Critical Appraisal of Studies of Aetiology

Running head: CRITICAL APPRAISAL OF STUDIES OF AETIOLOGY
CRITICAL APPRAISAL OF STUDIES OF AETIOLOGY
Name of the student
Name of the university
Author note

1CRITICAL APPRAISAL OF STUDIES OF AETIOLOGY
Article selected for this paper
Katakami, N., Kaneto, H., Matsuoka, T. A., Takahara, M., Osonoi, T., Saitou, M., ... &
Shimomura, I. (2014). Accumulation of oxidative stress-related gene polymorphisms and the risk
of coronary heart disease events in patients with type 2 diabetes–an 8-year prospective
study. Atherosclerosis, 235(2), 408-414.
Question 1
Life course model mentioned in the paper
As per Astell-Burt, Mitchell and Hartig (2014), the life course model of epidemiological
study of disease discusses about the physical and social exposure of people to different stressors
due to which, people and their health in later stage of life is affected. This life course model
helps the healthcare professionals to understand the socio- economic aspects, the history of
disease so that the occurrence of chronic disease and health outcomes could be achieved (Kuh et
al., 2014).
In this paper by Katakami et al. (2014), the discussed life curse model was related to
oxidative stress due to which patients with diabetes develops risk of coronary heart disease.
The period of the life course which was associated to this higher risk factor is more than 60 years
of age, when the environmental and life event stressors affects the cardiac system and modifies
the genotype to develop coronary heart disease among patients.
The paper provided a detailed hypothesis through which the life course incidence could
affect the life of the patient. Oxidative stress and resultant vulnerabilities are associated to the
genetic background of the person. As per Harris et al. (2015), glutathione is the primary

2CRITICAL APPRAISAL OF STUDIES OF AETIOLOGY
antioxidant available in most of the cells and helps to regulate the redox state so that those cells
could be protected from the oxidative injury. However, due to the environmental stress, the
catalytic subunit of the Glutamate cysteine ligase, increases the rate of GSH limiting enzyme
synthesis. Due to this, the gene expression for the GSH prevented and the oxidative stress of the
person increases. However, in hypothesis for the increased risk factor for the coronary heart
disease and associated side effects of oxidative stress, determinants of these gene polymorphisms
and the predicted occurrence of coronary heart disease in patients with type 2 diabetes mellitus
was not provided strongly and hence, this was the research topic of this selected article.
While summarizing the findings of this paper, it was seen that after 7.5 years of exposure
to life events and stresses, 85 events of coronary heart disease was observed in the patients as
well as 198 cardio vascular diseases was observed (Katakami et al., 2014). All these participants
of the 3 participatory hospitals were analyzed and it was found that stress and depression was the
primary reasons due to which patients developed hypertension, and dyslipidemia. Further, due to
the 5 genotype associated polymorphism in the genotype of the patients, their risk of
development of coronary heart disease increased (Katakami et al., 2014). However, while
statistical analysis; no such significant data connecting both these events were identified.
Answer 2
As per this study, three type of study were conducted so that the association between the
environmental stressors, life events, gene-polymorphism and the occurrence of coronary heart
disease could be assessed (Katakami et al., 2014). These studies were finding connection
between individual oxidative stresses and gene polymorphism that leads to CHD, oxidative stress
associated factors that lead to gene polymorphism and the CHD and CVD associated results. For