Biomedical subjects

J M Sprafka

Publications and source records attributed to J M Sprafka.

At least 55 records · Page 3Linked to original sources

PubMed1992

Correlates of obesity in young black and white women: the CARDIA Study.

OBJECTIVES: Although differences in obesity between Blacks and Whites are well documented in adult women, less information is available on potential correlates of these differences, especially in young adults. METHODS: The association between behavioral and demographic factors and body size was assessed in 2801 Black and White women aged 18 to 30 years. RESULTS: Black women had significantly higher age-adjusted mean body mass index and subscapular skinfold thickness than did White women. Obesity had different associations with age and education across racial groups. A positive relationship between age and obesity was seen in Black women but not in White women, whereas a negative association between education and body size was noted only in White women. Potential contributing factors to the increased prevalence of obesity in Black women include a more sedentary lifestyle, higher energy intake, earlier menarche, and earlier age at first childbirth. CONCLUSIONS: The difference in obesity across race could not be explained completely by these factors, since within virtually all strata, Black women had higher body mass indexes. Further investigation is needed to develop interventional strategies to prevent or reduce excess levels of obesity in Black women.

Adolescent↗

PubMed1992

Double-blind randomized trial of nicotinamide on early-onset diabetes.

OBJECTIVE: To determine the efficacy of nicotinamide in inducing remission in early-onset insulin-dependent diabetes mellitus. RESEARCH DESIGN AND METHODS: This study was a double-blind, randomized clinical trial. CONCLUSIONS: Nicotinamide failed to induce remission or differences on beta-cell secretion between the two groups.

Blood Glucose Self-Monitoring↗

PubMed1991

Trends in serum cholesterol levels from 1980 to 1987. The Minnesota Heart Survey.

BACKGROUND AND METHODS: We assessed community trends in the awareness, treatment, and control of hypercholesterolemia (defined as a serum cholesterol level greater than 6.21 mmol per liter [240 mg per deciliter]) during the 1980s in the Minneapolis-St. Paul (Twin Cities) metropolitan area. Twin Cities residents 25 to 74 years old participated in independent, cross-sectional, population-based surveys of risk factors for cardiovascular disease in 1980-1982 (n = 3365) and 1985-1987 (n = 4545). RESULTS: Mean serum total cholesterol levels, as adjusted for age, decreased significantly (P less than 0.01) from 1980-1982 to 1985-1987 in men (from 5.30 mmol per liter [205 mg per deciliter] to 5.16 mmol per liter [200 mg per deciliter]) and women (from 5.19 mmol per liter [201 mg per deciliter] to 5.04 mmol per liter [195 mg per deciliter]). The prevalence of hypercholesterolemia as adjusted for age decreased significantly (P less than 0.05) in men (17.8 to 15.1 percent) and women (17.1 to 13.6 percent). The ratio of total cholesterol to high-density lipoprotein (HDL) cholesterol was unchanged during this period, because of a concurrent decline in the level of HDL cholesterol. Participants with hypercholesterolemia in the 1985-1987 survey were more likely than those in the 1980-1982 survey to be aware of their condition (32.6 vs. 25.4 percent), to be treated with lipid-lowering agents (4.3 vs. 1.9 percent), and to have their condition controlled (1.9 vs. 0.3 percent). Among those who reported treatment by a physician for hyperlipidemia, changes were observed in the type of treatment recommended. A significant increase (P less than 0.05) was noted from 1980-1982 to 1985-1987 in the percentage of men being treated for hyperlipidemia with lipid-lowering medication (5.2 vs. 11.6 percent) and with exercise programs (10.3 vs. 20.1 percent). In women being treated for hyperlipidemia, a nonsignificant increase was noted in the use of lipid-lowering medication (8.2 vs. 13.9 percent), and a significant increase (P less than 0.05) was observed in the number of exercise prescriptions (4.1 vs. 12.0 percent). CONCLUSIONS: We found a substantial decline in the prevalence of hypercholesterolemia in the Twin Cities between 1980-1982 and 1985-1987 that may be attributed to changes in lifestyle, such as diet and exercise, and to a lesser extent to more aggressive intervention with lipid-lowering drugs by physicians.

Adult↗

PubMed1991

Differences in leisure-time physical activity levels between blacks and whites in population-based samples: the Minnesota Heart Survey.

Energy expenditure in leisure-time physical activity (LTPA) was measured using the Minnesota LTPA Questionnaire in 35- to 74-year-old black and white residents of Minneapolis-St. Paul, Minnesota. Estimates of the geometric mean LTPA energy expenditure were 129 and 204 kcal per day for black and white men (p less than .05) and 91 and 123 kcal per day for black and white women (p less than .05). The percentage of individuals expending 2000 kcal or more per week in LTPA was significantly lower in black men than white men (25 vs. 35%; p = .01) but was not different in black versus white women (18 vs. 17%). Although black men and women reported greater occupational physical activity than their white counterparts, LTPA and job activity were unrelated in all race and sex groups. In both races, LTPA energy expenditure declined with age. LTPA increased with level of formal education, and the largest LTPA difference between blacks and whites was observed in those who had a high-school diploma or less. Blacks had lower participation rates than whites in most of the individually assessed physical activities. Additional research is needed on the determinants and promoters of LTPA in population subgroups.

Black or African American↗

PubMed1991

A 5-year evaluation of a smoking cessation incentive program for chemical employees.

BACKGROUND: This 5-year study of the Dow Chemical Texas Operations 1984-1985 Smoking Cessation Incentive Program (SCIP) evaluated the smoking habits of 1,097 participants and 1,174 nonparticipants. RESULTS: We observed, via questionnaire and saliva cotinine data, that participants were 2.3 times more likely to be long-term (greater than or equal to 5 years) nonusers of tobacco than nonparticipants (10.2% vs 4.4%, P less than or equal to 0.01). However, smoking cessation rates for 3-4 years, 1-2 years, and less than 1 year were similar for participants who remained smokers at the conclusion of SCIP and nonparticipants. Age and the interaction between the management job category and having quit smoking for at least 30 days sometime prior to the worksite program were important predictors of smoking cessation among participants. Thirty-six percent of the participants who were considered exsmokers of 6 months duration at the conclusion of the program in 1985 remained long-term quitters 5 years later. Stress and enjoyment of smoking were the two most important reasons provided by participants for recidivism. CONCLUSIONS: The results of this 5-year evaluation demonstrate the heterogeneity of employee participation and success with a worksite smoking cessation program.

Absenteeism↗

PubMed1991

Increased incidence of diabetes mellitus in relation to abdominal adiposity in older women.

The relationship between body fat distribution, measured by the ratio of waist-to-hip circumferences (WHR), and the 2 year incidence of diabetes mellitus was examined in a cohort of 41,837 women aged 55-69 years. The 399 women who reported the new onset of diabetes had a significantly greater mean body mass index (kg/m2) and WHR than non-cases. After adjustment for body mass index (BMI), age and education level using multivariate logistic regression, WHR was a significant independent predictor of diabetes in a dose-response fashion. Cases were 4.6 times (95% CI = 3.8, 5.6) more likely than non-cases to be in the upper tertile of WHR and 2.2 times (95% CI = 1.8, 2.7) more likely to be in the middle tertile. Women in the highest tertiles of both WHR and BMI had a 14.4-fold (95% CI = 9.5, 21.9) higher risk of diabetes than women in the lowest tertiles. These results demonstrate that increased abdominal adiposity is a significant independent risk factor for the development of diabetes mellitus in older women.

Aged↗

PubMed1991

The effect of cuff size on blood pressure measurement in adults.

We measured blood pressure differences by cuff size in 181 adults aged 25 to 74 years, allocated to a random sequence that involved the measurement of blood pressure using a small cuff, a large cuff, and an appropriate cuff as determined by standardized arm circumference measurement. Systolic and diastolic blood pressure were underestimated by 3-5 mm Hg in men and 1-3 mm Hg in women when the cuff was one size larger than appropriate. Systolic and diastolic blood pressure were overestimated by 2-6 mm Hg in men and 3-4 mm Hg in women when the cuff was one size smaller than appropriate. In addition, 30-40% of subjects were "misclassified" when blood pressure cutpoints were used to define hypertension.

Adult↗

PubMed1991

Parkinson's and motoneuron disease morbidity in the Twin Cities metropolitan area: 1979-1984.

To better characterize the morbidity from Parkinson's disease and motoneuron disease, we examined hospital discharge diagnosis data for all acute care facilities (except for the Veterans Administration Medical Center) in the Minneapolis-St. Paul area in each year from 1979 to 1984 for persons aged 30-74 years. For each person in whom the discharge diagnosis included either Parkinson's disease or motoneuron disease, the age, gender, and year of admission were recorded. Annual age-gender-specific and age-adjusted gender-specific hospital discharge diagnosis rates were calculated. For Parkinson's disease, for both, men and women, the age-adjusted hospital discharge diagnosis rate declined by 26-27%. Component age-specific data for Parkinson's disease showed more variable temporal changes. For motoneuron disease, no temporal changes were observed, although the number of observations was small. These data suggest that Parkinson's disease is declining in prevalence in the hospitalized population. The implications for motoneuron disease are less clear. Further studies in this area are needed.

Adult↗

PubMed1991

Relation of risk factor levels in young adulthood to parental history of disease. The CARDIA study.

BACKGROUND: The relation between self-reported parental disease and risk factor levels was examined in 2,637 black and 2,478 white men and women aged 18-30 years at the Coronary Artery Risk Development in Young Adults (CARDIA) Study baseline examination (1985-1986). METHODS AND RESULTS: The prevalence of parental disease (at least one parent) in white versus black participants was 44% and 56% for hypertension, 47% and 44% for obesity, 16% and 13% for myocardial infarction, 11% and 17% for diabetes, and 6% and 10% for stroke, respectively. Among these young adults, parental hypertension was associated with higher sex- and age-adjusted systolic and diastolic blood pressure levels. Parental myocardial infarction was associated with higher plasma cholesterol, higher blood pressure levels, and lower high density lipoprotein cholesterol levels in white participants. Parental diabetes was associated with higher fasting blood glucose and insulin levels in all race-sex groups and with higher triglycerides and lower high density lipoprotein cholesterol in black participants only. Parental history of obesity was related to less favorable age- and sex-adjusted lipid levels in white participants and higher blood pressure levels in black participants. Parental history of stroke was associated with higher systolic blood pressure levels in black participants. In general, these differences across family history were predicted only in part by obesity. The prevalence of more than one disease reported in parents occurred more frequently than would have been expected due to chance alone. CONCLUSIONS: These associations between parental disease and risk factors in their adult children probably reflects the impact of both environmental and genetic factors. Parental history may be a useful marker for high risk individuals.

Adult↗

PubMed1991

Trends in prevalence of diabetes mellitus in patients with myocardial infarction and effect of diabetes on survival. The Minnesota Heart Survey.

OBJECTIVE: The purpose of this study was to document trends in the prevalence of diabetes among men and women hospitalized for myocardial infarction (MI) and to determine the effect of diabetes on in-hospital case fatality rates and long-term survival. RESEARCH DESIGN AND METHODS: The Minnesota Heart Survey is a population-based surveillance system that has monitored trends in coronary heart disease morbidity since 1970. As part of this effort, a 50% random sample of acute MI discharge records in Minneapolis-St. Paul metropolitan area hospitals was abstracted in 1970, 1980, and 1985. RESULTS: The prevalence of diabetes among MI patients was compared over time, and the data indicated a significant increase between 1970 and 1985 in both men (8.2 vs. 16.8%, P less than 0.001) and women (16.0 vs. 25.8%, P = 0.01). Diabetic individuals had an odds ratio of in-hospital death after an MI 1.5 times that of nondiabetic individuals (P less than 0.01) after controlling for the effects of sex, age, and year of MI. Among discharged MI survivors, the risk of death was 40% higher (P less than 0.01) in diabetic individuals than nondiabetic individuals after 6 yr of follow-up. Compared with nondiabetic individuals, diabetic individuals appeared more likely to have cardiac (pump) failure with acute MI. CONCLUSIONS: Our findings suggest that the risk of coronary heart disease morbidity and mortality attributable to diabetes may be increasing over time. Therefore, clinicians need to take extra care in the management of MIs in diabetic individuals, and public health efforts to reduce diabetes prevalence are warranted.

Adult↗

PubMed1991

Time trends in leisure-time physical activity in the upper midwest 1957-1987: University of Minnesota studies.

The assessment of leisure-time physical activity in four studies that used a similar questionnaire was carried out by the University of Minnesota between 1957-1960 and 1985-1987. Each study included adults living in the Upper Midwest. In men, age-adjusted leisure-time energy expenditure consistently increased over time, with the greatest increase occurring between 1957-1960 and 1974-1975. Much of this increase occurred in moderate and heavy intensity activity and was greater for white collar workers than for blue collar workers. The increase in the last period was similar for both classes of workers. Data were unavailable for women before 1980. Age-adjusted leisure-time physical activity in women also increased between 1980-1982 and 1985-1987. This increase was greater for blue collar than for white collar women. A major strength of these analyses is the last two surveys, which were specifically designed to assess time trends. Exact comparability of the earlier two surveys with the two latter surveys cannot be established; however, the use of the same detailed questionnaire across 30 years is unique. We conclude that leisure-time physical activity has been increasing for three decades, including substantial increases in vigorous activities.

Adult↗

PubMed1990

Type A behavior and its association with cardiovascular disease prevalence in blacks and whites: the Minnesota Heart Survey.

Population-based surveys were conducted in 1985 and 1986 to measure the prevalence of coronary heart disease (CHD) history and risk factors in Black and White adults. Type A behavior was measured by the Jenkins Activity Survey (JAS). JAS scores were associated with age (negatively), education (positively), and sex (men greater than women) but were largely unrelated to CHD risk factors. Blacks had significantly lower age- and education-adjusted Type A and component scores than Whites, more so for men than women. Univariate analysis indicated that a history of angina and/or heart attack was positively associated with the Type A score in both Blacks and Whites. Following adjustment for known cardiovascular risk factors, Type A score remained positively and significantly associated with CHD prevalence. These findings are consistent with other cross-sectional studies and suggest that Type A behavior, as measured by the JAS, may increase the risk of CHD in both Blacks and Whites. Follow-up of these cohorts may help to clarify the complex relationship of Type A behavior to the risk of CHD.

Adult↗

PubMed1990

Hospitalization and case fatality for pulmonary embolism in the twin cities: 1979-1984.

To better characterize the morbidity from pulmonary embolism, we examined hospital discharge data for all acute care facilities (except for the Veterans Administration Medical Center) in the Minneapolis-St. Paul metropolitan area in each year from 1979 to 1984 for persons aged 30 to 74 years. For each person in whom the discharge diagnoses included pulmonary embolism, the age, sex, year of admission, and vital status at discharge were recorded. Annual age-sex-specific and age-adjusted sex-specific hospitalization rates were calculated. Similar analyses were undertaken for case fatality. With the exception of men younger than 55 years of age, all groups experienced significant decline in the pulmonary embolism discharge rate. No significant temporal changes were observed in any of the case fatality rates. These data suggest that changes in pulmonary embolism mortality in the United States from 1979 to 1984 may reflect declining occurrence of the disease and are likely not the result of changes in case fatality. Further studies in this area are needed.

Age Factors↗

PubMed1990

Contrast nephropathy in azotemic diabetic patients undergoing coronary angiography.

PURPOSE: To evaluate the incidence of, risk factors for, and outcome of contrast nephropathy in azotemic diabetic patients undergoing coronary angiography. PATIENTS AND METHODS: Fifty-nine insulin-dependent diabetics with a mean serum creatinine level of 522 mumol/L (5.9 mg/dL) underwent coronary angiography as part of a pretransplant evaluation. Twenty-four azotemic diabetics undergoing inpatient evaluation not including angiography for transplantation formed the control group. Serum creatinine measurements obtained at baseline and after radiocontrast exposure were compared in patients and control subjects. Risk factors for contrast nephropathy were evaluated in patients with a 25% or greater increase in serum creatinine. RESULTS: Serum creatinine was significantly elevated 24 hours after radiocontrast exposure in patients (557 +/- 141 mumol/L versus 522 +/- 141 mumol/L, mean +/- SD; p less than 0.001) but not in controls. Seven patients required dialysis within 6 days of coronary angiography and two additional patients required dialysis within 14 days. Contrast nephropathy, defined as a serum creatinine increase of greater than 25% when measured 48 hours after radiocontrast exposure, occurred in 50% of patients and no controls. Univariate analysis of risk factors for contrast nephropathy revealed a significant association with dye quantity (p = 0.002), mean arterial pressure less than 100 mm Hg (p = 0.02), and ejection fraction less than 50% (p = 0.04). Stepwise logistic regression verified the independence of dye quantity and low mean arterial pressure but not low ejection fraction as risk factors for contrast nephropathy. Follow-up serum creatinine values were not significantly different in patients and control subjects. CONCLUSIONS: Azotemic patients with diabetes are at high risk of developing contrast nephropathy even when less than 100 mL of radiocontrast agent is used. The acute renal failure is reversible but precipitates the need for short-term dialysis in some patients. Radiocontrast quantity is an important risk factor not previously noted. The incidence of contrast nephropathy can be minimized by using less than 30 mL of radiocontrast agent.

Acute Kidney Injury↗

PubMed1990

Obesity and overweight in young adults: the CARDIA study.

The associations of body size with age, race, sex, and education in young adults were examined in 5,115 black and white, men and women ages 18-30 years. Black women were more obese than white women with greater mean levels of body mass index (25.8 vs 23.1 kg/m2), subscapular skinfold thickness (19.9 vs 15.2 mm), and waist girth (76.7 vs 72.0 cm), all P less than 0.0001. Black women were more likely to exceed 20% of ideal body weights (black women 23.7%, white women 9.1%, P less than 0.0001). No similar differences were found in men. Associations of measures of body size with age and education differed among race/sex groups. Body mass index and skinfolds increased with age among white and black men and black women, but not among white women. The association of education with obesity was negative among white women and positive among black men with no significant association noted among white men and black women. These data show a complex relationship between age, sex, race, education, and obesity in young adulthood.

Adolescent↗

PubMed1990

Continued decline in cardiovascular disease risk factors: results of the Minnesota Heart Survey, 1980-1982 and 1985-1987.

Systematic, simultaneous surveillance of cardiovascular disease risk factors, morbidity, and mortality is ongoing in the Minnesota Heart Survey. Risk factors for cardiovascular disease were measured in population-based surveys of Twin Cities metropolitan area residents aged 25-74 years in 1980-1982 and 1985-1987. During this period, age-adjusted, average systolic blood pressure declined nonsignificantly in men and significantly in women, and average, age-adjusted diastolic blood pressure declined 1.1 mmHg in men and 0.9 mmHg in women. Between 1980-1982 and 1985-1987, serum total cholesterol declined significantly, 5.2 and 5.8 mg/dl in men and women, respectively. Serum high density lipoprotein cholesterol decreased 1.6 mg/dl in men and 0.9 mg/dl in women. The prevalence of cigarette smoking declined by 14% in men and 18% in women. In contrast, the average body mass index increased 0.6 kg/m2 in men and 1.2 kg/m2 in women. Systematic hospital and death certificate surveillance found that mortality rates for coronary heart disease in the Twin Cities metropolitan area declined 20.1% in men and 12.9% in women from 1981 to 1986. Despite difficulties in interpretation of ecologic studies, it appears likely that improvements in population risk factor levels played a role in the decline in disease rates and could influence future mortality trends in this population.

Adult↗

PubMed1990

Comparison of two procedures for tracing participants in an epidemiologic cohort study.

The effectiveness and accuracy of using a commercial firm for tracing survey participants were compared with the results of an established, University of Minnesota tracing protocol. Studying a cohort of 622 survey participants ages 25-74 who were living in a single Midwestern community, we were unable to locate 142 (23%) at their original address after four years. We traced them according to the Minnesota protocol, using information obtained from contact persons (friends or relatives) and other sources. Overall, current address information was found for 96% of the participants lost to follow-up, and 113 (81%) of 139 addresses were supplied through the contact person. An independent attempt to obtain similar information using only credit bureau tracing through Associated Credit Services provided addresses for 123 of the participants. Associated Credit Services provided correct, current addresses for 39 (29%) of the 136 surviving participants (six fatal cases were excluded) and supplied correct, current addresses for a majority (58%) of the study participants found by protocol to be living in the study area and eligible for a follow-up clinic examination. We support the use of commercial services as secondary sources of address information in tracing participants after the initial use of contact persons to optimize participant contact. We recommend the use of commercial services as primary sources when contact persons are unavailable.

Adult↗

PubMed1990

Population-based study of impaired glucose tolerance and type II diabetes in Wadena, Minnesota.

The Wadena City Health Study was undertaken to assess the nature of type II (non-insulin-dependent) diabetes and its relationship to aging. This article reports the study methodology and prevalence estimates for type II diabetes and impaired glucose tolerance (IGT) for the adult population of Wadena, Minnesota. The sampling frame for the study included all known diabetic individuals and all other residents based on a complete citywide census of residents greater than or equal to 20yr of age. A stratified random sample that included three stratifying factors (age [20-39, 40-59, greater than or equal to 60 yr], sex, and self-reported weekly use of any prescribed medication was drawn from the other residents). The study protocol required diet preparation and two full mornings of testing. Data collected included height, weight, and blood pressure measurements and both a personal interview and a medications questionnaire. A 75-g oral glucose tolerance test (OGTT) and a test with a standard liquid meal (Ensure-Plus challenge test [EPCT], Ross) were done on two mornings, with the order of testing randomly assigned. Clinical tests included one-time samples for hemoglobin, glycosylated hemoglobin, plasma cholesterol, triglycerides, and lipoproteins. Blood samples for glucose and creatinine assays were taken during the OGTT; blood samples for glucose, free fatty acid, creatinine, and C-peptide were taken during the EPCT. Urine collections were performed for both challenge tests and assayed for C-peptide and creatinine. Seventy-one percent of the known diabetic subjects, and 65% of the stratified random sample participated in the study.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗