Biomedical subjects

L L Perkins

Publications and source records attributed to L L Perkins.

16 recordsLinked to original sources

PubMed1992

Hostility and health behaviors in young adults: the CARDIA Study. Coronary Artery Risk Development in Young Adults Study.

Hostility has been associated with coronary heart disease mortality. To assess possible mechanisms linking hostility to coronary heart disease risk, the authors conducted analyses in a cross-sectional study from data collected in 1985 and 1986 on 5,115 young adults, aged 18-30 years, black and white, male and female, in four large urban areas of the United States. The results show that higher levels of hostility as determined by the Cook-Medley Hostility Scale were strongly associated with tobacco and marijuana smoking, increased alcohol consumption, and greater caloric intake in both blacks and whites and in both men and women. The increased caloric consumption was evident in the higher waist/hip ratios, particularly in men (p less than 0.05). The associations were particularly strong (p less than 0.001) for tobacco cigarette smoking and marijuana smoking, with roughly a 1.5 times higher prevalence in the top hostility quartile compared with the bottom quartile after adjusting for age and education. Hostility levels were not related to the percentage of calories from fat or from sucrose intake, to plasma cholesterol levels, or to physical fitness (except for a weak association in the latter in white women). The results describe relations between hostility and health behaviors that may be detrimental to health. The findings provide a possible explanation for the association between hostility and coronary heart disease mortality.

Adolescent↗

PubMed1992

Distributed data analysis in a multicenter study: the CARDIA Study.

Unlike distributed data entry, which is used in many large epidemiologic studies and multicenter clinical trials, distributed data analysis is a relatively new concept. This paper reports on the usefulness of such a system in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. CARDIA distributes the entire examination dataset to participating centers soon after completion of each round of data collection. The process was designed to encourage more numerous, diverse, and rapid publications, and to allow for more efficient use of the manpower and expertise in centers. Responsibilities of the coordinating center have changed from a conventional coordinating center but remain substantial due to the need for collating, monitoring, verifying, and documenting the distributed data analysis (DDA) system. DDA is successful from the standpoint of implementation and operation--21 manuscripts representing work analyzed at six participating centers had been submitted for publication within 3.5 years of the completion of the baseline examination.

Adolescent↗

PubMed1992

An assessment of critical anthropometric dimensions for predicting the fit of a half-mask respirator.

The purpose of this study was to determine if facial dimensions for a group of subjects were predictive of the fit factors measured while one brand of half-mask respirator was worn. Fit factors and 12 facial dimensions measured on 30 female and 38 male subjects were analyzed by correlation coefficients; weighted, multiple linear regression; and discriminant analysis. Data were analyzed for all subjects, gender subgroups, a race subgroup (whites only), and race/gender subgroups. Significant correlation coefficients with the log-transformed fit factors were found for four dimensions; four dimensions had significant coefficients in four or more multiple linear regression models. Only two dimensions had significant coefficients in four or more discriminant analysis models. Menton-subnasale (lower face) length was the only dimension included in all three of these groups. Gender-specific regression models had very high coefficient of determination values (R2 > 0.85). Discriminant analysis of the data for all subjects and race/gender subgroups found very good predictive scores for statistical software-generated models and menton-subnasale length alone; these scores were significantly better than those for the model with the respirator test panel dimensions (face length and lip width). These analyses found that facial dimensions were good predictors of respirator fit for those subjects wearing one brand of half-mask respirator. Lower face length was consistently indicated as being correlated or associated with fit. These results would indicate that dimensions other than those currently used may be more appropriate to define a half-mask respirator test panel.

Adult↗

PubMed1992

Misclassification of smoking status in the CARDIA study: a comparison of self-report with serum cotinine levels.

BACKGROUND: Although widely used in epidemiological studies, self-report has been shown to underestimate the prevalence of cigarette smoking in some populations. METHODS: In the CARDIA study, self-report of cigarette smoking was validated against a biochemical marker of nicotine uptake, serum cotinine. RESULTS: The prevalence of smoking was slightly lower when defined by self-report (30.9%) than when defined by cotinine levels equal to or greater than 14 ng/mL (32.2%, P less than .05). The misclassification rate (proportion of reported nonsmokers with cotinine levels of at least 14 ng/mL) was 4.2% and was significantly higher among subjects who were Black, had a high school education or less, or were reported former smokers. Possible reasons for misclassification include reporting error, environmental tobacco smoke, and an inappropriate cutoff point for delineation of smoking status. Using self-report as the gold standard, the cotinine cutoff points that maximized sensitivity and specificity were 14, 9, and 15 ng/mL for all, White, and Black subjects, respectively. The misclassification rate remained significantly higher in Black than in White subjects using these race-specific criteria. CONCLUSIONS: Misclassification of cigarette smoking by self-report was low in these young adults; however, within certain race/education groups, self-report may underestimate smoking prevalence by up to 4%.

Adolescent↗

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

HIV antibody testing in young, urban adults.

We surveyed men and women aged 21 to 34 years to determine the rates of human immunodeficiency virus (HIV) antibody testing in blacks and whites of diverse education levels in four US cities. Responses to the anonymous, mailed questionnaire were received from 90% of 777 white women, 64% of 734 black women, 79% of 677 white men, and 48% of 541 black men. The percentages reporting HIV testing for these four race-gender groups were 29%, 22%, 30%, and 38%, respectively. The percentages reporting testing that was voluntarily sought (ie, not in connection with blood donation, military service) were 16%, 14%, 18%, and 22%, respectively. In each race-gender group, roughly half of those who had not been tested said they "might have a blood test for the AIDS virus in the future". Education level was not correlated with HIV-testing frequency. Blacks were significantly less likely than whites to be aware of "a blood test that can detect the AIDS virus infection" (58% vs 77%), but blacks who knew of the test were more likely than whites to have been tested (47% vs 37%). Eleven percent of subjects reported at least one major risk factor for HIV infection. In these people, HIV testing was most common among homosexually active men (56% tested; 52% voluntarily sought), intermediate among injection drug users (40% tested; 31% voluntarily sought), and least common among the sexual partners of injection-drug users (21% tested; 11% voluntarily sought). Health education programs need to communicate the availability of, and need for, anonymous HIV testing.

AIDS Serodiagnosis↗

PubMed1991

Gestational diabetes mellitus among African-American women.

Gestational diabetes mellitus (GDM) is associated with increased risk of poor outcomes for the pregnancy. It is a strong risk factor for subsequent diabetes. The epidemiology of GDM in African-American women is not well known. It has not been demonstrated that their risk factors are similar in character and weight to those among White women. There is considerable multicollinearity among GDM risk factors such as age, parity, obesity, hypertension, and family history of diabetes, and this needs to be sorted out. This review is based on the results of a nested case-control study to evaluate the frequency of, and the relationships of the known risk factors with, the onset of GDM among African-American women. All cases of GDM within a cohort of women seen at any of the county health department clinics in Jefferson County, Alabama from 1981 to 1987 were identified. The cohort represents approximately 63% of all African-American pregnancies in the county during the period. With few exceptions (5.1% based on fasting plasma glucose greater than or equal to 120 mg/dl), potential GDM cases (7.1%) were selected on the basis of a 2 h post 100 g carbohydrate meal screening plasma glucose measure at their second prenatal visit and again at 28-32 weeks greater than or equal to 115 mg/dl and diagnosed on the basis of the results of an oral glucose tolerance test (OGTT) using the criteria of O'Sullivan and Mahan. Women with any prior history of diabetes (even in pregnancy), 1.6%, were excluded. The frequency of the new diagnosis of GDM among African-American women in this pregnancy in the cohort was 2.5% of pregnancies and 3.4% of women, which is similar to the values reported in the other studies. Controls were selected from women with negative screening tests who delivered after a GDM subject. The results reported in this paper reflect 358 cases (86% of all eligible GDM cases identified) and 273 controls. Cases were significantly older (28.3 vs. 21.7 years), of higher gravidity (2.7 vs. 1.9), more obese (76.7 vs. 61.7 kg), gained weight more rapidly (0.34 vs. 0.28 kg/week), had more hypertension in this pregnancy (28.2 vs. 2.6%), and there was a higher proportion with a family history of diabetes (41.3 vs. 16.5%) (p less than 0.001 for all comparisons). Because there were significant correlations among the risk factors in both cases and controls, multivariable logistic regression analyses were performed.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

PubMed1991

Autoantibodies in black women with class A1 or class GB diabetes mellitus.

No marker except repeated fasting glucose determinations has proven useful to ascertain prospectively which women with gestational diabetes mellitus will remain euglycemic by diet modification or will require insulin therapy. We screened 183 black women with gestational diabetes mellitus to determine if the presence of islet cell, mitochondrial, nuclear, DNA, parietal cell, smooth muscle, thyroid microsomal, thyroid thyroglobulin autoantibodies, or rheumatoid factor predicted the need for insulin therapy to maintain euglycemia in women with gestational diabetes mellitus. One hundred forty-two women maintained normal fasting plasma glucose levels with dietary modifications and 41 required institution of split-dose insulin therapy. We found no significant differences in the prevalence of these autoantibodies in black women with Class GB versus Class A1 diabetes mellitus. We conclude that screening for autoantibodies in women with gestational diabetes mellitus is not useful in determining which patients will subsequently require insulin therapy during their pregnancies.

Antibodies, Antinuclear↗

PubMed1991

Histocompatibility antigen subtypes in black women with class A1 or class GB diabetes mellitus.

Insulin-dependent diabetes mellitus is associated with an increased frequency of certain histocompatibility antigens located on chromosome six, the most common types being B-8, B-15, DR-3, DR-4, and DR-7. We therefore theorized that screening for these subtypes may allow the identification of those women with gestational diabetes who will remain euglycemic on dietary modification (class A1) compared with those who will require insulin to achieve euglycemia (class GB). From 1982 to 1987, 228 black women with gestational diabetes were screened for the above histocompatibility antigens. As theorized, certain histocompatibility antigen subtypes were more common in women with class GB gestational diabetes mellitus; DR-2 (41.8% versus 23.7% p = 0.015), B-15 (p = 0.07), and DR-3 (p = 0.08). However, because of the low sensitivity (42%), specificity (75%), and positive predictive value (36%), this test is impractical in the clinical management of women with gestational diabetes mellitus.

Black People↗

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↗

PubMed1990

Cigarette smoking behavior is strongly related to educational status: the CARDIA study.

The prevalence and correlates of cigarette smoking were examined in 5,116 men and women ages 18-30 years including both blacks and whites of varied educational levels. Prevalence of smoking was approximately 30% in each race by gender subgroup after adjusting for age and education. The prevalence decreased with increasing education, from 54% among participants with less than a high school education to 12% among those with graduate degrees (P less than 0.001). Cessation rates followed a similar pattern, with former smokers twice as common among those with more education. Differences in smoking prevalence across occupational groups were largely explained by differences in educational achievement. More educated individuals smoked fewer cigarettes per day and chose brands with lower nicotine yield. Race and gender were not strongly related to smoking prevalence. However, among smokers, whites reported smoking 50% more cigarettes per day than blacks but the average nicotine and tar content of the cigarette was nearly three times higher among blacks than whites. The strong inverse relationship between education and cigarette smoking patterns has important implications for public health efforts directed at the prevention of cigarette smoking.

Adolescent↗

PubMed1990

Distribution of faceseal leak sites on a half-mask respirator and their association with facial dimensions.

Faceseal leaks on one brand of half-mask respirator worn by 73 human subjects were identified by deposition of a fluorescent tracer aerosol during a standard quantitative fit test. The identified leaks were categorized according to their location and shape. It was found that about 89% of all observed leaks occurred at the nose or chin or were multiple leaks which included these sites. Fit factors for these types of leaks were significantly lower than for other types of leaks. About 73% of all leaks approximated the shape of a slit rather than a round orifice, and the prevalence of these leaks was affected by gender. Significant association of facial dimensions and leak sites were found. Most of these were attributed to differences in gender, and only a very small percentage were for the facial dimensions used to define the Los Alamos respirator test panel. Significant correlation of facial dimensions and fit factor were found for only three facial dimensions; none of which are used to define the test panel. Evidence of airflow streamlining within the facepiece was observed on 22% of the subjects. Results of this study indicate that respirator leakage is strongly affected by nose and chin leaks, that gender is a factor in how a respirator fits, and that consideration should be given to including nasal dimensions when defining a respirator test panel and selecting a respirator for an individual wearer.

Adult↗

PubMed1990

Risk factors for gestational diabetes in black population.

In a long-term longitudinal study of gestational diabetes mellitus in Black women, risk factors that were identified were age, obesity, a family history of diabetes, and the presence of hypertension. Poor predictors were a history of a previous large-for-date infant, parity, and age at first pregnancy. The prevalence of smooth muscle and nuclear autoantibodies was higher in gestational diabetic subjects. Gestational diabetic subjects who required insulin for glycemic control were more obese, had a lower frequency of the Bf-F phenotype and a higher frequency of the Bf-F1 phenotype, and had a lower frequency of the type 2 allele at the polymorphic locus adjacent to the insulin gene. Restriction-fragment-length polymorphisms flanking the insulin and apolipoprotein A-I and C-III genes, although not associated with gestational diabetes mellitus, may be associated with hyperlipidemia and subsequent atherosclerosis.

Adult↗

PubMed1988

Cataracts in Dunedin Program participants: an evaluation of risk factors.

A geriatric health screening program in Dunedin, Florida, was used to evaluate risk factors leading to development of cataracts. A total of 2,787 participants completed the fourth yearly visit to the program. At the time of the fourth visit, 49.3% of women (mean age 75.1 years) and 38.2% of men (mean age 75.4 years) reported the presence of cataracts. Age was found to be the most significant risk factor in cataract development (P less than .0001). Both men and women with cataracts had significantly lower serum cholesterol concentrations than subjects without cataracts. After adjusting for age and sex, diazepam (P less than .03), furosemide (P less than .04), isosorbide (P less than .003), and ibuprofen (P less than .03) were found to be positively associated with cataracts; triamterene (P less than .05) had a negative association, indicating a protective relationship. Aspirin was not shown to have a protective effect on reported cataracts.

Age Factors↗

PubMed1986

Symptom prevalence in the elderly. An evaluation of age, sex, disease, and medication use.

Prevalence of reported symptoms was studied in 1927 women and 1140 men over 65 years of age in an ambulatory health screening program. Reports of 28 common symptoms were obtained from a standardized questionnaire completed by participants at the time of their fourth annual visit to the program. A comparison was made of the prevalence of specific symptoms by sex, age, disease states, and drug use patterns. The most common symptoms reported by women were nocturia (80.4%), swollen feet or ankles (30.5%), cold feet and/or legs (28.6%), and irregular heartbeat (23.2%), whereas men complained most often of nocturia (79.8%), irregular heartbeat (24.8%), cold feet and/or legs (23.6%), and tinnitus (23.1%). Women reported a mean of 3.99 symptoms compared with 3.22 reported by men (P less than .0001). In women their was a statistically significant association for most symptoms in subjects reporting the use of medication compared with a group who did not use medication. In men the use of medication was less highly correlated with reports of symptoms. Nearly 100% of participants reported having at least one disease state. The number of symptoms reported was strongly related to the number of disease states, and after adjusting for diseases, women reported more symptoms than men. The best predictor of symptom prevalence was the number of disease states followed by the number of drugs used and then age.

Age Factors↗

PubMed1986

Vitamin E effect on symptoms and laboratory values in the elderly.

The effect of vitamin E use on selected medical disorders and laboratory parameters was studied in a large ambulatory elderly population. Information obtained from a standardized questionnaire concerning reports of numerous clinical disorders, such as hypertension, fatigue, and vaginal bleeding, was used to determine whether the use of vitamin E predisposed to those conditions. During a 2-year period, information was available on 369 vitamin E users and 1,861 non-users. No differences were noted in the prevalence of reported clinical disorders between the two groups, except that men using vitamin E complained more often of shortness of breath (p less than .04) and angina (p less than .03). There were no significant differences between vitamin E users and controls in any hematologic parameters studied. After the groups had been adjusted for age and sex differences, only one biochemical parameter, serum glutamic-oxaloacetic transaminase (SGOT) in men, was found to be significantly different in vitamin E users as compared with controls. Use of vitamin E by the participants in this study appeared to have little influence on clinical disorders or hematologic or biochemical parameters.

Aged↗