The New England journal of medicine
-
Comparative Study
Disparities in incidence of diabetic end-stage renal disease according to race and type of diabetes.
The incidence of end-stage renal disease in patients with diabetes mellitus is reportedly higher among blacks than among whites. This finding may be explained by the greater prevalence of diabetes among blacks. The relation of the type of diabetes to the risk of diabetic end-stage renal disease is largely unstudied. ⋯ For both races combined, the risk of diabetic end-stage renal disease during the 10-year period we studied was markedly greater for patients with IDDM (5.8 percent) than for those with NIDDM (0.5 percent). Our results indicate an increased risk of diabetic end-stage renal disease among blacks as compared with whites, particularly blacks with NIDDM. Although the risk of diabetic end-stage renal disease is higher in patients with IDDM, the majority of patients with diabetic end-stage renal disease in the population we studied had NIDDM.
-
Editorial Comment
Diabetic renal disease in blacks--inevitable or preventable?
-
Advances in the management of both chronic and acute hepatic disease have been made possible and even mandated by the development of liver transplantation. The clinical use of transplantation has proceeded at a rapid pace since a Consensus Development Conference of the National Institutes of Health concluded in June 1983 that liver transplantation had become a service and not simply an experimental procedure. ⋯ This article will focus primarily on the orthotopic procedure. However, there has been renewed interest in the auxiliary operation, which will be discussed separately.
-
Polyunsaturated fatty acids are thought to lower the serum cholesterol level more effectively than monounsaturated fatty acids. It is unclear whether the difference--if any--is due to a lowering of the level of high-density lipoprotein (HDL) or low-density lipoprotein (LDL) cholesterol. We therefore placed 31 women and 27 men on a mixed natural diet rich in saturated fat (19.3 percent of their daily energy intake from saturated fat, 11.5 percent from monounsaturated fat, and 4.6 percent from polyunsaturated fat) for 17 days. ⋯ In women, the HDL cholesterol level did not change with either. We conclude that a mixed diet rich in monounsaturated fat was as effective as a diet rich in (n-6)polyunsaturated fat in lowering LDL cholesterol. Both diets lowered the level of HDL cholesterol slightly in men but not in women.