Biomedical subjects

E B Marcus

Publications and source records attributed to E B Marcus.

10 recordsLinked to original sources

PubMed1991

Body fat and obesity in Japanese Americans.

In 1965 a prospective study of greater than 12,000 Japanese men 45-69 y old and living in Japan, Hawaii, and California was initiated. Among the factors measured were height, weight, skinfold thicknesses, and 24-h dietary recall. The mean body mass index (BMI) was substantially lower for Japanese men in Japan than for Japanese men in California or Hawaii for each 5-y age group. Mean BMIs in Hawaii and California were similar. Values for subscapular skinfold thickness were also lower in Japan than in Hawaii or California in all age groups. Although total caloric intake was not greatly different between Japan and Hawaii, the percent caloric intake as fat was two times greater in Hawaii. Thus, these largely first- and second-generation immigrants exhibit increases in body weight that could be expected to significantly affect cardiovascular risk factor levels and endpoints.

Adipose Tissue↗

PubMed1991

Body fat, coronary heart disease, and stroke in Japanese men.

The Honolulu Heart Program (HHP) is a prospective study of heart disease and stroke in Japanese-American men in Hawaii. Body weight, height, and subscapular and triceps skinfold thicknesses were measured by using standard methods at the baseline exam held in 1965-1968. The relationship of measures of body fatness to the 20-y follow-up for coronary heart disease (CHD) and stroke of these men was explored. Body mass index (BMI), subscapular skinfold thicknesses, and centrality index (subscapular skinfold thickness/triceps skinfold thickness) were predictors of CHD in this population, even after other risk factors were added to a multivariate model, indicating an independent contribution of body fat to CHD risk. Neither BMI nor centrality index was related to stroke. However, subscapular skinfold thickness was an independent predictor of stroke. The implications of these findings are that lifestyle changes that lead to an increase in obesity of Japanese men in Hawaii may increase risk for cardiovascular disease.

Adult↗

PubMed1991

Prospective study of pulmonary function and lung cancer.

The role of pulmonary function as an independent predictor of lung cancer risk was studied in a community-based cohort of 6,317 Japanese-American men who were aged 45 to 68 at the time of examination. After a follow-up period of about 22 yr, 172 incident cases of lung cancer were identified. The percentage of the predicted FEV1 was inversely related to lung cancer (p value for trend = 0.01) after adjustment for age and cigarette smoking history. The subjects in the lowest quartile of pulmonary function (% predicted FEV1 less than 84.5) had a relative risk of 2.1 (95% confidence interval = 1.3 to 3.5) for lung cancer compared with subjects in the highest quartile (% predicted FEV1 = 103.5+). For the 84 cases with a squamous or small cell histologic type of lung cancer, the subjects in the lowest quartile had a relative risk of 2.5 (95% Cl = 1.2 to 5.6) compared with subjects in the highest quartile of pulmonary function. For the 84 patients with lung cancer whose tumors were located within 4 cm of the pulmonary hilum, the subjects in the lowest quartile had a relative risk of 4.0 (95% Cl = 1.7 to 9.7). The results suggest that impaired pulmonary function in a community-based population is a predictor of lung cancer.

Aged↗

PubMed1990

Smoking, pulmonary function, and mortality.

The association of pulmonary function (as percent of predicted forced expiratory volume in 1 second [FEV1]) with total and cause-specific mortality over 15 to 18 years was investigated in a large cohort (5924) of prospectively followed Japanese-American men. Among those who never smoked, pulmonary function was found not to be significantly predictive of total mortality in a multivariate model in which adjustment for variables that might confound the results was made. Among past and current smokers, highly significant associations were found (P < 0.0001). The positive relationship of pulmonary function to mortality in smokers was so strong that it overshadowed these differences in nonsmokers in a model including all smoking groups combined, even after adjusting for smoking. A smoking-pulmonary function interaction term added to this model was statistically significant (P < 0.003). This illustrates the need for attention to the potential for complex interactions between biologic variables when carrying out multivariate statistical analysis. Findings for cardiovascular and noncardiovascular mortality were similar. This analysis indicates that while pulmonary function is associated with subsequent mortality, the relationship is significantly associated with smoking history.

Asian↗

PubMed1989

Relative impact of smoking and reduced pulmonary function on peptic ulcer risk. A prospective study of Japanese men in Hawaii.

The aim of this study was to determine whether reduced pulmonary function is an independent risk factor for peptic ulcer. Among 5933 Japanese men studied in Hawaii, 243 developed gastric ulcers and 99 developed duodenal ulcers 20 yr after an examination completed in 1968. The examination included measurement of forced expiratory volume in 1 s and a detailed smoking history. The percent predicted forced expiratory volume was significantly and inversely related to ulcer incidence, but not after adjustment for smoking or among those who had never smoked. Cigarettes were associated with increased ulcer risk in both stomach and duodenum but showed a dose-response in pack years only for gastric ulcer. We conclude that the association of reduced pulmonary function with peptic ulcer in the Japanese in Hawaii is largely attributable to smoking and that smoking is more strongly related to gastric than duodenal ulcer. The especially strong link between cigarettes and gastric ulcer suggests that decreased smoking or synchronous decrease in cigarette tar content may have contributed to the recent unexplained decrease in male gastric ulcer.

Asian↗

PubMed1989

Regression of Q waves following acute myocardial infarction.

The predictors and effects of Q wave regression following acute Q wave myocardial infarction were examined in 1965-1982 in 127 Japanese-American men who participated in a prospective epidemiologic study of cardiovascular disease. Of these 127 men, 53 (42%) showed total regression of Q waves, 17 (13%) showed partial regression, and 57 (45%) showed no Q wave regression following acute myocardial infarction. Age at myocardial infarction and location of myocardial infarction did not predict which men would undergo Q wave regression. Q wave status after myocardial infarction (total, partial, or no regression) did not predict survival or recurrence of myocardial infarction. This study found that a substantial proportion of acute myocardial infarction cases undergo Q wave regression, indicating that clinicians and investigators alike require additional evidence to identify people with previous myocardial infarction.

Electrocardiography↗

PubMed1989

Pulmonary function as a predictor of coronary heart disease.

The role of pulmonary function as an independent predictor of coronary heart disease was examined in 1965-1983 in a cohort of Japanese-American men. As part of the Honolulu Heart Program, the authors measured pulmonary function in 5,924 men aged 45-68 years who were free of coronary heart disease at baseline examination and followed them for 15-18 years for the development of nonfatal myocardial infarction and fatal coronary heart disease. Per cent predicted forced expiratory volume in one second (%PFEV1) was significantly inversely related to coronary heart disease incidence in the total cohort after adjusting for age (p less than 0.0001) and then for all known coronary heart disease risk factors (p = 0.0004). However, when examined by smoking status, %PFEV1 was a predictor of coronary heart disease only among past and current smokers, and not for men who had never smoked cigarettes (p = 0.36). The association between pulmonary function and coronary heart disease can be explained by cigarette smoking, which leads to both lung impairment and coronary heart disease incidence.

Aged↗

PubMed1989

Twenty-year trends in mortality from chronic obstructive pulmonary disease: the Honolulu Heart Program.

There is evidence of a rising trend in COPD mortality. Whether this is due to changes in coding or diagnostic practices, increase in disease incidence or severity, or other causes is unknown. The Honolulu Heart Program (HHP) has followed a cohort of 11,136 Japanese-American men, 45 to 65 yr of age at onset, from 1965 to 1984. Following a fixed protocol, study physicians assigned cause of death after review of hospital records, pathology and autopsy reports, the death certificate, and, in doubtful cases, after interview with family and personal physician. The eighth revision of the international Classification of Diseases was used throughout. During 20 yr of follow-up, 2,624 men died, 113 from COPD by HHP coding and 105 from COPD by State Health Department (HD) coding. There was no change in age-adjusted or age-specific COPD mortality rates from 1965 to 1984 by HHP coding (tests for trend, p greater than 0.05). In contrast, when HD coding was used there was a significant decline in COPD mortality over the same time period. The frequency with which COPD was found on the death certificate decreased significantly for diagnoses listed in Section 1 and increased for those in Section 2. Current smokers showed increasing trends and past smokers decreasing trends in COPD mortality. When HHP and HD codings were compared, there was agreement in only 46% (69 of 149) of the cases. Agreement was greater in 1965-1974 than in 1975-1984. This study found no evidence of increasing mortality rates from 1965 to 1984 in this cohort of Japanese-American men.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗

PubMed1988

Reference values for FEV1 in Japanese-American men from 45 to 68 years of age.

Pulmonary function is known to vary by racial group, yet no standards have been published for Asian-Americans. The Honolulu Heart Program, a prospective epidemiologic study of cardiovascular disease, provided an opportunity to examine pulmonary function, specifically, forced expiratory volume in one second (FEV1), in Japanese-American men 45 to 68 yr of age. Of a cohort of 6,346 men, 1,490 were identified as healthy asymptomatic nonsmokers. Prediction equations and reference values were derived from this subgroup. When the prediction equation was compared with those derived from Caucasian and black populations, mean predicted FEV1 for Japanese-Americans was intermediate to higher values for Caucasians and lower values for blacks. In addition to age and height, skinfolds, dynamometry, and biacromial diameter were found to be independent predictors of FEV1. In summary, standards derived from Japanese-American populations should be used when measuring pulmonary function in this group and additional physical measurements make a small contribution to the accuracy of prediction equations.

Aged↗

PubMed1988

Correlates of FEV1 and prevalence of pulmonary conditions in Japanese-American men.

Correlates of forced expiratory volume in one second (FEV1) and the prevalence of pulmonary disease and symptoms were examined in 6,346 Japanese-American men 45 to 68 yr of age. There was a significant inverse dose-response relationship between FEV1 and cigarette smoking measured as pack-years, number of cigarettes, or number of years smoked. Ex-smokers had FEV1 values that were intermediate to the higher values for nonsmokers and the lower values for current smokers. Among current smokers, inhaling and starting to smoke at a younger age were associated with lower values of FEV1, independent of pack-years. FEV1 was also correlated with a variety of other biologic and sociobehavioral variables, even after removing the effects of smoking. These variables included skinfold thickness, dynamometry, hematocrit, triglycerides, and systolic blood pressure. When compared with Caucasian populations, these Japanese-American men had low prevalence rates of airflow obstruction and pulmonary disease symptoms.

Aged↗