Journal of internal medicine
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Physical fitness and leisure time physical activity are strongly correlated, and both are inversely correlated with risk of ischaemic heart disease. Does this mean, however, that a very fit man has a lower risk of ischaemic heart disease (IHD), even if he is inactive? And does it also mean that an unfit, but active man, does not have a lower risk of IHD than an unfit, inactive man? In the Copenhagen Male Study, we analysed the joint effect of fitness and leisure time activity. In 1970/71, 4999 men aged 40-59 years, were classified according to level of physical fitness, i.e. indirectly measured maximal oxygen uptake, and physical activity, and their mortality was recorded over the following 17 years. ⋯ Adjusted for age, social class and smoking in a multiple logistic regression equation, this was estimated to an RR (95% C. I.) of 1.67 (1.06-2.64) (P = 0.027). The two major new findings of this study were (a) that being very fit, provides no protection against IHD--nor all-cause mortality--in sedentary men, and (b) that unfit but sedentary men have a higher risk of IHD than unfit but active men, i.e. those performing light physical activity for at least 4 h per week.
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Comparative Study
Evaluation of regional body fat distribution: comparison between W/H ratio and computed tomography in obese women.
Measurements of regional body fat distribution as determined by waist-to-hip ratio and visceral-to-subcutaneous adipose tissue ratio were compared in 63 obese women. Subjects were divided into three CT-evaluated tertiles on the basis of visceral-to-subcutaneous adipose tissue ratio (group I, 0.05-0.231; group II, 0.232-0.344; group III, 0.345-0.781). The three groups showed no appreciable differences in body weight, body mass index or total abdominal adipose tissue. ⋯ Partial correlations between waist-to-hip ratio and visceral-to-subcutaneous adipose tissue ratio and metabolic variables, adjusted for body mass index, showed statistically significant relationships for visceral-to-subcutaneous adipose tissue ratio, but not for waist-to-hip ratio. Visceral-to-subcutaneous adipose tissue ratio correlated with waist-to-hip ratio in the study population as a whole, but only in group I did the correlation between visceral-to-subcutaneous adipose tissue ratio and waist-to-hip ratio prove statistically significant. The present study demonstrates that visceral-to-subcutaneous adipose tissue ratio is a better index of body fat distribution than waist-to-hip ratio.
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Serum levels of various cytokines were measured in three patients with cardiac myxomas presenting with and without constitutional symptoms, immunological features and elevated plasma levels of interleukin-6. Interleukin-6 but not other cytokines (interleukin-1, tumour necrosis factor-alpha, interferon-gamma) relate to immunological features of the patients. Circulating levels of atrial natriuretic peptide correspond to haemodynamic changes but not to the tumour-bearing state itself.
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Hypertriglyceridaemia, as defined by fasting triglyceride levels of greater than 2.8 mmol l-1, is a prevalent dyslipoproteinaemia in our population. The underlying pathophysiological mechanisms that result in elevations of plasma triglycerides are heterogeneous and, in most cases, incompletely understood. However, in a subset of patients presenting with this lipid disorder, the biochemical and genetic defects that lead to hypertriglyceridaemia have been well characterized. ⋯ Together, these two proteins initiate the hydrolysis of triglycerides present in chylomicrons and very low density lipoproteins. In the past decade our understanding of the underlying molecular defects that lead to familial chylomicronaemia has been greatly enhanced by the identification of mutations in the genes for LPL and apoC-II. Characterization of these defects has provided new insights into the structure and function of apoC-II and LPL and established the important role that these two proteins play in normal triglyceride metabolism.
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European physicians may occasionally be confronted with cases of snake venom poisoning. The increasing interest in snakes as pets has unfortunately resulted in the importation of a number of venomous snakes. ⋯ The prolonged bleeding diathesis and the complete depletion of fibrinogen observed in our patient are consistent with the presence of a factor X activator in the venom, as has been described in a murine model. In agreement with the two previous case reports, we found no evidence of severe organ damage, despite active intravascular coagulation.