Biomedical subjects

D R Labarthe

Publications and source records attributed to D R Labarthe.

At least 19 recordsLinked to original sources

PubMed2001

Community-wide coronary heart disease mortality in Mexican Americans equals or exceeds that in non-Hispanic whites: the Corpus Christi Heart Project.

PURPOSE: Previous comparisons of coronary heart disease mortality between Mexican Americans and non-Hispanic whites have given paradoxic results: despite their adverse cardiovascular risk profiles, especially a greater prevalence of diabetes, Mexican Americans are reported to have lower rates of mortality from coronary heart disease. SUBJECTS AND METHODS: We performed a community-based surveillance among all residents of Nueces County, Texas, aged 25 to 74 years, from 1990 to 1994. All death certificates were obtained and coded, and deaths potentially related to coronary heart disease were selected and validated by standardized methods blinded to ethnicity. Validated in-hospital and out-of-hospital coronary heart disease mortality was compared between 785 Mexican Americans and 862 non-Hispanic white women and men. RESULTS: Validated coronary heart disease mortality in Mexican Americans exceeded that for non-Hispanic whites in the same community. Among women, definite coronary heart disease mortality was 40% greater among Mexican Americans (rate ratio [RR] 1.43, 95% confidence interval [CI]: 1.12 to 1.82), as was all coronary heart disease mortality (RR, 1.32, 95% CI: 1.08 to 1.63). Among men, Mexican Americans had greater rates of all (RR, 1.11; 95% CI: 0.96 to 1.28) and definite coronary heart disease mortality (RR, 1.16; 95% CI: 0.91 to 1.47), but the associations were not statistically significant. CONCLUSIONS: When community-wide mortality rates from coronary heart disease are properly validated, Mexican Americans have rates equal to or higher than those of non-Hispanic whites. Community-based surveillance with validation of coronary heart disease as the cause of death is necessary to avoid the errors that occur with the use of death certificates alone.

Adult↗

PubMed2001

Birth cohort evidence of population influences on blood pressure in the United States, 1887-1994.

PURPOSE: Mean blood pressure (BP) has declined in the U.S. for several decades. It is unknown to what extent this decline was due to treatment of persons with recognized high BP or to population-wide influences on BP. Treatment would shift only the highest values lower, whereas, population-wide influences on BP would shift the entire distribution downward. METHODS: We examined changes in the distributions of systolic and diastolic BP (SBP, DBP) across birth cohorts born between 1887 and 1975 in 52,646 individuals examined in the National Health (and Nutrition) Examination Surveys between 1960 and 1994. The BP distributions were estimated as functions of age and birth-year to examine changes between birth cohorts. We postulated that the age-adjusted 10th, 50th and 90th percentiles of SBP and DBP had decreased in more recent versus earlier birth cohorts. RESULTS: The series of birth cohorts exhibited successively lower SBP and DBP at low, middle and high percentiles. In general, the 10th percentile of SBP decreased approximately 1.19 mmHg per decade of birth-year, whereas the 50th percentile decreased 2.40 mmHg per decade, and the 90th percentile decreased 4.62 mmHg per decade. A similar pattern of results was seen for DBP. CONCLUSIONS: The entire distribution of both SBP and DBP shifted downward. The downward shifts at the 50th percentile and below unequivocally demonstrate a strong prevention effect in the U.S. population during the period 1887 through 1975. This epidemiologic analysis indicates that population-wide influences can alter favorably the distribution of BP throughout the whole population.

Adolescent↗

PubMed2001

Tracking body fat distribution during growth: using measurements at two occasions vs one.

OBJECTIVE: To investigate whether within-individual variation is a factor in the generally reported poor tracking of central body fat distribution (CBFD) during development and whether two measurements of CBFD during each measurement occasion would improve the estimate of tracking over time. METHODS: A longitudinal study compared the results of two measurements of body fat (BF) and CBFD during each measurement occasion to the results of one measurement of BF and CBFD during each occasion every 4 months over 1-3 y. A total of 345 boys and 333 girls in three age cohorts of 8, 11 and 14 y at baseline were examined. BF variables were: body mass index (BMI); fat mass and percentage body fat from bioelectrical impedance; two skinfold sums; and abdominal circumference. CBFD variables were: waist/hip and waist/thigh ratios; conicity; and log upper-lower skinfold ratio. RESULTS: Three-year tracking of BF varied from 0.79 to 0.90 for one- and from 0.81 to 0.93 for two-occasion measurements showing no apparent sex- or cohort-effects. Three-year tracking of CBFD was lower than that of BF (0.68-0.75), but improved significantly with two-occasion measurements (0.75-0.82). CONCLUSIONS: Within-individual variation is a significant factor in reported low tracking of CBFD in childhood. Estimates of tracking currently in the literature may underestimate the predictive value of CBFD, possibly because this research has used one-occasion measurement. The increased use of two-occasion measurement should significantly improve the tracking of CBFD during development and provide a more realistic understanding of its predictive value.

Adipose Tissue↗

PubMed2000

[Pattern of the distribution of total cholesterol and cHDL cholesterol Spanish children and adolescents: RICARDIN Study].

BACKGROUND: The RICARDIN Study multicenter study of cardiovascular risk factors in children and adolescents has described the standards of normality of blood cholesterol levels in the Spanish school population. The objective of the present study was to compare mean values of cholesterol between different regions of Spain, and to compare the global mean with a pool international study. Also, the pattern of total cholesterol and cHDL by age and sex using mathematical model is described, and comparison with two international studies carried out in USA and Japan is performed. SUBJECTS AND METHODS: 10,683 children aged 6 to 18 were selected from 7 different Spanish provinces (Madrid, Vizcaya, Lugo, Badajoz, Murcia, Asturias and Barcelona). Blood samples were obtained by capilar puncture (Reflotron). RESULTS: Mean values of total cholesterol was different among provinces, and globally, were lower than the international pooled population, although the pattern observed in each population was very similar. Total cholesterol curve for Spanish boys showed a curvilinear trend that can be estimated through a cubic function that explains 89% of observed data, while for girls the best estimate was obtained through an inverse function (R2 = 0.40). cHDL for boys showed a cubic function as the best estimate (R2 = 0.90), while for girls the best estimate was obtained through a quadratic function (R2 = 0.59). CONCLUSIONS: There are important physiological variations of total cholesterol level by age and sex in children and adolescents. The pattern of cholesterol does not follow a linear model but a curvilinear one, that need to be considered in clinically assessing individual determinations of cholesterol, since highest percentiles can vary by age and sex.

Adolescent↗

PubMed2000

Change in level of physical activity and risk of all-cause mortality or reinfarction: The Corpus Christi Heart Project.

BACKGROUND: The role of physical activity (PA) in reducing the risk of all-cause mortality or reinfarction after a first myocardial infarction (MI) remains unresolved, particularly for minority populations. The association between change in level of PA and risk of death or reinfarction was studied in 406 Mexican American and non-Hispanic white women and men who survived a first MI. METHODS AND RESULTS: MI patients were interviewed at baseline and annually thereafter about PA, medical history, and risk factors of coronary heart disease. Change in level of PA after the index MI was categorized as (1) sedentary, no change (referent group), (2) decreased activity, (3) increased activity, and (4) active, no change. Over a 7-year period, the relative risk (95% CI) of death was as follows: 0.21 (0.10 to 0.44) for the active, no change group; 0.11 (0.03 to 0.46) for the increased activity group; and 0.49 (0.26 to 0.90) for the decreased activity group. The relative risk of reinfarction was as follows: 0.40 (0.24 to 0.66) for the active, no change group; 0.22 (0.09 to 0.50) for the increased activity group; and 0.93 (0.59 to 1.42) for the decreased activity group. CONCLUSIONS: These findings are consistent with a beneficial role of PA for Mexican American and non-Hispanic white women and men who survive a first MI and have practical implications for the management of MI survivors.

Adult↗

PubMed2000

Effect of a community intervention on patient delay and emergency medical service use in acute coronary heart disease: The Rapid Early Action for Coronary Treatment (REACT) Trial.

CONTEXT: Delayed access to medical care in patients with acute myocardial infarction (AMI) is common and increases myocardial damage and mortality. OBJECTIVE: To evaluate a community intervention to reduce patient delay from symptom onset to hospital presentation and increase emergency medical service (EMS) use. DESIGN AND SETTING: The Rapid Early Action for Coronary Treatment Trial, a randomized trial conducted from 1995 to 1997 in 20 US cities (10 matched pairs; population range, 55,777-238,912) in 10 states. PARTICIPANTS: A total of 59,944 adults aged 30 years or older presenting to hospital emergency departments (EDs) with chest pain, of whom 20,364 met the primary population criteria of suspected acute coronary heart disease on admission and were discharged with a coronary heart disease-related diagnosis. INTERVENTION: One city in each pair was randomly assigned to an 18-month intervention that targeted mass media, community organizations, and professional, public, and patient education to increase appropriate patient actions for AMI symptoms (primary population, n=10,563). The other city in each pair was randomly assigned to reference status (primary population, n=9801). MAIN OUTCOME MEASURES: Time from symptom onset to ED arrival and EMS use, compared between intervention and reference city pairs. RESULTS: General population surveys provided evidence of increased public awareness and knowledge of program messages. Patient delay from symptom onset to hospital arrival at baseline (median, 140 minutes) was identical in the intervention and reference communities. Delay time decreased in intervention communities by -4.7% per year (95% confidence interval [CI], -8.6% to -0.6%), but the change did not differ significantly from that observed in reference communities (-6. 8% per year; 95% CI, -14.5% to 1.6%; P=.54). EMS use by the primary study population increased significantly in intervention communities compared with reference communities, with a net effect of 20% (95% CI, 7%-34%; P<.005). Total numbers of ED presentations for chest pain and patients with chest pain discharged from the ED, as well as EMS use among patients with chest pain released from the ED, did not change significantly. CONCLUSIONS: In this study, despite an 18-month intervention, time from symptom onset to hospital arrival for patients with chest pain did not change differentially between groups, although increased appropriate EMS use occurred in intervention communities. New strategies are needed if delay time from symptom onset to hospital presentation is to be decreased further in patients with suspected AMI. JAMA. 2000;284:60-67

Acute Disease↗

PubMed2000

Comparison of stroke hospitalization rates among Mexican-Americans and non-Hispanic whites.

The authors performed a prospective, community-based pilot stroke surveillance project in Nueces County, TX. Mexican-Americans showed a trend toward higher completed ischemic stroke hospitalization rates compared with non-Hispanic whites. Mexican-Americans were more commonly uninsured (p = 0.007) and were less likely to receive neuroimaging (p = 0.001). Additional studies are needed to confirm this finding and to determine the role of stroke risk factors and access to care variables.

Aged↗

PubMed1999

Prevention of cardiovascular risk factors in the first place.

Cardiovascular disease (CVD) prevention can address the major risk factors-blood lipids, blood pressure, and smoking-and their determinants throughout the lifespan, with approaches varying according to age and risk. The Task Force on Research in Epidemiology and Prevention of Cardiovascular Diseases gave new impetus to the concept of early intervention: Their highest priority in CVD prevention was "to prevent the development of CVD risk in the first place." Six issues follow: (1) the relation between "primordial prevention" of CVD and "prevention of the risk factors in the first place"; (2) the place of youth in context with older and younger age groups; (3) the importance of bridging institutional gaps between youth and adulthood; (4) the need to strengthen the scientific base linking the major risk factors (e.g., blood cholesterol concentration) with their determinants; (5) the value of rate of change in risk factors with age, and not only incidence of "treatable" levels of risk factors, as an outcome in assessing interventions; and (6) the role and appropriate design strategies for both observational and intervention studies. It is time for a radical expansion of our investment in preventing the risk factors in the first place.

Adult↗

PubMed1999

Apolipoprotein E affects serial changes in total and low-density lipoprotein cholesterol in adolescent girls: Project HeartBeat!

Apolipoprotein E (apo E) polymorphism is a genetic determinant of lipid and lipoprotein levels and the risk for coronary heart disease. The extent to which serial patterns of change in total cholesterol and low-density lipoprotein cholesterol (LDL-C) concentrations varied by apo E genotype was therefore investigated in 247 Caucasian girls aged 8 to 14 at baseline who were participating in Project HeartBeat!, a mixed longitudinal study of cardiovascular disease (CVD) risk factor development in children. Plasma lipid concentrations were determined for each participant three times per year (every 4 months) for up to 4 years from October 1991 through August 1995. Mean total cholesterol values for individuals with epsilon2/3, epsilon3/3, and epsilon3/4 genotypes were 141.7, 161.6, and 165.9 mg/dL, respectively (P < .001). Corresponding LDL-C values for individuals with epsilon2/3, epsilon3/3, and epsilon3/4 genotypes were 74.6, 94.8, and 98.7 mg/dL, respectively (P < .001). The results of longitudinal modeling indicated that age trajectories for total cholesterol and LDL-C varied significantly by apo E genotype. Individuals with epsilon3/3 and epsilon3/4 genotypes exhibited similar patterns of change in total cholesterol and LDL-C from ages 8 to 18, while individuals with the epsilon2/3 genotype demonstrated a significantly different pattern of change (age2 x genotype interaction, P < .05). For example, individuals with the epsilon2/3 genotype showed a slight increase in total cholesterol from approximately 141 to 146 mg/dL from ages 8 to 10; total cholesterol then decreased monotonically from ages 10 to 18 from 146 to 115 mg/dL. The apo E effect on total cholesterol and LDL-C and their change during adolescence is strong and may be modified by factors affecting growth, maturation, and reproductive function.

Adolescent↗

PubMed1999

Greater stroke rate during hospitalization for acute heart disease among Mexican Americans than non-Hispanic whites.

BACKGROUND AND PURPOSE: This study compared the risk for stroke during acute myocardial infarction (AMI), percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass grafting (CABG) between Mexican Americans (MAs) and non-Hispanic whites. METHODS: We examined the age-specific rate ratios (RR) of acute stroke during hospitalization for AMI, CABG and PTCA in a population-based study in Corpus Christi, Tex. by searching the cardiac surveillance data for ICD-9 codes for stroke (430-437). ICD-9 stroke codes were validated by comparing medical chart abstraction with ICD-9 discharge diagnoses. RESULTS: Stroke codes were found in 220 of the 5,697 admissions for AMI, CABG and PTCA. In the 45- to 59-year age-group MAs had a RR of 2.66 (95% CI 1.36-5.23) relative to non-Hispanic whites. In the 60- to 74-year age-group the RR was 1.52 (95% CI 1.11-2.08). There were no significant differences in the 25- to 44-year age-group. These ethnic relationships were found in nondiabetics but not in diabetics. Women in the 45- to 59-year age-group had a RR of 1.88 (95% CI 1.09-3.25) compared with men, but there were no significant sex differences in the 25- to 44- or 59- to 74-year age-groups. Stroke ICD-9 codes have a poor positive predictive value for acute stroke ranging from 10 to 76%. The stroke misclassifications were nondifferential with respect to ethnicity or sex. CONCLUSIONS: MAs have a higher stroke rate complicating acute heart disease in Corpus Christi. A rigorous stroke surveillance project is needed to study the burden of stroke in MAs, the United States' largest Hispanic population.

Adult↗

PubMed1999

Validity of echocardiographic measurement in an epidemiological study. Project HeartBeat!

In Project HeartBeat!, a longitudinal study of cardiovascular disease risk factors in healthy children and adolescents, 3 samples of 40, 80, and 182 echocardiograms, respectively, were randomly selected and reread to evaluate intraobserver and interobserver variabilities and comparability between measurements of field echocardiographic technicians and reference readings at Texas Children's Hospital. Included in the evaluation were 8 M-mode echocardiographic measurements, ie, aortic root diameter, left atrial diameter, and end-diastolic and end-systolic measurements of interventricular septal thickness, left ventricular (LV) diameter, and LV posterior wall thickness; 8 Doppler measurements; and a calculated LV mass. Means and SDs of the differences of the paired measurements were used to assess the relative bias and random error of the measurements. For the intraobserver comparison, means and SDs of the differences were very small, indicating that the echo measurements were performed consistently by each project echo technician. Interobserver comparison showed statistically but not clinically significant differences between the paired readings of end-diastolic septal thickness, end-systolic LV posterior wall thickness, and 5 Doppler measurements. Comparison with reference readings at Texas Children's Hospital showed significant differences in diastolic LV diameter, systolic septal thickness, and right ventricular ejection time. These differences, however, were minimal with limited clinical significance. Mean differences in LV mass for the corresponding comparisons were -1.82, 4.50, and 0.0013 g, and the SDs were 18.79, 24.16, and 12.35 g, respectively. We conclude that the echocardiographic measurements taken from healthy children in a longitudinal study can be made accurately with acceptable reproducibility.

Adolescent↗

PubMed1997

Summary measures of the insulin resistance syndrome are adverse among Mexican-American versus non-Hispanic white children: the Corpus Christi Child Heart Study.

BACKGROUND: Mexican-American (MA) adults are known to have a greater burden of diabetes and insulin resistance than non-Hispanic white (NHW) people. In this report, we examined data obtained from MA and NHW third-grade children for evidence of a pattern consistent with the insulin resistance syndrome. In addition, we developed two summary measures characterizing insulin resistance syndrome to compare measures of this syndrome among our population. METHODS AND RESULTS: Data regarding fasting insulin, triglycerides, HDL cholesterol, systolic blood pressure, and body mass index (BMI) were available for 403 third-grade children. Median levels of insulin and glucose were significantly higher in MA boys and girls than in NHW boys and girls. Risk factors characterizing insulin resistance, including levels of insulin, triglycerides, systolic blood pressure, HDL cholesterol, and BMI were categorized as above or below the total population median. MA children were more likely than NHW children to have three or more adverse risk factors (55% versus 37%). When risk factors were converted to Z scores, and the five Z scores were summed for each individual, MA boys and girls had higher mean scores than NHW boys and girls (means for boys, 0.65 versus -0.97, P<.0001; girls, 0.52 versus -0.30, P<.04). Principal components analysis was used to create a summary score or index representing the insulin resistance syndrome. This summary score was significantly higher among MA boys and girls than NHW boys and girls (means for boys, 0.34 versus -0.72, P<.0001; girls, 0.35 versus -0.04, P=.056). CONCLUSIONS: Our results support the hypothesis that MA children exhibit a greater degree of the insulin resistance syndrome than NHW children, especially among boys. We conclude that some of the factors responsible for the increased risk of NIDDM seen among MA adults are demonstrable in childhood.

Blood Pressure↗

PubMed1997

Cardiovascular risk factors in Mexican-American and non-Hispanic white children: The Corpus Christi Child Heart Study.

BACKGROUND: Information concerning differences in cardiovascular disease risk factors between Mexican-American and non-Hispanic white children is limited. We conducted a study to determine if there were ethnic differences in cardiovascular disease risk factors in children and whether such differences were explained by differences in body mass index. METHODS AND RESULTS: Fasting glucose, insulin, and blood lipid concentrations, blood pressure, weight, and height were measured in a cross-sectional survey among 403 third-grade children in Corpus Christi, Tex. We found significantly higher fasting insulin and glucose concentrations among Mexican-American than among non-Hispanic white children. Mexican-American boys had slightly lower levels of HDL cholesterol and higher systolic blood pressure than non-Hispanic white boys. Ethnic differences in insulin and glucose were not explained by body mass index. CONCLUSIONS: These results provide preliminary evidence that ethnic differences in insulin, glucose, body mass index, and other risk factors occur as early as age 8 to 10 years. Additional research is warranted on differences in risk factors in Mexican-American and non-Hispanic white children and the potential importance of insulin in influencing the natural history of these characteristics.

Blood Glucose↗

PubMed1997

Development of cardiovascular risk factors from ages 8 to 18 in Project HeartBeat! Study design and patterns of change in plasma total cholesterol concentration.

BACKGROUND: Project HeartBeat! is a longitudinal study of the development of cardiovascular risk factors as growth processes. Patterns of serial change, or trajectories, from ages 8 to 18 years for plasma total cholesterol concentration (TC) and percent body fat illustrate the design and synthetic cohort approach of the study. METHODS AND RESULTS: Six hundred seventy-eight children (49.1% female, 20.1% black) entered the study at ages 8, 11, and 14 years and were followed up with examinations every 4 months for < or = 4 years. Multilevel analysis demonstrated trajectories for population mean values of TC and percent body fat in sex-specific synthetic cohorts from ages 8 to 18 years. Polyphasic patterns of change in TC were confirmed, with notable sex differences in age patterns and with minimum mean values of TC of 3.85 mmol/L for females and 3.59 for males. As illustrated by data for males, the approximate 75th percentile values of mean TC ranged from 4.78 mmol/L at its early peak to 4.06 at its late-teen nadir. Percent body fat exhibited a trajectory closely parallel with that for TC only for males and appeared to be unrelated for females. CONCLUSIONS: The polyphasic trajectory for TC from ages 8 to 18 years differs between females and males, indicates marked age variation in 75th percentile values and, in males only, closely parallels the trajectory for percent body fat. These and other results indicate the value of both follow-up every 4 months across age intervals to detect rapid risk factor change and the synthetic cohort approach for gaining new insights into the dynamics and possible determinants of this change from ages 8 to 18 years.

Adipose Tissue↗

PubMed1997

Greater incidence of hospitalized myocardial infarction among Mexican Americans than non-Hispanic whites. The Corpus Christi Heart Project, 1988-1992.

BACKGROUND: Since Mexican Americans have adverse patterns of risk factors for myocardial infarction relative to non-Hispanic whites, the incidence of myocardial infarction should be greater among Mexican Americans than among non-Hispanic whites. This expectation conflicts with reports generated from death certificate registries. METHODS AND RESULTS: Data regarding myocardial infarction attacks and incident events were collected for a 4-year period in the Corpus Christi Heart Project, a population-based surveillance project for hospitalized coronary heart disease events. For both women and men, Mexican Americans experienced greater hospitalization rates for both attacks and incident events than non-Hispanic whites. Age-adjusted attack rate ratios comparing Mexican Americans with non-Hispanic whites were 1.59 (95% CI, 1.05 to 2.41) and 1.31 (95% CI, 1.18 to 1.45) among women and men, respectively. Corresponding incidence ratios were 1.52 (95% CI, 1.28 to 1.80) and 1.25 (95% CI, 1.10 to 1.42). CONCLUSIONS: This is the first report documenting greater incidence of hospitalized myocardial infarction among Mexican Americans than among non-Hispanic whites, a biologically plausible finding given the risk factor patterns observed in the Mexican-American population. Public health planners and clinicians should be aware of the importance of myocardial infarction as a health problem in the Mexican-American population. Culturally appropriate prevention strategies should be developed for and tested in Mexican-American populations.

Adult↗

PubMed1997

Low birth weight and blood pressure at age 7-11 years in a biracial sample.

The hypothesis that birth weight predicts blood pressure inversely at age 7 through 11 years was examined in 1,446 white children and black children in Washington Parish, Louisiana. Two data sets of the Bogalusa Heart Study were merged: 1) newborn cohort participants (n = 233), initially examined at birth, 1973-1974, and reexamined in 1984-1985 at ages 9 through 11 years; and 2) subjects examined at ages 7 through 11 years in 1987-1988 (n = 1,213) whose birth weight was collected from birth certificates in 1991. The prevalence ratios for being in the race-, sex-, and age-specific upper decile of diastolic blood pressure in children born with low birth weight (< 2,500 g) versus those with birth weight > or = 2,500 g were 0.85 (95% confidence interval 0.28-2.56) for white boys, 2.66 (95% confidence interval 1.24-5.70, p < 0.05) for black boys, 1.38 (95% confidence interval 0.63-3.03) for white girls, and 1.05 (95% confidence interval 0.40-2.75) for black girls. For systolic blood pressure, the corresponding prevalence ratio for each race-sex group did not differ from one. When the analyses were restricted to full-term births, prevalence ratios in any race-sex group did not differ from one for systolic and diastolic blood pressure. In multiple linear regression analyses, the concurrently determined Quetelet index (p < 0.001) was a much stronger correlate of systolic and diastolic blood pressure after appropriate adjustment than was birth weight (p > 0.05). From this study, there is some evidence that low birth weight may determine a risk for subsequent high blood pressure in black boys in the age group 7 through 11 years, but the inconsistency of the results for other race-sex groups was unexpected and remains unexplained, if the underlying hypothesis is true.

Black or African American↗

PubMed1997

Low birth weight and serum lipid concentrations at age 7-11 years in a biracial sample.

The relation between birth weight and serum lipid concentrations at age 7 through 11 years was examined in a sample of 1,411 black children and white children in Washington Parish, Louisiana. Two data sets of the Bogalusa Heart Study were merged: 1) newborn cohort participants (n = 225) initially examined at birth, 1973-1974, and reexamined in 1984-1985 at age 9 through 11 years; and 2) subjects examined at ages 7 through 11 years in 1987-1988 (n = 1,186) whose birth weight was collected from birth certificates in 1991. The prevalence ratios for being in the race-, sex-, and age-specific upper decile of serum lipid concentrations in children born with low birth weight (< 2,500 g) versus those with birth weight > or = 2,500 g were calculated per race-sex group. Among white boys with low birth weight, higher than expected percentages of subjects were in the highest decile group of triglyceride concentrations (0.01 < p < 0.05). The prevalence ratio was 2.42 (95% confidence interval 1.19-4.91). When premature infants were excluded, only for white girls was a greater than expected percentage of subjects with low birth weight found to be in the highest decile group of triglyceride concentrations. The corresponding prevalence ratio for white girls was 3.23 (95% confidence interval 1.16-9.00). In analyses that either included or excluded premature infants, prevalence infants, prevalence ratios for triglyceride concentrations in black boys and black girls and for the low density lipoprotein cholesterol/high density lipoprotein cholesterol ratio, total cholesterol concentration, and very low density lipoprotein cholesterol concentration in all race-sex groups were not significantly different from one. To our knowledge, this is the first study finding associations between low birth weight and elevated triglyceride concentrations in later childhood. A follow-up study among adults is recommended.

Black or African American↗

PubMed1997

[Research methods in clinical cardiology (VII). Experimental studies in cardiology].

Experimental designs in clinical investigation are discussed in this article. Guideline examples have been used in the area of Cardiology using always the same one only one whenever possible. We have looked for a different perspective from what is generally used in the discussion of the general characteristics of experimental designs, and more specifically of clinical trials and we deal with the aspects of clinical trials which are usually ignored due to their marginal character. We also discuss those characteristics which differentiate clinical trials in respect to other designs and types of questions which are answered by clinical trials. And we finally discuss various aspects such as randomization and its various types (simple, block, stratified, pre-randomized) and variable types of evaluating the answers, masking and the problems in its maintenance, with certain kinds of designs, sample size, etc. There is a brief mention of two particular cases: factorial and cross over designs are both discussed, mentioning their strong and weak points. Likewise, we discuss community trials as another experimental design and examples are provided. Finally, we discuss aspects of criteria: such as, When to stop the trials? or Who are the results applicable to?, and we suggest points to take into consideration when these decisions are made.

Cardiology↗