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  • Changing contribution of smoking to the sex differences in life expectancy in Europe, 1950–2014
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2020-01-22
    Fanny Janssen

    Abstract This article provides a detailed and overarching illustration of the contribution of smoking to sex differences in life expectancy at birth (e0) in Europe, focusing on changes over time and differences between both European countries and European regions. For this purpose, the sex difference in e0 for 31 European countries over the 1950–2014 period was decomposed into a smoking- and a non-smoking-related part, using all-cause mortality data and indirectly estimated smoking-attributable mortality rates by age and sex, and a formal decomposition analysis. It was found that smoking-attributable mortality contributed, on average, 3 years (43.5%) to the 7-year life expectancy difference between women and men in 2014. This contribution, was largest in 1995, at 5.2 out of 9.0 years, and subsequently declined in parallel with the average sex difference in life expectancy. The average contribution of smoking-attributable mortality was especially large in North-Western Europe around 1975; in Southern Europe around 1985; and in Eastern Europe around 1990–1995, when smoking-attributable mortality reached maximum levels among men, but was still low among women. The observed parallel decline from 1995 onwards in the sex differences in e0 and the absolute contribution of smoking to this sex difference suggests that this recent decline in the sex difference in e0 can be almost fully explained by historical changes in sex differences in smoking, and, consequently, smoking-attributable mortality. In line with the progression of the smoking epidemic, the sex differences in life expectancy in Europe are expected to further decline in the future.

    更新日期:2020-01-22
  • Seasonal and pandemic influenza during pregnancy and risk of fetal death: A Norwegian registry-based cohort study
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2020-01-16
    Nina Gunnes, Håkon Kristian Gjessing, Inger Johanne Bakken, Sara Ghaderi, Jon Michael Gran, Olav Hungnes, Per Magnus, Sven Ove Samuelsen, Anders Skrondal, Camilla Stoltenberg, Lill Trogstad, Allen J. Wilcox, Siri Eldevik Håberg

    Previous studies of fetal death with maternal influenza have been inconsistent. We explored the effect of maternal influenza-like illness (ILI) in pregnancy on the risk of fetal death, distinguishing between diagnoses during regular influenza seasons and the 2009/2010 pandemic and between trimesters of ILI. We used birth records from the Medical Birth Registry of Norway to identify fetal deaths after the first trimester in singleton pregnancies (2006–2013). The Norwegian Directorate of Health provided dates of clinical influenza diagnoses by primary-health-care providers, whereas dates of laboratory-confirmed influenza A (H1N1) diagnoses were provided by the Norwegian Surveillance System for Communicable Diseases. We obtained dates and types of influenza vaccinations from the Norwegian Immunisation Registry. Cox proportional-hazards regression models were fitted to estimate hazard ratios (HRs) of fetal death, with associated 95% confidence intervals (CIs), comparing women with and without an ILI diagnosis in pregnancy. There were 2510 fetal deaths among 417,406 eligible pregnancies. ILI during regular seasons was not associated with increased risk of fetal death: adjusted HR = 0.90 (95% CI 0.64–1.27). In contrast, ILI during the pandemic was associated with substantially increased risk of fetal death, with an adjusted HR of 1.75 (95% CI 1.21–2.54). The risk was highest following first-trimester ILI (adjusted HR = 2.28 [95% CI 1.45–3.59]). ILI during the pandemic—but not during regular seasons—was associated with increased risk of fetal death in the second and third trimester. The estimated effect was strongest with ILI in first trimester.

    更新日期:2020-01-16
  • Short-term exposure to desert dust and the risk of acute myocardial infarction in Japan: a time-stratified case-crossover study
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2020-01-16
    Masanobu Ishii, Tomotsugu Seki, Koichi Kaikita, Kenji Sakamoto, Michikazu Nakai, Yoko Sumita, Kunihiro Nishimura, Yoshihiro Miyamoto, Teruo Noguchi, Satoshi Yasuda, Hiroyuki Tsutsui, Issei Komuro, Yoshihiko Saito, Hisao Ogawa, Kenichi Tsujita, Koji Kawakami

    Abstract Particulate matter from natural sources such as desert dust causes harmful effects for health. Asian dust (AD) increases the risk of acute myocardial infarction (AMI). However, little is known about the risk of myocardial infarction with nonobstructive coronary arteries (MINOCA), compared to myocardial infarction with coronary artery disease (MI-CAD). Using a time-stratified case-crossover design and conditional logistic regression models, the association between short-term exposure to AD whereby decreased visibility (< 10 km) observed at each monitoring station nearest to the hospitals was used for exposure measurements and admission for AMI in the spring was investigated using a nationwide administrative database between April 2012 and March 2016. According to presence of revascularization and coronary atherosclerosis, AMI patients (n = 30,435) were divided into 2 subtypes: MI-CAD (n = 27,202) or MINOCA (n = 3233). The single lag day-2 was used in AD exposure based on the lag effect analysis. The average level of meteorological variables and co-pollutants on the 3 days prior to the case/control days were used as covariates. The occurrence of AD events 2 days before the admission was associated with admission for MINOCA after adjustment for meteorological variables [odds ratio 1.65; 95% confidence interval (CI) 1.18–2.29], while the association was not observed in MI-CAD. The absolute risk difference of MINOCA admission was 1.79 (95% CI 1.21–2.38) per 100,000 person-year. These associations between AD exposure and the admission for MINOCA remained unchanged in two-pollutant models. This study provides evidence that short-term exposure to AD is associated with a higher risk of MINOCA, but not MI-CAD.

    更新日期:2020-01-16
  • Coffee consumption and risk of bladder cancer: a pooled analysis of 501,604 participants from 12 cohort studies in the BLadder Cancer Epidemiology and Nutritional Determinants (BLEND) international study
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2020-01-11
    Evan Y. W. Yu, Yanan Dai, Anke Wesselius, Frits van Osch, Maree Brinkman, Piet van den Brandt, Eric J. Grant, Emily White, Elisabete Weiderpass, Marc Gunter, Bertrand Hemon, Maurice P. Zeegers

    Recent epidemiological studies have shown varying associations between coffee consumption and bladder cancer (BC). This research aims to elucidate the association between coffee consumption and BC risk by bringing together worldwide cohort studies on this topic. Coffee consumption in relation to BC risk was examined by pooling individual data from 12 cohort studies, comprising of 2601 cases out of 501,604 participants. Pooled multivariate hazard ratios (HRs), with corresponding 95% confidence intervals (CIs), were obtained using multilevel Weibull regression models. Furthermore, dose–response relationships were examined using generalized least squares regression models. The association between coffee consumption and BC risk showed interaction with sex (P-interaction < 0.001) and smoking (P-interaction = 0.001). Therefore, analyses were stratified by sex and smoking. After adjustment for potential confounders, an increased BC risk was shown for high (> 500 ml/day, equivalent to > 4 cups/day) coffee consumption compared to never consumers among male smokers (current smokers: HR = 1.75, 95% CI 1.27–2.42, P-trend = 0.002; former smokers: HR = 1.44, 95% CI 1.12–1.85, P-trend = 0.001). In addition, dose–response analyses, in male smokers also showed an increased BC risk for coffee consumption of more than 500 ml/day (4 cups/day), with the risk of one cup (125 ml) increment as 1.07 (95% CI 1.06–1.08). This research suggests that positive associations between coffee consumption and BC among male smokers but not never smokers and females. The inconsistent results between sexes and the absence of an association in never smokers indicate that the associations found among male smokers is unlikely to be causal and is possibly caused by residual confounding of smoking.

    更新日期:2020-01-13
  • Using Mendelian randomization to evaluate the causal relationship between serum C-reactive protein levels and age-related macular degeneration
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2020-01-03
    Xikun Han, Jue-Sheng Ong, Jiyuan An, Alex W. Hewitt, Puya Gharahkhani, Stuart MacGregor

    Serum C-reactive protein (CRP), an important inflammatory marker, has been associated with age-related macular degeneration (AMD) in observational studies; however, the findings are inconsistent. It remains unclear whether the association between circulating CRP levels and AMD is causal. We used two-sample Mendelian randomization (MR) to evaluate the potential causal relationship between serum CRP levels and AMD risk. We derived genetic instruments for serum CRP levels in 418,642 participants of European ancestry from UK Biobank, and then conducted a genome-wide association study for 12,711 advanced AMD cases and 14,590 controls of European descent from the International AMD Genomics Consortium. Genetic variants which predicted elevated serum CRP levels were associated with advanced AMD (odds ratio [OR] for per standard deviation increase in serum CRP levels: 1.31, 95% confidence interval [CI]: 1.19–1.44, P = 5.2 × 10−8). The OR for the increase in advanced AMD risk when moving from low (< 3 mg/L) to high (> 3 mg/L) CRP levels is 1.29 (95% CI: 1.17–1.41). Our results were unchanged in sensitivity analyses using MR models which make different modelling assumptions. Our findings were broadly similar across the different forms of AMD (intermediate AMD, choroidal neovascularization, and geographic atrophy). We used multivariable MR to adjust for the effects of other potential AMD risk factors including smoking, body mass index, blood pressure and cholesterol; this did not alter our findings. Our study provides strong genetic evidence that higher circulating CRP levels lead to increases in risk for all forms of AMD. These findings highlight the potential utility for using circulating CRP as a biomarker in future trials aimed at modulating AMD risk via systemic therapies.

    更新日期:2020-01-04
  • Blood pressure, hypertension and the risk of sudden cardiac death: a systematic review and meta-analysis of cohort studies
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2019-12-24
    Han Pan, Makoto Hibino, Elsa Kobeissi, Dagfinn Aune

    Abstract Cardiovascular disease is the leading cause of death worldwide, while sudden cardiac death (SCD) accounts for over 60% of all cardiovascular deaths. Elevated blood pressure and hypertension have been associated with increased risk of SCD, but the findings have not been consistent. To clarify whether blood pressure or hypertension is associated with increased risk of SCD and to quantify the size and the shape of any association observed. PubMed and Embase databases were searched for published prospective studies on blood pressure or hypertension and SCD up to 30 April 2018. Summary relative risks (RRs) and 95% confidence intervals (CIs) were calculated using a random effects model. The meta-analysis included 2939 SCDs among 418,235 participants from 18 studies. The summary RRs were 2.10 (95% CI 1.71–2.58, I2 = 56.7%, pheterogeneity = 0.018, n = 10) for prevalent hypertension, 1.28 (95% CI 1.19–1.38, I2 = 45.5%, pheterogeneity = 0.07, n = 10) per 20 mmHg increment in systolic blood pressure (SBP) and 1.09 (95% CI 0.83–1.44, I2 = 83.4%, pheterogeneity = 0.002, n = 3) per 10 mmHg increment in diastolic blood pressure (DBP). A nonlinear relationship was suggested between SBP and SCD. The results persisted in most subgroup and sensitivity analyses. There was no evidence of publication bias. This meta-analysis found an increased risk of SCD with hypertension diagnosis and increasing SBP. Future studies should clarify the association for DBP and the shape of the dose–response relationship between blood pressure and SCD.

    更新日期:2019-12-25
  • Hospitalization following influenza infection and pandemic vaccination in multiple sclerosis patients: a nationwide population-based registry study from Norway
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2019-12-23
    Sara Ghaderi, Pål Berg-Hansen, Inger Johanne Bakken, Per Magnus, Lill Trogstad, Siri Eldevik Håberg

    Abstract Patients with multiple sclerosis (MS) are at increased risk of infections and related worsening of neurological function. Influenza infection has been associated with increased risk of various neurological complications. We conducted a population-based registry study to investigate the risk of acute hospitalization of MS patients in relation to influenza infection or pandemic vaccination in Norway. The entire Norwegian population in the years 2008–2014 was defined as our study population (N = 5,219,296). Information on MS diagnosis, influenza infection and vaccination were provided by Norwegian national registries. The self-controlled case series method was used to estimate incidence rate ratios (IRRs) with 95% confidence intervals (95% CI) in defined risk periods. 6755 MS patients were identified during the study period. Average age at first registration of an MS diagnosis was 51.8 years among men and 49.9 years among females (66.9%). The IRR for emergency hospitalization among MS patients the first week after an influenza diagnosis was 3.4 (95% CI 2.4–4.8). The IRR was 5.6 (95% CI 2.7–11.3) after pandemic influenza, and 4.8 (95% CI 3.1–7.4) after seasonal influenza. Pandemic vaccination did not influence risk of hospitalization [IRR within the first week: 0.7 (95% CI 0.5–1.0)]. Among MS patients, influenza infection was associated with increased risk for acute hospitalization while no increased risk was observed after pandemic vaccination. Influenza vaccination could prevent worsening of MS-related symptoms as well as risk of hospitalization.

    更新日期:2019-12-23
  • Annual rate of newly treated atrial fibrillation by age and gender in France, 2010–2016
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2019-12-23
    Amélie Gabet, Edouard Chatignoux, Cécile Billionnet, Géric Maura, Maurice Giroud, Yannick Béjot, Valérie Olié

    Few studies are available on atrial fibrillation (AF) burden at a whole country scale. The objective was to estimate the rate of AF patients newly treated with oral anticoagulants (OAC) in France each year between 2010 and 2016 and to describe age and gender differences. We used the French national health data system. For each year between 2010 and 2016, we identified patients aged over 20 initiating OAC. OAC indicated for the treatment of AF was determined by hospitalization diagnoses, specific procedures and registered long-term disease status, or a multiple imputation process for patients with no recorded information as to why they initiated OAC. Among the 421,453 individuals initiating OAC treatment in 2016, the estimated number of newly treated AF patients was 210,131, women accounting for 46%, patients under 65 years old 17%, and 21.4% of patients living in most deprived area. Age-standardized rates reached 400/100,000 inhabitants. Approximately 19% of patients were recently hospitalized for heart failure and 7% for stroke. Age-standardized rates increased by 35% over the study period in both genders, with a marked increase in patients under 55 (+ 41%) and those over 85 years old (+ 60%). Annual rates of AF patients newly treated with OAC increased by 35% between 2010 and 2016. Important differences in rates were observed according to age, gender and the deprivation level of the living area.

    更新日期:2019-12-23
  • Pathology-confirmed versus non pathology-confirmed cancer diagnoses: incidence, participant characteristics, and survival
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2019-12-20
    Kimberly D. van der Willik, Liliana P. Rojas-Saunero, Jeremy A. Labrecque, M. Arfan Ikram, Sanne B. Schagen, Bruno H. Stricker, Rikje Ruiter

    Cancer diagnoses which are not confirmed by pathology are often under-registered in cancer registries compared to pathology-confirmed diagnoses. It is unknown how many patients have a non pathology-confirmed cancer diagnosis, and whether their characteristics and survival differ from patients with a pathology-confirmed diagnosis. Participants from the prospective population-based Rotterdam Study were followed between 1989 and 2013 for the diagnosis of cancer. Cancer diagnoses were classified into pathology-confirmed versus non pathology-confirmed (i.e., based on imaging or tumour markers). We compared participant characteristics and the distribution of cancers at different sites. Furthermore, we investigated differences in overall survival using survival curves adjusted for age and sex. During a median (interquartile range) follow-up of 10.7 (6.3–15.9) years, 2698 out of 14,024 participants were diagnosed with cancer, of which 316 diagnoses (11.7%) were non pathology-confirmed. Participants with non pathology-confirmed diagnoses were older, more often women, and had a lower education. Most frequently non pathology-confirmed cancer sites included central nervous system (66.7%), hepato-pancreato-biliary (44.5%), and unknown primary origin (31.2%). Survival of participants with non pathology-confirmed diagnoses after 1 year was lower compared to survival of participants with pathology-confirmed diagnoses (32.6% vs. 63.4%; risk difference of 30.8% [95% CI 25.2%; 36.2%]). Pathological confirmation of cancer is related to participant characteristics and cancer site. Furthermore, participants with non pathology-confirmed diagnoses have worse survival than participants with pathology-confirmed diagnoses. Missing data on non pathology-confirmed diagnoses may result in underestimation of cancer incidence and in an overestimation of survival in cancer registries, and may introduce bias in aetiological research.

    更新日期:2019-12-20
  • Vaccines and the risk of Guillain-Barré syndrome
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2019-12-19
    Yong Chen, Jinlin Zhang, Xuhua Chu, Yuanling Xu, Fubao Ma

    The role of vaccination in the development of Guillain-Barré syndrome (GBS) is controversial, although cases of GBS have been reported following a wide range of vaccines. A nested case–control study was conducted between January 2011 and December 2015 in three Chinese cities. Four controls were matched to a case by gender, age, address and index date. An independent expert committee validated the diagnoses of cases and controls according to the Brighton Collaboration GBS case definition. Data on vaccinations were obtained from computerized vaccination records. Causal relations were assessed by conditional logistic regression. 1056 cases of GBS and 4312 controls were included in the analyses. Among paediatric and adult population, adjusted ORs for GBS occurrence within 180 days following vaccination were 0.94 (95% CI 0.54–1.62) and 1.09 (95% CI 0.88–1.32), respectively. No increased risk of GBS was detected for vaccination against hepatitis B, influenza, hepatitis A, varicella, rabies, polio(live), diphtheria, pertuss(acellular), tetanusis, measles, mumps, rubella, Japanese Encephalitis, and meningitis vaccines. Adjusted ORs for the recurrence of GBS after vaccination among paediatric and adult population were 0.85 (95% CI 0.07–9.50) and 1.18 (95% CI 0.49–2.65), respectively. In this large retrospective study, we did not find evidence of an increased risk of GBS and its recurrence among either paediatric (≤ 18 years) or adult (> 18 years) individuals within the 180 days following vaccinations of any kind, including influenza vaccination.

    更新日期:2019-12-19
  • Risk of intellectual disability in children born appropriate-for-gestational-age at term or post-term: impact of birth weight for gestational age and gestational age
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2019-12-02
    Ruoqing Chen, Kristina Tedroff, Eduardo Villamor, Donghao Lu, Sven Cnattingius

    Children born small for gestational age have a higher risk of intellectual disability. We investigated associations of birth weight for gestational age percentile and gestational age with risk of intellectual disability in appropriate-for-gestational-age (AGA) children. We included 828,948 non-malformed term or post-term AGA singleton children (including 429,379 full siblings) born between 1998 and 2009 based on data from the Swedish Medical Birth Register. Diagnosis of intellectual disability after 3 years of age was identified through the Patient Register. Using Cox regression models, we calculated hazard ratios (HRs) with 95% confidence intervals (CIs) of intellectual disability among children with different birth weight percentiles and gestational age in the whole population and in a subpopulation of full siblings. A total of 1688 children were diagnosed with intellectual disability during follow-up. HRs (95% CIs) of intellectual disability for the low birth weight percentile groups (10th–24th and 25th–39th percentiles, respectively) versus the reference group (40th–59th percentiles) were 1.43 (1.22–1.67) and 1.28 (1.10–1.50) in population analysis and 1.52 (1.00–2.31) and 1.44 (1.00–2.09) in sibling comparison analysis. The increased risk for low birth weight percentiles in population analysis was stable irrespective of gestational age. A weak U-shaped association between gestational age and intellectual disability was observed in population analysis, although not in sibling comparison analysis. These findings suggest that among AGA children born at term or post-term, lower birth weight percentiles within the normal range are associated with increased risk of intellectual disability, regardless of gestational age.

    更新日期:2019-12-02
  • Association of aortic stiffness with cognitive decline: Whitehall II longitudinal cohort study
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2019-11-27
    Marzieh Araghi, Martin J. Shipley, Ian B. Wilkinson, Carmel M. McEniery, Carlos A. Valencia-Hernández, Mika Kivimaki, Séverine Sabia, Archana Singh-Manoux, Eric J. Brunner

    Aortic stiffness is associated with an increased risk of cardio- and cerebrovascular disease and mortality and may increase risk of dementia. The aim of the present study is to examine the association between arterial stiffness and cognitive decline in a large prospective cohort study with three repeated cognitive assessment over 7 years of follow-up. Aortic pulse wave velocity (PWV) was measured among 4300 participants (mean ± standard deviation age 65.1 ± 5.2 years) in 2007–2009 and categorized based on the tertiles: (lowest third: < 7.41 m/s), (middle third: 7.41–8.91 m/s), and (highest third: > 8.91 m/s). A global cognitive score was calculated in 2007–2009, 2012–2013, and 2015–2016 based on responses to memory, reasoning and fluency tests. Standardized global cognitive score (mean = 0, SD = 1) in highest third versus lowest third of PWV category was lower at baseline (− 0.12, 95% CI − 0.18, − 0.06). Accelerated 7-year cognitive decline was observed among individuals with the highest PWV [difference in 7-year cognitive change for highest third versus lowest third PWV: − 0.06, 95% CI − 0.11, − 0.01, P < 0.01]. Higher aortic stiffness was associated with faster cognitive decline. Clinicians may be able to use arterial stiffness severity as an indicator to administer prompt treatments to prevent or delay the onset of cognitive decline or dementia. Future studies need to determine whether early intervention of vascular stiffness is effective in delaying these outcomes.

    更新日期:2019-11-28
  • Circulating total bilirubin and risk of non-alcoholic fatty liver disease in the PREVEND study: observational findings and a Mendelian randomization study
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2019-11-26
    Setor K. Kunutsor, Monika Frysz, Niek Verweij, Lyanne M. Kieneker, Stephan J. L. Bakker, Robin P. F. Dullaart

    The relationship between circulating total bilirubin and incident non-alcoholic fatty liver disease (NAFLD) is uncertain. We aimed to assess the association of total bilirubin with the risk of new-onset NAFLD and investigate any causal relevance to the association using a Mendelian randomization (MR) study. Plasma total bilirubin levels were measured at baseline in the PREVEND prospective study of 3824 participants (aged 28–75 years) without pre-existing cardiovascular disease or NAFLD. Incident NAFLD was estimated using the biomarker-based algorithms, fatty liver index (FLI) and hepatic steatosis index (HSI). Odds ratios (ORs) (95% confidence intervals) for NAFLD were assessed. The genetic variant rs6742078 located in the UDP-glucuronosyltransferase (UGT1A1) locus was used as an instrumental variable. Participants were followed up for a mean duration of 4.2 years. The multivariable adjusted OR (95% CIs) for NAFLD as estimated by FLI (434 cases) was 0.82 (0.73–0.92; p = 0.001) per 1 standard deviation (SD) change in loge total bilirubin. The corresponding adjusted OR (95% CIs) for NAFLD as estimated by HSI (452 cases) was 0.87 (0.78–0.97; p = 0.012). The rs6742078 variant explained 20% of bilirubin variation. The ORs (95% CIs) for a 1 SD genetically elevated total bilirubin level was 0.98 (0.69–1.38; p = 0.900) for FLI and 1.14 (0.81–1.59; p = 0.451) for HSI. Elevated levels of total bilirubin were not causally associated with decreased risk of NAFLD based on MR analysis. The observational association may be driven by biases such as unmeasured confounding and/or reverse causation. However, due to low statistical power, larger-scale investigations are necessary to draw definitive conclusions.

    更新日期:2019-11-27
  • Genetic instrumental variable analysis: time to call mendelian randomization what it is. The example of alcohol and cardiovascular disease
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2019-11-24
    Kenneth J. Mukamal, Meir J. Stampfer, Eric B. Rimm

    In recent years, epidemiologists have increasingly sought to employ genetic data to identify ‘causal’ relationships between exposures of interest and various endpoints – an instrumental variable approach sometimes termed Mendelian randomization. However, this approach is subject to all of the limitations of instrumental variable analysis and to several limitations specific to its genetic underpinnings, including confounding, weak instrument bias, pleiotropy, adaptation, and failure of replication. Although the approach enjoys some utility in testing the etiological role of discrete biochemical pathways, like folate metabolism, examples like that of alcohol consumption and cardiovascular disease demonstrate that it must be treated with all of the circumspection that should accompany all forms of observational epidemiology. Going forward, we urge the elimination of randomization or causality in reports of its use and suggest that Mendelian randomization instead be termed exactly what it is – genetic instrumental variable analysis.

    更新日期:2019-11-26
  • Soy intake and breast cancer risk: a prospective study of 300,000 Chinese women and a dose–response meta-analysis
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2019-11-21
    Yuxia Wei, Jun Lv, Yu Guo, Zheng Bian, Meng Gao, Huaidong Du, Ling Yang, Yiping Chen, Xi Zhang, Tao Wang, Junshi Chen, Zhengming Chen, Canqing Yu, Dezheng Huo, Liming Li, the China Kadoorie Biobank Collaborative Group

    Epidemiological evidence on the association of soy intake with breast cancer risk is still inconsistent due to different soy intake levels across previous studies and small number of breast cancer cases. We aimed to investigate this issue by analyzing data from the China Kadoorie Biobank (CKB) study and conducting a dose–response meta-analysis to integrate existing evidence. The CKB study included over 300,000 women aged 30–79 from 10 regions across China enrolled between 2004 and 2008, and followed-up for breast cancer events until 31 December 2016. Information on soy intake was collected from baseline, two resurveys and twelve 24-h dietary recalls. We also searched for relevant prospective cohort studies to do a dose–response meta-analysis. The mean (SD) soy intake was 9.4 (5.4) mg/day soy isoflavones among CKB women. During 10 years of follow-up, 2289 women developed breast cancers. The multivariable-adjusted relative risk was 1.00 (95% confidence interval [CI] 0.81–1.22) for the fourth (19.1 mg/day) versus the first (4.5 mg/day) soy isoflavone intake quartile. Meta-analysis of prospective studies found that each 10 mg/day increment in soy isoflavone intake was associated with a 3% (95% CI 1–5%) reduced risk of breast cancer. The CKB study demonstrated that moderate soy intake was not associated with breast cancer risk among Chinese women. Higher amount of soy intake might provide reasonable benefits for the prevention of breast cancer.

    更新日期:2019-11-22
  • Predicted lean body mass, fat mass and risk of lung cancer: prospective US cohort study
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2019-11-21
    Su-Min Jeong, Dong Hoon Lee, Edward L. Giovannucci

    An inverse association between body mass index (BMI) and risk of lung cancer has been reported. However, the association of body composition such as fat mass (FM) and lean body mass (LBM) with risk of lung cancer has not been fully investigated. Using two large prospective cohort studies (Nurses’ Health Study, 1986–2014; Health Professionals Follow-up Study, 1987–2012) in the United States, we included 100,985 participants who were followed for occurrence of lung cancer. Predicted FM and LBM derived from validated anthropometric prediction equations were categorized by sex-specific deciles. During an average 22.3-year follow-up, 2615 incident lung cancer cases were identified. BMI showed an inverse association with lung cancer risk. Participants in the 10th decile of predicted FM and LBM had a lower risk of lung cancer compared with those in the 1st decile, but when mutually adjusted for each other, predicted FM was not associated with lung cancer risk (adjusted hazard ratio [aHR] = 0.98, 95% confidence interval [CI] 0.72–1.35; P(trend) = 0.97) whereas predicted LBM had an inverse association (aHR = 0.73, 95% CI 0.53–1.00; P(trend) = 0.03), especially among participants who were current smokers or had smoked in the previous 10 years (aHR = 0.55, 95% CI 0.36–0.84; P(trend) = 0.008). In conclusion, BMI was inversely associated with lung cancer risk. Based on anthropometric prediction equations, low LBM rather than low FM accounted for the inverse association between BMI and lung cancer risk.

    更新日期:2019-11-21
  • Pregnancy, pregnancy loss and the risk of diabetes in Chinese women: findings from the China Kadoorie Biobank
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2019-11-19
    Sanne A. E. Peters, Ling Yang, Yu Guo, Yiping Chen, Zheng Bian, Huarong Sun, Yanjie Li, Liming Li, Mark Woodward, Zhengming Chen, China Kadoorie Biobank Collaboration Group

    Pregnancy and pregnancy loss may be associated with increased risk of diabetes in later life. However, the evidence is inconsistent and sparse, especially among East Asians where reproductive patterns differ importantly from those in the West. We examined the associations of pregnancy and pregnancy loss (miscarriage, induced abortion, and still birth) with the risk of incident diabetes in later life among Chinese women. In 2004–2008, the nationwide China Kadoorie Biobank recruited 302 669 women aged 30–79 years from 10 (5 urban, 5 rural) diverse localities. During 9.2 years of follow-up, 7780 incident cases of diabetes were recorded among 273,383 women without prior diabetes and cardiovascular disease at baseline. Cox regression yielded multiple-adjusted hazard ratios (HRs) for the risk of diabetes associated with pregnancy and pregnancy loss. Overall, 99% of women had been pregnant, of whom 10%, 53%, and 6% reported having a history of miscarriage, induced abortion, and stillbirth, respectively. Among ever pregnant women, each additional pregnancy was associated with an adjusted HR of 1.04 (95% CI 1.03; 1.06) for diabetes. Compared with those without pregnancy loss, women with a history of pregnancy loss had an adjusted HR of 1.07 (1.02; 1.13) and the HRs increased with increasing number of pregnancy losses, irrespective of the number of livebirths; the adjusted HR was 1.03 (1.00; 1.05) for each additional pregnancy loss. The strength of the relationships differed marginally by type of pregnancy loss. Among Chinese women, a higher number of pregnancies and pregnancy losses were associated with a greater risk of diabetes.

    更新日期:2019-11-19
  • Serum albumin and atrial fibrillation: insights from epidemiological and mendelian randomization studies
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2019-11-18
    Li-zhen Liao, Shao-zhao Zhang, Wei-dong Li, Ying Liu, Jia-ping Li, Xiao-dong Zhuang, Xin-xue Liao

    Atrial fibrillation (AF) is the most common arrhythmia in clinical practice. Low serum albumin level is linked to the emergence of many cardiovascular diseases, including AF. In this study, we aim to characterize the nature and magnitude of the prospective association between serum albumin and incident AF in the Atherosclerosis Risk in Communities (ARIC) Study and investigate any causal relevance to the association between them. ARIC Study is a population-based, prospective, cohort study of cardiovascular risk factors in four US communities, initially consisting of 15,792 participants, aged 45–64 years, recruited between 1987 and 1989 (visit 1). The final sample size was 12,833 in this study. Baseline (visit 1) characteristics were compared between groups using one-way ANOVA test, Chi square test, or Kruskal–Wallis test as appropriate. We used multivariable Cox’ hazard regression models to assess the association between albumin and incident AF. Two-sample Mendelian randomization (MR) based on publicly available summary-level data from genome-wide association studies was used to estimate the causal influence of the serum albumin and incident AF. During a median follow-up of 25.1 years, 2259 (17.6%) participants developed incident AF. After multiple adjustment, serum albumin was inversely associated with incidence of AF [HR = 0.90, 95% CI 0.86–0.94, per SD (0.27 g/dL) increase; HR = 0.80, 95% CI 0.71–0.91, Q4 vs. Q1]. In MR analysis, we detected no evidence for a causal relation between serum albumin level and AF in inverse-variance weighted (IVW) method (odds ratio: 0.996, 95% CI 0.980–1.012, per 1 g/dL increase of albumin; P = 0.620) without evidence of heterogeneity between estimates from individual SNPs (Pheterogeneity = 0.981 [MR-Egger] and Pheterogeneity = 0.860 [IVW]) nor pleiotropy effect (Ppleiotropy = 0.193). The serum albumin level is independently inverse associated with incident AF in a linear pattern. However, MR analyses did not support a causal role of serum albumin in the etiology of AF.

    更新日期:2019-11-18
  • Risk of colorectal cancer in users of bisphosphonates: analysis of population-based electronic health records
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2019-11-16
    Gemma Ibáñez-Sanz, Elisabet Guinó, Caridad Pontes, Rosa Morros, Luisa C. de la Peña-Negro, Mª Ángeles Quijada-Manuitt, Victor Moreno

    The use of bisphosphonates has been associated with a decrease in the risk of colorectal cancer (CRC) in observational studies, but with controversial results and difficult to interpret because of routine concomitant use of calcium and vitamin D. We aimed to assess the association between CRC risk and outpatient exposure to antiosteoporotic drugs using a large cohort with prescription data in Catalonia. A case–control study was performed using the Information System for Development of Primary Care Research (SIDIAP) which is a primary care medical record database that has linked data on reimbursed medication. The study included 25,836 cases with an incident diagnosis of CRC between 2010 and 2015 and 129,117 matched controls by age (± 5 years), sex and healthcare region. A multivariable model was built adjusting for known risk factors and comorbidities that were significantly associated to CRC in the dataset, and a propensity score for bisphosphonates. Tests for interaction for multiple drug use and stratified analysis for tumour location were prospectively planned. Overall 18,230 individuals (11.5%) were users of bisphosphonates. A significant but modest protective effect on CRC was observed for bisphosphonates (OR 0.95, 95% CI 0.91–0.99), that was no longer significant when adjusted for calcium and vitamin D (OR 0.98, 95% CI 0.93–1.03). Bisphosphonates, however, showed a dose–response effect with duration of use even when adjusted for calcium and vitamin D (OR for use > 40 months: 0.90, 95% CI 0.81–1.00, P value for trend: 0.018). The use of bisphosphonates was associated with a modest decrease in the risk of CRC, but this effect was essentially explained by concomitant use of calcium or vitamin D. The observed protective effect was stronger for long durations of use, which deserves further study.

    更新日期:2019-11-17
  • Progress against inequalities in mortality: register-based study of 15 European countries between 1990 and 2015
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2019-11-15
    Johan P. Mackenbach, José Rubio Valverde, Matthias Bopp, Henrik Brønnum-Hansen, Giuseppe Costa, Patrick Deboosere, Ramune Kalediene, Katalin Kovács, Mall Leinsalu, Pekka Martikainen, Gwenn Menvielle, Maica Rodriguez-Sanz, Wilma J. Nusselder

    Socioeconomic inequalities in mortality are a challenge for public health around the world, but appear to be resistant to policy-making. We aimed to identify European countries which have been more successful than others in narrowing inequalities in mortality, and the factors associated with narrowing inequalities. We collected and harmonised mortality data by educational level in 15 European countries over the last 25 years, and quantified changes in inequalities in mortality using a range of measures capturing different perspectives on inequality (e.g., ‘relative’ and ‘absolute’ inequalities, inequalities in ‘attainment’ and ‘shortfall’). We determined which causes of death contributed to narrowing of inequalities, and conducted country- and period-fixed effects analyses to assess which country-level factors were associated with narrowing of inequalities in mortality. Mortality among the low educated has declined rapidly in all European countries, and a narrowing of absolute, but not relative inequalities was seen in many countries. Best performers were Austria, Italy (Turin) and Switzerland among men, and Spain (Barcelona), England and Wales, and Austria among women. Ischemic heart disease, smoking-related causes (men) and amenable causes often contributed to narrowing inequalities. Trends in income inequality, level of democracy and smoking were associated with widening inequalities, but rising health care expenditure was associated with narrowing inequalities. Trends in inequalities in mortality have not been as unfavourable as often claimed. Our results suggest that health care expansion has counteracted the inequalities widening effect of other influences.

    更新日期:2019-11-15
  • A quarter century of decline of autopsies in the Netherlands
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2019-11-14
    Bartholomeus G. H. Latten, Lucy I. H. Overbeek, Bela Kubat, Axel zur Hausen, Leo J. Schouten

    Autopsy rates have been declining worldwide. The present study reports the outcome of a retrospective analysis of all non-forensic autopsies in the Netherlands over a course of 25 years, and compares these with the most recent Dutch study.

    更新日期:2019-11-14
  • Physical activity and risk of venous thromboembolism: systematic review and meta-analysis of prospective cohort studies
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2019-11-14
    Setor K. Kunutsor, Timo H. Mäkikallio, Samuel Seidu, Claudio Gil Soares de Araújo, Richard S. Dey, Ashley W. Blom, Jari A. Laukkanen

    The inverse association between physical activity and arterial thrombotic disease is well established. Evidence on the association between physical activity and venous thromboembolism (VTE) is divergent. We conducted a systematic review and meta-analysis of published observational prospective cohort studies evaluating the associations of physical activity with VTE risk. MEDLINE, Embase, Web of Science, and manual search of relevant bibliographies were systematically searched until 26 February 2019. Extracted relative risks (RRs) with 95% confidence intervals (CIs) for the maximum versus minimal amount of physical activity groups were pooled using random effects meta-analysis. Twelve articles based on 14 unique prospective cohort studies comprising of 1,286,295 participants and 23,753 VTE events were eligible. The pooled fully-adjusted RR (95% CI) of VTE comparing the most physically active versus the least physically active groups was 0.87 (0.79–0.95). In pooled analysis of 10 studies (288,043 participants and 7069 VTE events) that reported risk estimates not adjusted for body mass index (BMI), the RR (95% CI) of VTE was 0.81 (0.70–0.93). The associations did not vary by geographical location, age, sex, BMI, and methodological quality of studies. There was no evidence of publication bias among contributing studies. Pooled observational prospective cohort studies support an association between regular physical activity and low incidence of VTE. The relationship does not appear to be mediated or confounded by BMI.

    更新日期:2019-11-14
  • A 24-step guide on how to design, conduct, and successfully publish a systematic review and meta-analysis in medical research
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2019-11-13
    Taulant Muka, Marija Glisic, Jelena Milic, Sanne Verhoog, Julia Bohlius, Wichor Bramer, Rajiv Chowdhury, Oscar H. Franco

    To inform evidence-based practice in health care, guidelines and policies require accurate identification, collation, and integration of all available evidence in a comprehensive, meaningful, and time-efficient manner. Approaches to evidence synthesis such as carefully conducted systematic reviews and meta-analyses are essential tools to summarize specific topics. Unfortunately, not all systematic reviews are truly systematic, and their quality can vary substantially. Since well-conducted evidence synthesis typically involves a complex set of steps, we believe formulating a cohesive, step-by-step guide on how to conduct a systemic review and meta-analysis is essential. While most of the guidelines on systematic reviews focus on how to report or appraise systematic reviews, they lack guidance on how to synthesize evidence efficiently. To facilitate the design and development of evidence syntheses, we provide a clear and concise, 24-step guide on how to perform a systematic review and meta-analysis of observational studies and clinical trials. We describe each step, illustrate it with concrete examples, and provide relevant references for further guidance. The 24-step guide (1) simplifies the methodology of conducting a systematic review, (2) provides healthcare professionals and researchers with methodologically sound tools for conducting systematic reviews and meta-analyses, and (3) it can enhance the quality of existing evidence synthesis efforts. This guide will help its readers to better understand the complexity of the process, appraise the quality of published systematic reviews, and better comprehend (and use) evidence from medical literature.

    更新日期:2019-11-13
  • Association between cardiorespiratory fitness and colorectal cancer in the UK Biobank
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2019-11-09
    Andrea Hillreiner, Sebastian E. Baumeister, Anja M. Sedlmeier, Jonas D. Finger, Hans J. Schlitt, Michael F. Leitzmann

    Increased cardiorespiratory fitness is related to decreased risk of major chronic illnesses, including cardiovascular disease, type 2 diabetes, and cancer, but its association with colorectal cancer specifically has received very little attention. We examined the relation of cardiorespiratory fitness to colorectal cancer in 59,191 UK Biobank participants aged 39–70 years without prevalent cancer at baseline, followed from 2009 to 2014. Submaximal bicycle ergometry was conducted at study entry, and cardiorespiratory fitness was defined as physical work capacity at 75% of the maximum heart rate, standardised to body mass (PWC75%). Multivariable Cox proportional hazards regression was performed to obtain hazard ratios (HR) and corresponding 95% confidence intervals (CI). During a mean follow-up of 4.6 years, 232 participants developed colorectal cancer (151 colon cancers; 79 rectal cancers). When comparing the 75th to the 25th percentiles of PWC75%, the multivariable-adjusted HR of colorectal cancer was 0.78 (95% CI 0.62–0.97). That relation was largely driven by an inverse association with colon cancer (HR 0.74, 95% CI 0.56–0.97) and less so with rectal cancer (HR 0.88, 95% CI 0.62–1.26; p value for difference by colorectal cancer endpoint = 0.056). The inverse relation of cardiorespiratory fitness with colorectal cancer was more evident in men (HR 0.72, 95% CI 0.55–0.94) than women (HR 0.99, 95% CI 0.71–1.38), although the gender difference was not statistically significant (p value for interaction = 0.192). Increased cardiorespiratory fitness is associated with decreased risk of colorectal cancer. Potential heterogeneity by colorectal cancer anatomic subsite and gender requires further study.

    更新日期:2019-11-11
  • Rationale and Design of the Hamburg City Health Study
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2019-11-08
    Annika Jagodzinski, Christoffer Johansen, Uwe Koch-Gromus, Ghazal Aarabi, Gerhard Adam, Sven Anders, Matthias Augustin, Ramona B. der Kellen, Thomas Beikler, Christian-Alexander Behrendt, Christian S. Betz, Carsten Bokemeyer, Katrin Borof, Peer Briken, Chia-Jung Busch, Christian Büchel, Stefanie Brassen, Eike S. Debus, Larissa Eggers, Jens Fiehler, Jürgen Gallinat, Simone Gellißen, Christian Gerloff, Evaldas Girdauskas, Martin Gosau, Markus Graefen, Martin Härter, Volker Harth, Christoph Heidemann, Guido Heydecke, Tobias B. Huber, Yassin Hussein, Marvin O. Kampf, Olaf von dem Knesebeck, Alexander Konnopka, Hans-Helmut König, Robert Kromer, Christian Kubisch, Simone Kühn, Sonja Loges, Bernd Löwe, Gunnar Lund, Christian Meyer, Lina Nagel, Albert Nienhaus, Klaus Pantel, Elina Petersen, Klaus Püschel, Hermann Reichenspurner, Guido Sauter, Martin Scherer, Katharina Scherschel, Ulrich Schiffner, Renate B. Schnabel, Holger Schulz, Ralf Smeets, Vladislavs Sokalskis, Martin S. Spitzer, Claudia Terschüren, Imke Thederan, Tom Thoma, Götz Thomalla, Benjamin Waschki, Karl Wegscheider, Jan-Per Wenzel, Susanne Wiese, Birgit-Christiane Zyriax, Tanja Zeller, Stefan Blankenberg

    The Hamburg City Health Study (HCHS) is a large, prospective, long-term, population-based cohort study and a unique research platform and network to obtain substantial knowledge about several important risk and prognostic factors in major chronic diseases. A random sample of 45,000 participants between 45 and 74 years of age from the general population of Hamburg, Germany, are taking part in an extensive baseline assessment at one dedicated study center. Participants undergo 13 validated and 5 novel examinations primarily targeting major organ system function and structures including extensive imaging examinations. The protocol includes validate self-reports via questionnaires regarding lifestyle and environmental conditions, dietary habits, physical condition and activity, sexual dysfunction, professional life, psychosocial context and burden, quality of life, digital media use, occupational, medical and family history as well as healthcare utilization. The assessment is completed by genomic and proteomic characterization. Beyond the identification of classical risk factors for major chronic diseases and survivorship, the core intention is to gather valid prevalence and incidence, and to develop complex models predicting health outcomes based on a multitude of examination data, imaging, biomarker, psychosocial and behavioral assessments. Participants at risk for coronary artery disease, atrial fibrillation, heart failure, stroke and dementia are invited for a visit to conduct an additional MRI examination of either heart or brain. Endpoint assessment of the overall sample will be completed through repeated follow-up examinations and surveys as well as related individual routine data from involved health and pension insurances. The study is targeting the complex relationship between biologic and psychosocial risk and resilience factors, chronic disease, health care use, survivorship and health as well as favorable and bad prognosis within a unique, large-scale long-term assessment with the perspective of further examinations after 6 years in a representative European metropolitan population.

    更新日期:2019-11-11
  • 更新日期:2019-11-01
  • Interaction between co-morbidities and cancer survival.
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2019-08-26
    Andrew G Renehan,Nasra N Alam,Matthew Sperrin

    更新日期:2019-11-01
  • 更新日期:2019-11-01
  • A critical reflection on the grading of the certainty of evidence in umbrella reviews.
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2019-06-22
    Sabrina Schlesinger,Lukas Schwingshackl,Manuela Neuenschwander,Janett Barbaresko

    更新日期:2019-11-01
  • 更新日期:2019-11-01
  • Measles vaccine immune escape: Should we be concerned?
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2019-11-05
    Luojun Yang,Bryan T Grenfell,Michael J Mina

    更新日期:2019-11-01
  • 更新日期:2019-11-01
  • Umbrella reviews: what they are and why we need them.
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2019-03-11
    Stefania Papatheodorou

    更新日期:2019-11-01
  • Suicide in married couples in Sweden: Is the risk greater in same-sex couples?
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2016-05-12
    Charlotte Björkenstam,Gunnar Andersson,Christina Dalman,Susan Cochran,Kyriaki Kosidou

    Minority sexual orientation is a predictor of suicide ideation and attempts, though its association with suicide mortality is less clear. We capitalize on Sweden's extensively linked databases, to investigate whether, among married individuals, same-sex marriage is associated with suicide. Using a population-based register design, we analyzed suicide risk among same-sex married women and men (n = 6456), as compared to different-sex married women and men (n = 1181723) in Sweden. We selected all newly partnered or married individuals in the intervening time between 1/1/1996 and 12/31/2009 and followed them with regard to suicide until 12/31/2011. Multivariate Poisson regression was used to calculate adjusted incidence risk ratios (IRR) with 95 % confidence intervals (CI). The risk of suicide was higher among same-sex married individuals as compared to different-sex married individuals (IRR 2.7, 95 % CI 1.5-4.8), after adjustment for time at risk and socioeconomic confounding. Sex-stratified analyses showed a tentatively elevated risk for same-sex married women (IRR 2.5, 95 % CI 0.8-7.7) as compared to different-sex married women. Among same-sex married men the suicide risk was nearly three-fold greater as compared to different-sex married (IRR 2.895 % CI 1.5-5.5). This holds true also after adjustment for HIV status. Even in a country with a comparatively tolerant climate regarding homosexuality such as Sweden, same-sex married individuals evidence a higher risk for suicide than other married individuals.

    更新日期:2019-11-01
  • 更新日期:2019-11-01
  • The Apgar paradox.
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2018-12-14
    Henning Tiemeier,Marie C McCormick

    更新日期:2019-11-01
  • You are smarter than you think: (super) machine learning in context.
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2018-05-11
    Alexander P Keil,Jessie K Edwards

    更新日期:2019-11-01
  • Dietary sugar/starches intake and Barrett's esophagus: a pooled analysis.
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2017-09-03
    Nan Li,Jessica Leigh Petrick,Susan Elizabeth Steck,Patrick Terrence Bradshaw,Kathleen Michele McClain,Nicole Michelle Niehoff,Lawrence Stuart Engel,Nicholas James Shaheen,Douglas Allen Corley,Thomas Leonard Vaughan,Marilie Denise Gammon

    Barrett's esophagus (BE) is the key precursor lesion of esophageal adenocarcinoma, a lethal cancer that has increased rapidly in westernized countries over the past four decades. Dietary sugar intake has also been increasing over time, and may be associated with these tumors by promoting hyperinsulinemia. The study goal was to examine multiple measures of sugar/starches intake in association with BE. This pooled analysis included 472 BE cases and 492 controls from two similarly conducted case-control studies in the United States. Dietary intake data, collected by study-specific food frequency questionnaires, were harmonized across studies by linking with the University of Minnesota Nutrient Database, and pooled based on study-specific quartiles. Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for age, sex, race, total energy intake, study indicator, body mass index, frequency of gastro-esophageal reflux, and fruit/vegetable intake. In both studies, intake of sucrose (cases vs. controls, g/day: 36.07 vs. 33.51; 36.80 vs. 35.06, respectively) and added sugar (46.15 vs. 41.01; 44.18 vs. 40.68, respectively) were higher in cases than controls. BE risk was increased 79% and 71%, respectively, for associations comparing the fourth to the first quartile of intake of sucrose (ORQ4vs.Q1 = 1.79, 95% CI = 1.07-3.02, P trend = 0.01) and added sugar (ORQ4vs.Q1 = 1.71, 95% CI = 1.05-2.80, P trend = 0.15). Intake of sweetened desserts/beverages was associated with 71% increase in BE risk (ORQ4vs.Q1 = 1.71, 95% CI = 1.07-2.73, P trend = 0.04). Limiting dietary intake of foods and beverages that are high in added sugar, especially refined table sugar, may reduce the risk of developing BE.

    更新日期:2019-11-01
  • Prostate-specific antigen testing for prostate cancer: Depleting a limited pool of susceptible individuals?
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2016-07-20
    Morten Valberg,Tom Grotmol,Steinar Tretli,Marit B Veierød,Tron A Moger,Susan S Devesa,Odd O Aalen

    After the introduction of the prostate specific antigen (PSA) test in the 1980s, a sharp increase in the incidence rate of prostate cancer was seen in the United States. The age-specific incidence patterns exhibited remarkable shifts to younger ages, and declining rates were observed at old ages. Similar trends were seen in Norway. We investigate whether these features could, in combination with PSA testing, be explained by a varying degree of susceptibility to prostate cancer in the populations. We analyzed incidence data from the United States' Surveillance, Epidemiology, and End Results program for 1973-2010, comprising 511,027 prostate cancers in men ≥40 years old, and Norwegian national incidence data for 1953-2011, comprising 113,837 prostate cancers in men ≥50 years old. We developed a frailty model where only a proportion of the population could develop prostate cancer, and where the increased risk of diagnosis due to the massive use of PSA testing was modelled by encompassing this heterogeneity in risk. The frailty model fits the observed data well, and captures the changing age-specific incidence patterns across birth cohorts. The susceptible proportion of men is [Formula: see text] in the United States and [Formula: see text] in Norway. Cumulative incidence rates at old age are unchanged across birth cohort exposed to PSA testing at younger and younger ages. The peaking cohort-specific age-incidence curves of prostate cancer may be explained by the underlying heterogeneity in prostate cancer risk. The introduction of the PSA test has led to a larger number of diagnosed men. However, no more cases are being diagnosed in total in birth cohorts exposed to the PSA era at younger and younger ages, even though they are diagnosed at younger ages. Together with the earlier peak in the age-incidence curves for younger cohorts, and the strong familial association of the cancer, this constitutes convincing evidence that the PSA test has led to a higher proportion, and an earlier timing, of diagnoses in a limited pool of susceptible individuals.

    更新日期:2019-11-01
  • Overweight duration in older adults and cancer risk: a study of cohorts in Europe and the United States.
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2016-06-15
    Melina Arnold,Heinz Freisling,Rachael Stolzenberg-Solomon,Frank Kee,Mark George O'Doherty,José Manuel Ordóñez-Mena,Tom Wilsgaard,Anne Maria May,Hendrik Bas Bueno-de-Mesquita,Anne Tjønneland,Philippos Orfanos,Antonia Trichopoulou,Paolo Boffetta,Freddie Bray,Mazda Jenab,Isabelle Soerjomataram,

    Recent studies have shown that cancer risk related to overweight and obesity is mediated by time and might be better approximated by using life years lived with excess weight. In this study we aimed to assess the impact of overweight duration and intensity in older adults on the risk of developing different forms of cancer. Study participants from seven European and one US cohort study with two or more weight assessments during follow-up were included (n = 329,576). Trajectories of body mass index (BMI) across ages were estimated using a quadratic growth model; overweight duration (BMI ≥ 25) and cumulative weighted overweight years were calculated. In multivariate Cox models and random effects analyses, a longer duration of overweight was significantly associated with the incidence of obesity-related cancer [overall hazard ratio (HR) per 10-year increment: 1.36; 95 % CI 1.12-1.60], but also increased the risk of postmenopausal breast and colorectal cancer. Additionally accounting for the degree of overweight further increased the risk of obesity-related cancer. Risks associated with a longer overweight duration were higher in men than in women and were attenuated by smoking. For postmenopausal breast cancer, increased risks were confined to women who never used hormone therapy. Overall, 8.4 % of all obesity-related cancers could be attributed to overweight at any age. These findings provide further insights into the role of overweight duration in the etiology of cancer and indicate that weight control is relevant at all ages. This knowledge is vital for the development of effective and targeted cancer prevention strategies.

    更新日期:2019-11-01
  • An epidemiological model for prediction of endometrial cancer risk in Europe.
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2015-05-15
    Anika Hüsing,Laure Dossus,Pietro Ferrari,Anne Tjønneland,Louise Hansen,Guy Fagherazzi,Laura Baglietto,Helena Schock,Jenny Chang-Claude,Heiner Boeing,Annika Steffen,Antonia Trichopoulou,Christina Bamia,Michalis Katsoulis,Vittorio Krogh,Domenico Palli,Salvatore Panico,N Charlotte Onland-Moret,Petra H Peeters,H Bas Bueno-de-Mesquita,Elisabete Weiderpass,Inger T Gram,Eva Ardanaz,Mireia Obón-Santacana,Carmen Navarro,Emilio Sánchez-Cantalejo,Nerea Etxezarreta,Naomi E Allen,Kay Tee Khaw,Nick Wareham,Sabina Rinaldi,Isabelle Romieu,Melissa A Merritt,Marc Gunter,Elio Riboli,Rudolf Kaaks

    Endometrial cancer (EC) is the fourth most frequent cancer in women in Europe, and as its incidence is increasing, prevention strategies gain further pertinence. Risk prediction models can be a useful tool for identifying women likely to benefit from targeted prevention measures. On the basis of data from 201,811 women (mostly aged 30-65 years) including 855 incident EC cases from eight countries in the European Prospective Investigation into Cancer and Nutrition cohort, a model to predict EC was developed. A step-wise model selection process was used to select confirmed predictive epidemiologic risk factors. Piece-wise constant hazard rates in 5-year age-intervals were estimated in a cause-specific competing risks model, five-fold-cross-validation was applied for internal validation. Risk factors included in the risk prediction model were body-mass index (BMI), menopausal status, age at menarche and at menopause, oral contraceptive use, overall and by different BMI categories and overall duration of use, parity, age at first full-term pregnancy, duration of menopausal hormone therapy and smoking status (specific for pre, peri- and post-menopausal women). These variables improved the discriminating capacity to predict risk over 5 years from 71% for a model based on age alone to 77% (overall C statistic), and the model was well-calibrated (ratio of expected to observed cases = 0.99). Our model could be used for the identification of women at increased risk of EC in Western Europe. To achieve an EC-risk model with general validity, a large-scale cohort-consortium approach would be needed to assess and adjust for population variation.

    更新日期:2019-11-01
  • The Brighton declaration: the value of non-communicable disease modelling in population health sciences.
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2014-12-17
    Laura Webber,Oliver T Mytton,Adam D M Briggs,James Woodcock,Peter Scarborough,Klim McPherson,Simon Capewell

    更新日期:2019-11-01
  • Associations of adherence to the New Nordic Diet with risk of preeclampsia and preterm delivery in the Norwegian Mother and Child Cohort Study (MoBa).
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2014-09-07
    Elisabet Rudjord Hillesund,Nina C Øverby,Stephanie M Engel,Kari Klungsøyr,Quaker E Harmon,Margaretha Haugen,Elling Bere

    Preeclampsia and preterm delivery are serious complications of pregnancy and leading causes of perinatal mortality and morbidity worldwide. Dietary factors might be associated with these adverse outcomes. We investigated whether adherence to the New Nordic Diet (NND) was associated with preeclampsia and preterm delivery risks in the Norwegian Mother and Child Cohort Study (MoBa). Participants were recruited from all over Norway during the period 1999-2008. A previously constructed diet score assessing meal frequency, and the consumption of Nordic fruits, root vegetables, cabbages, potatoes, oatmeal porridge, whole grains, wild fish, game, berries, milk and water, was used to assess NND adherence. Associations between NND adherence and the outcomes were estimated in adjusted multivariate logistic regression models. Odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated. A total of 72,072 women was included in the study. High versus low NND adherence was associated with lower risk of total preeclampsia (OR 0.86; 95 % CI 0.78-0.95) and early preeclampsia (OR 0.71; 95 % CI 0.52-0.96). High compared with low NND adherence was associated with a lower risk of spontaneous preterm delivery among nulliparous women (OR 0.77; 95 % CI 0.66-0.89), whereas multiparous women with high NND adherence had a marginally significant higher risk of preterm delivery (OR 1.24; 95 % CI 1.00-1.53). High NND adherence was associated with a lower relative risk of preeclampsia and of spontaneous preterm delivery among nulliparous women; however, among multiparous women there was a higher relative risk of preterm delivery.

    更新日期:2019-11-01
  • Fruit and vegetable intake and cause-specific mortality in the EPIC study.
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2014-08-27
    Max Leenders,Hendriek C Boshuizen,Pietro Ferrari,Peter D Siersema,Kim Overvad,Anne Tjønneland,Anja Olsen,Marie-Christine Boutron-Ruault,Laure Dossus,Laureen Dartois,Rudolf Kaaks,Kuanrong Li,Heiner Boeing,Manuela M Bergmann,Antonia Trichopoulou,Pagona Lagiou,Dimitrios Trichopoulos,Domenico Palli,Vittorio Krogh,Salvatore Panico,Rosario Tumino,Paolo Vineis,Petra H M Peeters,Elisabete Weiderpass,Dagrun Engeset,Tonje Braaten,Maria Luisa Redondo,Antonio Agudo,María-José Sánchez,Pilar Amiano,José-María Huerta,Eva Ardanaz,Isabel Drake,Emily Sonestedt,Ingegerd Johansson,Anna Winkvist,Kay-Tee Khaw,Nick J Wareham,Timothy J Key,Kathryn E Bradbury,Mattias Johansson,Idlir Licaj,Marc J Gunter,Neil Murphy,Elio Riboli,H Bas Bueno-de-Mesquita

    Consumption of fruits and vegetables is associated with a lower overall mortality. The aim of this study was to identify causes of death through which this association is established. More than 450,000 participants from the European Prospective Investigation into Cancer and Nutrition study were included, of which 25,682 were reported deceased after 13 years of follow-up. Information on lifestyle, diet and vital status was collected through questionnaires and population registries. Hazard ratios (HR) with 95% confidence intervals (95% CI) for death from specific causes were calculated from Cox regression models, adjusted for potential confounders. Participants reporting consumption of more than 569 g/day of fruits and vegetables had lower risks of death from diseases of the circulatory (HR for upper fourth 0.85, 95% CI 0.77-0.93), respiratory (HR for upper fourth 0.73, 95% CI 0.59-0.91) and digestive system (HR for upper fourth 0.60, 95% CI 0.46-0.79) when compared with participants consuming less than 249 g/day. In contrast, a positive association with death from diseases of the nervous system was observed. Inverse associations were generally observed for vegetable, but not for fruit consumption. Associations were more pronounced for raw vegetable consumption, when compared with cooked vegetable consumption. Raw vegetable consumption was additionally inversely associated with death from neoplasms and mental and behavioral disorders. The lower risk of death associated with a higher consumption of fruits and vegetables may be derived from inverse associations with diseases of the circulatory, respiratory and digestive system, and may depend on the preparation of vegetables and lifestyle factors.

    更新日期:2019-11-01
  • Impact of body size and physical activity during adolescence and adult life on overall and cause-specific mortality in a large cohort study from Iran.
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2014-02-22
    Arash Etemadi,Christian C Abnet,Farin Kamangar,Farhad Islami,Hooman Khademi,Akram Pourshams,Hossein Poustchi,Mohammad Bagheri,Amir Ali Sohrabpour,Ali Aliasgar,Masoud Khoshnia,Sholom Wacholder,Charles C Matthews,Paul D Pharoah,Paul Brennan,Paolo Boffetta,Reza Malekzadeh,Sanford M Dawsey

    We conducted this study to examine life-course body size and physical activity in relation to total and cause-specific mortality, which has not previously been studied in the low and middle-income countries in Asia. The Golestan Cohort Study is a population-based cohort in northeastern Iran in which 50,045 people above the age of 40 have been followed since 2004. Participants were shown a validated pictogram to assess body size at ages 15, 30, and the time of recruitment. Information on occupational physical activity at these ages was also collected. Subjects were followed up annually, and cause of death was determined. Cox regression models were adjusted for age at cohort start, smoking, socioeconomic status, ethnicity, place of residence, education, and opium use. Models for body size were also adjusted for physical activity at the same age, and vice versa. During a total of 252,740 person-years of follow-up (mean follow-up duration 5.1 ± 1.3 years) through December 2011, 2,529 of the cohort participants died. Larger body sizes at ages 15 or 30 in both sexes were associated with increased overall mortality. Cancer mortality was more strongly associated with adolescent obesity, and cardiovascular mortality with early adulthood body size. Weight gain between these ages was associated with cardiovascular mortality. Obese adolescents who lost weight still had increased mortality from all medical causes in both sexes. Physical activity during adolescence and early adulthood had no association with mortality, but at cohort baseline higher levels of activity were associated with reduced mortality. Mortality in this Middle-Eastern population was associated with obesity both during adolescence and early adult life.

    更新日期:2019-11-01
  • Adult height and head and neck cancer: a pooled analysis within the INHANCE Consortium.
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2013-11-26
    Emanuele Leoncini,Walter Ricciardi,Gabriella Cadoni,Dario Arzani,Livia Petrelli,Gaetano Paludetti,Paul Brennan,Daniele Luce,Isabelle Stucker,Keitaro Matsuo,Renato Talamini,Carlo La Vecchia,Andrew F Olshan,Deborah M Winn,Rolando Herrero,Silvia Franceschi,Xavier Castellsague,Joshua Muscat,Hal Morgenstern,Zuo-Feng Zhang,Fabio Levi,Luigino Dal Maso,Karl Kelsey,Michael McClean,Thomas L Vaughan,Philip Lazarus,Mark P Purdue,Richard B Hayes,Chu Chen,Stephen M Schwartz,Oxana Shangina,Sergio Koifman,Wolfgang Ahrens,Elena Matos,Pagona Lagiou,Jolanta Lissowska,Neonila Szeszenia-Dabrowska,Leticia Fernandez,Ana Menezes,Antonio Agudo,Alexander W Daudt,Lorenzo Richiardi,Kristina Kjaerheim,Dana Mates,Jaroslav Betka,Guo-Pei Yu,Stimson Schantz,Lorenzo Simonato,Hermann Brenner,David I Conway,Tatiana V Macfarlane,Peter Thomson,Eleonora Fabianova,Ariana Znaor,Peter Rudnai,Claire Healy,Paolo Boffetta,Shu-Chun Chuang,Yuan-Chin Amy Lee,Mia Hashibe,Stefania Boccia

    Several epidemiological studies have shown a positive association between adult height and cancer incidence. The only study conducted among women on mouth and pharynx cancer risk, however, reported an inverse association. This study aims to investigate the association between height and the risk of head and neck cancer (HNC) within a large international consortium of HNC. We analyzed pooled individual-level data from 24 case-control studies participating in the International Head and Neck Cancer Epidemiology Consortium. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated separately for men and women for associations between height and HNC risk. Educational level, tobacco smoking, and alcohol consumption were included in all regression models. Stratified analyses by HNC subsites were performed. This project included 17,666 cases and 28,198 controls. We found an inverse association between height and HNC (adjusted OR per 10 cm height = 0.91, 95% CI 0.86-0.95 for men; adjusted OR = 0.86, 95% CI 0.79-0.93 for women). In men, the estimated OR did vary by educational level, smoking status, geographic area, and control source. No differences by subsites were detected. Adult height is inversely associated with HNC risk. As height can be considered a marker of childhood illness and low energy intake, the inverse association is consistent with prior studies showing that HNC occur more frequently among deprived individuals. Further studies designed to elucidate the mechanism of such association would be warranted.

    更新日期:2019-11-01
  • Seventeen year risk of all-cause and cause-specific mortality associated with C-reactive protein, fibrinogen and leukocyte count in men and women: the EPIC-Norfolk study.
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2013-07-04
    Sara Ahmadi-Abhari,Robert N Luben,Nicholas J Wareham,Kay-Tee Khaw

    There is strong evidence from observational studies suggesting serum C-reactive protein (CRP) is associated with cardiovascular and all-cause mortality. However, less is known about whether there are differences in the association of CRP with all-cause or cause specific mortality by sex, smoking, body mass index (BMI), or physical activity. We aimed to investigate these interactions and also investigate and compare the association of CRP and other inflammation markers (i.e., fibrinogen and leukocyte count) with all-cause and cause-specific mortality. Men and women aged 40-79 were recruited in 1993-1997 in the EPIC-Norfolk cohort study. A total of 16,850 participants with high-sensitivity assayed CRP data who had no known cancer, myocardial infarction and stroke at baseline were entered in the analysis to test the association of CRP, fibrinogen and leukocyte count with risk of all-cause and cause specific mortality. A total of, 2,603 all-cause deaths (1,452 in men) including 823 cardiovascular and 1,035 cancer deaths, were observed after 231,000 person-years of follow-up (median 14.3 years). CRP was positively associated with risk of all-cause, cardiovascular, and non-cancer non-cardiovascular mortality independent of established risk factors. The hazard ratio of all-cause mortality (95 % CI) for participants with CRP in the range of 3-10 and >10 mg/l (vs. <0.5 mg/l) was 1.56 (1.26-1.93) and 1.87 (1.43-2.43) respectively in men and 1.34 (1.07-1.68) and 1.98 (1.50-2.63) in women. The association was less positively graded in women with the increased risk being significant only at higher levels of the CRP distribution. The association persisted in never smokers and did not vary by levels of BMI or physical activity. Although fibrinogen and leukocyte count were also positively associated with mortality risk, only CRP remained a significant predictor of mortality when the inflammation markers were adjusted for one another in multivariable models. Serum CRP levels were a long-term predictor of risk of cardiovascular and non-cardiovascular mortality independent of known risk factors, fibrinogen, and leukocyte count.

    更新日期:2019-11-01
  • Hazardous alcohol consumption is associated with increased levels of B-type natriuretic peptide: evidence from two population-based studies.
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2013-05-07
    David A Leon,Vladimir M Shkolnikov,Svetlana Borinskaya,Juan-Pablo Casas,Alun Evans,Artyom Gil,Frank Kee,Nikolay Kiryanov,Martin McKee,Mark G O'Doherty,George B Ploubidis,Olga Polikina,Maxim Vassiliev,Stefan Blankenberg,Hugh Watkins

    Russia has very high mortality from cardiovascular disease (CVD), with evidence that heavy drinking may play a role. To throw further light on this association we have studied the association of alcohol with predictors of CVD risk including B-type natriuretic peptide (BNP). Levels of BNP increase primarily in response to abnormal cardiac chamber wall stretch which can occur both as a result of atherosclerosis as well as due to other types of damage to the myocardium. No previous population-based studies have investigated the association with alcohol. We analysed cross-sectional data on drinking behaviour in 993 men aged 25-60 years from the Izhevsk Family Study 2 (IFS2), conducted in the Russian city of Izhevsk in 2008-2009. Relative to non-drinkers, men who drank hazardously had an odds ratio (OR) of being in the top 20 % of the BNP distribution of 4.66 (95 % CI 2.13, 10.19) adjusted for age, obesity, waist-hip ratio, and smoking. Further adjustment for class of hypertension resulted in only slight attenuation of the effect, suggesting that this effect was not secondary to the influence of alcohol on blood pressure. In contrast hazardous drinking was associated with markedly raised ApoA1 and HDL cholesterol levels, but had little impact on levels of ApoB and LDL cholesterol. Similar but less pronounced associations were found in the Belfast (UK) component of the PRIME study conducted in 1991. These findings suggest that the association of heavy drinking with increased risk of cardiovascular disease may be partly due to alcohol-induced non-atherosclerotic damage to the myocardium.

    更新日期:2019-11-01
  • The association between frequency of vigorous physical activity and hepatobiliary cancers in the NIH-AARP Diet and Health Study.
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2013-01-29
    Gundula Behrens,Charles E Matthews,Steven C Moore,Neal D Freedman,Katherine A McGlynn,James E Everhart,Albert R Hollenbeck,Michael F Leitzmann

    Despite a potential preventive effect of physical activity on hepatobiliary cancer, little information is available on the relation between the two. We studied the association between frequency of vigorous physical activity and hepatobiliary cancer among 507,897 participants of the NIH-AARP Diet and Health Study, aged 50-71 years at baseline in 1995/1996. During 10 years of follow-up, 628 incident cases of liver cancer and 317 cases of extrahepatic biliary tract cancer were registered. Physical activity levels were assigned according to the frequency of engagement in 20 min or more of vigorous physical activity per week: never/rarely (lowest level), less than once per week, 1-2 times per week, 3-4 times per week, 5 or more times per week (highest level). Using Cox regression, multivariate-adjusted relative risks (RR) comparing the highest with the lowest level of physical activity revealed a statistically significant decreased risk for liver cancer (RR = 0.64, 95% confidence interval (CI) = 0.49-0.84, p-trend <0.001), particularly hepatocellular carcinoma (RR = 0.56, 95% CI = 0.41-0.78, p-trend <0.001), independent of body mass index. By comparison, multivariate analyses indicated that physical activity was not statistically significantly associated with extrahepatic bile duct cancer (RR = 0.86, 95% CI = 0.45-1.65), ampulla of Vater cancer (RR = 0.66, 95% CI = 0.29-1.48), or gallbladder cancer (RR = 0.63, 95% CI = 0.33-1.21). These results suggest a potential preventive effect of physical activity on liver cancer but not extrahepatic biliary tract cancer, independent of body mass index.

    更新日期:2019-11-01
  • Coronary artery calcium distributions in older persons in the AGES-Reykjavik study.
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2012-09-20
    Elias Freyr Gudmundsson,Vilmundur Gudnason,Sigurdur Sigurdsson,Lenore J Launer,Tamara B Harris,Thor Aspelund

    Coronary Artery Calcium (CAC) is a sign of advanced atherosclerosis and an independent risk factor for cardiac events. Here, we describe CAC-distributions in an unselected aged population and compare modelling methods to characterize CAC-distribution. CAC is difficult to model because it has a skewed and zero inflated distribution with over-dispersion. Data are from the AGES-Reykjavik sample, a large population based study [2002-2006] in Iceland of 5,764 persons aged 66-96 years. Linear regressions using logarithmic- and Box-Cox transformations on CAC+1, quantile regression and a Zero-Inflated Negative Binomial model (ZINB) were applied. Methods were compared visually and with the PRESS-statistic, R(2) and number of detected associations with concurrently measured variables. There were pronounced differences in CAC according to sex, age, history of coronary events and presence of plaque in the carotid artery. Associations with conventional coronary artery disease (CAD) risk factors varied between the sexes. The ZINB model provided the best results with respect to the PRESS-statistic, R(2), and predicted proportion of zero scores. The ZINB model detected similar numbers of associations as the linear regression on ln(CAC+1) and usually with the same risk factors.

    更新日期:2019-11-01
  • Dietary patterns at 6, 15 and 24 months of age are associated with IQ at 8 years of age.
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2012-07-20
    Lisa G Smithers,Rebecca K Golley,Murthy N Mittinty,Laima Brazionis,Kate Northstone,Pauline Emmett,John W Lynch

    Diet supplies the nutrients needed for the development of neural tissues that occurs over the first 2 years of life. Our aim was to examine associations between dietary patterns at 6, 15 and 24 months and intelligence quotient (IQ) scores at 8 years. Participants were enrolled in an observational birth cohort (ALSPAC study, n = 7,097). Dietary data was collected by questionnaire and patterns were extracted at each time using principal component analysis. IQ was measured using the Wechsler Intelligence Scale for Children at 8 years. Associations between dietary patterns and IQ were examined in regression analyses adjusted for potential confounding and by propensity score matching, with data imputation for missing values. At all ages, higher scores on a Discretionary pattern (characterized by biscuits, chocolate, sweets, soda, crisps) were associated with 1-2 point lower IQ. A Breastfeeding pattern at 6 months and Home-made contemporary patterns at 15 and 24 months (herbs, legumes, cheese, raw fruit and vegetables) were associated with 1-to-2 point higher IQ. A Home-made traditional pattern (meat, cooked vegetables, desserts) at 6 months was positively associated with higher IQ scores, but there was no association with similar patterns at 15 or 24 months. Negative associations were found with patterns characterized by Ready-prepared baby foods at 6 and 15 months and positive associations with a Ready-to-eat foods pattern at 24 months. Propensity score analyses were consistent with regression analyses. This study suggests that dietary patterns from 6 to 24 months may have a small but persistent effect on IQ at 8 years.

    更新日期:2019-11-01
  • Bidirectional association between physical activity and symptoms of anxiety and depression: the Whitehall II study.
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2012-05-25
    Marine Azevedo Da Silva,Archana Singh-Manoux,Eric J Brunner,Sara Kaffashian,Martin J Shipley,Mika Kivimäki,Hermann Nabi

    Although it has been hypothesized that the association of physical activity with depressive and anxiety symptoms is bidirectional, few studies have examined this issue in a prospective setting. We studied this bidirectional association using data on physical activity and symptoms of anxiety and depression at three points in time over 8 years. A total of 9,309 participants of the British Whitehall II prospective cohort study provided data on physical activity, anxiety and depression symptoms and 10 covariates at baseline in 1985. We analysed the associations of physical activity with anxiety and/or depression symptoms using multinomial logistic regression (with anxiety and depression symptoms as dependent variables) and binary logistic regression (with physical activity as the dependent variable). There was a cross-sectional inverse association between physical activity and anxiety and/or depressive symptoms at baseline (ORs between 0.63 and 0.72). In cumulative analyses, regular physical activity across all three data waves, but not irregular physical activity, was associated with reduced likelihood of depressive symptoms at follow-up (OR = 0.71, 95 % CI 0.54, 0.99). In a converse analysis, participants with anxiety and depression symptoms at baseline had higher odds of not meeting the recommended levels of physical activity at follow-up (OR = 1.79, 95 % CI 1.17, 2.74). This was also the case in individuals with anxiety and/or depression symptoms at both baseline and follow-up (OR = 1.70, 95 % CI 1.10, 2.63). The association between physical activity and symptoms of anxiety and/or depression appears to be bidirectional.

    更新日期:2019-11-01
  • A genetic instrument for Mendelian randomization of fibrinogen.
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2012-03-06
    Gie Ken-Dror,Steve E Humphries,Meena Kumari,Mika Kivimaki,Fotios Drenos

    Mendelian randomization studies on fibrinogen commonly use a single genetic variant as an instrument, but this may explain only a small proportion of the total phenotypic variance. We examined the contribution of multiple common single nucleotide polymorphisms (SNPs) and haplotypes in the entire fibrinogen gene cluster to plasma fibrinogen levels in two prospective cohorts, for use as instruments in future Mendelian randomization studies. Genotypes for 20 SNPs were determined in 2,778 middle-age (49-64 years) men from the Second-Northwick-Park-Heart Study (NPHS-II). These were replicated in 3,705 men from the Whitehall-II study (WH-II). Plasma fibrinogen levels were determined six times in NPHS-II and three times in WH-II. The minor alleles of four SNPs from the FGB gene, two from the FGA gene, and one from the FGG gene were associated with higher plasma fibrinogen levels. SNP rs1800790 (-455G>A) commonly used in Mendelian randomization studies was associated with R2=1.22% of the covariate adjusted residual variance in fibrinogen level. A variable selection procedure identified one additional SNP: rs2070011 (FGA) altogether explaining R2=1.45% of the residual variance in fibrinogen level. Using these SNPs no evidence for causality between the fibrinogen levels and coronary heart diseases was found in instrumental variables analysis. In the replication cohort, WH-II, the effects of the two SNPs on fibrinogen levels were consistent with the NPHS-II results. There is statistical evidence for several functional sites in the fibrinogen gene cluster that determine an individual's plasma fibrinogen levels. Thus, a combination of several SNPs will provide a stronger instrument for fibrinogen Mendelian randomization studies.

    更新日期:2019-11-01
  • Validity of a short questionnaire to assess physical activity in 10 European countries.
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2011-11-18
    ,Tricia Peters,Soren Brage,Kate Westgate,Paul W Franks,Anna Gradmark,Maria Jose Tormo Diaz,Jose Maria Huerta,Benedetta Bendinelli,Mattheaus Vigl,Heiner Boeing,Wanda Wendel-Vos,Annemieke Spijkerman,Kristin Benjaminsen-Borch,Elisavet Valanou,Blandine de Lauzon Guillain,Françoise Clavel-Chapelon,Stephen Sharp,Nicola Kerrison,Claudia Langenberg,Larraitz Arriola,Aurelio Barricarte,Carlos Gonzales,Sara Grioni,Rudolf Kaaks,Timothy Key,Kay Tee Khaw,Anne May,Peter Nilsson,Teresa Norat,Kim Overvad,Domenico Palli,Salvatore Panico,Jose Ramón Quirós,Fulvio Ricceri,Maria-Jose Sanchez,Nadia Slimani,Anne Tjonneland,Rosario Tumino,Edith Feskins,Elio Riboli,Ulf Ekelund,Nick Wareham

    To accurately examine associations of physical activity (PA) with disease outcomes, a valid method of assessing free-living activity is required. We examined the validity of a brief PA questionnaire (PAQ) used in the European Prospective Investigation into Cancer and Nutrition (EPIC). PA energy expenditure (PAEE) and time spent in moderate and vigorous physical activity (MVPA) was measured in 1,941 healthy individuals from 10 European countries using individually-calibrated combined heart-rate and movement sensing. Participants also completed the short EPIC-PAQ, which refers to past year's activity. Pearson (r) and Spearman (σ) correlation coefficients were calculated for each country, and random effects meta-analysis was used to calculate the combined correlation across countries to estimate the validity of two previously- and one newly-derived ordered, categorical PA indices ("Cambridge index", "total PA index", and "recreational index") that categorized individuals as inactive, moderately inactive, moderately active, or active. The strongest associations with PAEE and MVPA were observed for the Cambridge index (r = 0.33 and r = 0.25, respectively). No significant heterogeneity by country was observed for this index (I(2) = 36.3%, P = 0.12; I(2) = 0.0%, P = 0.85), whereas heterogeneity was suggested for other indices (I(2) > 48%, P < 0.05, I(2) > 47%, P < 0.05). PAEE increased linearly across self-reported PA categories (P for trend <0.001), with an average difference of approximately 460 kJ/d for men and 365 kJ/d for women, between categories of the Cambridge index. The EPIC-PAQ is suitable for categorizing European men and women into four distinct categories of overall physical activity. The difference in PAEE between categories may be useful when estimating effect sizes from observational research.

    更新日期:2019-11-01
  • Parkinson's disease risk from ambient exposure to pesticides.
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2011-04-21
    Anthony Wang,Sadie Costello,Myles Cockburn,Xinbo Zhang,Jeff Bronstein,Beate Ritz

    Due to the heavy and expanding agricultural use of neurotoxic pesticides suspected to affect dopaminergic neurons, it is imperative to closely examine the role of pesticides in the development of Parkinson's disease (PD). We focus our investigation on pesticide use in California's heavily agricultural central valley by utilizing a unique pesticide use reporting system. From 2001 to 2007, we enrolled 362 incident PD cases and 341 controls living in the Central Valley of California. Employing our geographic information system model, we estimated ambient exposures to the pesticides ziram, maneb, and paraquat at work places and residences from 1974 to 1999. At workplaces, combined exposure to ziram, maneb, and paraquat increased risk of PD three-fold (OR: 3.09; 95% CI: 1.69, 5.64) and combined exposure to ziram and paraquat, excluding maneb exposure, was associated with a 80% increase in risk (OR:1.82; 95% CI: 1.03, 3.21). Risk estimates for ambient workplace exposure were greater than for exposures at residences and were especially high for younger onset PD patients and when exposed in both locations. Our study is the first to implicate ziram in PD etiology. Combined ambient exposure to ziram and paraquat as well as combined ambient exposure to maneb and paraquat at both workplaces and residences increased PD risk substantially. Those exposed to ziram, maneb, and paraquat together experienced the greatest increase in PD risk. Our results suggest that pesticides affecting different mechanisms that contribute to dopaminergic neuron death may act together to increase the risk of PD considerably.

    更新日期:2019-11-01
  • Lifelong socioeconomic position and physical performance in midlife: results from the British 1946 birth cohort.
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2011-03-19
    Bjørn Heine Strand,Rachel Cooper,Rebecca Hardy,Diana Kuh,Jack Guralnik

    Socioeconomic position (SEP) across life is found to be related to adult physical performance, but the underlying pathways are not well characterized. Using a British birth cohort (N = 2956), the associations of SEP from childhood into midlife with objective physical performance measures in midlife were examined, adjusting for possible confounders or mediators, including indicators of muscle development and central nervous system function. Childhood and adulthood SEP were positively related to standing balance and chair rise performance, but not to grip strength after basic adjustments. When both father's occupation and mother's education were included in the same model, having a mother with low education was associated with 0.6 standard deviations (SD) (95% confidence interval (CI: 0.3, 0.8)) poorer standing balance time compared with having a mother with the highest educational level, and having a father in the lowest occupational group was associated with a 0.3 SD (95% CI: 0.1, 0.6) lower chair rise score compared with having a father in the highest occupational group. These associations were maintained, albeit attenuated, after adjustment. In contrast, the associations of own education and adult occupation with physical performance were generally not maintained after adjustment. SEP across life impacts on midlife physical performance, and thereby the ageing process.

    更新日期:2019-11-01
  • Association of CRP and IL-6 with lung function in a middle-aged population initially free from self-reported respiratory problems: the Whitehall II study.
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2011-02-05
    David Gimeno,George L Delclos,Jane E Ferrie,Roberto De Vogli,Marko Elovainio,Michael G Marmot,Mika Kivimäki

    To assess whether two inflammatory markers, C-reactive protein (CRP) and interleukin-6 (IL-6), and change in their concentrations over 12 years, are associated with lung function (FVC and FEV(1)) 12 years after baseline. Data are from over 1,500 participants free from self-reported respiratory problems in a large-scale prospective cohort study of white-collar male and female civil servants. CRP and IL-6 measured at baseline (1991-1993) and follow-up (2002-2004) and FVC and FEV(1), measured at follow-up. Results adjusted for sociodemographic and anthropometric characteristics, health behaviours, biological factors, chronic conditions and medications, and corrected for short-term variability in CRP and IL-6 concentrations. Higher baseline levels of CRP and IL-6 were strongly associated with lower FVC and FEV(1), independent of potential confounders. A 10% increase serum CRP from baseline to follow-up was associated with lower values of FVC and FEV(1) at follow-up, 4.7 and 3.0 ml, respectively. The corresponding values for a 10% increase in IL-6 were 12.6 ml for FVC and 7.3 ml for FEV(1). Systemic low-grade inflammation is associated with only slightly poorer pulmonary function in a population free from self-reported respiratory problems 12 years earlier. These data provide evidence linking inflammation to adverse outcomes beyond cardiovascular disease. Interventions targeting inflammation may prevent lung function impairment.

    更新日期:2019-11-01
  • Physical activity during pregnancy in a prospective cohort of British women: results from the Avon longitudinal study of parents and children.
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2010-12-31
    Jihong Liu,Steven N Blair,Yanping Teng,Andrew R Ness,Debbie A Lawlor,Chris Riddoch

    We sought to examine the levels, types, and changes of physical activity and their correlates among pregnant women. Data came from 9,889 pregnant women with due dates between April 1, 1991 and December 31, 1992 who were participants of the Avon Longitudinal Study of Parents and Children (ALSPAC) in Bristol, Avon, Southwest England. Self-reported physical activity during pregnancy was collected via questionnaires administered at 18 and 32 weeks of gestation. We found, at 18 weeks of gestation, the prevalence of engaging in physical activity that was sufficient to cause sweating for ≥ 3 h/week (referred to as strenuous physical activity) was 48.8%. This percentage was similar at 32 weeks of gestation. The most common physical activity during pregnancy reported by these women was brisk walking, followed by swimming and ante-natal exercise. In models that mutually adjusted for all characteristics examined, younger women, women in lower social classes, those not employed during pregnancy, married and parous women (compared to those not in each of these groups) were more likely to report engaging in strenuous physical activity. After becoming pregnant, about two out of three of these women reported reducing physical activity levels at 18 weeks of gestation. In mutually adjusted models, women who were younger, fit and well, parous, and women from lower social classes (compared to those not in each of these groups) were less likely to report reducing their physical activity. Our findings provide insights that are relevant to the design of future observational and intervention studies concerned with the effects of physical activity during pregnancy on health outcomes for mothers and offspring.

    更新日期:2019-11-01
  • Early life patterns of common infection: a latent class analysis.
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2010-10-27
    Sarah J Hepworth,Graham R Law,Debbie A Lawlor,Patricia A McKinney

    Early life infection has been implicated in the aetiology of many chronic diseases, most often through proxy measures. Data on ten infectious symptoms were collected by parental questionnaire when children were 6 months old as part of the Avon Longitudinal Study of Parents and Children, United Kingdom. A latent class analysis was used to identify patterns of infection and their relationship to five factors commonly used as proxies: sex, other children in the home, maternal smoking, breastfeeding and maternal education. A total of 10,032 singleton children were included in the analysis. Five classes were identified with differing infectious disease patterns and children were assigned to the class for which they had a highest probability of membership based on their infectious symptom profile: 'general infection' (n = 1,252, 12.5%), 'gastrointestinal' (n = 1,902, 19.0%), 'mild respiratory' (n = 3,560, 35.5%), 'colds/ear ache' (n = 462, 4.6%) and 'healthy' (n = 2,856, 28.5%). Females had a reduced risk of being in all infectious classes, other children in the home were associated with an increased risk of being in the 'general infection', 'mild respiratory' or 'colds/ear ache' class. Breastfeeding reduced the risk of being in the 'general infection' and 'gastrointestinal' classes whereas maternal smoking increased the risk of membership. Higher maternal education was associated with an increased risk of being in the 'mild respiratory' group. Other children in the home had the greatest association with infectious class membership. Latent class analysis provided a flexible method of investigating the relationship between multiple symptoms and demographic and lifestyle factors.

    更新日期:2019-11-01
  • Cognitive ability, parental socioeconomic position and internalising and externalising problems in adolescence: findings from two European cohort studies.
    Eur. J. Epidemiol. (IF 6.529) Pub Date : 2010-06-11
    Martijn Huisman,Ricardo Araya,Debbie A Lawlor,Johan Ormel,Frank C Verhulst,Albertine J Oldehinkel

    We investigated whether cognitive ability (CA) may be a moderator of the relationship of parental socioeconomic position (SEP) with internalising and externalising problems in adolescents. We used data from two longitudinal cohort studies; the Avon Longitudinal Study of Parents and Children (ALSPAC) and the Tracking Adolescents' Individual Lives Survey (TRAILS). Indicators of SEP were mother's education and household income. CA was estimated with IQ scores, derived from the Wechsler Intelligence Scale for Children. Internalising and externalising problems were measured with the Strengths and Difficulties Questionnaire in ALSPAC and with the Child Behavior Checklist in TRAILS. Logistic regression analyses were used to estimate the relative index of inequality (RII) for each outcome; the RII provides the odds ratio comparing the most to least deprived for each measure of SEP. In fully adjusted models an association of mother's education with externalising problems was observed [ALSPAC RII 1.42 (95%CI: 1.01-1.99); TRAILS RII 2.21 (95%CI: 1.37-3.54)], and of household income with internalising and externalising problems [pooled ALSPAC & TRAILS internalising RII 1.30 (95%CI: 0.99-1.71); pooled ALSPAC & TRAILS externalising RII 1.38 (95%CI: 1.03-1.84)]. No consistent associations were observed between mother's education and internalising problems. Results of stratified analyses and interaction-terms showed no evidence that CA moderated the association of SEP with internalising or externalising problems.

    更新日期:2019-11-01
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