Thursday, December 18, 2008

Perut buncit berakibat gangguan ingatan

Hubungan antara obesitas dan penyakit jantung serta diabetes telah banyak diketahui. Penelitian ini mencari hubungan antara obesitas dan dementia (gangguan ingatan). Diteliti >6500 subyek, dari catatan medis 36 tahun kemudian, sebanyak 1049 pasien (15.9%) didiagnosis dementia.
 
Peneliti mendapatkan bahwa subyek dengan sagittal abdominal diameter (SAD) terbesar (the highest quintiles) berisiko 3 kali lebih besar untuk terkena dementia dibanding mereka dengan SAD terkecil (the lowest quintiles).
 
Bila menyertakan indeks massa tubuh, subyek obes (IMT>30) dan SAD terbesar menghadapi risiko 3,6 kali.
 
Kesimpulan obesitas sentral meningkatkan risiko dementia terlepas dari diabetes dan penyakit jantung. Mekanisme hubungan obesitas dan dementia perlu diteliti lebih lanjut.

Abstract

Neurology, September 30 2008;71:1057-1064 © 2008 American Academy of Neurology
Central obesity and increased risk of dementia more than three decades later.

R. A. Whitmer, PhD, D. R. Gustafson, PhD, E. Barrett-Connor, MD, M. N. Haan, DrPH, E. P. Gunderson, PhD and K. Yaffe, MD

From Kaiser Permanente Division of Research (R.A.W., E.P.G.), Oakland, CA; Goteberg University (D.R.G.), Goteberg, Sweden; the Department of Family Medicine (E.B.-C.), University of California, La Jolla; the Department of Epidemiology (M.N.H.), University of Michigan, Ann Arbor; and the Departments of Psychiatry, Neurology and Epidemiology (K.Y.), University of California, San Francisco.

Background: Numerous reports show that a centralized distribution of adiposity is a more dangerous risk factor for cardiovascular disease and diabetes than total body obesity. No studies have evaluated whether the same pattern exists with dementia. The objective was to evaluate the association between midlife central obesity and risk of dementia three decades later.

Methods: A longitudinal analysis was conducted of 6,583 members of Kaiser Permanente of Northern California who had their sagittal abdominal diameter (SAD) measured in 1964 to 1973. Diagnoses of dementia were from medical records an average of 36 years later, January 1, 1994, to June 16, 2006. Cox proportional hazard models adjusted for age, sex, race, education, marital status, diabetes, hypertension, hyperlipidemia, stroke, heart disease, and medical utilization were conducted.

Results: A total of 1,049 participants (15.9%) were diagnosed with dementia. Compared with those in the lowest quintile of SAD, those in the highest had nearly a threefold increased risk of dementia (hazard ratio, 2.72; 95% CI, 2.33–3.33), and this was only mildly attenuated after adding body mass index (BMI) to the model (hazard ratio, 1.92; 95% CI, 1.58–2.35). Those with high SAD (>25 cm) and normal BMI had an increased risk (hazard ratio, 1.89; 95% CI, 0.98–3.81) vs those with low SAD (<25 cm) and normal BMI (18.5–24.9 kg/m2), whereas those both obese (BMI >30 kg/m2) and with high SAD had the highest risk of dementia (HR, 3.60; 95% CI, 2.85–4.55).

Conclusions: Central obesity in midlife increases risk of dementia independent of diabetes and cardiovascular comorbidities. Fifty percent of adults have central obesity; therefore, mechanisms linking central obesity to dementia need to be unveiled.

Perut buncit meningkatkan risiko kematian

Dalam penelitian multisenter di Eropa terhadap 360 ribu partisipan yang di-follow-up selama hampir 10 tahun, ditemukan bahwa risiko kematian pada pria dan wanita dengan lingkar pinggang besar (the highest quintile) meningkat masing-masing 2.05 kali dan 1.78 kali. Demikian pula untuk waist-to-hip ratio besar (the highest quintile) meningkat masing-masing 1.68 dan 1.51.
 
Risiko terendah adalah yang mempunyai indeks massa tubuh <25.3 untuk pria dan <24.3 untuk wanita.
 
Kesimpulan baik general adiposity maupun abdominal adiposity berhubungan dengan risiko kematian. Sebaiknya dilakukan pengukuran lingkar pingang, waist-to-hip ratio, dan indeks massa tubuh untuk menilai risiko kematian.
 
 
 
N Engl J Med 359(20):2105-2120, 13 November 2008 © 2008 to the Massachusetts Medical Society
General and Abdominal Adiposity and Risk of Death in Europe.
T. Pischon, H. Boeing, K. Hoffmann, et al.
 
ABSTRACT

Background Previous studies have relied predominantly on the body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) to assess the association of adiposity with the risk of death, but few have examined whether the distribution of body fat contributes to the prediction of death.

Methods We examined the association of BMI, waist circumference, and waist-to-hip ratio with the risk of death among 359,387 participants from nine countries in the European Prospective Investigation into Cancer and Nutrition (EPIC). We used a Cox regression analysis, with age as the time variable, and stratified the models according to study center and age at recruitment, with further adjustment for educational level, smoking status, alcohol consumption, physical activity, and height.

Results During a mean follow-up of 9.7 years, 14,723 participants died. The lowest risks of death related to BMI were observed at a BMI of 25.3 for men and 24.3 for women. After adjustment for BMI, waist circumference and waist-to-hip ratio were strongly associated with the risk of death. Relative risks among men and women in the highest quintile of waist circumference were 2.05 (95% confidence interval [CI], 1.80 to 2.33) and 1.78 (95% CI, 1.56 to 2.04), respectively, and in the highest quintile of waist-to-hip ratio, the relative risks were 1.68 (95% CI, 1.53 to 1.84) and 1.51 (95% CI, 1.37 to 1.66), respectively. BMI remained significantly associated with the risk of death in models that included waist circumference or waist-to-hip ratio (P<0.001).

Conclusions These data suggest that both general adiposity and abdominal adiposity are associated with the risk of death and support the use of waist circumference or waist-to-hip ratio in addition to BMI in assessing the risk of death.

Monday, December 15, 2008

Kopi menghambat pertumbuhan janin

Bagi ibu hamil yang gemar minum kopi ada baiknya memperhatikan penelitian berikut.
Penelitian ini dilakukan di Inggris terhadap >2600 ibu hamil normal (usia kehamilan 8-12 minggu).
Hasil penelitian menunjukkan bahwa semakin besar konsumsi kafein selama kehamilan semakin besar pula risiko gangguan pertumbuhan janin.
Sehingga dianjurkan untuk mengurangi konsumsi kafein sebelum dan selama hamil.
 
Abstract
BMJ 3 November 2008;337:a2332 © 2008 BMJ Publishing Group Ltd
Maternal caffeine intake during pregnancy and risk of fetal growth restriction: a large prospective observational study. CARE Study Group.
 
Objective To examine the association of maternal caffeine intake with fetal growth restriction.

Design Prospective longitudinal observational study.

Setting Two large UK hospital maternity units.

Participants 2635 low risk pregnant women recruited between 8-12 weeks of pregnancy.

Investigations Quantification of total caffeine intake from 4 weeks before conception and throughout pregnancy was undertaken with a validated caffeine assessment tool. Caffeine half life (proxy for clearance) was determined by measuring caffeine in saliva after a caffeine challenge. Smoking and alcohol were assessed by self reported status and by measuring salivary cotinine concentrations.

Main outcome measures Fetal growth restriction, as defined by customised birth weight centile, adjusted for alcohol intake and salivary cotinine concentrations.

Results Caffeine consumption throughout pregnancy was associated with an increased risk of fetal growth restriction (odds ratios 1.2 (95% CI 0.9 to 1.6) for 100-199 mg/day, 1.5 (1.1 to 2.1) for 200-299 mg/day, and 1.4 (1.0 to 2.0) for >300 mg/day compared with <100 mg/day; test for trend P<0.001). Mean caffeine consumption decreased in the first trimester and increased in the third. The association between caffeine and fetal growth restriction was stronger in women with a faster compared to a slower caffeine clearance (test for interaction, P=0.06).

Conclusions Caffeine consumption during pregnancy was associated with an increased risk of fetal growth restriction and this association continued throughout pregnancy. Sensible advice would be to reduce caffeine intake before conception and throughout pregnancy.