News in brief - June 7, 2004

Teens taking fewer risks - Antidepressant withdrawn from U.S. market - Diabetes linked to increased risk of Alzheimer's - BMD confirmed as key to fracture risk

Teens taking fewer risks

Although there have been significant improvements in various health-related behaviors among high school students, many still engage in behavior that puts them at risk for injury and disease, according to the 2003 Youth Risk Behavior Surveillance System released on May 20 by the Centers for Disease Control and Prevention.

During the past 12 years, the surveillance system has detected improvements in risky behaviors related to sexual activity, injuries and violence, and tobacco and alcohol use.

For example, the percentage of high school students who reported ever having sexual intercourse was 47% in 2003 compared with 54% in 1991. There was also a decrease in the number of high school students who reported having had four or more sex partners -- 14% in 2003 compared with 19% in 1991. The percentage of sexually active students who used a condom during their last sexual intercourse increased from 46% in 1991 to 63% in 2003.

For behaviors associated with tobacco and alcohol use: The percentage of high school students who reported current cigarette smoking -- which had increased from 28% in 1991 to 36% in 1997 -- fell to 22% in 2003 and the percentage of high school students who had ever drunk alcohol dropped to 75% in 2003 compared with 82% in 1991.

For the 2003 national survey, 15,214 questionnaires were completed by students in the 9th to 12th grades. Parental permission was obtained, student participation was voluntary and responses were anonymous. States and cities could modify the questionnaires to meet their needs.

Antidepressant withdrawn from U.S. market

Officials from Bristol-Myers Squibb announced May 18 that the company will end wholesale distribution of the antidepressant Serzone, or nefazodone, as of June 14 because of declining sales.

The drug, which is available as a generic, has been taken off the market in other countries and is the subject of several lawsuits in the United States that charge it causes liver damage.

Bristol-Myers has said the drug was safe and that it intends to continue to defend itself against the lawsuits.

The advocacy group Public Citizen sued the Food and Drug Administration in March over the agency's failure to act on a petition filed by the group last year seeking a ban of nefazodone, citing 21 cases of liver failure and 11 deaths between 1994 and 2002 that it blamed on the drug.

Public Citizen also faulted Bristol-Myers Squibb for not issuing a recall of the drug instead of merely withdrawing it, leaving the drug still available to patients.

The drug was approved in 1994 and has had a black box warning of liver failure since January 2002.

Diabetes linked to increased risk of Alzheimer's

The cognitive problems sometimes associated with diabetes may also lead to the development of Alzheimer's, according to a paper published in the Archives of Neurology last month.

Researchers at Rush University Medical Center in Chicago followed participants in the Religious Orders Study, which includes hundreds of Catholic nuns and priests, for nine years correlating the development of blood sugar problems with that of Alzheimer's. Those with diabetes made up just more than 15% of the overall study group, but more than 20% of this group went on to develop the brain disease.

Authors of the paper adjusted for age, sex and educational level to find that those with diabetes had a 65% increased risk of developing this form of cognitive impairment.

Those with diabetes also started the study with a lower cognitive function. All participants have agreed to donate their brains at deaths and researchers are hoping to explore further the connection of diabetes to cognitive decline.

BMD confirmed as key to fracture risk

Bone mineral density is the main indicator of osteoporosis and an increased risk of broken bones but can also be an indicator of impending death, according to two papers presented at the Osteoporosis World Congress in Rio de Janeiro, Brazil, last month.

BMD has long been considered a strong indicator of fracture risk but a meta-analysis by the World Health Organization's Center for Metabolic Bone Diseases pulling together studies looking at more than 39,000 people seems to confirm its predictive power. At the age of 65, a decrease in BMD was associated with a near tripling of the hip fracture risk in both men and women. The risk, however, varied according to age with those in their 50s having the most fracture risk from bone loss and those in their 80s having less.

In addition, an analysis from the Center for Clinical and Basic Research in Denmark suggested that BMD can indicate an increased risk of mortality. Researchers followed more than 6,000 postmenopausal women for 10 years, finding that those who died during the study period had lower bone mass.

The only exception seemed to be that women with a high BMD appeared to be at a higher risk for death from breast cancer.