|
Childless Men More Likely To Die Of Heart Disease
A decade-long study of 135,000 men found that those who did not
have children had a higher risk of dying from heart disease than
those who did, raising new questions over the links between
fertility and overall health, U.S. researchers said on Monday.
While the findings do not show that not having children causes
heart problems in men, they do suggest that infertility may be a
potential early warning sign of future heart trouble, the team
reported in the journal Human Reproduction.
"There is emerging evidence to suggest that infertility may be a
window into a man's later health," said Dr. Michael Eisenberg of
Stanford University in California.
He said men who are infertile have a higher risk of certain
cancers, and his team wanted to look for other signs that
infertility might be playing a role later in a man's life.
The researchers used a large study of men over 50 who were
members of AARP. The team did not know whether men in the study
wanted to be fathers or not, so they specifically looked only at
men who were married.
And they used childlessness as a surrogate for male infertility,
Eisenberg said.
"In general, most married men will have the opportunity to
reproduce. Whether they and their partner chose not to have
children or whether there were some biological problems, we
can't determine," Eisenberg said.
Eisenberg and colleagues focused on 135,000 married or formerly
married men who were 50 or older at the start of the study in
1996. Almost all, or 92 percent, had fathered at least one child
and 50 percent had three or more offspring.
Nearly all of the men -- 95 percent -- were white.
The researchers then tracked death rates from some 70 causes
using Social Security and other databases and questionnaires
sent to surviving family members.
Over the course of the 10-year follow up period, some 10 percent
of the men died, and one out of every five of these deaths was
from heart disease.
When looking at the parental status of these men, childless
participants in the study had about a 17 percent higher risk of
heart disease than those who were fathers.
Eisenberg said it was not possible to determine whether men in
the study simply chose not to have children or whether the men's
partners were infertile.
But excluding unmarried men offered an approximation of male
infertility, and the link to heart disease raises important
questions that merit further research.
"My belief it there is a biologic reason," Eisenberg said.
The researchers stress that the study does not suggest being
childless causes heart problems, but since infertility affects a
man's health at a much younger age, understanding this link
could help doctors identify heart problems earlier, when there
is more time to intervene.###
Asthma
Tied To Poorer Diabetes Control In Kids
Kids with diabetes may have a higher-than-average rate of
asthma, and those with both conditions seem to have a tougher
time keeping their blood sugar under control, a study out Monday
suggests.
Researchers found that among 2,000 3- to 21-year-olds with
diabetes, 11 percent had asthma -- higher than the roughly 9
percent rate among children and young adults in the U.S.
The difference was bigger when the researchers looked at the 311
young people with type 2 diabetes, the form associated with
obesity and usually diagnosed in adults.
In that group, 16 percent had asthma, compared with 10 percent
of those with type 1 diabetes.
Type 1 diabetes is caused by an abnormal immune system reaction
that kills off the pancreatic cells that make insulin, a hormone
that helps shuttle sugar from the blood and into body cells to
be used for energy. People with the disease have to take shots
of synthetic insulin (or use an insulin pump) every day to keep
their blood sugar levels normalized.
In this study, kids with both type 1 diabetes and asthma were
more likely to have poor blood sugar control than their peers
who were asthma-free: 15.5 percent, versus 9 percent.
"Poor" blood sugar control meant having a hemoglobin A1C level
of more than 9.5 percent. Hemoglobin A1C is a measure of
long-term blood sugar control, and experts say it should be kept
below 7 percent in adults, while children's can go as high as
8.5 percent depending on their age.
The reasons for the findings, which appear in the journal
Pediatrics, are not completely clear.
But the higher rate of asthma among young people with type 2
diabetes suggests a role for obesity, according to lead
researcher Mary Helen Black, of the department of research and
evaluation at Kaiser Permanente Southern California.
"It's pretty well-established that there's an obesity-asthma
connection," Black told Reuters Health in an interview.
As for why young people with type 1 diabetes and asthma had
poorer blood sugar control, one possibility is that there is a
"real biological connection," Black said.
Some past research, for example, has found that people with
poorly controlled diabetes are more likely to show dips in lung
function over time than those with well-controlled diabetes. But
the reasons for that are unknown.
On the other hand, Black said, it may simply be tougher for kids
with type 1 diabetes to control their blood sugar when they have
another chronic health problem.
"It can be incredibly challenging to manage both conditions,"
Black said.
The researchers did find that when kids with both diseases were
on asthma medication, their blood sugar control was better.
In particular, poor blood sugar control was seen in less than 5
percent of those taking asthma drugs called leukotriene
modifiers (sold under the brand-names Singulair, Accolate and
Zyflo).
That compared with about 30 percent of type 1 diabetics who were
not on medication for their asthma.
The researchers are not sure if that means there's an effect of
the asthma drugs themselves. It may just be that kids with
better-controlled asthma are also more likely to have
well-controlled diabetes, according to Black.
She said the bottom line for doctors and parents is to be aware
that kids with diabetes may have a somewhat higher rate of
asthma -- and that those with both may have more trouble with
blood sugar control.
If parents notice potential signs of asthma -- like wheezing,
coughing or breathing problems that are not related to a cold or
other infection -- they should talk to their child's doctor,
Black said.###
Creepy-Crawlies May Help Heal Diabetes Wounds
To jump-start the healing of difficult diabetic wounds,
researchers have a suggestion: let maggots do the work.
To allow such wounds to heal, doctors remove infected or dead
tissue with scalpels or enzymes, a process they call
debridement. But these tools often fail.
"These problem patients with diabetes really need better
treatments in order to salvage their limbs," said Lawrence Eron
from Kaiser Hospital and the University of Hawaii in Honolulu,
who with colleagues presented their findings at a recent
scientific meeting in Chicago.
"Maggot debridement treatment is overwhelmingly effective. After
just one treatment these wounds start looking better," he told
Reuters Health.
The results from Eron's team, which treated 37 diabetics with
the maggots, still haven't been vetted by independent
researchers.
All of the patients in the study suffered from a type of artery
disease that causes poor circulation in the limbs and they all
had stubborn wounds, some up to five years old.
The doctors put 50 to 100 maggots, of the species Lucilia
sericata, on the wounds and left them there for two days, at
which time they applied new ones. They repeated this five times
on average.
"We cage the maggots in a mesh-like material. Nylon panty hose
might be used. And then we seal them so they don't get out,"
Eron said.
Maggots secrete substances into wounds that liquefy dead tissue
and then ingest the material to further degrade it in their gut.
The wounds are cleaned, and other substances contained in the
maggot secretions allow the development of granulation tissue, a
type of connective tissue that forms during wound healing.
Twenty-one of the patients had successful outcomes, defined as
eradication of infection, complete removal of dead tissue,
formation of robust connective tissue in the wound and more than
three-quarters closure of the wound.
Five wounds were infected with the "superbug" MRSA, but they
healed successfully with the maggot therapy. Nine wounds were
infected with another bacterium called MSSA, and six of those
healed. All 10 cases with infection due to group B streptococci
were successfully treated, Eron said.
The treatment failed in some patients. One had excessive
inflammation surrounding the wound, two bled too much, and three
had problems with infected bones.
Asked how he persuades patients to undergo the treatment, Eron
said he carefully explains the procedure and then has them sign
a consent form.
"A lot of patients might be somewhat wary of having live insects
placed into their wounds so we explain how it works and what
possible problems might occur," he said.
"After this, we go on to do further treatment with hydrogels,
grafts of cell culture tissue, or negative pressure dressings.
But to get to the point there these treatments will work, you
really need to clean up the wound, get rid of dead tissue, and
get robust granulation tissue into the wound -- and this is
where the maggots help."###
Can Eating Fish Lower The RiskCan Eating Fish Lower The Risk Of
Strokes?
People who eat fish a few times each week are slightly less
likely to suffer a stroke than those who only eat a little or
none at all, according to an international analysis.
The omega-3 fatty acids in fish may lower stroke risk through
their positive effects on blood pressure and cholesterol, wrote
Susanna Larsson and Nicola Orsini of Sweden's Karolinska
Institute in the journal Stroke.
Their analysis was based on 15 studies conducted in the United
States, Europe, Japan and China, each of which asked people how
frequently they ate fish, then followed them for between four
and 30 years to see who suffered a stroke.
"I think overall, fish does provide a beneficial package of
nutrients, in particular the omega-3s, that could explain this
lower risk," said Dariush Mozaffarian, a Harvard School of
Public Health epidemiologist whose research was included in the
analysis.
"A lot of the evidence comes together suggesting that about two
to three servings per week is enough to get the benefit."
Vitamin D, selenium, and certain types of proteins in fish may
also have stroke-related benefits, he added.
Data for the analysis came from close to 400,000 people aged 30
to 103.
Over anywhere from a few years to a few decades, about 9,400
people had a stroke. Eating three extra servings of fish each
week was linked to a six-percent drop in stroke risk, which
translates to one fewer stroke among a hundred people eating
extra fish over a lifetime.
The people in each study who ate the most fish were 12 percent
less likely to have a stroke than those that ate the least.
Mozaffarian's report separated the effects of different kinds of
fish and found that people who ate more fried fish and fish
sandwiches, not surprisingly, didn't get any stroke benefit.
But the research can't prove that adding more non-fried fish to
your diet will keep you from having a stroke, Mozaffarian told
Reuters Health.
People "could have healthier diets in other ways, people could
exercise more, people could have better education that could
lead them to see their doctors more," he added, all of which
could decrease their risk of strokes.
Still, most studies have tried to take those other health and
nutrition factors into account to isolate the effects of fish as
much as possible -- and they suggest a cause-and-effect
relationship, he said.
It's likely that people who start out eating no fish or very
little probably have the most to gain by putting it on their
plate more often.
"You get a lot of bang for your buck when you go from low intake
to moderate, a few servings per week," Mozaffarian said.
After that, the benefit from each extra serving probably goes
down.
Fatty fish such as salmon and herring are especially high in
omega-3s, The American Heart Association recommends at least two
servings of fatty fish in particular each week. ###
Dads Less
Likely To Die Of Heart Problems
Fatherhood may be a kick in the old testosterone, but it may
also help keep a man alive. New research suggests that dads are
a little less likely to die of heart-related problems than
childless men are.
The study — by the AARP, the government and several universities
— is the largest ever on male fertility and mortality, involving
nearly 138,000 men. Although a study like this can't prove that
fatherhood and mortality are related, there are plenty of
reasons to think they might be, several heart disease experts
said.
Marriage, having lots of friends and even having a dog can lower
the chance of heart problems and cardiac-related deaths,
previous research suggests. Similarly, kids might help take care
of you or give you a reason to take better care of yourself.
Also, it takes reasonably good genes to father a child. An
inability to do so might mean a genetic weakness that can spell
heart trouble down the road.
"There is emerging evidence that male infertility is a window
into a man's later health," said Dr. Michael Eisenberg, a
Stanford University urologist and fertility specialist who led
the study. "Maybe it's telling us that something else is
involved in their inability to have kids."
The study was published online Monday by the journal Human
Reproduction.
Last week, a study by other researchers of 600 men in the
Philippines found that testosterone, the main male hormone,
drops after a man becomes a dad. Men who started out with higher
levels of it were more likely to become fathers, suggesting that
low levels might reflect an underlying health issue that
prevents reproduction, Eisenberg said.
In general, higher levels of testosterone are better, but too
much or too little can cause HDL, or "good cholesterol," to fall
— a key heart disease risk factor, said Dr. Robert Eckel, past
president of the American Heart Association and professor of
medicine at the University of Colorado, Denver.
"This is a hot topic," Eckel said. "I like this study because I
have five children," he joked, but he said many factors such as
job stress affect heart risks and the decision to have children.
Researchers admit they couldn't measure factors like stress, but
they said they did their best to account for the ones they
could. They started with more than 500,000 AARP members age 50
and over who filled out periodic surveys starting in the 1990s
for a long-running research project sponsored by the National
Cancer Institute.
For this study, researchers excluded men who had never been
married so they could focus on those most likely to have the
intent and opportunity to father a child. Men with cancer or
heart disease also were excluded to compare just men who were
healthy when the study began.
Of the remaining 137,903 men, 92 percent were fathers and half
had three or more children. After an average of 10 years of
follow-up, about 10 percent had died. Researchers calculated
death rates according to the number of children, and adjusted
for differences in smoking, weight, age, household income and
other factors.
They saw no difference in death rates between childless men and
fathers. However, dads were 17 percent less likely to have died
of cardiovascular causes than childless men were.
Now for all the caveats.
Researchers don't know how many men were childless by choice and
not because of a fertility problem.
They don't know what fertility problems the men's partners may
have had that could have left them childless.
They didn't have cholesterol or blood pressure information on
the men — key heart risk factors.### |
