Diet and duodenal ulcer Misciagna, G.; Cisternino, A.M.; Freudenheim, J.
Digestive and liver disease,
08/2000, Letnik:
32, Številka:
6
Journal Article
Recenzirano
Background. Despite the fact that the main cause of duodenal ulcer incidence and recurrence is the
Helicobacter pylori bacterium, more than 80% of
Helicobacter pylori-infected people never develop an ...ulcer. Diet may be one of the most important environmental factors contributing to duodenal ulcer.
Aims. To explore the role of diet in causation, treatment and prevention of duodenal ulcer recurrence.
Methods. All research papers published in English from 1966 to October 1999 present in Medline, involving human subjects, and having duodenal ulcer as outcome, entered the review.
Results and Conclusions. Soluble fibre from fruit and vegetables seem to be protective against duodenal ulcer and refined sugars a risk factor. The role of fibre in the treatment and prevention of recurrence of duodenal ulcer is uncertain, as is that of essential fatty acids. However, none of the epidemiological studies on the relationship between diet and duodenal ulcer disease controlled for
Helicobacter pylori.
Gallstones are a highly prevalent condition; however, the nutritional and lifestyle risk factors of this disease are not well understood.
We evaluated the association between diet, physical activity, ...and incident cases of gallstones diagnosed by ultrasound in a population-based, case-control study.
One hundred patients with newly diagnosed gallstones and 290 randomly selected control subjects without gallstones were enrolled in the study. The presence of gallstones was determined by ultrasonography. Both patients and control subjects completed a questionnaire about their usual diet and physical activity for the 12 mo before the ultrasonography. The association between diet and physical activity and risk of gallstone formation was analyzed by using multiple logistic regression.
Body mass index and intake of refined sugars were directly associated with risk of gallstone formation, whereas physical activity, dietary monounsaturated fats, dietary cholesterol, and dietary fibers from cellulose were inversely associated with risk of gallstone formation. Saturated fats were a risk factor for gallstone formation and the association appeared to be stronger for men than for women.
These findings suggest that a sedentary lifestyle and a diet rich in animal fats and refined sugars and poor in vegetable fats and fibers are significant risk factors for gallstone formation.
Estrogen receptors have been found in normal and neoplastic gastrointestinal mucosa. The aim of our study was to verify whether the content of cytosolic estrogen receptor in normal and neoplastic ...tissue has a prognostic value in patients with colorectal adenocarcinoma. Eighty consecutive patients entered the study, and their follow-up was complete because none were lost to follow-up. Estrogen receptors were evaluated by an enzymatic immunoassay. Fifty-four percent of neoplastic samples and 84% of samples from surrounding mucosa showed an estrogen receptor content higher than 1.0 fmol/mg of cytosolic proteins (cut point for positive/negative hormone receptor status). Estrogen receptor levels were lower in neoplastic tissue than surrounding mucosa (1.2 +/- 1.05 fmol/mg protein vs 2.07 +/- 1.36 fmol/mg protein, respectively, t test P = 0.001). The survival of patients with estrogen receptor expression in uninvolved surrounding mucosa was longer than that of patients without estrogen receptor in the same type of mucosa (log rank test, P < 0.01). In the neoplastic tissue, receptor status had no prognostic value (log rank, P = 0.8). After taking into account the most important potential confounders by using the Cox proportional hazard model, the estrogen receptor status in normal mucosa samples maintained an independent prognostic value. These results support an association between the estrogen receptor status in normal mucosa and survival of patients with colorectal adenocarcinoma.
Glycated apolipoprotein B (ApoB-G), a non enzymatically glycated protein, has recently been associated with myocardial infarction. Our aim is to evaluate, in diabetic and non diabetic subjects, the ...relationship of ApoB-G with serum fasting glucose, fructosamine, stable and labile fractions of glycated hemoglobin (SHbA1c, LHbA1c, respectively) and insulin. The subjects were recruited from a previous study on ApoB-G and myocardial infarction: 141 of them were studied, 43 with and 98 without diabetes. ApoB-G was measured using a monoclonal antibody, and linear regression and correlation were used for statistical analysis of the data. ApoB-G was higher in diabetic than in non diabetic subjects. There was a statistically significant correlation of ApoB-G with triglycerides (r = 0.38, p = 0.01) in diabetic subjects, and with total proteins (r = 0.37, p = 0.0002), triglycerides (r = 0.34, p = 0.0007), and cholesterol (r = 0.23, p = 0.02) in non diabetic subjects. In the most parsimonious multiple linear regression model of ApoB-G on all the other serum variables, there was a statistically significant association of ApoB-G with triglycerides, in both diabetic and non diabetic subjects. The main results of this study suggest that serum ApoB-G is associated with serum triglycerides in both diabetic and non diabetic subjects.
Background: Glycated hemoglobin (HbA
1c), a marker of glycemia in the previous 3 months, was found to be associated with dietary saturated, fat but not with carbohydrates, in recent population ...surveys. Another nonenzymatically glycated substance in the blood, fructosamine, a marker of glycemia in the previous 3 weeks, is poorly correlated with HbA
1c in nondiabetic subjects. The aim of this study is to compare the correlation of glycated hemoglobin and fructosamine with dietary carbohydrate intake in the same subjects.
Subjects and methods: Seventy-one individuals from a cohort study on diet and cancer entered this study. Serum fructosamine was measured by a standard colorimetric method, and glycated hemoglobin by high-performance liquid chromatography (HPLC). Diet was measured by a validated semiquantitative food frequency questionnaire. The correlation of fructosamine and glycated hemoglobin with dietary variables, corrected for calories, was evaluated by multiple correlation.
Results: Fructosamine was more strongly correlated with dietary sugar (
r=0.26,
p=0.05) than HbA
1c was (
r=0.001,
p=0.99). Fructosamine was also inversely correlated with energy, and glycated hemoglobin with vitamin C.
Conclusions: Fructosamine appears to be more related to dietary sugar intake than glycated hemoglobin and may be a marker of exposure to dietary carbohydrates, particularly simple sugars, in epidemiological studies.
Hepatitis C virus (HCV) has been recognized as a major cause of liver disease, but little is known about its diffusion at population level. To estimate the prevalence and incidence of HCV infection ...and to explore potential risk factors at population level, an epidemiologic study was carried out.
A cohort was built up in 1985, on a random sample of the population of Castellana, a small town in southern Italy (Bari province), and followed up until 1993. HCV ELISA II and RIBA HCV 2.0 were used as screening and confirmatory tests, respectively.
The overall anti-HCV prevalence was 26.0% (511/1969) at enrollment. The HCV infection incidence rate was 34.2x100,000 person-years (3 cases/8766 persons-years). A secular trend (referent born before 1930; born 1930-39 Odds Ratio (OR) 0.72, 95% Confidence Interval (95% CI) 0.56-0.94; born 1940-49, OR 0.33, 95% CI 0.25-0.44; born 1950 or after, OR 0.15, 95% CI 0.09-0.23) and geographical pattern (referent born outside Bari province; born in Bari province, OR 1.71, 95% CI 0.93-3.16; born in Castellana G, OR 2.29, 95% CI 1.29-4.05) were found by logistic regression analysis after controlling for several confounding factors.
The high prevalence, moderate incidence, and marked decrease in HCV infection in the cohort of birth in a population without known risk factors suggest that an epidemiological transition has been operating at population level since the 1950's.
Serum Fructosamine and Colorectal Adenomas Misciagna, Giovanni; De Michele, Giampietro; Guerra, Vito ...
European journal of epidemiology,
05/2004, Letnik:
19, Številka:
5
Journal Article
Recenzirano
The relationship of glucose in the blood with colorectal adenoma or cancer is not clear. Fructosamine, equivalent to total serum glycated proteins, is a marker of blood glucose levels in the previous ...3 weeks. We evaluated in a case-control study the association between fructosamine and colorectal adenoma, a precursor of colorectal cancer. Cases were subjects with the first occurrence of one or more histologically confirmed colorectal adenomatous polyps removed after a complete colonoscopy (153 cases), and controls were subjects with normal colonoscopy performed in the same endoscopy units during the same period (84 controls). Serum fructosamine was measured by a colorimetric method. Unconditional multiple logistic regression was used for statistical analysis. We found that in non-diabetic subjects the risk of colorectal adenoma increased with the level of fructosamine, and the odds ratio of colorectal adenoma in subjects with fructosamine levels higher than the median (270 μg/100 ml), in comparison with subjects with fructosamine lower than the median, was 2.3 (95% CI: 1.1-4.8). The risk of colorectal adenoma increased also with increasing levels of serum triglycerides and cholesterol, and decreased with increasing levels of fasting serum insulin. The results of this study show that the risk of colorectal adenoma increases with the level of fructosamine, an indicator of the level of glucose in the blood more sensitive to foods with a high glycemic index.
We evaluate whether Billroth II (BII) gastric resection is a predisposing condition in the formation of gallstones. In our department radiologic and echographic imaging is a routine examination ...before abdominal surgery. From 1980 to 1985, 202 patients underwent cholecystography or ultrasonography before BII gastric resections for peptic ulcers. The prevalence of cholelithiasis in a random sample of the population of the town near our institution was used to calculate the expected frequency of gallstones. The comparison of the expected and the observed frequencies of cholelithiasis in these patients did not show any statistically significant difference between men and women. All these patients were recalled for a follow-up of the long-term effects of gastric surgery, and 66% (133/202) returned and were examined. They underwent ultrasonography of the biliary tract. Again the observed and the expected (obtained as before) frequencies of cholelithiasis were compared. A statistically significant difference was apparent in male patients. We conclude that BII gastric resection could be a predisposing factor in the formation of gallstones in men.
The risk of colo-rectal cancer (CRC) in subjects with a positive family history (FH+) for malignancy has been assessed by means of a case-control study carried out between 1987-89 in an area of about ...215,000 inhabitants in Southern Italy. One hundred and nineteen CRC cases were compared with sex - and age - frequency matched population controls. Detailed pedigrees were collected at the family homes of both cases and controls. The odds ratio (OR) of CRC, adjusted by means of logistic regression for age, sex and number of first-degree relatives, increased with the number of any kinds of cancers in first-degree relatives with a significant linear trend (p = 0.042), while there was no risk with a FH+ for digestive cancer excluding CRC or for other cancers excluding large bowel and digestive organs. The OR (and 95% confidence interval) for CRC was 5.9 (1.64-21.23) for at least one first-degree relative with CRC. After a mutual adjustment between CRC and the other cancers in the families of cases and controls, the risk of CRC with a FH+ for other cancers did not change, revealing a strong association (p = 0.002) for CRC alone. From the analysis of the family history of cancer in the case group, the relative frequency of families that satisfied the criteria for so-called hereditary non-polyposic colo-rectal cancer (HNPCC) was 2.6%. The increased relative risk of CRC observed only in families with FH+ for CRC is a supportive finding for organizing and planning prevention and genetic counselling for these families, whose members should be referred for further assessment.
Background Hepatitis C virus (HCV) is a common cause of chronic liver diseases but the degree to which these diseases contribute to liver-related mortality is not well established. The aim of this ...study was to estimate the absolute and relative effects of HCV infection on liver-related mortality. Methods A population random sample of 2472 subjects aged ≥30 years was enrolled and followed up from 1985 to 1996. At enrolment, a structured interview and a clinical evaluation were performed. Serum samples were tested using HCV ELISA and RIBA HCV. Outcomes were overall and liver-related mortality and tracing procedures included review of office and hospital records, death certificates, and interviews with general practitioners, attending hospital and next of kin. Statistical analysis was performed using Poisson and binomial prospective data regression. Results Crude overall and liver-related mortality rates were 7.66 (95% CI : 6.68–8.79) and 0.9 (95% CI : 0.3–2.2) per 103 person-years, respectively. For HCV infection effect, incidence rate ratio and difference (per 103 person-year), risk ratio and difference were 27.5 (95% CI : 6.5–115.6), 4 (95% CI : 3–7), 33.1 (95% CI : 7.8– 139.3) and 0.06 (95% CI : 0.04–0.08), respectively; all measures were adjusted for age at death, sex and daily alcohol intake. Conclusions The results show a strong relative but weak absolute effect of HCV infection on liver-related mortality in the 10-year period considered. Poisson and binomial models are virtually equivalent, but the choice of the summarizing measure of effect may have a different impact on health policy.
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