RESUMO
The pathogenesis of testicular germ cell tumours (GCTs) is potentially influenced by high-energy nutrition during infancy. As adult height is a proxy for childhood nutrition, we investigated the role of nutrition in GCT pathogenesis by comparing stature of patients with healthy men. In a matched case-control study, 6415 patients with GCT were compared with healthy army conscripts (1:6 matching modus) with regard to height (cm) and body mass index (BMI; kg/m(2)). Statistical analysis involved tabulation of descriptive height measures and BMI. Conditional logistic regression models were used to quantify the association of GCT with height, with odds ratios (OR) adjusted for BMI. The literature was searched for studies on stature in GCT patients. Body size is significantly associated with risk of GCT, very tall men (>195 cm) having a GCT risk of OR=3.35 (95% confidence intervals (CI): 2.88-3.90; adjusted). Short stature is protective (OR=0.798; 95% CI: 0.68-0.93). Both histologic subgroups are associated with tallness. Of 16 previous reports, 7 were confirmative, 5 had null and 4 equivocal results. The association of stature with GCT risk accords with the nutrition hypothesis of GCT. This study expands the current view of GCT tumorigenesis by suggesting that high-calorie intake in childhood promotes GCT precursors originating in utero.
Assuntos
Estatura , Neoplasias Embrionárias de Células Germinativas/etiologia , Neoplasias Testiculares/etiologia , Adolescente , Adulto , Índice de Massa Corporal , Estudos de Casos e Controles , Ingestão de Energia , Humanos , Modelos Logísticos , Masculino , Fatores de RiscoRESUMO
AIM: The aim of this study was to determine the incidence/frequency of march fractures in the German Armed Forces in the years from 1998 to 2000. In particular, the age, length of service, distribution of the metatarsals and the occurrence of anthropometric risk factors were considered. METHODS: At the Medicostatistical Institute of the German Armed Forces the records of soldiers, 191 cases with 204 fractures, with diagnosed "march fractures" were selected and analyzed. RESULTS: 82% of the affected soldiers were between 19 and 22 years old. More than 50% of the fractures occurred within the first eight weeks of service. In about 64% the 3rd metatarsal was affected, in 25% the 2nd metatarsal and in only 11% of all cases the 4th, 5th, and 1st metatarsals. Soldiers were exempted from duty for an average of 26.5 days. No specific anthropometric risk factors were found to be connected with the occurrence of march fractures. CONCLUSION: March fractures in the German Armed Forces are non-predictable injuries of young and physically fit individuals; youth is not a protective factor. There is an increased risk for march fractures during the first weeks of military service. There appears to be no possibility for a screening.
Assuntos
Traumatismos do Pé/epidemiologia , Fraturas Ósseas/epidemiologia , Fraturas de Estresse/epidemiologia , Ossos do Metatarso/lesões , Militares/estatística & dados numéricos , Medição de Risco/métodos , Adolescente , Adulto , Feminino , Alemanha/epidemiologia , Humanos , Incidência , Masculino , Estudos Retrospectivos , Fatores de RiscoRESUMO
OBJECTIVE: Obesity prevalence is increasing worldwide and obesity is associated with low education. To assess if the overall increase of obesity prevalence is due to increasing obesity prevalence among low educated strata only. DESIGN: Data on n=1,883,783 males in their 19th year of life seen at physical examinations due to general conscription in Germany from 1989 to 1998. MEASUREMENTS: Stature and weight were measured in underpants and obesity defined as body mass index > 30 kg/m(2). RESULTS: From 1989 to 1998 an increase of body mass index values >70th percentile was observed. Overall obesity prevalence increased from 3.4% (95% CI 3.3-3.5) to 5.7% (95% CI 5.6-5.8). During the whole observation period, the prevalence of obesity was inversely related to educational level. The increase of obesity prevalence, however, was unrelated to educational level: for education less than 10 y from 4.9% (95% CI 4.7-5.0) to 7.7% (95% CI 7.5-7.9), for education of 10 y from 2.6% (95% CI 2.5-2.7) to 5.3% (95% CI 5.1-5.5) and for education of more than 10 y from 1.6% (95% CI 1.4-1.8) to 3.4% (95%CI 3.2-3.5). CONCLUSION: Prevalence of obesity increased among recruits of all educational levels, suggesting that preventive measures against obesity have to target all educational levels.
Assuntos
Militares , Obesidade/epidemiologia , Classe Social , Adulto , Estudos de Coortes , Surtos de Doenças , Escolaridade , Alemanha/epidemiologia , Humanos , Masculino , Prevalência , População BrancaRESUMO
Surveys of conscripts give a chance to pursue the somatic development and the nourishment situation of young men over long times. At the beginning a historical view is given of the organization and methodological basis of medical examinations of German recruits since the introduction of the general conscription at the beginning of the 19th century. Secular changes of the body height are sketched out for selected regions of Germany until the middle of the 20th century. Data of the body weight hardly exist for this time. Until now the greatest continuous documentation of data for body height and body weight is available for West Germany since 1957 and for East Germany between 1973 and the reunion in 1989. The body height of German conscripts has nearly permanently increased since 1957 and reached in 1994 a maximum with 180.0 cm. In general East German conscripts have body height data which are smaller on an average than those of West German conscripts. But in the last years a catch-up in body height could be seen. The body weight of German conscripts also shows an increase apart from some short-time exceptions. The data of West German conscripts are also higher than those of the East German conscripts. Until the reunion the West-East-differences could partly be due to the different mustering age. But the differences also continue in the nineties despite the now identical mustering age. The Body Mass Index (BMI) of the German conscripts (calculated from the average values of body height and body weight) is characterized by increments in the last years. This indicates greater changes in body weight than in body height. The BMI also shows marked West-East-differences. There is no uniform tendency in differences between urban and country side regions for body height and body weight. On the other hand until now differences between selected professional groups are existing. Especially the over-proportional increase of the number of conscripts in the higher body-weight-classes requires a further continuous analysis of the available mustering data.