Michael J LaMonte

State University of New York, New York, New York, United States

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Publications (139)720.79 Total impact

  • Cancer Research 08/2015; 75(15 Supplement):848-848. DOI:10.1158/1538-7445.AM2015-848 · 9.28 Impact Factor
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    ABSTRACT: Background: Declines in endogenous estrogen levels after menopause can lead to systemic bone loss, including loss of oral bone and alveolar crestal bone height (ACH). However, few studies have assessed both serum 17β-estradiol (E2) and exogenous hormone therapy (HT) use in relation to oral bone loss. Methods: We examined the associations between serum E2, HT use and ACH in 613 postmenopausal women from the Buffalo OsteoPerio study. Baseline ACH levels and 5-year ACH were assessed for E2 level groups (non-detectable, 5.00-18.00, 18.00-46.07, and >46.07 pg/ml) and among HT use (never, ever) using analysis of variance and analysis of covariance. Logistic regression was used to analyze the association of ACH loss with serum E2 and HT use. Results: In cross-sectional analyses, we found no association of serum E2 with whole mouth mean or worst site ACH. However, history of HT use was associated with ACH. Women who had never used HT had more ACH loss when assessed as a whole mouth mean ACH (p-value=0.01) and as worst site of ACH loss (p-value=0.03). In logistic regression analyses of baseline ACH loss severity, HT never users had a 2-fold higher odds of being in the severe ACH loss category compared to ever users (OR=2.00; 95% CI: 1.11-3.62). We observed no association of five-year change in ACH with baseline serum E2 or HT use. Conclusion: While our study did not detect an association with current serum E2 level and ACH, we found HT use to be associated with less ACH loss in postmenopausal women.
    Journal of Periodontology 01/2015; 86(4):1-17. DOI:10.1902/jop.2015.140533 · 2.57 Impact Factor
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    ABSTRACT: INTRODUCTION: Obesity is a major risk factor for physical disability in older adults. The contribution of early onset of obesity and weight history to physical impairment later in life remains inconclusive. METHODS: Postmenopausal women (n=76,016, 63.5 ± 7.3 years) recalled weight and height at ages 18, 35, 50 years and reported it at their baseline measurement. Standard body mass index (BMI=kg/m2) categories were used to evaluate associations between early onset obesity and weight transitions on severe physical impairment (SPI), defined as scoring < 60 on the Rand 36-Item Health survey. RESULTS: Women reporting being overweight or obese at 18 years had a higher likelihood of SPI (1.48, 95% Confidence Interval (CI): 1.32-1.65; and 2.07, 95% CI: 1.66-2.58, respectively) than normal weight counterparts. Weight changes from normal to high (overweight/obese) or underweight BMI’s yielded higher SPI rates [1.98 (1.82-2.12) and 1.34 (1.07-1.70), respectively] compared to women who remained weight stable. Women shifting from underweight to high BMI’s were more likely to have SPI [1.57 (1.15-2.14)]. High to normal BMI transitions resulted in a lower SPI rate [0.52 (0.39-0.70)]. Results were adjusted for demographics, behaviors, comorbidities and medications. DISCUSSION: Obesity in early adulthood was associated with higher severe physical impairment rates later in life. Weight transitions toward being underweight, overweight or obese also increased the risk of SPI. In contrast, overweight women who lost weight over their lifetime show reduced risk of impairment. Maintenance of a healthy body weight throughout life is important for reducing risk of physical impairment.
    142nd APHA Annual Meeting and Exposition 2014; 11/2014
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    ABSTRACT: Objectives: We evaluated the association between childhood physical activity and incident cardiovascular disease (CVD) during the postmenopausal years. Methods: Proportional hazards and logistic regression were used to describe the association between self-reported childhood physical activity and CVD incidence and mortality in 36,741 postmenopausal women. Results: Older women, African Americans, and nondrinkers or past drinkers self-reported the highest levels of youth physical activity and women with a history of diabetes, hypertension, overweight or obesity, or current smoking reported the highest youth physical activity dose. Youth physical activity was not associated with CVD incidence (HR=1.11; 0.93, 1.34) or mortality (HR=1.2; 0.9, 1.73). Conclusions: Self-reported youth activity was not associated with postmenopausal CVD incidence or mortality.
    11/2014; 1(6). DOI:10.14485/HBPR.1.6.5
  • Cancer Research 10/2014; 74(19 Supplement):256-256. DOI:10.1158/1538-7445.AM2014-256 · 9.28 Impact Factor
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    ABSTRACT: Background-Healthy levels of lifestyle factors can reduce the risk of cardiovascular disease. However, except for smoking status, often considered a traditional risk factor, their effect on cardiovascular risk prediction is unclear. Methods and Results-We used a case-cohort design of postmenopausal nonsmokers in the multiethnic Women's Health Initiative Observational Study (1587 cases and 1808 subcohort participants) with a median follow-up of 10 years in noncases. Compared with nonsmokers with no other healthy lifestyle factors (healthy diet, recreational physical activity, moderate alcohol use, and low adiposity), the risk of cardiovascular disease was lower for each additional factor (hazard ratio for trend, 0.82; 95% confidence interval, 0.76-0.89), with a 45% reduction in risk with all factors (95% confidence interval, 0.36-0.84). When lifestyle factors were added to traditional risk factor models (variables from the Pooled Cohort and Reynolds risk scores), only recreational physical activity remained independently associated with the risk of cardiovascular disease. The addition of detailed lifestyle measures to traditional models showed a change in the integrated discrimination improvement and continuous net reclassification improvement (P<0.01 for both) but had little impact on more clinically relevant risk stratification measures. Conclusions-Although lifestyle factors have important effects on cardiovascular disease risk factors and subsequent risk, their addition to established cardiovascular disease risk models does not result in clear improvement in overall prediction.
    Circulation 08/2014; 130(17). DOI:10.1161/CIRCULATIONAHA.114.012069 · 14.95 Impact Factor
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    ABSTRACT: Objectives: Mean and visit-to-visit variability (VVV) of blood pressure (BP) are associated with an increased cardiovascular disease risk. We examined the effect of hormone therapy on mean and VVV of BP in postmenopausal women from the Women's Health Initiative (WHI) randomized controlled trials. Methods: BP was measured at baseline and annually in the two WHI hormone therapy trials, in which 10 739 and 16 608 postmenopausal women were randomized to conjugated equine estrogens (CEEs, 0.625 mg/day) or placebo, and CEEs and medroxyprogesterone acetate (MPA, 2.5 mg/day) or placebo, respectively. Results: At the first annual visit (year 1), mean SBP was 1.04 mmHg [95% confidence interval (CI) 0.58, 1.50] and 1.35 mmHg (95% CI 0.99, 1.72) higher in the CEEs and CEEs and MPA arms, respectively, compared with the corresponding placebos. These effects remained stable after year 1. CEEs also increased the VVV of SBP (ratio of VVV in CEEs vs. placebo, 1.03; P < 0.001), whereas CEEs and MPA did not (ratio of VVV in CEEs and MPA vs. placebo, 1.01; P = 0.20). After accounting for study drug adherence, the effects of CEEs and CEEs and MPA on mean SBP increased at year 1, and the differences in the CEEs and CEEs and MPA arms vs. placebos also continued to increase after year 1. Further, both CEEs and CEEs and MPA significantly increased the VVV of SBP (ratio of VVV in CEEs vs. placebo, 1.04; P < 0.001; ratio of VVV in CEEs and MPA vs. placebo, 1.05; P < 0.001). Conclusion: Among postmenopausal women, CEEs and CEEs and MPA at conventional doses increased mean and VVV of SBP.
    Journal of Hypertension 07/2014; 32(10). DOI:10.1097/HJH.0000000000000287 · 4.72 Impact Factor
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    ABSTRACT: Background-Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with increased risk of stroke and death. Obesity is an independent risk factor for AF, but modifiers of this risk are not well known. We studied the roles of obesity, physical activity, and their interaction in conferring risk of incident AF. Methods and Results-The Women's Health Initiative (WHI) Observational Study was a prospective observational study of 93 676 postmenopausal women followed for an average of 11.5 years. Incident AF was identified using WHI-ascertained hospitalization records and diagnostic codes from Medicare claims. A multivariate Cox's hazard regression model adjusted for demographic and clinical risk factors was used to evaluate the interaction between obesity and physical activity and its association with incident AF. After exclusion of women with prevalent AF, incomplete data, or underweight body mass index (BMI), 9792 of the remaining 81 317 women developed AF. Women were, on average, 63.4 years old, 7.8% were African American, and 3.6% were Hispanic. Increased BMI (hazard ratio [HR], 1.12 per 5-kg/m(2) increase; 95% confidence interval [CI], 1.10 to 1.14) and reduced physical activity (>9 vs. 0 metabolic equivalent task hours per week; HR, 0.90; 95% CI, 0.85 to 0.96) were independently associated with higher rates of AF after multivariate adjustment. Higher levels of physical activity reduced the AF risk conferred by obesity (interaction P=0.033). Conclusions-Greater physical activity is associated with lower rates of incident AF and modifies the association between obesity and incident AF.
    Journal of the American Heart Association 06/2014; 3(4). DOI:10.1161/JAHA.114.001127 · 2.88 Impact Factor
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    ABSTRACT: While some evidence suggests that periodontal disease (PD) might be positively associated with lung cancer, prospective studies in women are limited. Previous findings may reflect residual confounding by smoking. The study aims to determine whether history of PD diagnosis is associated with incident lung cancer in a large cohort of postmenopausal women.
    Cancer Causes and Control 06/2014; 25(8). DOI:10.1007/s10552-014-0405-3 · 2.96 Impact Factor
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    ABSTRACT: Background: The objective of this study was to characterize the association between metabolic syndrome (Metsyn) and periodontitis in women, for which there is limited evidence. Methods: Cross-sectional associations between Metsyn and periodontitis were examined in 657 postmenopausal women age 50-79 years enrolled in a periodontal disease study ancillary to the Women's Health Initiative Observational Study. Whole mouth measures of alveolar crestal height (ACH), clinical attachment level (CAL), probing depth (PD), gingival bleeding and supragingival plaque, and measures to define Metsyn using National Cholesterol Education Program criteria were from a clinical examination. Study outcomes were defined as: (1) mean ACH ≥3mm, or 2 sites ≥5mm, or tooth loss to periodontitis; (2) ≥2 sites with CAL ≥6mm and ≥1 site with PD ≥5mm; (3) gingival bleeding at ≥50% of sites; and (4) supragingival plaque at ≥50% of sites. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI). Results: In unadjusted analyses, Metsyn (prevalence, 25.6%) was significantly associated with supragingival plaque (OR, 1.74, 95% CI: 1.22, 2.50) and nonsignificantly associated with periodontitis defined by ACH (OR, 1.23, 95% CI: 0.81, 1.85) and gingival bleeding (OR, 1.20, 95% CI: 0.81, 1.77). Adjustment for age, smoking and other confounders attenuated observed associations, though supragingival plaque remained significant (OR, 1.47, 95% CI: 1.00, 2.16, p = .049). Metsyn was not associated with periodontitis defined by CAL and PD. Conclusions: A consistent association between Metsyn and measures of periodontitis was not seen in this cohort of postmenopausal women. An association between Metsyn and supragingival plaque requires further investigation.
    Journal of Periodontology 05/2014; 85(11):1-15. DOI:10.1902/jop.2014.140185 · 2.57 Impact Factor
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    ABSTRACT: Background: Vitamin D is hypothesized to prevent periodontal disease progression through its immune modulating properties and its role in maintaining systemic calcium concentrations. We investigated associations between plasma 25(OH)D (collected 1997-2000) and the five-year change in periodontal disease measures from baseline (1997-2000) to follow-up (2002-2005) among 655 postmenopausal women in a Women's Health Initiative Observational Study ancillary study. Exploratory analyses were conducted in 628 women who also had 25(OH)D measures at follow-up. Methods: Four continuous measures of five-year change in periodontal disease were assessed using alveolar crestal height (ACH), clinical attachment level (CAL), probing pocket depth (PD), and percent of gingival sites that bled upon assessment. Linear regression was used to estimate beta-coefficients (β), standard errors (SE), and p-values corresponding to change in periodontal disease (either a 1 mm change in ACH, CAL or PD, or 1 unit change in the percent of gingival sites that bled) for a 10 nmol/L difference in 25(OH)D. Models were adjusted for age, education, dental visit frequency, smoking, diabetes status, current medications affecting bone health, baseline measures of periodontal disease, body mass index, and recreational physical activity. Results: No statistically significant associations were observed between baseline 25(OH)D and change in periodontal disease measures, overall or in a subset (n=442) of women with stable 25(OH)D concentrations (women whose 25(OH)D changed less than ± 20 nmol/L from baseline to follow-up). Results also did not vary significantly in analyses that were stratified by baseline periodontal disease status. Conclusion: No association between baseline 25(OH)D and the subsequent five-year change in periodontal disease measures was observed. Vitamin D status may not influence periodontal disease progression. More studies are needed to confirm these results.
    Journal of Periodontology 05/2014; 85(10). DOI:10.1902/jop.2014.130686 · 2.57 Impact Factor
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    ABSTRACT: Objective To evaluate the association between self-reported daily sitting time and the incidence of type II diabetes in a cohort of postmenopausal women. Design and Methods Women (N = 88,829) without diagnosed diabetes reported the number of hours spent sitting over a typical day. Incident cases of diabetes were identified annually by self-reported initiation of using oral medications or insulin for diabetes over 14.4 years follow-up. Results Each hour of sitting time was positively associated with increased risk of diabetes (Risk ratio (RR): 1.05; 95% confidence interval (CI): 1.02–1.08]. However, sitting time was only positively associated with incident diabetes in obese women. Obese women reporting sitting 8–11 (RR: 1.08; 95% CI 1.0–1.1), 12–15 (OR: 1.13; 95% CI 1.0–1.2), and ≥16 hours (OR: 1.25; 95% CI 1.0–1.5) hours per day had an increased risk of diabetes compared to women sitting ≤ 7 hours per day. These associations were adjusted for demographics, health conditions, behaviors (smoking, diet and alcohol intake) and family history of diabetes. Time performing moderate to vigorous intensity physical activity did not modify these associations. Conclusion Time spent sitting was independently associated with increased risk of diabetes diagnosis among obese women— a population already at high risk of the disease.
    Obesity 04/2014; 22(4). DOI:10.1002/oby.20620 · 4.39 Impact Factor
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    ABSTRACT: Background Ovarian cancer is often diagnosed at late stages and consequently the 5-year survival rate is only 44%. However, there is limited knowledge of the association of modifiable lifestyle factors, such as physical activity and obesity on mortality among women diagnosed with ovarian cancer. The purpose of our study was to prospectively investigate the association of (1) measured body mass index (BMI), and (2) self-reported physical activity with ovarian cancer-specific and all-cause mortality in postmenopausal women enrolled in the Women's Health Initiative (WHI). Methods Participants were 600 women diagnosed with primary ovarian cancer subsequent to enrollment in WHI. Exposure data, including measured height and weight and reported physical activity from recreation and walking, used in this analysis were ascertained at the baseline visit for the WHI. Cox proportional hazard regression was used to examine the associations between BMI, physical activity and mortality endpoints. Results Vigorous-intensity physical activity was associated with a 26% lower risk of ovarian cancer specific-mortality (HR = 0.74; 95% CI: 0.56–0.98) and a 24% lower risk of all-cause mortality (HR = 0.76; 95% CI: 0.58–0.98) compared to no vigorous-intensity physical activity. BMI was not associated with mortality. Conclusions Participating in vigorous-intensity physical activity, assessed prior to ovarian cancer diagnosis, appears to be associated with a lower risk of ovarian cancer mortality.
    Gynecologic Oncology 04/2014; 133(1):4–10. DOI:10.1016/j.ygyno.2014.01.033 · 3.69 Impact Factor
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    ABSTRACT: Objectives: This study examined the accuracy of self-reported periodontal disease in a cohort of older women. Methods: Participants were 972 postmenopausal women ages 53-83 years who completed baseline (1997-2001) and follow-up (2002-2006) whole mouth oral examinations including probing pocket depth (PPD), clinical attachment level (CAL), and oral radiographs for alveolar crestal height (ACH) in a study ancillary to the Women's Health Initiative Observational Study (WHI-OS) conducted in Buffalo NY, the OsteoPerio study. Participants also self-reported history of diagnosis for periodontal/gum disease on a WHI-OS study-wide questionnaire administered during the time interval between the two OsteoPerio examinations. Results: Women reporting diagnosis of periodontal/gum disease on the WHI-OS questionnaire (n = 259; 26.6%) had worse oral hygiene habits, periodontal disease risk factors, and clinical periodontal measures as compared to women not reporting periodontal/gum disease. Frequency of reported periodontal/gum disease was 13.5%, 24.7%, and 56.2% across OsteoPerio baseline examination categories of none/mild, moderate, and severe periodontal disease (trend, p <.001), defined by criteria of the Centers for Disease Control and Prevention/American Academy of Periodontology (CDC/AAP). Sensitivity, specificity, positive and negative predictive values for reported periodontal disease status were 56.2%, 78.8%, 32.8%, and 90.7%, respectively, when CDC/AAP defined severe periodontal disease at baseline was the criterion measure (prevalence = 15%); and were 76.0%, 77.4%, 22.0%, and 97.4% when tooth loss to periodontitis (prevalence = 7%) was the criterion. Conclusions: A simple question for self-reported periodontal disease characterizes periodontal disease prevalence with moderate accuracy in postmenopausal women who regularly visit their dentist, particularly in those with more severe disease.
    Journal of Periodontology 12/2013; DOI:10.1902/jop.2013.130488 · 2.57 Impact Factor
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    ABSTRACT: Background: Previous findings of an association between 25-hydroxyvitamin D (25(OH)D) concentrations and periodontal disease, may be partially explained by vitamin D's antimicrobial properties. To our knowledge, no study has investigated the association between 25(OH)D and pathogenic oral bacteria, a putative cause of periodontal disease. Methods: We examined the association between plasma 25(OH)D concentrations and pathogenic oral bacteria among postmenopausal women in the Buffalo Osteoporosis and Periodontal Disease Study (1997-2000), an ancillary study of the Women's Health Initiative Observational Study. Subgingival plaque samples were assessed using immunofluorescence for the presence of Porphyromonas gingivalis, Tannerella forsythensis, Fusobacterium nucleatum, Prevotella intermedia and Campylobacter rectus. Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for prevalent bacteria by quintile (Q) of 25(OH)D concentrations adjusting for age and body mass index. Results: Of the 855 participants, 288 (34%) had deficient/inadequate (<50 nmol/L) 25(OH)D concentrations and 497 (58%) had at least one species of pathogenic bacteria. No significant association was found between 25(OH)D and presence of any of these bacteria (adjusted OR for high (Q5) compared to low (Q1) 25(OH)D=0.96; 95% CI: 0.61-1.50, p for trend=0.50). Inverse, although not statistically significant, associations were found between 25(OH)D and more than one species of pathogenic bacteria (adjusted OR for adequate compared to deficient/inadequate 25(OH)D=0.85; 95% CI: 0.60-1.19). Conclusions: No association was observed between pathogenic oral bacteria and 25(OH)D concentrations in postmenopausal women. This may be due to the species of bacteria assessed, small effect size or a true absence of an association.
    Journal of Periodontology 11/2013; 85(7). DOI:10.1902/jop.2013.130518 · 2.57 Impact Factor
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    ABSTRACT: IMPORTANCE The effect of obesity on late-age survival in women without disease or disability is unknown. OBJECTIVE To investigate whether higher baseline body mass index and waist circumference affect women's survival to 85 years of age without major chronic disease (coronary disease, stroke, cancer, diabetes mellitus, or hip fracture) and mobility disability. DESIGN, SETTING, AND PARTICIPANTS Examination of 36 611 women from the Women's Health Initiative observational study and clinical trial programs who could have reached 85 years or older if they survived to the last outcomes evaluation on September 17, 2012. Recruitment was from 40 US clinical centers from October 1993 through December 1998. Multinomial logistic regression models were used to estimate odds ratios and 95% CIs for the association of baseline body mass index and waist circumference with the outcomes, adjusting for demographic, behavioral, and health characteristics. MAIN OUTCOMES AND MEASURES Mutually exclusive classifications: (1) survived without major chronic disease and without mobility disability (healthy); (2) survived with 1 or more major chronic disease at baseline but without new disease or disability (prevalent diseased); (3) survived and developed 1 or more major chronic disease but not disability during study follow-up (incident diseased); (4) survived and developed mobility disability with or without disease (disabled); and (5) did not survive (died). RESULTS Mean (SD) baseline age was 72.4 (3.0) years (range, 66-81 years). The distribution of women classified as healthy, prevalent diseased, incident diseased, disabled, and died was 19.0%, 14.7%, 23.2%, 18.3%, and 24.8%, respectively. Compared with healthy-weight women, underweight and obese women were more likely to die before 85 years of age. Overweight and obese women had higher risks of incident disease and mobility disability. Disability risks were striking. Relative to healthy-weight women, adjusted odds ratios (95% CIs) of mobility disability were 1.6 (1.5-1.8) for overweight women and 3.2 (2.9-3.6), 6.6 (5.4-8.1), and 6.7 (4.8-9.2) for class I, II, and III obesity, respectively. Waist circumference greater than 88 cm was also associated with higher risk of earlier death, incident disease, and mobility disability. CONCLUSIONS AND RELEVANCE Overall and abdominal obesity were important and potentially modifiable factors associated with dying or developing mobility disability and major chronic disease before 85 years of age in older women.
    JAMA Internal Medicine 11/2013; 174(1). DOI:10.1001/jamainternmed.2013.12051 · 13.25 Impact Factor
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    ABSTRACT: Using data from the Women's Health Initiative (1993-2009; n = 158,833 participants, of whom 84.1% were white, 9.2% were black, 4.1% were Hispanic, and 2.6% were Asian), we compared all-cause, cardiovascular, and cancer mortality rates in white, black, Hispanic, and Asian postmenopausal women with and without diabetes. Cox proportional hazard models were used for the comparison from which hazard ratios and 95% confidence intervals were computed. Within each racial/ethnic subgroup, women with diabetes had an approximately 2-3 times higher risk of all-cause, cardiovascular, and cancer mortality than did those without diabetes. However, the hazard ratios for mortality outcomes were not significantly different between racial/ethnic subgroups. Population attributable risk percentages (PARPs) take into account both the prevalence of diabetes and hazard ratios. For all-cause mortality, whites had the lowest PARP (11.1, 95% confidence interval (CI): 10.1, 12.1), followed by Asians (12.9, 95% CI: 4.7, 20.9), blacks (19.4, 95% CI: 15.0, 23.7), and Hispanics (23.2, 95% CI: 14.8, 31.2). To our knowledge, the present study is the first to show that hazard ratios for mortality outcomes were not significantly different between racial/ethnic subgroups when stratified by diabetes status. Because of the "amplifying" effect of diabetes prevalence, efforts to reduce racial/ethnic disparities in the rate of death from diabetes should focus on prevention of diabetes.
    American journal of epidemiology 09/2013; 178(10). DOI:10.1093/aje/kwt177 · 4.98 Impact Factor
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    ABSTRACT: Moderate intensity physical activity is recommended for individuals with diabetes to control glucose and prevent diabetes-related complications. The extent to which a diabetes diagnosis motivates patients to increase physical activity is unclear. This study used data from the Women's Health Initiative Observational Study (baseline data collected from 1993-1998) to examine change in physical activity and sedentary behavior in women who reported a diabetes diagnosis compared to women who did not report diabetes over 7 years of follow-up (up to 2005). Participants (n=84,300) were post-menopausal women who did not report diabetes at baseline [mean age=63.49; standard deviation (SD)=7.34; mean BMI=26.98 kg/m; SD=5.67]. Linear mixed model analyses were conducted adjusting for study year, age, race/ethnicity, BMI, education, family history of diabetes, physical functioning, pain, energy/fatigue, social functioning, depression, number of chronic diseases and vigorous exercise at age 18. Analyses were completed in August 2012. Participants who reported a diabetes diagnosis during follow-up were more likely to report increasing their total physical activity (p=0.002), walking (p<0.001) and number of physical activity episodes (p<0.001) compared to participants who did not report a diabetes diagnosis. On average, participants reporting a diabetes diagnosis reported increasing their total physical activity by 0.49 MET-hours/week, their walking by 0.033 MET-hours/week and their number of physical activity episodes by 0.19 MET-hours/week. No differences in reported sedentary behavior change were observed (p=0.48). A diabetes diagnosis may prompt patients to increase physical activity. Healthcare professionals should consider how best to capitalize on this opportunity to encourage increased physical activity and maintenance.
    Medicine and science in sports and exercise 07/2013; 46(1). DOI:10.1249/MSS.0b013e3182a33010 · 4.46 Impact Factor
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    ABSTRACT: OBJECTIVES: The aim was to examine the independent and joint associations of sitting time and physical activity with risk of incident cardiovascular disease (CVD). BACKGROUND: Sedentary behavior is recognized as a distinct construct beyond lack of leisure-time physical activity, but limited data exists on the interrelationship between these two components of energy balance. METHODS: Participants in the prospective Women's Health Initiative Observational Study (N = 71,018), aged 50-79 and free of CVD at baseline (1993-1998), provided information on sedentary behavior, defined as hours of sitting per day, and usual physical activity at baseline and during follow-up through September 2010. First CVD (coronary heart disease or stroke) events were centrally adjudicated. RESULTS: Sitting ≥ 10 hours/day compared to ≤ 5 hours/day was associated with increased CVD risk (HR=1.18, 95% CI 1.09, 1.29) in multivariable models including physical activity. Low physical activity was also associated with higher CVD risk (P,trend <0.001). When women were cross-classified by sitting time and physical activity (P,interaction = 0.94), CVD risk was highest in inactive women (≤1.7 MET-hrs/week) who also reported ≥10 hrs/day of sitting. Results were similar for CHD and stroke when examined separately. Associations between prolonged sitting and risk of CVD were stronger in overweight versus normal weight women and women aged 70 years and older compared to younger women. CONCLUSIONS: Prolonged sitting time was associated with increased CVD risk, independent of leisure-time physical activity, in postmenopausal women without a history of CVD. A combination of low physical activity and prolonged sitting augments CVD risk.
    Journal of the American College of Cardiology 04/2013; 61(23). DOI:10.1016/j.jacc.2013.03.031 · 15.34 Impact Factor
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    ABSTRACT: Multiplexing arrays increase the throughput and decrease sample requirements for studies employing multiple biomarkers. The goal of this project was to examine the performance of Multiplex arrays for measuring multiple protein biomarkers in saliva and serum. Specimens from the OsteoPerio ancillary study of the Women's Health Initiative Observational Study were used. Participants required the presence of at least 6 teeth and were excluded based on active cancer and certain bone issues but were not selected on any specific condition. Quality control (QC) samples were created from pooled serum and saliva. Twenty protein markers were measured on five multiplexing array panels. Sample pretreatment conditions were optimized for each panel. Recovery, lower limit of quantification (LLOQ) and imprecision were determined for each analyte. Statistical adjustment at the plate level was used to reduce imprecision estimates and increase the number of usable observations. Sample pre-treatment improved recovery estimates for many analytes. The LLOQ for each analyte agreed with manufacturer specifications except for MMP-1 and MMP-2 which were significantly higher than reported. Following batch adjustment, 17 of 20 biomarkers in serum and 9 of 20 biomarkers in saliva demonstrated acceptable precision, defined as <20% coefficient of variation (<25% at LLOQ). The percentage of cohort samples having levels within the reportable range for each analyte varied from 10% to 100%. The ratio of levels in saliva to serum varied from 1∶100 to 28∶1. Correlations between saliva and serum were of moderate positive magnitude and significant for CRP, MMP-2, insulin, adiponectin, GM-CSF and IL-5. Multiplex arrays exhibit high levels of analytical imprecision, particularly at the batch level. Careful sample pre-treatment can enhance recovery and reduce imprecision. Following statistical adjustments to reduce batch effects, we identified biomarkers that are of acceptable quality in serum and to a lesser degree in saliva using Multiplex arrays.
    PLoS ONE 04/2013; 8(4):e59498. DOI:10.1371/journal.pone.0059498 · 3.23 Impact Factor

Publication Stats

6k Citations
720.79 Total Impact Points


  • 2012–2014
    • State University of New York
      New York, New York, United States
  • 2007–2014
    • University at Buffalo, The State University of New York
      • Department of Social and Preventive Medicine
      Buffalo, New York, United States
    • University of North Carolina at Chapel Hill
      North Carolina, United States
  • 2013
    • Fred Hutchinson Cancer Research Center
      • Division of Public Health Sciences
      Seattle, Washington, United States
  • 2010
    • SUNY Ulster
      Kingston, New York, United States
  • 2000–2007
    • University of South Carolina
      • • Department of Exercise Science
      • • Department of Epidemiology & Biostatistics
      • • Prevention Research Center
      Columbia, SC, United States
  • 2006
    • University of Hawaiʻi at Mānoa
      Honolulu, Hawaii, United States
  • 2005
    • Brigham Young University - Provo Main Campus
      • College of Health and Human Performance
      Provo, UT, United States
  • 2004
    • San Diego State University
      San Diego, California, United States
  • 2000–2004
    • University of Utah
      • Department of Exercise and Sport Science
      Salt Lake City, Utah, United States
  • 2001–2003
    • Salt Lake City Community College
      Salt Lake City, Utah, United States
  • 2002
    • University of North Carolina at Greensboro
      Greensboro, North Carolina, United States