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Richard Nelesen

Publications and source records attributed to Richard Nelesen.

4 recordsLinked to original sources
PubMed2005

The association of obesity, cytokine levels, and depressive symptoms with diverse measures of fatigue in healthy subjects.

BACKGROUND: Fatigue is a common symptom, even among healthy individuals, but little is understood about it. We examined the associations among adiposity, depressive symptoms, cytokine levels, and multidimensional fatigue symptoms in otherwise healthy subjects. Furthermore, we examined whether obesity would account for a significant portion of fatigue and, if so, what kind of fatigue complaints appear to be related to obesity. METHODS: Seventy healthy subjects (36 women and 34 men) with an average age of 36.0 years and at less than or equal to 170% of ideal body weight participated in the study. Participants had their height, weight, neck circumference, ratio of the waist to hip circumference, percentage of body fat, and plasma interleukin 6 and soluble intercellular adhesion molecule 1 concentrations measured. Their sleep was monitored with an overnight polysomnogram, and subjects completed the short form of the Multidimensional Fatigue Symptom Inventory, which measures 5 domains of fatigue, and the Center for Epidemiologic Studies-Depression Scale. RESULTS: Obesity, as measured by body mass index (calculated as weight in kilograms divided by the square of height in meters) and percentage of body fat, was associated with general fatigue. Depression scores were significantly related to all subscales of fatigue; the highest correlation was shown with emotional fatigue. The effect of obesity on physical fatigue was significant, even after controlling for depression. In general, interleukin 6 and soluble intercellular adhesion molecule-1 levels were unrelated to measures of fatigue. CONCLUSIONS: Obesity, cytokine concentrations, and depressive symptoms explained different dimensions of fatigue as measured by the short form of the Multidimensional Fatigue Symptom Inventory. Obesity accounted for a significant portion of physical fatigue after controlling for depressive symptoms and circulating levels of interleukin 6 and soluble intercellular adhesion molecule-1.

Adult↗
PubMed2004

Sleep quality and blood pressure dipping in normal adults.

OBJECTIVES: To investigate the relationship between sleep quality and nocturnal blood pressure dipping in normal subjects. We hypothesized that sleep quality correlates with dipping. DESIGN: Cross-sectional study. SETTING: Unattended polysomnography in the home followed by a 24-hour ambulatory blood pressure measurement. PATIENTS: Eighty-eight self-described normal subjects were evaluated; 26 were excluded due to an apnea-hypopnea index > or = 10. None were taking antihypertensive medications. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: Subjects were divided into dippers and nondippers based on > or = 10% drop in nocturnal mean arterial pressure (MAP). Sleep-quality variables included total sleep time; sleep latency; percentage of stages 1, 2, 3, 4, and rapid-eye-movement sleep; percentage of wake time after sleep onset (WASO); total arousal index; and sleep efficiency. Of the remaining 62 subjects, 17.7% were nondippers, and 7 were hypertensive. There was no difference in age, body mass index, apnea-hypopnea index, blood pressure, or sleep quality between groups. Stage 4 sleep correlated significantly with dipping of diastolic blood pressure and MAP (r = 0.410 and 0.378, respectively, P < or = .002), and percentage of WASO was negatively correlated with dipping of diastolic blood pressure (r = -0.360, P = .004), suggesting that greater dipping was associated with better sleep quality. On multivariate analyses, Stage 4 sleep was independently associated with dipping of diastolic blood pressure (P = .034) after adjusting for screening MAP, percentage of WASO, total arousal index, and Stage 1 sleep. The same link was found between Stage 4 sleep and dipping of MAP (P = .05) after adjusting for screening MAP, age, sex, and body mass index. Repeat analyses excluding hypertensives yielded similar findings. CONCLUSION: Our data suggest that deeper and less-fragmented sleep is associated with more blood pressure dipping in normal subjects.

Adult↗
PubMedDate not supplied

Age and ethnicity differences in short-term heart-rate variability.

OBJECTIVE: Hypertension is more frequent and more severe in older individuals and in African Americans. Differences in autonomic nervous system activity might contribute to these differences. Autonomic effects on the heart can be studied noninvasively through analysis of heart rate variability (HRV). We examined the effects of age and ethnicity on HRV. METHODS: We studied 135 subjects (57 African Americans and 78 Caucasian Americans), aged 23 to 54 years. Using their surface electrocardiogram (ECG) data, we calculated the HRV indices with spectral analyses. High frequency (HF) power was used to index parasympathetic activity, whereas the ratio of low to high frequency power (LF/HF) was used to index sympathovagal balance. RESULTS: Three HRV indices (HF, LF power, and LF/HF) were significantly related to age in Caucasian Americans but not in African Americans. The effect of age, ethnicity, and the age-by-ethnicity interaction on HF and LF power was significant, even after controlling for gender, body mass index, and blood pressure. CONCLUSIONS: Young African Americans manifested a pattern of HRV response similarly to older Caucasian Americans. These results suggest that young African American individuals might show signs of premature aging in their autonomic nervous system.

Adult↗