Selected methodologic aspects of the International Atherosclerosis Project.
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Biomedical subjects
Publications and source records attributed to L A Solberg.
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In 1972-1973, about 16,200 men living in Oslo, aged 40 to 49 years, were examined for cardiovascular disease, and had a number of coronary risk factors measured. This report gives the results of 129 autopsied cases with regard to the association between raised atherosclerotic lesions in coronary and cerebral arteries and various coronary risk factors. For coronary raised lesions, the high density lipoprotein (HDL) cholesterol ratio was the most significant risk factor. Systolic blood pressure and total serum cholesterol were also significantly associated. Physical activity at work and at leisure, nonfasting triglycerides, and cigarette smoking did not show a significant association with coronary artery raised lesions. The association between total serum cholesterol and systolic blood indicates that total serum cholesterol may be more important than systolic pressure in the synergism affecting the development of coronary atherosclerosis. For cerebral artery raised lesions, blood pressure was the most important risk factor, even though serum cholesterol was highly associated with the lesions. The interaction analysis also suggested that blood pressure was more important than serum cholesterol in the synergism.
This review assesses the current status of knowledge concerning the relationship of risk factors to atherosclerotic lesions. Risk factors for atherosclerotic lesions per se need not necessarily be identical to those related to clinically overt coronary heart disease (CHD). This review is based on 1) autopsy studies where information risk factors was gathered in a retrospective fashion; and 2) autopsy studies where information on risk factors was gathered prospectively. In spite of differences in study designs and grading methods among the studies, the general findings were similar. Elevated serum cholesterol and blood pressure are positively and significantly related to atherosclerotic lesions. High density lipoprotein cholesterol is inversely related to coronary and probably also to cerebral atherosclerosis. Almost all studies indicate a significant association between cigarette smoking and degree of aortic atherosclerosis; a positive relationship between smoking and coronary atherosclerosis is found between obesity or physical activity and the degree of atherosclerosis. Data from the Community Pathology Study in New Orleans indicate that the average extent of coronary atherosclerosis in a population may be subject to changes within a relatively short period of time; these changes might be expected to parallel changes in risk factors in the population.
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Histological examination of nasal biopsy specimens, rhinoscopical evaluation and nickel analysis in plasma and urine were performed on 59 retired nickel workers. The histological characteristics were graded according to a numerical classification table. Workers with short employment and short retirement time had a significantly lower mean histological scores than those with long employment and long retirement. Thirteen persons (22%) showed epithelial dysplasia, possibly representing precancerous lesions. Also included in the material were four cases of nasal carcinoma. Presence of hyperplastic/polypoid nasal mucosa was inversely related to the duration of retirement, possibly reflecting gradual regression of the mucosal swelling after termination of the irritation. The nickel concentration in plasma and urine was significantly higher among former roasting/smelting workers than in former electrolysis and non-process workers. This is probably a consequence of the slow release of heavy soluble nickel compounds that have accumulated in the organism at the former place of work.
Recent reports suggest that softwood exposed woodworkers may have an increased incidence of sinonasal carcinoma. The present study was undertaken in order to evaluate the histological changes, especially the presence of possible precancerous lesions, in the nasal mucosa of furniture workers exclusively exposed to softwood. Histological examination of nasal biopsies from 44 furniture workers and 37 controls revealed a higher degree of metaplastic changes in the former group. In addition we observed four cases (9%) of dysplasia among softwood exposed workers. Nasal epithelial dysplasia is morphologically similar to dysplasia in other organs where the precancerous state of this lesion has been proved. Acceptance of nasal dysplasia as a precancerous lesion means that histological examination of biopsies is an appropriate tool in identifying occupational groups with an increased incidence of sinonasal carcinoma.
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