Oxidative modification of LDL renders it immunogenic and autoantibodies to epitopes of oxidised LDL, such as malondialdehyde (MDA)-lysine, are found in serum and recognise material in atheromatous tissue. However, there has been no prospective study to assess the importance of oxidised LDL among patients with vascular disease. We compared the titre of autoantibodies to MDA-modified LDL and native LDL in baseline serum samples of 30 eastern Finnish men with accelerated two-year progression of carotid atherosclerosis and 30 age-matched controls without progression. Neither group had specific antibody binding to native LDL. A titre was defined as a ratio of antibody binding to MDA-LDL/binding to native LDL. Cases had a significantly higher titre to MDA-LDL (2.67 vs 2.06, p = 0.003). Cases also had a greater proportion of smokers (37% vs 3%), higher LDL cholesterol (4.2 mmol/l vs 3.6 mmol/l), and higher serum copper concentration (1.14 mg/l vs 1.04 mg/l). Even after adjusting for these variables and the severity of baseline atherosclerosis, the difference in antibody titre remained significant in a multifactorial logistic model (p = 0.031). Thus, the titre of autoantibodies to MDA-LDL was an independent predictor of the progression of carotid atherosclerosis in these Finnish men. Our data provide further support for a role of oxidatively modified LDL in atherogenesis.

The association between an a priori measure of social connections and five-year mortality from all causes, cardiovascular diseases (International Classification of Diseases, Eighth Revision (ICD-8) codes 390-458), and ischemic heart disease (ICD-8 codes 410-414) was studied in 13,301 men and women from eastern Finland who were first interviewed in 1972 or 1977. For men, there was a graded association between extent of social connections and mortality. In multivariate models with adjustment for age, smoking, serum cholesterol, mean weighted blood pressure, measures of prevalent illness, and other possible confounders, men who were in the two lowest quintiles of the social connections scale were at increased risk compared with those in the highest quintile (odds ratio (OR)all cause = 1.54, 95% confidence interval (CI) = 1.21-1.95; ORcardiovascular disease = 1.54, 95% CI = 1.11-2.13; ORischemic heart disease = 1.34, 95% CI = 0.94-1.90). No strong or consistent association was found for women. The association for men was modified by levels of blood pressure with the effect of low social connections greater at higher levels of blood pressure. In three separate analyses, there was no evidence for confounding or effect modification due to prevalent illness at baseline.

Catechol-O-methyltransferase (COMT) is an enzymewhich has a crucial role in the metabolism of dopamine. It has been suggested that a common functional genetic polymorphism in the COMT gene, which results in 3 to 4-fold difference in COMT enzyme activity, 1,2 may contribute to the etiology of mental disorders such as bipolar disorder and alcoholism. 1 Since ethanol-induced euphoria is associated with the rapid release of dopamine in limbic areas, it is conceivable that subjects who inherit the allele encoding the low activity COMT variant would have a relatively low dopamine inactivation rate, and therefore would be more vulnerable to the development of ethanol dependence. The aim of this study was to test this hypothesis among type 1 (late-onset) alcoholics. The COMT polymorphism was determined in two independent male late onset (type 1) alcoholic populations in Turku (n = 67) and Kuopio (n = 56). The high (H) and low (L) activity COMT genotype and allele frequencies were compared with previously published data from 3140 Finnish blood donors (general population) and 267 race-and gender-matched controls. The frequency of low activity allele (L) was markedly higher among the patients both in Turku (P = 0.023) and in Kuopio (P = 0.005) when compared with the general population. When all patients were compared with the general population (blood donors), the difference was even more significant (P = 0.0004). When genotypes of all alcoholics (n = 123) were compared with genotypes of matched controls, the odds ratio (OR) for alcoholism for those subjects having the LL genotype vs those with HH genotype was 2.51, 95% CI 1.22-5.19, P = 0.006. Also, L allele frequency was significantly higher among alcoholics when compared with controls (P = 0.009). The estimate for population etiological (attributable) fraction for the LL genotype in alcoholism was 13.3% (95% CI 2.3-25.7%). The results indicate that the COMT polymorphism contributes significantly to the development of late-onset alcoholism.Catechol-O-methyltransferase (COMT) is an enzyme which has a crucial role in the metabolism of dopamine. A common functional polymorphism in the COMT gene is responsible for enzyme activity variability found in the general population. It has been suggested that this genetic polymorphism may contribute to the etiology of mental disorders such as schizophrenia, obsessive compulsive disorder (OCD) and alcoholism. 1 There is solid evidence that a G → A transition at COMT codon 158 is associated with three-to four-fold variation in COMT enzyme activity in human hepatic tissue and red blood cells. Thus far empirical evidence for an association between the COMT L allele and mental disorders has been reported in patients with velo-cardio-facial syndrome (VCFS), 3 rapid cycling bipolar disorder, 4,5 schizophrenia and schizoaffective disorder with increased violent behavior, 6,7 and in patients with OCD. 8 On the other hand, some studies have failed to show any association between COMT polymorphism and schizophrenia or affective disorders. [9][1...

Change in risk factors for coronary heart disease during 10 years of a community intervention programme (North Karelia project) (1977) and 10 (1982)

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Summary and conclusions A comprehensive community programme studying the control of cardiovascular diseases (CVD) was carried out in North Karelia, Finland, between 1972 and1977. The main objective was to reduce the mortality and morbidity of CVD, particularly in middle-aged men. Changes in the mortality and incidence of CVD were monitored by community-based registers of cases of acute myocardial infarction (AMI) and stroke and data on death certificates. During the programme the total mortality in the area decreased by 5% and the mortality from CVD decreased by 13% among men and 31% among women aged 30-64 years. were compared with those in a matched control area; the difference between the two areas was not significant.The true effect of the programme cannot be deduced from these results, but mortality from CVD and the incidence of AMI and stroke feli during the five years studied. Thus the changes in mortality and morbidity of CVD accorded with the initial objectives of the programme.

The association of socioeconomic status with the risk of death from ischaemic heart disease and any disease as well as the risk of cerebral stroke and any cancer was studied in 3644 men aged 30-59, based on a random sample from the population of eastern Finland. Age, smoking, blood pressure, and serum cholesterol concentration were allowed for in multiple logistic models. On the basis of these data, not being married, short education, and low income are associated with an excessive risk of death from ischaemic heart disease and any disease. The data also indicated that men who were not married and who lived in urban areas might have an increased risk of cerebral stroke and those with a short education an increased risk of cancer.

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