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1.  Synergistic association between alcohol intake and body mass index with serum alanine and aspartate aminotransferase levels in older adults: the Rancho Bernardo Study 
Alimentary pharmacology & therapeutics  2009;30(11-12):1137-1149.
Background
Body-mass-index (BMI) and alcohol consumption predict elevated serum alanine (ALT) and aspartate (AST) aminotransferase levels in young adults. It is unclear if alcohol intake and BMI and their joint association have a differential effect on ALT and AST levels in older adults.
Objective
To determine the association between alcohol, BMI, and their combined effect with serum ALT and AST in older community-dwelling adults in the United States.
Design and Setting
A cross-sectional, population-based study in older adults
Participants
(n=2364) from the Rancho Bernardo Study (54% women; mean age: 70 years, BMI: 25 kg/m2, alcohol users: 63%) who attended a research visit in 1984-87. BMI was recorded by a trained nurse and alcohol use ascertained by a validated questionnaire.
Outcome
Multiply adjusted odds-ratio (OR) and 95% confidence intervals (CI) of elevated serum ALT and AST (defined as ≥ 30 U/L in men and ≥ 19 U/L in women) were calculated for alcohol and BMI separately and their joint exposure using multivariate logistic regression models adjusted for age, body mass index, total cholesterol, serum triglycerides, fasting plasma glucose, systolic blood pressure, and diabetes mellitus.
Results
In multivariate-adjusted logistic regression models, obesity independently increased the odds of elevated ALT in this cohort of older men and women by 3.0 (95% CI, 1.7-5.3) and 1.8 (95%CI, 1.1-2.7), respectively. Joint effects of consuming > 3 alcoholic drinks/day and obesity raised the odds of elevated ALT by 8.9 (95%CI, 2.4-33.1) and AST by 21-fold (95%CI, 2.6-170.1), demonstrating synergism. Obese had higher odds of elevated ALT even at 0 ≤ 1 drink/day.
Conclusions
In older men and women, combination of obesity with alcohol is synergistic in increasing the risk of liver injury. Older obese should restrict their alcohol intake as the risk of liver injury is higher.
doi:10.1111/j.1365-2036.2009.04141.x
PMCID: PMC3220929  PMID: 19737152
Obesity; body mass index; alanine aminotransferase; aspartate aminotransferase; nonalcoholic fatty liver disease; nonalcoholic steatohepatitis; population-based; sex-based; epidemiology
2.  Effect of dehydroepiandrosterone supplementation on bone mineral density, bone markers, and body composition in older adults 
Summary
We present results of a randomized, placebo-controlled trial to examine the effect of 50 mg daily oral DHEA supplementation for one year on bone mineral density (BMD), bone metabolism and body composition in 225 healthy adults aged 55 to 85 years.
Introduction
Dehydroepiandrosterone (DHEA) levels decline dramatically with age, concurrent with the onset of osteoporosis, suggesting a role for DHEA supplementation in preventing age-related bone loss.
Methods
We conducted a randomized, placebo-controlled trial to examine the effect of 50 mg daily oral DHEA supplementation for one year on bone mineral density (BMD), bone metabolism and body composition in 225 healthy adults aged 55 to 85 years.
Results
DHEA treatment increased serum DHEA and DHEA sulfate levels to concentrations seen in young adults. Testosterone, estradiol and insulin-like growth factor (IGF-1) levels increased in women (all p<0.001), but not men, receiving DHEA. Serum C-terminal telopeptide of type-1 collagen levels decreased in women (p=0.03), but not men, whereas bone-specific alkaline phosphatase levels were not significantly altered in either sex. After 12 months, there was a positive effect of DHEA on lumbar spine BMD in women (p=0.03), but no effect was observed for hip, femoral neck or total body BMD, and no significant changes were observed at any site among men. Body composition was not affected by DHEA treatment in either sex.
Conclusion
Among older healthy adults, daily administration of 50 mg of DHEA has a modest and selective beneficial effect on BMD and bone resorption in women, but provides no bone benefit for men.
doi:10.1007/s00198-007-0520-z
PMCID: PMC2435090  PMID: 18084691
Body composition; Bone metabolism; Bone mineral density (BMD); Dehydroepiandrosterone (DHEA) levels; Placebo-controlled trial; Testosterone

Results 1-2 (2)