Socioeconomic status and anthropometric changes-A meta-analytic approach from seven German cohorts.

OBJECTIVE: To study the association between socioeconomic status (SES) and annual relative change in anthropometric markers in the general German adult population. METHODS: Longitudinal data of 56,556 participants aged 18-83 years from seven population-based German cohort studies (CARLA, SHIP, KORA, DEGS, EPIC-Heidelberg, EPIC-Potsdam, PopGen) were analyzed by meta-analysis using a random-effects model. The indicators of SES were education and household income. RESULTS: On average, all participants gained weight and increased their waist circumference over the study's follow-up period. Men and women in the low education group had a 0.1 percentage points greater annual increase in weight (95% CI men: 0.06-0.20; and women: 0.06-0.12) and waist circumference (95% CI men: 0.01-0.45; and women: 0.05-0.22) than participants in the high education group. Women with low income had a 0.1 percentage points higher annual increase in weight (95% CI 0.00-0.15) and waist circumference (95% CI 0.00-0.14) than women with high income. No association was found for men between income and obesity markers. CONCLUSIONS: Participants with lower SES (education and for women also income) gained more weight and waist circumference than those with higher SES. These results underline the necessity to evaluate the risk of weight gain based on SES to develop more effective preventive measures.

Regional variation of chronic kidney disease in Germany: results from two population-based surveys.

BACKGROUND/AIMS: Due to the increasing prevalence of risk factors for chronic kidney disease (CKD), kidney dysfunction becomes a major public health problem. We investigated the CKD prevalence and determined to what extent the variation of risk factors explains the different CKD prevalence in Germany. METHODS: We analyzed data from 6,054 participants, aged 31 to 82 years, from the Study of Health in Pomerania (SHIP-1) in Northeast Germany and the Cooperative Health Research in the Region of Augsburg (KORA F4) Study in Southern Germany. Regional differences in selected percentiles corresponding to the cutpoints for estimated glomerular filtration rate (eGFR, <60 ml/min per 1.73 m(2)) and albumin-to-creatinine ratio (ACR, ≥30 mg/g) were tested using quantile regression models that adjusted for CKD risk factors. RESULTS: The prevalence of decreased eGFRcreatinine-cystatinC (5.9 vs. 3.1 %, p <0.001) and albuminuria (20.2 vs. 8.8 %, p<0.001) were higher in SHIP-1 than in KORA F4. The differential distribution of risk factors explained 18-21% of the regional differences of decreased eGFRcreatinine-cystatinC and high ACR. CONCLUSIONS: The CKD prevalence is higher in Northeast than in Southern Germany. Differences in the prevalence of risk factors partly explain the higher disease burden of CKD in Northeast than in Southern Germany.

Inverse association of estimated cystatin C- and creatinine-based glomerular filtration rate with left ventricular mass: Results from the Study of Health in Pomerania.

BACKGROUND: Left ventricular hypertrophy (LVH) is an independent predictor of cardiovascular disease in the general population and in patients with chronic kidney disease. The objective of this study was to investigate the association of estimated glomerular filtration rate (eGFR) with left ventricular mass index (LVMI), LVH and left ventricular geometry. A question of clinical relevance is whether estimated glomerular filtration rate based on cystatin C (eGFRcystatinC) is a better marker for cardiovascular risk than estimated glomerular filtration rate based on creatinine (eGFRcreatinine). METHODS: The study sample included 2830 individuals from the population-based Study of Health in Pomerania (SHIP). LVH was defined as echocardiographic LVMI >48 g/m(2.7) in men and >44 g/m(2.7) in women. Kidney function, as assessed by eGFR, was determined from established equations: the creatinine-based Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation and a cystatin-based multivariable equation. RESULTS: We found an inverse association between eGFR and LVMI. This association was stronger in models with eGFRcystatinC than in models with eGFRcreatinine. Subjects with moderately-to-severely decreased kidney function (defined as eGFR 15-<60 mL/min per 1.73 m(2)) had higher odds for abnormal geometric patterns of the left ventricle than subjects with normal eGFR when eGFRcystatinC was used. CONCLUSIONS: The findings suggest that eGFRcystatinC is superior to eGFRcreatinine for assessing the risk of cardiovascular disease.

Peroxiredoxin III protects pancreatic ß cells from apoptosis.

Type 1 diabetes mellitus is characterized by a progressive autoimmune destruction of insulin-producing ß cells. Macrophages and T lymphocytes release cytokines, which induce the synthesis of oxygen and nitrogen radicals in the pancreatic islets. The resulting cellular and mitochondrial damage promotes ß cell death. ß cells are very sensitive to the autoimmune free radical-dependent attack due to their low content of antioxidant enzymes such as glutathione peroxidase and catalase. A focal point of ß cell protection should be the control of the mitochondrial redox status, which will result in the preservation of metabolic stimulus-secretion coupling. For this reason, there is a considerable interest in the mitochondrial peroxiredoxin III (PRX III), a thioredoxin-dependent peroxide reductase, which was shown to be able to protect against both oxidative and nitrosative stress. Using the Tet-On-system, we generated stably transfected rat insulinoma cells over- or under-expressing PRX III in a doxycyclin-dependent manner to analyze the effect of increased or decreased amounts of cellular PRX III, following treatment with several stressors. We provide evidence that PRX III protects pancreatic ß cells from cell stress induced by accumulation of hydrogen peroxide, or the induction of inducible nitric oxide synthase or caspase-9 and -3 by pro-inflammatory cytokines or streptozotocin. Basal insulin secretion was markedly decreased in cells expressing lower levels of PRX III. We suggest PRX III may be a suitable target for promoting deceleration or even prevention of stress-associated apoptosis in pancreatic ß cells and the manifestation of insulin-dependent diabetes mellitus.

Subclinical hyperthyroidism is not associated with progression of cardiac mass and development of left ventricular hypertrophy in middle-aged and older subjects: results from a 5-year follow-up.

BACKGROUND: Decreased serum TSH levels are associated with increased cardiovascular mortality in elderly, and subclinical hyperthyroidism (SCH) was associated with left ventricular hypertrophy (LVH) as a predictor of cardiovascular mortality in some cross-sectional and case-control studies. The aim was to assess whether SCH independently impacts development of LVH over time. METHODS: Of 3300 participants of the population-based Study of Health in Pomerania those with overt hyperthyroidism, hypothyroidism, possible thyroid disease or missing echocardiographic baseline data or follow-up were excluded, resulting in a study population of 1112 individuals (556 women) aged 45-81 years. Echocardiographic left ventricular mass divided by height(2·7) (LVMI(ht)), and LVH(ht) (LVMI(ht) > 44 g/m(2·7) in women and > 48 g/m(2·7) in men) was measured at baseline and after 5-year follow-up (median 5·00; range 4·92; 5·08). Comparison of subjects with (n = 107) and without (n = 1005) SCH were made by linear and logistic regression models adjusted for age, gender, smoking status, hypertension, and waist circumference. RESULTS: At follow-up, LVMI(ht) did not differ between subjects with and without SCH (50·2 g/m(2·7), interquartile range (IQR) 41·2; 59·5 vs 47·8 g/m(2·7), IQR 39·3; 56·9; P = 0·29). LVH(ht) was present in 66 (61·7%) subjects with and 543 (54·0%) persons without SCH (P = 0·13). Analyses revealed no association between SCH and progression of LVMI(ht) (ß = -0·18; 95%-confidence interval (CI) -2·34; -1·99; P = 0·873), and development of LVH(ht) (relative risk 0·86, 95%-CI 0·60; 1·26; P = 0·462), respectively. CONCLUSIONS: In this population-based sample, SCH had no impact on progression of LVMI and development of LVH during 5-year follow-up in subjects aged 45 years or older.

Lack of association between insulin-like growth factor-1 or insulin-like growth factor-binding protein-3 and left ventricular hypertrophy: results of the Study of Health in Pomerania.

OBJECTIVE: Left ventricular hypertrophy (LVH) is a major cardiac sequel of hypertension and a powerful predictor of cardiovascular morbidity and mortality. Several nonpopulation-based studies explored the association between insulin-like growth factor-1 (IGF-I) and LVH with conflicting results. The aim of the present study was to investigate the association of serum IGF-I or IGF-binding protein-3 (IGFBP-3) levels with LVH in a population-based study. METHODS: From the cross-sectional Study of Health in Pomerania, 1865 participants aged 45-79 years were included. Echocardiography was performed and left ventricular mass index calculated. LVH was defined as left ventricular mass index more than 48 g/m for men and more than 44 g/m for women. Serum IGF-I and IGFBP-3 levels were determined by chemiluminescence immunoassays. Analysis of variance and logistic regression were performed. RESULTS: LVH was present in 52.0% of the women and 50.8% of the men. Our data did not obtain any significant association between serum IGF-I levels and left ventricular mass index or LVH in both men and women. Regarding IGFBP-3, women with low IGFBP-3 levels had an almost two-fold higher odds of LVH [odds ratio 1.76 (95% confidence limit 1.04-2.95)] compared with women with moderate IGFBP-3 levels. No such relation became apparent in men. CONCLUSION: No association between IGF-I levels and LVH was found. Potential hypertrophic effects of free serum IGF-I levels might be mediated by lower IGFBP-3 levels.

Hepatic steatosis is associated with low serum testosterone and high serum DHEAS levels in men.

Obesity and metabolic syndrome are associated with low serum testosterone levels. Hepatic steatosis contributes to the metabolic syndrome and might be regarded as its hepatic manifestation. In this study, we sought to investigate the relationship between hepatic steatosis, serum testosterone and dehydroepiandrosterone sulphate (DHEAS) levels in men. This is a cross-sectional population-based study. We used data of 1912 men recruited for the population-based Study of Health in Pomerania, which was conducted in a region with high prevalence of metabolic syndrome and related diseases. Hepatic steatosis was defined according to sonographic criteria. The relationship of hepatic steatosis with serum testosterone and DHEAS levels was analysed by multivariable logistic regression. Men with low serum testosterone levels had a higher risk of hepatic steatosis than men with high serum testosterone levels. Adjustment for age and further confounders attenuated this association, but did not affect statistical significance (odds ratio 2.36; 95% confidence interval 1.66-3.37; p < 0.05). In the full model, the highest risk of hepatic steatosis was found in subjects with the highest serum DHEAS levels (odds ratio 1.59; 95% confidence interval 1.04-2.43; p < 0.05). Exclusion of men with high alcohol consumption did not affect these results substantially. Hepatic steatosis is associated with low serum testosterone and high serum DHEAS levels. These associations are independent of alcohol consumption.

Inverse association between number of teeth and left ventricular mass in women.

OBJECTIVES: Recently, we have demonstrated a sex-specific inverse association between the number of teeth and hypertension. Left ventricular hypertrophy is a major cardiac sequel of hypertension. With the present study we sought to investigate whether there is also an inverse association between the number of teeth and left ventricular mass (LVM). METHODS: We used data from 1913 subjects (1036 women and 877 men) who were recruited for the population-based Study of Health in Pomerania (SHIP). The number of teeth, with the exception of the third molars, was counted in the full mouth. LVM was determined echocardiographically. Multivariable analyses were adjusted for major confounders. RESULTS: Women with fewer teeth had higher values for LVM than women with more teeth. This association was stable when controlled for major confounders. In the full model, edentulous women had an adjusted LVM of 178.4 g [95% confidence interval (CI) 170.4, 186.3 g] while women with 24-28 teeth had an adjusted LVM of 164.8 g (95% CI 156.8, 172.9 g; P < 0.01). In men, no such differences were observed. CONCLUSIONS: We conclude that there is an association between the number of teeth and LVM in women aged 45 years or older. In women, these findings further explain why poor oral health predicts all-cause and circulatory mortality. Further research in young, low-risk populations is needed to explore this association in men.