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- Bogers, Rik P., et al.
(author)
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Association of overweight with increased risk of coronary heart disease partly independent of blood pressure and cholesterol levels - A meta-analysis of 21 cohort studies including more than 300,000 persons
- 2007
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In: Archives of Internal Medicine. - 0003-9926. ; 167:16, s. 1720-1728
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Research review (peer-reviewed)abstract
- Background: The extent to which moderate overweight (body mass index [BMI], 25.0-29.9 [calculated as weight in kilograms divided by height in meters squared]) and obesity ( BMI, >= 30.0) are associated with increased risk of coronary heart disease (CHD) through adverse effects on blood pressure and cholesterol levels is unclear, as is the risk of CHD that remains after these mediating effects are considered. Methods: Relative risks (RRs) of CHD associated with moderate overweight and obesity with and without adjustment for blood pressure and cholesterol concentrations were calculated by the members of a collaboration of prospective cohort studies of healthy, mainly white persons and pooled by means of random-effects models (RRs for categories of BMI in 14 cohorts and for continuous BMI in 21 cohorts; total N=302296). Results: A total of 18 000 CHD events occurred during follow-up. The age-, sex-, physical activity-, and smoking-adjusted RRs (95% confidence intervals) for moderate overweight and obesity compared with normal weight were 1.32 (1.24-1.40) and 1.81 (1.56-2.10), respectively. Additional adjustment for blood pressure and cholesterol levels reduced the RR to 1.17 (1.11-1.23) for moderate overweight and to 1.49 (1.32-1.67) for obesity. The RR associated with a 5-unit BMI increment was 1.29 (1.22-.35) before and 1.16 (1.11-1.21) after adjustment for blood pressure and cholesterol levels. Conclusions: Adverse effects of overweight on blood pressure and cholesterol levels could account for about 45% of the increased risk of CHD. Even for moderate overweight, there is a significant increased risk of CHD independent of these traditional risk factors, although confounding (eg, by dietary factors) cannot be completely ruled out.
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| 2. |
- Schwid, SR, et al.
(author)
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Enhanced benefit of increasing interferon beta-1a dose and frequency in relapsing multiple sclerosis - The EVIDENCE study
- 2005
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In: Archives of Neurology. - 0003-9942. ; 62:5, s. 785-792
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Journal article (peer-reviewed)abstract
- Background: The EVIDENCE (Evidence of Interferon Dose-Response: European North American Comparative Efficacy) Study demonstrated that patients with multiple sclerosis (MS) who initiate interferon beta-la therapy with 44 μ g 3 times weekly (TIW) were less likely to have a relapse or activity on magnetic resonance imaging (MRI) compared with those who initiate therapy at a dosage of 30 μ g 1 time weekly (QW). Objective: To determine the effect of changing the dosage from 30 μ g QW to 44 μ g TIW in this extension of the EVIDENCE StudyDesign/Patients: Patients with relapsing MS originally randomized to interferon beta-1a, 30 μ g QW, during the comparative phase of the study changed to 44 μ g TIW, whereas patients originally randomized to 44 μ g TIW continued that regimen. Patients were followed up, on average, for an additional 32 weeks. Main Outcome Measure: The within-patient pretransition to posttransition change in relapse rate. Results: At the transition visit, 223 (73%) of 306 patients receiving 30 μ g QW converted to 44 μ g TIW, and 272 (91%) of 299 receiving 44-μ g TIW continued the same therapy. The posttransition annualized relapse rate decreased from 0.64 to 0.32 for patients increasing the dose (P<.001) and from 0.46 to 0.34 for patients continuing 44-μ g TIW (P =.03). The change was greater in those increasing dose and frequency (P=.047). Patients converting to the 44-μ g,TIW regimen had fewer active lesions on T2-weighted MRI compared with-before the transition (P=.02), whereas those continuing the 44-μ g TIW regimen had no significant change in T2 active lesions. Patients who converted to high-dose/high-frequency interferon beta-la therapy had increased rates of adverse events and treatment terminations consistent with the initiation of high-dose subcutaneous interferon therapy. Conclusions: Patients receiving interferon beta-la improved on clinical and MRI disease measures when they changed from 30μ g QW to 44 μ g TIW.
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