Wider Waist Boosts Asthma Risk

Women with extra fat around their waists are more likely to develop asthma, even if they aren't overweight, a new study finds. The California Teachers Study of more than 88,000 women found the same association between obesity and increased incidence of asthma that has been seen in other research. But it also found a 37 percent increased incidence of asthma among women with a waist circumference of 88 centimeters -- about 35 inches -- even if they were of normal weight. That finding was an offshoot of a study originally intended to look at factors related to breast cancer in women, said study author, a research associate at the Northern California Cancer Center. But the researchers also got a lot of other information about the participants, including waistline measurements and asthma risk factors, such as smoking exposure. Using the standard designations of "overweight" for a woman with a body-mass index (BMI) of 30 or higher and "extreme obesity" for a body-mass index (BMI) of 40 or higher, the study found a doubled incidence of asthma among the obese women and a more than tripled incidence among the extremely obese. While the study was not designed to determine why the location of body fat could play a role in development of asthma, "waist size can be an indicator of the type of body fat," the researcher explained. "Abdominal fat is visceral fat, which is more biologically active. It has been linked to diabetes and heart disease." The researcher added, “Fat around the waist "could be acting in some inflammatory way,"  That is a plausible, though unproven, explanation, said a pulmonologist and chairman of medicine at the Scott & White Memorial Hospital and Clinic in Temple, Texas. "We know that obesity can cause an inflammatory state," the researcher said. "Markers of inflammation are increased in obesity." Other studies have documented the overall association between obesity and asthma, he said. "This is one of the biggest, with more than 88,000 women. While one conventional explanation is that body fat puts a squeeze on airways, some previous studies have pointed toward the composition of body fat as a possible element in asthma risk, he added. "But it is still unclear why there is this association," the scientist said. "The biological explanation lags behind the epidemiological evidence." Whatever the reason, the association with asthma provides just another reason not to put on extra weight, the researcher said.

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Protein May Identify Breast Cancer

A protein linked to more aggressive and advanced breast cancer tumors has been identified by German researchers. The investigators analyzed 229 breast tissue samples from patients with cancer and compared them with healthy breast tissue. The study found that patients whose tumors had elevated levels of GLI1 (glioma-associated oncogene homolog 1) protein tended to have a more advanced stage of cancer, had an increased number of cancerous lymph nodes and a greater chance of death. GLI1 could be a useful measurement for determining cancer prognosis, according to the study. "GLI1, a mediator of the so-called 'hedgehog' signaling pathway, has previously been implicated in the development of different human tumor entities," said lead study author of RWTH Aachen's University Hospital in Germany. "We've found a positive, significant association between overexpression of GLI1 and unfavorable overall survival outcome in human breast cancer," the researcher added. The researchers also noted that overexpression of GLI1 has also been implicated in esophageal cancer, "Taken together, these results support a role of GLI1 as a new prognostic biomarker in breast cancer," the scientist said. "Future studies will determine whether GLI1 can be successfully included into multimarker panels for early cancer detection or molecular sub-typing of breast cancer. This could support personalized breast cancer medicine.".

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New Anti-Clotting Drug Beats Clopidogrel

A new anti-clotting drug, ticagrelor, was better than clopidogrel in preventing new heart attacks and in reducing deaths among patients who have had a heart attack, a new study finds. "Clopidogrel is widely used in the treatment of acute coronary syndrome," said lead researcher, director of the Duke Clinical Research Institute at Duke University. "Ticagrelor looks to be a superior antiplatelet agent in patients with acute coronary syndrome." Co-researcher, a professor of cardiology at the Uppsala Clinical Research Center at University Hospital, in Sweden, added that "now we have a new and better alternative to standard treatment to prevent patients with myocardial infarction from new myocardial infarction, and also to improve their chances of survival." For this phase 3 study, called PLATO (Platelet Inhibition and Patient Outcomes), 18,624 patients were randomly assigned to ticagrelor or clopidogrel. Both drugs prevent blood clotting, which could lead to another heart attack. Over 12 months, patients taking ticagrelor had fewer heart attacks and strokes compared with patients taking clopidogrel (9.8 percent versus 11.7 percent), the researchers found. Moreover, fewer patients taking ticagrelor died (4.5 percent) compared with patients taking clopidogrel (5.9 percent). The greatest risk associated with these drugs is life-threatening bleeding, but there was no significant difference between the drugs in the risk of bleeding, the researchers noted. However, patients taking ticagrelor were more likely to have spontaneous intracranial and gastrointestinal bleeding than people taking clopidogrel (4.5 percent versus 3.8 percent). In addition, shortness of breath was more common in patients taking ticagrelor, compared with patients taking clopidogrel (14.2 percent versus 9.2 percent). However, only a few patients stopped treatment because of it, the study authors reported. The researcher noted that ticagrelor and clopidogrel work differently. "Clopidogrel has an irreversible affect on the platelets, so platelets remain inactive for up to a week. With ticagrelor, as soon as the treatment stopped, the effect stays for one to two days," he said. This difference is important for patients who need surgery where excess bleeding is a major risk, he added. Also, about 30 percent of patients do not respond to clopidogrel, the researcher said. "But with the new compound, everybody has enough protection," he added. Ticagrelor is not yet approved by the U.S. Food and Drug Administration.

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