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Single nucleotide polymorphism (SNP) genotype frequencies were examined to determine whether variation in 6 estrogen-related genes was associated with differences in cognitive functioning in women at midlife. DNA from a multiracial/multiethnic sample of 875 African American, Caucasian, Chinese, and Japanese women aged 45 to 56 years participating in the Study of Women’s Health Across the Nation (SWAN) was genotyped. Gene markers from the sex steroid hormone pathway were linked to measures of cognitive functioning including the Digit Span Backward Test (DSB), a measure of working memory; the Symbol Digit Modalities Test (SDMT), a measure of perceptual speed; and the East Boston Memory Test (EBMT), a measure of episodic memory. Statistical models were fit using logistic regression and general linear models to estimate the strength of association of estrogen-related polymorphisms with DSB, SDMT, and EBMT scores. On the EBMT, African American women and Caucasian women with ESR1 rs9340799 GG genotypes had about 1.5 to 2.0 times greater odds of remembering story elements on the EBMT-immediate recall test. Caucasian women with ESR1 rs2234693 CC genotypes had 1.3 to 1.5 times greater odds of remembering story elements on the EBMTdelayed recall test. Chinese women with 17HSD rs615942 GG genotypes, 17HSD rs592389 TT genotypes, and 17HSD rs2830 GG genotypes had about 1.7 times greater odds of remembering story elements on the EBMT-immediate recall test. African American women with CYP 19 rs936306 CC genotypes had about 0.25 to 0.40 lower odds of remembering story elements on the EBMT-immediate recall test, whereas Chinese women with CYP 19 rs936306 CC genotypes had about 2.3 times greater odds of remembering story elements on both the EBMT-immediate and -delayed recall tests. On the DSB, African American women with CYP 19 rs749292 GG genotype had a higher mean score. On the SDMT, Japanese women with ESR1 rs728524 GG genotypes had a higher mean score. On the 3 tests of cognitive functioning, there was 1 significant finding for CYP1A1 and none for the YP1B1 or ESR2 SNPs. We conclude that selected genes involved in estrogen synthesis and metabolism may be associated with performance differences on cognitive function tests. Also, the relevant estrogen-related polymorphisms may vary by race/ethnicity.

Addresses many of the statistical and epidemiological flaws identified in previous studies of campus student suicides. Analyses, based on longitudinal data covering 261 student suicides, reveal a significantly higher suicide risk for students 25 and over, although the overall student suicide rate is one half of the national rate. (RJM)

The Big Ten Student Suicide Study was undertaken from 1980-1990 to determine the suicide rates on Big Ten University campuses. The study design attempted to address many of the statistical and epidemiological flaws identified in previous studies of campus student suicides. The 10-year study collected demographic and correlational data on 261 suicides of registered students at 12 midwestern campuses. The largest number of suicides for both males and females were in the 20-24-year-old age group (46%), and amongst graduate students (32%). The overall student suicide rate of 7.5/100,000 is one half of the computed national suicide rate (15.0/100,000) for a matched sample by age, gender, and race. Despite the overall lower suicide rate, the analyses revealed that students 25 and over have a significantly higher risk than younger students. Although women have rates roughly half those of men throughout their undergraduate years, graduate women have rates not significantly different from their male counterparts (graduate women 9.1/ 100,000 and graduate men 11.6/100,000).

Black people may have a significantly higher risk of cardiac arrest than whites. Survival rates may also be lower among black patients after cardiac arrest. Among 6,451 patients who had an out-of-hospital cardiac arrest in Chicago, IL between Jan 1, 1987 and Dec 31, 1988, 2,910 were black, 3,207 were white and 334 were members of other races. For every age group, black individuals had a significantly higher incidence of cardiac arrest than white individuals. Less than 1% of black patients survived after cardiac arrest, compared with 3% of white patients. Significantly fewer black patients had bystander-initiated cardiopulmonary resuscitation or were admitted to the hospital. The response time of emergency medical services was similar for black patients and white patients.

OBJECTIVE -- To examine depression and 3-year change in insulin resistance and risk of diabetes and whether associations vary by race. RESEARCH DESIGN AND METHODS -- We analyzed data from 2,662 Caucasian, African-American, Hispanic, Japanese-American, and Chinese-American women without a history of diabetes from the Study of Women's Health Across the Nation. We estimated regression coefficients and odds ratios to determine whether depression (Center for Epidemiological Studies Depression Scale score ≤ 16) predicted increases in homeostasis model assessment of insulin resistance (HOMA-IR) and greater risk of incident diabetes, respectively, over 3 years. RESULTS -- Mean baseline HOMA-IR was 1.31 (SD 0.86) and increased 0.05 units per year for all women (P < 0.0001). A total of 97 incident cases of diabetes occurred. Depression was associated with absolute levels of HOMA-IR (P < 0.04) but was unrelated to changes in HOMAIR; associations did not vary by race. The association between depression and HOMA-IR was eliminated after adjustment for central adiposity (P = 0.85). Depression predicted a 1.66-fold greater risk of diabetes (P < 0.03), which became nonsignificant after adjustment for central adiposity (P = 0.12). We also observed a depression-by-race interaction (P < 0.05) in analyses limited to Caucasians and African Americans, the only groups with enough diabetes cases to reliably test this interaction. Race-stratified models showed that depression predicted 2.56-fold greater risk of diabetes in African Americans only, after risk factor adjustment (P = 0.008). CONCLUSIONS -- Depression is associated with higher HOMA-IR values and incident diabetes in middle-aged women. These associations are mediated largely through central adiposity. However, African-American women with depression experience increased risk of diabetes independent of central adiposity and other risk factors. [ABSTRACT FROM AUTHOR]

The article focuses on a study that evaluated the effectiveness of pioglitazone (PIO) and glimepiride (GLM) on adipose tissue distribution. It states that there were changes in BMI, waist-hip ratio, and abdominal adipose tissue distribution based on the measurement made through the use of electron beam tomography. The findings indicate that the ratio of visceral to total adipose tissue volume tended to increase with GLM and decrease with PIO.

Patients with type 2 diabetes (T2D) manifest a form of dyslipidemia typified by high LDL particle concentration (PC), small LDL particle size (PS), and high triglyceride and low HDL-C levels. This diabetic dyslipidemia may contribute to the excess cardiovascular events seen in T2D. In CHICAGO, a randomized, double-blind, multicenter, 72-week study, pioglitazone (PIO) was associated with less CIMT progression compared to glimepiride (GLM) in patients with T2D (N=462). We also observed significant improvements in TG and HDL-C levels with PIO vs GLM, with no difference in LDL-C levels. Here we report the results of the lipoprotein subfraction analysis. Blood samples were obtained at baseline and weeks 24, 48, and 72 (or time of withdrawal) for determination of PC and PS of VLDL, LDL, and HDL, measured by NMR spectroscopy. At Final Visit, PIO therapy produced a significant reduction in VLDL PS due to significant decreases in large and medium VLDL PC and increases in small VLDL PC. LDL PS significantly increased due to a significant reduction in small LDL and increase in large LDL PC. HDL PS also significantly increased due to a reduction in small and an increase in large HDL PC. In aggregate, the changes in lipoprotein subfraction distribution would be predicted to produce a reduction in CVD risk with PIO vs GLM and may contribute to beneficial effects of PIO on CIMT. [ABSTRACT FROM AUTHOR]

A response by Lance B. Becker and Peter M. Meyer to a letter to the editor about their article "Racial Differences in the Incidence of Cardiac Arrest and Subsequent Survival" in the August 26, 1993 issue, is presented.