Biomedical subjects

S T Weiss

Publications and source records attributed to S T Weiss.

At least 19 recordsLinked to original sources

PubMed1992

Obesity and body fat distribution in relation to the incidence of non-insulin-dependent diabetes mellitus. A prospective cohort study of men in the normative aging study.

The relation between the abdominal accumulation of body fat, total-body adiposity, and blood glucose level and the risk of non-insulin-dependent diabetes mellitus was evaluated prospectively among 1,972 male participants in the Department of Veterans Affairs Normative Aging Study cohort. The risk of non-insulin-dependent diabetes mellitus was assessed by means of the proportional hazards model; 226 cases of diabetes occurred among the 1,972 men (mean age at entry, 41.9 years; range, 22-80 years) over 35,496 person-years of observation. The relation of body mass index to diabetes risk was partly explained by body fat distribution; after adjusting for age, the ratio of abdominal circumference to hip breadth, and cigarette smoking, men in the top tertile for body mass index had a 1.3-fold greater risk of diabetes than did men in the lowest tertile (95% confidence interval 0.9-1.8). Moreover, after adjusting for age, body mass index, and cigarette smoking, men in the top tertile for the ratio of abdominal circumference to hip breadth had a 2.4-fold greater risk of diabetes than did men in the lowest tertile (95% confidence interval 1.7-3.7). When blood glucose was analyzed as a continuous outcome variable, the findings were consistent, i.e., a positive association with abdominal fat independent of total-body adiposity. These results confirm previous reports of a prospective relation between abdominal adiposity and the risk of diabetes and provide prospective evidence of a relation between blood glucose levels and both body fat distribution and obesity.

Abdomen↗

PubMed1992

The relationship of nasal disorders to lower respiratory tract symptoms and illness in a random sample of children.

We examined the relationship of nasal disorders, defined as frequent colds and sinus trouble, to lower respiratory tract symptoms in a random population of 718 children aged 4 to 11 years in East Boston, Massachusetts. Frequent colds were significantly associated with maternal smoking (odds ratio (OR) = 3.00; 95% confidence interval (CI) = 1.97, 4.58), and so was sinus trouble (OR = 4.73; 95% CI = 1.78, 12.51). After adjustment for maternal smoking, age and sex, frequent colds (OR = 2.88; 95% CI = 1.87, 4.42) and sinus trouble (OR = 4.95, 95% CI = 1.83, 13.39) remained significant predictors of lower respiratory tract symptoms in separate logistic regressions. If one restricted the cohort to the 513 children who also had personal smoking information and adjusted for this variable as well, the results for colds were unchanged (OR = 2.94; 95% CI = 1.78, 4.84) but the results for sinus trouble were now not statistically significant (OR = 2.30, 95% CI = 0.67, 7.94). We conclude that nasal disorders are associated with lower respiratory tract symptoms in children.

Child↗

PubMed1992

Caffeine intake and asthma symptoms.

Methylxanthines in the form of coffee and tea may be dietary factors that function as pharmacologic bronchodilators. To examine this hypothesis, we analyzed data from the Second National Health and Nutrition Examination Survey (NHANES II). NHANES II was conducted on a sample representative of the civilian noninstitutionalized US population, which included white and black adults aged 30 years or older. We examined the relationship of usual coffee and tea consumption from a medical history questionnaire to the presence of asthma and wheezing symptoms. Subjects who drank coffee on a regular basis had a 29% reduction in the odds of having current asthma symptoms (odds ratio, 0.71; 95% confidence interval, 0.55 to 0.93) when compared with non-coffee drinkers. The effect exhibited a significant dose-response relationship, with the number of cups of coffee consumed per day being inversely related to asthma prevalence. This relationship was independent of age, gender, and cigarette smoking. Tea consumption was not significantly related to asthma prevalence in this cohort.

Adult↗

PubMed1992

Relationship of catecholamine excretion to body size, obesity, and nutrient intake in middle-aged and elderly men.

Catecholamine release from sympathetic nerves and the adrenal medulla is influenced by diet under controlled research conditions. To test whether diet affects catecholamine excretion in free-living men, the urinary content of dopamine (DA), epinephrine (Epi), or norepinephrine (NE) was measured in 24-h collections provided by 572 participants of the Normative Aging Study of the Veterans Administration. Average daily intakes of energy and macronutrients were assessed by means of a semiquantitative food frequency questionnaire and sodium intake by quantitation of sodium excretion. Catecholamine excretion was also examined in relation to anthropometric variables. Because DA and Epi excretion were inversely related to age, all subsequent analyses included adjustments for age. Although DA and NE were positively related to measures of body size and fatness, Epi was negatively related to body fatness. Excretion rates of all three catecholamines were directly related to total energy intake and inversely related to energy-adjusted CHO consumption.

Adult↗

PubMed1992

Trans-fatty acid intake in relation to serum lipid concentrations in adult men.

The relation of trans-fatty acid intake to fasting serum lipid concentrations was evaluated in a cross-sectional study of 748 men aged 43-85 y. Multiple-linear-regression analysis was used to adjust for age, body mass index, waist-to-hip circumference ratio, smoking status, physical activity, alcohol intake, total energy, dietary cholesterol and linoleic acid, and previous serum cholesterol concentration. Trans-fatty acid intake was directly related to total serum (r = 0.07, P = 0.04) and low-density-lipoprotein cholesterol (LDL) (r = 0.09, P = 0.01), and inversely related to high-density-lipoprotein (HDL) cholesterol (r = 0.08, P = 0.03). Trans-fatty acid intake was positively associated with the ratios of total to HDL cholesterol (r = 0.11, P = 0.002) and LDL to HDL cholesterol (r = 0.12, P = 0.001). The estimated ratios of total to HDL cholesterol were 4.4 and 4.9 for persons at the 10th (2.1 g/d) and 90th (4.9 g/d) percentiles of trans-fatty acid intake, respectively. On the basis of results from other studies, these ratios would correspond to a 27% increase in risk of myocardial infarction.

Adult↗

PubMed1992

Single breath transfer factor for carbon monoxide in an asymptomatic population of never smokers.

BACKGROUND: Data on reference values of transfer factor variables in general populations of asymptomatic never smokers are limited. The aim of this study was to examine the relation between test variables and age, height, haemoglobin concentration and carboxyhaemoglobin concentration. METHODS: Measurements of single breath transfer factor for carbon monoxide (TLCO) were obtained for a randomly selected sample of never smokers in north western Europe who were 18-73 years old and had no respiratory symptoms or disorders. Two recordings of TLCO with a ratio of inspiratory vital capacity to forced vital capacity of greater than 0.09 were obtained by standardised techniques for 304 subjects. RESULTS: The measurement errors expressed as a percentage of the common mean value of TLCO, volume adjusted TLCO (KCO), and alveolar volume (VA) were 4.5%, 4.2%, and 2.4% respectively. Multiple linear regressions showed sex specific effects of height and age on TLCO, and, in addition, of haemoglobin and carboxyhaemoglobin concentrations on KCO. VA was associated with height but not with age. The 5th and 95th centiles for TLCO and KCO in men and women were between 78% and 82% and between 120% and 127%, respectively, of predicted values when age and height were taken into account. CONCLUSION: Reference equations and normal values for transfer test variables in a large healthy population of never smokers are described in relation to age, height, and haemoglobin concentrations. To our knowledge, this is the first report of an association between carboxyhaemoglobin concentrations and KCO in a population of never smoking men and women.

Adolescent↗

PubMed1992

Elevated soluble interleukin-2 receptors in young healthy cigarette smokers: lack of association with atopy or airways hyperresponsiveness.

To study the relationship of atopy and nonspecific airways hyperresponsiveness to circulating levels of soluble interleukin-2 receptors (sIL-2R), we measured serum sIL-2R concentrations in 40 young, healthy smokers and non-smokers. Levels of sIL-2R were significantly higher in current smokers than in nonsmokers (median sIL-2R levels 605 vs. 398 U/ml, respectively; p less than 0.05). Serum sIL-2R levels were not related to nonspecific airways hyperresponsiveness to methacholine, allergy skin test reactivity, doctor-diagnosed asthma or hay fever, or respiratory symptoms of wheeze. Among current smokers, a trend toward higher sIL-2R levels (not statistically significant) was observed among subjects reporting symptoms of phlegm production. The increase in sIL-2R levels associated with cigarette smoking was similar in magnitude to that reported for immune-mediated conditions such as collagen vascular diseases and eczema. These data confirm that cigarette smoking is an important determinant of sIL-2R level, even among young healthy subjects. This effect does not appear to be related to atopic status or bronchial responsiveness. Among cigarette smokers, sIL-2R level may be related to the presence of conditions associated with phlegm production.

Humans↗

PubMed1992

Effects of asthma on pulmonary function in children. A longitudinal population-based study.

Data from a longitudinal study of childhood factors influencing the development of chronic obstructive lung disease were used to assess the effects of asthma on lung function development in male and female children. A population-based cohort of 602 white children, initially aged 5 to 9 yr, was observed prospectively for 13 yr. Spirometry was performed and a standardized respiratory and illness questionnaire was administered by trained interviewers on a yearly basis. Forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and forced expiratory flow between 25 and 75% of vital capacity (FEF25-75) were used as measures of lung function. The total number of children reporting asthma over the course of the study was 67. Male asthmatic subjects (n = 42) had larger average percentage of predicted FVC than nonasthmatic males (n = 277). Female asthmatic subjects (n = 23) had a lower average percentage of predicted FEV1 than nonasthmatic females (n = 260). In a multivariate analysis of the individual lung function measures, adjusting for previous level of pulmonary function, age, height, change in height, and personal and maternal smoking, males reporting active asthma had a significantly larger FVC than males with no history of asthma. In contrast, females with active asthma had a significantly smaller FEV1 than females with no history of asthma. Both males and females with active asthma had decreased FEF25-75. From our analysis, we would predict that a female who develops asthma at age 7 would experience a 5% reduction in FEV1 by age 10 and a 7% deficit by age 15.(ABSTRACT TRUNCATED AT 250 WORDS)

Asthma↗

PubMed1992

The effect of maternal smoking during pregnancy on early infant lung function.

We studied the effect of prenatal maternal cigarette smoking on the pulmonary function (PF) of 80 healthy infants tested shortly after birth (mean, 4.2 +/- 1.9 wk). Mothers' prenatal smoking was measured by: (1) questionnaire reports at each prenatal visit of the number of cigarettes smoked per day, and (2) urine cotinine concentrations (corrected for creatinine) obtained at each visit. Infant PF was assessed by partial expiratory flow-volume curves and helium-dilution measurement of FRC. Forced expiratory flow rates were significantly lower in infants born to smoking mothers, both when unadjusted and after controlling for infant size, age, sex, and passive exposure to environmental tobacco smoke (ETS) between birth and the time of PF testing. Flow at functional residual capacity (VFRC) in infants born to smoking mothers was lower than that found in infants whose mothers did not smoke during pregnancy (74.3 +/- 15.9 versus 150.4 +/- 8.9 ml/s; p = 0.0007). Differences remained significant when flow was corrected for lung size (VFRC/FRC: 0.87 +/- 0.26 versus 1.77 +/- 0.12 s-1; p = 0.013). No differences in pulmonary function were evident among infants exposed and unexposed to ETS in the home after stratifying by prenatal exposure status. We conclude that maternal smoking during pregnancy is associated with significant reductions in forced expiratory flow rates in young infants. The results suggest that maternal smoking during pregnancy may impair in utero airway development and/or alter lung elastic properties. We speculate that these effects of maternal prenatal smoking on early levels of forced expiratory flow may be an important factor predisposing infants to the occurrence of wheezing illness later in childhood.

Adult↗

PubMed1992

Recovery of leukotriene E4 from the urine of patients with airway obstruction.

The urinary excretion of leukotriene E4 (LTE4) was measured in subjects presenting for emergency treatment of airway obstruction. A total of 72 subjects presenting with airway obstruction performed peak flow determinations before and after three treatments with nebulized albuterol given at 20-min intervals. Of these subjects, 22 more than doubled their peak flow rates, while 19 failed to increase their peak flow rates more than 25% during the treatment period. These groups were designated "responders" and "nonresponders," respectively. Urinary LTE4 excretion was determined in 16 of the 22 responders and 12 of the 19 nonresponders as well as 13 normal subjects by precolumn extraction, analytic reversed-phase high-performance liquid chromatography, and enzyme immunoassay. In the normal subjects the urinary LTE4 excretion was significantly (p less than 0.0001) less than the urinary LTE4 measured in the responder subjects, but not less than the urinary LTE4 excretion in the nonresponder group (p = 0.071). The enhanced recovery of LTE4 from the urine of subjects with acutely reversible airway narrowing is consistent with a bronchoconstrictor role for the cysteinyl leukotrienes in spontaneous acute asthma.

Acute Disease↗

PubMed1992

Perception of airway obstruction in a random population sample. Relationship to airway hyperresponsiveness in the absence of respiratory symptoms.

Subjects with asymptomatic airway hyperresponsiveness in epidemiologic studies may have variable airway obstruction that is not perceived as dyspnea. We tested the hypothesis that such subjects are less likely to report an increase in dyspnea during histamine-induced bronchoconstriction than symptomatic hyperresponders. A random population sample of 412 middle-aged subjects was studied. Before and after a standardized histamine challenge test, subjects recorded Borg scores for dyspnea: any increase in Borg score was considered significant. More than 80% of hyperresponsive subjects (PC10 histamine < or = 16 mg/ml) had no symptoms. The presence of prechallenge dyspnea was related to increased airways responsiveness and current smoking. An increase in Borg score was associated with younger age, more severe airway responsiveness, atopy, and female sex. The level of and increase in the Borg score were not significantly related to level and change in airway caliber (FEV1). In hyperresponsive subjects (PC10 < or = 16 mg/ml), subjects who reported dyspnea, wheeze, or asthma were more likely to show an increase in Borg score during histamine provocation than asymptomatic subjects (adjusted odds ratio 4.01, 95% confidence interval 1.01 to 16.00, p = 0.049), after adjustment for age, sex, smoking habits, FEV1, and atopy. This suggests that asymptomatic hyperresponders may have variable airway obstruction that is not recognized as breathlessness.

Adult↗

PubMed1992

Relationship of skin test reactivity and eosinophilia to level of pulmonary function in a community-based population study.

We studied the relationship of skin test reactivity (sumscore greater than or equal to 3) and eosinophilia (greater than or equal to 275 cells/mm3 blood), separately and combined, to the level of FEV1 in a community cohort. We used the regression analysis technique, adjusting for age and area of residence, and stratifying by gender and cigarette smoking. Eosinophilia, among men, was associated with lower levels of FEV1 in skin test negative subjects with moderate cigarette smoking (greater than or equal to 10 pack-yr: beta = -250 ml, p = 0.02; greater than or equal to 10 pack-yr: beta = -234 ml, p less than 0.01) and in skin test positive subjects who either never smoked (beta = -228 ml, p = 0.06) or had only a brief history of smoking (beta = -428 ml, p less than 0.01). Eosinophilia, among women, was significantly associated with lower levels of FEV1 in never smokers (beta = -95 ml, p less than 0.01), especially if subjects were skin test positive as well (beta = -289 ml, p less than 0.01). Moderate cigarette smoking was uncommon in women. These data suggest an association of indices of inflammation (eosinophilia alone) and allergic inflammation (eosinophilia combined with skin test reactivity) with lower levels of FEV1, independent of the effect of cigarette smoking.

Age Factors↗

PubMed1992

Longitudinal lung function decline in subjects with respiratory symptoms.

The relation of respiratory symptoms and lung function has not been extensively investigated. To determine better the rate of FEV1 decline in subjects reporting persistent wheeze, chronic cough, chronic phlegm, and/or dyspnea, longitudinal data from an adult population sample of 3,948 subjects (1,757 men; 2,191 women) followed for 12 yr were analyzed. At the initial and subsequent follow-up visits, subjects completed a standardized respiratory questionnaire and performed spirometry using the same methods and spirometers. Subjects were categorized based on the presence or absence of self-reported respiratory symptoms (persistent wheeze, chronic cough, chronic phlegm, or shortness of breath) at the initial visit. Six-specific linear regression models were fitted to determine the effect of these respiratory symptoms on lung function. In both men and women, reporting of any respiratory symptoms was associated with both a reduction in initial lung function and more rapid decline in height-adjusted FEV1. Furthermore, after adjustment for height, age, and cigarette smoking, men with cough or phlegm and women with cough alone showed accelerated loss in FEV1. Clinicians should be aware of the predictive value of these respiratory symptoms, because therapeutic intervention may modify the associated decline in lung function.

Cough↗

PubMed1992

Relationship of urinary serotonin excretion to cigarette smoking and respiratory symptoms. The Normative Aging Study.

The relationship of 2-h urinary excretion of serotonin and 5-hydroxyindoleacetic acid (5-HIAA) to cigarette smoking and respiratory symptoms was examined among 631 male participants in the Normative Aging Study (age range, 44 to 85 years). The amount of serotonin excreted in urine was inversely related to age (p less than 0.001). Mean 2-h excretion of serotonin varied from 8.01 micrograms for men 40 to 49 years of age to 5.84 micrograms for those 70 years of age or over. No clear relationship was evident between the amount of 5-HIAA excreted in urine and age. After adjustment for age, current smokers were found to excrete more serotonin (p less than 0.001) and 5-HIAA (p = 0.001) than never smokers. Former smokers did not differ significantly from never smokers in these respects. After adjustment for age and smoking status in a multivariate model, chronic cough was a significant predictor of serotonin excretion (p = 0.005); chronic cough was less predictive of 5-HIAA excretion (p = 0.07). Other respiratory symptoms were unrelated to urinary excretion of serotonin and 5-HIAA. The mechanisms underlying the observed relationships of urinary serotonin and 5-HIAA excretion to smoking and to chronic cough and their potential relevance to chronic bronchitis remain to be determined.

Age Factors↗

PubMed1992

Association of intrauterine cigarette smoke exposure with indices of fetal lung maturation.

The timing of fetal lung maturation is regulated, at least in part, by the fetal endocrine milieu, which in turn may be influenced by environmental factors. Infants of smoking mothers are at decreased risk of neonatal respiratory distress syndrome (RDS), a disease of lung immaturity. Therefore, we measured fetal lung maturity and cigarette smoke exposure to determine whether the lungs of smoke-exposed fetuses mature more quickly and whether changes in maturation are associated with alterations in amniotic fluid (AF) cortisol levels. Amniotic fluid lecithin-sphingomyelin ratio (L/S) and saturated phosphatidylcholine levels were used as measures of lung maturity, while smoke exposure was assessed by measuring AF cotinine, a stable nicotine metabolite. Lung maturity was more advanced in smoke-exposed fetuses as measured by saturated phosphatidylcholine (P = .02) and L/S ratio (P = .04). Smoke-exposed fetuses attained sufficient lung maturity to minimize the risk of RDS approximately 1 week earlier than in unexposed fetuses. The AF of smoke-exposed fetuses also had higher levels of free, conjugated, and total cortisol. Acceleration of lung maturation in smoke-exposed fetuses is consistent with the decreased risk of RDS in infants of smoking mothers. Maternal smoking could influence lung maturation by directly or indirectly enhancing the production and/or secretion of cortisol. Despite the decreased risk of RDS, the developmental process by which smoke-exposed fetuses attain early pulmonary maturity is abnormal and may contribute to the decreased lung function and increased respiratory illness noted in infants of smoking mothers.

Adult↗

PubMed1991

Host and environmental factors influencing the peripheral blood leukocyte count.

The peripheral leukocyte count is an important predictor of mortality. Hence, host and environmental factors influencing the peripheral leukocyte count are of interest. The authors studied 8,635 subjects, aged 30-74 years, who were seen as part of the National Health and Nutrition Examination Survey II in 1976-1980, and sought to assess the relation of age, sex, obesity (body mass index), alcohol use, and various parameters of cigarette smoking to the peripheral leukocyte count using multiple regression analysis. Various parameters of cigarette smoking were statistically significant independent predictors of the peripheral leukocyte count with higher leukocyte counts seen among current smokers, relative to former or never smokers. Among current smokers, a dose-response relation was seen for cigarettes/day and total pack-years smoked. A dose-response relation with pack-years and years since quitting was seen in former smokers. Other variables that were statistically significant independent predictors of a higher peripheral blood leukocyte count were younger age, male sex, increased body mass index, and decreased alcohol consumption. Although the specific cell or cells responsible for these relations are not defined by this analysis, the results support the suggestion that a number of host and environmental factors can influence cellular markers of inflammation.

Adult↗

PubMed1991

Obesity, blood pressure, and the sympathetic nervous system.

Obesity has long been recognized as a major risk factor for the development of hypertension. Recently, insulin level has been shown to correlate with blood pressure in clinical and population-based studies. Since insulin is a major signal in the relationship between dietary intake and sympathetic nervous system activity, the possibility that insulin-mediated sympathetic stimulation is involved in the pathogenesis of hypertension in the obese has been raised. This hypothesis, developed on the basis of studies in laboratory rodents and normal human subjects, is currently being tested in the Normative Aging Study in Boston. Utilizing epidemiologic techniques applied to this defined population, evidence in support of this hypothesis has been accumulated. The preliminary results indicate that in this population, the abdominal form of obesity is associated with higher insulin levels and increased 24-hour urinary norepinephrine excretion (an index of sympathetic activity).

Animals↗

PubMed1991

Cigarette smoking, dietary intake, and physical activity: effects on body fat distribution--the Normative Aging Study.

Studies have indicated that although smokers weigh less than nonsmokers, smokers have greater waist-to-hip circumference ratios after adjustment for age and body mass index (BMI). The purpose of this investigation was to determine whether factors associated with smoking, such as dietary intake, alcohol intake, and physical activity, modified or confounded the relationship between smoking and body fat distribution. The study used cross-sectional data for 765 men aged 43-85 y from the Normative Aging Study. Current smokers were found to have a greater amount of central adiposity, as represented by the abdomen-to-hip circumference ratio (abdomen-hip ratio), than did former smokers and people who never smoked after adjustment for age, BMI, dietary and alcohol intakes, and physical activity. Multiple-linear-regression analysis revealed that physical activity was negatively associated with and alcohol intake was positively associated with the abdomen-hip ratio. These results suggest a direct effect of smoking on body fat distribution, independent of other smoking-related behaviors.

Adipose Tissue↗