Mental illness among adults aged 18 or older is defined as having had a diagnosable mental, behavioral, or emotional disorder (excluding developmental and substance use disorders) in the past year, based on criteria specified in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association [APA], 1994).

The Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Survey on Drug Use and Health also shows that 11.4 million adults (5 percent of the adult population) suffered from serious mental illness in the past year. Serious mental illness is defined as one that resulted in serious functional impairment, which substantially interfered with or limited one or more major life activities.

SAMHSA, through its strategic initiative on substance abuse and mental illness prevention and recovery, is working to assist states, territories, tribal governments, and communities to adopt evidence-based practices; deliver health education related to prevention; and establish effective policies, programs, and infrastructure to help address these problems. Throughout the Nation new programs are underway to strengthen the capacity of communities to better service the needs of those suffering from mental illness.

“Mental illnesses can be managed successfully, and people do recover,” said SAMHSA Administrator Pamela S. Hyde. “Mental illness is not an isolated public health problem. Cardiovascular disease, diabetes, and obesity often co-exist with mental illness and treatment of the mental illness can reduce the effects of these disorders. The Obama Administration is working to promote the use of mental health services through health reform. People, families, and communities will benefit from increased access to mental health services.”

The economic impact of mental illness in the United States is considerable—about $300 billion in 2002. According to the World Health Organization, mental illness accounts for more disability in developed countries than any other group of illnesses, including cancer and heart disease.

In terms of treatment statistics, the report indicates that about 4 in 10 people experiencing any mental illness in the past year (39.2 percent) received mental health services during that period. Among those experiencing serious mental illness, the rate of treatment was notably higher (60.8 percent).

The report also noted that an estimated 8.7 million American adults had serious thoughts of suicide in the past year—among them, 2.5 million made suicide plans and 1.1 million attempted suicide. Those in crisis or knowing someone they believe may be at immediate risk of attempting suicide are urged to call the National Suicide Prevention Lifeline 1-800-273-TALK (8255) or http:/www.suicidepreventionlifeline.org. This suicide prevention hotline network funded by SAMHSA provides immediate free and confidential crisis round-the-clock counseling to anyone in need throughout the country, everyday of the year.

According to the report, rates for substance dependence were far higher for those who had experienced either any mental illness or serious mental illness than for the adult population which had not experienced mental illness in the past year. Adults experiencing any mental illness in the past year were more than three times as likely to have met the criteria for substance dependence or abuse in that period than those who had not experienced mental illness in the past year (20 percent versus 6.1 percent). Those who had experienced serious mental illness in the past year had even a higher rate of substance dependence or abuse (25.2 percent). “These data underscore the importance of substance abuse treatment as well,” said SAMHSA Administrator Pamela S. Hyde.

“Mental illness is a significant public health problem in itself, but also because it is associated with chronic medical diseases such as cardiovascular disease, diabetes, obesity, and cancer, as well as several risk behaviors including physical inactivity, smoking, excessive drinking, and insufficient sleep,” said Ileana Arias, Ph.D., Principal Deputy Director of CDC. “Today’s report issued by SAMHSA provides further evidence that we need to continue efforts to monitor levels of mental illness in the United States in order to effectively prevent this important public health problem and its negative impact on total health.”

The report also has important findings regarding mental health issues among those aged 12 to 17. According to the report 1.9 million youth aged 12 to 17 (8 percent of this population) had experienced a major depressive episode in the past year. A major depressive episode is defined as a period of at least two weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had at least four of seven additional symptoms reflecting the criteria as described in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association [APA], 1994).

In addition, the report finds that young people aged 12 to 17 who experienced a major depressive episode in the past year have more than twice the rate of past year illicit drug use (37.2 percent) as their counterparts who had not experienced a major depressive episode during that period (17.8 percent).

The complete survey findings from this report are available on the SAMHSA Web site at http://www.samhsa.gov/data/NSDUH/2k10MH_Findings/. The 2010 National Survey on Drug Use and Health is a scientifically conducted annual survey of approximately 67,500 people throughout the country, aged 12 and older. Because of its statistical power, it is the nation’s premier source of statistical information on the scope and nature of many behavioral health issues affecting the nation.

Low levels of vitamin D already are associated with a cavalcade of health woes from cardiovascular diseases to neurological ailments. This new study – published in Mayo Clinic Proceedings – helps clarify a debate that erupted after smaller studies produced conflicting results about the relationship between vitamin D and depression. Major depressive disorder affects nearly one in 10 adults in the U.S.

Vitamin D levels are now commonly tested during routine physical exams, and they already are accepted as risk factors for a number of other medical problems: autoimmune diseases; heart and vascular disease; infectious diseases; osteoporosis; obesity; diabetes; certain cancers; and neurological disorders such as Alzheimer’s and Parkinson’s diseases, multiple sclerosis, and general cognitive decline.

“Our findings suggest that screening for vitamin D levels in depressed patients – and perhaps screening for depression in people with low vitamin D levels – might be useful,” said Dr. E. Sherwood Brown, professor of psychiatry and senior author of the study, done in conjunction with The Cooper Institute in Dallas. “But we don’t have enough information yet to recommend going out and taking supplements.”

UT Southwestern researchers examined the results of almost 12,600 participants from late 2006 to late 2010. Dr. Brown and colleagues from The Cooper Institute found that higher vitamin D levels were associated with a significantly decreased risk of current depression, particularly among people with a prior history of depression. Low vitamin D levels were associated with depressive symptoms, particularly those with a history of depression, so primary care patients with a history of depression may be an important target for assessing vitamin D levels. The study did not address whether increasing vitamin D levels reduced depressive symptoms.

The scientists have not determined the exact relationship – whether low vitamin D contributes to symptoms of depression, whether depression itself contributes to lower vitamin D levels, or chemically how that happens. But vitamin D may affect neurotransmitters, inflammatory markers and other factors, which could help explain the relationship with depression, said Dr. Brown, who leads the psychoneuroendocrine research program at UT Southwestern.

Investigators used information gathered by the institute, which has 40 years of data on runners and other fit volunteers. UT Southwestern has a partnership with the institute, a preventive medicine research and educational nonprofit located at the Cooper Aerobics Center, to develop a joint scientific medical research program aimed at improving health and preventing a wide range of chronic diseases. The institute maintains one of the world’s most extensive databases – known as the Cooper Center Longitudinal Study – that includes detailed information from more than 250,000 clinic visits that has been collected since Dr. Kenneth Cooper founded the institute and clinic in 1970.

"Using different manipulations of power and measures of perceived height, we found that people literally perceived themselves as taller when they occupied a more powerful position,” according to research by Jack Goncalo, associate professor of organizational behavior at Cornell’s School of Industrial and Labor Relations.
 
“Although a great deal of research has shown that physically imposing individuals are more likely to acquire power, this work is the first to show that the powerful may actually feel taller than they are,” Goncalo and co-author Michelle Duguid of Washington University write in an upcoming issue of Psychological Science.
 
In other words, there is actually a physical experience that goes along with feeling powerful.
 
Three experiments with 266 American men and women confirmed for Goncalo and Duguid that there is a relationship between feelings of power and one's self-perception of height.
 
Goncalo noted that the research begs a number of questions:  Would it be possible to psychologically empower people by giving them an office on the top floor?  Do short people attempt to capture power by physically elevating themselves above others?
 

 

Knee Replacements on the Rise for People in their Fifties

 

The incidence of total knee arthroplasty rose from 0.5 per 100,000 in 1980 to 65 per 100,000 in 2006, for an incidence rate ratio (IRR) of 1.19 (95% CI 1.19 to 1.20, P<0.001), according to Jarkko Leskinen, MD, of Helsinki University Central Hospital, and colleagues.

 

And among those ages 50 to 59, the incidence increased from 1.5 to 160 per 100,000, with an IRR of 16.8 (95% CI 12.2 to 23.2, P<0.001), the researchers reported online in Arthritis & Rheumatism. According to the research, women were more likely to undergo Knee arthroplasty (knee replacement surgeries) than men, reaching a 1.6 to 2.4-fold higher incidence during the last ten years.

 

Most long-term data are for patients who were 60 and older at the time of the surgery, but younger patients increasingly have been undergoing total or partial knee replacements.

 

Knee Arthroplasty

 

Knee arthroplasty is a common and effective treatment for patients with severe osteoarthritis who are not responsive to medical therapy. 

 

Knee replacement is surgery for people with severe knee damage. Knee replacement can relieve pain and allow you to be more active. Your doctor may recommend  Knee replacement if you have knee pain and medicine and other treatments are not helping you anymore.

 

Partial Knee Replacement vs. Total Knee Replacement

 

In a partial knee replacement, the surgeon only replaces one part of your knee joint. When you have a total knee replacement, the surgeon removes damaged cartilage and bone from the surface of your knee joint and replaces them with a man-made surface of metal and plastic.

 

Knee Arthroplasty Study

 

To explore trends in incidence over time among younger patients, Leskinen and colleagues analyzed data from the national Finnish arthroplasty register, which now includes 98% of patients with these implants.

 

Among the 95,577 primary knee arthroplasties done in the country between 1980 and 2006, 8,961 were for osteoarthritis in individuals younger than 60.

 

A total of 65% of these were in women, and mean age at implantation was 55.

 

The most rapid increase overall for total knee replacement was between 2001 and 2006, when the rate rose from 18 to 65 per 100,000.

 

The incidence of partial, or unicondylar, arthroplasty also rose, though less than for the total knee procedure, increasing from 0.2 to 10 per 100,000 (IRR 1.19, 95% CI 1.19 to 1.20, P<0.001).

 

Throughout the study period, women were the recipients more often than men, reaching a 1.6 to 2.4-fold higher incidence during the last ten years.

 

When the researchers looked at the data according to age groups, they found only minor increases for both total and partial arthroplasties in patients ages 30 to 39 and those 40 to 49.

 

As with total knee arthroplasty, the incidence of partial knee replacement rose most rapidly among patients ages 50 to 59, with an IRR of 147.2 (95% CI 66 to 328.5, P<0.001) when that group was compared with those ages 30 to 39, according to Leskinen and colleagues.

 

The researchers also looked at trends in incidence according to the volume of procedures by hospital, and found that low- and intermediate-volume centers had the greatest increases.

 

The IRR between intermediate- and high-volume centers was 1.23 (95% CI 1.16 to 1.31, P<0.001) and 1.23 (95% CI 1.13 to 1.34, P<0.001) for low- versus high-volume centers.

 

Despite the significant increases in knee replacement surgeries since 1980, the researchers noted that the incidence of osteoarthritis has actually fallen in Finland in that time.

 

"Possible explanations for this phenomenon include the high functional and quality of life demands of younger patients," the researchers observed.

 

Greater awareness of osteoarthritis treatment options among Baby Boomers and ongoing refinements of surgical technique also are likely to have contributed.

 

Knee Arthroplasty Demand Rising in the US

 

In the U.S., demand for Knee arthroplasty is expected to increase by almost 675% by the year 2030.

 

Long Term Knee Arthroplasty Risks Need to be Studied

 

Leskinen and colleagues cautioned that long-term data are needed on the use of knee arthroplasty among younger patients, because their outcomes and risks may be different than older patients.

 

"Since younger patients are likely to have more strenuous physical demands and to make treatment choices that support an active lifestyle, the longevity or 'survival' of knee implants in this group may be lower than in older patients," Elena Losina, PhD, and Jeffrey N. Katz, MD, of Harvard University in Boston. wrote in a accompanying editorial.

 

"In fact, as data on this issue emerge, it appears that rates of knee replacement failure leading to revision in younger patients are two-fold higher than in older patients," they observed.

 

Losina and Katz called for further "intensive study" before even wider adoption of knee arthroplasty for younger patients.

 

"We would be wise to heed the time-honored investment advice that past performance may not guarantee future success," they warned.

 

The authors had no financial disclosures, while the editorialists were supported by the National Institutes of Health.

 

References:

• Leskinen J, et al. "The incidence of knee arthroplasty for primary osteoarthritis grows rapidly among baby boomers -- A population based study" Arthritis Rheum 2012; DOI: 10.1002/art.33367.
• Losina E, Katz J. "Total knee arthroplasty on the rise in younger patients: Are we sure that past performance will guarantee future success?" Arthritis Rheum 2012; DOI: 10.1002/art.33371.

 

 

Increasing levels of vitamin D in the blood are linked with lower levels of a popular marker for cardiovascular inflammation — c-reactive protein (also known as CRP) according to the Vitamin D Study leader Muhammad Amer, M.D., an assistant professor in the division of general internal medicine at the Johns Hopkins University School of Medicine.

 

The researchers examined data from more than 15,000 adult participants in the continuous National Health and Nutrition Examination Survey, a nationally representative sample, from 2001 and 2006. The researchers found an inverse relationship between vitamin D and CRP in adults without cardiovascular symptoms but with relatively low vitamin D levels. Healthier, lower levels of cardiovascular inflammation were found in people with normal or close to normal vitamin D levels. But beyond blood levels of 21 nanograms per milliliter of 25-Hydroxyvitamin D, considered the low end of the normal range for vitamin D, any additional increase in vitamin D was associated with an increase in CRP, a factor linked to stiffening of the blood vessels and an increased risk of cardiovascular problems.

 

“The inflammation that was curtailed by vitamin D does not appear to be curtailed at higher levels of vitamin D,” says Amer. “Clearly vitamin D is important for your heart health, especially if you have low blood levels of vitamin D. It reduces cardiovascular inflammation and atherosclerosis, and may reduce mortality, but it appears that at some point it can be too much of a good thing.”

 

Amer says consumers should exercise caution before taking supplements and physicians should know the potential risks. Each 100 international unit of vitamin D ingested daily produces about a one nanogram per milliliter increase 25-Hydroxyvitamin D levels in the blood. “People taking vitamin D supplements need to be sure the supplements are necessary,” Amer says. “Those pills could have unforeseen consequences to health even if they are not technically toxic.”

 

Amer and Qayyum, also an assistant professor in the division of general internal medicine at Hopkins, say the biological and molecular mechanisms that account for the loss of cardiovascular benefits are unclear.

 

Vitamin D is often called the “sunshine vitamin” because its primary source is the sun. It is found in very few foods, though commercially sold milk is usually fortified with it. As people spend more and more time indoors and slather their bodies with sunscreen, concern is rising that many are vitamin D-deficient, Amer notes.

 

As a result, Amer says, many doctors prescribe vitamin D supplements, and many consumers, after reading news stories about the vitamin D benefits, dose themselves with extra vitamin D. Older women often take large doses of vitamin D to fight and prevent osteoporosis. Many younger people are also taking extra vitamin D supplementation because of recent hype calling vitamin D the new "miracle supplement" with touted benefits ranging from immunity building to life sustaining.

 

These new findings about vitamin D appears in the Jan. 15 issue of the American Journal of Cardiology

 

On a national healthy-eating index that measured compliance with U.S. dietary guidelines from 2005, the average overall diet score was only about 60 points out of 100. This failing grade "indicating Americans' diets need improvement," Bethene Ervin, PhD, RD, wrote in a National Health Statistics Report.

 

The Healthy Eating Index, or HEI-2005, assesses specific intake of various nutritional categories, including dark green vegetables, orange vegetables, whole grains, whole fruits, milk, meat, beans, fats, oils, sodium, alcohol, and added sugar.

 

To come up with the estimates, Ervin looked at data on 4,448 adults ages 20 and up from the National Health and Nutrition Examination Survey (NHANES) 2003-2004.

 

Ervin found that American adults were well below the maximum standard for all the Healthy Eating Index (HEI-2005) component scores except for total grains, beans and meats.

 

Scores for dark green vegetables, orange vegetables and whole grains were particularly poor, reflecting insufficient intake, Ervin reported, while those for sodium and calories from alcohol and sugars reflected excessive intakes.

 

Men's diets appeared unhealthier than women's diets, Ervin noted, as men had lower Healthy Eating Index (HEI-2005) scores on fruit, vegetable, and discretionary calorie intakes as well as slightly better overall diets.

 

Men's diets also appeared unhealthier than older patients, adults age 60 and up.

 

Better-educated Americans, Americans with at least a high school education, more closely complied with the national dietary recommendations than those who had less education, Ervin reported.

 

Ervin added that no racial or ethnic group stood out as having better dietary scores than any other.

 

Ervin concluded that adults need to up their intake of most of the recommended dietary components, especially dark green and orange vegetables and legumes and whole grains, while lowering the amount of sodium and calories from sugar and alcohol consumed.

 

 

According to two researchers from Children's Memorial Hospital in Chicago, a relatively simple diet low in fats and high in whole grains, fruits, and vegetables is one of the best alternatives to drug therapy for ADHD. Omega-3 and omega-6 fatty acid supplements have also been shown to help in some controlled studies, they noted.

 

Writing online in Pediatrics, J. Gordon Millichap, MD, and Michelle M. Yee, CPNP, reviewed nearly 70 publications on diet-based interventions in ADHD, emphasizing recent ADHD research and controlled trials.

 

The researchers noted that diet is one established contributor to ADHD that parents can modify.

 

One of the most provocative findings in recent years came from the Australian Raine study, which was a prospective cohort study that followed children from birth to age 14, Millichap and Yee indicated.

 

The Australian Raine study found that development of ADHD was significantly associated with so-called Western diets rich in saturated fats and sugar, compared with a "healthy" diet of proteins derived from low-fat fish and dairy products and with a high proportion of vegetables (including tomatoes), fruits, and whole grains.

 

However, their review indicated that controlled trials had failed to show significant benefits for such intensive modifications as oligoantigenic, elimination, or additive-free Feingold-type diets except in small subgroups. Such diets also "are complicated, disruptive to the household, and often impractical," they wrote.

 

The Feingold diet and other diets are based on the idea that artificial colors and salicylates contribute to ADHD; a belief that became popular in the 1970s. Federally funded trials showed that most ADHD children did not improve significantly on such diets, although some children with genuine sensitivities to additives and preservatives have been identified.

 

Such children, the researchers suggested, "might benefit from their elimination." More recent ADHD research has also indicated that atopic children with ADHD responded to a highly restrictive diet lacking colorings, preservatives, and certain food types.

 

Millichap and Yee reached similar conclusions for so-called elimination diets that avoid common allergens such as nuts, dairy, and chocolate, as well as citrus fruits. "ADHD Studies have provided mixed opinions of efficacy," they noted.

 

For both types of diet, the researchers pointed out, "a parent wishing to follow [them] needs patience, perseverance, and frequent evaluation by an understanding physician and dietitian."

 

In another finding likely to raise eyebrows, if not hackles, Millichap and Yee concluded that only weak evidence supports the widespread belief that refined sugar promotes hyperactivity.

 

Some effects on brain electrical activity have been documented, and reactive hypoglycemia following big jolts of sugary foods may account for behavioral changes seen in some ADHD children.

 

But studies linking sugar consumption to ADHD have also been compromised by methodological problems. For example, one trial gave children sugar or placebo at breakfast with a high-carbohydrate cereal, which may have contributed to subsequent reactions to the sugar. Millichap and Yee cited a separate study that demonstrated when children ate a protein meal before or simultaneously with sugar, no hyperactivity reaction occurred.

 

Still, the researchers conceded, the notion that sugar exacerbates ADHD has become so entrenched it may not matter whether it's true or not.

 

"No controlled study or physician counsel is likely to change this perception. Parents will continue to restrict the allowance of candy for their hyperactive child at Halloween in the belief that this will curb the level of exuberant activity, an example of the Hawthorne effect. The specific type of therapy or discipline may be less important than the attention provided by the treatment," Millichap and Yee wrote.

 

They also reviewed studies exploring the potential roles of zinc and iron deficiency in ADHD. The upshot is that there is currently little indication that such deficiencies explain more than a small minority of ADHD cases. Children with confirmed deficiencies should receive supplements or appropriate dietary adjustments regardless of their ADHD status.

 

The researchers were more impressed with the literature on polyunsaturated fatty acid supplements, especially the 2005 Oxford-Durham study.

 

In that trial, several ADHD symptoms were significantly improved in children receiving omega-3 and omega-6 fatty acid supplements, "an effect duplicated in other...supplement trials," Millichap and Yee wrote.

 

The researcher acknowledged that not all studies have confirmed the result, and recent studies have used too many different methodologies to yield firm conclusions. Nevertheless, they indicated that they now recommend it to parents of their patients, though not as the sole treatment approach.

 

"In almost all cases, for treatment to be managed effectively, medication is also required," they wrote. "The beneficial effects of omega-3 and omega-6 supplements are not clearly demonstrated."

 

"Supplemental diet therapy is simple, relatively inexpensive, and more acceptable to patient and parent," Millichap and Yee concluded. "Public education regarding a healthy diet pattern and lifestyle to prevent or control ADHD may have greater long-term success."

 

They suggested that diet-based interventions in ADHD are most appropriate when any of the following apply:

• Children suffer ADHD medication reactions or ADHD treatment failure.
• Parents or children want to try dietary modifications.
• Mineral deficiencies are evident.

Reference: Millichap J, et al. "The diet factor in attention-deficit/hyperactivity disorder" Pediatrics 2012; DOI: 10.1542/peds.2011-2199.

 

In a recent study published in Physical Medicine & Rehabilitation, Mayo Clinic researchers reported that the combination of PRP injections and tenotomy produced significant improvement in patients with long-standing tendon injuries and tendon pain.

“These disorders can be hard to treat, and patients tend to receive one therapy or the other, depending on what a doctor happens to offer. Our study was the first clinical study to investigate the combination of both treatments in injured tendons,” says study author Jay Smith, M.D., of Mayo Clinic’s Department of Physical Medicine & Rehabilitation.

The study included 34 patients with a wide range of tendon and soft tissue injuries, from rotator cuff tendinitis to plantar fasciitis, an inflammation on the bottom of the foot. In the first stage of the two-part treatment, researchers used high-resolution ultrasound technology to guide a needle to the injured area, and the physicians repeatedly poked the tendon with the needle, inducing minor bleeding within the tissue.

“The needle breaks up nonhealing, degenerative tissue and induces bleeding, hopefully converting a chronic, degenerative injury into an acute injury that has healing potential,” Dr. Smith explains. Afterward, patients received an injection of concentrated platelets from their own blood. The platelets release growth factors into the area to start the healing process.

Researchers found maximum benefits tended to occur within four months after the procedure. More than 70 percent of patients had better use of their tendons, and 76 percent reported improvement in tendon pain. In addition, researchers found some indication of tendon healing, which was detected with sophisticated ultrasound imaging.

“Larger studies are still necessary to determine whether the combination is particularly helpful for certain injuries or types of tendons, but this investigation showed these therapies together are safe and effective for some people who have an ongoing tendinopathy,” says Dr. Smith.

“Smaller plates are often recommended as a way of controlling intake, but that simply isn’t an effective strategy,” said Meena Shah, senior researcher and professor of kinesiology at Texas Christian University in Ft. Worth. “There was no plate size, weight status, or plate size by weight status effect on meal energy intake.”

Researchers examined 10 normal weight women and 10 overweight or obese women over two different days at lunch. Subjects were randomly assigned to consume lunch using either a large (27.4 cm) or small (21.6 cm) plate. The meal, which consisted of spaghetti and tomato sauce, was served in an individual serving bowl. Each subject was asked to self-serve the food from the bowl onto the assigned plate and instructed to eat until satisfied. The meal was consumed alone and without any distractions. During the second lunch, each subject went through the same procedure but using the alternative size plate.

“It is possible that plate size does not have an impact on energy intake because people eat until they are full regardless of what utensils they are using,” said Shah.

“Those who were overweight/obese reported lower levels of hunger and prospective consumptions before the meals and felt less full after the meals compared to normal weight subjects despite no difference in energy consumption between two groups,” said Shah. “This suggests that overweight/obese individuals may have a lower ability to sense hunger and fullness than normal weight adults.”

Earlier studies have shown that ANA can actually develop many years before the clinical appearance of autoimmune diseases, such as type 1 diabetes, lupus, and rheumatoid arthritis. ANA are frequently measured biomarkers for detecting autoimmune diseases, but the presence of autoantibodies does not necessarily mean a person will get an autoimmune disease. Other factors, including drugs, cancer, and infections, are also known to cause autoantibodies in some people.

“Previous estimates of ANA prevalence have varied widely and were conducted in small studies not representative of the general population,” said Frederick Miller, M.D., Ph.D., an author of the study and acting clinical director at NIEHS. “Having this large data set that is representative of the general U.S. population and includes nearly 5,000 individuals provides us with an accurate estimate of ANA and may allow new insights into the etiology of autoimmune diseases.” The findings appear online in the Jan. 11 issue of the journal Arthritis and Rheumatism.

Miller, who studies the causes of autoimmune diseases, explains that the body’s immune system makes large numbers of proteins called antibodies to help the body fight off infections. In some cases, however, antibodies are produced that are directed against one's own tissues. These are referred to as autoantibodies.

A multi-disciplinary team of researchers evaluated blood serum samples using a technique called immunofluorescence to detect ANA in 4,754 individuals from the 1994-2004 National Health and Nutrition Examination Survey (NHANES). The overall prevalence of ANA in the population was 13.8 percent, and was found to be modestly higher in African-Americans compared to whites. ANA generally increased with age and were higher in women than in men, with the female to male ratio peaking at 40-49 years of age and then declining in older age groups.

“The peak of autoimmunity in females compared to males during the 40-49 age bracket is suggestive of the effects that the hormones estrogen and progesterone might be playing on the immune system,” said Linda Birnbaum, Ph.D., director of NIEHS and an author on the paper.

The paper also found that the prevalence of ANA was lower in overweight and obese individuals than persons of normal weight. “This finding is interesting and somewhat unexpected,” said Edward Chan, Ph.D., an author on the study and professor of the Department of Oral Biology at the University of Florida.

“It raises the likelihood that fat tissues can secrete proteins that inhibit parts of the immune system and prevent the development of autoantibodies, but we will need to do more research to understand the role that obesity might play in the development of autoimmune diseases,” said Minoru Satoh, M.D., Ph.D., another author on the study and associate professor of rheumatology and clinical immunology at the University of Florida.

The researchers say the paper should serve as a useful baseline for future studies looking at changes in ANA prevalence over time and the factors associated with ANA development. The paper is the first in a series analyzing these data from the NHANES dataset, and exploring possible environmental associations with ANA.

Reference: Satoh M, Chan EKL, Ho LA, Rose KM, Parks CG, Cohn RD, Jusko TA, Walker NJ, Germolec DR, Whitt IZ, Crockett PW, Pauley BA, Chan JYF, Ross SJ, Birnbaum LS, Zeldin DC, Miller, FW. 2012. Arthritis and Rheumatism; doi: 10.1002/art.34380 [online 2012 January 11].