News in brief - Nov. 8, 2004

More flu vaccine available in January - Intra-abdominal fat raises risk for metabolic syndrome - WHI results for HT may not be relevant for younger women

More flu vaccine available in January

Aventis Pasteur will produce 2.6 million additional doses of flu vaccine by January, and MedImmune will provide an additional 1 million doses of FluMist, Dept. of Health and Human Services Secretary Tommy Thompson has announced. This will bring the nation's supply of vaccine to 61 million doses -- still about 40 million doses short of the amount expected by the nation's physicians until contamination problems led to the current shortage.

In other developments as the flu season unfolds:

Aventis Pasteur, the lone manufacturer of injectable vaccine, is continuing to ship supplies to physicians who serve populations deemed to be at high risk of flu complications.
The American College of Emergency Physicians called on Thompson to convene a meeting to develop a response plan if a surge of flu patients should flood the nation's emergency departments.
More than half of the 677 pharmacy directors surveyed by the American Society of Health-System Pharmacists reported being offered flu vaccine at vastly inflated prices.
The Centers for Disease Control and Prevention is encouraging physicians to use antiviral medications to limit the spread and impact of institutional influenza outbreaks. Amantadine or rimantadine is recommended for chemoprophylaxis and oseltamivir or zanamivir is recommended for treatment, particularly for patients at high risk for complications.

Intra-abdominal fat raises risk for metabolic syndrome

The location of fat within the body is a better risk indicator for metabolic syndrome and heart disease in older women than their level of obesity, according to a study in the November Journal of Clinical Endocrinology and Metabolism.

Researchers at Wake Forest University School of Medicine examined 58 obese, postmenopausal women, one-half of whom had metabolic syndrome. They looked at not only whether the fat was carried on the hips or in the abdomen, but whether abdominal fat was stored between the skin and the abdominal muscle wall or as visceral fat that was wrapped around internal organs.

"Women with metabolic syndrome had 33% more visceral fat, but were similar in all other respects, including waist circumference, with almost exactly the same amount of subcutaneous fat and identical fat cell size" as women without metabolic syndrome, said Barbara Nicklas, PhD, associate professor at Wake Forest and the principal investigator in the study.

She noted that high-intensity exercise seems to preferentially reduce visceral fat but that general weight loss also provides improvement.

WHI results for HT may not be relevant for younger women

Hormone therapy should only be prescribed for alleviation of menopausal symptoms, and the data from the Women's Health Initiative may not be applicable to younger women who are the most appropriate candidates for the pills, according to a presentation at the American Academy of Family Physicians scientific sessions in Orlando last month by one of the study's principal investigators.

"We really need to be attentive to the primary indications for this medication," said Robert D. Langer, MD, MPH, associate professor in the department of family and preventive medicine at the University of California, San Diego.

According to his presentation, the WHI underenrolled younger women, and more analysis is needed to determine how the effects of HT differ according to age of initiation and the health status of the women.

"The results are not generalizeable to younger women," he said. "And there are possibly later benefits if started nearer menopause."

The final results of the arms of the WHI looking at a low-fat diet or calcium and vitamin D supplementation are due out in March of next year.