Segregation Analysis of Body Mass Index in an Unselected French-Canadian Sample: The Québec Family Study

Interest in a single gene etiology for obesity, as assessed by the body mass index (BMI), has been spurred recently by reports of a putative recessive major gene for extreme values, which accounts for as much as 40% of the variance. The major gene hypothesis was evaluated here in the Québec Family Study, a random sample of 375 French-Canadian volunteer families. This report represents one component in a more complete investigation of obesity in these families. In contrast to the recent studies, a major gene hypothesis for BMI was not verified here. Although there was a major effect, it did not conform to a Mendelian pattern of transmission. A multifactorial component (i.e., polygenic and/or common environmental factors) accounted for 42% of the phenotypic variance. In addition, evidence of heterogeneity between the generations was found. The heterogeneity was traced to the major non-Mendelian component (which accounted for 0.01% of the variance in parents and over 40% in offspring) rather than to the multifactorial one. These results would suggest that a simple recessive gene mixed model may not be sufficient to explain the familial distribution of the BMI. Several factors which may have contributed to these results include temporal trends and surrogate effects such as those related to variation in body composition and energy balance components. (OBESITY RESEARCH 1993; 1:288–294)     

Correcting eggshell indices of raptor eggs for hole size and eccentricity

Eggshell thickness is often expressed by means of an index based on the length, breadth and weight of the shell. The effect of the blow-hole and egg eccentricity on Ratcliffe's shell thickness index was investigated in a sample of 585 eggs from six raptor species. Corrections for the size of the hole and egg eccentricity are proposed, as is a combined formula to correct both sources of error at the same time. It is shown that by using these formulae, considerable improvements in estimates of shell thinning are obtained. These may be especially useful when sample sizes are small, which is often the case when working with species that have been reduced in numbers.     

Outbreak of boils in an Alaskan village: a case-control study

Objective To determine whether taking steam baths was associated with furunculosis and to evaluate possible risk factors for the occurrence of boils during a large outbreak in Alaska. Design A cohort study of village residents, a case-control study, and assessment of environmental cultures taken from steam baths. Setting Village in southwestern Alaska. Participants 1 adult member from 77 of the 92 house-holds in the village was interviewed; 115 residents with at least one boil occurring between January 1 and December 12, 1996 were considered to be cases; 209 residents without a boil acted as the control group. All 459 village residents were included in the cohort study. Main outcome measure Rate of infection among all residents and residents who regularly took steam baths, risk factors for infection, and relative risk of infection. Results 115 people (25%) had had at least one boil. Men were more likely to have had a boil than women (relative risk 1.5; 95% confidence interval 1.1 to 2.2). The highest rate of infection was among people ages 25-34 years (32/76; 42%). No children younger than 2 years had had boils. Boils were associated with using a steam bath (odds ratio 8.1; 3.3 to 20.1). Among those who used a steam bath, the likelihood of developing boils was reduced by routinely sitting on a towel while bathing, which women were more likely to do, and bathing with fewer than 8 people. Of the 93 samples taken from steam baths, one Staphylococcus aureus isolate was obtained from a bench in an outer dressing room. Conclusion Using a steam bath was associated with developing boils in this outbreak in a village in Alaska. People should be advised to sit on towels while using steam baths.     

A comparison of the metabolic response to abdominal obesity in two Canadian Inuit and First Nations population

Inuit and Cree populations are known for high obesity rates despite markedly different rates of type 2 diabetes (T2DM). To document this apparent discrepancy we evaluated the impact of body size parameters and fasting insulin (FI) on several T2DM risk factors among Inuit and Cree populations (Québec, Canada). A total of 1,104 adults (≥18 years) Inuit and Cree individuals participated in a cross-sectional investigation. Interestingly, across both genders, across all levels of waist circumference (WC), Inuit showed lower levels of FI (age-adjusted, P < 0.0001) and fasting glucose (P < 0.0001) than Cree individuals. In both groups, a comparison of multi-sample structural equation models confirmed the predominant influence of WC on other traditional risk factors, compared to BMI. A preponderant direct impact of WC was observed on blood pressure (BP) parameters (P < 0.0001), high-density lipoprotein cholesterol (HDL-C) (P < 0.0001), and FI (P < 0.0001). Fasting glucose level appear to be influenced by WC via FI in both ethnic groups (P < 0.0001), while triacylglycerol (TAG) level was predominantly impacted by WC via FI, but only in Cree individuals (P < 0.0001). The main ethnic difference found was the strength of the impact of WC on FI, which was considerably higher among the Cree (λ = 2.4, P < 0.0001) than the Inuit (λ = 1.8, P < 0.0001). These results confirm the predominant role of abdominal adiposity in the complex and tenuous links of different traditional T2DM determinants. However, the ethnic difference in the impact of abdominal obesity on insulin levels across all WCs needs to be explored further.     

Cross-sex pattern of bone mineral density in early onset gender identity disorder

Hormonally controlled differences in bone mineral density (BMD) between males and females are well studied. The effects of cross-sex hormones on bone metabolism in patients with early onset gender identity disorder (EO-GID), however, are unclear. We examined BMD, total body fat (TBF) and total lean body mass (TLBM) in patients prior to initiation of sex hormone treatment and during treatment at months 3 and 12. The study included 33 EO-GID patients who were approved for sex reassignment and a control group of 122 healthy Norwegians (males, n=77; females, n=45). Male patients (n=12) received an oral dose of 50 mug ethinylestradiol daily for the first 3 months and 100 mug daily thereafter. Female patients (n=21) received 250 mg testosterone enantate intramuscularly every third week. BMD, TBF and TLBM were estimated using dual energy X-ray absorptiometry (DXA). In male patients, the DXA measurements except TBF were significantly lower compared to their same-sex control group at baseline and did not change during treatment. In female patients, the DXA measurements were slightly higher than in same-sex controls at baseline and also remained unchanged during treatment. In conclusion, this study reports that body composition and bone density of EO-GID patients show less pronounced sex differences compared to controls and that bone density was unaffected by cross-sex hormone treatment.     

Bias Assessment of General Chemistry Analytes using Commutable Samples

Harmonisation of reference intervals for routine general chemistry analytes has been a goal for many years. Analytical bias may prevent this harmonisation. To determine if analytical bias is present when comparing methods, the use of commutable samples, or samples that have the same properties as the clinical samples routinely analysed, should be used as reference samples to eliminate the possibility of matrix effect. The use of commutable samples has improved the identification of unacceptable analytical performance in the Netherlands and Spain. The International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) has undertaken a pilot study using commutable samples in an attempt to determine not only country specific reference intervals but to make them comparable between countries. Australia and New Zealand, through the Australasian Association of Clinical Biochemists (AACB), have also undertaken an assessment of analytical bias using commutable samples and determined that of the 27 general chemistry analytes studied, 19 showed sufficiently small between method biases as to not prevent harmonisation of reference intervals. Application of evidence based approaches including the determination of analytical bias using commutable material is necessary when seeking to harmonise reference intervals.