Tuesday 7 October 1997: Posters Menopause 175

ones in younger adults. A medical intervention would be necessary in a high number of persons following the general recommendations.

We observed no positive association between food intake and the lipid profile in this group.

)2.p.280) Serum sialic acid in elderly

J. Viiava’, R. C&i’, G. Subramanyam’ , Ch. Appa Rae’. IDepartment of Cardiology, S.VR.R.G.G. Hospital and S.VM. College, lirupati, 7 (A.P); 2Department of Biochemistry, S. V University, Tirupati (A. P). India

We have studied serum sialic acid levels in elderly subjects (n = 150). Coronary risk factors were recorded. Serum sialic acid, total-C, HDL-C, Tg, LDL-C, VL DL-C and glucose levels ware estimated ECG was also recorded. It was observed that 25% were angina pectoris and 42% were hypertensives. The remaining were normals with out any chronic diseases. High serum sialic acid levels were observed in 75% of angina pectoris, 70% of hypertensives. High serum glucose total-C, Tg and LDL-C were observed in angina pectoris and hypertensives, when compared with normals. An elevated serum lipid profile was a risk factor in cardiovascular disease. However, serum sialic acid was elevated in elderly with angina pectoris and hypertensives. Hence, serum sialic acid was a strong predictor of cardiovascular disease.

a 2.P281 Risk factors for aortic atherosclerosis in elderly men and women

J.C.M. Witteman, H.A.P. Pols, A. Hofman. Department of Epidemiology & Biostatistics, Erasmus University Medical School, Rotterdam, The Netherlands

Few data are present on risk factors for atherosclerosis in a healthy elderly population. We studied risk factors for aortic atherosclerosis in a population- based study of 7983 subjects aged 55 years and over (Rotterdam Study). In the second phase of the study, all participants were examined radiographically for calcified deposits in the abdominal aorta, which have been shown to represent intimal atherosclerosis. Subjects with selfreported cardiovascular disease were excluded. Mild and moderate to severe atherosclerosis were observed in 20 and 37% of men and 19 and 36% of women, respectively.

In men, moderate to severe aortic atherosclerosis was independently associ- ated with systolic blood pressure [OR (per 10 mmHg) 1.16, 95% confidence interval 1.09-1.221, smoking (>= 20 cig/day vs none) (1.9,l. l-3.3) and serum total cholesterol (per mmol/l) (1.2, 1.0-1.3). In women, moderate to severe atherosclerosis was independently associated with systolic blood pressure (per 10 mmHg) (1.14, 1.08-1.20), smoking (>= 10 c&/day vs none) (6.8,4.8-9.7), serum total cholesterol (per mmov1) (1.3, 1.2-1.4), HDL-cholesterol (per mmol/l) (0.5,0.4-0.7) and diabetes (1.4, 1.0-2.1). Associations with waist-hip ratio in both sexes were largely mediated by other risk factors. These results show that the known cardiovascular risk factors are associated with aortic atherosclerosis in an elderly population. Risk factors known to cluster with diabetes mellitus were most pronounced in women.

a 2 P 282 White cell count and cardiovascular risk factors in the elderly. The Val Vibrata Aging project

G. Zuliani, E. Palmieri, S. Volpato, F. Costantinit , A. Mezzetti’ , T. Imbastaro2, R. Fellin. Associazione Medica Sabin, Nereto, Teramo; 2”d Department of Internal Medicine, University of Ferrara; ‘Institute of Physiopathology, University of Chieti; 2Laboratory of Clinical Pathology, Hospital S.S. Annunziata, Chieti. Italy

White blood cell count (WBC) have been found to be a risk factor for coronary heart disease (CHD), stroke, and all cause mortality in adult populations. Leukocyte count, as well as monocyte (MC), lymphocyte (LC), and neutrophil (NC) counts, have been associated with several risk factor for CHD. Less is known about the relationship between WBC and other CHD risk factors in very old individuals. We studied a large number of clinical chemistry parameters, including white cell count, in 130 free-living healthy octo-nona- genarians (72 M and 58 F, mean age 84.5 f 3.2 yrs) from the Vibrata valley (Italy). Inclusion criteria were: 1) no history of cardiovascular, respiratory, and neurological disease, neoplasia, diabetes, severe arthrosis, major depression, alcoholism; 2) absence of abnormal changes in clinical chemistry parameters; 3) no disability; only subjects in A-B class of the Katz index were enrolled. The W.H.O. questionnaire was used to rule out CHD and peripheral artery disease. WBC was correlated with log-triglycerides (TG)(r: 0.27, p < 0.002) apo B (r: 0.20, p < 0.02) and fasting plasma glucose (r: 0.16, p < 0.06).

NC was correlated with log-TG (r: 0.21, p < 0.01) and HDL-C (r: -0.15, p < 0.07). LC was associated with plasma total cholesterol (TC) (r: 0.24, p < 0.005), log-TG (r: 0.24, p < 0.005), apo B (r: 0.29, p < O.oOl), HDL-C (r: 0.17, p < 0.04) and fasting glucose (r: 0.18, p < 0.03). MC was correlated with log-TG (r: -0.22, p < 0.01). Fibrinogen was correlated with NC (r: 0.22, p < 0.03). Hypertriglyceridemic subjects had higher WBC, NC, and LC, while smokers had higher LC but lower NC; hypercholesterolernic subjects had higher MC and LC. Fasting plasma insulin >75” percentile was associated with higher MC. Age was negatively correlated with WBC (r: -0.19, p < 0.02). and L.C (r: -0.22, p < 0.01). Multiple regression analysis showed an association of WBC with TG and age (3: 0.12), and LC with TG, TC, and age (f: 0.12). Conclusions are: 1) WBC, LC, NC and MC are correlated with some major risk factors for atherosclerosis also in very old individuals, 2) in our sample, only TG are independently associated with WBC and LC.

I. 2 P.283 Yutritional and functional status independently influence the ‘Lipoprotein proiile in institutionalized elderly subjects. ‘The I.R.A. study

G. Zuliani, F. Romagnoni, E. Palmieri, S. Volpato, R. Fellin. 2& Department of Internal Medicine, University of Ferrara, Italy

As a consequence of comorbidity and disability the meaning of lipoprotein parameters m old individuals is complex. Some lipid profile alterations seem to be associated with coronary heart disease in the elderly, but the deterioration of health and/or functional status often induce significant modifications on lipid parameters. We studied a large number of anthropometric, metabolic (including lipoprotein profile), and nutritional parameters in a sample of 344 institutionalized elderly individuals (272 females and 72 males) living in a nursing home (I.R.A.) in Padua (Italy). The aim of the study was to evaluate the contribution of diierent factors associated with chronic illness, and of disability to the modification of plasma lipids. Basic activities of daily living were evaluated by the Katz index; age, number of pathologies and drugs were recorded. Total cholesterol, LDL-cholesterol, HDL-cholesterol, apo B, and apo A-I were significantly lower in the subjects with mild/high disability (Katz class D-G) compared with subjects with low disability (Katz class: A-C); no differences in triglycerides levels were found. Stepwise multiple regression analysis was used to test the association of lipoprotein parameters with metabolic, nutritional, and anthropometric parameters, and functional status. The nutrition indicators (transfertin and albumin) were positively asso- ciated with all plasma lipoprotein parameters levels; T3 levels were positively associated with apo B, LDL-C and triglycerides levels. The functional status was associated only with serum HDL-C and apo A-I: the higher the disability level, the lower HDL-C and apo A-I levels. Logistic regression analysis was then used to test the association of functional status with metabolic parameters. Subjects were divided in 2 categories: low/mild disability (Katz class:A-E), and high disability (Katz: F-G); age, gender, and number of pathologies were included as confounding variables. Among the lipid parameters, only HDL-C was included into the final lo&tic model (hieh disabilitv O.R. for HDL-C t40 mg/dl vs >50 mg/dl: 2.08; p < 0.003). Co&lusions are the following: 1) the nutritional status is associated with significant modifications of lipoprotein profile, 2) T3 levels are associated with apo B containing lipoprotein levels; 3) the fun-ctional status is specifically and independently associated with HDL-C levels.

1 2.P.284 ]

MENOPAUSE

Plasma lipid levels associated with transdetmal estrogen replacement therapy in south-western French postmenopausal women

V. Bonnam, J.B. Ruidavets, J. Fen&es. INSERM CJF 94-06, Faculty of Medicine, Epidemiology Laboratory, Toulouse, France

The association of 17B-estradiol (mainly transdermal) and progestin is the most commonly used hormone replacement therapy in France. However, the effects of transdermal estrogen on plasma lipids and lipoproteins is less well established than for oral estrogen. The aim of this cross-sectional study was to assess those effects. We studied 245 post menopausal women selected from the 569 women recruited within the Toulouse MONICA survey on cardiovascular risk factors (1995-1996). The criteria of postmenopausal status were: previous bilateral oophorectomy, intact utc~s with no menstruation for more than 12 months, and hysterectomy without bilateral oophorectomy if they were older

11th International Symposium on Atherosclerosis, Paris, October 1997