Journals watch: MMR, depression and weight gain

No time to read the journals? Allow Dr Louise Newson to be your guide to the latest findings

A study has found that previous techniques used to implicate MMR vaccination in the development of autism yielded false positive results

No link between MMR vaccine and autism

Pediatrics 2006; 118: 1,664–75

This is another excellent study to reassure healthcare professionals and parents that there is no link between MMR vaccine and autism. Fifty-four children with autism spectrum disorder and 34 developmentally normal children were investigated.

Molecular studies showed no evidence for the persistence of measles virus following vaccination in the peripheral blood mononuclear cells of children with autism spectrum disorder. Furthermore, there was no difference in anti-measles antibody titres between the autism and control groups.

The study also found that previous techniques used to implicate MMR vaccination in the development of autism actually yielded false positive results.

Systolic BP a strong predictor of stroke

Neurology 2006; 67: 820–3

Although we know the importance of lowering both diastolic and systolic BP in order to reduce the risk of cardiovascular disease (CVD), this study has shown that systolic BP is more important when reducing stroke risk in men. Over 11,000 healthy men were followed for nearly 20 years, during which time 508 strokes occurred (411 ischaemic, 89 haemorrhagic, eight of unknown aetiology).

The results found that systolic BP was the strongest single predictor of the risk of stroke — both ischaemic and haemorrhagic. Interestingly, reducing diastolic BP did not cut stroke risk further.

Stroke patients and depression

Stroke 2006; doi: 10.1161/01.STR.0000244806. 05099.52

Depression is very common in patients who have had a stroke. This Australian study has shown that the prevalence of depression in those who had a stroke five years previously was high (17 per cent out of 441 post-stroke patients). However, of those diagnosed with depression, only 22 per cent were taking antidepressants. More surprisingly, 28 per cent of those taking antidepressants were still depressed.

The study results show that depression in stroke patients is underdiagnosed and undertreated, and serve as a reminder of the importance of managing depression appropriately in these patients, especially as stroke survivors who are not depressed live longer, higher-quality lives than those who are depressed.

Weight gain with glitazones not linked to CVD

Int J Clin Pract 2006; 60: 1,272–80

Central obesity, rather than peripheral obesity, is associated with an increased CVD risk. Although weight gain can occur in those patients with diabetes taking thiazolidinediones (glitazones), this may not actually be a detrimental side-effect, according to this review.

The obesity associated in these patients is not linked with an increase in CVD. In fact, there is some evidence that the increase in body weight associated with these drugs may lead to a reduction in central obesity.

Possible way of preventing type-2 diabetes

Lancet 2006; 368: 1,096–1,105

Rosiglitazone may have a role in the prevention of type-2 diabetes in high-risk patients, according to DREAM trial results. In this study, 5,269 adults with ‘pre-diabetes’ — impaired glucose tolerance or impaired fasting glucose — were followed for three years and randomised to either 8mg rosiglitazone or placebo.

Taking rosiglitazone actually reduced the risk of developing type-2 diabetes by 62 per cent. This is the largest diabetes prevention trial undertaken and offers extremely interesting results.

Dr Newson is a GP in the West Midlands, and a member of our team who regularly review the journals
 

The quick study
 

MMR and autism are not linked.

Systolic BP is a strong predictor of stroke.  

Depression in stroke patients is underdiagnosed and undertreated.  

Central obesity in diabetes patients taking glitazones is not a CVD risk.  

Rosiglitazone may prevent type-2 diabetes. 

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