Question

Part 1: Base your answers on the article: Rathmann W. et. al. Relations of hyperuricemia with the various components of the insulin resistence syndrome in young black and white adults: the CARDIA study. Ann Epidemiol 1998; 8: 250-261 (each question is worth 4 points)

1. The CARDIA study is

1. A cohort study
2. A case-control study
3. A cross-sectional study
4. A longitudinal but not a cohort study  

2. The data the authors used were:

1. Longitudinal
2. Cross-sectional
3. Collected in a nested case-control fashion
4. Prospective

3. What was the age-range of the CARDIA study participants at baseline?

1. 18-30
2. 45-70
3. 55 and over
4. 65 and over

4. What is hyperuricemia?

1. High blood liver enzymes
2. High blood calcium
3. High blood uric acid
4. High blood fatty acids

5. The Insulin Resistance Syndrome (IRS) is a cluster of metabolic abnormalities related to non-response to insulin. Which of the following abnormalities is NOT reportedly part of the IRS?

1. High insulin levels
2. High blood pressure
3. Adverse lipid profile
4. High HDL cholesterol

6. Which of the following describes a rationale for doing this analysis?

1. Since IRS and hyperuricemia are both risk factors for CAD, it is important to know whether hyperuricemia is part of the IRS, or a separate independent risk factor.
2. Since IRS and hyperuricemia are both risk factors for CAD, it is important to know  
3. How they biologically interact.
4. Since IRS and hyperuricemia are both risk factors for CAD, it is important to know which one develops first.
5. Since hyperuricemia is a risk factor for CAD, it is important to find out if it can be successfully treated with insulin.

7. Based on Table 2, which of the following is (are) true?

1. Body mass index is lower in hyperuremic than in normouremic persons
2. Alcohol intake is lower in hyperuremic than in normouremic persons.   
3. Oral contraceptive use is lower in hyperuremic than in normouremic women.  
4. All of the above.

8. In Table 2, the fasting glucose values do not have plus or minus signs. This is because:

1. The authors made a mistake.
2. The numbers are odds ratios
3. The numbers are ratios of geometric means (note: a geometric means is the exponential of the mean of log-transformed values).
4. B and C

9. The authors reported that they log-transformed insulin, triglyceride and creatinine prior to analysis. This implies:

1. The original data are skewed to the right
2. The original data are skewed to the left
3. The original data are normally distributed
4. The original data are bi-modal

10. Based on information on page 254, 1st column, last paragraph (Fasting insulin and glucose), which of the following is true?

1. Smoking is a confounder of the insulin-hyperuricemia relationship.
2. Serum creatinine is a confounder of the insulin-hyperuricemia relationship.
3. Adjustment for BMI does not affect the insulin-hyperuricemia relationship.
4. None of the above

11.   Based on Table 4, which of the following may be an effect modifier of the relationship between BMI and hyperuremia.

1. Waist-to-hip ratio
2. Gender (among whites)
3. Insulin
4. Serum creatinine

12.    In general, the results of the study are:

1. Adjustment for insulin and other markers of IRS reduces the observed relationship between hyperuricemia and any individual markers of IRS, while factors not thought to be part of the IRS have no effect.   
2. Adjustment for insulin and other markers of IRS strengthens the observed relationship between hyperuricemia and any individual markers of IRS, while factors not thought to be part of the IRS have no effect.   
3. Adjustment for insulin and other markers of IRS have no effect on the observed relationship between hyperuricemia and any individual markers of IRS, while factors not thought to be part of the IRS nullify the association.
4. Adjustment for insulin and other markers of IRS have no effect on the observed relationship between hyperuricemia and any individual markers of IRS, while factors not thought to be part of the IRS strengthen the association.       

13.   The conclusion of the study is:

1. Hyperuricemia causes excess body weight.
2. Hyperuricemia causes insulin resistance
3. Hyperuricemia is part of the IRS.
4. Waist to hip ratio is not a risk factor for hyperuricemia.

14. In the discussion, the authors claim

1. Hyperuricemia causes insulin resistance
2. Excess alcohol causes insulin resistance
3. Insulin resistance causes excess alcohol intake
4. None of the above - it's a cross-sectional analysis.

Answer 1

ANSWERS :

1. The CARDIA study is a C. A cross sectional study.

2. The data the authors used for is B. Cross sectional

3. The age-range of the CARDIA study participants at baseline is A. 18-30

4. Hyperurecemia means C. High blood uric acid