Do postmenopausal women with NIDDM have a reduced capacity to deposit and conserve lower-body fat?

OBJECTIVE: To compare regional body fat distribution and sex hormone status of postmenopausal women with NIDDM with those of age- and BMI-matched normoglycemic women. RESEARCH DESIGN AND METHODS: The regional body fat distribution and sex hormone status of 42 postmenopausal women with NIDDM were compared with those of 42 normoglycemic women matched for age and BMI, who served as control subjects. Body composition was measured by dual-energy X-ray absorptiometry, and sex hormone-binding globulin (SHBG) and testosterone were measured in serum. RESULTS: Although the levels of total body fat were similar between the two groups, the women with NIDDM had significantly less lower-body fat (LBF) (P < 0.01) than the control subjects matched for age and BMI. This pattern of fat deposition in women with NIDDM was accompanied by an androgenic hormone profile, with decreased SHBG concentration and an increased free androgen index (P < 0.05 and P < 0.01, respectively). CONCLUSIONS: A reduced capacity to deposit and/or conserve LBF may be an independent factor associated with (or may be a marker of) the metabolic manifestations of the insulin resistance syndrome in women with NIDDM. The possibility that the smaller relative accumulation of LBF is a consequence of the androgenic hormonal profile should be investigated in future studies.

Evaluation of the autonomic cardiovascular response in Arnold-Chiari deformities and cough syncope syndrome.

OBJECTIVE: To study the autonomic control of heart rate in patients with Arnold-Chiari deformity types I and II who exhibit the signs and symptoms of cough syncope syndrome. DESIGN: Prospective, clinical descriptive study. SETTING: University clinical research center. PATIENTS: Nine patients with Arnold-Chiari deformity and cough syncope syndrome. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Changes in heart rate, blood pressure, and electrocardiograms for power spectral analysis of heart rate variability were studied in the supine and standing positions, preoperatively (n = 9) and postoperatively (n = 5). RESULTS: Preoperatively, 8 (89%) of 9 patients increased their heart rate after postural change from supine to standing (mean +/- SD delta = 13 +/- 13 beats per minute [bpm]). Postoperatively, 4 (80%) of the 5 patients exhibited a greater increase in standing heart rate (mean delta = 19 +/- 16 bpm) compared with preoperative values. Changes in systolic, diastolic, and mean blood pressure with postural change were variable. Preoperatively, all patients exhibited abnormal control of heart rate in response to postural change. Three patients (33%) showed an abnormal decrease in low-frequency heart rate power (mean delta = -27 +/- 35 bpm2); the remaining 6 (67%) demonstrated an abnormal increase in high-frequency heart rate power (mean delta = 25 +/- 41 bpm2). All patients were clinically asymptomatic at 2 months after surgery. A normal spectral response to postural change was demonstrated in heart rate power in all 5 patients who were reevaluated postoperatively, with an increase in low-frequency power (mean delta = 33 +/- 21 bpm2) and a decrease in high-frequency power (mean delta = -21 +/- 23 bpm2). CONCLUSIONS: Patients with cervicomedullary anatomic abnormalities caused by Arnold-Chiari deformities may exhibit abnormal autonomic control of heart rate, and the autonomic control of their heart rate returns to a normal pattern after surgical palliation in conjunction with resolution of clinical symptoms.

Blood pressure in the Australian- and Italian-born: a Melbourne suburb revisited after 20 years.

The aim of this study was to investigate changes in the average blood pressure of Australian-born and Italian-born men and women after a 20-year interval, in the same location, the Melbourne suburb of Brunswick, located about five km north of the centre of the city. Data pertaining to blood pressure and its control were obtained from all Australian- and Italian-born residents of Brunswick enrolled in the Melbourne Collaborative Cohort Study between 1990 and 1994. Comparisons were made with published data from a random household survey in Brunswick in 1972. Within the age group 40 to 59 years (in contrast to the earlier study) average blood pressure was significantly higher in Italian-born men and women relative to the Australian-born. Between 1972 and 1990-1994, significant reductions in average systolic and diastolic blood pressure occurred in Australian-born women aged 40 to 59 years. Average systolic and diastolic blood pressures also fell in Australian-born men, although the reduction in systolic blood pressure for those aged 50 to 59 was not statistically significant. Average systolic blood pressure increased in Italian-born men and women. However, the increase was statistically significant only for men aged 50 to 59 years. Average diastolic blood pressure increased in Italian-born men aged 50 to 59 and fell in Italian-born women of the same age. The observed changes in blood pressure could not be attributed directly to changes in the diagnosis and treatment of hypertension, or to changes in the prevalence of overweight and obesity.

Dietary factors and the risk of glioma in adults: results of a case-control study in Melbourne, Australia.

In a population-based case-control study of 416 incident gliomas in adults carried out in Melbourne, Australia, between 1987 and 1991, 409 age-sex-matched case-control pairs (243 male and 166 female) had adequate data available to examine associations between the dietary intake of N-nitroso compounds, N-nitroso precursors, other nutrients including N-nitroso inhibitors, and the risk of glioma. Dietary intakes were based on the reported frequency of consumption of 59 food items. Increased odds ratio (OR) were observed in males who consumed high levels of bacon, corned meats, apples, melons and oil. OR less than unity were observed in men consuming cabbage and cola drinks, and in women who consumed wholegrain bread, pasta, corned meat, bananas, cauliflower, brocoli, cola drinks and nuts. Generally, N-nitroso associations were greater in men and micronutrient associations were greater in women. Elevated OR in men, but not women, were associated with the intake of N-nitroso dimethylamine (NDMA), retinol and vitamin E. The intake of nitrate (largely of vegetable origin) was protective in women but not in men. When analyzed using multiple logistic regression, the association with NDMA intake in males was not modified by dietary micronutrient intakes. In females, beta carotene alone, though not directly associated with risk, modified the effect of NDMA. On balance, this study added only limited support to the N-nitroso hypothesis of glial carcinogenesis.

Ultrasonographic and electrophysiological adjuncts to surgery within the brain stem: technical note.

The surgical approach to intrinsic lesions within the brain stem is undertaken by the surgeon knowing the potential for significant operative morbidity. We report the use of real-time intraoperative ultrasound and electrophysiological mapping techniques to aid in the localization and resection of an intrinsic brain-stem tumor in a child. These techniques permitted an aggressive surgical approach without encountering adverse postoperative neurological sequelae.

Fatty acid pattern outcomes of a nutritional program for overweight and hyperlipidemic Australian men.

There is growing recognition of the value of changing tissue fatty acid patterns in their own right as coronary risk factors. To examine the effects of a conventional nutritional program on plasma triglyceride (TG), cholesterol ester, and phospholipid fatty acid patterns, a group of 20 hyperlipidemic men and a control group (n = 6) of normolipidemic men were followed for 6 months. As an index of change in energy balance in the hyperlipidemic men, body mass index decreased from 26.5 to 24.4 kg m-2 (an 8% decrease) at 6 months. Saturated fat intake fell from 46.7 to 25.3 g/day (a 46% decrease). Dietary polyunsaturated:saturated fat ratio (P:S) rose from 0.38 and to 0.70 (an 84% increase) at the 6-month review. Ethanol intake fell from 18 to 15 g/day (a 17% decrease). Changes in plasma fatty acid (FA) patterns were found in TG, cholesterol ester, and phospholipid fractions at the 6-week to 3-month period, and these changes were maintained at 6 months. Of the factors possibly contributory to plasma FA pattern change in these men, dietary FA intake underwent the greatest percentage shift and therefore probably makes an important contribution to the change. It was of interest that fatty acid patterns in plasma neutral lipids (triglyceride, cholesterol ester, and phospholipid) significantly predicted body mass index and serum total cholesterol, triglyceride, and high-density-lipoprotein cholesterol.

Effects on plasma lipids and fatty acid composition of very low fat diets enriched with fish or kangaroo meat.

The effects of very low fat diets (less than 7% energy) enriched with different sources of long chain (C20 and C22) polyunsaturated fatty acids (PUFA) on plasma lipid levels and plasma fatty acid composition were studied in 13 healthy volunteers. Three diets provided 500 g/day of tropical Australian fish (rich in arachidonic acid and docosahexaenoic acid), southern Australian fish (rich in docosahexaenoic acid) or kangaroo meat (rich in linoleic and arachidonic acids). The fourth diet was vegetarian, similarly low in fat but containing no 20- and 22-carbon PUFA. Subjects ate their normal or usual diets on weeks 1 and 4 and the very low fat diets in weeks 2 and 3. Weighed food intake records were kept, and weeks 2, 3 and 4 were designed to be isoenergetic with week 1. Plasma cholesterol levels fell significantly on all diets within one week. There were reductions in both low density (LDL) and high density lipoprotein (HDL) cholesterol levels, with effects on HDL cholesterol being more consistent. There were no consistent or significant effects on total triglyceride levels despite the high carbohydrate content of the diets. On all diets the percentage of linoleic acid fell in the plasma phospholipid and cholesteryl ester fractions, while the percentage of palmitic acid in the phospholipids and cholesteryl esters and palmitoleic acid in the cholesteryl ester fraction rose on all diets. The percentage of arachidonic acid rose in the phospholipid and cholesteryl esters on the two diets that were good sources of this fatty acid (tropical fish and kangaroo meat).(ABSTRACT TRUNCATED AT 250 WORDS)