Urocortin levels point to premature births
NINE months is a long time to wait for the birth of a baby, but if it happens too early, the newborn’s health may be at risk. Now scientists have discovered a reliable way to predict whether a baby will be born prematurely, giving doctors some advance warning. Premature birth is defined as birth before 37 weeks of pregnancy. Women can show signs of premature labour, including painful regular contractions of the uterus and dilation of the cervix, but go on to deliver at term (after 37 weeks). The study, in the current issue of the JournalofClinical EndocrinologyandMetabolism , included 85 women admitted to hospital with signs of early labour between 28 and 34 weeks of pregnancy. They were each given a blood test for urocortin. Urocortin levels in those who gave birth prematurely were 38 per cent higher than those who went on to deliver at term. The new blood test could become an important tool in caring for women and babies at risk of premature birth. J Clin Endocrinol Metab 2007;92:4734-4737 (Florio P, et al) SMOKERS are at increased risk of developing type 2 diabetes compared to non-smokers, concludes a new study in the Journal of the American Medical Association. Researchers combined the results of 25 separate studies, published between 1992 and 2006, involving a total of 1.2 million participants. Overall, there were 45,844 new cases of diabetes reported during the follow-up periods ranging from 5 to 30 years. Heavy smokers (20 or more cigarettes per day) had a 61 per cent increased risk of developing diabetes compared to nonsmokers, and lighter smokers (less than 20 cigarettes per day) had a 29 per cent increased risk. Even former smokers had a 23 per cent increased risk compared to non-smokers. The study doesn’t prove that smoking causes diabetes, say the authors, as smoking often goes hand-in-hand with other unhealthy habits such as lack of exercise, poor diet and high alcohol intake. But the link is very strong, and provides yet another reason to kick the habit. JAMA 2007;298:2654-2664 (Willi C, et al) HIGH blood pressure could lead to mild brain damage and difficulties with thinking and learning, concludes research in the Archives of Neurology. The findings further highlight the importance of keeping blood pressure under control. Mild brain damage— known as ‘‘ cognitive impairment’’ — can be an early warning sign of Alzheimer’s disease. Researchers studied 918 adults aged 65 and older (average age 76.3) with no cognitive impairment. Every 18 months for nearly five years, participants were interviewed and given health and brain function tests. During this time, 334 people developed mild cognitive impairment, including memory, thinking and learning problems. Having high blood pressure increased the risk of such brain damage by 40 per cent, suggesting that maintaining normal blood pressure could help to protect the brain as we age. Arch Neurol 2007;64:1734-1740 (Reitz C, et al) BABIES delivered by elective caesarean section have a four-fold greater risk of developing breathing problems compared to babies born by vaginal delivery or emergency caesarean, according to a study published online in the BritishMedicalJournal this week. The findings suggest that labour may help to mature the baby’s lungs, and support the argument for reducing the number of elective caesareans performed. The study included 34,458 healthy babies born in Denmark between 37 and 41 weeks of pregnancy. In total, 2687 infants were delivered by elective caesarean section. Compared to babies born by vaginal delivery or emergency caesarean at the same stage of pregnancy, those born by elective caesarean at 37 weeks of pregnancy were four times more likely to develop breathing problems. Those born by elective caesarean at 38 and 39 weeks of pregnancy had three-fold and double the risk, respectively. If caesarean delivery is chosen, say the authors, then it should be postponed until after 39 weeks of pregnancy to limit the effect on the baby’s lungs. BMJ 2007;doi:10.1136/bmj.39405.539282.BE (Hansen AK, et al) TESTOSTERONE therapy could help older men to slow down the ageing process, with new Australian research in the Journalof ClinicalEndocrinologyandMetabolism showing that the hormone can boost muscle and decrease fat. Led by doctor Carolyn Allan and colleagues at Prince Henry’s Institute in Melbourne, the study involved 60 healthy, non-obese men aged 55 and older with low testosterone levels. They were randomly assigned to use either testosterone patches or inactive placebo patches for 12 months, and body composition was measured at the beginning and end of the study. In the testosterone group, blood levels of the hormone increased by an average of 30 per cent over 12 months, while testosterone levels in the placebo group fell by 10 per cent. Compared to the placebo patches, testosterone patches increased muscle size and decreased abdominal fat, making the patches a promising approach to lowering the risks of diabetes and heart disease in ageing men. J Clin Endocrinol Metab 2007;doi:10.1210/jc.2007-1291 (Allan CA, et al) OVER-40s who can still climb stairs and carry the groceries have a reduced risk of stroke compared to those in worse physical shape. A new study, published in the latest issue of Neurology, examined 13,615 healthy men and women between the ages of 40 and 79. Participants were given a health check and surveyed about their physical fitness, including their ability to climb stairs, carry groceries, kneel, bend and lift. Over the next 7.5 years, there were 244 strokes. People who scored in the top 25 per cent on the physical function test had a 50 per cent lower risk of stroke than those with the lowest test scores, regardless of other health and lifestyle factors. According to the authors, fitness testing could identify those at an increased risk of stroke who may benefit the most from preventative treatments. Neurology 2007;69:2243-2248 (Myint PK, et al) Want to know more? Items are referenced where possible. A reference such as ‘‘ 2007;35:18-25’’ means the source article was published on pages 18-25 in volume number 35 of the publication, in 2007. A doi number or website address is used for research published on a journal’s website.
Blood pressure: Too high and it can lead to mild brain damage