Biomedical subjects

Y Friedlander

Publications and source records attributed to Y Friedlander.

At least 109 records · Page 6Linked to original sources

PubMed1988

An epidemiologic study of mortality among bereaved parents.

To study the health consequences of parental bereavement, we compared the mortality in two groups of bereaved Israeli parents with that in the general population. One cohort comprised the parents of all 2518 soldiers 18 to 40 years of age who were killed during the Yom Kippur War in 1973. The second consisted of the parents of 1128 men 18 to 30 years of age who died in accidents between 1971 and 1975. Both groups were followed through 1983. The comparison population was the entire population of Jewish Israelis for which sex-, age-, and calendar year-specific mortality rates were available. The 10-year age-adjusted life-table mortality was higher among fathers whose sons died in accidents rather than in war (P = 0.045), but mortality did not differ significantly between the two groups of mothers. Overall, we found no excess mortality among the bereaved parents as compared with the general population. The standardized mortality ratios for the fathers and mothers of sons killed at war were 0.91 and 0.90, respectively; for fathers and mothers whose sons died by accident, they were 1.04 and 0.91, respectively. None were significantly different from unity. There was no consistent evidence of an elevated risk of death, early or late, after the loss. Widowed and divorced parents who lost a son did have increased mortality, which was statistically significant in mothers. Our findings provide no support for the hypothesis that the loss of an adult son is associated with increased short-term or long-term mortality in married parents.

Accidents↗

PubMed1988

Biological and cultural sources of familial resemblance in plasma lipids: a comparison between North America and Israel--the Lipid Research Clinics Program.

Heterogeneity in determinants of familial resemblance of lipid and lipoprotein levels between populations in North America and Israel was investigated using path analysis. A common protocol, identical measurement techniques, and the same statistical procedures were used in the two samples. Both genetic (h2) and cultural (c2) determinants of inheritance were significant for all lipid variables in the two studies. Genetic and cultural heritability of total cholesterol (h2 = 0.61, c2 = 0.02), low-density lipoprotein cholesterol (h2 = 0.59, c2 = 0.02), and high-density lipoprotein cholesterol (h2 = 0.55, c2 = 0.06) did not differ significantly between North America and Israel, while there was a significant difference for triglyceride (h2 = 0.41, c2 = 0.07 in North America; h2 = 0.61, c2 = 0.05 in Israel). Secondary parameters of the path model describing intrafamilial environmental relationships differed between the two countries. In particular, there was a higher correlation between marital environments in Israel for all traits except triglyceride, and a larger effect of father's environment on offspring's environment in Israel for all traits. Within both populations, variation of plasma lipids and lipoproteins was mostly explained by genetic factors and random unmeasured environmental factors. The contribution of common family environment was found to be small, though statistically significant. This is probably due to homogeneity of the distribution of familial environmental determinants within both countries.

Cholesterol↗

PubMed1988

Family resemblance for serum uric acid in a Jerusalem sample of families.

Familial aggregation of serum uric acid was studied in a sample of families examined in the Jerusalem Lipid Research Clinic. We first examined homogeneity of familial correlations across the major origin groups in the Israeli population sample. In general correlations were homogeneous across origin groups, except for spouse pairs. Pooled correlations among biological relatives across the origin groups were all statistically significant. Spouse correlation upon adjustment for concomitant variables was moderately positive (r = 0.115), yet significantly different from zero. Genetic and cultural determinants of uric acid were estimated utilizing a path model with 10 parameters to be estimated from a total of 16 correlations. Under a reduced model, genetic heritability (h2) was estimated to be 0.47 +/- 0.05 and cultural heritability (c2) was 0.11 +/- 0.03. However, our data gave suggestive evidence that cultural heritability was higher in parents (c2 = 0.28) than in children (c2 = 0.10). Commingling analysis and segregation analysis were also performed, and our findings imply that in the Israeli population there is no evidence for a major gene for high uric acid levels segregating in families.

Adult↗

PubMed1988

Familial aggregation of coronary heart disease: partial mediation by high density lipoproteins?

The potential explanation of coronary heart disease inheritance by the major coronary risk factors was explored in a random sample of 1044 males, aged 40-70 years, who formed part of the Jerusalem Lipid Research Clinic Prevalence Study. Standardised data were available on personal and family history, coronary risk factors, resting and exercise electrocardiography. Twelve percent of subjects had coronary heart disease (previous myocardial infarction or electrocardiographic changes) and 20% had a family history of heart attack before 60 years in first degree relatives. In the presence of a family history of heart attack, the mean level of high density lipoprotein-cholesterol (HDL-C) was 5 mg/dl lower in cases of coronary heart disease than in controls. No such difference existed in the absence of a family history of heart attack. In multiple logistic regression, HDL-C was a significant negative predictor of coronary heart disease presence, but only in subjects having a positive family history. A 1 standard deviation (10 mg/dl) increment in HDL-C was associated with a two-thirds reduction in heart disease risk. Other risk factors did not predict the occurrence of coronary heart disease to any significant extent in subjects with a positive family history of heart attack. In an overall logistic model combining family history with other risk factors, the significant predictors of heart disease were: age, total plasma cholesterol, hypertension, family history and HDL-C. The interaction term, family history X HDL-C, was also a significant negative predictor of heart disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1988

Biological and environmental sources of familial aggregation of blood pressure: the Jerusalem Lipid Research Clinic.

Genetic and cultural determinants of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were estimated using a path model on a sample of families examined in the Jerusalem Lipid Research Clinic. This model involves 10 parameters to be estimated from a total of 16 correlations (leaving ample degrees of freedom to test the goodness-of-fit). The general model fitted SBP (X2(6) = 6.95, p = 0.33) and DBP (X2(6) = 5.44, p = 0.49) very well. Both genetic (h2) and cultural (c2) components of inheritance were statistically significant for both blood pressure variables. Under the most parsimonious model, genetic heritabilities (h2) were estimated to be 0.20 and 0.28 for SBP and DBP respectively. Cultural heritability (c2) was 0.12 for SBP and 0.08 for DBP. A significant fraction of the estimate for cultural inheritance was due to a sibling environmental effect not mediated through their parents. Within this population genetic factors, common environmental factors and concomitant variables such as sex, age and origin explained about 40% of blood pressure variability. Most of the variance appears to be due to unmeasured environmental factors and errors of measurement.

Adolescent↗

PubMed1988

Acute renal failure in the elderly treated by one-time peritoneal dialysis.

To determine the factors affecting outcome of acute renal failure (ARF) in the elderly, we retrospectively studied 44 patients over the age of 65 who had undergone acute peritoneal dialysis. Thirteen patients (29%) survived 2 months or longer after dialysis treatment ("survivors"). Thirty-one patients (71%) died within this period ("nonsurvivors"). The main factor distinguishing survivors was the frequency of sepsis (none of 13 survivors vs 17 of 31 nonsurvivors). Preexisting malignancy and total number of acute insults to renal function were significantly less frequent, and immediate clinical and biochemical outcome of dialysis significantly better in survivors. The overall complication rate of dialysis was high (31 of 44 patients), but was significantly lower in survivors. Acute peritoneal dialysis is a useful procedure in the management of ARF in the elderly. However, we suggest that elderly patients in whom sepsis is a contributory factor to the development of ARF do not benefit from peritoneal dialysis therapy.

Acute Kidney Injury↗

PubMed1988

Familial aggregation of body mass index in ethnically diverse families in Jerusalem. The Jerusalem Lipid Research Clinic.

Familial aggregation of body mass index in different ethnic populations was studied in a sample of nearly 4000 families resident in Jerusalem. Covariate adjustments were applied to body mass index (BMI) to adjust for variation in means and variances with sex, age and origin and for the effect of education, socioeconomic status and seasonality. The analyses were done separately in each of the origin groups categorized according to the parents' country of birth (Europe, Asia, North Africa, Israel/mixed origin), in order to account for the heterogeneity among the groups. Parent-child correlations were generally homogeneous across the origin groups. Sibling correlations for BMI differed to a greater extent among the groups. The highest correlation was observed in the Asian group (r = 0.49) and the lowest in the North African group (r = 0.16). Pooled correlations among biological relatives across the origin groups were highly significant. Spouse correlation, although significant was smaller, suggesting a stronger influence of genes than shared environment in the determination of the trait. Father-child correlation was significantly higher (r = 0.25) than mother-child value (r = 0.19), suggesting a possible paternal influence on BMI. There was also asymmetry in parent-offspring correlations by the sex of the offspring. Sibling correlation was higher (r = 0.33) than parent-offspring correlation (r = 0.22), suggesting that shared environment within generations tended to have some importance.

Adolescent↗

PubMed1987

Religious observance and plasma lipids and lipoproteins among 17-year-old Jewish residents of Jerusalem.

The association of religious observance and plasma lipids and lipoproteins was studied in a sample of 673 Jewish residents of Jerusalem ages 17-18 years. Religious observance was classified according to the parents' ranking of their perceived degree of religiosity. The study group included children whose parents were orthodox Jews who pedantically observed religious commandments, children of traditional parents who observed some of the rules, and children of nonobservant secular parents. Plasma levels of cholesterol, triglyceride, and low-density lipoprotein were higher in secular children than in the orthodox group. These associations were independent of sex, origin, social class, body mass, and season. High-density lipoprotein cholesterol was somewhat higher in the orthodox group than in the secular children although this difference was not statistically significant. Regression analysis showed that offspring's environment and parental phenotype were the most important predictors of lipid concentrations in adolescents. The association of religious observance with plasma lipids and lipoproteins, however, was independent of parental phenotype lipid values and the contribution of offspring and parents' environment. These findings are consistent with similar differences in plasma lipids described previously among the parents, as well as the lower incidence of myocardial infarction in the orthodox religious group, which has been shown in the Israeli adult population.

Adolescent↗

PubMed1987

Parent-offspring aggregation of plasma lipids in selected populations in North America and Israel. The Lipid Research Clinics Prevalence Study.

Parent-offspring associations of total cholesterol and triglycerides were compared between family dyads in six North American populations examined between 1972 and 1976 as part of the North American Lipid Research Clinics Prevalence Study and those from families examined between 1976 and 1979 at the Lipid Research Clinic located in Jerusalem. Common study design, protocol, and laboratory techniques were used by all Lipid Research Clinics. The authors first examined homogeneity of familial correlations across clinics in the North American population and across origin groups in the Israeli sample. In general, correlations were homogeneous across clinics and origin groups, except for parent-daughter pairs for triglycerides in North America. The pooled familial correlations were similar in the two study populations. There was no asymmetry in parent-offspring correlations by the sex of the offspring. The pooled mother-child correlations were significantly higher than father-child values in the North American sample only. The strength of parent-offspring similarity showed no consistent pattern of change with level of education of parents in either study group. Patterns of familial similarity are discussed in relation to genetic, cultural, and environmental differences between the two study populations.

Adolescent↗

PubMed1987

Family resemblance for fasting blood glucose: the Jerusalem Lipid Research Clinic.

Familial aggregation of fasting plasma glucose was studied in a sample of families examined at the Jerusalem Lipid Research Clinic. We first examined homogeneity of familial correlations across major origin groups in the Israeli sample. Correlations were generally homogeneous across origin groups, except for mother-son pairs. The pooled familial correlations were relatively low for unadjusted blood glucose values, and somewhat higher upon adjustment for sex, age, ethnicity, education, seasonality, body mass, cigarette smoking, alcohol consumption and dietary intake. Genetic and cultural determinants of blood glucose were estimated utilizing a path model with 10 parameters to be estimated from a total of 16 correlations. Under a reduced model genetic heritability (h2) was estimated to be 0.18 +/- 0.08 and cultural heritability (c2) was 0.10 +/- 0.02. However, within this population the additive variation could be explained by a cultural model of inheritance without introducing genetic parameters, and most of the variance is due to "random" unmeasured environmental factors. Commingling analysis was also performed, and our findings imply that there is no evidence for admixture in the distribution of fasting blood glucose in this Israeli population sample.

Adolescent↗

PubMed1987

Complex segregation analysis of plasma lipid and lipoprotein variables in a Jerusalem sample of nuclear families.

Plasma lipid and lipoprotein concentrations from 3,074 nuclear families in the multiethnic Jerusalem Lipid Research Clinic study population were analyzed for possible involvement of major genes in determination of high levels of these traits. Complex segregation analysis under a mixed model including major gene and multifactorial transmissible components was performed on transformed-plasma lipids and lipoproteins after covariance adjustment for age, sex and environmental measures. Likelihood analysis provided evidence for recessive major genes influencing plasma triglyceride, and low-density lipoprotein cholesterol (LDL-C). The estimated gene frequencies for triglyceride and for hyperbetalipoproteinemia in our study population were about 0.1. Our positive results for total cholesterol and high-density lipoprotein cholesterol (HDL-C) were nonconclusive and the major effects could result from causes other than major genes. The mixed-model parameters were homogeneous across origin groups for LDL-C and HDL-C and heterogeneous for total plasma cholesterol and triglyceride. The multifactorial-transmission heritability index was similar in all origin groups for all the traits. The origin heterogeneity in the major gene parameters appeared to be mainly due to the North African group which favored a multifactorial transmission for all traits except for LDL-C.

Cholesterol↗

PubMed1987

Peripheral vascular disease in a middle-aged population sample. The Jerusalem Lipid Research Clinic Prevalence Study.

Peripheral artery status and prevalence of peripheral vascular disease were studied in a sample of 1,036 men and 556 women, residents of Jerusalem. Ankle blood pressures determined by the Doppler ultrasound technique (Parks Electronic Lab, USA), were higher in men than in women and increased with age. In a multivariable regression analysis, systolic blood pressure and plasma cholesterol levels were significantly and inversely related to the ankle/arm blood pressure in men, and alcohol intake was inversely associated in women. The prevalence of peripheral vascular disease, as determined by symptoms of intermittent claudication, was 1.3% in men and 1.8% in women; absent pedal pulses were found in 1.1% of the men and in 2.0% of the women; leg pain on the treadmill was a reason for termination of exercise in 3.7% of the men and in 5.4% of the women and an ankle/arm blood pressure ratio of less than 0.90 in 4.2% of the men and in 5.4% of the women. The overlapping of the diagnostic criteria was low. No consistent determinants of the various measures of peripheral vascular status were found. In multivariable logistic models, cigarette smoking was significantly associated with intermittent claudication [Odd ratio (OR) = 3.03, 95% confidence interval (CI) 1.27 to 7.26], age was associated with leg pain on the treadmill (OR = 1.91, 95% CI 1.08 to 3.40 in men and OR 3.52, 95% CI 1.52 to 8.16 in women), body mass index was associated with absent and diminished pulses in women (OR = 1.61, 95% CI 1.07 to 2.42, systolic blood pressure was associated with an ankle/arm ratio of less than 0.90 in men (OR = 1.35, 95% CI 1.01 to 1.81), and glucose was associated with absent and diminished pulses in women (OR = 1.20, 95% CI 1.00 to 1.44).

Adult↗

PubMed1986

Heterogeneity in multifactorial inheritance of plasma lipids and lipoproteins in ethnically diverse families in Jerusalem.

Genetic and cultural determinants of total cholesterol (TC), triglyceride (TG), low- and high-density lipoprotein cholesterol (LDL-C, HDL-C), and HDL-C/TC were estimated utilizing a path model in a random sample of nearly 4,000 families examined in the Jerusalem Lipid Research Clinic. The analyses were done separately in each of the ethnic groups categorized according to the parents' country of birth (Europe, Asia, North Africa, and Israel/mixed origin) in order to identify the nature and sources of any heterogeneity among the groups. Both genetic (h2) and cultural (c2) components of inheritance were significant for all lipid variables in each of the ethnic groups. Under the most parsimonious model, estimates of h2 in the ethnic groups were .40-.55, .40-.51, .45-.50, .41-.48, and .42-.78 for TC, LDL-C, HDL-C, HDL-C/TC, and TG, respectively. The c2 ranged from 3% to 5% for TC and LDL-C and from 4% to 10% for HDL-C, HDL-C/TC, and TG. The major parameters of the path model were generally homogeneous across the origin groups. The h2 appeared to be higher in the Asian and c2 was slightly greater in the European group. The stronger sibling environmental effect in the Asia group, the somewhat lower transmission of environment in the North African group, and the lower correlation between spouse environments in the North African group were the major sources of the origin heterogeneity. Within this population, genetic factors appear to be the major determinants of lipid variations, suggesting relative homogeneity of the distribution of environmental determinants of plasma lipids.

Adolescent↗

PubMed1986

Complex segregation analysis of low levels of plasma high-density lipoprotein cholesterol in a sample of nuclear families in Jerusalem.

Low levels of high-density lipoprotein cholesterol (HDL-C) are associated with increased risk of coronary heart disease (CHD). Therefore, assessment of the mode of inheritance of HDL-C is of importance. HDL-C concentrations in 3,074 nuclear families in the multiethnic Jerusalem Lipid Research Center study population were analyzed for possible involvement of major genes in determination of low levels of this trait. Complex segregation analysis under the mixed model of inheritance (major gene and multifactorial components) was performed on transformed HDL-C concentrations after adjustment for age, sex, and environmental measures. Evidence for segregation of a recessive major gene for depressed HDL-C, with an allele frequency of q = 0.06, in addition to multifactorial transmission (H = 0.45) was found in these families. Estimates from the mixed model were homogeneous across the different ethnic groups. When the substantial multifactorial background was excluded from the model, we found evidence for an additive (codominant) Mendelian gene (d = 0.48), which demonstrates the necessity of using the mixed model. Our previous results were inconclusive with respect to the involvement of a major gene in determination of high levels of HDL-C. However, we tentatively postulate an uncommon recessive gene for low levels of HDL-C in the Israeli population in addition to polygenic and environmental determinants.

Adolescent↗

PubMed1986

Comparison of plasma lipids, lipoproteins and dyslipoproteinemia in Israel and the United States. The Lipid Research Clinics Program Prevalence Study.

Based on the common study design, protocol, and laboratory techniques used by the Lipid Research Clinics (LRCs), the study reported here compared the adult study populations examined by the U.S. LRCs and the LRC located in Jerusalem, Israel. A number of 2388 residents of Jerusalem were contrasted with 6528 examinees of the U.S. LRCs regarding their plasma lipid and lipoprotein cholesterol distributions. Marked differences between the U.S. and Jerusalem LRCs were observed in the plasma levels of lipids and lipoprotein cholesterol fractions. Mean total cholesterol concentrations were 2-8% higher in the U.S. compared to the Jerusalem sample. Low density lipoprotein cholesterol levels were higher by approximately 5-15% in the U.S. LRCs, a phenomenon more marked in men than women and in older compared to younger study participants. High density lipoprotein cholesterol values were also higher in the U.S. compared to the Jerusalem LRC, by approximately 10-14% in men and women. These differences were also more pronounced in older compared to younger participants. By contrast, median plasma total triglycerides (and by implication very low density lipoprotein cholesterol) were higher in the Jerusalem compared to the U.S. study participants. This difference ranged from 10-21% by age and sex. The correlations between the plasma lipid/lipoprotein measurements were similar in the two study populations. Only the degree of linear association between plasma total triglyceride and very low density lipoprotein cholesterol was different between the U.S. and Jerusalem, with a correlation coefficient of greater magnitude in the latter. Employing common cutpoints to define dyslipoproteinemia (DLP) observed differences in plasma lipid/lipoprotein distributions determined differences in the frequency of DLP categories between the U.S. and the Jerusalem samples. Higher proportions of Type IV and hypo-HDL were observed in Jerusalem compared to the U.S. By contrast, fewer individuals were classified as Type IIa, Type IIb, and hyper-HDL in Jerusalem relative to the U.S.

Adult↗

PubMed1986

Analysis of risk factors in 532 survivors of first myocardial infarction hospitalized in Jerusalem.

During the period January 1979-March 1983, we have conducted in Jerusalem a case control study of all patients under the age of 65 surviving their first diagnosed myocardial infarction, in order to evaluate the importance of the conventional risk factors and to detect additional factors through quantifying plasma apolipoprotein concentrations. As a control group, we have chosen a sample from a previously studied Jewish population (LRC study), representative of the adult Jerusalemite population, parents of children born during 1958-1961. To complete the younger age group missing in the LRC population, we added a population studied in the Kiryat Yovel district of Jerusalem. We report here the results obtained from interviews and analysis of 532 cases (448 males and 84 females), and 869 controls (457 males and 412 females). In order to overcome the effects of age and ethnic origin on the risk factors, we have divided our populations according to age and country of origin of their fathers. Age, sex, smoking, history of high blood pressure, diabetes, elevated plasma triglycerides and/or cholesterol, and decrease in plasma HDL cholesterol, emerged as the most powerful and significant risk factors in this study. Other putative risk factors such as socioeconomic status, dietary habits, physical activity and obesity index were not found to be significantly different between cases and controls. It is noteworthy that smoking was more important as a risk factor in the younger age groups, whereas hypertension and diabetes were more important in the older age groups, particularly in females. The differences in lipid levels were considerably more prominent in the young age groups in both sexes. Myocardial infarction was observed more frequently in patients of European or American extractions. Apolipoproteins A-I, A-II, E and B determined in this study were shown to be affected partly by age and country of origin. Apo E and apo B levels were significantly higher and Apo A-I significantly lower in patients with myocardial infarction when compared to controls.

Aged↗

PubMed1986

Religious orthodoxy and myocardial infarction in Jerusalem--a case control study.

We examined the hypothesis that the degree of religious orthodoxy is an independent risk factor for coronary heart disease incidence in a study of 454 men and 85 women who experienced a first myocardial infarction. They were compared with a control group of 295 men and 391 women. All were Jewish residents of Jerusalem. The degree of religious orthodoxy was ascertained by interview of participants. Among the cases, 51% of the men and 50% of the women defined themselves as secular compared with 21% and 16%, respectively, among the controls. In a multivariate logistic model (including terms for age, ethnicity, education, smoking, physical exercise, body mass index and religious orthodoxy), the coefficients for age and smoking were positive and statistically significant, and those for education negative and significant. The risk for European born subjects was greater than for the other ethnic origin groups (statistically significant only in men). Secular subjects had a significantly higher risk of myocardial infarction compared to orthodox subject (odds ratio of 4.2 (95% confidence interval 2.6-6.6) for men and 7.3 (95% confidence interval 2.3-23.0 for women). This relationship was independent of the other variables in the model. The relation persisted in a subsample of cases who were examined 2-3 months after the acute phase of the infarction upon controlling for plasma cholesterol, high density lipoprotein cholesterol and hypertension. This finding should be substantiated. It would appear important to identify the components of religiosity associated with reduced risk.

Adolescent↗

PubMed1986

Comparison of nutrient intakes of selected populations in the United States and Israel: the Lipid Research Clinics prevalence study.

Nutrient intakes of 2,772 US and 2,680 Jerusalem participants of the Lipid Research Clinics Program were assessed by 24-h dietary recall in men aged 15-19 and 40-59 yr and women aged 15-19 and 35-59 yr. Energy intake was higher in the US than in Jerusalem. In Jerusalem intake of total fat ranged between 32.2-33.7% of kcal, of saturated fatty acids (SFA) between 9.8-10.9%, of polyunsaturated fatty acids (PFA) between 7.9-8.6%, of carbohydrates between 50.5-53.9%, and of starch between 24.0-30.5%. The P:S ratio ranged between 0.80 and 1.01. The corresponding ranges for the US were 38.8-40.8% for fat, 14.3-15.9% for SFA, 5.9-6.8% for PFA, 38.9-46.2% for carbohydrates, 17.0-17.9% for starch, and 0.40-0.53 for the P:S ratio. Intake of cholesterol (mg/1000 kcal) was higher in Jerusalem than in the US. These data address the feasibility of reducing fat in diets of free-living, Western populations.

Adolescent↗