News Flash

Protein may Hold key to Stop Cancer (November 4, 2002)
(Ivanhoe Newswire) -- Carol Otey, Ph.D., and colleagues from the University of North Carolina in Chapel Hill are studying the relationship between metastatic cancer cells and the amount of a protein called paladin found in them. If there is a relationship, palladin may be used in the future to stop the spread of cancer cells.

Otey was part of a team that discovered palladin three years ago. The protein is involved in actin assembly, which gives cells their shape. Researchers found palladin levels increase when cells move. In order to move, cells have to change shape. For example, when you cut yourself, cells on either side of the wound move in to help heal the injury. In the process, the cells' shapes are changing and there is an increase in palladin. Otey has cloned palladin, and can now add it to a cell or block its production, thereby inhibiting or promoting cell movement.

Otey and her team are now studying five primary cancer tumors taken from a tumor bank. Since the tumors have been stored for years, researchers will be able to study whether the amount of palladin in a tumor is linked to advanced disease. If there are high levels of palladin in tumors that have led to advanced cancer, Otey could then inhibit palladin to determine if it will stop the spread.

Otey says, because the study involves matter that is already available, the outcome of the study will be faster and easier to determine. In an interview with Ivanhoe, she said, "If we can find a way to inhibit cells from moving, this could potentially be a cure for cancer."

SOURCE: Ivanhoe Health Correspondent Shanida Smith's interview with Carol Otey, Ph.D., Nov. 1, 2002

C-Section may Help Twins (November 4, 2002)
(Ivanhoe Newswire) -- A new study shows second twins born at term are at a higher risk of death, due to complications during labor and delivery, than first twins. However, planned caesarean section may prevent such deaths.

Researchers analyzed the births of more than 4,500 twins born in Scotland between 1992 and 1997. They found significantly increased risks of death during labor and neonatal death among second twins born at term. No deaths were recorded among 454 second twins delivered at term by planned caesarean section.

The absolute risk of death for second twins was one in 350 due to lack of oxygen during birth and one in 500 for lack of oxygen due to mechanical problems. Researchers say these absolute risks are high in comparison with similar data for singleton term births in Scotland over the same period.

Researchers say planned caesarean delivery may offer some protection. Previous studies show second twins are vulnerable to complications during labor and delivery.

SOURCE: British Medical Journal, 2002;325:1004-1006

Combination Treatment for Multiple Myeloma (November 4, 2002)
(Ivanhoe Newswire) -- A new study shows thalidomide is effective as first-line therapy for newly diagnosed multiple myeloma patients when combined with a standard chemotherapy agent.

Researchers from the Mayo Clinic in Rochester, Minn. gave 50 newly diagnosed myeloma patients the drug thalidomide along with the synthetic steroid dexamethasone. Results show 64 percent of patients responded to the combination. Researchers also observed an improvement in associated symptoms and in disturbances in the blood.

Results also show the thalidomide combination was well tolerated. Researchers say current chemotherapy regimens used as initial therapy for multiple myeloma have significant toxicity. In addition, the thalidomide combination is administered orally while current chemotherapy requires intravenous administration.

Multiple myeloma is a malignant cancer of the plasma cell, which is a type of white blood cell found in many tissues of the body. As the cancer grows, it destroys normal bone tissue, which causes pain and crowds out normal cell production.

Multiple myeloma is the second most common blood cancer in the United States. There are 45,000 people in the United States living with this condition. It remains incurable despite the use of conventional and high dose chemotherapy.

SOURCE: Journal of Clinical Oncology, 2002;20:4319-4323

Driving Doesn't Cause Back Problems (November 1, 2002)
(Ivanhoe Newswire) -- Truck drivers and others who spend a lot of time behind the wheel can't blame their back problems on driving alone, reveals a new study.

Researchers followed 45 pairs of identical twins in which one twin had an occupation that required extensive driving and the other did not. They found no difference in the occurrence of back problems between the two groups.

Work-related back pain is more common among people who drive vehicles for a living than any other group. Doctors generally attribute that finding to the whole body vibration experienced while driving, suggesting the vibration somehow leads to disc degeneration and herniation. This implies permanent damage to the back and life-long symptoms.

Investigators from the University of Alberta and elsewhere assessed male twins participating in the Finnish Twin Cohort study. Occupational exposure to driving and other factors, which could lead to back pain, were assessed through interviews, and all participants underwent MRIs to assess disc degeneration.

Results show no difference in disc degeneration between twins who drove for a living and their brothers. Driving brothers also had no greater tendency for back-related disease than their non-driving brothers.

Authors conclude occupational driving does not cause disc damage. While they admit driving may worsen back pain among those with back problems, they believe their findings should prove encouraging to many people who make their living behind the wheel.

SOURCE: The Lancet, 2002;360:1369-1374

Walk Faster And Sit Less To Reduce CV Risk (November 1, 2002)

Postmenopausal women who engage in walking have a significantly lower risk of cardiovascular events, regardless of race or ethnic group, age or weight. That's one of the findings from a study of more than 73,000 women aged 50 to 79 in the Women's Health Initiative Observational Study.

Further, increasing levels of physical activity were associated with decreasing risk of heart attack, stroke and CV disease. Those with a brisker walking pace or regular vigorous exercise were at lowest risk. The study found that brisk walking for 2.5 hours a week reduced the risk of heart attack and stroke by about a third. Prolonged sitting was predictive of increased CV risk.

ERT and Breast Cancer (October 31, 2002)
(Ivanhoe Newswire) -- The debate over estrogen replacement therapy continues with a new study by researchers at the University of Texas M.D. Anderson Cancer Center.

They report women with a history of localized breast cancer who took ERT were no more likely to die or suffer a recurrence of their cancer than those who did not.

Even though many women who develop breast cancer go through premature ovarian failure due to chemotherapy, these women are not usually given the option of ERT because doctors have feared estrogen could reactivate their tumors. Several small studies, however, have suggested ERT can be safely given to women with small tumors, which have been cured by treatment, although all have looked at survival and cancer recurrence over the short term only.

These researchers say this is the first long-term study to evaluate the use of ERT in women with breast cancer. They looked at about 300 women who had survived breast cancer. In a randomized arm of the study, 34 women took ERT and 43 others did not use the treatment. In a larger, non-randomized group, 22 women received ERT and 200 did not. Women whose cancers were known to be positive for an estrogen receptor were excluded from the study.

All women were followed for five years with regular check-ups. Results showed no significant difference in either overall or disease-free survival among women who took ERT and those who did not. What's more, those on ERT were actually less likely to develop new or recurring tumors when compared to those who did not take the medication. Researchers found new or recurrent disease in 33 of the women not on ERT (13.5 percent) vs. just 2 (3.6 percent) of those who did take ERT.

Compared with women who did not take ERT, those on the therapy experienced small improvements in both bone density and cholesterol by the end of the study.

The authors believe these results reinforce previous findings indicating ERT is safe for some women who have had breast cancer. They call for additional studies to further define appropriate treatment.

SOURCE: Cancer, 2002;95:1017-1026

FDA Public Health Web Notification: Complications Related to the Use of Bone Cement in Vertebroplasty and Kyphoplasty Procedures
(October 31, 2002)
This notification is to inform you about reports related to the use of polymethylmethacrylate bone cement to treat osteoporotic compression fractures of the spine using surgical procedures known as vertebroplasty and kyphoplasty. Complications related to these procedures have been reported in the literature and to FDA. Reported complications, such as soft tissue damage and nerve root pain and compression, are related specifically to the leakage of bone cement. Other reported complications include pulmonary embolism, respiratory and cardiac failure, and death.1-9

Current Status

FDA is currently working with appropriate professional organizations and manufacturers of orthopedic devices to consider the regulatory options available to evaluate the long-term safety and effectiveness of bone cement in vertebroplasty and kyphoplasty procedures. We encourage you to be aware of considerations and recommendations regarding patient selection, vertebroplasty and kyphoplasty techniques, complications, and patient monitoring described in the literature when considering these procedures to treat osteoporotic compression fractures of the spine.3,10-12

Background

Vertebroplasty involves the percutaneous injection of a mixture of polymethylmethacrylate bone cement and a contrast agent, typically barium sulfate, into the vertebral bodies using fluoroscopic and/or computed tomography guidance. Early vertebroplasty procedures were primarily performed to alleviate pain and to stabilize fractured bone in patients with hemangiomas, malignant metastases, or other types of tumors of the spine. The use of vertebroplasty to treat osteoporotic compression fractures in patients where conservative treatment has failed is relatively recent with no prospective, randomized, controlled trials to characterize its long-term safety or effectiveness.

In kyphoplasty procedures, a surgical instrument is introduced, with the intent to expand the vertebra. Once this instrument is withdrawn, the space created is then filled with the bone cement mixture. By creating space in this way, kyphoplasty procedures may correct deformity or restore body height. Like vertebroplasty, the use of kyphoplasty to treat osteoporotic compression fractures in patients where conservative treatment has failed is relatively recent with no prospective, randomized, controlled trials to characterize its long-term safety or effectiveness.

Although acrylic bone cement has been used for many years for the fixation of metal and plastic prostheses in joint replacement and less frequently in the fixation of pathological fractures, it has not been specifically evaluated for the treatment of spinal compression fractures. Acrylic bone cement is modified for vertebroplasty and kyphoplasty procedures by increasing the amount of contrast agent and changing the handling properties. The effects of these modifications are not well known in the spine. To date, there are no standardized formulations, biomechanical standards or safety guidelines for the types or amounts of opacifying additives used.

Reporting Adverse Events to FDA

The Safe Medical Devices Act of 1990 (SMDA) requires hospitals and other user facilities to report deaths and serious injuries associated with the use of medical devices, including bone cement. We request that you follow the procedures established by your facility for such mandatory reporting.

We also encourage you to report bone cement malfunctions. You can report these directly to the device manufacturer. You can also report to MedWatch, the FDA’s voluntary reporting program. You may submit reports to MedWatch one of four ways: online athttp://www.accessdata.fda.gov/scripts/medwatch/ by telephone at 1-800-FDA-1088; by FAX at 1-800-FDA-0178; or by mail to MedWatch, Food and Drug Administration, HF-2, 5600 Fishers Lane, Rockville, MD 20857.

Reversing Bone Loss Without Side Effects (October 28, 2002)
(Ivanhoe Newswire) -- New research shows a new drug may reverse bone loss without estrogen's side effects.

Along with their bone-related benefits, estrogen supplements can also have unwanted effects in the body's reproductive tissues. Several months ago, a major clinical study showed the risks of estrogen plus progesterone outweighed the benefits. The combination therapy modestly increases the risk of breast and uterine cancer.

Results of the new study show a synthetic compound called estren helps build bone without affecting the reproductive organs of both female and male mice. If the same is true for humans, this could lead to an alternative to standard hormone replacement therapy for treating osteoporosis.

Study author Stavros Manolagas, M.D., Ph.D., from the University of Arkansas for Medical Sciences, says, "For a long time we have been giving hormone replacement to women, based on the evidence that estrogens are effective in preventing osteoporosis. The big assumption was that estrogen works the same way in all the tissues."

In the study, researchers removed the mice's reproductive organs, which are major sources of estrogen and testosterone. The animals then lost bone density and strength. The surgery also led to the shrinking of the uterus in female mice, and of a male sex gland called the seminal vesicle. Researchers then compared the effects of treating the mice with either normal hormones or estren.

Overall, researchers found estrogen brought the females' bone density back to around normal, improved bone strength only slightly, and increased uterine weight to above normal. In contrast, estren improved bone density and strength over their initial levels, and kept uterine weight low.

Results in male mice were similar. Estren and testosterone were equally effective in restoring bone strength. Dr. Manolagas adds, "It's very exciting that this may be a gender-neutral therapy."

Alternative Medicine and Asthma (October 21, 2002)
(Ivanhoe Newswire) -- Much is known about the use of complementary or alternative (CAM) medicine among adults, but not much is known about the use in adolescents. A new study highlights how often young men and women turn to alternative methods.

Research shows about 40 percent of American adults use CAM for health problems. In this study, 160 inner-city high school students with asthma were surveyed. Of those, they found 33 percent reported having weekly symptoms from their condition and 14 percent had daily symptoms. Overall, 80 percent of the students reported using CAM for asthma.

According to the study, asthma is the most prevalent chronic disease affecting adolescents in the United States. The study authors believe it is important for physicians who treat adolescents to know 80 percent are using CAM. Only 54 percent of the students reported telling their physician about their use of alternative medicines.

The list of alternatives ranged from herbal teas to prayer to massages and rubs. Close to a quarter of all the adolescents reported using Jarabe 7, an herbal preparation commonly sold in Puerto Rican communities. About 60 percent of the study participants felt the alternative methods helped and they would try it again.

The researchers say, "Of particular significance was the prevalence of CAM use in this study population, which was twice the national average reported for adults." Again, they point out the importance for treating physicians to be aware of this number.

SOURCE: Archives of Pediatrics & Adolescent Medicine, 2002;156:1042-1044

On-the-job Stress Linked to Heart Disease (October 21, 2002)
(Ivanhoe Newswire) -- A new study shows on-the-job stress doubles the risk of heart disease.

Pressure from work demands, insignificant job control, and dwindling job security can cause on-the-job stress. However, until now researchers only speculated that the interaction of these stress factors could also be risk factors for cardiovascular death.

Researchers from the University of Helsinki, Finland, monitored the stress, blood pressures, cholesterol levels, and body mass index of 812 employees in a Finland metal company. Researchers tracked the employees' health for over 25 years. All of the participants were healthy at the beginning of the study in 1973.

Researchers found workers with high work demands, low job control, low job security and few career opportunities had a risk for heart disease that was double that of their co-workers who had little work stress. They also found that high levels of work stress was also linked to high cholesterol and an increased body mass among the stressed employees.

Overall, researchers suggest that prevention of on-the-job stress should be controlled to improve overall cardiovascular health.

SOURCE: British Medical Journal, 2002;325:857-860

Option for Healing Broken Bones (October 21, 2002)
(Ivanhoe Newswire) -- Research shows an alternative treatment can help mend slow-to-heal broken bones.

At the American Academy of Orthopaedic Surgeons Orthopaedics Update 2002 Web conference, Fred Ritchie Trew Nelson, M.D., from Sharp Memorial Hospital in San Diego, explained that physical fields include specific magnetic, electrical and sonic fields applied to an area of bone fracture healing. Physical field treatment is based on the concept of natural physiologic events that already exist in our bodies. It is natural for bone to bend slightly under normal physiological forces. This bending causes small electrical charges. When a bone breaks, blood vessels are broken and bleeding around the bone occurs. Cells in the immediate neighboring tissue send out chemical messages that, within days, incite a large number of small vessels to grow into the fracture area.

Under proper conditions for healing, the cells will divide and form different connective tissues such as cartilage and bone. If this process is delayed or does not happen, a physical field applied at the point can be used to stimulate increased calcium, which appears to be essential in healing the bone.

Physical field therapy is not widely used. Dr. Nelson says: "It's not new technology, in fact physical field stimulation has been shown to heal broken bones in documented cases dating all the way back to 1812." He says one reason it is not widely used is because few studies have been done on return rates to work and specific activities. Another factor is cost. However, Dr. Nelson says the benefits outweigh the costs and there are no side effects.

About 6 million people in the United States each year experience bone fractures. Of these, about 300,000 are slow to heal or do not heal at all with standard treatment.

SOURCE: American Academy of Orthopaedic Surgeons Orthopaedics Update 2002 Web conference, Oct. 16, 2002

New Drug Effective for Clots (October 21, 2002)
(Ivanhoe Newswire) -- The first new oral anticoagulant to be tested widely among patients to prevent leg clots is at least as effective as the standard treatment, a new study reveals. Results show it is also easier to monitor.

A high number of patients who undergo knee or hip-replacement surgery develop blood clots in the large veins of the legs. Physicians have been prescribing the anticoagulant warfarin, commonly known as Coumadin, for decades to prevent this potentially lethal complication.

Researchers from the University of Rochester Medical Center conducted a trial comparing warfarin and the new drug ximelagatran in 680 patients from the United States and Canada. All of the participants had undergone total knee replacement.

Results show around 19 percent of the group given ximelagatran developed blood clots compared to nearly 26 percent of the group treated with warfarin. Bleeding or wound complications were infrequent and did not differ significantly between the two groups.

Lead study author Charles W. Francis, M.D., says the drug may represent an improvement for many people. He says: "Any time you can offer patients a better or easier treatment, it's important. Over the years, Coumadin has worked well for a lot of people but it's not for everyone. For many patients, it's a hassle." Ximelagatran does not require coagulation monitoring or dose adjustment, as does warfarin.

Researchers are now studying ximelagatran to prevent stroke. The FDA has not yet approved the drug.

SOURCE: Annals of Internal Medicine, 2002;137:648-655

Endometriosis and Infertility (October 18, 2002)
(Ivanhoe Newswire) -- A new study confirms what doctors and women have said for some time -- endometriosis is linked to infertility. There has long been an association between the two, but now research reveals one of the reasons why the disease may cause infertility. The study is published in the current issue of The Lancet.

Doctors worked with only six patients, but conclude endometriosis causes a certain action that decreases fertility. The researchers examined the peritoneal fluid, fluid located near the fallopian tubes. They then studied the effect it had on the tiny hairs inside the fallopian tubes that push the egg toward the sperm. They found endometriosis greatly changes the activity of the tiny hairs.

The movement through the fallopian tubes was slowed by about 25 percent in the women who had endometriosis. It slowed even more with the passing of time. The doctors conclude this change is what may increase infertility. They suspect there may be a few other mechanisms that contribute to infertility as well and they suggest perhaps loose material in the body may also be slowing down the movement within the tubes.

Endometriosis is a condition in which the tissue that normally lines the uterus grows in other areas of the body, causing pain, irregular bleeding, and frequently infertility. Tissue typically grows in the pelvic area, outside of the uterus, on the ovaries, bowel, rectum, bladder, and the delicate lining of the pelvis, but it can occur in other areas of the body as well.

SOURCE: The Lancet, 2002;360:1221-1222

Soy and Flaxseed for Weight Loss (October 18, 2002)
(Ivanhoe Newswire) -- With more than 60 percent of the nation labeled as overweight or obese, it seems more and more people are concerned with weight loss. Though the focus is often on cutting foods from your diet to shed pounds, adding a few supplements could be just what you need to drop that weight.

Soy comes in all shapes and sizes. New research shows it could help your shape and size, too.

Larry Alexander, M.D., of Central Florida Regional Hospital in Sanford, Fla., tells Ivanhoe, "With the recent obesity epidemic that's hit this country, people have really started looking at other methods of trying to deal with the obesity factor, and soy has come to the forefront as a potential candidate for that."

Soy lowers bad cholesterol, makes the body more sensitive to insulin, and pushes food into muscle cells not fat cells.

"It works on fat metabolism so that you don't actually wind up storing as much of your calories as fat," says Dr. Alexander.

Chef spokesman for the Chef Spokesman for the Soy Council of America, Jason Hanners, says studies in rats show it works.

"The lean rats just got leaner, extra lean, and the obese rats started to show processes of leaning out," says Hanners.

According to Hanners, i's easy to work soy into your diet. He says, "Soy yogurt, soy ice creams, soy snacks. Usually people can find that they can go with a soy-enriched cereal much easier than they can go into, say, a tofu."

Dr. Alexander says flaxseed may help with weight loss, too. "Flaxseed seems to affect both the cholesterol and some of the triglycerides or just the, quote, fats within the system," he says.

Talk to your doctor first before adding flaxseed. Too much can be dangerous. You can get flaxseed in your diet through fortified cereals, bread or by adding the oil to your favorite foods.

Dr. Alexander says flaxseed may also help healing after radiation and chemotherapy for breast cancer and it has been mentioned as a treatment for arthritis. However, a recent study shows high doses of flaxseed may be dangerous for men in their middle years who are predisposed to prostate cancer. Be sure to talk with your physician before adding soy or flaxseed to your diet.

Folic Acid Levels Linked to Spontaneous Abortions (October 16, 2002)
(Ivanhoe Newswire) -- According to a new study, pregnant mothers with low levels of folic acid are at a much higher risk for having a spontaneous abortion over other mothers-to-be.

Researchers from Sweden and the National Institute of Health examined the folate levels of 468 pregnant women who had a spontaneous abortion and 921 healthy pregnant women to see if there was a link between folate levels and spontaneous abortions. Spontaneous abortion is the natural phenomenon that occurs when a fetus is delivered with an unplanned delivery before the 20th week of pregnancy.

All the women in the study had their folate levels evaluated during the 6th to 12th week of their pregnancy. Results showed that pregnant women with low levels of folate were at 50 percent increased risk for having a spontaneous abortion. However, the study also found that women with high levels of folic acid had no evidence of being at an increased risk for spontaneous abortions.

The authors say, "Our results have important public health and clinical implications. High folate status ... is not associated with an increased risk of spontaneous abortion, whereas low folate levels are associated with an increased risk of spontaneous abortion."

SOURCE: Journal of the American Medical Association, 2002;288:1867-1873

Diagnosing Impaired Consciousness (October 14, 2002)
(Ivanhoe Newswire) -- A new study indicates that systolic blood pressure is a good indicator for diagnosing brain lesions in patients with impaired consciousness. This means doctors may now have a better way to assess patients, as opposed to using expensive and time-consuming imaging technology.

Researchers studied the vital signs of 529 patients who were admitted to an emergency room with impaired consciousness. Of the patients, 312 had brain lesions that led to their condition.

The correlation of vital signs before and after brain lesion diagnosis showed that systolic blood pressure levels was more precise in the determination of brain lesions than diastolic blood pressure levels or pulse rate. However, the authors say, "Compared with those patients without a lesion, those with a lesion had significantly higher systolic blood pressure, higher diastolic blood pressure, and significantly lower pulse rates."

Previous studies have tried to show the cause and location of brain lesions that impaired consciousness. They have determined individual factors but have not produced any usable results. Brain lesions are more common in coma patients with stroke, brain tumors, epilepsy or meningitis.

The authors say, "Our study confirms the validity of systolic blood pressure for discriminating between patients with impaired consciousness who have a brain lesion and those who do not. Using systolic blood pressure in the diagnosis of impaired consciousness should give both clinical and economical benefits."

SOURCE: British Medical Journal, 2002;325:800-802

Birth Weight Linked to Diabetes in Pregnancy (October 14, 2002)
(Ivanhoe Newswire) -- Women who were classified as low birth weight when they were born are more likely to develop pregnancy-related diabetes, say investigators publishing in this month's Diabetes Care.

The link is especially strong for low birth weight women who give birth to larger babies.

A scientific hypothesis called the "thrifty phenotype" holds that low birth weight is related to insulin resistance and the development of type 2 diabetes in adults, mainly due to a delay in organ maturation triggered by smaller neonatal size. Pregnancy is known to create insulin resistance, and many women develop a condition known as gestational diabetes mellitus, or GDM, which generally clears up after the baby is born. These researchers studied the relationship between low birth weight and diabetes in pregnancy.

They enrolled 604 pregnant women in their study, 142 of whom were found to suffer from GDM. They classified the women into groups according to maternal birth weight. Results showed women in the lowest birth weight group were about twice as likely to have GDM than those in the higher birth weight groups.

In the second part of the study, researchers assessed the relationship between birth weight of the offspring and the rate of GDM in 450 of the women. This analysis indicated a two-fold greater incidence of GDM in low birth weight women who had larger infants.

The authors believe a woman's own birth weight could play a significant role in helping doctors determine which women are at especially high risk of developing diabetes during pregnancy.

SOURCE: Diabetes Care, 2002;25:1761-1765

Insulin Resistance and Social Class (October 14, 2002)
(Ivanhoe Newswire) -- A new study finds women who grow up in a lower social class are more likely to develop insulin resistance than those who grow up in a higher class, regardless if they change classes in adulthood.

Insulin resistance is a major public health problem, often leading to type 2 diabetes and the cardiovascular risks inherent in that disease. Many studies have investigated the link between cardiovascular problems and socioeconomic status, and most have found an association between the two, particularly when it comes to socioeconomic status in childhood.

Researchers from England report findings in this week's British Medical Journal from a study involving around 4,300 women ages 60 to 79. All of the women were assessed for insulin resistance and other factors. Results were compared according to the women's socioeconomic class during childhood and adulthood.

Women who grew up in a lower socioeconomic class were significantly more likely to exhibit insulin resistance than those in higher classes, and the finding held true even among those women who ended up in a higher class in adulthood. The researchers speculate poorer nutrition during childhood among those who grew up in the lower classes may explain the difference and suggest public health officials need to address health across a person's lifespan in order to prevent diabetes and its cardiovascular complications.

SOURCE: British Medical Journal, 2002;325:805-807

Soy Benefits Diabetic Women (October 11, 2002)
Oct. 11, 2002 (Ivanhoe Newswire) -- Diabetic women who are past menopause may be able to improve their blood sugar control and reduce their risk of heart disease by taking a daily soy supplement, according to a new study.

British researchers publishing in this month's Diabetes Care report women had lower levels of LDL, or bad, cholesterol, reduced insulin resistance, and improved blood sugar control during the 12 weeks they took the supplement compared to another 12 weeks when they took a placebo.

Heart disease is the leading cause of death among women, and diabetic women are at even higher risk because of the effects the disease has on the heart. Statistics show diabetes at least doubles the risk of death from heart disease for women, and diabetic women are four-times more likely to die from heart disease than diabetic men.

The phytoestrogens present in soy protein have been shown to reduce cardiovascular risks by reducing cholesterol levels. Studies comparing Japanese-Americans with diabetes with their counterparts in Japan, who regularly consume soy, suggest soy may provide protection against heart disease for diabetics.

In this study, researchers looked at the effect soy protein supplements would have on 32 postmenopausal women with type 2 diabetes. The women first took the soy supplements for 12 weeks, then took a break for two weeks, and took a sham treatment for another 12 weeks.

Results showed significant improvements in all measures of diabetes control and blood cholesterol for the treatment period compared to the sham period. The researchers believe if these findings are replicated by other studies, soy supplements may have a role to play in diabetes care. They write, "Studies of longer duration are needed to determine whether these effects are sustained and have a beneficial effect on reducing cardiovascular events."

SOURCE: Diabetes Care, 2002;25:1709-1714

Picking the Perfect Embryo (October 13, 2002)
IRVINE, Calif. (Ivanhoe Newswire) -- For many couples, having a baby is a dream. But for others it can also be a source of great disappointment and emotional difficulties. Now, a new procedure takes away some of the guess work and does away with procedures that are doomed to unknowingly fail.

According to this baby's parents, "He's just amazing." "We call him our miracle baby."

A miracle, however, that almost did not happen. This couple tried for two years to have a baby. Doctors suggested in vitro fertilization. In the midst of their grief, they said no.

"An hour later we came back and we said, okay, we changed our mind, we're going to do it," they say.

Their doctor, Larry Werlin, M.D., offered a procedure that would ease some of their anxiety. He says, "It's made us take another look at how we evaluate things."

Instead of relying on the appearance of the embryos to decide which to implant, pre-implantation genetic diagnosis (PGD) tests for chromosome abnormalities -- a major problem in women over age 38, those who have recurrent pregnancy loss, and women who failed in vitro.

Dr. Werlin, an infertility specialist at Coastal Fertility in Irvine, Calif., tells Ivanhoe, "In those groups we have now data that shows that perhaps as much as 70 percent of the embryos they make are abnormal."

Embryos like this one (left photo) that looks perfect but has an extra chromosome or this one (right photo) that had multiple abnormalities.

"This would have been an unsuccessful implantation or a probable early pregnancy loss," says Werlin.

For this mother, PGD proved the emotional winner. She says, "Just to see him and know he's ours, it's just amazing."

For dad, the proof is in the numbers. "Our odds increased 84-fold just by doing the PGD," he says, and for the doctor, it comes down to the end product.

Dr. Werlin points out PGD is not for everyone. His new research will determine who it can help. So far, it seems most effective in women with recurrent pregnancy loss and does not seem to make a difference in woman of advanced maternal age -- over 38.

HRT for Diabetic Women (October 9, 2002)
(Ivanhoe Newswire) -- A new study adds yet another twist to the confusion of the benefits and risks of hormone replacement therapy. The research reports diabetic women who use HRT are more likely to have better glucose control and lower cholesterol levels than women who never used HRT.

This summer the federal government abruptly stopped a nationwide clinical trial on HRT because of concerns that the combination of estrogen and progesterone did not protect against cardiovascular disease. Now, a study done by University of Buffalo researchers reports HRT has a positive effect on important risk factors for heart disease in diabetic women.

"Although there may be some risk in using certain types of HRT among certain women, there might be a segment of women who would be better off using HRT, says lead researchers Carlos Crespo, Ph.D. "These findings indicate that diabetic women may be one such segment."

The study included 2,786 diabetic and non-diabetic postmenopausal women. Researchers compared data on their lipid profiles, glucose and insulin levels and concentrations of selected blood components known to increase or decrease the risk of heart disease. Participants were either using HRT at the time of the study, used it before the study, or had never used it.

The results of the study showed that diabetic women on HRT had lower fasting levels of total cholesterol than women who were on HRT in the past or never used it. Researchers also report current non-diabetic HRT users had higher levels of the "good" cholesterol and overall lower cholesterol levels than those who were not currently on HRT.

Researchers conclude diabetic and non-diabetic women currently taking HRT had better cholesterol levels than women who never or previously used HRT. Furthermore, diabetic women currently taking HRT had better glucose control and other positive health benefits.

SOURCE: Diabetes Care, 2002;25:1675-1680

Obesity on the Rise (October 9, 2002)
(Ivanhoe Newswire) -- Obesity in adults in the United States keeps increasing according to new findings, it now affects 30 percent of the population, a new study shows. In a related study, researchers say the prevalence of overweight in children in the United States also continues to increase.

Researchers at the National Center for Health Statistics conducted two studies examining trends in obesity and overweight. In the first study, more than 4,000 adults were surveyed between 1999 and 2000. They also had their body weight and height measured. Researchers found the age-adjusted prevalence of obesity was 30.5 percent compared to 22.9 percent found in studies conducted between 1988 and 1994. The prevalence of overweight increased from 55.9 percent to 64.5 percent. Extreme obesity also increased from 2.9 percent to 4.7 percent.

Lead researcher Cynthia L. Ogden, Ph.D., says, "Although not all changes were statistically significant, increases occurred for both men and women in all age groups and for non-Hispanic whites, non-Hispanic blacks, and Mexican Americans." She adds that it will be difficult to reverse the increasing prevalence of overweight and obesity in the United States.

In the second study, researchers followed more than 4,000 children from birth through age 19. They found the prevalence of overweight was 15.5 percent among teens between ages 12 and 19, up from 10.5 percent between 1988 and 1994. The prevalence of overweight among children ages 6 to 11 grew to 15.3 percent from 11.3 percent, and the prevalence in children ages 2 to 5 increased to 10.4 percent from 7.2 percent. The study also shows a 10-percentage point increase of overweight prevalence among non-Hispanic black and Mexican-American adolescents.

Researchers say, "Changes that have contributed to the increase in overweight may relate to increasing food portion sizes, consumption of high-fat, energy-dense fast foods, and an increasingly sedentary lifestyle. Interventions may focus on parental behaviors because parents determine the diet and physical activity practices of their children. School-based programs also may help to change diet or reduce sedentary behaviors."
SOURCE: Journal of the American Medical Association, 2002;288:1723-1727, 1728-1732

Healthy Diet Reduces Cancer Risk (October 8, 2002)
(Ivanhoe Newswire) -- Following the Dietary Guidelines for Americans may reduce your risk of cancer, according to a new study.

Although scientific data on nutrition serves as the basis for recommendations for the Dietary Guidelines for Americans, there is not much data on whether this nutritional plan will reduce the incidence of cancer. Researchers from the University of Minnesota in Minneapolis examined the association between the Dietary Guidelines and incidence of cancer.

For the study, researchers included data on 34,708 postmenopausal women. Women were asked to report their consumption of 127 food items over the last year. The list included fruits, vegetables, dairy foods, meat, poultry, seafood, egg items, breads, beverages and sweets. Daily intake of nutrients were calculated from food frequency. Researchers also noted the incidence of cancer.

Researchers found women who followed the dietary guidelines had a lower risk of cancer. Specifically, the risk in the postmenopausal women was reduced for cancer of the colon, bronchus and lung, breast and uterus. However, better compliance with the dietary guidelines was associated with an increased risk of ovarian cancer, but its incidence is a small proportion of total cancer.

In an accompanying editorial, researchers from Harvard School of Public Health comment, "There is good news. Next to smoking cessation, weight control and increased physical activity appear to be crucial lifestyle behaviors that can reduce the risk not only of cancer but of several other chronic disorders."

SOURCE: American Journal of Clinical Nutrition, 2002;76:889-896

Training Helps Diabetes Patients (October 7, 2002)
(Ivanhoe Newswire) -- A new study shows people with diabetes who are trained to adjust their insulin doses to match their food choices can improve their diabetes control and quality of life.

Researchers in England analyzed data from 140 adults with type 1 diabetes and moderate or poor glycemic control. Patients either attended a five-day training course, or continued to receive usual care for six months, and then attended one course.

Results show participants who received intensive training had improved glycemic control and, despite intensified insulin treatment, reported greater satisfaction with treatment, general well being, and quality of life. Severe hypoglycemia, weight, and lipids remained unchanged.

Authors of the study say skill training enables patients to fit diabetes into their lives rather than their lives into diabetes. They add that the training can be successfully applied across different healthcare systems.

Researchers say this approach was developed in Germany but has not been widely adopted elsewhere. Previous studies show current treatment of type 1 diabetes fails to engage patients in intensive self-management.

SOURCE: British Medical Journal, 2002;325:746-749

Amino Acid Linked to Stroke and Alzheimer's (October 7, 2002)
(Ivanhoe Newswire) -- An amino acid considered to be toxic to blood vessels is now linked to an increased risk of stroke and Alzheimer's disease.

High levels of the amino acid, homocysteine, increase the risk of stroke five times greater than the normal risk, and increase the risk of Alzheimer's by three times. The new study, led by Stephen P. McIlroy, Ph. D., from Queen's University in Belfast, Ireland, showed that sufferers of stroke, Alzheimer's disease, and vascular dementia had higher levels of homocysteine than healthy counterparts of the same age. McIlroy says: "Since B vitamins and foods fortified with folate can reduce homocysteine levels, this study suggests that B vitamin supplementation may be appropriate for most adults. It warrants a large placebo-controlled study of folate, and vitamins B6 and B12 in people at risk from dementia and stroke."

Researchers measured homocysteine levels of 83 Alzheimer's patients, 78 patients with vascular dementia, 64 patients of stroke, and 71 healthy individuals. The Alzheimer's and vascular dementia patients averaged age 77, while the stroke patients and healthy participants averaged age 74. They also examined factors connected to the risk of Alzheimer's disease, such as smoking history, diet, cholesterol, and blood pressure.

The findings show participants with high levels of homocysteine were at a 2.9-times higher risk for Alzheimer's, a 5.5-times greater risk of stroke and a 4.9-times elevated risk of vascular dementia than the risk of healthy individuals with low homocysteine levels.

McIlroy says: "Since dietary habits are so different among people, it may be appropriate to recommend 2 to 5 mg folic acid and a similar dose of vitamin B12 daily. This recommendation is based on the known safety of both vitamins, which do not have side effects even if used in excessive amounts, and their low cost." However, according to the American Heart Association, the use of supplements can be omitted if individuals consume sufficient amounts of the vitamins in various nutrient-rich foods.

SOURCE: Stroke, 2002;33:2351-2356

Risk of Falling for Senior Diabetics (October 7, 2002)
(Ivanhoe Newswire) -- A new study shows that older women with diabetes are at an increased risk of falling, and those using insulin are at an even greater risk.

Researchers examined 9,249 women, average age 67, every two years over seven years to determine if diabetes, along with other known factors for falls, increases the risk of falling. Of the participants, 629 were diabetic and, of those, 99 used insulin. According to the researchers, falls are a main cause for injuries among the elderly, and diabetes appears to add to the risk.

The study shows that women with diabetes who do not use insulin are at a 68-percent increased risk of falling than non-diabetic participants. They were also at a higher risk of falling more that one or two times in a year. Those using insulin had twice the risk of falling more than once a year as compared to non-diabetic participants.

The authors say, "This increased risk is due, in part, to a higher prevalence of previously identified risk factors for falls among women with diabetes, including poor balance, arthritis, cardiovascular disease, depression, poor vision, and use of medications for sleeplessness or anxiety. Our findings suggest that fall prevention efforts should be a consideration in the treatment of older women with diabetes."

SOURCE: Diabetes Care, 2002;25:1749-1754

Picking the Perfect Embryo (October 6, 2002)
IRVINE, Calif. (Ivanhoe Newswire) -- For many couples, having a baby is a dream. But for others it can also be a source of great disappointment and emotional difficulties. Now, a new procedure takes away some of the guess work and does away with procedures that are doomed to unknowingly fail.

According to this baby's parents, "He's just amazing." "We call him our miracle baby."

A miracle, however, that almost did not happen. This couple tried for two years to have a baby. Doctors suggested in vitro fertilization. In the midst of their grief, they said no.

"An hour later we came back and we said, okay, we changed our mind, we're going to do it," they say.

Their doctor, Larry Werlin, M.D., offered a procedure that would ease some of their anxiety. He says, "It's made us take another look at how we evaluate things."

Instead of relying on the appearance of the embryos to decide which to implant, pre-implantation genetic diagnosis (PGD) tests for chromosome abnormalities -- a major problem in women over age 38, those who have recurrent pregnancy loss, and women who failed in vitro.

Dr. Werlin, an infertility specialist at Coastal Fertility in Irvine, Calif., tells Ivanhoe, "In those groups we have now data that shows that perhaps as much as 70 percent of the embryos they make are abnormal."

Embryos like this one (left photo) that looks perfect but has an extra chromosome or this one (right photo) that had multiple abnormalities.

"This would have been an unsuccessful implantation or a probable early pregnancy loss," says Werlin.

For this mother, PGD proved the emotional winner. She says, "Just to see him and know he's ours, it's just amazing."

For dad, the proof is in the numbers. "Our odds increased 84-fold just by doing the PGD," he says, and for the doctor, it comes down to the end product.

Dr. Werlin points out PGD is not for everyone. His new research will determine who it can help. So far, it seems most effective in women with recurrent pregnancy loss and does not seem to make a difference in woman of advanced maternal age -- over 38.

Nutrition Counseling Needed (October 4, 2002)
(Ivanhoe Newswire) -- Each year 300,000 to 800,000 people die as a result of a nutrition-related disease. Yet a new study finds doctors are not talking to high-risk patients about what they should and should not be eating.

"The need for nutrition counseling is pressing in light of the epidemic of chronic diseases such as hypertension, diabetes mellitus, obesity and hyperlipidemia (excessive fat content in blood)," says study author Charles Eaton, M.D., from Brown Medical School and Memorial Hospital.

Dr. Eaton and his colleagues analyzed information from a study of 138 physicians. For the study, research nurses observed about 3,500 patient examinations. The nurses recorded any discussion of food intake or nutrition during the office visit with the doctor.

The study showed one in four patients received nutrition counseling during their doctor visit. Specifically, nutrition counseling occurred in 17 percent of visits for acute illnesses, 30 percent of chronic illness visits, and 41 percent of well-care visits. Researchers say the average time spent on nutrition counseling was 55 seconds. Researchers add the counseling was more likely to happen during visits by patients who were older or had diabetes.

According to the study, the Healthy People 2010 national nutritional objectives suggest that 75 percent of office visits should include nutritional counseling. Clearly this study shows the goal is not being reached. Dr. Eaton says the findings from this study suggest that more in-depth nutrition counseling may have to happen outside of the primary care office visit. Some experts suggest registered dieticians be used more often.

If nutrition counseling is expected to be done with the primary care physician, researchers say training on how to do effective concise nutrition counseling is needed in order to keep within the time constraints of the doctor's schedule.

SOURCE: American Journal of Preventative Medicine, 2002;23:174-179

Aspirin May Help Pregnancy Problems (October 2, 2002)
(Ivanhoe Newswire) -- Women at risk of developing gestational high blood pressure may be able to reduce their risk by taking low-dose aspirin at bedtime, according to a new study.

Researchers gave 341 women who were between 12 and 16 weeks pregnant either an aspirin or a placebo once a day upon awakening, eight hours after awakening, or at bedtime. All the women were at risk for developing gestational high blood pressure due to obesity, family history, past personal history of gestational high blood pressure or preeclampsia or a history of previous miscarriages.

Results show there was no difference in blood pressure between the aspirin and placebo when taken upon awakening, but there was a considerable reduction in blood pressure when aspirin was taken eight hours after awakening. Blood pressure was drastically reduced in participants who took the aspirin at bedtime. Lead author, Ramon C. Hermida, Ph. D., from the University of Vigo in Vigo, Spain says, "This is the first study to show that aspirin at bedtime works and aspirin at awakening hours does not."

In the group of women who took the placebo, over 14 percent had preeclampsia, 30 percent had gestational high blood pressure, and nearly 18 percent had pre-term labor. Of the aspirin group, none had pre-term labor, about 7 percent had gestational high blood pressure and only 1.7 percent had preeclampsia.

It was unexpected when researchers found the babies from mothers who took aspirin at bedtime were on average 9 ounces heavier. "All the results are really surprising. This study shows remarkable reductions in all gestational high blood pressure and preeclampsia complications," says Hermida. It is also noted that pregnant women should only take aspirin under a doctor's guidance and recommendation.

SOURCE: American Heart Association's 56th Annual High Blood Pressure Convention, Orlando, Fla., Sept. 25-28, 2002

Light at Night Risk for Breast Cancer (October 1, 2002)
(Ivanhoe Newswire) -- Researchers found light at night may be associated with an increased risk in breast cancer. Richard G. Stevens, Ph.D., from the University of Connecticut Health Center, presented his findings this week at the "Era of Hope" Department of Defense Breast Cancer Research Program meeting in Orlando, Fla.

Stevens says electromagnetic fields released by light suppress the normal nocturnal production of melatonin, which could increase the release of estrogen by the ovaries. He says this would explain why industrialized societies have five times the risk of breast cancer.

Stevens and his colleagues examined the association between light and breast cancer risk in 800 healthy women and 800 women with breast cancer in Seattle. Researchers gathered information on sleep habits and bedroom lighting in the 10 years before diagnosis and lifetime occupational history. Results show a slight increase in risk for women who frequently did not sleep during the period of the night when melatonin levels are typically at their highest. There was an indication of increased risk among women with the brightest bedrooms. Graveyard shiftwork was also associated with increased breast cancer risk, with a trend of increased risk with increasing years and with more hours per week of graveyard shiftwork.

Previous studies show slight increases of breast cancer risk for flight attendants and rotational shift nurses, but half the risk for blind women. Stevens suggests researchers also examine restaurant workers and women who work in photography dark rooms. In addition, he says researchers should study light effects on mammary tissue in rats. Though several studies show low or no associations between electromagnetic fields and breast cancer risk, Stevens and fellow panelists at the meeting agree there is not a lot of concrete evidence and many questions remain.

The Department of Defense Breast Cancer Research Program meeting is for breast cancer survivors, military, scientists and physicians to meet and discuss the latest advances in breast cancer research.

SOURCE: Ivanhoe Health Correspondent Shanida Smith at the "Era of Hope" Department of Defense Breast Cancer Research Program meeting, Orlando, Fla., Sept. 25-28, 2002

Soy May Reduce Breast Cancer Risk (October 1, 2002)
(Ivanhoe Newswire) -- A new study shows a link between soy and a reduced risk of breast cancer. Maureen Sanderson, Ph.D., from the University of Texas-Houston, School of Public Health at Brownsville, presented the study at this week's "Era of Hope" Department of Defense Breast Cancer Research Program meeting in Orlando, Fla.

Nearly 800 women participated in the study to examine whether consumption of soy food in adulthood would interact with insulin like growth factor-1. IGF-1, a hormone, has been shown to increase the risk of breast cancer in pre-menopausal women. Results show soy eaters with high levels of IGF-1 who consumed high amounts of soy lowered their risk of breast cancer compared to women with high IGF-1 levels and low soy consumption.

In an interview with Ivanhoe Broadcast News, Sanderson said it's too early to tell whether consuming large amounts of soy decreases your risk of breast cancer. She said: "[Soy] may only be effective in a subgroup of women. More research needs to be done to confirm our findings."

Sanderson's research is part of the larger Shanghai Cancer Institute Breast Cancer study in China. Women in China consume more soy than women in the United States. About 3,000 women participated in the larger study, which was the first to look at adolescent intake of soy.

SOURCE: Interview with Maureen Sanderson, Ph.D., from the University of Texas-Houston, School of Public Health at Brownsville, Sept. 27, 2002

Estrogen and Osteoarthritis Linked (October 1, 2002)
(Ivanhoe Newswire) -- A new study finds postmenopausal women who use estrogen are at a higher risk for developing osteoarthritis.

Osteoarthritis is a tissue change in the joints that causes pain in that area. Osteoarthritis affects 10 percent to 15 percent of adults over 30 years old. Experts estimate up to 68 percent of women 65 years or older suffer from osteoarthritis. Researchers from the University of California at San Diego conducted a study to see if estrogen plays a role in the development of osteoarthritis in postmenopausal women.

More than 1,000 postmenopausal women between 43 and 97 years old took part in the study. The women were examined for osteoarthritis in the hip, hand and knee. Information on their estrogen use was also collected.

Researchers say 638 women reported using estrogen for at least one year. The study finds 34.5 percent of the women on estrogen had osteoarthritis and 30.9 percent who did not use estrogen had osteoarthritis. While osteoarthritis in the knee did not differ between the groups, there was a difference with hip and hand osteoarthritis. Women who were on estrogen were more likely to have hip or hand osteoarthritis. Even after researchers adjusted for other factors such as age, body mass index, smoking and exercise, women on estrogen were still more likely to have hip or hand osteoarthritis.

Researchers conclude postmenopausal estrogen use is associated with a higher prevalence of osteoarthritis. Researchers say this could be due to the complex effect of estrogen on growth factors, but further research is needed to determine the relationship between estrogen use and osteoarthritis.

SOURCE: Journal of Women's Health & Gender-Based Medicine, 2002;11:511-517

Test Predicts Pregnancy Problems (September 27, 2002)
(Ivanhoe Newswire) -- A study reveals that the new tolerance-hyperbaric test can determine more than 90 percent of pregnant women who will be at risk of gestational high blood pressure or preeclampsia. The test allows pregnant women the chance of knowing their risk months in advance of symptoms or standard tests.

Preeclampsia affects roughly 7 percent of new mothers and up to 2 percent of mothers who are in their second pregnancy or greater. It is also a leading cause of maternal mortality. High blood pressure is a symptom of preeclampsia that can develop or cause the expectant mother to have potentially fatal. In other pregnancies the mother might not have the seizure condition called eclampsia, but would be at risk of delivering early or delivering a baby with low birth weight.

Ramon C. Hermida, Ph. D., from the University of Vigo in Vigo, Spain and lead author of the study, says, "The only way to cure preeclampsia is to eliminate its cause, which is pregnancy its self." He also says, "In most cases, that leads to delivering the baby early. Therefore, it is important to focus on prevention." The tolerance-hyperbaric test compares the expected blood pressure pattern of pregnant mothers over a 48-hour period and whose blood pressure exceeds the expected range.

In the study of the tolerance-hyperbaric test, 403 pregnant women had their blood pressure monitored every four weeks. Of the participants, 235 women did not develop any complications, whereas 168 women developed high blood pressure or preeclampsia. Hermida says, "On average, the test provided early identification of gestational high blood pressure and preeclampsia 23 weeks before clinical confirmation of the disease." He also says: "Ambulatory blood pressure monitoring should be performed at least once in the first half of the pregnancy, and repeated in those women with a positive THT. Women at high risk for preeclampsia because of family or medical history, including those over 35 years of age, should have the test without question."

SOURCE: American Heart Association's 56th Annual High Blood Pressure Research Convention, Orlando, Fla., Sept. 25-28, 2002.

Bone Cement for Osteoporosis (September 26, 2002)
(Ivanhoe Newswire) -- Doctors have a solid solution to relieve pain for patients who have collapsed vertebra, as a result of osteoporosis. The procedure, vertebroplasty, has been shown to relieve pain immediately and long-term. The procedure uses bone cement to stabilize the collapsed vertebra.

Doctors from Ohio say this procedure has been used for the last several years, but now they have confirmation that it works well. The study involved the review of records from 100 patients, 92 of whom had compression fractures from osteoporosis. Nearly every patient reported relief immediately following the procedure and 93 percent reported relief that continued long-term, which ranged from 6 to 44 months.

The researchers say patients who have these types of fractures experience significant pain. It can limit their movement and sometimes even require extended bedrest. They say this group of patients can benefit greatly from pain relief. The doctors conclude this is a minimally invasive procedure that is beneficial to patients who have not found relief from medication or rest.

This study looked at previous patients and the doctors say a new randomized, controlled clinical trial is needed to confirm their results.

SOURCE: Journal of Vascular and Interventional Radiology, 2002;13:883-886

Diabetic Women On Hormone Replacement Therapy Have Better Glycemic And Lipid Profiles (September 26, 2002)
Diabetic and nondiabetic women on HRT have lower total cholesterol levels.
Diabetic women who use hormone replacement therapy (HRT) were more likely to have their blood glucose under control, and have lower cholesterol levels than women who never used hormone therapy, a study by University at Buffalo epidemiologists has found.

Nondiabetic women who were using HRT also had lower total cholesterol levels, as well as higher levels of beneficial cholesterol, the study results showed.

The study, published in the current issue of Diabetes Care, adds yet another twist to the murky risks-benefits scenario surrounding HRT.

The federal government suspended a nationwide clinical trial of HRT in July, citing, among other concerns, that the combination of estrogen and progesterone used in the trial did not protect against cardiovascular disease as expected.

Yet, the UB researchers found that HRT had a positive effect on two important risk factors for heart disease -- blood levels of fats and glucose -- in a population-based study of 2,786 diabetic and non-diabetic postmenopausal women between the ages of 40 and 74. Carlos Crespo, Ph.D., associate professor of social and preventive medicine in the UB School of Medicine and Biomedical Sciences and lead author on the study, noted that the national HRT clinical trial did not include women with diabetes and that scientists haven't researched the benefits or risks of hormone replacement in this group.

"Although there may be some risk in using certain types of HRT among certain women, there might be a segment of women who would be better off using HRT," Crespo said. "These findings indicate that diabetic women may be one such segment."

The study, based on data from the Third National Health and Nutrition Examination Survey (NHANES III), compared lipid profiles, glucose and insulin levels and concentrations of selected blood components known to increase or decrease the risk of heart disease in diabetic and nondiabetic women. Participants were grouped into one of three HRT-use categories: current, previous or never.

Results showed that diabetic women on HRT had significantly lower fasting levels of total cholesterol compared to diabetic women who were previous or never users: 225 mg/dl, 247 mg/dl and 241 mg/dl, respectively. The difference in fasting glucose levels among diabetic women according to HRT status were equally significant: 112 mg/dl for current users compared to 151 mg/dl and 154 mg/dl for previous and never users.

Among nondiabetic women, current HRT users had significantly higher levels of beneficial high-density lipoprotein (HDL) than previous or never users -- 64 mg/dl, 57 mg/dl and 55 mg/dl, respectively.

HRT also appeared to have a beneficial effect on several additional markers of heart health and glycemic control in both diabetic and nondiabetic women:
· Fibrinogen, a protein associated with increased risk of coronary heart disease, stroke and peripheral artery disease through its role in blood clotting and platelet aggregation was lower among HRT users in both groups of women compared to never users.
· ApoA, a protein component of HDL that allows it to remove excess cholesterol from the bloodstream, was higher among HRT users in both groups of women compared to never users.
· ApoB, associated with vessel blockage, was lower among HRT users in both groups of women compared to never users.
· GHb, or glycosylated hemoglobin, an indicator of poor glycemic control, was lower among diabetic women using HRT compared to previous and never users.

Additional researchers involved in the study were Christopher T. Sempos, Ph.D., and Ellen Smit, Ph.D., from the UB Department of Social and Preventive Medicine; Anastacia Snelling, Ph.D., from American University, and Ross E. Anderson, Ph.D., from The Johns Hopkins University.

The research was supported by the National Institute on Aging and Wyeth-Ayerst Laboratories
SOURCE: University at Buffalo.