Multiple myeloma (MM) incidence is markedly higher in blacks compared with whites, which may be related to a higher prevalence of monoclonal gammopathy of undetermined significance (MGUS). Our ...objective was to define the prevalence and risk factors of MGUS in a large cohort representative of the US population. Stored serum samples from the National Health and Nutritional Examination Survey (NHANES) III or NHANES 1999-2004 were available for 12,482 individuals of age ⩾50 years (2331 'blacks', 2475 Hispanics, 7051 'whites' and 625 'others') on which agarose-gel electrophoresis, serum protein immunofixation, serum-free light-chain assay and M-protein typing were performed. MGUS was identified in 365 participants (2.4%). Adjusted prevalence of MGUS was significantly higher (P<0.001) in blacks (3.7%) compared with whites (2.3%) (P=0.001) or Hispanics (1.8%), as were characteristics that posed a greater risk of progression to MM. The adjusted prevalence of MGUS was 3.1% and 2.1% for the North/Midwest versus South/West regions of the United States, respectively (P=0.052). MGUS is significantly more common in blacks, and more often has features associated with higher risk of progression to MM. A strong geographic disparity in the prevalence of MGUS between the North/Midwest versus the South/West regions of the United States was found, which has etiologic implications.
CONTEXT Human adipose tissue expresses and releases the proinflammatory cytokine
interleukin 6, potentially inducing low-grade systemic inflammation in persons
with excess body fat. OBJECTIVE To test ...whether overweight and obesity are associated with low-grade
systemic inflammation as measured by serum C-reactive protein (CRP) level. DESIGN AND SETTING The Third National Health and Nutrition Examination Survey, representative
of the US population from 1988 to 1994. PARTICIPANTS A total of 16,616 men and nonpregnant women aged 17 years or older. MAIN OUTCOME MEASURES Elevated CRP level of 0.22 mg/dL or more and a more stringent clinically
raised CRP level of more than 1.00 mg/dL. RESULTS Elevated CRP levels and clinically raised CRP levels were present in
27.6% and 6.7% of the population, respectively. Both overweight (body mass
index BMI, 25-29.9 kg/m2) and obese (BMI, ≥30 kg/m2)
persons were more likely to have elevated CRP levels than their normal-weight
counterparts (BMI, <25 kg/m2). After adjustment for potential
confounders, including smoking and health status, the odds ratio (OR) for
elevated CRP was 2.13 (95% confidence interval CI, 1.56-2.91) for obese
men and 6.21 (95% CI, 4.94-7.81) for obese women. In addition, BMI was associated
with clinically raised CRP levels in women, with an OR of 4.76 (95% CI, 3.42-6.61)
for obese women. Waist-to-hip ratio was positively associated with both elevated
and clinically raised CRP levels, independent of BMI. Restricting the analyses
to young adults (aged 17-39 years) and excluding smokers, persons with inflammatory
disease, cardiovascular disease, or diabetes mellitus and estrogen users did
not change the main findings. CONCLUSION Higher BMI is associated with higher CRP concentrations, even among
young adults aged 17 to 39 years. These findings suggest a state of low-grade
systemic inflammation in overweight and obese persons.
Hepatitis C virus (HCV) infection is a leading cause of chronic liver disease in the United States. Before the characterization of HCV,
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the magnitude of infection could not be reliably ...determined because assessment of clinical disease (i.e., non-A, non-B hepatitis) underestimated the true extent of infection. After tests to detect antibody to HCV (anti-HCV) became available, studies to determine the prevalence of HCV infection in the general population were performed, mostly with volunteer blood donors as the subjects.
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However, the prevalence of HCV among blood donors does not reflect the prevalence in the general population, since even first-time . . .
Background. Herpes simplex virus types 1 and 2 (HSV-1 and HSV-2) are common infections with serious sequelae. HSV-1 is an increasingly important cause of genital herpes in industrialized countries. ...Methods. Using nationally representative data from the National Health and Nutrition Examination Survey (NHANES), we examined HSV-1 and HSV-2 seroprevalence among 14- to 49-year-olds in the United States. We estimated seroprevalence in 1999-2004 and 2005-2010, stratified by sociodemographic characteristics and sexual behaviors. We also reviewed HSV-1 and HSV-2 seroprevalence from 1976-1980 to 2005-2010. Results. In 2005-2010, the seroprevalence of HSV-1 was 53.9%, and the seroprevalence of HSV-2 was 15.7%. From 1999-2004 to 2005-2010, HSV-1 seroprevalence declined by nearly 7% (P<.01), but HSV-2 seroprevalence did not change significantly. The largest decline in HSV-1 seroprevalence from 1999-2004 to 2005-2010 was observed among adolescents aged 14-19 years, among whom seroprevalence declined by nearly 23%, from 39.0% to 30.1% (P < .01). In this age group, HSV-1 seroprevalence declined > 29% from 1976-1980 to 2005-2010 (P < .01). Conclusions. An increasing number of adolescents lack HSV-1 antibodies at sexual debut. In the absence of declines in HSV-2 infections, the prevalence of genital herpes may increase.
Human adipose tissue expresses and releases the proinflammatory cytokine interleukin-6, potentially inducing low-grade systemic inflammation in persons with excess body fat. To limit potential ...confounding by inflammation-related diseases and subclinical cardiovascular disease, we tested the hypothesis that overweight is associated with low-grade systemic inflammation in children.
The third National Health and Nutrition Examination Survey, 1988-1994, a representative sample of the US population.
A total of 3512 children 8 to 16 years of age.
Elevated serum C-reactive protein concentration (CRP; >/=.22 mg/dL) and white blood cell count (10(9) cells/L).
Elevated CRP was present in 7.1% of the boys and 6.1% of the girls. Overweight children (defined as having a body mass index or a sum of 3 skinfolds (triceps, subscapula, and supra-iliac) above the gender-specific 85th percentile) were more likely to have elevated CRP than were their normal-weight counterparts. After adjustment for potential confounders, including smoking and health status, the odds ratio (OR) was 3.74 (95% confidence interval CI: 1.66-8.43) for overweight boys and the OR was 3.17 (95% CI: 1.60-6.28) for overweight girls, based on the body mass index. Based on the sum of 3 skinfolds, these ORs were 5.11 (95% CI: 2.36-11.06) and 2.89 (95% CI: 1.49-5.59) for boys and girls, respectively. Overweight was also associated with statistically significant higher white blood cell counts. The results were similar when restricted to healthy, nonsmoking, nonestrogen-using children.
In children 8 to 16 years of age, overweight is associated with higher CRP concentrations and higher white blood cell counts. These findings suggest a state of low-grade systemic inflammation in overweight children. inflammation, obesity, children.
This study estimated future morbidity, mortality, and costs resulting from hepatitis C virus (HCV).
We used a computer cohort simulation of the natural history of HCV in the US population.
From the ...year 2010 through 2019, our model projected 165,900 deaths from chronic liver disease, 27,200 deaths from hepatocellular carcinoma, and $10.7 billion in direct medical expenditures for HCV. During this period, HCV may lead to 720,700 years of decompensated cirrhosis and hepatocellular carcinoma and to the loss of 1.83 million years of life in those younger than 65 at a societal cost of $21.3 and $54.2 billion, respectively. In sensitivity analysis, these estimates depended on (1) whether patients with HCV and normal transaminase levels develop progressive liver disease, (2) the extent of alcohol ingestion, and (3) the likelihood of dying from other causes related to the route of HCV acquisition.
Our results confirm prior Centers for Disease Control and Prevention projections and suggest that HCV may lead to a substantial health and economic burden over the next 10 to 20 years.
Because chronic liver disease may develop many years after acute hepatitis C virus (HCV) infection, the past incidence of acute infections is a major determinant of the future burden of ...HCV‐associated complications. We estimated past incidence of acute HCV infection using national seroprevalence data and relative age‐specific incidence data from a sentinel counties surveillance system. Projections of the future prevalence of HCV‐infected patients were derived from models that included an 85% drop in HCV infection incidence as observed for reported cases in the early 1990s. The models showed a large increase in the incidence of HCV infections from the late 1960s to the early 1980s. The degree of increase was dependent on the assumed rate of antibody loss; a model with 2.5% annual antibody loss showed annual incidence increasing from 45,000 infections (95% confidence interval 95% CI: 0‐110,000) in the early 1960s to 380,000 infections (95% CI: 250,000 to 500,000) in the 1980s. Projections showed that although the prevalence of HCV infection may be declining currently because of the decline in incidence in the 1990s, the number of persons infected for ≥20 years could increase substantially before peaking in 2015. If the incidence of new HCV infections does not increase in the future, persons born between 1940 and 1965 will be at highest lifetime risk of acquiring the infection.
This report describes the distribution of serum creatinine levels by sex, age, and ethnic group in a representative sample of the US population. Serum creatinine level was evaluated in the third ...National Health and Nutrition Examination Survey (NHANES III) in 18,723 participants aged 12 years and older who were examined between 1988 and 1994. Differences in mean serum creatinine levels were compared for subgroups defined by sex, age, and ethnicity (non-Hispanic white, non- Hispanic black, and Mexican-American). The mean serum creatinine value was 0.96 mg/dL for women in the United States and 1.16 mg/dL for men. Overall mean creatinine levels were highest in non-Hispanic blacks (women, 1.01 mg/dL; men, 1.25 mg/dL), lower in non-Hispanic whites (women, 0.97 mg/dL; men, 1.16 mg/dL), and lowest in Mexican-Americans (women, 0.86 mg/dL; men, 1.07 mg/dL). Mean serum creatinine levels increased with age among both men and women in all three ethnic groups, with total US mean levels ranging from 0.88 to 1.10 mg/dL in women and 1.00 to 1.29 mg/dL in men. The highest mean creatinine level was seen in non-Hispanic black men aged 60+ years. In the total US population, creatinine levels of 1.5 mg/dL or greater were seen in 9.74% of men and 1.78% of women. Overall, among the US noninstitutionalized population, 10.9 million people are estimated to have creatinine values of 1.5 mg/dL or greater, 3.0 million have values of 1.7 mg/dL or greater, and 0.8 million have serum creatinine levels of 2.0 mg/dL or greater. Mean serum creatinine values are higher in men, non-Hispanic blacks, and older persons and are lower in Mexican-Americans. In the absence of information on glomerular filtration rate (GFR) or lean body mass, it is not clear to what extent the variability by sex, ethnicity, and age reflects normal physiological differences rather than the presence of kidney disease. Until this information is known, the use of a single cutpoint to define elevated serum creatinine values may be misleading. (Am J Kidney Dis 1998 Dec;32(6):992-9)
Herpes Simplex Virus Type 2 in the United States, 1976 to 1994 Fleming, Douglas T; McQuillan, Geraldine M; Johnson, Robert E ...
New England journal of medicine/The New England journal of medicine,
10/1997, Letnik:
337, Številka:
16
Journal Article
Recenzirano
Odprti dostop
Herpes simplex virus type 2 (HSV-2) causes vesicular and ulcerative lesions in adults
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and may cause severe systemic disease in neonates and immunosuppressed hosts.
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In addition, genital ...ulceration caused by HSV-2 may facilitate the transmission of the human immunodeficiency virus (HIV).
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Infections with HSV-2 typically affect the genital area, and transmission is usually sexual.
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In contrast, herpes simplex virus type 1 (HSV-1) commonly causes oropharyngeal infection, and transmission is primarily by nongenital personal contact.
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However, both viruses are capable of causing either genital or oropharyngeal infection and can produce mucosal lesions that are clinically . . .
Infection with human papillomavirus (HPV) type 16 accounts for about half of cervical cancers worldwide. This study investigated the seroepidemiology of HPV-16 infection in the United States by using ...a population-based survey. Serum samples and questionnaire data were collected from 1991 to 1994 for the National Health and Nutrition Examination Surveys. HPV-16–specific IgG antibody was detected by use of an HPV-16 virus-like particle ELISA. HPV-16 seropositivity in the US population aged 12–59 years was 13.0% (95% confidence interval, 11.5%–14.7%). Seroprevalence was higher in women (17.9%) than in men (7.9%). Age, race/ethnicity, and number of lifetime sex partners were associated with HPV seropositivity in women. Race/ethnicity, age at first intercourse, urban/nonurban residence, years of sexual activity, and having had sex with a man were associated with HPV seropositivity in men. Information on HPV-16 seroepidemiology will be important for designing prevention efforts including vaccine programs
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