Serum true insulin concentration and the risk of clinical non-insulin dependent diabetes during long-term follow-up.

Background: There is considerable evidence that insulin resistance with compensatory hyperinsulinaemia is an early and modifiable defect in the pathogenesis of non-insulin dependent diabetes (NIDDM). Current data, however, are largely based on studies that have used insulin assays which cross-react with proinsulin and other insulin precursors. Using a specific assay, we have addressed the hypothesis that an elevation of serum true insulin concentration, reflecting insulin resistance, is an early event in the pathogenesis of NIDDM.

Measuring the prevalence of disease in middle-aged British men.

Objective: To identify and validate a measure of disease prevalence in a town or other subpopulation for the purpose of estimating variations in morbidity and health care needs between groups.

Design: A national prospective study of cardiovascular disease based in 24 British towns.

Subjects: 7,735 men aged 40-59 years sampled from 24 general practice age-sex registers between 1978 and 1980.

Nonfasting serum glucose and insulin concentrations and the risk of stroke.

Background And Purpose: Type 2 diabetes is an established risk factor for stroke, but the relations between asymptomatic hyperglycemia, hyperinsulinemia, and stroke incidence remain uncertain. We have examined the relationship between established diabetes, nonfasting serum glucose and serum insulin concentrations, and subsequent risk of stroke.

Methods: We performed a prospective study of 7735 men aged 40 to 59 years drawn from general practices in 24 British towns.

Type of alcoholic drink and risk of major coronary heart disease events and all-cause mortality.

Objectives: This study examined the effects of beer, spirits, and wine drinking on coronary heart disease (CHD) events (fatal and nonfatal) and all-cause mortality.

Methods: Men aged 40 to 59 years (n = 7735) were drawn at random from one general practice in each of 24 British towns and followed up for an average of 16.8 years.

Is serum uric acid a risk factor for coronary heart disease?

The role of uric acid as an independent risk factor in the development of coronary heart disease (CHD) has been questioned as serum urate is related to many of the established etiological risk factors for cardiovascular disease which could confound the observed association. This review assesses the role of elevated serum uric acid as an independent role for coronary heart disease.

Role of risk factors for major coronary heart disease events with increasing length of follow up.

Background: It has been suggested that the predictive value of certain risk factors for coronary heart disease (CHD) measured at one point in time diminishes with increasing length of follow up.

Designs And Methods: The relation was examined between a wide range of risk factors and the risk of major CHD events over 15 years' total (cumulative) follow up and for three separate five year periods (0-5.0, 5.

The J-shaped curve and changes in drinking habit.

The accepted interpretation of the J-shaped curve relating alcohol intake to mortality or coronary heart disease is that the lowest point on the curve (light/moderate drinking) represents optimum exposure to alcohol and that the increased risk in non-drinkers reflects the consequence of sub-optimum exposure. However, non-drinkers, both ex-drinkers and lifelong teetotallers, consistently show an increased prevalence of conditions likely to increase morbidity and mortality compared with occasional or light drinkers. In addition, regular light drinkers tend to have characteristics extremely advantageous to health.

Lifestyle and 15-year survival free of heart attack, stroke, and diabetes in middle-aged British men.

Background: To examine the relationship between modifiable lifestyle factors (smoking, physical activity, alcohol intake, and body mass index [BMI]) and the likelihood of 15-year survival free of major cardiovascular end points and diabetes in middle-aged men.

Methods: A prospective study of 7142 men aged 40 to 59 years at screening with no history of coronary heart disease, diabetes, and stroke drawn from 1 general practice in each of 24 British towns and followed up for 15 years.

Main Outcome Measures: Death from any cause and a combined end point, including survival free of heart attacks or stroke or the development of diabetes over a follow-up of 15 years for each man.

Adult height, stroke, and coronary heart disease.

An inverse relation between adult height and risk of coronary heart disease (CHD) has been reported in many studies, but the association between adult height and stroke remains uncertain. The authors examined the relation between adult height and risk of stroke and CHD in a prospective study of 7,735 men drawn from general medical practices in 24 towns in England, Wales, and Scotland. The men were followed up for an average of 16.

Hypertension, serum insulin, obesity and the metabolic syndrome.

Background And Aims: In recent years it has been proposed that hypertension is part of a cluster of metabolic risk factors (syndrome X) involving hyperlipidaemia and hyperglycaemia, with hyperinsulinaemia as the common link. This study has investigated: (1) the prevalence of the metabolic syndrome and its component variables and their relationship to body mass index (BMI) and non-fasting insulin levels in a general population; and (2) the distribution and clustering of metabolic variables in normotensives and hypertensives.

Methods: Cross-sectional study of 5222 men aged 40-59 years with no history of coronary heart disease (CHD), diabetes mellitus or stroke drawn from general practices in 18 British towns.

Alcohol, coronary heart disease and stroke: an examination of the J-shaped curve.

The consistent findings of higher risk of coronary heart disease (CHD) and total mortality in non-drinkers compared to light to moderate drinking has been interpretated as showing that light or moderate drinking is beneficial to health. Non-drinkers, both ex-drinkers and lifelong teetotallers, have an increased prevalence of conditions likely to increase morbidity and mortality compared with occasional or light drinkers. In addition, regular light drinkers tend to have characteristics extremely advantageous to health.

Changes in physical activity, mortality, and incidence of coronary heart disease in older men.

Background: We studied the relations between physical activity and changes in physical activity, all-cause mortality, and incidence of major coronary-heart-disease events in older men.

Methods: In 1978-80 (Q1), 7735 men aged 40-59 were selected from general practices in 24 British towns, and enrolled in a prospective study of cardiovascular disease, which included physical activity data. In 1992 (Q92), 12-14 years later, 5934 of the men (91% of available survivors, mean age 63 years) gave further information on physical activity and were then followed up for a further 4 years.

Clinical and immunological features of human immunodeficiency virus infection in patients from Bangkok, Thailand.

Background: To assess the association between the CD4 count and clinical diseases in a cohort of Thai patients.

Methods: In all, 1902 patients who presented with human immunodeficiency virus (HIV) infection at the Chulalongkorn University Hospital in Bangkok were investigated.

Results: At the time of presentation 295 (15.

Prospective study of serum gamma-glutamyltransferase and risk of NIDDM.

Objective: Serum gamma-glutamyltransferase (GGT) levels are raised in obese individuals, and a particularly strong association with central obesity has been described. We hypothesized that elevated GGT levels are a marker for visceral fat, and specifically for hepatic steatosis (fatty liver), and that hepatic steatosis leads to hepatic insulin resistance. To test this hypothesis, we examined the association between GGT levels and risk of NIDDM.

Chest pain on questionnaire and prediction of major ischaemic heart disease events in men.

Objective: To examine the prediction of major ischaemic heart disease events by questionnaire-assessed chest pain and other symptoms.

Design: Population-based prospective study.

Subjects: 7735 randomly selected men, aged 40-59 years at entry.

Serum urate and the risk of major coronary heart disease events.

Objective: To examine the relation between serum urate and the risk of major coronary heart disease events.

Design: A prospective study of a male cohort.

Setting: One general practice in each of 24 British towns.

Socioeconomic status within social class and mortality: a prospective study in middle-aged British men.

Objective: It has been suggested that mortality differences between groups in society may be greater than are indicated by social class based on occupation. We have examined the relationship between social class and mortality using home and car ownership as additional indices of socioeconomic status within social class.

Design: A prospective study of a cohort of men representative of the social class distribution of middle-aged men in Great Britain.

Lifelong teetotallers, ex-drinkers and drinkers: mortality and the incidence of major coronary heart disease events in middle-aged British men.

Background: To determine the risk of all cause mortality and the incidence of major coronary heart disease (CHD) events in lifelong teetotallers and in ex-drinkers compared with occasional and regular drinkers.

Methods: A prospective study of middle-aged men drawn at random from one general practice in each of 24 British towns. Five years after the screening of 7735 men aged 40-59 years, 7167 provided further information on postal questionnaire enabling separation of non-drinkers into lifelong teetotallers and ex-drinkers.

Body weight: implications for the prevention of coronary heart disease, stroke, and diabetes mellitus in a cohort study of middle aged men.

Objective: To determine the body mass index associated with the lowest morbidity and mortality.

Design: Prospective study of a male cohort.

Setting: One general practice in each of 24 British towns.

Serum potassium, cigarette smoking, and mortality in middle-aged men.

The relation between serum potassium level and all-cause mortality was examined in a prospective study of 7,636 middle-aged British men followed for 11.5 years (1978-1991). Men being treated for hypertension had a significantly lower mean (+/- standard error) potassium level than men not in treatment (4.

Serum creatinine concentration and risk of cardiovascular disease: a possible marker for increased risk of stroke.

Background And Purpose: Elevated serum creatinine has been associated with increased mortality in hypertensive persons, the elderly, and patients with myocardial infarction or stroke in whom cardiovascular disease is the major cause of death. We have examined the relationship between serum creatinine concentration and the risk of major ischemic heart disease and stroke events and all-cause mortality in a general population of middle-aged men.

Methods: We present a prospective study of middle-aged men (aged 40 to 59 years) drawn from 24 British towns who have been followed up for an average of 14.

Influence of fathers' social class on cardiovascular disease in middle-aged men.

Background: The independent effect of early life circumstances on adult cardiovascular risk is still unresolved. We assessed the associations of father's social class with cardiovascular risk factors and with risk of ischaemic heart disease and stroke in adult life.

Methods: We did a longitudinal study of cardiovascular disease in 5934 men aged 40-59 years at enrollment.

Life expectancy in men who have never smoked and those who have smoked continuously: 15 year follow up of large cohort of middle aged British men.

Objective: To estimate the life expectancy in a representative sample of men who have never smoked and of those who have smoked all their adult lives.

Design: 15 year follow up of a large representative cohort of British men in the British regional heart study and use of national mortality statistics for 1992.

Subjects: 7735 middle aged British men aged 40-59 at the time of screening (between 1978 and 1980).

History of parental death from stroke or heart trouble and the risk of stroke in middle-aged men.

Background And Purpose: The purpose of this study was to determine the effect of a history of parental death from stroke or heart trouble on the risk of major stroke events (fatal and nonfatal) in middle-aged British men.

Methods: A prospective study was undertaken of 7735 middle-aged men, drawn at random from general practices in 24 British towns, who were followed up for an average of 14.8 (range, 13.

Serum insulin and incident coronary heart disease in middle-aged British men.

Earlier studies have not resolved the question of whether elevated circulating insulin levels are independently related to the development of coronary heart disease. Previous studies have not used a specific insulin assay and in all but a minority of studies that have addressed this issue it has not been possible to adjust for possible confounding due to high density lipoprotein (HDL) cholesterol. The authors examined the relation between serum insulin concentration and major coronary disease events (fatal and non-fatal myocardial infarction) in the British Regional Heart Study.