Serum retinol and airway obstruction.

The relation of serum retinol and carotenoids to airway obstruction was investigated in a population-based study. Respiratory symptoms and the pulmonary function of 83 white males were assessed in 1979 5 years after their blood had been drawn. Airway obstruction in 1979, defined as a forced expiratory volume in 1 second which was equal to or less than 75% of the forced vital capacity, was associated with a decreased 1974 level of serum retinol.

Cardiovascular reactivity to the cold pressor test as a predictor of hypertension.

Cardiovascular reactivity to stress is hypothesized to be a marker for subsequent neurogenic cardiovascular disease, but few prospective studies of this hypothesis are available. We studied 910 white male medical students who had their blood pressure and pulse rate measured before and during a cold pressor test in the years 1948-1964. Hypertensive status (requiring drug treatment) was ascertained by annual questionnaires in the 20- to 36-year follow-up period. An association was observed between maximum change in systolic blood pressure and later hypertension, with a cumulative incidence of hypertension by age 44 of 6.7%, 3.0%, and 2.4% for a change in systolic blood pressure in the upper, middle two, and lowest quartiles, respectively (Kaplan-Meier, p less than 0.02). After adjustment for study entry age, Quetelet Index, cigarette smoking, pretest systolic blood pressure, and paternal or maternal history of hypertension in a Cox model, the association persisted. The excess risk associated with systolic blood pressure reactivity was not apparent until the population aged some 20 years and was most apparent among those in whom hypertension developed before age 45 (relative risk = 2.5, 95% confidence intervals = 1.47, 4.71 for a 20 mm Hg change). Diastolic blood pressure and heart rate changes were not associated with later hypertension. These data suggest that persons prone to later hypertension manifest an altered physiology at a young age.

[Reflections on 25 failures during the immunologic treatment of 247 cases of spondylarthritis]. / Réflexions sur vingt-cinq échecs survenus au cours du traitement immunologique de 247 spondylarthrites.

Ten per cent of 247 patients suffering from Bechterew's disease failed to respond as expected to "classic" immunological treatment. Amongst those treated, there was a distribution of H.L.A. DR groups which deviated from the central group, similar to the incidence observed in psoriatic arthropathy.

Serum levels of retinol, beta-carotene, and alpha-tocopherol in older adults.

Levels of retinol, beta-carotene, and alpha-tocopherol were determined in the serum of 415 adults over age 35 years who had volunteered in 1974 to donate blood for cancer research in Washington County, Maryland. Males had higher levels of serum retinol, lower levels of beta-carotene, and only slightly lower levels of alpha-tocopherol than did females. No clear-cut association was noted with age. Smokers had decreased serum levels of beta-carotene. Vitamin supplementation was associated with higher serum levels. Persons taking medication for high blood pressure had higher levels of retinol and alpha-tocopherol, but lower levels of beta-carotene.

Serum beta-carotene, vitamins A and E, selenium, and the risk of lung cancer.

We studied the relation of serum vitamin A (retinol), beta-carotene, vitamin E, and selenium to the risk of lung cancer, using serum that had been collected during a large blood-collection study performed in Washington County, Maryland, in 1974. Levels of the nutrients in serum samples from 99 persons who were subsequently found to have lung cancer (in 1975 to 1983) were compared with levels in 196 controls who were matched for age, sex, race, month of blood donation, and smoking history. A strong inverse association between serum beta-carotene and the risk of squamous-cell carcinoma of the lung was observed (relative odds, 4.30; 95 percent confidence limits, 1.38 and 13.41). Mean (+/- SD) levels of vitamin E were lower among the cases than the controls (10.5 +/- 3.2 vs. 11.9 +/- 4.90 mg per liter), when all histologic types of cancer were considered together. In addition, a linear trend in risk was found (P = 0.04), so that persons with serum levels of vitamin E in the lowest quintile had a 2.5 times higher risk of lung cancer than persons with levels in the highest quintile. These data support an association between low levels of serum vitamin E and the risk of any type of lung cancer and between low levels of serum beta-carotene and the risk of squamous-cell carcinoma of the lung.