These results suggest that plasma BNP determination provides important, independent prognostic information after AMI. Although plasma ANP appears to be a better predictor of left ventricular dysfunction, plasma BNP may have greater potential to complement standard prognostic indicators used in risk stratification after AMI because of its strong, independent association with long-term survival, enhanced in vitro stability, and simplicity of analysis.

A coherent pattern of behavioral and neuroendocrine characteristics was found in subjects with NES.

Objective: To study whether lifestyle factors and/or chronic disease are associated with the age-related decline of total and free testosterone in men, or if these factors might be associated with the variation of total and free testosterone but not with their age-related decline. Design: A population-based, cross-sectional study was used. Methods: Total testosterone and sex hormone binding globulin (SHBG) levels were analyzed and free testosterone levels were calculated in 1563 men participating in the Tromsø study in 1994/1995. Anthropometric characteristics were also measured and two standardized questionnaires completed, including lifestyle factors and medical history. The data were analyzed with multiple linear regression analysis of covariance, and logistic regression. Results: Total and free testosterone were inversely associated (P ¼ 0.001 and P , 0.001), while SHBG was positively associated (P , 0.001) with age. Body mass index (BMI) was inversely associated with total (P , 0.001) and free (P ¼ 0.016) testosterone and SHBG (P , 0.001). Both total and free testosterone were positively associated with tobacco consumption (P , 0.001 and P ¼ 0.004) and total testosterone was positively associated with coffee consumption (P , 0.001). SHBG was positively associated with smoking (P ¼ 0.004) and coffee consumption (P , 0.001). Men who reported having had a stroke or having a cancer diagnosis had lower levels of total testosterone (P , 0.001 and P , 0.01) and free testosterone (P , 0.01). Conclusions: BMI and smoking are independent contributors to the variation of total and free testosterone and SHBG levels, and coffee consumption to the variation of total testosterone and SHBG. Thus, lifestyle factors can have a direct effect on circulating levels of free endogenous sex hormones and to total levels due to the effect on SHBG levels.

Objective: To investigate whether there is an association between serum thyroid-stimulating hormone (TSH) within the normal range and body mass index (BMI). Design and subjects: The study was performed in 6164 subjects (2813 males) who attended the fifth Tromsø study in 2001, and in 1867 subjects (873 males) that attended both the fourth Tromsø study in 1994/1995 as well as the fifth Tromsø study. Measurements: Height, weight, and serum TSH were measured in all subjects, and smoking status was recorded. Results: Smokers and nonsmokers were analyzed separately. In the fifth Tromsø study, serum TSH was positively and significantly associated with BMI in the nonsmokers. Within the normal TSH range (defined as the 2.5-97.5 percentile), nonsmoking males in the highest TSH quartile had a mean BMI 0.4 kg/m 2 higher compared to those in the lower quartile, whereas the difference for nonsmoking women was 1.4 kg/m 2 . Similarly, in nonsmokers in the longitudinal study, there was a significant and positive association between delta serum TSH (serum TSH in 2001 minus serum TSH in 1994) and delta BMI in those with serum TSH within the normal range both in 1994 and 2001. In these subjects, the quartile with the highest delta serum TSH had a mean increase in BMI from 1994 to 2001 that was 0.3 kg/m 2 higher compared to those in the quartile with the lowest delta serum TSH. For the smokers, relations between serum TSH and BMI were not statistically significant. Conclusion: In nonsmokers there is a positive association between serum TSH within the normal range and BMI.

In subjects with SHT where the serum TSH level is in the 3.5-10.0 mIU/liter range, there is no neuropsychological dysfunction, and compared with healthy controls, there is no difference in symptoms related to hypothyroidism.

To examine the relationship of total and free testosterone and sex hormone-binding globulin (SHBG) with central obesity in men, we studied 1548 men aged 25-84 years that took part in the 1994--1995 survey of the Tromsø study. Total testosterone and SHBG were measured by immuno-assay and the free testosterone fraction was calculated. These measurements were analyzed in relation to anthropometric data and lifestyle factors. The age-adjusted correlation between waist circumference (WC) and total testosterone was -0.34 (p < 0.001), between WC and free testosterone -0.09 (p < 0.001) and, between WC and SHBG -0.44 (p < 0.001). Adjusting for BMI and lifestyle factors weakened, but did not eliminate these associations. All hormone and SHBG associations were stronger for WC than for waist-hip ratio or BMI. In age- and BMI-adjusted analyses men with a WC > or = 102 cm had significantly lower levels of total testosterone and SHBG compared to men with an optimal WC, defined as < 94 cm (12.3 vs. 13.9 nmol/l; p < 0.01 and 48.5 vs. 55.1 nmol/l; p < 0.001, respectively). The lowest levels of total and free testosterone were observed in men with relatively high WC despite relatively low overall obesity (BMI), suggesting that WC should be the preferred anthropometric measurement in predicting endogenous testosterone levels.

The role played by endogenous hormones in many diseases makes it important to understand factors influencing their levels. This study examined the distribution of total and free estradiol, FSH, and dehydroepiandrosterone sulfate (DHEAS) by age and sex and associations of these hormones with body mass index (BMI), lifestyle factors, and chronic diseases. Plasma samples taken from 1555 men and 1952 women 25-84 yr of age in 1994-1995 Tromsø Study were analyzed in 2001. Total estradiol increased with age among men (P < 0.001), with or without adjustment for BMI and lifestyle factors. FSH increased with age both in men (P < 0.001) as well as pre- (P < 0.001) and postmenopausal women (P = 0.01) after similar adjustment, and DHEAS decreased with age in both sexes (P < 0.001). With increasing BMI, free estradiol increased in men (P = 0.004), total and free estradiol increased in postmenopausal women (P < 0.001), and FSH decreased in men (P = 0.03) and postmenopausal women (P < 0.001). Men with chronic diseases had lower levels of DHEAS, compared with healthy men (P < 0.001). Smokers had higher DHEAS levels than nonsmokers. Further studies are needed to confirm these hormonal changes with age and disease.

Abstract-Total serum calcium levels were measured in 12 865 men and 14 293 women, between the ages of 25 and 97 years, in the Tromsø Study during 1994 and 1995. With the use of a sex-specific multiple linear regression model with age, calcium, body mass index, cholesterol, HDL cholesterol, triglycerides, systolic and diastolic blood pressure, and pulse as possible covariates, serum calcium was significantly (PϽ0.001) and positively associated with systolic and diastolic blood pressure, serum cholesterol, and HDL cholesterol in both sexes. A similar but weaker association was observed between serum calcium and triglycerides in men (PϽ0.01). In all age groups, serum calcium levels were higher in men with a history of myocardial infarction than in those without, and the difference was significant (PϽ0.0001) in a linear regression analysis adjusted for age. When all the other variables were also included in a logistic regression model, serum calcium was a highly significant (PϽ0.0001) predictor of myocardial infarction in men, with an odds ratio of 1.2 per 0.1 mmol/L increase in serum calcium. In women, a nonsignificant trend was again seen. Because the free or ionized form of calcium is the physiologically important form and serum calcium was not corrected for serum albumin in our study, the results must be interpreted with caution. However, it appears likely that serum calcium is a predictor of cardiovascular disease in men. (Hypertension. 1999;34:484-490.)Key Words: calcium Ⅲ blood pressure Ⅲ cholesterol Ⅲ triglycerides Ⅲ cardiovascular diseases I n epidemiological studies, serum calcium has been found to increase with increasing levels of systolic and diastolic blood pressure (BP). 1,2 Furthermore, in patients with hyperparathyroidism and therefore chronic hypercalcemia, hypertension is prevalent 3 and an increased mortality rate exists, particularly from cardiovascular diseases. 4 Serum calcium has also been found to correlate with serum cholesterol and blood glucose 2 and therefore is apparently associated with the metabolic syndrome. Recently, serum calcium has been reported to be an independent, prospective risk factor for myocardial infarction in middle-aged men. 5 In the municipality of Tromsø, which is located in northern Norway, 4 large health surveys have been performed, the first in 1974 and the last in 1994 -1995. The Tromsø studies have primarily focused on cardiovascular risk factors and diseases, and in the last study, serum calcium was also analyzed. Because Ͼ27 000 persons were examined, a large database was therefore available to study relationships between serum calcium and risk factors for coronary heart disease. Methods SubjectsIn 1994 -1995, all men and women who were Ͼ24 years of age and who lived in the municipality of Tromsø were invited to participate in a health survey performed by the National Health Screening Service in cooperation with the University of Tromsø and local health authorities. Generally, this health survey was conducted in a manner similar to previous studies. 6 A questi...