Acid reflux drugs linked to kidney failure in the elderly: CMAJ

(Reuters Health) – Older patients taking drugs known as proton pump inhibitors, a common remedy for heartburn and acid reflux, are two times more likely to be hospitalized with kidney failure than peers who don’t take the pills, a study finds.

While the side effect is extremely rare, and the study doesn’t prove the drugs cause kidney failure, the association is worrisome because tens of millions of people a year take these pills, sold by prescription and over-the-counter in some countries, with brand names including Prilosec, Prevacid and Zegerid.

“Generally, the drugs are very well tolerated, and the vast majority of patients who take them will not develop (kidney failure) or other serious problems,” lead study author Tony Antoniou, a researcher at the Institute for Clinical Evaluative Sciences and St. Michael’s Hospital in Toronto, said by email. “But the drugs should be used for the shortest possible duration.”

Antoniou and colleagues identified about 290,000 people aged 66 or older taking proton pump inhibitors in Ontario between 2002 and 2011, as well as a similar number of individuals not taking the drugs.

The researchers then looked at how many people were hospitalized for acute kidney injury within 120 days of starting treatment, and compared that to the group not taking the drugs.




Posted in Elder Care, Gastroenterology: GERD, Nephrology: Chronic Kidney Disease | Leave a comment

Exploring the ADHD-Autism Link

Newswise — For the better part of the last decade, a growing body of research has been revealing more and more similarities between attention-deficit/hyperactivity disorder and autism.

Jean Gehricke, an associate professor of pediatrics at UC Irvine and a licensed clinical psychologist with the Center for Autism & Neurodevelopmental Disorders, is focusing on this link to better understand why people with ADHD and autism may be more prone to substance abuse and, in the process, to develop more effective behavioral therapies.

“This is an emerging field with great promise,” Gehricke says. “We know a bit about the underlying causes of ADHD, and through this, we may be able to improve how we treat autism.”

The Center for Autism & Neurodevelopmental Disorders – which provides assessment, diagnosis, treatment, care coordination, family support and education for children, teens and young adults with autism and other developmental disorders – is one of only a few in the region to deliver a continuum of services until age 22 and to conduct research aimed at transforming the approach to autism.

Gehricke, who teaches 25 students in his lab, has expertise in the assessment and treatment of autism, ADHD and co-occurring problems such as depression, anxiety and drug abuse.

He joined the center in 2013. Before that, he worked at the UCLA Neuropsychiatric Institute & Hospital, the UCI Transdisciplinary Tobacco Use Research Center and the UCI Child Development Center, where he also provided comprehensive clinical assessments and cognitive behavioral therapy.

Gehricke is well-known for his scientific work on the underlying mechanisms of ADHD and drug abuse, having published a number of breakthrough articles showing why individuals with ADHD are more prone to smoke cigarettes or get hooked on other nicotine and tobacco products.

He’s taking this knowledge and applying it to autism. While people with ADHD and high-functioning autism share certain characteristics, such as difficulty interacting with others and problems with emotional control, Gehricke is especially interested in whether these issues have similar neurobiological underpinnings.

In a December 2014 study, he and his colleagues identified a genetic trait shared by those with ADHD and those with autism that sheds light on some of the more troubling behaviors associated with the disorders.

Gehricke explains that aggression and health-risk actions are driven by distorted dopamine signaling in the brain and that the DRD4 gene is critical in regulating this function. The researchers found that one form of the gene – called the 7R allele and linked to altered dopamine regulation – is overrepresented in both individuals with ADHD and those with autism. It’s the genetic fingerprint of these types of conduct, Gehricke says.

“This study provides a conceptual model for risky behaviors, which we often see in our patients, and explores the possibility of tailoring information to reduce them,” he says. “More specifically, it points to the need to use strong visual images to induce behavioral changes.”

Gehricke is especially focused on nicotine addiction – which, he points out, is another shared ADHD-autism inclination. He believes that early behavioral intervention with autistic children could be a particularly effective deterrent to smoking – the No. 1 preventable health threat in the world – and “vaping.”

Gehricke says that the intervention should include warning labels (such as those used with nicotine and tobacco) depicting the negative consequences of health-risk behaviors and presenting distinctive imagery visually stimulating enough to alter the activities of teenagers and young adults with ADHD and autism. Testing the effectiveness of this deterrent is the next step Gehricke plans to take with his 7R allele group.

“Research – such as the projects conducted by Jean – is one of the core pillars of our mission at the Center for Autism & Neurodevelopmental Disorders,” says Catherine Brock, executive director. “Through his efforts and the families that participate, we are better able to understand the underlying mechanisms of autism spectrum disorders and ADHD.”

The Santa Ana-based center is a collaboration of the UC Irvine School of Medicine, CHOC Children’s Hospital, Chapman University’s College of Educational Studies, the Children & Families Commission of Orange County, and the William & Nancy Thompson Family Foundation.

Posted in ADHD, Autism | Leave a comment

Celiac disease linked to miscarriages and preterm deliveries

(Reuters Health) – Women with doctor-diagnosed celiac disease are more likely to miscarry or deliver preterm than women with no history of the condition, according to a small U.S. study. Researchers say that women experiencing miscarriages or preterm deliveries should be checked for undiagnosed celiac.

While there are many more common causes of pregnancy complications, women who don’t know why they can’t conceive or carry a baby to term should find out if they have celiac disease, said lead study author Dr. Stephanie Moleski, a researcher at Thomas Jefferson University Hospital in Philadelphia.

“Miscarriage in celiac disease patients has been linked to vitamin deficiencies of zinc, selenium, iron and folate,” Moleski said by email. “When I see patients who have had fertility or pregnancy complications I feel it is appropriate to consider testing for celiac disease.”

Moleski and colleagues surveyed 329 women with biopsies confirming celiac disease as well as 641 women without the condition. Using online questionnaires, the researchers asked reproductive health questions ranging from the age the women started menstruating to the number of pregnancies they experienced and the birth circumstances for any babies delivered.





Posted in Celiac Disease, Pregnancy: Miscarriage, Pregnancy: Premature Delivery, Science Updates | Leave a comment

Are you guilty of these 12 micro biases?

Most people don’t intend to be racist, sexist or homophobic, or even consider themselves capable of discrimination or bias. Yet, researchers say, people often engage with the world around them unaware of the subtle and sometimes unconscious beliefs they hold about difference, including skin color, gender or sexuality.

That is when they are prone to committing what’s known as a microaggression, or behavior that communicates a derogatory or hostile message to the recipient. Anyone can make these mistakes, but the concept of microaggression is based on an understanding of institutional oppression — who has historically wielded power, and who hasn’t. That’s why the research on microaggressions focuses on the experiences of marginalized people of color, women and queer individuals, and not on those of white men.

Microaggressions are insidious precisely because the person who makes them isn’t even aware of what has happened, and might react indignantly if questioned. At the same time, the intended target may encounter such microaggressions regularly, feel hurt and angry, but not know how to address the situation.

In 2007, a group of researchers led by Dr. Derald Sue at Columbia University published a paper identifying nine common racial microaggression “themes,” which include treating an American-born person of color like an “alien,” denying someone else’s experience of racism by insisting on color blindness, and perpetuating racial stereotypes by proclaiming that only meritocracy, and not race, determines life success.



Posted in Human Behavior: Bias, Human Behavior: Sexuality, LGBT | Leave a comment

Women’s Silk Scarves Recalled Due to Burn Hazard, Violation of Federal Flammability Standard

Recall Summary: Name of product: Silk scarves
Hazard: The scarves fail to meet the federal flammability standard for wearing apparel and pose a burn hazard to consumers.
Remedy: Refund
Consumer Contact: Gena Accessories Inc. toll-free at (866) 974-4362 from 9 a.m. to 6 p.m. ET Monday through Friday or email for more information.
Report an Incident Involving this Product
Recall Details: Units: About 9,400

Description: This recall involves Gena Accessories women’s silk scarves. The recalled scarves measure 64 inches long by 18 inches wide and were sold in the colors black, brown, burgundy, camel, fuchsia, green, grey, lavender, light blue, light green, light pink, orange, red, turquoise, white and yellow.

Consumers should immediately stop using the recalled scarves and contact Gena Accessories Inc. for a full refund.
Sold at Specialty accessory boutiques in New York City and online at, and from January 2007 through February 2015 for about $12.
Importer(s): Gena Accessories Inc., of New York, N.Y.
Manufactured in China

See photo

Posted in Recalls | Leave a comment

Is sugar a drug? High consumption may relieve stress, say researchers

Newswise — Washington, DC—Drinking sugar-sweetened beverages can suppress the hormone cortisol and stress responses in the brain, but diet beverages sweetened with aspartame do not have the same effect, according to a new study published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism.

“This is the first evidence that high sugar – but not aspartame – consumption may relieve stress in humans,” said one of the study’s authors, Kevin D. Laugero, PhD, of the University of California, Davis, and the U.S. Department of Agriculture’s Agricultural Research Service. “The concern is psychological or emotional stress could trigger the habitual overconsumption of sugar and amplify sugar’s detrimental health effects, including obesity.”

About 35 percent of adults and nearly 17 percent of children nationwide are obese, according to the Society’s Endocrine Facts & Figures report. Sugary drinks such as soda and juice have been linked to this problem. Half of the U.S. population consumes sugar-sweetened drinks on any given day, according to the U.S. Centers for Disease Control and Prevention.

The parallel-arm, double-masked diet intervention study examined the effects of consuming sugar- and aspartame-sweetened beverages on a group of 19 women between the ages of 18 and 40. The researchers assigned eight women to consume aspartame-sweetened beverages, and 11 to drink sugar-sweetened beverages. For a 12-day period, the women drank one of the assigned beverages at breakfast, lunch and dinner. The participants were instructed not to consumer other sugar-sweetened drinks, including fruit juice.

For 3.5 days prior to and after the study, the women consumed a standardized low-sugar diet and stayed at the UC Davis Clinical and Translational Science Center’s Clinical Research Center.

Before and after the 12-day experimental period, the women underwent functional MRI screenings after performing math tests to gauge the brain’s stress response. The participants also provided saliva samples to measure levels of cortisol – a hormone made by the adrenal glands that is essential for the body’s response to stress.

The researchers found women who drank sugar-sweetened beverages during the study had a diminished cortisol response to the math test, compared to women who were assigned to consume aspartame-sweetened beverages. In addition, the women who consumed sugar-sweetened beverages exhibited more activity in the hippocampus – a part of the brain that is involved in memory and is sensitive to stress – than the women who drank aspartame-sweetened beverages.

The hippocampus typically is less active when the body is under stress. When the study participants drank sugar-sweetened beverages, this response was inhibited. The findings offer new clues that help explain how sugar positively reinforces the temptation to eat comfort food when a person is stressed, Laugero said.

“The results suggest differences in dietary habits may explain why some people underreact to stressful situations and others overreact,” he said. “Although it may be tempting to suppress feelings of stress, a normal reaction to stress is important to good health. Research has linked over- and under-reactivity in neural and endocrine stress systems to poor mental and physical health.”

Other authors of the study include: Matthew S. Tryon, Kimber L. Stanhope, Valentina Medici and Peter J. Havel of the University of California, Davis in Davis, CA; and Elissa S. Epel, Ashley E. Mason and Rashida Brown of the University of California, San Francisco in San Francisco, CA.

The study, “Excessive Sugar Consumption May Be a Difficult Habit to Break: A View from the Brain and Body,” will be published online at, ahead of print.

For more information on the high costs of junk food, visit the Hormone Health Network’s website.

Posted in Cortisol, Human Behavior: Stress, Mental Health: Early Life Stress, Nutrition: Food: Soft Drinks, Nutrition: Food: Sugar, Nutrition: Habits, Obesity | Leave a comment

Higher rate of sudden deafness among people with bone disease

Newswise — Washington, DC—People who have osteoporosis face a 1.76-fold higher risk of developing sudden deafness than those who do not have the bone disease, according to a new study published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism.

Osteoporosis is a progressive condition in which bones become structurally weak and are more likely to fracture or break, according to the Hormone Health Network. More than 40 million people nationwide already have osteoporosis or are at risk of developing the condition due to low bone mass, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

Sudden sensorineural hearing loss (SSHL), also called sudden deafness, is an unexplained, rapid loss of hearing that typically happens in one ear, according to the National Institute on Deafness and Other Communication Disorders. It can happen at once or over the course of several days. About half of the people who develop SSHL will spontaneously regain their hearing, but it is important to seek treatment immediately. About 85 percent of those who are treated for the condition recover some hearing.

“A growing body of evidence indicates that osteoporosis affects not only bone health, but the cardiovascular and cerebrovascular systems,” said one of the study’s authors, Kai-Jen Tien, MD, of the Chi Mei Medical Center in Taiwan. “Our findings suggest sudden sensorineural hearing loss (SSHL) can be another broader health problem connected to osteoporosis.”

The retrospective cohort study examined medical records for 10,660 Taiwan residents who were diagnosed with osteoporosis between 1999 and 2008, compared them to 31,980 people who did not have the condition. Using national insurance records, the researchers analyzed how many participants were diagnosed with sudden deafness by the end of 2011.

The participants who were diagnosed with osteoporosis had a much higher risk of developing sudden sensorineural hearing loss than the control group. Among the participants who had osteoporosis, 91 were diagnosed with SSHL during the follow-up period. In comparison, the control group, which was triple the size, included 155 people who were diagnosed with SSHL.

Researchers aren’t sure what biological mechanism is responsible for the relationship. Tien theorizes cardiovascular risk factors, bone demineralization, inflammation and endothelial dysfunction may contribute to the association.

“More people worldwide are suffering from osteoporosis, and our work shows they are at risk of sensorineural hearing loss as well as bone fracture and other problems,” Tien said. “Patients who have osteoporosis should be aware they need to seek medical help immediately if they experience hearing loss.”

Other authors of the study include: Mei-Chen Yeh, Shih-Feng Weng, Chien-Wen Chou, Chwen-Yi Yang, and Jhi-Joung Wang of Chi Mei Medical Center; and Yuan-Chi Shen of Kaohsiung Chang Gung Memorial Hospital and Cheng Shiu University in Kaohsiung, Taiwan.

The study, “Increased Risk of Sudden Sensorineural Hearing Loss in Patients with Osteoporosis: A Population-based, Propensity Score-matched, Longitudinal Follow-up Study,” will be published online at, ahead of print.

Posted in Audiology, Osteoporosis | Leave a comment

E-cigarette use triples among middle and high school students in just one year; hookah use doubles; no decline seen in overall tobacco use among middle or high school students

In 2014, the products most commonly used by high school students were e-cigarettes (13.4 percent), hookah (9.4 percent), cigarettes (9.2 percent), cigars (8.2 percent), smokeless tobacco (5.5 percent), snus (1.9 percent) and pipes (1.5 percent).  Use of multiple tobacco products was common; nearly half of all middle and high school students who were current tobacco users used two or more types of tobacco products. The products most commonly used by middle school students were e-cigarettes (3.9 percent), hookah (2.5 percent), cigarettes (2.5 percent), cigars (1.9 percent), smokeless tobacco (1.6 percent), and pipes (0.6 percent).

Cigarettes, cigarette tobacco, roll-your-own tobacco and smokeless tobacco are currently subject to FDA’s tobacco control authority. The agency currently is finalizing the rule to bring additional tobacco products such as e-cigarettes, hookahs and some or all cigars under that same authority. Several states have passed laws establishing a minimum age for purchase of e-cigarettes or extending smoke-free laws to include e-cigarettes, both of which could help further prevent youth use and initiation.

“In today’s rapidly evolving tobacco marketplace, the surge in youth use of novel products like e-cigarettes forces us to confront the reality that the progress we have made in reducing youth cigarette smoking rates is being threatened,” said Mitch Zeller, J.D., director of FDA’s Center for Tobacco Products. “These staggering increases in such a short time underscore why FDA intends to regulate these additional products to protect public health.”

Today’s report concludes that further reducing youth tobacco use and initiation is achievable through regulation of the manufacturing, distribution, and marketing of tobacco products coupled with proven strategies. These strategies included funding tobacco control programs at CDC-recommended levels, increasing prices of tobacco products, implementing and enforcing comprehensive smoke-free laws, and sustaining hard-hitting media campaigns. The report also concludes that because the use of e-cigarettes and hookahs is on the rise among high and middle school students, it is critical that comprehensive tobacco control and prevention strategies for youth focus on all tobacco products, and not just cigarettes.

The National Youth Tobacco Survey (NYTS) is a school-based, self-administered questionnaire given annually to middle and high-school students in both public and private schools. NYTS, which surveyed 22,000 students in 2014, is a nationally representative survey.

The 2012 Surgeon General’s Report found that about 90 percent of all smokers first tried cigarettes as teens; and that about three of every four teen smokers continue into adulthood. To learn more about quitting and preventing children from using tobacco, visit

For broadcast-quality video and audio clips featuring FDA’s Center for Tobacco Products Director Mitch Zeller speaking about the findings from the 2014 National Youth Tobacco Survey, visit Please note that these clips will not be available until Thursday, April 16 at 1 p.m. ET.  

Posted in E-cigarettes, Pediatric Health: Teenagers, Smoking, Smoking: Hookah, Smoking: Menthol | Leave a comment

Puerto Rico has lower rates of new cases of lung and breast cancer than the rest of US

Puerto Rico has the lowest incidence rate of new lung cancer compared with all other races and ethnic groups in the United States, according to a study published today in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.  The report also shows that Puerto Rico has a lower incidence rate of female breast cancer compared with U.S. non-Hispanic white and black women.

The report presents for the first time invasive cancer incidence rates for 2007–2011 among Puerto Rican residents by sex, age, cancer site, and region using U.S. Cancer Statistics data. Puerto Rico has similar incidence rates to U.S. populations for cancer of the colon and rectum. Cancers of the prostate (152 cases per 100,000 men), female breast (84 cases per 100,000 women), and colon and rectum (43 cases per 100,000 persons) are the most common cancer sites among Puerto Rico residents.

“These data underscore the importance of Puerto Ricans getting proper screening for breast, cervical, and colorectal cancer to identify them early when they are most treatable,” said Guillermo Tortolero-Luna, M.D., Ph.D., director of Cancer Control and Populations Sciences at the University of Puerto Rico and a co-author of the paper.

The differences in reported cancer incidence rates between U.S. and Puerto Rican residents may be partly explained by differences in health behaviors and risk factors associated with cancers. For example, Puerto Rico has lower smoking rates than all American states (with the exception of Utah), which could explain the lower rates of lung cancer.

“We are encouraged to see lower lung cancer incidence rates in Puerto Rico than the rest of the U.S.  However, we must remain diligent in our cancer control efforts to continue progress,” said Blythe Ryerson, Ph.D., M.P.H., a lead epidemiologist in CDC’s Division of Cancer Prevention and Control and an author of the paper. “We recommend all smokers quit for good.”

The full report, “Invasive Cancer Incidence – Puerto Rico, 2007-2011,” can be found at For more information about CDC’s efforts in cancer prevention and control, visit For tips from former smokers about how to quit, visit:

Posted in Cancer: Breast, Cancer: Lung, Health Care: Disparities | Leave a comment

Firearm-Related Hospitalizations and U.S. Stock Market Performance Linked: The American Journal of Medicine

Over 2001-2011, the national incidence of firearm-related hospitalizations has closely tracked the national stock market performance, suggesting that economic perturbations and resultant insecurities might underlie the perpetuation of firearm-related injuries, according to a new study published in The American Journal of Medicine. Although the fatality rates have remained stable over the last two decades, the average length of stay and hospitalization costs have increased, imposing additional burden on existing healthcare resources.

Firearms are the second leading cause of injury-related deaths after motor vehicle accidents in the U.S. with approximately 88 people dying every day, including suicides, homicides, unintentional injuries, or accidents. “Although there is a large amount of literature detailing the vital statistics relating to firearm-injuries, there is a conspicuous paucity of literature exploring burden on healthcare resources imposed by firearm injuries,” explained author Shikhar Agarwal, MD, MPH, Department of Cardiovascular Medicine, Cleveland Clinic. “One could surmise that there would be a relationship between the national economic situation and national firearm-related hospitalization rates.”

Smith & Wesson: Gun orders are picking up again

Dr. Agarwal analyzed data from the Nationwide Inpatient Sample (NIS) database from 2001-2011, which indicated that 70,974 hospitalizations were the result of firearm-related injuries. The number of hospitalizations fluctuated during this timeframe with a modest increase during 2002 and 2004, a slow decline until 2008, a sharp increase in 2009 and 2010, followed by a sharp decline in 2011.

The overall fatality rate for hospitalization following firearm-related injury has been stable at about 8%, with suicide responsible for more than 30% of those deaths. Analysis of the data also showed that there has been an increase in the prevalence of mental-health disorders among people admitted with firearm-related injuries.

Using the Dow Jones Industrial Average as an indicator of the overall economic health of the country, Dr. Agarwal determined that “the national incidence of firearm-related hospitalizations in the US has closely tracked the national stock market performance, suggesting that economic perturbations may be a ‘root cause’ or at least an important predictor of firearm injuries.”

Separating the data into two time intervals, 2001-2006 and 2007-2011, Dr. Agarwal found that there was a small but significant drop in the number of patients discharged to home during the later time interval. In addition, the average length of stay following firearm-related injury increased from 6.6 days in 2001-2006 to 7.4 days in 2007-2011, including a significant increase in the proportion of patients who were in hospital for more than 10 days (18.1% in 2001-2006 to 20.8% in 2007-2011.) This was also associated with an average hospitalization cost of $25,155 in 2007-2011 vs. $20,686 in 2001-2006.


Posted in Domestic Violence, Guns, Human Behavior: Aggression, Human Behavior: Violence | Leave a comment

Synthetic drugs: evidence that they can cause cancer: Medical University of Vienna

Almost weekly, a new synthetic psychoactive drug comes onto the market somewhere in Europe that can be ordered legally and easily, for example as an incense blend, via the Internet. Synthetic cannabinoids are difficult to identify chemically and the possible unwanted toxic effects that can occur following their consumption have so far barely been investigated. As part of the international EU project “SPICE II Plus”, which is now coming to an end, scientists from the MedUni Vienna’s Institute for Cancer Research have now also found evidence that synthetic substances damage the DNA of human cells and can therefore possibly have cancer-causing effects.

Synthetic cannabinoids, similar to tetrahydrocannabinol (the psychoactive ingredient of marijuana), bind to cannabinoid receptors in the human brain, triggering similar neurophysiological effects. These synthetic cannabinoids are marketed in incense mixtures as “legal highs” via the Internet and are “flooding the market”, as Siegfried Knasmüller from the Institute for Cancer Research at the MedUni Vienna warns.

“The substances are directly active, in other words they are not activated via enzymes that metabolise foreign substances”, explains Knasmüller. “The respiratory organs and the digestive tract especially are subjected to increased concentrations of these drugs. Our investigations on human cell lines in the laboratory have shown that synthetic cannabinoids, in the high concentrations found in cells in the oral cavity or in the lungs, for example, are likely to trigger damage to the DNA that may have significant consequences for the consumers of such substances. They damage chromosomes, and this is directly associated with cancer.”

Effects on consumers cannot be quantified

Synthetic cannabinoids bind very differently and some have an effect even in very small quantities. Consumers have absolutely no information about the varying levels of effect, since they are unaware of the detailed composition of synthetically manufactured drugs. Even with “known” products, the type and quantity of ingredients added change constantly. The risk of an unwanted overdose is correspondingly great. As a result, there have been repeated cases of damage to users’ health or poisoning, and in some cases users have even died.

Between 2005 and 2012, the European Union’s early warning system registered just under 240 new psychoactive substances that were disguised as incense blends, bath salts or plant fertiliser, and around 140 of them contained synthetic cannabinoids.

SPICE I and SPICE II Plus are international cooperation projects at EU level that have been led by the Institute of Medical Jurisprudence at the University Hospital of Freiburg (Prof. Volker Auwärter) and which have also involved the MedUni Vienna and the Goethe University of Frankfurt, the University of Helsinki, the Institute of Therapy Research in Munich, as well as input from partners such as the Federal Criminal Office of Wiesbaden.



Posted in Cancer, Cannabis, Health Care: Medical Errors, Synthetic Drugs | Leave a comment

Statins up diabetes risk by 46 per cent: Diabetologia, the journal of the European Association for the Study of Diabetes

Researchers investigate the effects of statin treatment on the risk of type 2 diabetes and deterioration of blood sugar control

New research published in Diabetologia (the journal of the European Association for the Study of Diabetes) shows that use of statins is associated with a 46% increase in the risk of developing diabetes, even after adjustment for confounding factors. The study is by Professor Markku Laakso, Institute of Clinical Medicine, University of Eastern Finland and Kuopio University Hospital, Finland, and colleagues.

Previous studies have suggested an increased risk (of varying levels) of developing diabetes associated with statin use. However, these studies have had limitations: study populations have been selective especially in statin trials which have included participants at high risk of cardiovascular disease. Therefore, the risk of diabetes in clinical trials is likely to differ from that in the general population. Very often in previous studies the diagnosis of diabetes has been based on self-reported diabetes or fasting glucose measurement, leading to an underestimation of the actual numbers of incident diabetes cases.

In this new study, the authors investigated the effects of statin treatment on the risk of type 2 diabetes and deterioration of blood sugar control in 8,749 non-diabetic men in a 6-year follow-up of the population-based Metabolic Syndrome in Men (METSIM) study, based in Kuopio, Finland. The authors also investigated the mechanisms of statin-induced diabetes by evaluating changes in insulin resistance and insulin secretion.

The participants, aged 45-73 years, were followed up for 5.9 years. New diabetes was diagnosed in 625 men with either an oral glucose tolerance test (OGTT), an HbA1c level of 6.5% or higher, or anti-diabetic medication started during the follow-up, and insulin sensitivity and secretion were evaluated.

The researchers found that, after the results were adjusted for age, body mass index (BMI), waist circumference, physical activity, smoking, alcohol intake, family history of diabetes, and beta-blocker and diuretic treatment, patients treated with statins were 46% more likely to develop diabetes than those not treated with statins.

The risk was dose-dependent for simvastatin and atorvastatin. Statin treatment significantly increased 2-h glucose (2hPG) at follow-up, with a nominally significant increase in fasting glucose (FPG). Insulin sensitivity was decreased by 24% and insulin secretion by 12% in individuals on statin treatment.

Furthermore, decreases in insulin sensitivity and insulin secretion were dose-dependent for simvastatin and atorvastatin. And, after adjustment for all the confounders mentioned above, high-dose simvastatin was associated with a 44% increased risk of developing diabetes, while for low-dose simvastatin the increased risk was 28% and for high-dose atorvastatin the increased risk was 37%. Overall, 29% of participants were taking simvastatin, while 53% were taking atorvastatin.

The authors say, “The association of statin use with increased risk of developing diabetes is most likely directly related to statins decreasing both insulin sensitivity and secretion.”

Furthermore, they stress that while the size of the study makes their conclusions reliable, the study sample was Caucasian men, so the applicability to women or people of other ethnic origin cannot be confirmed without further research.

They conclude: “Statin therapy was associated with a 46% increased risk of type 2 diabetes after adjustment for confounding factors, suggesting a higher risk of diabetes in the general population than previously reported.”



Posted in Cholesterol, Diabetes, Health Care: Medical Errors, Statins | 1 Comment

Phthalate used in auto upholstery, baby toys, building materials can undermine female reproductive health: University of Illinois at Urbana-Champaign

CHAMPAIGN, Ill. — Two studies in mice add to the evidence that the phthalate DEHP, a plasticizing agent used in auto upholstery, baby toys, building materials and many other consumer products, can undermine female reproductive health, in part by disrupting the growth and function of the ovaries.

In the first study, reported in the journal Reproductive Toxicology, researchers found that exposing pregnant mice to DEHP increased the male-to-female sex ratio of their pups. Reproductive outcomes for the pups also were altered. About one in four of those exposed to DEHP in the womb took longer to become pregnant and/or lost some of their own pups.

The second study, reported in the journal Toxicology and Applied Pharmacology, revealed that DEHP disrupts the growth and function of follicles in the adult ovary. Exposure to DEHP increased the production of proteins that inhibit growth and promote degradation of the follicles, and decreased the production of steroid hormones, the researchers found.

“The follicles are the structures that contain the egg, and if you’re killing those, you may have fertility issues,” said University of Illinois comparative biosciences professor Jodi Flaws, who led both studies. “The bottom line is that DEHP may damage the follicles and impair the ability of the ovary to make sex steroids like estrogens and androgens, which are really important for reproduction.”

Most of the research conducted so far on the reproductive effects of phthalates has focused on males, “because phthalates are thought to interfere with the androgen system,” Flaws said.

“Studies that were done on females historically used very high doses of chemicals that aren’t environmentally relevant,” she said. “So our work has been to focus on the female and on environmentally relevant doses that people might see, either in the environment or occupationally or medically.”

It is important to evaluate lower phthalate doses because they reflect real-world exposures, and also because low doses of endocrine-disrupting chemicals like phthalates can have more serious consequences than high doses, Flaws said.

“Sometimes it’s at the low doses that you have the most profound effects, and that’s what we’re seeing with the phthalates,” she said.

These studies are among several initiatives of the Children’s Environmental Health and Disease Prevention Research Center at the U. of I., which is funded by the National Institute of Environmental Health Sciences at the National Institutes of Health and the U.S. Environmental Protection Agency.



The paper, “Prenatal exposure to di-(2-ethylhexyl) phthalate (DEHP) affects reproductive outcomes in female mice,” is available online.

The paper, “Di(2-ethylhexyl) phthalate inhibits antral follicle growth, induces atresia, and inhibits steroid hormone production in cultured mouse antral follicles,” is available online. B


Posted in Environmental Health: Phthalates, Pregnancy: Fertility | Leave a comment