Tuesday, February 23, 2010

Statins raise small diabetes risk

Statins have been used as cholesterol-lowering drugs to prevent heart attacks and strokes although trials of statins have produced conflicting results.

A new report based on a meta-analysis of 13 randomised controlled trials of statins between 1994 and 2009 involving 91,000 patients showed that there was a clear link between statin treatment and a small but significant increased risk of diabetes - 9% increase over 4 years in those using the drug than those without the treatment. The researchers said that the risk is very low and outweighed by the benefits of this drug and concluded that patients with moderate or high cardiovascular risk should not stop taking this drug.

Critics say this is a well-conducted review, when all the results were combined into a meta-analysis, the diabetes risk was relatively small, however various unidentified cofounding factors may have affected the observed results. The study was published in The Lancet online.

Source: "Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials". The Lancet, Early Online Publication, 17 February 2010

Can aspirin reduce breast cancer recurrence?

According to a new study published online in the Journal of Clinical Oncology, there was an association between frequent use of aspirin and lower risk of dying from cancer.

Researchers used survey data from US Nurses' Health Study to examine the effect of aspirin on breast cancer recurrence and survival including over 4000 nurses between 1980 and 2006. They found that women who took aspirin after finishing breast cancer treatment were half as likely to die from the disease compared with those who did not use aspirin regularly. However, the researchers pointed out that the participants were all nurses, the results may not be applied to the general population and they called for a randomised controlled trial to establish whether aspirin really caused the reduced risks they had found.

Previous studies on aspirin's anticancer effects have come to mixed conclusions, experts warned that patients should not start taking aspirin as there are risks associated with taking aspirin including bleeding and gastrointestinal complications.

Source: Holmes MD, Chen WY, Li L, et al. "Aspirin Intake and Survival After Breast Cancer". Journal of Clinical Oncology 2010 ( f/t via Athens)

Monday, February 22, 2010

Gastric banding achieved more weight loss in obese teens

According to a study published in the February 10 issue of JAMA, gastric banding achieved significant weight loss than lifestyle intervention in severely obese adolescents.


Australian researchers conducted a randomised controlled trial to compare the outcomes of gastric banding with a lifestyle program on adolescent obesity including 50 people aged between 14 and 18 with a BMI >35. The study, carried out between 2005 and 2008, was followed up for 2 years.


The researchers found that more than 50% weight loss was achieved by 84% in the gastric banding group compared with just 12% in the lifestyle group. The average weight loss was about 34 kg in the gastric banding group and only 3 kg in the lifestyle group. The differences between the 2 groups were significant for all weight measures at 24 months with 24 in the gastric banding group and 18 in the lifestyle group completed the study.


The authors concluded that "Among obese adolescent participants, use of gastric banding compared with lifestyle intervention resulted in a greater percentage achieving a loss of 50% of excess weight" and "There were associated benefits to health and quality of life".


Critics say there are limitations to the study including recruitment bias, small number of participants and short follow-up period. An accompanying editorial "Surgical Treatment of Obesity in Adolescence" notes that this study provides important evidence about the bebefits and risks of bariatric surgery.


Source:"Laparoscopic Adjustable Gastric Banding in Severely Obese Adolescents : A Randomized Trial" JAMA. 2010;303(6):519-526 (f/t via Athens)

Serotonin deficit may cause SIDS

A new study published in JAMA found that the brainstems of babies who have died from Sudden Infant Death Syndrome (SIDS) had lower level of serotonin than those babies who died from other causes. SIDS is still the leading cause of death in infants.

Previous studies had found that serotonin levels have been linked to SIDS, but this study sheds light on the defect in the infants' brain that might account for SIDS.

The researchers found that in 35 of the 41 SIDS babies, serotonin levels were 26 % lower than in those who died of other causes and levels of an enzyme that stimulates serotonin production were 22 % lower. Serotonin receptor was 50 % lower in SIDS babies.

Experts say that this is an important advance in the understanding of what's wrong with the brainstem of SIDS babies but there is still a long way to go to finding a detection test and then a treatment. The authors emphasized avoiding known risk factors such as bed sharing, soft bedding and smoking.

Source: "Brainstem Serotonergic Deficiency in Sudden Infant Death Syndrome" JAMA 2010;303(5):430-437. ( f/t via Athens)