Diabetes Drug Pioglitazone Associated With Bladder Cancer Risk

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Main Category: Cancer / Oncology
Also Included In: Urology / Nephrology;  Diabetes
Article Date: 01 Jun 2012 - 0:00 PDT Current ratings for:
'Diabetes Drug Pioglitazone Associated With Bladder Cancer Risk'

According to a study published in British Medical Journal (BMJ), a drug for treating type 2 diabetes called Pioglitazone is linked to a higher risk of bladder cancer and taking the drug continuously for longer than two years doubles the risk. The researchers stress, however, that the risk in absolute terms is relatively low with up to 137 extra cases per 100,000 person years.

Rosiglitazone, which is a similar drug, showed no increased risk. Both pioglitazone and rosiglitazone are thiazolidinediones, which help control blood sugar levels in patients with type 2 diabetes and are known to increase the risk of heart failure, yet following a safety review, the European Medicines Agency (EMA) decided to keep pioglitazone on the market. ??

A Canadian team of researchers decided to investigate if pioglitazone was linked to a higher risk of bladder cancer in people with type 2 diabetes and after obtaining data from the General Practice Research Database (GPRD), they evaluated 115,727 patients who initiated diabetes therapy from 1988 to 2009. The GPRD contains anonymous patient records from over 600 UK GPs. The team identified cases of bladder cancer and matched them to up to 20 healthy control patients. ??

The results revealed that from 376 cases that were matched against 6,699 controls, 470 patients were diagnosed with bladder cancer during the average 4.6 years of follow-up, which translates to a rate of 89 per 100,000 person years, whilst the rate of bladder cancer in the general UK population aged 65 years and above is 73 per 100,000 person years. ??

Patients who had taken pioglitazone at any time were found to have a 83% higher risk of bladder cancer, which translates into 74 per 100,000 person years. The figures increased to 88 per 100,000 person years for those who had taken the drug for two years or longer and increased even further, to 137 per 100,000 person years those who had taken 28,000mg or more. ??

The researchers cross-checked the results in several further analyses, but the results remained consistent, and "provide evidence that pioglitazone is associated with an increased risk of bladder cancer, whereas no increased risk was observed with the thiazolidinedione rosiglitazone."??

They believe that these links may have been underestimated during earlier observational studies and comment that doctors, patients and regulatory agencies "should be aware of this association when assessing the overall risks and benefits of this therapy."??

Dominique Hillaire-Buys and Jean-Luc Faillie from the Department of Medical Pharmacology and Toxicology in Montpellier, France comment in a linked editorial: "It can confidently be assumed that pioglitazone increases the risk of bladder cancer. It also seems that this association could have been predicted earlier."

They continue saying that in view of pioglitazone's benefits of reducing cardiovascular events being questionable, they remark that, "prescribers who are ultimately responsible for therapeutic choices can legitimately question whether the benefit-risk ratio of pioglitazone is still acceptable for their patients with diabetes."

Written By Petra Rattue
Copyright: Medical News Today
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7 Jun. 2012. APA

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Tree Nut Consumption Associated With Better Diet Quality In Children And Adults

Main Category: Nutrition / Diet
Also Included In: Heart Disease;  Cholesterol
Article Date: 15 Apr 2012 - 0:00 PDT Current ratings for:
'Tree Nut Consumption Associated With Better Diet Quality In Children And Adults'

In a study published in Nutrition Research, researchers looked at the association of out-of-hand nut (OOHN) consumption with nutrient intake, diet quality and the prevalence of risk factors for cardiovascular disease and metabolic syndrome in both children and adults. Consumers of OOHN, including tree nuts (almonds, Brazil nuts, cashews, hazelnuts, macadamias, pecans, pine nuts, pistachios and walnuts), had higher intakes of energy, monounsaturated and polyunsaturated fats (the good fats) and dietary fiber, and lower intakes of carbohydrates, cholesterol and sodium than non-consumers.

"Adult consumers also had a 19% decreased risk of hypertension and a 21% decreased risk of low high-density lipoprotein (HDL - -the good cholesterol) levels - both risk factors for metabolic syndrome and cardiovascular disease," stated Carol O'Neil, PhD, MPH, RD, lead author on the paper and Professor at Louisiana State University Agricultural Center.

The study looked at 24,385 individuals aged 2+ years participating in the 1999-2004 National Health and Nutrition Examination Surveys (NHANES). Intake was from 24-hour recall data and OOHN consumers were defined as those who consumed at least ¼ ounce of nuts per day, solely as nuts and not as part of products (i.e., in breads, cereals and bars.)

According to Dr. O'Neil, "We decided to look at OOHN specifically because this shows an individual's conscious decision to consume nuts, which may be associated with a desire for a healthier lifestyle." Interestingly, the percent of OOHN consumers increased with age: 2.1% ± 0.3%, 2.6% ± 0.3%, 6.5% ± 0.5%, and 9.6% ± 0.5% of those aged 2 to 11, 12 to 18, 19 to 50, and 51+ years, respectively. The two latter groups were combined into a single group of consumers aged 19+ years for subsequent analyses.

"In all of the age groups, although energy intake was higher in OOHN consumers than non-consumers, neither weight nor body mass index (BMI) was higher. This suggests that OOHN consumers are better able to balance energy intake with energy output than non-consumers," stated Dr. O'Neil. This research comes on the heels of another study by the same authors, published in the Journal of the American College of Nutrition, which showed that tree nut consumers specifically (ages 19+) had lower body weight, as well as lower BMI and waist circumference compared to non-consumers. The mean weight, BMI, and waist circumference were 4.19 pounds, 0.9kg/m2 and 0.83 inches lower in consumers than non-consumers, respectively.

"These new data, along with previous research, show once again that nuts can and should play an important role in a healthy diet," adds Maureen Ternus, M.S., R.D., Executive Director of the International Tree Nut Council Nutrition Research & Education Foundation (INC NREF). "With current nut consumption well below the recommended 1.5 ounces of nuts per day (in the FDA qualified health claim for nuts and heart disease) people should be encouraged to grab a handful of nuts every day. Eat them as a snack or throw some on yogurt, salad or oatmeal."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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Gestational Diabetes Risk Associated With Antipsychotic Drugs During Pregnancy

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Main Category: Pregnancy / Obstetrics
Also Included In: Diabetes;  Psychology / Psychiatry
Article Date: 03 Jul 2012 - 10:00 PDT Current ratings for:
Gestational Diabetes Risk Associated With Antipsychotic Drugs During Pregnancy

Women who take antipsychotic drugs during pregnancy are more likely to develop gestational diabetes, say researchers.

The study, conducted by Robert Bodén. M.D., Ph.D., of the Centre for Pharmacoepidemiology, Karolinska Institutet, Stockholm, and Uppsala University, Uppsala, Sweden, and colleagues, is published in Archives of General Psychiatry.

Antipsychotic drugs are used to treat severe mental illnesses such as schizophrenia and bipolar disorder, "however, the evidence concerning use of antipsychotics during pregnancy is generally lacking or weak," say the researchers.

For the study, the team examined medical records of Swedish women who gave birth in Sweden between July 2005 and December 2009. Of the women examined, 357,696 had no prescriptions for antipsychotics, 169 women were prescribed the antipsychotics olanzapine and/or clozapine, and 338 were prescribed other antipsychotics.

The researchers said:

"Gestational diabetes was more than twice as common in mothers who used antipsychotics (seven mothers [4.1 percent] for those prescribed olanzapine and/or clozapine and 15 [4.4 percent] for those prescribed other antipsychotics) than in the total population of pregnant women (5,970 [1.7 percent])."

Although the team found that women were more likely to give birth to a small for gestational age (SGA) infant if they were using antipsychotics, the risk was no longer statistically significant after adjusting for maternal factors.

The researchers explained:

"In conclusion, maternal use of antipsychotics during pregnancy, regardless of the drug group, is associated with an increased risk of gestational diabetes. The increased risk of giving birth to an SGA infant observed among women treated with antipsychotics during pregnancy is probably an effect of the confounding factors, such as smoking."

In addition, results showed that exposure to olanzapine and/or clozapine did not increased the risks of being large for gestational age (LGA) for birth weight or birth length. However, the risks did increase for head circumference.

The researchers conclude: "Pregnant women treated with antipsychotics should be closely monitored for gestational diabetes and deviating fetal growth."

Written by Grace Rattue
Copyright: Medical News Today
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