Agreement between self-report questionnaires and medical record data was substantial for diabetes, hypertension, myocardial infarction and stroke but not for heart failure

Overproduction of IL-6, a proinflammatory cytokine, is associated with a spectrum of age-related conditions including cardiovascular disease, osteoporosis, arthritis, type 2 diabetes, certain cancers, periodontal disease, frailty, and functional decline To describe the pattern of change in IL-6 over 6 years among older adults undergoing a chronic stressor, this longitudinal community study assessed the relationship between chronic stress and IL-6 production in 119 men and women who were caregiving for a spouse with dementia and 106 noncaregivers, with a mean age at study entry of 7058 (SD = 803) for the full sample On entry into this portion of the longitudinal study, 28 of the caregivers' spouses had already died, and an additional 50 of the 119 spouses died during the 6 years of this study Levels of IL-6 and health behaviors associated with IL-6 were measured across 6 years Caregivers' average rate of increase in IL-6 was about four times as large as that of noncaregivers Moreover, the mean annual changes in IL-6 among former caregivers did not differ from that of current caregivers even several years after the death of the impaired spouse There were no systematic group differences in chronic health problems, medications, or health-relevant behaviors that might have accounted for caregivers' steeper IL-6 slope These data provide evidence of a key mechanism through which chronic stressors may accelerate risk of a host of age-related diseases by prematurely aging the immune response

/pdf/chronic-stress-and-age-related-increases-in-the-oeey4cil7q.pdf

Chronic stress and age-related increases in the proinflammatory cytokine IL-6.

Self-reports and general practitioner information on the presence of chronic diseases in community dwelling elderly. A study on the accuracy of patients' self-reports and on determinants of inaccuracy.

ContextMortality from coronary heart disease has declined
substantially in the United States during the past 30 years. However,
it is unknown whether patients with diabetes have also experienced a
decline in heart disease mortality.ObjectiveTo compare adults with diabetes with those without
diabetes for time trends in mortality from all causes, heart disease,
and ischemic heart disease.Design, Setting, and ParticipantsRepresentative cohorts of
subjects with and without diabetes were derived from the First National
Health and Nutrition Examination Survey (NHANES I) conducted between
1971 and 1975 (n=9639) and the NHANES I Epidemiologic
Follow-up Survey conducted between 1982 and 1984
(n=8463). The cohorts were followed up prospectively
for mortality for an average of 8 to 9 years.Main Outcome MeasureChanges in mortality rates per 1000
person-years for all causes, heart disease, and ischemic heart disease
for the 1982-1984 cohort compared with the 1971-1975 cohort.ResultsFor the 2 periods, nondiabetic men experienced a 36.4%
decline in age-adjusted heart disease mortality compared with a 13.1%
decline for diabetic men. Age-adjusted heart disease mortality declined
27% in nondiabetic women but increased 23% in diabetic women. These
patterns were also found for all-cause mortality and ischemic heart
disease mortality.ConclusionsThe decline in heart disease mortality in the general
US population has been attributed to reduction in cardiovascular risk
factors and improvement in treatment of heart disease. The smaller
declines in mortality for diabetic subjects in the present study
indicate that these changes may have been less effective for people
with diabetes, particularly women.

https://jamanetwork.com/journals/jama/articlepdf/189432/JOC81736.pdf

Diabetes and Decline in Heart Disease Mortality in US Adults

OBJECTIVE —Short-term partial sleep restriction results in glucose intolerance and insulin resistance. The purpose of this study was to assess the long-term relationship between sleep duration and the incidence of clinical diabetes. RESEARCH DESIGN AND METHODS —A cohort of men from the Massachusetts Male Aging Study without diabetes at baseline (1987–1989) were followed until 2004 for the development of diabetes. Average number of hours of sleep per night was grouped into the following categories: ≤5, 6, 7, 8, and >8 h. Incidence rates and relative risks (RRs) were calculated for the development of diabetes in each sleep duration category. Those reporting 7 h of sleep per night served as the reference group. Multivariate analysis was performed using Poisson regression. RESULTS —Men reporting short sleep duration (≤5 and 6 h of sleep per night) were twice as likely to develop diabetes, and men reporting long sleep duration (>8 h of sleep per night) were more than three times as likely to develop diabetes over the period of follow-up. Elevated risks remained essentially unchanged after adjustment for age, hypertension, smoking status, self-rated health status, education, and waist circumference (RR 1.95 [95% CI 0.95–4.01] for ≤5 h and 3.12 [1.53–6.37] for >8 h). RRs were altered considerably for the two extreme sleep groups when adjusted for testosterone (1.51 [0.71–3.19] for ≤5 h and 2.81 [1.34–5.90] for >8 h), suggesting that the effects of sleep on diabetes could be mediated via changes in endogenous testosterone levels. CONCLUSIONS —Short and long sleep durations increase the risk of developing diabetes, independent of confounding factors. Sleep duration may represent a novel risk factor for diabetes.

/pdf/sleep-duration-as-a-risk-factor-for-the-development-of-type-273as4l9ko.pdf

Sleep duration as a risk factor for the development of type 2 diabetes.

The authors compared self-reported medical history and medication use in a cataract case-control study of 1,380 persons (1985-1989) in Boston, Massachusetts, with information from the participants' physicians. Under- and overreporting varied by condition and type of medication. A self-reported history of hypertension had the highest sensitivity (91%), and diabetes history had the highest specificity (97%). Among different medications investigated, self-reported antihypertensive medication use was the most sensitive (88%), while self-reported use of insulin was the most specific (99%). Differences between patient- and physician-reported frequencies were very small, except for arthritis (15%) and regular aspirin use (21%). Results suggest an accurate recall of medical and drug usage history in well-defined chronic conditions.

Comparing self-reported and physician-reported medical history.

Objective: To evaluate the possible relation-ship of hypertension and diabetes with theABO, Rhesus, and Duffy blood groups, whichare known markers of African ancestry.Design: Population-based study.Setting and Participants: A random sample of1253 Barbados residents, $40 years of age.Main Outcome Measures: Hypertension wasdefined as a systolic blood pressure.140 mm Hg or a diastolic blood pressure.90 mm Hg or use of antihypertensive treat-ment; type 2 diabetes was defined as a glyco-sylated hemoglobin level .10% and/or a his-tory of treatment in those .30 years of age.Results: In logistic regression analyses, elevat-ed diastolic blood pressure was positivelyassociated with years of age (odds ratio [OR]1.03, 95% confidence interval CI 1.02–1.05),the Rhesus D+ antigen (OR 2.68, 95% CI1.21–5.97) and body mass index (OR 1.53,95% CI 1.19–1.96), but negatively associatedwith the ABO blood group A allele (OR 0.68,95% CI .48–.97). A separate logistic regressionmodel indicated that the likelihood of diabetesincreased with years of age (OR 1.03, 95% CI1.01–1.04), hypertension (OR 1.56, 95% CI1.10–2.20), body mass index (OR 1.68, 95%CI 1.29–2.20), and waist-hip ratio (OR 1.36,95% CI 1.05–1.75), but decreased withpresence of the Rhesus C+ antigen (OR .66,95% CI .44–.97).Conclusions: The associations of diabetes andhypertension to these blood groups supportpossible genetic influences on both conditionsin this and similar African-origin populations;however, further investigations in other settingsare necessary to more fully elucidate thesefindings. (Ethn Dis. 2006;16:822–829)Key Words: Duffy and Rhesus BloodGroups, ABO, Blood Pressure, Diabetes

Hypertension ,t ype 2d iabetes, and blood groups in a population of

BACKGROUND. African American men (AA) exhibit a disproportionate share of prostatecancer (PRCA) incidence, morbidity, and mortality. Several genetic association studies haveimplicated select 8q24 loci in PRCA risk in AA. The objective of this investigation is to evaluatethe association between previously reported 8q24 risk alleles and PRCA in African-Barbadian(AB) men known to have high rates of PRCA.METHODS. Ten previously reported candidate tag SNPs were genotyped and/or imputed inthe 8q24 region in 532 AB men with PRCA and 513 AB controls from the Prostate Cancer in aBlack Population (PCBP) study.RESULTS. Rs2124036 was significant in AB men, (OR¼2.7, 95% CI (1.3–5.3), P¼0.005,Empirical (max (T), corrected for multiple testing) P¼0.03) for the homozygous C/Cgenotype. Only a single SNP from this region remained statistically significant in our analysisof our AB population. These results may indicate the presence of a founder effect or due to thechosen SNPs not tagging an ancestral haplotype bearing the 8q24 risk allele(s) in this

2 IntegratedCancerGenomicsDivision,TranslationalGenomicsResearchInstitute(TGen),Phoenix,Arizona 3 DepartmentofPreventiveMedicine,KeckSchoolofMedicine,UniversityofSouthernCalifornia,

Suh-Yuh Wu

Papers

Comparing self-reported and physician-reported medical history.

Hypertension ,t ype 2d iabetes, and blood groups in a population of

2 IntegratedCancerGenomicsDivision,TranslationalGenomicsResearchInstitute(TGen),Phoenix,Arizona 3 DepartmentofPreventiveMedicine,KeckSchoolofMedicine,UniversityofSouthernCalifornia,