Biomedical subjects

J C Seidell

Publications and source records attributed to J C Seidell.

At least 127 records · Page 7Linked to original sources

PubMed1995

Fasting serum insulin in relation to components of the metabolic syndrome in European healthy men: the European Fat Distribution Study.

To investigate the "metabolic" syndrome in different European populations, samples of 38-year-old healthy men were randomly selected from six centers: Gothenburg (Sweden), Warsaw (Poland), Deinze (Belgium), Verona (Italy), Lumiar (Portugal), and Ede (The Netherlands). In total, 515 men were studied. Anthropometric measurements and blood pressure levels were taken by one or two operators in each center after a common operator's training course. Each blood parameter was analyzed in one laboratory. There were significant intercenter differences in mean values for anthropometric parameters, blood pressure, serum lipids (except for low-density lipoprotein [LDL] cholesterol), and fasting insulin. In particular, fasting serum insulin showed the highest values in Sweden and The Netherlands and the lowest values in Italy and Portugal. In pooled men, fasting insulin was strongly related (P < .001) to body mass index (BMI), waist to hip (WHR) and waist to thigh (WTR) circumference ratios, serum lipids (except for LDL cholesterol), and blood pressure. On the contrary, there were relevant differences in the correlation of insulin with serum lipids and blood pressure when the data were evaluated for each center. However, generally both in each center and in all centers together all these correlations disappeared after adjustment for BMI, with the exception of the correlation with serum triglycerides. In pooled men, multiple regression analysis showed an independent association of fasting insulin, BMI, and WHR with serum triglyceride (P < .001). On the contrary, total, LDL, and high-density lipoprotein (HDL) cholesterol and blood pressure values showed independent associations with BMI and/or WHR but not with fasting insulin in multivariate models.2+ off

Adult↗

PubMed1995

A lipoprotein lipase mutation (Asn291Ser) is associated with reduced HDL cholesterol levels in premature atherosclerosis.

A reduction of high density lipoprotein cholesterol (HDC) is recognized as an important risk factor for coronary artery disease (CAD). We now show in approximately 1 in 20 males with proven atherosclerosis that an Asn291Ser mutation in the human lipoprotein lipase (LPL) gene is associated with significantly reduced HDL levels (P = 0.001) and results in a significant decrease in LPL catalytic activity (P < 0.0009). The relative frequency of this mutation increases in those patients with lower HDL cholesterol levels. In vitro mutagenesis and expression studies confirm that this change is associated with a significant reduction in LPL activity. Our data support the relationship between LPL activity and HDL-C levels, and suggest that a specific LPL mutation may be a factor in the development of atherosclerosis.

Adult↗

PubMed1995

Dietary calcium, potassium, magnesium and blood pressure in the Netherlands.

BACKGROUND: The quantitative contribution of dietary calcium, potassium and magnesium to blood pressure levels remains unknown as does the combined effect of dietary calcium, potassium and magnesium. METHODS: The relation between blood pressure and dietary calcium, potassium and magnesium and the combined effect of these minerals on blood pressure was studied in 20,921 Dutch men and women aged 20-59 years. Food intake was measured by a food frequency questionnaire. The data were adjusted for age, body mass index, heart rate, alcohol and energy intake. RESULTS: An inverse association was observed between blood pressure and dietary potassium and magnesium in both men and women. Dietary calcium was inversely related to systolic blood pressure (SBP) in women and with diastolic blood pressure (DBP) in men. The relation between magnesium intake and blood pressure was stronger than those between blood pressure and intakes of potassium and calcium. Men and women who consumed a diet with intakes in the upper tertiles of all three minerals had a lower SBP and DBP compared to those who had intakes in the lower tertiles (men: SBP = -1.3 (95% CI: -2.6, -0.1), DBP = -1.9 (95% CI: -2.7, -1.0), women: SBP = -1.8 (95% CI: -3.1, -0.5), DBP = -1.5 (95% CI: -2.4, -0.7). CONCLUSION: These results suggest that diets rich in calcium, potassium and magnesium are associated with lower blood pressure.

Adult↗

PubMed1995

Relationships of blood pressure to fibrinolysis: influence of anthropometry, metabolic profile and behavioural variables.

OBJECTIVE: To investigate the relationship between blood pressure and the plasma fibrinolytic system and to verify whether this association was independent or mediated by one or more potential confounding factor. DESIGN: A random sample of 94 males aged 38 years subdivided into normotensives, hypertensives and those hypertensives with the highest blood pressure values. METHODS: Overall and regional obesity, blood lipids, fasting and 2-h post-load glucose, C-peptide and insulin levels, and main behavioural variables, including adipose tissue fatty acid composition (an objective index of dietary fat intake), were measured. The plasma fibrinolytic system was evaluated by determining activities and total plasma concentrations of both tissue-type plasminogen activator before and after venous occlusion, and its inhibitor plasminogen activator inhibitor type-1 (PAI-1). RESULTS: PAI-1 activity was significantly higher in the hypertensives than in the normotensives. PAI-1 antigen tended to parallel PAI-1 activity, and levels of tissue-type plasminogen activator antigen and activity tended to be lower in the hypertensives at baseline and after venous occlusion, but not significantly different from those in the normotensives. The hypertensives also had significantly higher body mass index and body fat content (measured by bio-impedance), increased plasma triglycerides, uric acid, fasting and 2-h glucose, C-peptide and insulin concentrations. In univariate linear regression analysis both systolic and diastolic blood pressures were found to be positively correlated with PAI-1 levels (r = 0.27, P < 0.01, for both). This correlation was maintained after adjustment for total body fat, fasting glucose, fasting insulin concentration or adipose tissue alpha-linolenic acid; however, it was no longer significant after adjustment for plasma 2-h insulin, 2-h C-peptide, 2-h glucose or triglyceride levels. Multivariate regression analysis revealed that only 2-h insulin and triglyceride concentration showed an independent association with PAI-1 levels. CONCLUSIONS: This study confirms that, in 38-year-old males, hypertension is associated with increased PAI-1 activity. It supports the possibility that the relationship between blood pressure and PAI-1 may reflect the overall effect of the insulin resistance syndrome (in particular hyperinsulinaemia and hypertriglyceridaemia) rather than a direct effect of blood pressure on the fibrinolytic system.

Adult↗

PubMed1995

Breast size as a determinant of breast cancer.

OBJECTIVE: To determine whether breast size as reflected in cup size is independently associated with Wolfe's mammographic patterns. DESIGN: Univariate and multivariate associations between the waist/hip ratio (WHR), body mass index (BMI), cup size, age, parity, age at menarche menopausal status and Wolfe's mammographic parenchymal patterns were determined by (multiple) linear logistic regression. SETTING: Population based mammographic breast cancer screening project. SUBJECTS: 7819 women between 39 to 52 years of age. RESULTS: The univariate analysis demonstrated that women in the lowest tertile with respect to BMI and WHR when compared to women in the upper tertile were significantly more likely to display the high risk P2, Dy breast patterns. Cup size showed a similar inverse relation with the P2, Dy patterns. When age, WHR and BMI are entered together in the multivariate model the relation between cup size and the P2 Dy patterns is no longer significant in the upper tertile. CONCLUSION: Breast size is not a major independent determinant of the high risk P2, Dy parenchymal breast patterns when the WHR and BMI are taken into account.

Adult↗

PubMed1995

Obesity in Europe: scaling an epidemic.

Obesity, defined as a body mass index > 30 kg/m2 is relatively common in Europe especially among women and especially in Southern and Eastern European countries. Among men the distribution of body mass index values is surprisingly similar in most countries of Europe despite a large variability among women. Available data from European countries (Germany, Finland, Sweden, The Netherlands, England) suggest that the prevalence of obesity has been stable or (most often) increasing during the ninety-eighties. Publications from affluent countries outside Europe suggest similar trends. These trends suggest that public health policies recommending avoidance of overweight and the common practice of dieting fail to prevent an increase in the prevalence of obesity, let alone to reduce the prevalence. It is unclear which factors are responsible for weight gains in Europe. Continuing high fat intakes in combination with low physical activity and widespread cessation of smoking may contribute to the increasing prevalence although some studies suggest that increased prevalences are also found in smokers and non-smokers. Obesity as well as weight gain are both important and independent contributors to cardiovascular disease and diabetes mellitus. More research is needed to elucidate the reasons for the large variation in the prevalence of obesity among European women and to the health risks associated with obesity in different European countries.

Adolescent↗

PubMed1995

The impact of obesity on health status: some implications for health care costs.

Obesity (defined as a body mass index > 30 kg/m2) is common in middle-aged Europeans. The prevalence is notably high in women from Mediterranean and Eastern European countries. In most European countries the prevalence of obesity has been shown to be increasing. When the impact of obesity on health status is assessed this should be done at many levels. Not only should be looked at mortality or diseases and disorders associated with obesity. Physical functioning and quality of life are also of great importance although they may not be bound to any specific diagnosis. Mobility disability has been shown to be more strongly related to obesity than the association between obesity and mortality. Estimation of direct health care costs attributable to obesity vary between 1-5% of the total health care expenditure depending on the definition of obesity and the methods for calculating these costs. This ranks obesity among the major determinants of health care costs.

Adolescent↗

PubMed1995

Changes in body weight in relation to mortality in 6441 European middle-aged men: the Seven Countries Study.

OBJECTIVES: To study the relation between changes in body weight and subsequent mortality. DESIGN: Prospective follow-up study. SETTING: Population study. SUBJECTS: 6441 men aged 40-59 y at baseline participating in the European cohorts of the Seven Countries Study. The men were divided into groups depending on their weight pattern ascertained from three weight measurements with intervals of 5 years. They were also divided in quartiles according to the degree of weight variability. MAIN OUTCOME MEASURES: All-cause and cause-specific mortality during 15 years following the last weight measurement. Deaths occurring during the first 5 years of follow-up were excluded. RESULTS: Significantly elevated hazard ratios (RR) for death from all causes (RR = 1.3; 95% confidence interval (CI): 1.2-1.5), all cardiovascular diseases (RR = 1.2; 95% CI: 1.0-1.5) and other causes (RR = 1.6; 95% CI: 1.2-2.2) were found for men with a decreasing weight compared with men with a constant weight. A fluctuating weight was associated with an increased risk of all cause mortality (RR = 1.2; 95% CI: 1.0-1.4), coronary heart disease (RR = 1.5; 95% CI: 1.0-1.9) and myocardial infarction (RR = 1.5; 95% CI: 1.0-2.2). The group of men with an increasing body weight also had elevated hazard ratios for dying from coronary heart disease and myocardial infarction, but these were only significant when the total 15-year follow-up was analyzed. The risks of dying from all-causes, cardiovascular disease, cancer and other causes were increased in the upper quartile versus the lower quartile of weight variability. CONCLUSIONS: The results of the present study show that a decreasing and a fluctuating body weight are associated with increased mortality. An average increase of 7 kg body weight was associated with an elevated risk of dying from coronary heart disease and myocardial infarction. Lowest mortality in these middle-aged men was found in those who maintained a constant body weight.

Aging↗

PubMed1995

Prevalence and trends of obesity in The Netherlands 1987-1991.

OBJECTIVE: To study the prevalence and trends in obesity in the period 1987-1991. DESIGN: Linear regression of average body mass index (BMI in kg/m2) and prevalence of obesity (BMI > or = 30 kg/m2) in a continuous monitoring project in three towns in The Netherlands. RESULTS: It was estimated that over the whole period the prevalence of obesity was 7% in men and 9% in women. After adjustment for age and educational level the prevalence of obesity increased significantly in both men with about 1.7 percentage points (+/- standard error: 0.8) and in women with 1.9 +/- 0.8 percentage points between 1987 and 1991. When stratified by 10-year age category the increase was strongest in those aged 20-29 and 50-59 years. When stratified by educational level, the increase was only significant in the lowest category (primary education and lower secondary education) and was not significant in other categories. CONCLUSION: Obesity is relatively common in The Netherlands and, at least among responders to the yearly surveys, the prevalence of obesity has increased in the period 1987-1991 particularly in those with a relatively low educational level.

Adult↗

PubMed1994

No specific effect of fluoxetine treatment on fasting glucose, insulin, lipid levels, and blood pressure in healthy men with abdominal obesity.

In this paper we investigated the effect of fluoxetine (60 mg/d) on serum lipids, glucose and insulin concentrations and blood pressure by means of a randomized, double-blind placebo controlled trial. Thirty-eight overweight (BMI: 26-30 kg/m2), nondiabetic, nonhypertensive men with an abdominal fat distribution (waist/hip ratio: > 0.97) received dietary advice and placebo or fluoxetine for 12 weeks. The changes in serum parameters and blood pressure in the fluoxetine treated group were not different from the placebo treated group, despite a significantly larger weight loss in the fluoxetine group. In both groups serum total-cholesterol concentrations, serum LDL-cholesterol concentrations and the HDL/LDL ratio were significantly improved after treatment. Reductions in fasting glucose concentration and systolic blood pressure were only significant in the placebo group. A reduction of serum triglycerides and an increase of HDL-cholesterol were found in the fluoxetine treated group. In the total study population the changes in serum lipids seemed to be more strongly related to the change in total body fat or subcutaneous abdominal fat (assessed by MRI) compared to the change in visceral fat. The improvement of most of the serum lipids was related to the change in total body fat independent of the mechanism for attaining this fat loss. Our results indicate that fluoxetine treatment has no specific effect beyond that expected for weight loss on serum lipid, glucose and insulin concentrations, and blood pressure in overweight men.

Abdominal Fat↗

PubMed1994

Relationships of plasminogen activator inhibitor-1 to anthropometry, serum insulin, triglycerides and adipose tissue fatty acids in healthy men.

Increased plasma levels of plasminogen activator inhibitor-1 (PAI-1), responsible for reduced fibrinolytic activity, have been shown to be an important risk factor for cardiovascular disease. PAI-1 plasma levels are influenced by several factors which have not yet been fully clarified, including dietary fat intake. The relationships of PAI-1 with other cardiovascular risk factors are still not well known. In a random sample of 38-year-old healthy men (n = 94), the association of PAI-1 plasma levels (measured as activity and antigen) with anthropometric parameters, serum lipids, fasting and 2 h insulin and glucose concentration after oral glucose-load was analysed. Furthermore, the fatty acid composition of subcutaneous adipose tissue, as an objective and reliable index of dietary fat intake, was measured. The univariate analysis showed that plasma levels of PAI-1 were significantly associated with body mass index (BMI) (r = 0.37, P < 0.001), waist/hip ratio (WHR) (r = 0.26, P < 0.01), serum triglycerides (r = 0.47, P < 0.0001), HDL/total cholesterol ratio (r = -0.35, P < 0.001), fasting and 2-h insulin (r = 0.27, P < 0.01 and r = 0.34, P < 0.001) and glucose concentrations (r = 0.25, P < 0.05 and r = 0.28, P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose Tissue↗

PubMed1994

A prospective study on obesity and subcutaneous fat patterning in relation to breast cancer in post-menopausal women participating in the DOM project.

The associations of body fat and body fat distribution with breast cancer risk were examined in a prospective study in 9,746 post-menopausal women with a natural menopause, aged 49-66 at intake, participating in a breast cancer screening project (the DOM project in Utrecht). During a follow-up period of 15 years (mean follow-up time 12.5 years) 260 women developed breast cancer. Fat distribution, assessed by contrasting groups of subcapsular and triceps skinfold thickness, was found to be unrelated to breast cancer incidence. No significant relationship between body fat, measured either by weight, Quetelet's index, triceps skinfold or subscapular skinfold, and breast cancer risk was found when analysed in quartiles. However, women in the upper decile compared with the lower decile of the distribution of Quetelet's index were found to have a 1.9 times (95% CI 1.1-3.3) higher risk for breast cancer. These results seemed to be in contrast with the significant positive association between fatness, analysed in quartiles, and breast cancer observed in a cross-sectional study, based on mammographic screening, carried out previously in the same population. Although the differences between the present, prospective, study and our cross-sectional study may be due to chance it may be that there are differences between characteristics of breast cancer detected at screening and subsequently, which influence the associations between measures of fatness and risk of breast cancer.

Adipose Tissue↗

PubMed1994

Differences in the association between alcohol consumption and blood pressure by age, gender, and smoking.

The positive association between alcohol consumption and blood pressure is well known. Little is known, however, about effect modification by age, gender, and smoking on the alcohol-blood pressure association. We used data of a cross-sectional study conducted in the Netherlands to investigate the association between alcohol consumption and blood pressure. Between 1987 and 1990, we examined about 30,000 men and women age 20-59 years. After adjustment for age, body mass index, and smoking, we found that in men systolic and diastolic blood pressure increased by 0.9 and 0.6 mmHg per daily drink, respectively. In women, systolic and diastolic blood pressure were 2 and 1 mmHg higher in those who consumed 2 or more glasses per day compared with nondrinkers, respectively. We observed a stronger association between alcohol and blood pressure in older men compared with younger men and in male and female smokers compared with nonsmokers. These data show that gender, age, and smoking all are important effect modifiers of the alcohol-blood pressure relation.

Adult↗

PubMed1994

Plasma fibrinogen in relation to serum insulin, smoking habits and adipose tissue fatty acids in healthy men.

Recent prospective studies have reported an independent association between fibrinogen plasma levels and risk of cardiovascular events. Aim of this study was to investigate the relationships between fibrinogen level and conventional cardiovascular risk factors in a random sample of 38 year-old apparently healthy men (n = 94), and to verify whether the fatty acid composition of the diet might influence those relations. Anthropometric measurements, serum lipids, blood pressure, and smoking habits were evaluated. In addition, fasting and after glucose-load serum glucose and insulin concentrations were measured. The most significant difference in fibrinogen level was found among the tertiles of fasting serum insulin (F-ANOVA = 4.5; P < 0.01) with the highest plasma fibrinogen values in the third insulin tertile, whereas body mass index (BMI), waist/hip circumference ratio (WHR) and serum triglycerides were more weakly related. The current smokers had substantially higher levels of fibrinogen than subjects who never smoked (P < 0.001). A multivariate regression analysis showed that, among the above reported variables, only serum insulin and smoking were independently associated with plasma fibrinogen. Furthermore, as the possible association between fatty acid composition of the diet and fibrinogen level regards, we have examined the fatty acid composition of adipose tissue, as a good and objective index of quality of the dietary fat intake. It was found that, fibrinogen level was not associated with any adipose tissue fatty acid. In conclusion, this study performed in a random sample of healthy men indicates an independent relationship of fasting insulin and smoking to fibrinogen plasma level.

Adipose Tissue↗

PubMed1994

Visceral fat accumulation in relation to sex hormones in obese men and women undergoing weight loss therapy.

In 70 healthy obese subjects (37 men and 33 premenopausal women; aged 27-51 yr; body mass index, 28-38 kg/m2), associations between the initial amount of visceral fat and sex hormone levels were studied as well as between changes that occurred in response to a 4.2 mJ/day deficit diet for 13 weeks. Magnetic resonance imaging was used to quantify the visceral fat depot. In women, an abundance of visceral fat was significantly associated with diminished levels of sex hormone-binding globulin and free 17 beta-estradiol/free testosterone (T) ratio and to elevated levels of free T after adjustment for age and total fat mass. In men, no significant relationships could be found between visceral fat accumulation and any of the sex hormones. Mean total fat loss was 11.3 +/- 3.3 (+/- SD) kg. In women, loss of visceral fat was significantly related to rises in the sex hormone-binding globulin level and the free 17 beta-estradiol/free T ratio independent of total fat loss, whereas in men, only the association between visceral fat loss and increased estrone level reached statistical significance. In conclusion, in obese premenopausal women, visceral fat predominance seems to be related to a relatively increased androgenicity. In obese men, sex steroid levels appear not to depend on the amount of visceral fat. In obese women, but not in obese men, visceral fat loss seems to be accompanied by a relative reduction in androgenicity.

Adipose Tissue↗

PubMed1994

Obesity in Europe: prevalence and consequences for use of medical care.

Obesity {defined herein as a body mass index (BMI) greater than 30 kg/m2} is common in middle-aged Europeans, particularly in women from Mediterranean and Eastern European countries. Epidemiological comparison shows no relationship between obesity and coronary heart disease mortality in men, but a weak association in women, which became stronger after adjustment for smoking. Within individual countries, however, increased BMI is associated with increased cardiovascular risk factors in populations across Europe. In The Netherlands, the direct annual healthcare costs associated with overweight and obesity (BMI greater than 25 kg/m2) have been calculated to be approximately 1 billion Dutch guilders, which corresponds to about 4% of total healthcare costs.

Body Mass Index↗

PubMed1994

The sagittal waist diameter and mortality in men: the Baltimore Longitudinal Study on Aging.

The study objective was to determine the relationship between the abdominal sagittal diameter (waist depth) and subsequent mortality. This was a prospective study carried out in 981 male participants of the Baltimore Longitudinal Study on Aging which is a prospective study at the National Institute on Aging in Baltimore. The main outcome measures of the study were total and cause-specific mortality occurring during 17,529 person-years. The men were divided by age (cut-off point 55 years) at the start of follow-up. All-cause and coronary heart disease mortality rates (adjusted for age, height and body mass index) increased with increasing sagittal diameter in the younger group but not in the older group. No significant relationship was observed between the sagittal diameter and cancer mortality. Body mass index, skinfolds and waist/hip ratio were not significantly related to any of the endpoints studied. The increased risk of mortality with increasing sagittal diameter was somewhat stronger when the first ten years of follow-up were excluded and was more pronounced at lower levels of risk factors such as serum cholesterol, serum triglycerides, plasma glucose and diastolic blood pressure and in never plus ex-smokers compared to smokers. The study indicates that the abdominal sagittal diameter is a strong predictor of mortality in younger adult men independently of age, height, body mass index and conventional risk factors for mortality such as smoking, serum lipids and blood pressure. Regional adiposity may be a less strong risk factor for mortality in older men.

Adult↗

PubMed1993

Fat and female fecundity: prospective study of effect of body fat distribution on conception rates.

OBJECTIVES: To study the effect of body fat distribution in women of reproductive age on fecundity. DESIGN: Prospective cohort study of all women who had entered a donor insemination programme. SETTING: One fertility clinic serving a large part of the midwest of the Netherlands. SUBJECTS: Of 542 women attending the clinic for artificial insemination for the first time, 500 women were eligible for study. MAIN OUTCOME MEASURES: Probability of conception per cycle and number of insemination cycles before pregnancy or stopping treatment. RESULTS: A 0.1 unit increase in waist-hip ratio led to a 30% decrease in probability of conception per cycle (hazard ratio 0.706; 95% confidence interval 0.562 to 0.887) after adjustment for age, fatness, reasons for artificial insemination, cycle length and regularity, smoking, and parity. Increasing age was significantly related to lower fecundity (p < 0.05); very lean and obese women were less likely to conceive (p < 0.10) as were women with subfertile partners (p < 0.10). All other exposure variables were not significantly related to fecundity. CONCLUSIONS: Increasing waist-hip ratio is negatively associated with the probability of conception per cycle, before and after adjustment for confounding factors. Body fat distribution in women of reproductive age seems to have more impact on fertility than age or obesity.

Adipose Tissue↗