Cy Yeung

Adiponectin gene variants and the risk of coronary heart disease: a 16-year longitudinal study.

OBJECTIVE Circulating adiponectin levels have been shown to be associated with a risk of coronary heart disease (CHD). However, its primary role in protecting against the development of CHD remains controversial due to conflicting observations in prospective studies. To gain further insight into the primary role of adiponectin, our major objective was to investigate the relationship between single nucleotide polymorphisms (SNPs) of the adiponectin gene (ADIPOQ) and incident CHD in a population-based cohort with no CHD at baseline. DESIGN AND METHODS We conducted a 16-year longitudinal study in 2196 subjects from the Hong Kong Cardiovascular Risk Factor Prevalence Study (CRISPS). During 33 862 person-years of follow-up, 184 subjects developed CHD (cumulative incidence rate=5.4 per 1000 person-years). Nine ADIPOQ SNPs with potential functional relevance or shown to be associated with adiponectin levels and/or CHD were genotyped. RESULTS Among the nine ADIPOQ SNPs, +276G>T (rs1501299) was independently associated with incident CHD in men but not in women, even after adjustments for traditional cardiovascular risk factors (Padjusted=5.5×10(-3) to 0.023; hazard ratio=1.39-1.54). Furthermore, there was a significant association of the T allele of +276G>T with a lower adiponectin level (P=0.027; β (95% CI)=-0.05 (-0.10, -0.01). CONCLUSIONS This study demonstrated that +276G>T may be an independent predictor of CHD development. Our findings suggest that low adiponectin levels, as may be influenced by +276G>T, confer a higher risk of CHD, in keeping with a role of hypoadiponectinaemia in the development of CHD in the general population.

Obesity, adipokines and cancer: an update

Obesity causes dysfunction of adipose tissue, with resultant chronic inflammation and adverse interplay of various adipokines, sex steroids and endocrine hormones. All these drive tumourigenesis and explain the epidemiological link between obesity and cancer. Over the past decade, the associations among obesity, adipokines and cancer have been increasingly recognized. Adipokines and their respective signalling pathways have drawn much research attention in the field of oncology and cancer therapeutics. This review will discuss the recent advances in the understanding of the association of several adipokines with common obesity‐related cancers and the clinical therapeutic implications.

The changing pattern of severe neonatal staphylococcal infection: A 10‐year study

Abstract Forty‐two cases of severe staphylococcal infection occurring over a 10‐year period in the neonatal unit at Queen Mary Hospital are described. There was a 4.5‐fold increase in incidence in the latter half of the study period, when methicillin‐resistant Staphylococcus aureus (MRSA) emerged. The isolated MRSA were also resistant to gentamicin, but sensitive to vancomycin, fusidic acid, co‐trimoxazole and amikacin. Comparison between MRSA and methicillin‐sensitive cases showed that the former was associated with a longer hospital stay after diagnosis. Overall mortality was 9.5%. Two cases with meningitis died. MRSA is at least as virulent as its methicillin‐sensitive counterparts. The treatment implications of severe neonatal staphylococcal infection are discussed.

Variation in mortality and intraventricular haemorrhage in occupants of Pacific Rim nurseries

Objective:  A network of neonatal intensive care units in Pacific Rim countries was formed to compare infant risk factors, clinical practices, and outcomes for very low birthweight infants.

Effects of Anticoagulants and Incubation Time on Neutrophil Nitroblue Tetrazolium Score

We studied the effect of anticoagulants and incubation time on neutrophil nitroblue tetrazolium (NBT) scores. Heparin (10 IU/ml) and EDTA (1.5 mg/ml) were used, and the preparations were incubated for periods ranging from 20 to 180 min. Heparin, in contrast to EDTA, was found to be associated with cell destruction, cell aggregates and higher NBT scores; the effects were more profound with endotoxin stimulation. The duration of incubation significantly affects NBT scores in both the heparin- and EDTA-anticoagulated samples, and the effect is more marked with heparin. Cell destruction and cell clumping are both enhanced with incubation, again more so with heparin. It is concluded that when performing NBT tests, blood samples would best be anticoagulated with EDTA to ensure more consistent results.

Cardiometabolic risk profile of participants with prediabetes diagnosed by HbA1c criteria in an urban Hong Kong Chinese population over 40 years of age

To investigate the usefulness of the additional measurement of HbA1c, compared with performing only the oral glucose tolerance test (OGTT), in identifying participants at increased cardiometabolic risk, in an urban Chinese population.

Plasma Fibrinogen Level as a Predictor of Cardiovascular Diseases, Independent of Diabetes, in a Population-Based 16-Year Prospective Study in Hong Kong

1395-P Does Functional Decline in Older Adults Hasten the Onset of Diabetes? The Health and Retirement Study 1998-2010 BARBARA H. BARDENHEIER, EDWARD GREGG, XIAOHUI ZHUO, YILING J. CHENG, LINDA GEISS, Atlanta, GA Prospective studies have associated diabetes with a high risk of incident disability among older adults. However, the converse association could also occur, with functional decline hastening the onset of diabetes, particularly in those at high risk. 13,134 adults aged over 50 years who entered the longitudinal Health and Retirement Study between 1992 and 2006 with no disability or diabetes were followed to 2010 to determine if those who became disabled would subsequently develop diabetes. Mobility disability was assessed by self-reported diffi culty walking one block; walking several blocks; climbing one fl ight of stairs; stooping, crouching, or kneeling; and pushing or pulling a large object. Participants were classifi ed by disability: none, mild (diffi culty with stooping and walking several blocks or diffi culty with > 2 mobility measures other than climbing), moderate (diffi culty with climbing or diffi culty with > 3 mobility measures), and severe (diffi culty with > 4 mobility measures). 1,955 (14.9%) participants developed diabetes, 8,228 (62.6%) reported incident disability, and 2,482 (18.9%) died by 2010. Among those who did not develop disability, diabetes incidence was 8.67 per 1,000; among those who developed disability and remained disabled at least 50% of the reporting period, diabetes incidence was 13.5 per 1,000. In a generalized estimating equation controlling for body mass index, age, sex, race/ethnicity, net wealth, and year of report, we found a statistically signifi cant dose-response relationship between incident disability and later incident diabetes: severe vs. none (OR: 2.18, 95%CI: 1.82, 2.61); moderate vs. none (OR: 1.50, 95%CI: 1.25, 1.80); mild vs. none (OR: 1.40, 95%CI: 1.26, 1.56). We found those who become mildly disabled are at increased risk of developing diabetes within a few years. These fi ndings raise the question of whether approaches to delay functional decline, an almost ubiquitous aspect of aging, may reduce the risk of diabetes.

Neonatal Intensive Care Nurseries in Pacific Rim Countries: Differences in Clinical Practices and Neonatal Mortality. |[dagger]| 1210

A multicenter study comparing outcomes for very low birth weight infants(<1501g) in Pacific Rim nurseries was undertaken. Centers collected prospective data for all liveborn infants beginning January 1996. Data were collected for gestational age (GA), birth weight (BW), 5 minute Apgars, use of antenatal steroids (AS), cesarean rates (CS, surfactant use (Surf), and death. CRIB scores were derived from these data. Centers had similar mean BW (p=0.4). SFGH had less mature infants (p=0.03) and a lower distribution of Apgar scores, as well as the highest mortality. There was significant differences in clinical practices in the use of AS and Surf. Table

A NETWORK OF NEONATAL INTENSIVE CARE UNITS IN PACIFIC RIM COUNTRIES: DIFFERENCES IN ASSOCIATED RISK FACTORS FOR VLBW INFANTS. † 1209

A NETWORK OF NEONATAL INTENSIVE CARE UNITS IN PACIFIC RIM COUNTRIES: DIFFERENCES IN ASSOCIATED RISK FACTORS FOR VLBW INFANTS. † 1209