Wendy Carman | University of Michigan (original) (raw)
Papers by Wendy Carman
Journal of Epidemiology and Community Health, Aug 1, 2011
Archives of internal medicine, Sep 1, 1980
ABSTRACT A random sample of 568 participants in the Tecumseh, Mich, study, aged 30 to 59 years, w... more ABSTRACT A random sample of 568 participants in the Tecumseh, Mich, study, aged 30 to 59 years, was stratified according to blood glucose concentration to select a high proportion of diabetics. Subjects were categorized as overt diabetics, chemical or probable diabetics, or nondiabetics. Diabetic groups and nondiabetics were compared for levels of blood glucose, plasma insulin, serum cholesterol, serum triglyceride, blood pressure, and contours of glucose and insulin curves. Overt diabetics had high mean fasting blood glucose levels. Challenged diabetics had significantly higher concentrations of all variables except cholesterol than nondiabetics, even after adjustment for age and adiposity. Glucose intolerance, adiposity, and sex influenced variables independently. Risk of atherosclerosis is partly attributable to persistent hyperglycemia and related metabolic abnormalities in overt diabetics. Postchallenge diabetics have subtle hyperglycemia but a high frequency of other risk factors. Recent developments suggest that control of blood glucose may become feasible and useful in the prevention of cardiovascular disease in overt and challenged diabetics.
Annals of the Rheumatic Diseases, Jun 1, 2015
Background: Antibody profiling encompassing rheumatoid factor (RF) and anti-citrullinated peptide... more Background: Antibody profiling encompassing rheumatoid factor (RF) and anti-citrullinated peptide antibodies (ACPA) supports diagnosis in patients with Rheumatoid arthritis (RA). However, RF and ACPA are not specific for RA, and predictive values of tests depend heavily on the selection of individuals in which such tests are performed. Because testing for these antibodies is frequently ordered by non-Rheumatologists, at substantial costs, we sought to determine the predictive values of such testing in patients of a large tertiary hospital. Objectives: To evaluate the positive and negative predictive values (PPV, NPV) of RF and ACPA tested in a pre-selected population of all patients of the Vienna general hospital between 2006 and 2012. Methods: Results of all RF and ACPA tests performed between 2006 and 2012 were obtained from the Department of Laboratory Medicine and the ordering departments were determined. Diagnoses were extracted from the hospital-wide database. Results: Between 2006 and 2012 more than 45,000 RF and ACPA tests in 5496 patients were performed. Among these, 21% were positive for RF, 3% for ACPAs and 22% were positive for both antibodies. For 2250 patients (41% of all patients in whom RF/ACPA was tested) the tests were not ordered by the Department of Rheumatology. The tests were requested by the Departments of Infectiology (32.5%), Angiology (11.1%), Orthopedics (8%), Nephrology (8%), and Dermatology (7%). 1572 of these 2250 patients had a documented diagnosis. Figure 1 shows the distribution of diseases according to the ICD-10. Among the 2250 patients 134 (6%) were positive for RF, 72 (3.2%) for ACPA and 31 (1.4%) patients tested positive for both antibodies. PPV and NPV for the presence of musculoskeletal diseases were 22.4% and 89.9% for RF and 26.4% and 88.8% for ACPA testing. However, for presence of chronic inflammatory musculoskeletal diseases (ICD-10-Codes M05.X to M09.X and M30.X to M35.X) PPV was only 11.9% for RF and 16.7% for ACPA. NPV was 95.3% and 95.2%, respectively. Conclusions: RF and ACPA testing was frequently ordered by non-Rheumatologists. In this patient group, we found a relatively high NPV (95%) but a very low PPV of 11-17%. Thus, >83% of positive tests did not contribute to a diagnosis of inflammatory musculoskeletal disease. This observation underscores the necessity to use such testing only in the appropriate clinical context.
Annals of the Rheumatic Diseases, Jun 1, 2015
JAMA: The Journal of the American Medical Association, 1980
Physiological variables were compared among women who had never used oral contraceptives, past us... more Physiological variables were compared among women who had never used oral contraceptives, past users, and current users. Randomly selected subjects were aged 30 to 59 years. Blood was sampled for determination of blood glucose, serum cholesterol and triglyceride, and plasma insulin concentration. Summed postchallenge glucose and insulin values were used in analyses to represent the magnitude of response. Contours of glucose and insulin curves were represented by single numerical variables termed "G-CON" and "I-CON." Current users of oral contraceptives had significantly higher values of G-CON, I-CON, triglyceride, and systolic blood pressure than women who never used oral comtraceptives. Current users also had significantly higher levels of summed glucose, G-CON, and I-CON than former users. Use of currently prescribed oral contraceptives is associated with adverse physiological changes that are reversible after discontinuing such use.
International Journal of Epidemiology, 1989
Relationships between cardiovascular disease (CVD) mortality and breathlessness, a definition of ... more Relationships between cardiovascular disease (CVD) mortality and breathlessness, a definition of chronic bronchitis, and pulmonary function are investigated among men in two employed populations (17,717 London civil servants and 4904 Scottish workers) and in two communities (844 men in Tecumseh, Michigan and 6859 men in Renfrew and Paisley Burghs, Scotland). Men are aged 40-64 years at entry in all studies except Renfrew-Paisley, where they are aged 45-64 years. Length of follow-up ranges from 6 to 16 years. Age and smoking habits were controlled for in all analyses. Chronic phlegm production is not significantly associated with CVD mortality, and 'chronic bronchitis' is significantly associated with mortality only in the employed populations. Low FEV1 is significantly associated with CVD mortality only in the Whitehall study; however, the rate ratios are above one in all studies. Breathlessness is significantly associated with CVD mortality in all studies. These associations between CVD mortality and 'chronic bronchitis', low FEV1, and breathlessness persist after also controlling for employment grade, systolic blood pressure, antihypertensive medication, ECG changes, plasma cholesterol level, body mass index and diabetes. Only the associations between breathlessness and mortality persist after further controlling for low FEV1 and myocardial ischaemia. The rate ratios between breathlessness and mortality are about two for all studies. It is concluded that in these populations, breathlessness is an independent and major predictor of CVD mortality.
Contraception, 2007
Materials and Methods: In this cross-sectional study, endometrial biopsies were performed on 20 D... more Materials and Methods: In this cross-sectional study, endometrial biopsies were performed on 20 DMPA users who were having BTB and 20 DMPA users who were amenorrheic. CE was defined as greater than or equal to two plasma cells per endometrial sample. We used polymerase chain reaction technology to identify CT in paraffin-embedded endometrial biopsy tissue sections using a method developed by our laboratory. Negative and positive controls were validated for each specimen. Results: CE was the most common histologic finding (10/40, 25%) and occurred more often in women experiencing BTB (35% vs. 15%) (RR 1.62, 95% CI 0.91-2.87). Two patients, one with amenorrhea and one with BTB, neither with CE, were found to have CT endometritis. Conclusion: CT was not a cause of CE in this population of at-risk patients using DMPA. It is possible that CE in DMPA users reflects an inflammatory state, a function of an atrophic endometrium. This suggests the possibility of using nonsteroidal anti-inflammatory drugs for CE and BTB rather than antimicrobials or hormonal medication.
The online version of this article, along with updated information and services, is located on
Background A cohort of 2181 men and women, aged 40 to 79 years, without evidence of coronary hear... more Background A cohort of 2181 men and women, aged 40 to 79 years, without evidence of coronary heart disease or cancer at entry to the Tecumseh Study was evaluated. Methods and Results Subjects were defined as lean if their Metropolitan Life Insurance table relative weight was <110 (n=584) and as obese if their relative weight was 2120 (n= 1024). There were 688 subjects with hypertension at study entry (systolic blood pressure >160, diastolic blood pressure >95, or treated). The 29-year relative risk (RR) of mortality from ischemic heart disease (IHD) or cardiovascular disease (CVD) associated with systolic blood pressure level was significant for both lean and obese subjects. Among hypertensive subjects, the RR of fatal IHD for lean versus obese hypertensive subjects was 1.87 (95% confidence interval, 1.21 to 2.88) and the RR of fatal CVD was 1.56 (95% confidence interval,
ABSTRACT Dissertation (Ph.D.)--University of Michigan.
Journal of General Internal Medicine
Pharmacoepidemiology and Drug Safety
Objectives were to quantify prevalence estimates of pregnancy and infant outcomes including major... more Objectives were to quantify prevalence estimates of pregnancy and infant outcomes including major congenital malformations (MCMs) by etanercept (ETN) exposure among infants born to women with chronic inflammatory arthritis (cIA) or psoriasis (PsO). Claims-based data delineated pregnancy exposures and outcomes of live or nonlive births among women with cIA and PsO (ETN exposed, unexposed) and general population (GP) comparators. Infant outcomes were determined for live-born infants covered by the mother's insurer. Medical records were obtained from all accessible mother-infant pairs with claims for MCMs and a random sample of mothers. Multivariable logistic regression estimated the odds ratios (ORs) of having at least one algorithm-defined MCM in the ETN-exposed cohorts versus unexposed comparators. Prevalence estimates for pregnancy outcomes were comparable across cIA and PsO cohorts. Algorithm-defined prevalence estimates of having at least one MCM were 6.1% (ETN exposed), 5.5% (unexposed), and 5.7% (GP cohort) for the cIA cohort; PsO cohort estimates were 2.0%, 4.2%, and 4.7%, respectively. The ETN-exposure ORs for having at least one algorithm-defined MCM among infants of cIA mothers was 1.03 (95%CI: 0.51-2.10) and 0.39 (95%CI: 0.05-2.98) among infants of PsO mothers. Logistic regression with inverse probability of treatment weighting that included disease state resulted in an OR of 0.65 (0.24, 1.72). Overall, this study did not identify any new safety concerns associated with the use of etanercept during pregnancy. Etanercept, along with the other TNFis, remains a treatment without well-controlled clinical trials in pregnant women. Patients should continue to consult their doctor regarding benefit risk decisions of TNFi therapy during pregnancy.
American Journal of Epidemiology
Page 1. AMERICAN JOURNAL OF EPIDEMIOLOOY Vol. 116, No. 6 Copyright © 1982 by The Johns Hopkins Un... more Page 1. AMERICAN JOURNAL OF EPIDEMIOLOOY Vol. 116, No. 6 Copyright © 1982 by The Johns Hopkins University School of Hygiene and Public Health Printed in USA. All rights reserved DIABETES MELLITUS IN TECUMSEH, MICHIGAN ...
Journal of pregnancy, 2016
Objective. To examine pregnancy and birth outcomes among women with idiopathic thrombocytopenic p... more Objective. To examine pregnancy and birth outcomes among women with idiopathic thrombocytopenic purpura (ITP) or chronic ITP (cITP) diagnosed before or during pregnancy. Methods. A linkage of mothers and babies within a large US health insurance database that combines enrollment data, pharmacy claims, and medical claims was carried out to identify pregnancies in women with ITP or cITP. Outcomes included preterm birth, elective and spontaneous loss, and major congenital anomalies. Results. Results suggest that women diagnosed with ITP or cITP prior to their estimated date of conception may be at higher risk for stillbirth, fetal loss, and premature delivery. Among 446 pregnancies in women with ITP, 346 resulted in live births. Women with cITP experienced more adverse outcomes than those with a pregnancy-related diagnosis of ITP. Although 7.8% of all live births had major congenital anomalies, the majority were isolated heart defects. Among deliveries in women with cITP, 15.2% of live...
Seminars in Arthritis and Rheumatism, May 1, 1989
Dissertation (Ph.D.)--University of Michigan.
Journal of the American Medical Women's Association (1972), 2001
to estimate the prevalence of gestational diabetes mellitus (GDM), obesity, and excessive weight ... more to estimate the prevalence of gestational diabetes mellitus (GDM), obesity, and excessive weight gain during pregnancy among Latinas and African-American women in a large Detroit health system and explore risk factors associated with GDM and its implications. Descriptive statistics, chi2 tests, analysis of variance, and logistic regression analyses were used to describe the prevalence of obesity, excessive pregnancy weight gain, and GDM and to assess factors associated with GDM risk in a cohort of 552 African-American women and 653 Latinas in a large Detroit health system. Women ranged in age from 14 to 47 years. Almost 47% of African-American women and 37% of Latinas were overweight or obese, and 53% of African-American women and 38% of Latinas gained excessive weight during pregnancy. The prevalence of GDM was 5.4% among Latinas and 3.9% among African-American women. After adjusting for other risk factors, Latinas were 2.5 times more likely than African Americans to develop GDM. O...
American journal of epidemiology, Jan 15, 1994
The Tecumseh Community Health Study provides an opportunity to investigate the role of obesity in... more The Tecumseh Community Health Study provides an opportunity to investigate the role of obesity in the etiology of osteoarthritis. This longitudinal study, conducted in Tecumseh, Michigan, began in 1962 with baseline examinations of clinical, biochemical, and radiologic characteristics. A 1985 reexamination of the cohort characterized osteoarthritis status in 1,276 participants, 588 males and 688 females, who were aged 50-74 years at this follow-up. Baseline obesity, as measured by an index of relative weight, was found to be significantly associated with the 23-year incidence of osteoarthritis of the hands among subjects disease free at baseline. Greater baseline relative weight was also associated with greater subsequent severity of osteoarthritis of the hands. The difference between baseline and follow-up weight values was not significantly associated with the incidence of osteoarthritis of the hands. Furthermore, there was no evidence that development of osteoarthritis subsequent...
American journal of epidemiology, 1982
A high proportion of the population of Tecumseh, Michigan, participated in comprehensive assessme... more A high proportion of the population of Tecumseh, Michigan, participated in comprehensive assessments of health, personal habits, and socioeconomic status during the periods 1959-1960 and 1962-1965. A total of 5735 persons older than 20 years of age, comprising 2749 men and 2986 women, form the subject of this report. Diabetics were identified at entry and contrasted to nondiabetics with respect to personal characteristics. During the period 1977-1979, health status of 69% of the eligible cohort was ascertained. Age, adiposity, and blood glucose level were the principal predictor of new cases of diabetes. Family history was a significant predictor only among middle-aged, overweight men. Diabetes tended to be related to central fat distribution as indicated by subscapular skinfold thickness. Predictors of new cases of diabetes were not necessarily related to prevalence of the disease in this population.
American journal of epidemiology, 1985
The coronary heart disease mortality of participants in the Tecumseh study was examined with part... more The coronary heart disease mortality of participants in the Tecumseh study was examined with particular emphasis on the roles of diabetes and glucose tolerance as risk factors. The cohort consisted of 921 men and 937 women aged 40 years and older who did not have evident coronary heart disease at entry to the study during the period 1959-1965 and whose outcome was determined in the period 1977-1979. Previously diagnosed diabetes was a statistically significant risk factor for coronary heart disease mortality in both sexes even after controlling for systolic blood pressure, serum cholesterol, relative weight, and cigarette smoking. High blood glucose score in nondiabetics was associated with excess coronary heart disease mortality after controlling for other risk factors, but the magnitude of this effect was substantially below that of diabetes. The predictive power of most risk factors except age itself decreased among progressively older segments of the population.
Journal of Epidemiology and Community Health, Aug 1, 2011
Archives of internal medicine, Sep 1, 1980
ABSTRACT A random sample of 568 participants in the Tecumseh, Mich, study, aged 30 to 59 years, w... more ABSTRACT A random sample of 568 participants in the Tecumseh, Mich, study, aged 30 to 59 years, was stratified according to blood glucose concentration to select a high proportion of diabetics. Subjects were categorized as overt diabetics, chemical or probable diabetics, or nondiabetics. Diabetic groups and nondiabetics were compared for levels of blood glucose, plasma insulin, serum cholesterol, serum triglyceride, blood pressure, and contours of glucose and insulin curves. Overt diabetics had high mean fasting blood glucose levels. Challenged diabetics had significantly higher concentrations of all variables except cholesterol than nondiabetics, even after adjustment for age and adiposity. Glucose intolerance, adiposity, and sex influenced variables independently. Risk of atherosclerosis is partly attributable to persistent hyperglycemia and related metabolic abnormalities in overt diabetics. Postchallenge diabetics have subtle hyperglycemia but a high frequency of other risk factors. Recent developments suggest that control of blood glucose may become feasible and useful in the prevention of cardiovascular disease in overt and challenged diabetics.
Annals of the Rheumatic Diseases, Jun 1, 2015
Background: Antibody profiling encompassing rheumatoid factor (RF) and anti-citrullinated peptide... more Background: Antibody profiling encompassing rheumatoid factor (RF) and anti-citrullinated peptide antibodies (ACPA) supports diagnosis in patients with Rheumatoid arthritis (RA). However, RF and ACPA are not specific for RA, and predictive values of tests depend heavily on the selection of individuals in which such tests are performed. Because testing for these antibodies is frequently ordered by non-Rheumatologists, at substantial costs, we sought to determine the predictive values of such testing in patients of a large tertiary hospital. Objectives: To evaluate the positive and negative predictive values (PPV, NPV) of RF and ACPA tested in a pre-selected population of all patients of the Vienna general hospital between 2006 and 2012. Methods: Results of all RF and ACPA tests performed between 2006 and 2012 were obtained from the Department of Laboratory Medicine and the ordering departments were determined. Diagnoses were extracted from the hospital-wide database. Results: Between 2006 and 2012 more than 45,000 RF and ACPA tests in 5496 patients were performed. Among these, 21% were positive for RF, 3% for ACPAs and 22% were positive for both antibodies. For 2250 patients (41% of all patients in whom RF/ACPA was tested) the tests were not ordered by the Department of Rheumatology. The tests were requested by the Departments of Infectiology (32.5%), Angiology (11.1%), Orthopedics (8%), Nephrology (8%), and Dermatology (7%). 1572 of these 2250 patients had a documented diagnosis. Figure 1 shows the distribution of diseases according to the ICD-10. Among the 2250 patients 134 (6%) were positive for RF, 72 (3.2%) for ACPA and 31 (1.4%) patients tested positive for both antibodies. PPV and NPV for the presence of musculoskeletal diseases were 22.4% and 89.9% for RF and 26.4% and 88.8% for ACPA testing. However, for presence of chronic inflammatory musculoskeletal diseases (ICD-10-Codes M05.X to M09.X and M30.X to M35.X) PPV was only 11.9% for RF and 16.7% for ACPA. NPV was 95.3% and 95.2%, respectively. Conclusions: RF and ACPA testing was frequently ordered by non-Rheumatologists. In this patient group, we found a relatively high NPV (95%) but a very low PPV of 11-17%. Thus, >83% of positive tests did not contribute to a diagnosis of inflammatory musculoskeletal disease. This observation underscores the necessity to use such testing only in the appropriate clinical context.
Annals of the Rheumatic Diseases, Jun 1, 2015
JAMA: The Journal of the American Medical Association, 1980
Physiological variables were compared among women who had never used oral contraceptives, past us... more Physiological variables were compared among women who had never used oral contraceptives, past users, and current users. Randomly selected subjects were aged 30 to 59 years. Blood was sampled for determination of blood glucose, serum cholesterol and triglyceride, and plasma insulin concentration. Summed postchallenge glucose and insulin values were used in analyses to represent the magnitude of response. Contours of glucose and insulin curves were represented by single numerical variables termed "G-CON" and "I-CON." Current users of oral contraceptives had significantly higher values of G-CON, I-CON, triglyceride, and systolic blood pressure than women who never used oral comtraceptives. Current users also had significantly higher levels of summed glucose, G-CON, and I-CON than former users. Use of currently prescribed oral contraceptives is associated with adverse physiological changes that are reversible after discontinuing such use.
International Journal of Epidemiology, 1989
Relationships between cardiovascular disease (CVD) mortality and breathlessness, a definition of ... more Relationships between cardiovascular disease (CVD) mortality and breathlessness, a definition of chronic bronchitis, and pulmonary function are investigated among men in two employed populations (17,717 London civil servants and 4904 Scottish workers) and in two communities (844 men in Tecumseh, Michigan and 6859 men in Renfrew and Paisley Burghs, Scotland). Men are aged 40-64 years at entry in all studies except Renfrew-Paisley, where they are aged 45-64 years. Length of follow-up ranges from 6 to 16 years. Age and smoking habits were controlled for in all analyses. Chronic phlegm production is not significantly associated with CVD mortality, and &amp;#39;chronic bronchitis&amp;#39; is significantly associated with mortality only in the employed populations. Low FEV1 is significantly associated with CVD mortality only in the Whitehall study; however, the rate ratios are above one in all studies. Breathlessness is significantly associated with CVD mortality in all studies. These associations between CVD mortality and &amp;#39;chronic bronchitis&amp;#39;, low FEV1, and breathlessness persist after also controlling for employment grade, systolic blood pressure, antihypertensive medication, ECG changes, plasma cholesterol level, body mass index and diabetes. Only the associations between breathlessness and mortality persist after further controlling for low FEV1 and myocardial ischaemia. The rate ratios between breathlessness and mortality are about two for all studies. It is concluded that in these populations, breathlessness is an independent and major predictor of CVD mortality.
Contraception, 2007
Materials and Methods: In this cross-sectional study, endometrial biopsies were performed on 20 D... more Materials and Methods: In this cross-sectional study, endometrial biopsies were performed on 20 DMPA users who were having BTB and 20 DMPA users who were amenorrheic. CE was defined as greater than or equal to two plasma cells per endometrial sample. We used polymerase chain reaction technology to identify CT in paraffin-embedded endometrial biopsy tissue sections using a method developed by our laboratory. Negative and positive controls were validated for each specimen. Results: CE was the most common histologic finding (10/40, 25%) and occurred more often in women experiencing BTB (35% vs. 15%) (RR 1.62, 95% CI 0.91-2.87). Two patients, one with amenorrhea and one with BTB, neither with CE, were found to have CT endometritis. Conclusion: CT was not a cause of CE in this population of at-risk patients using DMPA. It is possible that CE in DMPA users reflects an inflammatory state, a function of an atrophic endometrium. This suggests the possibility of using nonsteroidal anti-inflammatory drugs for CE and BTB rather than antimicrobials or hormonal medication.
The online version of this article, along with updated information and services, is located on
Background A cohort of 2181 men and women, aged 40 to 79 years, without evidence of coronary hear... more Background A cohort of 2181 men and women, aged 40 to 79 years, without evidence of coronary heart disease or cancer at entry to the Tecumseh Study was evaluated. Methods and Results Subjects were defined as lean if their Metropolitan Life Insurance table relative weight was <110 (n=584) and as obese if their relative weight was 2120 (n= 1024). There were 688 subjects with hypertension at study entry (systolic blood pressure >160, diastolic blood pressure >95, or treated). The 29-year relative risk (RR) of mortality from ischemic heart disease (IHD) or cardiovascular disease (CVD) associated with systolic blood pressure level was significant for both lean and obese subjects. Among hypertensive subjects, the RR of fatal IHD for lean versus obese hypertensive subjects was 1.87 (95% confidence interval, 1.21 to 2.88) and the RR of fatal CVD was 1.56 (95% confidence interval,
ABSTRACT Dissertation (Ph.D.)--University of Michigan.
Journal of General Internal Medicine
Pharmacoepidemiology and Drug Safety
Objectives were to quantify prevalence estimates of pregnancy and infant outcomes including major... more Objectives were to quantify prevalence estimates of pregnancy and infant outcomes including major congenital malformations (MCMs) by etanercept (ETN) exposure among infants born to women with chronic inflammatory arthritis (cIA) or psoriasis (PsO). Claims-based data delineated pregnancy exposures and outcomes of live or nonlive births among women with cIA and PsO (ETN exposed, unexposed) and general population (GP) comparators. Infant outcomes were determined for live-born infants covered by the mother's insurer. Medical records were obtained from all accessible mother-infant pairs with claims for MCMs and a random sample of mothers. Multivariable logistic regression estimated the odds ratios (ORs) of having at least one algorithm-defined MCM in the ETN-exposed cohorts versus unexposed comparators. Prevalence estimates for pregnancy outcomes were comparable across cIA and PsO cohorts. Algorithm-defined prevalence estimates of having at least one MCM were 6.1% (ETN exposed), 5.5% (unexposed), and 5.7% (GP cohort) for the cIA cohort; PsO cohort estimates were 2.0%, 4.2%, and 4.7%, respectively. The ETN-exposure ORs for having at least one algorithm-defined MCM among infants of cIA mothers was 1.03 (95%CI: 0.51-2.10) and 0.39 (95%CI: 0.05-2.98) among infants of PsO mothers. Logistic regression with inverse probability of treatment weighting that included disease state resulted in an OR of 0.65 (0.24, 1.72). Overall, this study did not identify any new safety concerns associated with the use of etanercept during pregnancy. Etanercept, along with the other TNFis, remains a treatment without well-controlled clinical trials in pregnant women. Patients should continue to consult their doctor regarding benefit risk decisions of TNFi therapy during pregnancy.
American Journal of Epidemiology
Page 1. AMERICAN JOURNAL OF EPIDEMIOLOOY Vol. 116, No. 6 Copyright © 1982 by The Johns Hopkins Un... more Page 1. AMERICAN JOURNAL OF EPIDEMIOLOOY Vol. 116, No. 6 Copyright © 1982 by The Johns Hopkins University School of Hygiene and Public Health Printed in USA. All rights reserved DIABETES MELLITUS IN TECUMSEH, MICHIGAN ...
Journal of pregnancy, 2016
Objective. To examine pregnancy and birth outcomes among women with idiopathic thrombocytopenic p... more Objective. To examine pregnancy and birth outcomes among women with idiopathic thrombocytopenic purpura (ITP) or chronic ITP (cITP) diagnosed before or during pregnancy. Methods. A linkage of mothers and babies within a large US health insurance database that combines enrollment data, pharmacy claims, and medical claims was carried out to identify pregnancies in women with ITP or cITP. Outcomes included preterm birth, elective and spontaneous loss, and major congenital anomalies. Results. Results suggest that women diagnosed with ITP or cITP prior to their estimated date of conception may be at higher risk for stillbirth, fetal loss, and premature delivery. Among 446 pregnancies in women with ITP, 346 resulted in live births. Women with cITP experienced more adverse outcomes than those with a pregnancy-related diagnosis of ITP. Although 7.8% of all live births had major congenital anomalies, the majority were isolated heart defects. Among deliveries in women with cITP, 15.2% of live...
Seminars in Arthritis and Rheumatism, May 1, 1989
Dissertation (Ph.D.)--University of Michigan.
Journal of the American Medical Women's Association (1972), 2001
to estimate the prevalence of gestational diabetes mellitus (GDM), obesity, and excessive weight ... more to estimate the prevalence of gestational diabetes mellitus (GDM), obesity, and excessive weight gain during pregnancy among Latinas and African-American women in a large Detroit health system and explore risk factors associated with GDM and its implications. Descriptive statistics, chi2 tests, analysis of variance, and logistic regression analyses were used to describe the prevalence of obesity, excessive pregnancy weight gain, and GDM and to assess factors associated with GDM risk in a cohort of 552 African-American women and 653 Latinas in a large Detroit health system. Women ranged in age from 14 to 47 years. Almost 47% of African-American women and 37% of Latinas were overweight or obese, and 53% of African-American women and 38% of Latinas gained excessive weight during pregnancy. The prevalence of GDM was 5.4% among Latinas and 3.9% among African-American women. After adjusting for other risk factors, Latinas were 2.5 times more likely than African Americans to develop GDM. O...
American journal of epidemiology, Jan 15, 1994
The Tecumseh Community Health Study provides an opportunity to investigate the role of obesity in... more The Tecumseh Community Health Study provides an opportunity to investigate the role of obesity in the etiology of osteoarthritis. This longitudinal study, conducted in Tecumseh, Michigan, began in 1962 with baseline examinations of clinical, biochemical, and radiologic characteristics. A 1985 reexamination of the cohort characterized osteoarthritis status in 1,276 participants, 588 males and 688 females, who were aged 50-74 years at this follow-up. Baseline obesity, as measured by an index of relative weight, was found to be significantly associated with the 23-year incidence of osteoarthritis of the hands among subjects disease free at baseline. Greater baseline relative weight was also associated with greater subsequent severity of osteoarthritis of the hands. The difference between baseline and follow-up weight values was not significantly associated with the incidence of osteoarthritis of the hands. Furthermore, there was no evidence that development of osteoarthritis subsequent...
American journal of epidemiology, 1982
A high proportion of the population of Tecumseh, Michigan, participated in comprehensive assessme... more A high proportion of the population of Tecumseh, Michigan, participated in comprehensive assessments of health, personal habits, and socioeconomic status during the periods 1959-1960 and 1962-1965. A total of 5735 persons older than 20 years of age, comprising 2749 men and 2986 women, form the subject of this report. Diabetics were identified at entry and contrasted to nondiabetics with respect to personal characteristics. During the period 1977-1979, health status of 69% of the eligible cohort was ascertained. Age, adiposity, and blood glucose level were the principal predictor of new cases of diabetes. Family history was a significant predictor only among middle-aged, overweight men. Diabetes tended to be related to central fat distribution as indicated by subscapular skinfold thickness. Predictors of new cases of diabetes were not necessarily related to prevalence of the disease in this population.
American journal of epidemiology, 1985
The coronary heart disease mortality of participants in the Tecumseh study was examined with part... more The coronary heart disease mortality of participants in the Tecumseh study was examined with particular emphasis on the roles of diabetes and glucose tolerance as risk factors. The cohort consisted of 921 men and 937 women aged 40 years and older who did not have evident coronary heart disease at entry to the study during the period 1959-1965 and whose outcome was determined in the period 1977-1979. Previously diagnosed diabetes was a statistically significant risk factor for coronary heart disease mortality in both sexes even after controlling for systolic blood pressure, serum cholesterol, relative weight, and cigarette smoking. High blood glucose score in nondiabetics was associated with excess coronary heart disease mortality after controlling for other risk factors, but the magnitude of this effect was substantially below that of diabetes. The predictive power of most risk factors except age itself decreased among progressively older segments of the population.