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H Kushner

Publications and source records attributed to H Kushner.

74 records · Page 5Linked to original sources

Gender differences in the relationship between insulin-mediated glucose utilization and sex hormones in young African-Americans.

OBJECTIVE: To determine whether there are gender differences in insulin-mediated glucose utilization and if sex hormones correlate with measures of insulin sensitivity in young adult African-Americans. DESIGN: Cross-sectional case (women)-control (men) study. PARTICIPANTS: African-American men and women aged 27 to 35 years. Excluded were known diabetics, individuals on antihypertensive therapy, and women taking exogenous estrogen preparations. METHODS: Procedures included anthropometric and blood pressure measurement, oral glucose tolerance test, sex hormone assay, and euglycemic hyperinsulinemic clamp. Procedures for data analysis included two-way analysis of variance and Pearson's correlation coefficients. RESULTS: Data were analyzed on 104 men and 142 women with a mean age of 31.5 years. Insulin sensitivity was lower in women than in men. When insulin-mediated glucose utilization was corrected for body fat, there was no gender difference in insulin sensitivity. There was a significant correlation of androgen status with insulin sensitivity, but this relationship was divergent between men and women. For men, the correlation between insulin sensitivity and free testosterone was positive (r = .36, P < .001). For women, this correlation was negative (r = -.28, P = .001). CONCLUSION: These data on young African-Americans demonstrate no gender differences in insulin sensitivity when glucose utilization is corrected for adipose mass. Androgen status is significantly linked with insulin sensitivity, but the relationship is divergent in men and women. Insulin resistance in young women is strongly associated with relative androgen excess, which may augment the risk for cardiovascular disease.

Adult↗

Determinants of blood pressure in infants admitted to neonatal intensive care units: a prospective multicenter study. Philadelphia Neonatal Blood Pressure Study Group.

There are few blood pressure (BP) data reported for premature and term newborn infants after 24 hours of age. To determine BP levels and BP trends in a representative population of infants admitted to neonatal intensive care units (NICUs), this study was conducted in 14 NICUs in the greater Philadelphia area. All infants admitted to the 14 NICUs during a 3-month period were entered into the study. BP data, along with data on clinical conditions and therapeutic interventions (independent variables), were prospectively collected by a uniform protocol. Systolic BP (SBP) and diastolic BP (DBP) were measured indirectly by oscillometry and recorded every 8 hours. Data from 608 infants followed up for 1 to 99 days after delivery generated 9911 infant-day records and 24,052 individual BP measurements. On day 1, birth weight and gestational age were strong correlates of SBP (r = 0.68, p < 0.0001 and r = 0.66, p < 0.0001, respectively) and DBP (r = 0.48, p < 0.0001 and r = 0.47, p < 0.001, respectively). During the first 5 days of life there was a progressive rise in SBP (2.23 to 2.67 mm Hg/day) and DBP (1.58 to 2.02 mm Hg/day) regardless of gestational age or weight at birth. After day 5 there was a more gradual increment in the daily SBP (0.24 to 0.27 mm Hg/day) and DBP (0 to 0.15 mm Hg/day). Stepwise linear multiple regressions were used to examine the multiple correlations among the independent variables and to build a regression model for BP. Gestational age and day of life emerged in the first two steps of the multiple regression analysis (multiple R = 0.463 and 0.655, respectively; p < 0.0001 for both). The multiple R values for day of life and gestational age were virtually identical to that for postconceptional age (day of life + gestational age at birth). Although other common diagnosis and treatment variables contributed a small amount to the total variance in BP, postconceptional age was the primary determinant of BP in this population of infants.

Birth Weight↗