concentrations for total serum protein, statistical analyses were performed using Parfitt's correction formula. Multivariate analysis showed in both sexes a highly significant positive association between corrected calcium and total cholesterol independent of age, systolic blood pressure, body mass index, serum uric acid, P/S ratio of diet, cholesterol intake, smoking, educational level and geographical area. The adjusted differences in total cholesterol between the lowest and highest quartile range of the calcium distribution were about 13 mg/dl for both men and women. Protein-corrected calcium was among the strongest correlates with total cholesterol. The analysis of the relation with HDL cholesterol revealed an effect modification by gender. For men no statistically significant correlation between calcium and HDL cholesterol was observed while for women a strong increase of HDL with protein-corrected calcium was found resulting in an adjusted difference of 2.5 mg/dl between the lowest and highest calcium quartile range.

Adult↗
PubMed1994

The predictive value of electrocardiographic abnormalities for total and cardiovascular disease mortality in men and women.

The relationship between ECG abnormalities and mortality was studied in 4797 males and 4320 females aged 25 to 74 years who took part in the Belgian Inter-university Research on Nutrition and Health (The BIRNH study). At entry all were free of angina, had no history of acute myocardial infarction and showed no evidence of an old infarction on their baseline ECG. They were followed for an average of 5.6 years, and follow-up for vital status was completed satisfactorily in 99.5%. ECG abnormalities were grouped using several classifications: any abnormality, major and minor abnormalities, ischaemic changes, left ventricular hypertrophy and the separate Minnesota codes IV (ST depression), V (abnormal T-wave) and VIII (arrhythmias). Using logistic regression analysis, adjustment of odds ratios for cardiovascular disease (CVD) mortality was done for age, systolic blood pressure, serum total cholesterol and uric acid, diabetes, smoking and antihypertensive drug treatment. Men outnumbered women more than twice in total and CVD mortality. Multivariate analysis showed that the presence of major abnormalities on the ECG was significantly related to CVD mortality in both men and women (adjusted odds ratios 2.73 and 4.40 respectively). In contrast, minor abnormalities were not independently associated with CVD mortality. In men, ST depression (OR = 5.58), signs of an ischaemic ECG (OR = 3.02) and an abnormal T-wave (OR = 2.58) were independently related to CVD mortality. In women primarily a ST depression (OR = 5.87) and arrhythmias (OR = 4.22) had a significant independent effect on CVD mortality.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Use of pharmaceuticals in industrial workers--possible implications for epidemiological studies.

A total of 129 workers exposed to carbon disulphide (CS2) and 81 non-exposed controls were asked about their current use of pharmaceuticals, using a self-administered questionnaire. In all, 31% of the exposed and 19.8% of the non-exposed used some medicine (P = 0.08). The average number of pharmaceuticals per subject amounted to 0.71 in the exposed vs. 0.36 in the non-exposed (P = 0.049). Predominant types of medicines used were analgesics (12.4% in the exposed vs. 8.6% in the non-exposed, P = 0.50) and sedatives/hypnotics (10.1% in the exposed vs. 4.9% in the non-exposed, P = 0.21). The pharmaceuticals consumed can cause numerous (side) effects that are similar to the toxic effects of CS2. To take into account these possibly confounding agents, a classification system for possible (side) effects of pharmaceuticals was developed, taking the dose into account. According to this method, many (side) effects of pharmaceuticals that could occur were recorded with higher frequency and intensity in the exposed subjects. Potential (side) effects that occurred significantly more frequently in the exposed than in the non-exposed were: tiredness, sedation, dizziness (20.9% vs. 4.9%, P = 0.001), excitation, anxiety (10.9% vs. 2.5%, P = 0.03), vision disturbances (7.0% vs. 0%, P = 0.01), and erection decrease (5.4% vs. 0%, P = 0.045). The implications of these findings for epidemiological studies are discussed.

Adult↗
PubMed1992

Epidemiological study of the cardiovascular effects of carbon disulphide.

In an extensive health survey 115 male viscose rayon workers exposed to carbon disulphide (CS2) and 76 referents not exposed to this chemical were interviewed using the WHO cardiovascular questionnaire and responded to a self-administered questionnaire. A 12-lead ECG was taken and coded using the Minnesota code. Blood pressure (BP) was measured electronically and blood was examined for lipoproteins. In the viscose rayon factory the working conditions had not changed since 1932. Personal monitoring performed in 17 jobs, showed exposures varying from 4 to 112 mg/m3. For each individual a CS2 cumulative exposure index (CS2 index) was calculated. There were no significant differences between exposed and referents concerning the prevalence of angina, history of myocardial infarction, intermittent claudication and ECG signs of ischaemia. Blood pressure, low density lipoprotein (LDL)-cholesterol and the apolipoproteins A1 and B rose while high density lipoprotein (HDL)-cholesterol, the HDL-cholesterol/apolipoprotein A1 and the LDL-cholesterol/apolipoprotein B ratios decreased significantly with increasing exposure. Adjustment for age, body mass index, smoking, alcohol consumption, stress and tension at work, shift work, noise exposure and educational level in multiple linear regression analysis showed significant effects of the CS2 index on systolic BP, diastolic BP, cholesterol, HDL-cholesterol, LDL-cholesterol, apolipoprotein A1, apolipoprotein B, the LDL cholesterol/apolipoprotein B and HDL cholesterol/apolipoprotein A1 ratios; there were no significant effects on the triglycerides.

Adult↗
PubMed1992

Plasma lipoprotein(a) values and severity of coronary artery disease in a large population of patients undergoing coronary angiography.

To determine possible associations between lipoprotein(a) [Lp(a)] and the severity of coronary artery lesions, we measured lipid, apolipoprotein, and Lp(a) in a large population of Belgian patients (n = 1054) undergoing coronary angiography. In both women and men, univariate analysis demonstrated significant differences in the Lp(a) concentrations according to the severity of the coronary stenosis. However, after adjustment for possible confounding factors, many of these differences were attenuated, indicating that other variables that differentiate patients from control subjects also influence Lp(a) distribution. Differences in lipid, apolipoprotein, and Lp(a) concentrations between male and female patients are discussed.

Adult↗
PubMedDate not supplied

Epidemiological study of endocrinological effects of carbon disulfide.

One hundred seventeen viscose rayon workers exposed to carbon disulfide, and 66 workers who were not exposed to any toxic agent in the working environment, underwent an endocrinological examination that included determination of thyroxine, luteinizing hormone, follicle-stimulating hormone, prolactin, and testosterone in serum by radioimmunoassay methods. In the viscose rayon factory, the working conditions had not changed subsequent to 1932. Personal monitoring performed in 17 jobs showed that carbon disulfide exposures varied from 4 to 112 mg/m3. A carbon disulfide cumulative exposure index was calculated for each individual. Univariate analysis of the hormone levels versus exposure showed significantly lower levels of prolactin in the exposed versus nonexposed subjects (p = .01). After adjustment for age, alcohol, smoking, body mass index, and stress level, the carbon disulfide cumulative exposure index was not associated with any of the hormones. This discrepancy from previous studies may result from differences in exposure, in selection of the population, or in confounding biases.

Adult↗
PubMedDate not supplied

Epidemiological study of the effects of carbon disulfide on male sexuality and reproduction.

One hundred sixteen male viscose rayon workers exposed to carbon disulfide and 79 other workers, who were not exposed to any toxic agent in the working environment, were asked about their sexual behavior and reproductive record. Forty-three exposed and 35 nonexposed men provided a semen sample. The relationship with occupational exposure was analyzed with univariate and multivariate methods. The results indicate a significant effect of carbon disulfide exposure on libido and potency, but no effects were noted on fertility nor on semen quality.

Adult↗
PubMedDate not supplied

Cardiovascular effects in viscose rayon workers exposed to carbon disulfide.

The objectives of this study were to investigate the cardiovascular effects in workers currently exposed to carbon disulfide (CS2) below the threshold limit value (TLV) of 31 mg/m3 and to determine the prevalence of coronary heart disease (CHD) after long-term exposure. 172 men (91 workers exposed to CS2 in a viscose rayon factory and 81 referent workers) were examined using a medical and job history questionnaire, Rose's questionnaire, and electrocardiography at rest, and by measuring blood pressure and serum lipids and lipoproteins. Personal exposures were monitored simultaneously with active sampling and findings were analyzed according to the NIOSH 1600 method. As a result of technical and organizational improvements, personal CS2 exposures were well below the TLV (5.4-13.02 mg/m3). No significant effect of CS2 on blood pressure or lipids (total cholesterol, HDL and LDL cholesterol, triglycerides, and apolipoproteins AI and B) was found, even after allowance for confounding factors. The prevalence of CHD (ECG abnormalities and chest pain) was higher in the viscose rayon workers than in the workers with no exposure but reached statistical significance for men with exposure histories often years and more only (cumulative CS9 index > or = 150 mg/m3, the most highly exposed group). The findings suggest that the coronary risk is increased in workers previously exposed to high CS2 concentrations but not in those exposed to CS2 levels below the current TLV.

Adult↗