Keogh Institute for Medical Research » Publications

Chew KK, Finn J, Stuckey B, Gibson N, Sanfilippo F, Bremner A, Thompson P, Hobbs M and Jamrozik K

Bronwyn Stuckey — Sat, 09 Oct 2010 11:06:17 +0000

Erectile dysfunction as a predictor for subsequent atherosclerotic cardiovascular events: findings from a linked data study.
Journal of Sexual Medicine 7(1):192-202, 2010.

Introduction.
In spite of the mounting interest in the nexus between erectile dysfunction (ED) and cardiovascular (CV) diseases, there is little published information on the role of ED as a predictor for subsequent CV events.
Aim.
This study aimed to investigate the role of ED as a predictor for atherosclerotic CV events subsequent to the manifestation of ED.
Method.
The investigation involved the retrospective study of data on a cohort of men with ED linked to hospital morbidity data and death registrations. By using the linked data, the incidence rates of atherosclerotic CV events subsequent to the manifestation of ED were estimated in men with ED and no atherosclerotic CV disease reported prior to the manifestation of ED. The risk of subsequent atherosclerotic CV events in men with ED was assessed by comparing these incidence rates with those in the general male population.
Main Outcome Measure.
Standardized incidence rate ratio (SIRR), comparing the incidence of atherosclerotic CV events subsequent to the manifestation of ED in a cohort of 1,660 men with ED to the incidence in the general male population.
Results.
On the basis of hospital admissions and death registrations, men with ED had a statistically significantly higher incidence of atherosclerotic CV events (SIRR 2.2; 95% confidence interval 1.9, 2.4). There were significantly increased incidence rate ratios in all age groups younger than 70 years, with a statistically highly significant downward trend with increase of age (P < 0.0001) across these age groups. Younger age at first manifestation of ED, cigarette smoking, presence of comorbidities and socioeconomic disadvantage were all associated with higher hazard ratios for subsequent atherosclerotic CV events.
Conclusions.
The findings show that ED is not only significantly associated with but is also strongly predictive of subsequent atherosclerotic CV events. This is even more striking when ED presents at a younger age.

Stuckey BGA, Kent GN, Ward LC, Brown SJ and Walsh JP

Bronwyn Stuckey — Wed, 06 Oct 2010 01:36:09 +0000

Postpartum thyroid dysfunction and the longterm risk of hypothyroidism: results from a 12-year follow-up study of women with and without postpartum thyroid dysfunction
Clinical Endocrinology (2010) 73, 389–395
Abstract
Background. The long-term risk of hypothyroidism following postpartum thyroid dysfunction (PPTD) is uncertain. Most previous studies have been small, short term or have lacked a control group.
Objective. To ascertain the long-term risk of hypothyroidism in women following PPTD.
Design and participants. A 12 year longitudinal study of 409 women (including 71 with PPTD) who previously participated in a PPTD prevalence study.
Measurements. The primary outcome measure was hypothyroidism (defined as TSH greater than 4 mU/L or on thyroxine replacement) at follow-up. Outcomes in women with and without PPTD were compared by logistic regression. Receiver operating characteristic analysis was used to determine the optimal cut-off for baseline TSH as a predictor of hypothyroidism in the cohort.
Results. At follow-up, hypothyroidism was present in 27 of 71 women who had PPTD at baseline (38%) and 14 of 338 women without PPTD (4%). From multivariate analysis, odds ratios (with 95% confidence intervals) for hypothyroidism were – 4.8 (1.6, 14.1) for PPTD; 8.2 (2.8, 24.6) for positive TPOAb ; 9.7 (2.6, 37.0) for the hypothyroid phase of PPTD and 51.4 (19.2, 137.5) for hypothyroid PPTD with positive TPOAb. A baseline TSH above 2.6 mU/L was the optimal cut-off for predicting hypothyroidism (sensitivity 76%, specificity 86%).
Conclusions. PPTD is a strong predictor of hypothyroidism in the long-term. Women who present with postpartum hypothyroidism or have positive TPOAb are at particularly high risk, suggesting that close long-term follow-up is advisable if thyroxine replacement is not instituted at an early stage.

Chew KK, Bremner A, Stuckey B, Earle C and Jamrozik K

Bronwyn Stuckey — Fri, 18 Jun 2010 09:23:28 +0000

Alcohol consumption and male erectile dysfunction: an unfounded reputation for risk?

Journal of Sexual Medicine, 6(5): 1386-1394, 2009

Introduction. Alcohol consumption is a contentious social topic and is often assumed to have deleterious effects on sexual performance. There is a lack of consensus on whether alcohol consumption may in fact be beneficial to erectile function.

Aim. We examined the data from a population-based cross-sectional study of men’s health to assess the association between usual alcohol consumption and erectile dysfunction (ED).

Method. Reply-paid questionnaires were posted to a randomly selected age-stratified male population sample obtained from the Western Australian (WA) Electoral Roll.

Main Outcome Measures. The survey questionnaire included sociodemographic details, self-reported clinical

information, and drinking habits. The 5-item International Index of Erectile Function (IIEF-5) was used to assess erectile function.

Results. Most (87%) participants were current alcohol drinkers, with binge drinking, as defined by the Australian National Health and Medical Research Council (NHMRC), reported by 20% of drinkers. Compared with neverdrinkers, the age-adjusted odds of ED were lower among current, weekend, and binge drinkers and higher among ex-drinkers. Among current drinkers, the odds were lowest for consumption within the NHMRC guidelines of between 1 and 20 standard drinks a week. On further adjustment for cardiovascular disease (CVD) or for cigarette smoking, age-adjusted odds of ED were reduced by 25–30% among alcohol drinkers.

Conclusions. Our findings suggest a modest negative association between alcohol consumption and ED and confounding of the association by CVD and cigarette smoking. The Western Australia Men’s Health Study certainly provides no justification for advising men with ED whose drinking habits are consistent with NHMRC guidelines that they should cease or reduce their consumption of alcohol.

Cussons AJ, Watts GF, Burke V, Shaw JE, Zimmet PZ and Stuckey BGA

admin — Mon, 15 Dec 2008 19:30:45 +0000

Cardiometabolic risk in polycystic ovary syndrome: a comparison of different approaches to defining the metabolic syndrome.
Human Reproduction , 23(10):2352–2358, 2008.

BACKGROUND: Polycystic ovary syndrome (PCOS) is associated with insulin resistance and features in common with the metabolic syndrome (MetS)—factors shown to predict cardiovascular risk and type 2 diabetes. We investigated the prevalence and characteristics of the MetS in PCOS by three definitions—World Health Organization (WHO), National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP-III) and International Diabetes Federation (IDF)—and compared that with the background population.

METHODS: Cross-sectional study of 168 women with PCOS and 883 age-matched controls from the Australian Diabetes, Obesity and Lifestyle (AusDiab) study.

RESULTS: Prevalence of the MetS in PCOS subjects was 33% by WHO, 37% by NCEP-ATP-III and 40% by IDF criteria, compared with 10% by NCEP-ATP-III and 13% by IDF in controls (P < 0.001). MetS by WHO criteria was not calculated in the AusDiab population. Age was an independent predictor of MetS in PCOS and controls. The prevalence of MetS was significantly higher among those with PCOS (P 5 0.027) in obese women (BMI > 30 kg/m2), and higher but not significantly so in overweight (BMI 25–30 kg/m2) women (P = 0.052). Dehydroepiandrosterone sulphate was associated with a lower risk of the MetS—Odds ratio 0.86 (95% confidence interval, 0.77–0.97, P 5 0.011).

CONCLUSIONS: An approximate 4-fold increase in the prevalence of the MetS in women with PCOS compared with the general population, consistent with the proposed major role of insulin and obesity in the syndrome, implies greater risk of cardiometabolic disease in women with PCOS. However, this estimate is likely to vary according to PCOS definition, ethnicity and different aetiological pathways to PCOS.

Davis SR., Papalia MA, Norman RJ, O’Neill S, Redelman M, Williamson M, Stuckey BGA, Wlodarczyk J, Gard’ner K and Humberstone A

admin — Sun, 14 Dec 2008 19:34:40 +0000

Safety and efficacy of a testosterone metered-dose transdermal spray for treatment of decreased sexual satisfaction in premenopausal women: a placebo-controlled randomized, dose-ranging study.

Annals of Internal Medicine, 148:569-577, 2008.

Davis SR, Stuckey BGA, Norman RJ, Papalia MA, Drillich A and Bell RJ

admin — Sun, 14 Dec 2008 19:34:19 +0000

Effects of the route of estrogen administration on IGF-I, IGFBP-3 and insulin resistance in healthy postmenopausal women: results from a randomized-controlled study.

Menopause, 15(6):1065-1069, 2008.

Gilbert RM, Hadlow NC, Walsh JP, Fletcher SJ, Brown SJ, Stuckey BGA and Lim EM

admin — Sun, 14 Dec 2008 19:33:57 +0000

Assessment of thyroid function during pregnancy: first trimester (weeks 9-13) reference intervals derived from Western Australian women.

Medical Journal of Australia, 189(5): 250-253, 2008.

Chew KK, Bremner A, Earle CM, Jamrozik K and Stuckey BGA

admin — Sun, 14 Dec 2008 19:33:42 +0000

Is the relationship between cigarette smoking and male erectile dysfunction independent of cardiovascular disease? – findings from a population-based cross-sectional study.

Journal of Sexual Medicine, doi: 10.1111/j.1743-6109.2008.00971.x, 2008.

Walsh JP, Attewell R, Stuckey BGA, Hooper MJ, Wark JD, Fletcher S, Ferrari V and Eisman JA

admin — Sun, 14 Dec 2008 19:33:23 +0000

Treatment of Paget’s disease of bone: an audit of clinical practice in Australia.

Bone, 42(6):1219–1225, 2008.

Chew GT, GF Watts, TME Davis, BGA Stuckey, Beilin LJ, Thompson PL, Burke V and Currie PJ

admin — Sun, 14 Dec 2008 19:33:06 +0000

Haemodynamic effects of fenofibrate and coenzyme Q10 in type 2 diabetic subjects with left ventricular diastolic dysfunction.

Diabetes Care, 31(8):1502-9, 2008.