Biomedical subjects

Tricia M McKeever

Publications and source records attributed to Tricia M McKeever.

10 recordsLinked to original sources

PubMed2005

Lung function and glucose metabolism: an analysis of data from the Third National Health and Nutrition Examination Survey.

Although people with diabetes have decreased lung function, the dose-response relation between measures of glucose control and lung function in nondiabetic people is not known. The authors used data from the Third National Health and Nutrition Examination Survey (1988-1994) to investigate the relation between glucose tolerance test response and other measures of glucose homeostasis and lung function in an adult population without a clinical diagnosis of diabetes. Plasma glucose level 2 hours after oral administration of 75 g of glucose was inversely related to forced expiratory volume in 1 second (FEV(1)), with a difference of -144.7 ml (95% confidence interval: -231.9, -57.4) for persons in the highest quintile of postchallenge glucose compared with the lowest. Similar inverse associations with FEV(1) were found for other measures of glucose autoregulation. Lung function did not appear to be related to fasting glucose level. Similar associations were seen for forced vital capacity (FVC) but not for the FEV(1):FVC ratio. In the total study population, persons with previously diagnosed diabetes had an FEV(1) 119.1 ml (95% confidence interval: -161.5, -76.6) lower than persons without diabetes. This effect was greater in those with poorly controlled diabetes. These findings suggest that impaired glucose autoregulation is associated with impaired lung function.

Adult↗

PubMed2005

The association of acetaminophen, aspirin, and ibuprofen with respiratory disease and lung function.

RATIONALE: Oxidative stress may increase the risk of asthma, contribute to asthma progression, and decrease lung function. Previous research suggests that use of acetaminophen, which is hypothesized to reduce antioxidant capacity in the lung, is associated with an increased risk of asthma. We hypothesized that acetaminophen use may also be associated with chronic obstructive pulmonary disease (COPD) and decreased lung function. OBJECTIVES: To investigate the associations between use of pain medication, particularly acetaminophen, and asthma, COPD, and FEV1 in adults. METHODS: A cross-sectional analysis using the Third National Health and Nutrition Examination Survey. MEASUREMENT AND MAIN RESULTS: Increased use of acetaminophen had a positive, dose-dependent association with COPD (adjusted odds ratio for increasing category of intake, 1.16; 95% confidence interval [CI], 1.09-1.24; p value for trend < 0.001) and an inverse association with lung function (daily user compared with never users, -54.0 ml; 95% CI, -90.3 to -17.7, adjusted). Neither of these associations was explained by overlap between COPD and asthma occurrence. We confirmed a dose-response association of acetaminophen use and asthma (adjusted odds ratio, 1.20; 95% CI, 1.12-1.28; p value for trend < 0.001). CONCLUSIONS: This study provides further evidence that use of acetaminophen is associated with an increased risk of asthma and COPD, and with decreased lung function.

Acetaminophen↗

PubMed2004

Diet and asthma.

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Antioxidants↗

PubMed2004

Serum nutrient markers and skin prick testing using data from the Third National Health and Nutrition Examination Survey.

BACKGROUND: Diet nutrients and allergic sensitization both affect the development and severity of asthma, but the interrelationship between oral intake and allergic sensitization is not well characterized, although previous work suggests that a higher vitamin E intake may be protective against allergic sensitization. OBJECTIVE: To determine whether serum levels of dietary antioxidants, lipids, and other nutrients are associated with the presence of allergen skin sensitization. METHODS: Cross-sectional logistic regression analysis of 30 serum nutrient levels in relation to 10 skin test allergens in adults and children in the Third National Health and Nutrition Survey. RESULTS: In adults, allergic skin sensitization was less common in participants with higher serum levels of vitamin E: the adjusted odds ratio (OR) per SD difference in vitamin E level was 0.93 (95% CI, 0.87-0.99). Two of the carotenoids, beta-cryptoxanthin and alpha-carotene, were also inversely associated with allergic skin sensitization (OR, 0.89; 95% CI, 0.83-0.95; and OR, 0.95; 95% CI, 0.91-0.99, respectively). Among adults, serum lycopene had a positive association with allergen sensitization. In youths, however, vitamin A was associated with an increased risk, and high-density lipoprotein cholesterol was associated with a decreased risk of allergic sensitization. The use of vitamin or mineral supplements had little effect on the magnitude of all reported associations. CONCLUSION: Overall, there were no strong or consistent associations between serum levels of potentially antiallergic nutrients, and the occurrence of allergic skin sensitization in these data. However limited, findings suggest that increases in vitamin E, carotenoids, and high-density lipoprotein cholesterol may reduce the risk of allergic skin sensitization.

Adolescent↗

PubMed2004

Vaccination and allergic disease: a birth cohort study.

OBJECTIVES: We examined the effect of vaccination for diphtheria; polio; pertussis and tetanus; or measles, mumps, and rubella on the incidence of physician-diagnosed asthma and eczema. METHODS: We used a previously established birth cohort in the West Midlands General Practice research database. RESULTS: We found an association between vaccination and the development of allergic disease; however, this association was present only among children with the fewest physician visits and can be explained by this factor. CONCLUSIONS: Our data suggest that currently recommended routine vaccinations are not a risk factor for asthma or eczema.

Asthma↗

PubMed2002

The importance of prenatal exposures on the development of allergic disease: a birth cohort study using the West Midlands General Practice Database.

The etiology of allergic disease is not understood, but a decreased exposure to infection may play an important role. There are few published data on the impact of change in microbial exposure during pregnancy on the child's risk of developing allergic disease. Using a birth cohort of 24,690 children, derived from the West Midlands General Practice Research Database, we investigated a number of perinatal exposures on the incidence of asthma, eczema, and hay fever. Our findings suggest that exposure to antibiotics in utero is associated with an increased risk of asthma in a dose-related manner (more than two courses of antibiotics compared with none adjusted hazard ratio [HR] 1.68; 95% confidence interval [CI], 1.51-1.87), and similar associations are present for eczema (adjusted HR 1.17; 95% CI, 1.06-1.29) and hay fever (adjusted HR 1.56; 95% CI, 1.22-2.01). Exposure to a range of infections in utero was also associated with a small increased risk of developing allergic disease. Strong protective effects of older siblings on the incidence of allergy are present within this cohort, but previous pregnancies that did not result in a live birth were not protective. Our findings suggest that exposure to antibiotics and to infections in utero is a potentially important risk factor in the development of allergic disease.

Age Factors↗

PubMed2002

Prospective study of diet and decline in lung function in a general population.

We have investigated the relationship between decline in lung function and dietary intakes of magnesium, vitamin C, and other antioxidant vitamins in a general population cohort in Nottingham, United Kingdom. In 1991, we measured dietary intake by semiquantitative food frequency questionnaire, forced expiratory volume in 1 second (FEV1), and respiratory symptoms in a cross-sectional survey of 2,633 adults aged 18-70. Nine years later we repeated these measures in 1,346 of these individuals. In cross-sectional analyses, after adjustment for smoking and other confounders, higher intakes of vitamin C and magnesium, but not vitamins A or E, were associated with higher levels of FEV1 in both 1991 and 2000. In longitudinal analysis with adjustment for confounders, decline in FEV1 between 1991 and 2000 was lower amongst those with higher average vitamin C intake by 50.8 ml (95% confidence interval, 3.8-97.9) per 100 mg of vitamin C per day, but was unrelated to magnesium intake. There was no relationship between decline in FEV1 and intake of vitamins A or E. This study suggests that a high dietary intake of vitamin C, or of foods rich in this vitamin, may reduce the rate of loss of lung function in adults and thereby help to prevent chronic obstructive pulmonary disease.

Adult↗

PubMed2002

Early exposure to infections and antibiotics and the incidence of allergic disease: a birth cohort study with the West Midlands General Practice Research Database.

BACKGROUND: It has been suggested that the rise in prevalence of allergic disease in westernized countries is due in part to a decrease in exposure to infections and an increase in the use of antibiotics early in life. OBJECTIVE: The purpose of this investigation was to quantify the relationships between (1) exposure to personal infections, infections in siblings, and use of antibiotics in early life and (2) the incidence of allergic disease. METHODS: Using the West Midlands section of the UK General Practice Research Database, we established a historical birth cohort of children (N = 29,238). For each child, we identified all personal infections and infections in siblings and determined the use of antibiotics in early life; we also noted incident diagnoses of asthma, eczema, and hay fever. The data were analyzed through use of Cox regression. RESULTS: There was no clear protective effect of exposure to either personal infections or infections in siblings with respect to the incidence of allergic disease. Antibiotic exposure was associated with an increased risk of developing allergic disease in a dose-related manner: having 4 or more courses of antibiotics in the first year of life was associated with an increased incidence of asthma (hazard ratio [HR], 3.13; 95% CI, 2.75-3.57), eczema (HR, 1.48; 95% CI, 1.31-1.68), and hay fever (HR, 2.12; 95% CI, 1.68-2.66). However, adjusting for consulting behavior reduced these effects (adjusted HR [95% CI]: asthma, 1.99 [1.72-2.31]; eczema, 1.01 [0.88-1.17]; hay fever, 1.14 [0.88-1.47]). CONCLUSIONS: We found no evidence that exposure to infections reduced the incidence of allergic disease, and infections did not explain the previous findings of a strong birth order effect in this cohort. The use of antibiotics might be associated with early diagnoses of allergic disease.

Anti-Bacterial Agents↗

PubMed2002

Mode of delivery and risk of developing allergic disease.

The aim of this study was to quantify the relationship between mode of delivery and subsequent incidence of allergic disease. The analysis is based on data derived from a birth cohort of 24,690 children who contributed data to the West Midlands General Practice Research Database. We found no convincing evidence to suggest that babies born by caesarean, forceps, or breech delivery had an increased risk of developing allergic disease.

Asthma↗

PubMed2002

Increase in the prevalence of allergen skin sensitization in successive birth cohorts.

BACKGROUND: Little is known about longitudinal trends in the prevalence of allergen skin sensitization in the general population. OBJECTIVE: We sought to measure the change in prevalence of allergen skin sensitization over a 9-year period in a cohort of adults and hence to determine whether cross-sectional differences in prevalence between age groups are due to an aging or cohort effect. METHODS: In 1991 and 2000, we measured skin sensitization, defined as a wheal diameter of 3 mm or larger than that elicited by a saline control, to Dermatophagoides pteronyssinus, cat fur, mixed grass, Aspergillus fumigatus, and Cladosporium herbarum in a cohort of 1339 adults from Nottingham aged between 18 and 71 years in 1991. Subjects were divided into six 9-year successive birth cohorts, and the effects of birth cohort and the within-subject change from 1991 to 2000 were analyzed in a generalized estimating equation logit model. RESULTS: The unadjusted prevalence of sensitization to any allergen was 30.5% in 1991 and 31.8% in 2000. In cross-sectional analyses the prevalence of sensitization decreased with increasing age at both surveys (risk ratio, 2.15; 95% confidence interval [CI], 1.45-3.17 for 18- to 26-year-old patients relative to 63- to 70-year-old patients in the 1991 survey). In longitudinal analysis there was no within-subject change in sensitization from 1991 to 2000 (adjusted odds ratio, 1.07; 95% CI, 0.97-1.19), but there was a significant cohort effect (adjusted odds ratio per successive 9 year cohort, 1.27; 95% CI, 1.18-1.37). CONCLUSION: The cross-sectional decrease in allergen sensitization with age in the general population arises predominantly from a secular increase in sensitization prevalence with successive birth cohorts and not to a loss of sensitization within subjects over time. As a result of this cohort effect, the prevalence of allergic sensitization has increased in this general adult population sample.

Adolescent↗