Biomedical subjects

Ulrich John

Publications and source records attributed to Ulrich John.

At least 19 recordsLinked to original sources

PubMed2005

Low serum thyrotropin is associated with high plasma fibrinogen.

BACKGROUND: Elevated plasma fibrinogen levels are associated with an increased risk of cardiovascular events. Decreased serum TSH predicts vascular mortality, which hypothetically could be explained in part by alterations in the blood coagulation system. OBJECTIVE: The objective of this study was to investigate the association between thyroid function and plasma fibrinogen levels in a general population. DESIGN: The population-based Study of Health in Pomerania was performed in a previously iodine-deficient area in Germany, including 4310 subjects, aged 20-79 yr. Data for 3804 individuals without thyroid disease were analyzed. Analysis revealed an association between thyroid function status and plasma fibrinogen concentration. RESULTS: Elevated fibrinogen levels (>3.25 g/liter) were observed in 14 subjects with increased serum TSH levels (32.6%), 973 euthyroid subjects (28.9%), 158 subjects with decreased serum TSH levels (40.7%), and six individuals with overt hyperthyroidism (54.4%). Logistic regression analysis revealed decreased serum TSH as an independent risk factor for elevated fibrinogen levels (odds ratio, 1.42; 95% confidence interval, 1.12-1.80). CONCLUSIONS: Thyroid function is associated with plasma fibrinogen. Decreased serum TSH is an independent risk factor for elevated plasma fibrinogen levels as a possible explanation for the high cardiovascular mortality among affected subjects.

Adult↗

PubMed2005

Readiness for change and readiness for help-seeking: a composite assessment of client motivation.

AIMS: To investigate the correspondence between readiness for behaviour change in general and readiness for alcohol related help-seeking in particular. A related aim was to examine how, if at all, measures of dependence severity, use, and consequences were related to a composite measure depicting agreements and disagreements between general change readiness and help-seeking readiness. METHODS: Non-treatment seeking alcohol-dependent patients, numbering 549, from general hospitals in Germany were interviewed. RESULTS: When taking into account both dimensions of motivation, findings indicate 42% of the subjects were characterized by different motivation levels regarding readiness for change and readiness for help-seeking. Higher help-seeking readiness was associated with higher alcohol problem severity. Readiness to change was not affected by alcohol problem severity. CONCLUSIONS: Findings underscore the need to evaluate both motivational constructs in determining clients' need and receptivity to formal help.

Adult↗

PubMed2005

Association between thyroid function and gallstone disease.

AIM: To investigate those associations using data of the population-based Study of Health in Pomerania. METHODS: A study population of 3 749 residents aged 20-79 years without previously diagnosed thyroid disease was available for analyses. Serum TSH was used to assess thyroid function. Cholelithiasis was defined by either a prior history of cholecystectomy or the presence of gallstones on ultrasound. Logistic regression was performed to analyze independent associations between thyroid function and cholelithiasis. RESULTS: There were 385 persons (10.3%) with low (<0.3 mIU/L), 3 321 persons (88.6%) with normal and 43 persons (1.2%) with high serum TSH levels (>3 mIU/L). The proportion of cholelithiasis among males and females was 14.4% and 25.3%, respectively. Among males, there was an independent relation between high serum TSH and cholelithiasis (OR 3.77; 95%-CI 1.06-13.41; P<0.05). Also among males, there was a tendency towards an elevated risk of cholelithiasis in persons with low serum TSH (OR 1.40; 95%-CI 0.96-2.02; P = 0.07). In the female population, no such relation was identified. CONCLUSION: There is an association between thyroid and gallstone disease with a gender-specific relation between hypothyroidism and cholelithiasis.

Adult↗

PubMed2005

Association between alcohol consumption and subclinical carotid atherosclerosis: the Study of Health in Pomerania.

BACKGROUND AND PURPOSE: Epidemiologic studies have shown a J-shaped association between alcohol consumption and vascular diseases. However, only few studies have reported on the association between alcohol intake and subclinical atherosclerosis. The aim of the study was to investigate the relation between alcohol intake and carotid intima-media thickness (IMT) in participants of the population-based Study of Health in Pomerania. METHODS: In 1230 men and 1190 women, the mean IMT of the right and left common carotid arteries was measured by B-mode ultrasonography. Alcohol consumption was assessed with a computer-assisted face-to-face interview. RESULTS: In men, carotid IMT as a function of alcohol intake was depicted as a J-shaped curve with a nadir for the alcohol intake category of 61 to 80 g/d. Linear regression models controlled for age, diabetes, systolic blood pressure, leisure time physical activity, food frequency patterns, smoking status, and education revealed a significant inverse association between IMT and alcohol intake < or =80 g/d in men (beta=-0.009, P<0.02), which became insignificant after further controlling for HDL cholesterol and fibrinogen (beta=-0.007, P=NS). In women, neither a J-shaped relation nor significant differences in IMT between the drinking and nondrinking groups were found. CONCLUSIONS: Alcohol consumption is inversely correlated with carotid IMT in men but not in women. However, the total daily level of alcohol intake that shows a maximum protective effect against atherosclerosis is above the threshold where severe alcohol related comorbidity and organ damage have been reported.

Adult↗

PubMed2005

Intention to change drinking behaviour in general practice patients with problematic drinking and comorbid depression or anxiety.

AIMS: This paper examines the interaction of intention to change drinking behaviour with comorbid depression and anxiety in pro-actively recruited individuals with a range of drinking problems. METHODS: Cross-sectional data of 408 general practice (GP) patients aged 18-64 years, who meet the diagnostic criteria of alcohol dependence or abuse according to DSM-IV, criteria of at-risk drinking or binge drinking, were drawn from a brief intervention study. Of the sample, 89 participants were diagnosed with comorbid anxiety and/or depressive disorders. The Transtheoretical Model (TTM) of behaviour change constructs: stages and processes of change, self-efficacy, and decisional balance were assessed in relation to presence and absence of the respective psychiatric disorders. RESULTS: Analysis including all categories of problematic drinking revealed comorbid anxiety and/or depression to be significantly related to later stages of change. Within subgroups, this was only true for alcohol abuse, not for dependence, at-risk or binge drinking. In addition, comorbidity was related to higher use of processes of change and more pros and cons of drinking, when compared to non-comorbid participants. Comorbid individuals showed higher temptation to drink and lower self-efficacy to abstain from drinking. Separate analyses of readiness to change drinking between the categories anxiety/no comorbidity and depression/no comorbidity both obtained significance, while for anxiety disorders, this was more profound. A multinomial logistic regression analysis revealed that adverse consequences better predicted readiness to change when compared to comorbidity. DISCUSSION: Individuals with problematic drinking and comorbid anxiety or depression may be well accessible for pro-active intervention to reduce drinking. Strategies should focus on the enhancement of coping skills to control temptation and self-efficacy.

Adolescent↗

PubMed2005

Psychometric properties of the 'Processes of Change' scale for alcohol misuse and its short form (POC-20).

UNLABELLED: Regarding the processes of change, one of the core constructs of the transtheoretical model of intentional behavior change (TTM), extensive research has been done in the field of smoking. However, little is known about the processes of change for alcohol misuse and their measurement. This study's goals were to investigate the psychometric properties of the German Processes of Change (POC) scale and to refine a short version. METHOD: A sample of 653 non-treatment seeking general hospital patients with alcohol problems was used. Construct validity of the POC was analyzed using confirmatory factor analysis. As another validity aspect the use of processes of change across the stages of change was investigated. RESULTS: Internal consistency of the POC-20 ranged between r=.57 and .94. Construct validity was also good (CFI=.94). In line with TTM postulates subjects in later stages reported more behavioral processes compared to individuals in earlier stages. CONCLUSION: Findings indicated superiority of the POC-20 over the long version and good validity of the measure in a high per capita consumption nation.

Adult↗

PubMed2005

Gender and age differences among current smokers in a general population survey.

BACKGROUND: Evidence suggests a higher proportion of current smokers among female than among male ever smokers at the age above 50. However, little is known about the proportion of current smokers among ever smokers in old age groups with consideration of women in comparison to men from general population samples. The goal was to analyze the proportions of current smokers among female and among male ever smokers including those older than 80. METHODS: Cross-sectional survey study with a national probability household sample in Germany. Data of 179,472 participants aged 10 or older were used based on face-to-face in-home interviews or questionnaires. The proportions of current smokers among ever smokers were analyzed dependent on age, age of onset of smoking and cigarettes per day including effect modification by gender. RESULTS: Proportions of current smokers tended to be larger among female than among male ever smokers aged 40 or above. Women compared to men showed adjusted odds ratios of 1.7 to 6.9 at ages 40 to 90 or older in contrast to men. No such interaction existed for age of onset of smoking or cigarettes per day. CONCLUSION: Special emphasis should be given to current smokers among the female general population at the age of 40 or above in public health intervention.

Adolescent↗

PubMed2005

Occupational exposure to ionizing radiation is associated with autoimmune thyroid disease.

CONTEXT: The thyroid gland is a potential target organ for radiation-related damage. OBJECTIVE: The aim of the analysis was to investigate the association between occupational exposure to ionizing radiation and autoimmune thyroid disease (AITD). DESIGN: Our design was the cross-sectional Study of Health in Pomerania. SETTING: The setting was the general community. SUBJECTS: Analyses were performed in a population-based sample of 4299 subjects. Among them, 160 persons reported a history of occupational exposure to ionizing radiation. MAIN OUTCOME MEASURE: AITD was defined as the combined presence of hypoechogenicity in thyroid ultrasound and antithyroxiperoxidase antibodies greater than 200 IU/ml. RESULTS: Females with occupational exposure to ionizing radiation had more often AITD than nonexposed females (10.0 vs. 3.4%; P < 0.05). This association persisted after adjustment for relevant confounders (odds ratio, 3.46; 95% confidence interval, 1.16-10.31; P < 0.05). In males, there were too few subjects who fulfilled the criteria of AITD, but the association between the exposure to radiation and hypoechogenicity of the thyroid gland barely missed statistical significance (odds ratio, 2.20; 95% confidence interval, 0.92-5.26; P = 0.08). In both females and males, subjects who reported a length of exposure of more than 5 yr exhibited the highest risk of the endpoints. CONCLUSIONS: We conclude that occupational exposure to ionizing radiation is related to the risk of AITD. The usage of thyroid protection shields by radiation workers is strongly recommended.

Adult↗

PubMed2005

Relation of parity with common carotid intima-media thickness among women of the Study of Health in Pomerania.

BACKGROUND AND PURPOSE: Metabolic and hormonal changes associated with pregnancy and childbirth are assumed to contribute to the development of cardiovascular disease among women. We analyzed the association of parity with common carotid intima-media thickness (IMT), which has a predictive value of subsequent myocardial infarction and stroke. METHODS: The Study of Health in Pomerania (SHIP), an epidemiological study of the general population in the northeast of Germany, included 1195 women aged 45 to 79 years. Mean and maximum far-wall IMT of the common carotid arteries were assessed by high-resolution ultrasound. All women were comprehensively characterized as to their reproductive history as well as to socioeconomic, behavioral, and biological risk factors. RESULTS: There was a U-shaped association between the number of children (from 0 to > or =4) and mean and maximum IMT. Nulliparous women had the highest age-adjusted mean (0.81 mm [95% CI, 0.78 to 0.84]) and maximum IMT (1.04 mm [95% CI, 1.00 to 1.09]), and women with single parity the lowest (mean IMT, 0.73 [95% CI, 0.72 to 0.74]; maximum IMT, 0.91 mm [95% CI, 0.89 to 0.93]; P<0.001 versus nulliparity for both parameters). Stepwise multivariate adjustment for socioeconomic factors, lifestyle variables, and biological variables attenuated the magnitude of this association yet significance remained. CONCLUSIONS: Nulliparity and higher number of children are associated with increased carotid IMT. These findings add support to the hypothesis of a link between the reproductive history of women and cardiovascular disease.

Aged↗

PubMed2005

Hepatic steatosis is associated with an increased risk of carotid atherosclerosis.

AIM: Although an association between hepatic steatosis and vascular risk factors has been described, direct relationships between fatty liver and atherosclerosis have not yet been investigated. The aim of the present study has been to investigate those relationships. METHODS: The Study of Health in Pomerania examined a random population sample aged between 20 and 79 years. A study population of 4 222 subjects without hepatitis B and C infections and without liver cirrhosis was available for the present analysis. Hepatic steatosis was defined sonographically and intima-media thickness (IMT) as well as plaque prevalence were estimated by carotid ultrasound. RESULTS: The prevalence rate of hepatic steatosis was 29.9%. Among subjects aged > or =45 years, an association between hepatic steatosis and IMT of the carotid arteries was found in bivariate analysis, but not after adjustment for atherosclerotic risk factors. Individuals with fatty liver had more often carotid plaques than persons without fatty liver (plaque prevalence rate 76.8% vs 66.6%; P<0.001). This association persisted after adjustment for confounding factors and was predominantly present in subjects with no to mild alcohol consumption. CONCLUSION: There is an independent association between hepatic steatosis and carotid atherosclerotic plaques. Metabolic changes due to nonalcoholic fatty liver disease may explain this relationship.

Adult↗

PubMed2005

Independent risk factors for gallstone formation in a region with high cholelithiasis prevalence.

BACKGROUND/AIMS: Cholelithiasis is a common disorder in north-eastern Germany. Analyses of risk factors for gallstone formation in this population may have high explanatory power. Gender-specific risk factors for gallstone formation and their interactions were investigated by using data of the population-based Study of Health in Pomerania (SHIP). METHODS: Data of 4,202 persons aged 20-79 years were available. Cholelithiasis was defined by either a prior history of cholecystectomy or the presence of gallstones on abdominal ultrasound. Multivariable analyses were performed to identify independent risk factors for gallstone formation. RESULTS: There were 468 persons (11.1%) with previous cholecystectomy and 423 persons (10.1%) with sonographic evidence of gallstones. Women had a twofold higher risk for cholelithiasis compared to men. Age, body mass index and low serum HDL cholesterol levels were independently associated with cholelithiasis in both men and women. In the male population, low alcohol and high coffee consumption and in the female population, low physical activity, were further independently related to gallstone formation. Additionally, sex-specific interactions between risk factors were found. CONCLUSIONS: Female sex, age and being overweight are major risk factors for gallstone formation in this region where cholelithiasis is a frequent disorder. Additional factors and interactions contribute to a gender-specific gallstone risk.

Adult↗

PubMed2005

Relationships of psychiatric disorders with sleep duration in an adult general population sample.

The objective was to explore psychiatric disorders as potential predictors of sleep duration. A cross-sectional survey study with a probability sample of residents of a northern German area was carried out. There were 4075 study participants, aged 18--64 years, with a participation rate of 70.2%. Face-to-face in-home computer-aided interviews (Composite International Diagnostic Interview) provided diagnoses of nicotine and alcohol dependence, alcohol abuse, depressive, anxiety and somatoform disorders according to the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM-IV), and included questions about sleep duration. Results show that subjects with a short sleep duration of 5h or less had significantly increased odds ratios (OR) for current nicotine dependence (OR 1.9,; confidence interval, CI, 1.2--2.9), alcohol dependence (OR 2.6, CI 1.2--5.6), depressive disorder (OR 3.0, CI 1.7--5.4) or anxiety disorder (OR 2.1, CI 1.3--3.4) compared to individuals who never had the respective psychiatric disorder after adjustment for sex, age, and school education in a multinomial regression analysis. The conclusion is drawn that current nicotine or alcohol dependence, depressive, and anxiety disorders may add to short sleep duration in this random adult general population sample.

Adolescent↗

PubMed2005

Self-rated general health and psychiatric disorders in a general population sample.

The purpose of this study was to explore the relationships between nicotine and alcohol dependence, depressive, anxiety and somatoform disorders with self-rated general health (GH). A cohort study of a random sample of the non-institutionalised general population aged 18-64 with a participation rate of 70.2% was carried out in a German area (n = 4075 at baseline). A follow-up of tobacco smokers or heavy drinkers (n = 1083, 79.4% of those who had given consent to be followed-up) was conducted 30 months after baseline measurement. The assessments included self-ratings of GH and Diagnostic and Statistical Manual (DSM-IV) diagnoses based on the Composite International Diagnostic Interview. The results show that nicotine dependence, anxiety disorders and somatoform disorders moderately predicted self-rated GH at follow-up (general linear model, R(2) = 0.12). We conclude that psychiatric disorders may contribute to the prediction of a low self-rated GH.

Adolescent↗

PubMed2005

Stage of change transitions and processes of change, decisional balance, and self-efficacy in smokers: a transtheoretical model validation using longitudinal data.

Interactions were examined between stage of change transitions and intraindividual increases or decreases in the processes of change, pros and cons of smoking, and situational temptations longitudinally. A total of 786 ever smokers was assessed 2 times, 6 months apart, with respect to the transtheoretical model (TTM) constructs. Two significant discriminant functions within initial precontemplators and 1 significant function within initial contemplators were found. Ten out of 15 TTM variables contributed to at least 1 function. The functions mainly distinguished between preabstinence (precontemplation, contemplation, or preparation) and abstinence (action or maintenance) stages of change, that is, between current and former smokers. This is one of the few studies providing a longitudinal validation of the postulates of the TTM.

Adolescent↗

PubMed2005

Relationships of psychiatric disorders with overweight and obesity in an adult general population.

OBJECTIVE: To explore relationships of smoking and risk drinking status, nicotine and alcohol dependence, and anxiety, depressive, and somatoform disorders with overweight and obesity. RESEARCH METHODS AND PROCEDURES: A probability sample was drawn that was representative for the adult general population, 18 to 64 years of age, in one region of Germany; the participation rate was 70.2%. After excluding those who were pregnant or had a current eating disorder according to the DSM-IV, 4063 individuals remained. Overweight and obesity were defined according to the BMI that was assessed in the face-to-face in-home standardized interview (Composite International Diagnostic Interview) on psychiatric disorders. RESULTS: Men with a former nicotine dependence had higher odds of being overweight than men who never had a nicotine dependence (adjusted odds ratio, 1.5; confidence interval, 1.1 to 2.1). Men at current risk for drinking and current alcohol-dependent or abusing men had lower odds of being overweight compared with men who never were alcohol dependent, abusing, or at risk for drinking (adjusted odds ratio, 0.3; confidence interval, 0.8 to 0.9). Effect sizes were small. No relationship of overweight with depressive, anxiety, or somatoform disorders was found in the multivariate analysis. DISCUSSION: There is a relationship between being overweight and nicotine and alcohol dependence or abuse among men but not among women. Even though one reason for women to refrain from quitting smoking is the fear of weight gain, these results do not support this. This information could help convince women to try to quit smoking.

Adolescent↗

PubMed2005

Endothelial nitric oxide synthase Glu(298)-->Asp polymorphism, carotid atherosclerosis and intima-media thickness in a general population sample.

The Glu(298)-->Asp (E298D; 894G-->T) polymorphism of eNOS (endothelial nitric oxide synthase) has been related with cardiovascular disease. In the present study, we investigated the association of Glu(298)-->Asp with atherosclerotic plaques in different carotid vessel segments and with carotid IMT (intima-media thickness). The Glu(298)-->Asp eNOS polymorphism was determined by 5'-exonuclease assay among 2448 participants of the SHIP (Study of Health in Pomerania). Mean and maximum common carotid IMT, as well as carotid atherosclerosis, were measured by high-resolution ultrasound. The Asp/Asp(298) genotype was associated with an increased risk of atherosclerotic plaques at the level of the common carotid arteries [multivariate odds ratio, 1.57 and 95% CI (confidence interval), 1.05-2.34; P=0.025], but not in the carotid bifurcations or internal or external carotid arteries. Glu(298)-->Asp genotype was not associated with carotid IMT in the whole sample. However, the Asp/Asp(298) genotype was independently associated with both higher mean [adjusted increase by 0.046 mm (95% CI, 0.013-0.078); P=0.006] and maximum carotid IMT [0.137 mm (95% CI, 0.064-0.209); P<0.001] in the low-risk group of subjects without carotid atherosclerosis. In conclusion, the Asp/Asp(298) genotype is associated with atherosclerosis in the common carotid arteries and, in a low-risk group, also with carotid IMT. This suggests that the association of the Glu(298)-->Asp genotype with atherosclerosis in the carotid arteries is site-specific and is modified by overall cardiovascular risk.

Adult↗

PubMed2005

Association of malocclusion and functional occlusion with subjective symptoms of TMD in adults: results of the Study of Health in Pomerania (SHIP).

An analysis of exclusively representative population-based studies on adults has shown that only few and inconsistent associations could be detected between malocclusions and clinical signs of temporomandibular disorders (TMD)--and none for functional occlusion factors (occlusal interferences, non-working side contacts, etc). The aim of this study was to analyze associations between morphologic occlusion as well as factors of functional occlusion and subjectively perceived symptoms of TMD--again on the basis of the population-based Study of Health in Pomerania (SHIP), providing a sample of 4310 subjects (out of 7008 subjects yielding a response rate of 68.8%) aged 20 to 81 years, and other international representative studies from the systematic review. Besides occlusal factors also parafunctions and socioeconomic status (SES) were taken into account (including age and sex). Multiple logistic regression analysis was used--adjusted for SES. In this study, none of the occlusal factors were significantly associated with the indication of more frequent subjective TMD symptoms. However, the parafunction "frequent clenching" was connected with subjective TMD symptoms (odds ratio = 3.4). Compared with other population-based studies few and (across studies) inconsistent associations between malocclusions and subjective TMD symptoms could be ascertained. No significant associations of factors of functional occlusion with TMD symptoms were identifiable.

Adult↗

PubMed2005

[Mental distress and the use of psychiatric and psychotherapeutic treatments services: results of the Study of Health in Pomerania].

OBJECTIVE: Due to the lack of adequate data on the need of psychiatric and psychotherapeutic care in the community, an evidence-based goal directed development of treatment systems in socioeconomically poorer regions in former Eastern Germany is not feasible. METHOD: A community sample from the Study of Health in Pomerania (N = 4310) was investigated with the "Beschwerdenliste" from von Zerssen. The met and the unmet need of care were estimated. RESULTS: 3.1 % of all subjects were treated at least once by a mental health professional during the last 12 months. 12 % of the subjects, currently not in treatment, were estimated to be highly distressed by psychopathological symptoms and were considered to be potentially in need of mental health care. From this follows a treatment rate of 20 %. Subjects with high mental stress consulted their GP's, internists, orthopedics and neurologists significantly more often than subjects with low mental stress. CONCLUSION: A considerable need of psychiatric and psychotherapeutic treatment facilities has to be faced. Besides the improvement of psychiatric and psychotherapeutic treatment facilities, psychosocial networks should be established in order to provide an integrative and interdisciplinary approach to mental problems in the community.

Adult↗