Biomedical subjects

S A Kaye

Publications and source records attributed to S A Kaye.

33 records · Page 2Linked to original sources

PubMed1992

Dietary assessment of older Iowa women with a food frequency questionnaire: nutrient intake, reproducibility, and comparison with 24-hour dietary recall interviews.

The authors report the results of a dietary survey of 38,121 Iowa women, 55-69 years of age in 1986, based on a semiquantitative food frequency questionnaire previously tested among Boston-area women aged 34-59 years. The Iowa women, compared with the younger Boston-area women, consumed a similar amount of calories (1,767 vs. 1,844 kcal) and a similar amount of total calories from fat (35 vs. 37%) but had markedly greater intake of the following micronutrients after including supplement use: iron (+18%), calcium (+33%), vitamin A (+43%), riboflavin (+46%), thiamine (+50%), and pyridoxine (+122%). The reproducibility of the questionnaire was examined in two more administrations to 44 of the Iowa women in January and June of 1988. Reproducibility was highest for alcohol (Pearson's r = 0.99), caffeine (r = 0.95), and vitamin E (r = 0.90) and lowest for sucrose (r = 0.53), polyunsaturated fat (r = 0.56), and iron (r = 0.59). Micronutrient intakes were generally more reproducible than macronutrient intakes. The agreement between the June 1988 questionnaire and the average of five 24-hour dietary recalls was also assessed in the 44 subjects. The median correlations of energy-adjusted intake were as follows: for macronutrients, r = 0.45; for micronutrients without supplements, r = 0.33; and for micronutrients with supplements, r = 0.64. This food frequency questionnaire appears to be reasonably reproducible and accurate, so that its use may be extended to epidemiologic studies of older women with a broad range of socioeconomic backgrounds.

Energy Intake↗

PubMed1992

Effect of family history, body-fat distribution, and reproductive factors on the risk of postmenopausal breast cancer.

BACKGROUND: A family history of breast cancer reflects shared cultural factors, genetic predisposition, or both. There is evidence that the estimated risk associated with a family history of breast cancer increases multiplicatively in combination with other risk factors. We examined the combined effect of family history and anthropometric and reproductive factors on the risk of breast cancer in postmenopausal women. METHODS: Using data from a prospective cohort study, we studied 37,105 women 55 to 69 years of age to determine whether known risk factors for breast cancer are modified by a reported family history at the time of entry into the study. RESULTS: During the first 4 years of follow-up, 493 new breast cancers were diagnosed. The association of the waist-to-hip ratio (the circumference of the waist divided by that of the hips) with the risk of breast cancer was limited predominantly to women with a family history of breast cancer; the age-adjusted relative risk of breast cancer for the women above the fourth quintile for waist-to-hip ratio as compared with those below the first quintile was 3.2 in women with a family history of breast cancer and 1.2 for women without such a family history. An interaction was observed between a family history of breast cancer and the number of live-born children; the protective effect of higher parity was observed primarily among women with a family history of breast cancer. Similarly, the age-adjusted relative risk of breast cancer associated with a late age at first pregnancy (i.e., greater than or equal to 30 years) was 5.8 for women with a family history of breast cancer and 2.0 for women without such a family history. CONCLUSIONS: The increase in the risk of breast cancer associated with a high waist-to-hip ratio, low parity, or greater age at first pregnancy is more pronounced among women with a family history of breast cancer. These findings suggest etiologic differences between familial breast cancer and the sporadic form.

Adipose Tissue↗

PubMed1992

Parity-related weight change in women.

Pregnancy is thought to be a major contributor to the excess prevalence of obesity in women compared to men. Pregnancy-related increases in weight are purported to increase the risk that women will develop chronic diseases associated with high body weight. The assertion that pregnancy is associated with permanent weight gain and overweight was examined among 41184 post-menopausal women participating in a population-based study. Women reported lifetime parity, weight at ages 18, 30, 40 and 50 years, and current height. Body weight and body mass index (BMI) increased with age. On average, women gained 11.05 kg, or 0.35 kg per year between the ages of 18 and 50 years. Parity was associated with an increase in body weight from age 18 to 50 years of 0.55 kg per live birth, or 0.09 kg per live birth per year. At each age, women with lifetime parity of one or two live births had lower mean body weight and BMI, and a lower proportion overweight (BMI greater than 27 kg/m2), than either nulliparous women or those with three or more lifetime births. These results indicate a strong association between ageing and weight gain and a weak association between parity and both weight gain and overweight in women.

Adolescent↗

PubMed1991

Maternal reproductive history and birth characteristics in childhood acute lymphoblastic leukemia.

Using birth-registration data, a case-control study was done to investigate the possible associations of childhood acute lymphoblastic leukemia (ALL) with birth characteristics and maternal reproductive history. The data included cases born and diagnosed in Minnesota since 1969. Matched analyses were conducted using 337 cases and 1336 birth year-matched controls. There was a statistically significant increased odds of ALL for birth to older (greater than 35 years) mothers (odds ratio (OR) = 2.14, 95% confidence interval (CI) = 1.28, 3.58), older fathers (OR = 1.62, 95% CI = 1.14, 2.30), mothers with at least a high school education (OR = 1.61, 95% CI = 1.05, 2.48), and larger intervals (greater than 5 years) between the birth of the proband and the preceding sibling (OR = 1.86, 95% CI = 1.12, 3.09). The increased odds of ALL for birth by Caesarean section approached significance (OR = 1.42, P = 0.06). No overall association was found for: gender, race, paternal education, fetal-loss history, birth order, prenatal care history, pregnancy complications, inducement of labor, multiple birth, gestational age, or birth weight. Age at diagnosis was an important effect modifier of some analyses. For cases diagnosed before age 2 years, there was a 2.7-fold increased odds of ALL if the last pregnancy had resulted in a fetal loss (P = 0.03). For cases diagnosed before age 4 years, birth weight greater than 3800 g was associated with a significant 2.05-fold increased odds of ALL. These data strengthen the hypothesis that prenatal events may play a causative role in childhood ALL, particularly in those cases diagnosed at a younger age.

Abortion, Spontaneous↗

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

Associations of body mass and fat distribution with sex hormone concentrations in postmenopausal women.

The associations of body mass and body fat distribution, as measured by waist-to-hip circumference ratio, with serum concentrations of sex hormones and sex hormone binding globulin were examined in 88 postmenopausal women. Body mass index (BMI) was significantly and negatively associated with sex hormone binding globulin (SHBG) (r = -0.41), luteinizing hormone (LH) (r = -0.40) and follicle stimulating hormone (FSH) (r = -0.38) and was also significantly positively associated with both total and free oestradiol (r = 0.40 and 0.45, respectively). Waist-to-hip circumference ratio was significantly negatively correlated with SHBG (r = -0.53), LH (r = -0.35), and FSH (r = -0.35). After adjustment for BMI and other related factors, waist-to-hip circumference ratio was significantly and negatively associated with SHBG, LH, and FSH, and demonstrated a significant curvilinear relationship with free testosterone. These results suggest that in postmenopausal women, abdominal adiposity is associated with a relatively more androgenic sex hormone profile.

Adipose Tissue↗

PubMed1991

Is serum cortisol associated with body fat distribution in postmenopausal women?

The associations of body fat distribution, as measured by waist-to-hip circumference ratio (WHR), with fasting serum cortisol and adrenocorticotropic hormone (ACTH) were examined in 72 healthy postmenopausal women. WHR was not significantly correlated (P greater than 0.05) with either cortisol (r = -0.11) or ACTH (r = 0.10). There were no differences in either mean serum cortisol or ACTH for women in the highest tertile of WHR compared to those in the lowest tertile of WHR, even after adjustment for overall body mass. These results suggest that neither cortisol or ACTH is associated with body fat distribution in postmenopausal women.

Adipose Tissue↗

PubMed1990

Increased incidence of carcinoma of the breast associated with abdominal adiposity in postmenopausal women.

Epidemiologic studies have established that increased body weight is associated with a greater incidence of breast cancer in postmenopausal women. The authors hypothesized that abdominal adiposity further increases risk of postmenopausal breast cancer. They therefore investigated the waist-to-hip circumference ratio in relation to breast cancer incidence in a nested case-control study of 41,837 postmenopausal Iowa women aged 55-69 years. Women were recruited through a mail survey in January 1986 and were asked to have someone measure their body circumferences using a paper tape measure and written instructions. Cancer incidence was ascertained using a statewide cancer registry. A total of 229 incident breast cancers occurred among at-risk women during the first 2 years of follow-up (1986-1987). Compared with randomly selected controls (n = 1,839), women with incident breast cancer had a higher age-adjusted mean waist-to-hip ratio (by 0.013 units, p = 0.030), as well as greater mean weight (by 1.7 kg, p = 0.07), body mass index (by 0.6 kg/m2, p = 0.08), and weight gain since age 18 (by 2.7 kg, p less than 0.01). In multiple logistic regression models, age and current body mass index were significant effect modifiers of the association between the waist-to-hip ratio and breast cancer. A two-standard deviation increase in the waist-to-hip ratio (0.168 units) was associated with no increase in the relative risk of breast cancer in younger and lighter postmenopausal women. However, in older, heavier postmenopausal women, the same increase in the waist-to-hip ratio carried greater than a twofold excess relative risk. Adjustment for other breast cancer risk factors did not materially alter this finding. Two plausible explanations for elevated breast cancer incidence in women with abdominal adiposity include 1) increased concentrations of non-protein-bound estrogens due to reduced sex hormone binding globulin, or 2) increased conversion of adrenal androgens to estrone with abdominal adiposity.

Abdominal Muscles↗

PubMed1990

Incidence of hypertension and stroke in relation to body fat distribution and other risk factors in older women.

The relation between body fat distribution, as measured by the waist-to-hip circumference ratio, and the 2-year incidences of hypertension and stroke were examined in a cohort of 41,837 women aged 55-69 years. Women who developed hypertension were 2.1 (95% confidence interval 1.7-2.6) times more likely to be in the upper tertile of waist-to-hip ratio than those who did not. Adjustment for age, body mass index (kilograms per meter squared), cigarette smoking, physical activity, alcohol intake, and education level reduced this odds ratio to 1.6 (95% confidence interval 1.3-2.1). Women who developed a stroke were also 2.1 (95% confidence interval 1.5-2.9) times more likely to be in the upper tertile of waist-to-hip ratio than those who did not. Adjustment for the same covariates also lowered this odds ratio to 1.6 (95% confidence interval 1.1-2.4). Further adjustment for hypertension and diabetes mellitus reduced the estimated risk of stroke due to elevated waist-to-hip ratio to 1.3 (95% confidence interval 0.8-2.1). Hypertension, diabetes mellitus, and cigarette smoking remained significantly associated with stroke incidence in the multivariate model. These results indicate that abdominal adiposity, as measured by an increased waist-to-hip ratio, increases the risks of hypertension and stroke, even after accounting for overall body mass. The association of abdominal adiposity with risk of stroke is related, in part, to the association of abdominal adiposity with hypertension and diabetes.

Abdomen↗

PubMed1990

The association of body fat distribution with lifestyle and reproductive factors in a population study of postmenopausal women.

We examined the cross-sectional association of fat distribution with a number of lifestyle and reproductive factors in a random sample of 40,980 postmenopausal women, aged 55 to 69 years. The relationship of weight history with current fat distribution was also explored. Body fat distribution, defined by the ratio of waist-to-hip circumferences (WHR), was most strongly related to body mass index (BMI). WHR was also significantly and negatively associated with physical activity, alcohol consumption, and education, and was significantly positively associated with age, cigarette smoking, and a number of reproductive factors, such as history of infertility, number of live births, age at first live birth, and replacement estrogen use. WHR was not related to past BMIs, after adjusting for current body mass. The best-fit final regression model included (beta +/- s.e.) age (0.003 +/- 0.0001), BMI (0.02 +/- 0.0005), a curvilinear term for BMI (-0.0002 +/- 0.00001), greater than high school education (-0.007 +/- 0.001), cigarette smoking (0.02 +/- 0.001), alcohol drinker (-0.005 +/- 0.001), and number of live births (0.001 +/- 0.0002). The model R2 was 0.21. BMI (R2 = 0.18) and age (R2 = 0.02) accounted for most of the variation in WHR. The association of these lifestyle and reproductive factors with WHR suggests that the deposition of fat in the abdominal versus the gluteal region may be influenced somewhat by factors other than overall adiposity and genetics.

Abdomen↗

PubMed1989

Association of incident carcinoma of the endometrium with body weight and fat distribution in older women: early findings of the Iowa Women's Health Study.

Previous epidemiological studies have demonstrated that obesity increases endometrial cancer risk two- to 10-fold. To test the hypothesis that abdominal adiposity further increases this relative risk, we conducted a nested case-control study of endometrial cancer incidence in a cohort of 41,873 women ages 55-69 years. Women were recruited by mail and asked to have a friend measure circumferences of several body parts using a tape measure and written instructions. Two-year follow-up for cancer incidence was conducted using a state-wide cancer registry. Compared to random controls (n = 1,274), cases (n = 63) had higher age-adjusted mean values of waist-to-hip circumference ratio (P = 0.10) and trunk-to-limb circumference ratio (waist plus hip circumferences divided by arm plus calf circumferences, P = 0.008). Other anthropometric variables, including current body mass index and current weight, were also greater (P less than 0.001) in cases than controls. After accounting for the association with body mass index, neither the waist-to-hip ratio nor the trunk-to-limb ratio remained associated with endometrial cancer incidence (P greater than 0.40). A 5 kg/m2 increase in body mass index was associated with an adjusted relative risk of endometrial cancer of 1.80 [95% CI = 1.46, 2.22] when other significant risk factors, namely age, education level, extended use of exogenous estrogens, and age at menopause, were taken into account. We conclude that endometrial cancer risk is increased in relation to the amount but not the distribution of adiposity. This is in contrast with several other diseases in which, in addition to overall body mass, the distribution of adiposity is also important.

Abdomen↗

PubMed1989

Associations of abdominal adiposity, fasting insulin, sex hormone binding globulin, and estrone with lipids and lipoproteins in post-menopausal women.

The associations of abdominal adiposity, fasting serum levels of insulin, and sex hormones with blood lipids, lipoproteins, and apolipoproteins A-I and B were studied cross-sectionally in 75 healthy, postmenopausal white women. In univariate analyses, abdominal adiposity (increased waist-to-hip girth ratio) and fasting insulin concentrations were negatively and significantly associated (P less than 0.05) with plasma high density lipoprotein cholesterol (r = -0.47 and -0.38, respectively) and apolipoprotein A-I (r = -0.37 and -0.36), and positively associated with log triglycerides (r = 0.54 and 0.33) and apolipoprotein B (r = 0.43 and 0.22). Sex hormone binding globulin was positively and significantly associated with high density lipoprotein cholesterol (r = 0.32) and negatively associated with log triglyceride (r = -0.45) and apolipoprotein B (r = -0.36). Estrone was positively and significantly associated with high density lipoprotein cholesterol (r = 0.27), apolipoprotein A-I (r = 0.23) and negatively associated with low density lipoprotein cholesterol (r = -0.24) and apolipoprotein B (r = -0.25). Total estradiol, free estradiol, free testosterone, and total testosterone were more weakly associated with the lipid measures. In multivariate analyses, abdominal adiposity remained significantly associated with high density lipoprotein cholesterol, log triglycerides, apolipoproteins A-I and B after adjustment for sex hormone binding globulin, estrone, and insulin concentrations. Insulin remained associated only with apolipoprotein A-I after adjustment for abdominal adiposity, estrone, and sex hormone binding globulin. Sex hormone binding globulin remained marginally associated with log triglyceride (P = 0.07) after adjustment for the remaining three factors. Estrone remained significantly associated with high density lipoprotein cholesterol.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdomen↗

PubMed1989

Body fat distribution and self-reported prevalence of hypertension, heart attack, and other heart disease in older women.

The associations of self-reported body mass and fat distribution with self-reported prevalence rates of hypertension, heart attack, and other heart disease were examined in a sample of 40,000 women, aged 55-69 years. Fat distribution was measured by the waist-to-hip circumference ratio (WHR), which had a mean +/- SD of 0.838 +/- 0.085. Prevalence of hypertension was significantly and positively associated with both body mass index (BMI) and waist-to-hip ratio. The prevalence rate ratio for hypertension in the highest versus the lowest tertile of body mass index and waist-to-hip ratio (considered jointly) was 2.7. Prevalence rates of heart attack and other heart disease were significantly and positively associated with waist-to-hip ratio but not with body mass index. The prevalence rate ratios were 2.2 for heart attack and 1.4 for other heart disease in the highest versus the lowest tertile of body mass index and waist-to-hip ratio. Findings were substantiated using multiple logistic regression. These results support the hypothesis that a significant relationship exists between body fat distribution and the occurrence of cardiovascular disease in older women.

Adipose Tissue↗

PubMed1988

Accuracy and reliability of self-measurement of body girths.

Because body fat distribution has been recognized as a disease risk factor, practical methods for the measurement of body girths are needed. In two groups of postmenopausal women aged 55-69 years in the upper midwestern United States, the authors examined the reliability and accuracy of self-measurement by mail questionnaire of waist, hip, upper arm, wrist and calf girths. Intra-class correlations for waist girth were 0.96 when two self-measurements were compared and 0.93 when self-measurement was compared with technician measurement. Other intra-class correlations were at least 0.85 for repeat self-measurements except for wrist, which had an intra-class correlation of 0.66. For comparisons of self-measurement with technician measurement, intra-class correlations ranged from 0.71 for upper arm to 0.96 for hips. There was slight overestimation of waist girths and underestimation of hip girths when self-measurement was compared with technician measurement. Accuracy of self-measurement did not seem to vary according to age or educational status, but for hip, wrist, and calf girths it appeared that self-measurement underestimated technician measurement as girth size increased. For most girths, within-person variation in girth measurement also increased as girth size increased. Overall, girth self-measurement was both repeatable when re-ascertained by mail and accurate when compared with subsequent technician measurement.

Aged↗

PubMedDate not supplied

Treatment of polymyositis and dermatomyositis.

Polymyositis and dermatomyositis are serious inflammatory muscle disorders which may present life-threatening complications. It is important to recognise and treat the condition in the early stages of the disease. Corticosteroids remain the mainstay of treatment, and their resistance and other forms of immunotherapy are discussed.

Adrenal Cortex Hormones↗