Effect of time of day and fasting duration on measures of glycaemia: analysis from the Whitehall II Study.

AIMS/HYPOTHESIS: We aimed to study diurnal variation in glucose regulation by examining the effects of time of day and fasting duration on fasting plasma glucose (FPG), 2 h post-load plasma glucose (2hPG) and HbA(1c) levels. METHODS: We analysed data from 5,978 non-diabetic white men and women from the prospective Whitehall II Study. All studied participants fasted for at least 8 h before a clinical examination, which included an OGTT and anthropometric measurements. We fitted mixed-effects models for FPG, 2hPG and HbA(1c) as outcome variables, and time of day and/or fasting duration as explanatory variables. Models were adjusted for age, BMI and study phase. RESULTS: Time of day and fasting duration were associated inversely with FPG and positively with 2hPG. The mean difference between measures at 08:00 and 15:00 hours in men/women was -0.46 (95% CI -0.50, -0.42) mmol/l/-0.39 (95% CI -0.46, -0.31) mmol/l and 1.39 (95% CI 1.25, 1.52) mmol/l/1.19 (95% CI 0.96, 1.42) mmol/l for FPG and 2hPG, respectively. HbA(1c) levels were independent of either time. Time of day and fasting duration were independently associated with 2hPG. In contrast, the effect of fasting duration on FPG was markedly attenuated with adjustment for time of day. Ageing, but not obesity, was associated with increased diurnal variation in glucose tolerance. CONCLUSIONS/INTERPRETATION: Both time of day and fasting duration should be considered in clinical practice and epidemiological studies, since they have clinically relevant effects on FPG and 2hPG levels. As biochemically expected, HbA(1c) levels are independent of time of blood sampling and fasting duration.

Chlamydia trachomatis infection and the risk of perinatal mortality in Hungary.

INTRODUCTION: Chlamydial infections of the genital tract are thought to often lead to preterm birth, which is the most important perinatal problem in Hungary. AIM OF STUDY: A multicenter study was carried out to determine the prevalence of Chlamydia trachomatis infection, risk factors for the infection and to relate the infection to perinatal mortality, accounting for potential confounding effects. METHODS: The nucleic acid hybridization method (PACE2 Gen-Probe) was applied for the examination of Chlamydia trachomatis. Logistic regression analysis was used to assess risk. RESULTS: A total of 6156 pregnancy women were examined for the occurrence of Chlamydia trachomatis. The observed overall rate of chlamydial infection was 5.9%. Young age (less than 24 years old) (OR and 95% CI: 1.6 (1.3-2.0)), unmarried status (1.5 (1.2-1.9)) and the high unemployment rate (2.1 (1.6-2.7)) were statistically significant predictors of the infection. In logistic regression analysis, chlamydial infection (1.9 (1.1-3.3)), high unemployment rate (1.5 (1.2-2.2)) and low birth weight (1.7 (1.1-2.7) were significant predictors of perinatal mortality. CONCLUSIONS: Testing pregnant women for diseases that can be transmitted perinatally is an important part of obstetric care. Screening for C. trachomatis of unmarried women under 24 years of age is suggested and need increased observation during labor.

Global dynamics of a SEIR model with varying total population size.

A SEIR model for the transmission of an infectious disease that spreads in a population through direct contact of the hosts is studied. The force of infection is of proportionate mixing type. A threshold sigma is identified which determines the outcome of the disease; if sigma < or = 1, the infected fraction of the population disappears so the disease dies out, while of sigma > 1, the infected fraction persists and a unique endemic equilibrium state is shown, under a mild restriction on the parameters, to be globally asymptotically stable in the interior of the feasible region. Two other threshold parameters sigma' and sigma are also identified; they determine the dynamics of the population sizes in the cases when the disease dies out and when it is endemic, respectively.