Tuesday, November 29, 2011

Isolated Low Levels of High-Density Lipoprotein Cholesterol Are Associated With an Increased Risk of Coronary Heart Disease

Kadar kolesterol HDL rendah meningkatkan risiko PJK

Circulation 124(19):2056-2064, 8 November 2011 © 2011 American Heart Association, Inc.
Isolated Low Levels of High-Density Lipoprotein Cholesterol Are Associated With an Increased Risk of Coronary Heart Disease An Individual Participant Data Meta-Analysis of 23 Studies in the Asia-Pacific Region.
Rachel R. Huxley, Federica Barzi, Tai Hing Lam, et al.
Abstract
 
Background—Previous studies have suggested that there is a novel dyslipidemic profile consisting of isolated low high-density lipoprotein cholesterol (HDL-C) level that is associated with increased risk of coronary heart disease, and that this trait may be especially prevalent in Asian populations.
Methods and Results—Individual participant data from 220 060 participants (87% Asian) in 37 studies from the Asia-Pacific region were included. Low HDL-C (HDL <1.03 mmol/L in men and <1.30 mmol/L in women) was seen among 33.1% (95% confidence interval [CI], 32.9–33.3) of Asians versus 27.0% (95% CI, 26.5–27.5) of non-Asians (P<0.001). The prevalence of low HDL-C in the absence of other lipid abnormalities (isolated low HDL-C) was higher in Asians compared with non-Asians: 22.4% (95% CI, 22.2–22.5) versus 14.5% (95% CI, 14.1–14.9), respectively (P<0.001). During 6.8 years of follow-up, there were 574 coronary heart disease and 739 stroke events. There was an inverse relationship between low HDL-C with coronary heart disease in all individuals (hazard ratio, 1.57; 95% CI, 1.31–1.87). In Asians, isolated low levels of HDL-C were as strongly associated with coronary heart disease risk as low levels of HDL-C combined with other lipid abnormalities (hazard ratio, 1.67 [95% CI, 1.27–2.19] versus 1.63 [95% CI, 1.24–2.15], respectively). There was no association between low HDL-C and stroke risk in this population (hazard ratio, 0.95 [95% CI, 0.78 to 1.17] with nonisolated low HDL-C and 0.81 [95% CI, 0.67–1.00] with isolated low HDL-C).
Conclusion—Isolated low HDL-C is a novel lipid phenotype that appears to be more prevalent among Asian populations, in whom it is associated with increased coronary risk. Further investigation into this type of dyslipidemia is warranted.

Wednesday, November 23, 2011

Low-Density Lipoproteins Containing Apolipoprotein C-III and the Risk of Coronary Heart Disease

Risiko PJK akibat LDL lebih disebabkan kandungan LDL yang mengandung apoC-III


Circulation 124(19):2065-2072, 8 November 2011 © 2011 American Heart Association, Inc.
Low-Density Lipoproteins Containing Apolipoprotein C-III and the Risk of Coronary Heart Disease.
Carlos O. Mendivil, Eric B. Rimm, Jeremy Furtado, Stephanie E. Chiuve, Frank M. Sacks.
Abstract
 
Background—Low-density lipoprotein (LDL) that contains apolipoprotein (apo) C-III makes up only 10% to 20% of plasma LDL but has a markedly altered metabolism and proatherogenic effects on vascular cells.
Methods and Results—We examined the association between plasma LDL with apoC-III and coronary heart disease in 320 women and 419 men initially free of cardiovascular disease who developed a fatal or nonfatal myocardial infarction during 10 to 14 years of follow-up and matched controls who remained free of coronary heart disease. Concentrations of LDL with apoC-III (measured as apoB in this fraction) were associated with risk of coronary heart disease in multivariable analysis that included the ratio of total cholesterol to high-density lipoprotein cholesterol, LDL cholesterol, apoB, triglycerides, or high-density lipoprotein cholesterol and other risk factors. In all models, the relative risks for the top versus bottom quintile of LDL with apoC-III were greater than those for LDL without apoC-III. When included in the same multivariable-adjusted model, the risk associated with LDL with apoC-III (relative risk for top versus bottom quintile, 2.38; 95% confidence interval, 1.54–3.68; P for trend <0.001) was significantly greater than that associated with LDL without apoC-III (relative risk for top versus bottom quintile, 1.25; 95% confidence interval, 0.76–2.05; P for trend=0.97; P for interaction <0.001). This divergence in association with coronary heart disease persisted even after adjustment for plasma triglycerides.
Conclusions—The risk of coronary heart disease contributed by LDL appeared to result to a large extent from LDL that contains apoC-III.

Tuesday, November 22, 2011

Alkohol menyebabkan kanker payudara

Konsumsi alkohol meningkatkan risiko kanker payudara. Makin banyak alkohol makin tinggi risiko kanker payudara.

JAMA 306(17):1884-1890, 2 November 2011 © 2011 American Medical Association
Moderate Alcohol Consumption During Adult Life, Drinking Patterns, and Breast Cancer Risk. Wendy Y. Chen, Bernard Rosner, Susan E. Hankinson, Graham A. Colditz, Walter C. Willett.
Abstract
Context Multiple studies have linked alcohol consumption to breast cancer risk, but the risk of lower levels of consumption has not been well quantified. In addition, the role of drinking patterns (ie, frequency of drinking and "binge" drinking) and consumption at different times of adult life are not well understood.
Objective To evaluate the association of breast cancer with alcohol consumption during adult life, including quantity, frequency, and age at consumption.
Design, Setting, and Participants Prospective observational study of 105 986 women enrolled in the Nurses' Health Study followed up from 1980 until 2008 with an early adult alcohol assessment and 8 updated alcohol assessments.
Main Outcome Measures Relative risks of developing invasive breast cancer.
Results During 2.4 million person-years of follow-up, 7690 cases of invasive breast cancer were diagnosed. Increasing alcohol consumption was associated with increased breast cancer risk that was statistically significant at levels as low as 5.0 to 9.9 g per day, equivalent to 3 to 6 drinks per week (relative risk, 1.15; 95% CI, 1.06-1.24; 333 cases/100 000 person-years). Binge drinking, but not frequency of drinking, was associated with breast cancer risk after controlling for cumulative alcohol intake. Alcohol intake both earlier and later in adult life was independently associated with risk.
Conclusions Low levels of alcohol consumption were associated with a small increase in breast cancer risk, with the most consistent measure being cumulative alcohol intake throughout adult life. Alcohol intake both earlier and later in adult life was independently associated with risk.

Thursday, November 17, 2011

Tea and Coffee Consumption and MRSA Nasal Carriage

Konsumsi teh atau kopi panas menurunkan MRSA dalam hidung

Annals of Family Medicine 9(4):299-304, July 2011 © 2011 Annals of Family Medicine, Inc.
Tea and Coffee Consumption and MRSA Nasal Carriage.
Eric M. Matheson, Arch G. Mainous III, Charles J. Everett, and Dana E. King.
Abstract
 
PURPOSE Hot tea and coffee have been found to have antimicrobial properties. The purpose of this study was to determine whether the consumption of tea, coffee, or both is associated with less frequent nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA).
METHODS We performed a secondary analysis of data from the 2003–2004 National Health and Nutrition Examination Survey to investigate the relationship between the consumption of coffee, hot tea, cold tea, and soft drinks, and MRSA nasal carriage among the noninstitutionalized population of the United States.
RESULTS An estimated 2.5 million persons (1.4% of the population) were MRSA nasal carriers. In an adjusted logistic regression analysis controlling for age, race, sex, poverty-income ratio, current health status, hospitalization in the past 12 months, and use of antibiotics in the past month, individuals who reported consuming hot tea were one-half as likely to have MRSA nasal carriage relative to individuals who drank no hot tea (odds ratio = 0.47; 95% confidence interval, 0.31–0.71). Similarly, individuals who reported consuming coffee had about a one-half reduction in the risk of MRSA nasal carriage relative to individuals who drank no coffee (odds ratio = 0.47; 95% confidence interval, 0.24–0.93).
CONCLUSIONS Consumption of hot tea or coffee is associated with a lower likelihood of MRSA nasal carriage. Our findings raise the possibility of a promising new method to decrease MRSA nasal carriage that is safe, inexpensive, and easily accessible.

Monday, November 07, 2011

Alkohol meningkatkan kematian dan kanker (paru, kolorektal, prostat, payudara)

American Journal of Epidemiology published online 30 September 2011 © 2011  Johns Hopkins Bloomberg School of Public Health
Prospective Study of Alcohol Consumption Quantity and Frequency and Cancer-Specific Mortality in the US Population.
Rosalind A. Breslow, Chiung M. Chen, Barry I. Graubard and Kenneth J. Mukamal.
Prospective associations between quantity and frequency of alcohol consumption and cancer-specific mortality were studied using a nationally representative sample with pooled data from the 1988, 1990, 1991, and 1997–2004 administrations of the National Health Interview Survey (n = 323,354).
 
By 2006, 8,362 participants had died of cancer.
 
Cox proportional hazards regression was used to estimate relative risks.
 
Among current alcohol drinkers, for all-site cancer mortality, higher-quantity drinking (≥3 drinks on drinking days vs. 1 drink on drinking days) was associated with increased risk among men (relative risk (RR) = 1.24, 95% confidence interval (CI): 1.09, 1.41; P for linear trend = 0.001);
higher-frequency drinking (≥3 days/week vs. <1 day/week) was associated with increased risk among women (RR = 1.32, 95% CI: 1.13, 1.55; P-trend < 0.001).
 
Lung cancer mortality results were similar, but among never smokers, results were null.
For colorectal cancer mortality, higher-quantity drinking was associated with increased risk among women (RR = 1.93, 95% CI: 1.17, 3.18; P-trend = 0.03).
Higher-frequency drinking was associated with increased risk of prostate cancer (RR = 1.55, 95% CI: 1.01, 2.38; P for quadratic effect = 0.03) and tended to be associated with increased risk of breast cancer (RR = 1.44, 95% CI: 0.96, 2.17; P-trend = 0.06).
 
Epidemiologic studies of alcohol and cancer mortality should consider the independent effects of quantity and frequency.