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Biomedical subjects

Edward J Boyko

Publications and source records attributed to Edward J Boyko.

59 records · Page 4Linked to original sources

Improvement of BMI, body composition, and body fat distribution with lifestyle modification in Japanese Americans with impaired glucose tolerance.

OBJECTIVE: To determine whether diet and endurance exercise improved adiposity-related measurements in Japanese Americans with impaired glucose tolerance (IGT). RESEARCH DESIGN AND METHODS: This study compared the effects of an American Heart Association (AHA) step 2 diet (<30% of total calories as fat, <7% saturated fat, 55% carbohydrate, and < 200 mg cholesterol daily) plus endurance exercise for 1 h three times a week (treatment group) with an AHA step 1 diet (30% of total calories as fat, 10% saturated fat, 50% carbohydrate, and <300 mg cholesterol) plus stretching exercise three times a week (control group) on BMI, body composition (% fat), and body fat distribution at 6 and 24 months of follow-up in 64 Japanese American men and women with IGT, 58 of whom completed the study. RESULTS: At 6 months, the treatment group showed significantly greater reduction in percent, body fat (-1.4 +/- 0.4 vs. -0.3 +/- 0.3%); BMI (-1.1 +/- 0.2 vs. -0.4 +/- 0.1 kg/m(2)); subcutaneous fat by computed tomography at the abdomen (-29.3 +/- 4.2 vs. -5.7 +/- 5.9 cm(2)), thigh (-13.2 +/- 3.6 vs. -3.6 +/- 3.0 cm(2)), and thorax (-19.6 +/- 3.6 vs. -8.9 +/- 2.6 cm(2)); and skinfold thickness at the bicep (-2.0 +/- 0.6 vs. 1.1 +/- 0.6 mm) and tricep (-3.7 +/- 0.8 vs. -0.9 +/- 0.6 mm), which continued despite moving to home-based exercise for the last 18 months. CONCLUSIONS: Diet and endurance exercise improved BMI, body composition, and body fat distribution and, thus, may delay or prevent type 2 diabetes in Japanese Americans with IGT.

Asian↗

The millennium Cohort Study: a 21-year prospective cohort study of 140,000 military personnel.

Does military service, in particular operational deployment, result in a higher risk of chronic illness among military personnel and veterans? The Millennium Cohort Study, the largest Department of Defense prospective cohort study ever conducted, will attempt to answer this question. The probability-based sample of 140,000 military personnel will be surveyed every 3 years during a 21-year period. The first questionnaire, scheduled for release in summer 2001, will be sent to 30,000 veterans who have been deployed to southwest Asia, Bosnia, or Kosovo since August 1997 and 70,000 veterans who have not been deployed to these conflict areas. Twenty thousand new participants will be added to the group in each of the years 2004 and 2007 to complete the study population of 140,000. The participants will have the option of completing the study questionnaire either on the paper copy received in the mail or through the World Wide Web-based version, which is available at www.MillenniumCohort.org. This will be one of the first prospective studies ever to offer such an option. The initial survey instrument will collect data regarding demographic characteristics, self-reported medical conditions and symptoms, and health-related behaviors. Validated instruments will be incorporated to capture self-assessed physical and mental functional status (Short Form for Veterans), psychosocial assessment (Patient Health Questionnaire), and post-traumatic stress disorder (Patient Checklist-17). Information obtained from the survey responses will be linked with other military databases, including data on deployment, occupation, vaccinations, health care utilization, and disability. In addition to revealing changes in veterans' health status over time, the Millennium Cohort Study will serve as a data repository, providing a solid foundation upon which additional epidemiological studies may be constructed.

Chronic Disease↗

Diabetes-related comorbidities in Asian Americans: results of a national health survey.

OBJECTIVE: The aim of this study was to compare the prevalence of diabetes-related comorbidities in Asian Americans to the prevalence in other racial and ethnic groups in the United States using data from the 2001 Behavioral Risk Factor Surveillance System (BRFSS). METHODS: The BRFSS is a population-based telephone survey of the health status and health behaviors of 212,510 Americans aged > or = 18 years in all 50 states, Guam, Puerto Rico, and the U.S. Virgin Islands. In 2001, participants included 196 Asian Americans, 1138 African Americans, 1276 Hispanics, 294 Native Americans, 71 Pacific Islanders, and 7799 non-Hispanic Whites with a self-reported physician diagnosis of diabetes. Comorbidity was determined by self-report. Odds ratios (OR) were adjusted for age, sex, body mass index (BMI) or height and weight, duration of diabetes, smoking, and health-insurance status. RESULTS: The adjusted prevalences of hypercholesterolemia and retinopathy were similar across groups. Relative to Asian Americans, only African Americans were more likely to report hypertension [adjusted OR=2.1, 95% confidence interval (CI)=1.0-4.2, P<.05]. Higher odds of current or past foot ulceration was observed for Hispanics (adjusted OR=2.8, 95% CI=1.2-6.9), Native Americans (adjusted OR=4.2, 95% CI=1.4-12.8), and Pacific Islanders (adjusted OR=7.4, 95% CI=1.3-41.2) compared with Asian Americans. CONCLUSIONS: Among Americans with diabetes, Asian Americans have a prevalence of hypertension, hypercholesterolemia, retinopathy, and foot ulceration that is similar to that in Whites. Asian Americans had a significantly lower prevalence of hypertension than African Americans did and a lower prevalence of foot ulceration than Hispanics, Native Americans, and Pacific Islanders did.

Asia↗

Relationship of medial arterial calcinosis to autonomic neuropathy and adverse outcomes in a diabetic veteran population.

STATEMENT OF THE PROBLEM: Medial arterial calcinosis (MAC) is associated with neuropathy, amputation, and mortality through an unknown mechanism. We hypothesized that MAC was a marker of autonomic neuropathy rather than a risk factor and that the outcomes were due to autonomic neuropathy. METHODS: All subjects in an ongoing prospective study of diabetic foot conditions in a diabetic veteran cohort who received a foot radiograph between 11/7/90 and 11/5/93 were included. Autonomic neuropathy measured as either heart rate variability with timed respiration or postural hypotension. A logistic model predicted the presence of MAC at baseline and Cox proportional models assessed the relative contribution of autonomic neuropathy and traditional risk factors for the outcomes of ulceration, amputation, and death. RESULTS: MAC was identified in 181 subjects, no MAC in 253 subjects, and 39 were excluded due to disagreement between observers. Both measures of autonomic neuropathy were independent predictors of MAC at baseline, even after adjustment for vibration sensation loss in a logistic model. MAC was associated with an increased risk for ulceration (hazards ratio, HR: 2.1, 95% confidence intervals, CI, 1.4-3.1), amputation (HR 3.3, 95% CI 1.5-7.4), and mortality (HR 1.6, 95% CI 1.1-2.2). The addition of either autonomic measure of neuropathy did not change the MAC HR or significantly improved the fit of the model. CONCLUSIONS: Our hypothesis that the excess mortality, amputation, and ulceration in persons with MAC could be explained by autonomic neuropathy measured as postural hypotension or heart rate variability with measured respiration was not supported.

Age of Onset↗