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Björnsdottir S, Ulfsdottir H, Gudmundsson EF, Sveinsdottir K, Isberg AP, Dobies B, Akerlie Magnusdottir GE, Gunnarsdottir T, Karlsdottir T, Bjornsdottir G, Sigurdsson S, Oddsson S, Gudnason V. User Engagement, Acceptability, and Clinical Markers in a Digital Health Program for Nonalcoholic Fatty Liver Disease: Prospective, Single-Arm Feasibility Study. JMIR Cardio 2024; 8:e52576. [PMID: 38152892 PMCID: PMC10905363 DOI: 10.2196/52576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/15/2023] [Accepted: 12/26/2023] [Indexed: 12/29/2023] Open
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease in the world. Common comorbidities are central obesity, type 2 diabetes mellitus, dyslipidemia, and metabolic syndrome. Cardiovascular disease is the most common cause of death among people with NAFLD, and lifestyle changes can improve health outcomes. OBJECTIVE This study aims to explore the acceptability of a digital health program in terms of engagement, retention, and user satisfaction in addition to exploring changes in clinical outcomes, such as weight, cardiometabolic risk factors, and health-related quality of life. METHODS We conducted a prospective, open-label, single-arm, 12-week study including 38 individuals with either a BMI >30, metabolic syndrome, or type 2 diabetes mellitus and NAFLD screened by FibroScan. An NAFLD-specific digital health program focused on disease education, lowering carbohydrates in the diet, food logging, increasing activity level, reducing stress, and healthy lifestyle coaching was offered to participants. The coach provided weekly feedback on food logs and other in-app activities and opportunities for participants to ask questions. The coaching was active throughout the 12-week intervention period. The primary outcome was feasibility and acceptability of the 12-week program, assessed through patient engagement, retention, and satisfaction with the program. Secondary outcomes included changes in weight, liver fat, body composition, and other cardiometabolic clinical parameters at baseline and 12 weeks. RESULTS In total, 38 individuals were included in the study (median age 59.5, IQR 46.3-68.8 years; n=23, 61% female). Overall, 34 (89%) participants completed the program and 29 (76%) were active during the 12-week program period. The median satisfaction score was 6.3 (IQR 5.8-6.7) of 7. Mean weight loss was 3.5 (SD 3.7) kg (P<.001) or 3.2% (SD 3.4%), with a 2.2 (SD 2.7) kg reduction in fat mass (P<.001). Relative liver fat reduction was 19.4% (SD 23.9%). Systolic blood pressure was reduced by 6.0 (SD 13.5) mmHg (P=.009). The median reduction was 0.14 (IQR 0-0.47) mmol/L for triglyceride levels (P=.003), 3.2 (IQR 0.0-5.4) µU/ml for serum insulin (s-insulin) levels (P=.003), and 0.5 (IQR -0.7 to 3.8) mmol/mol for hemoglobin A1c (HbA1c) levels (P=.03). Participants who were highly engaged (ie, who used the app at least 5 days per week) had greater weight loss and liver fat reduction. CONCLUSIONS The 12-week-long digital health program was feasible for individuals with NAFLD, receiving high user engagement, retention, and satisfaction. Improved liver-specific and cardiometabolic health was observed, and more engaged participants showed greater improvements. This digital health program could provide a new tool to improve health outcomes in people with NAFLD. TRIAL REGISTRATION Clinicaltrials.gov NCT05426382; https://clinicaltrials.gov/study/NCT05426382.
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Affiliation(s)
- Sigridur Björnsdottir
- Department of Endocrinology, Metabolism and Diabetes, Karolinska Institutet, Stockholm, Sweden
| | | | | | | | | | | | | | | | | | - Gudlaug Bjornsdottir
- Icelandic Heart Association, Kopavogur, Iceland
- School of Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Sigurdur Sigurdsson
- Icelandic Heart Association, Kopavogur, Iceland
- School of Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | | | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, Iceland
- School of Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
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Bjornsdottir S, Ulfsdottir H, Gudmundsson EF, Sveinsdottir K, Isberg AP, Bjornsdottir G, Sigurdsson S, Oddsson S, Gudnason V. Abstract P519: Reduced Liver Fat and Improved Cardiometabolic Health in Individuals With Non Alcoholic Fatty Liver Disease After a 12 Week Digital Intervention - A Feasibility Study. Circulation 2023. [DOI: 10.1161/circ.147.suppl_1.p519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
Abstract
Introduction:
Cardiovascular disease is the most common cause of death among people with non-alcoholic fatty liver disease (NAFLD) and lifestyle changes can improve health outcomes. A NAFLD digital intervention was designed and here we report retention, engagement and satisfaction results in addition to the program's potential clinical impact on markers of liver- and cardiometabolic health.
Hypothesis:
We assessed the hypothesis that a digital intervention is feasible for individuals with metabolic derangements and NAFLD to improve cardiometabolic health.
Methods:
A prospective, open label, single arm, 12 week long study was conducted in Iceland.The intervention was delivered through the Sidekick app, with focus on disease education, low carbohydrate diet, increasing activity levels, reducing stress and healthy lifestyle coaching. Individuals with either BMI>30, metabolic syndrome or type 2 diabetes were screened for NAFLD with a FibroScan assessment. Other potential reasons for liver steatosis were excluded. Following recruitment and collection of demographic data, anthropometric and clinical measurements, MRI-PDFF for liver fat content, dual-energy X-ray absorptiometry for body composition and blood tests, were carried out at baseline and after 12 weeks. Primary outcomes were engagement and retention as measured in-app, and user satisfaction (mHealth App Usability Questionnaire); secondary outcomes were changes in weight, liver fat content and other cardiovascular risk factors.
Results:
In total, 38 individuals were included in the study and 34 (89%) completed the program (defined as being active 9/12 weeks). The median age was 59.5 [IQR 46.0,69.0] years and 23 (60.5%) were females. The median number of active days was 81 [IQR 45.8, 84.0] and the median user satisfaction score was 6.3 out of 7. The mean weight loss was 3.5 kg (SD=3.7) (p<0.001) with 5.0% (SD=7.0) reduction in fat mass (p<0.001), the average relative liver fat reduction was 19.3% (SD=23.9) (p<0.001). Systolic blood pressure reduced by 6.0 mmHg on average (SD=13.5) (p=0.009), diastolic blood pressure by 1.2 mmHg (SD=7.7) (p=0.357), triglyceride levels by 0.3 mmol/L (SD=0.6) (p=0.003) and waist circumference by 4.1 cm (SD=5.2) (p<0.001). In addition, participants who were active in-app at least 5 days per week on average achieved 3.8 kg (SD=3.7) (p<0.001) more weight loss and 19.3% (SD=23.9) (p=0.011) higher reduction in absolute liver fat percentage, compared to those who used the app less.
Conclusion:
This study suggests that a holistic digital intervention may improve liver-specific and cardiometabolic health in individuals with NAFLD, as indicated by the reduction in liver fat, systolic blood pressure and improvements in body composition. Together with the excellent program engagement, completion and satisfaction, this approach could provide a new tool to improve health outcomes in NAFLD.
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Jonsson BA, Bjornsdottir G, Thorgeirsson TE, Ellingsen LM, Walters GB, Gudbjartsson DF, Stefansson H, Stefansson K, Ulfarsson MO. Brain age prediction using deep learning uncovers associated sequence variants. Nat Commun 2019; 10:5409. [PMID: 31776335 PMCID: PMC6881321 DOI: 10.1038/s41467-019-13163-9] [Citation(s) in RCA: 157] [Impact Index Per Article: 31.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 10/21/2019] [Indexed: 02/08/2023] Open
Abstract
Machine learning algorithms can be trained to estimate age from brain structural MRI. The difference between an individual’s predicted and chronological age, predicted age difference (PAD), is a phenotype of relevance to aging and brain disease. Here, we present a new deep learning approach to predict brain age from a T1-weighted MRI. The method was trained on a dataset of healthy Icelanders and tested on two datasets, IXI and UK Biobank, utilizing transfer learning to improve accuracy on new sites. A genome-wide association study (GWAS) of PAD in the UK Biobank data (discovery set: \documentclass[12pt]{minimal}
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\begin{document}$$N=4456$$\end{document}N=4456) yielded two sequence variants, rs1452628-T (\documentclass[12pt]{minimal}
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\begin{document}$$P=1.15\times{10}^{-9}$$\end{document}P=1.15×10−9) and rs2435204-G (\documentclass[12pt]{minimal}
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\begin{document}$$\beta =0.102$$\end{document}β=0.102, \documentclass[12pt]{minimal}
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\begin{document}$$P=9.73\times 1{0}^{-12}$$\end{document}P=9.73×10−12). The former is near KCNK2 and correlates with reduced sulcal width, whereas the latter correlates with reduced white matter surface area and tags a well-known inversion at 17q21.31 (H2). Machine learning algorithms can be trained to estimate age from brain structural MRI. Here, the authors introduce a new deep-learning-based age prediction approach, and then carry out a GWAS of the difference between predicted and chronological age, revealing two associated variants.
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Affiliation(s)
- B A Jonsson
- deCODE Genetics/Amgen, Inc., 101, Reykjavik, Iceland.,University of Iceland, 101, Reykjavik, Iceland
| | | | | | | | - G Bragi Walters
- deCODE Genetics/Amgen, Inc., 101, Reykjavik, Iceland.,University of Iceland, 101, Reykjavik, Iceland
| | - D F Gudbjartsson
- deCODE Genetics/Amgen, Inc., 101, Reykjavik, Iceland.,University of Iceland, 101, Reykjavik, Iceland
| | - H Stefansson
- deCODE Genetics/Amgen, Inc., 101, Reykjavik, Iceland
| | - K Stefansson
- deCODE Genetics/Amgen, Inc., 101, Reykjavik, Iceland. .,University of Iceland, 101, Reykjavik, Iceland.
| | - M O Ulfarsson
- deCODE Genetics/Amgen, Inc., 101, Reykjavik, Iceland. .,University of Iceland, 101, Reykjavik, Iceland.
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Gudmundsson EF, Bjornsdottir G, Sigurdsson S, Eiriksdottir G, Thorsson B, Aspelund T, Gudnason V. Carotid Plaque is a Strong Surrogate Marker for CAC and Subclinical CHD in the General Population. ATHEROSCLEROSIS SUPP 2018. [DOI: 10.1016/j.atherosclerosissup.2018.04.040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Jonsson L, Magnusson TE, Thordarson A, Jonsson T, Geller F, Feenstra B, Melbye M, Nohr EA, Vucic S, Dhamo B, Rivadeneira F, Ongkosuwito EM, Wolvius EB, Leslie EJ, Marazita ML, Howe BJ, Moreno Uribe LM, Alonso I, Santos M, Pinho T, Jonsson R, Audolfsson G, Gudmundsson L, Nawaz MS, Olafsson S, Gustafsson O, Ingason A, Unnsteinsdottir U, Bjornsdottir G, Walters GB, Zervas M, Oddsson A, Gudbjartsson DF, Steinberg S, Stefansson H, Stefansson K. Rare and Common Variants Conferring Risk of Tooth Agenesis. J Dent Res 2018; 97:515-522. [PMID: 29364747 DOI: 10.1177/0022034517750109] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We present association results from a large genome-wide association study of tooth agenesis (TA) as well as selective TA, including 1,944 subjects with congenitally missing teeth, excluding third molars, and 338,554 controls, all of European ancestry. We also tested the association of previously identified risk variants, for timing of tooth eruption and orofacial clefts, with TA. We report associations between TA and 9 novel risk variants. Five of these variants associate with selective TA, including a variant conferring risk of orofacial clefts. These results contribute to a deeper understanding of the genetic architecture of tooth development and disease. The few variants previously associated with TA were uncovered through candidate gene studies guided by mouse knockouts. Knowing the etiology and clinical features of TA is important for planning oral rehabilitation that often involves an interdisciplinary approach.
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Affiliation(s)
- L Jonsson
- 1 deCODE genetics/Amgen, Reykjavik, Iceland.,2 Department of Pharmacology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - T E Magnusson
- 3 Faculty of Odontology, University of Iceland, Reykjavík, Iceland
| | - A Thordarson
- 3 Faculty of Odontology, University of Iceland, Reykjavík, Iceland
| | - T Jonsson
- 3 Faculty of Odontology, University of Iceland, Reykjavík, Iceland
| | - F Geller
- 4 Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - B Feenstra
- 4 Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - M Melbye
- 4 Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.,5 Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,6 Department of Medicine, School of Medicine, Stanford University, Stanford, California, USA
| | - E A Nohr
- 7 Research Unit for Gynaecology and Obstetrics, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - S Vucic
- 8 Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Centre, Rotterdam, The Netherlands.,9 Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - B Dhamo
- 8 Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Centre, Rotterdam, The Netherlands.,9 Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - F Rivadeneira
- 9 Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands.,10 Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,11 Department of Internal Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - E M Ongkosuwito
- 8 Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Centre, Rotterdam, The Netherlands.,9 Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - E B Wolvius
- 8 Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Centre, Rotterdam, The Netherlands.,9 Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - E J Leslie
- 12 Department of Oral Biology, Center for Craniofacial and Dental Genetics, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,13 Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
| | - M L Marazita
- 12 Department of Oral Biology, Center for Craniofacial and Dental Genetics, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,14 Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.,15 Clinical and Translational Science, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - B J Howe
- 16 Department of Family Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - L M Moreno Uribe
- 16 Department of Family Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - I Alonso
- 17 i3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.,18 UnIGENe, Instituto Biologia Molecular Celular, Universidade do Porto, Porto, Portugal
| | - M Santos
- 17 i3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.,18 UnIGENe, Instituto Biologia Molecular Celular, Universidade do Porto, Porto, Portugal
| | - T Pinho
- 17 i3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.,18 UnIGENe, Instituto Biologia Molecular Celular, Universidade do Porto, Porto, Portugal.,19 CESPU, Instituto de Investigacão e Formação Avançada em Ciências e Tecnologias da Saúde, Rua Central de Gandra, Gandra-PRD, Portugal
| | - R Jonsson
- 20 Icelandic Health Insurance, Reykjavík, Iceland
| | - G Audolfsson
- 21 Department of Plastic Surgery, Landspitali-University Hospital, Reykjavik, Iceland
| | | | - M S Nawaz
- 1 deCODE genetics/Amgen, Reykjavik, Iceland.,22 Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - S Olafsson
- 1 deCODE genetics/Amgen, Reykjavik, Iceland
| | | | - A Ingason
- 1 deCODE genetics/Amgen, Reykjavik, Iceland
| | | | | | - G B Walters
- 1 deCODE genetics/Amgen, Reykjavik, Iceland.,22 Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - M Zervas
- 1 deCODE genetics/Amgen, Reykjavik, Iceland
| | - A Oddsson
- 1 deCODE genetics/Amgen, Reykjavik, Iceland
| | | | | | | | - K Stefansson
- 1 deCODE genetics/Amgen, Reykjavik, Iceland.,22 Faculty of Medicine, University of Iceland, Reykjavik, Iceland
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Sturlaugsdottir R, Aspelund T, Bjornsdottir G, Sigurdsson S, Thorsson B, Eiriksdottir G, Gudnason V. Predictors of carotid plaque progression over a 4-year follow-up in the Reykjavik REFINE-study. Atherosclerosis 2017; 269:57-62. [PMID: 29274849 DOI: 10.1016/j.atherosclerosis.2017.12.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 11/29/2017] [Accepted: 12/05/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND AIMS Carotid plaque is an arterial marker suggested as a surrogate end point for cardiovascular disease. The aim of this study was to examine the association of risk factors at visit 1 with plaque formation and progression of total plaque area (TPA) during follow-up. METHODS We examined 1894 participants (50-69 years of age) in the population-based REFINE (Risk Evaluation For INfarct Estimates)-Reykjavik study. RESULTS Among those with no plaque at baseline, plaque formation was associated with low density lipoprotein, sex, waist, former smoker and physical activity. Furthermore, both the Icelandic Heart Association (IHA) coronary heart disease (CHD) risk score and the atherosclerotic cardiovascular disease (ASCVD) risk score were highly associated with plaque formation in these individuals (p < 0.001) and a better cardiovascular health score was protective. In those with plaque present at baseline, metabolic syndrome was associated with increased risk, while older age and statin use were associated with reduced risk of new plaque formation. Statin use was the only factor associated with the relative TPA progression, where participants not on treatment had 5.7% (p=0.029) greater rate of progression compared with statin users. CONCLUSIONS A number of conventional risk factors at visit 1 were individually associated with plaque formation, also when combined into CHD and ASCVD risk scores, but not with the relative progression in TPA. Medical intervention with statins can reduce the relative progression rate of TPA in the general population with low grade of atherosclerosis, supporting statin use to slow progression of atherosclerosis.
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Affiliation(s)
- Ran Sturlaugsdottir
- Icelandic Heart Association, Kopavogur, Iceland; University of Iceland, Reykjavik, Iceland
| | - Thor Aspelund
- Icelandic Heart Association, Kopavogur, Iceland; University of Iceland, Reykjavik, Iceland
| | - Gudlaug Bjornsdottir
- Icelandic Heart Association, Kopavogur, Iceland; University of Iceland, Reykjavik, Iceland
| | | | | | | | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, Iceland; University of Iceland, Reykjavik, Iceland.
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7
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Ulfarsson MO, Walters GB, Gustafsson O, Steinberg S, Silva A, Doyle OM, Brammer M, Gudbjartsson DF, Arnarsdottir S, Jonsdottir GA, Gisladottir RS, Bjornsdottir G, Helgason H, Ellingsen LM, Halldorsson JG, Saemundsen E, Stefansdottir B, Jonsson L, Eiriksdottir VK, Eiriksdottir GR, Johannesdottir GH, Unnsteinsdottir U, Jonsdottir B, Magnusdottir BB, Sulem P, Thorsteinsdottir U, Sigurdsson E, Brandeis D, Meyer-Lindenberg A, Stefansson H, Stefansson K. 15q11.2 CNV affects cognitive, structural and functional correlates of dyslexia and dyscalculia. Transl Psychiatry 2017; 7:e1109. [PMID: 28440815 PMCID: PMC5416713 DOI: 10.1038/tp.2017.77] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 02/22/2017] [Accepted: 02/23/2017] [Indexed: 02/07/2023] Open
Abstract
Several copy number variants have been associated with neuropsychiatric disorders and these variants have been shown to also influence cognitive abilities in carriers unaffected by psychiatric disorders. Previously, we associated the 15q11.2(BP1-BP2) deletion with specific learning disabilities and a larger corpus callosum. Here we investigate, in a much larger sample, the effect of the 15q11.2(BP1-BP2) deletion on cognitive, structural and functional correlates of dyslexia and dyscalculia. We report that the deletion confers greatest risk of the combined phenotype of dyslexia and dyscalculia. We also show that the deletion associates with a smaller left fusiform gyrus. Moreover, tailored functional magnetic resonance imaging experiments using phonological lexical decision and multiplication verification tasks demonstrate altered activation in the left fusiform and the left angular gyri in carriers. Thus, by using convergent evidence from neuropsychological testing, and structural and functional neuroimaging, we show that the 15q11.2(BP1-BP2) deletion affects cognitive, structural and functional correlates of both dyslexia and dyscalculia.
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Affiliation(s)
- M O Ulfarsson
- deCODE Genetics/Amgen, Reykjavik, Iceland,Faculty of Electrical and Computer Engineering, University of Iceland, Reykjavik, Iceland,deCODE Genetics/Amgen, Sturlugata 8, 101 Reykjavik, Iceland. E-mail: or
| | | | | | | | - A Silva
- Cardiff University Brain Imaging Research Center, Cardiff University, Cardiff, UK
| | - O M Doyle
- Institute of Psychiatry, King's College, London, UK
| | - M Brammer
- Institute of Psychiatry, King's College, London, UK
| | - D F Gudbjartsson
- deCODE Genetics/Amgen, Reykjavik, Iceland,Faculty of Physical Sciences, University of Iceland, Reykjavik, Iceland
| | - S Arnarsdottir
- deCODE Genetics/Amgen, Reykjavik, Iceland,Department of Psychiatry, Landspitali National University Hospital, Reykjavik, Iceland
| | | | | | | | - H Helgason
- deCODE Genetics/Amgen, Reykjavik, Iceland,Faculty of Electrical and Computer Engineering, University of Iceland, Reykjavik, Iceland
| | - L M Ellingsen
- Faculty of Electrical and Computer Engineering, University of Iceland, Reykjavik, Iceland
| | - J G Halldorsson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - E Saemundsen
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland,The State Diagnosis and Counselling Center, Kopavogur, Iceland
| | | | - L Jonsson
- deCODE Genetics/Amgen, Reykjavik, Iceland
| | | | | | | | | | | | - B B Magnusdottir
- Department of Psychiatry, Landspitali National University Hospital, Reykjavik, Iceland,School of Business, University of Reykjavik, Reykavik, Iceland
| | - P Sulem
- deCODE Genetics/Amgen, Reykjavik, Iceland
| | - U Thorsteinsdottir
- deCODE Genetics/Amgen, Reykjavik, Iceland,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - E Sigurdsson
- Department of Psychiatry, Landspitali National University Hospital, Reykjavik, Iceland,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - D Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland,Central Institute of Mental Health, University of Heidelberg Medical Faculty Mannheim, Mannheim, Germany
| | - A Meyer-Lindenberg
- Central Institute of Mental Health, University of Heidelberg Medical Faculty Mannheim, Mannheim, Germany
| | | | - K Stefansson
- deCODE Genetics/Amgen, Reykjavik, Iceland,Faculty of Medicine, University of Iceland, Reykjavik, Iceland,deCODE Genetics/Amgen, Sturlugata 8, 101 Reykjavik, Iceland. E-mail: or
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8
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Sturlaugsdottir R, Aspelund T, Bjornsdottir G, Sigurdsson S, Thorsson B, Eiriksdottir G, Gudnason V. Prevalence and determinants of carotid plaque in the cross-sectional REFINE-Reykjavik study. BMJ Open 2016; 6:e012457. [PMID: 27884845 PMCID: PMC5168519 DOI: 10.1136/bmjopen-2016-012457] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE Carotid plaque and intima-media thickness are non-invasive arterial markers that are used as surrogate end points for cardiovascular disease. The aim was to assess the prevalence and severity of carotid plaque, and examine its determinant risk factors and their association to the common carotid artery intima-media thickness (CCA-IMT) in a general population. METHODS We examined 6524 participants aged 25-69 years in the population-based REFINE (Risk Evaluation For INfarct Estimates)-Reykjavik study. Plaques at the bifurcation and internal carotid arteries were evaluated. Mean CCA-IMT was measured in the near and far walls of the common carotid arteries. RESULTS The prevalence of minimal, moderate and severe plaque was 35.0%, 8.9% and 1.1%, respectively, and the mean CCA-IMT was 0.73 (SD 0.14) mm. Age, sex, smoking and type 2 diabetes mellitus (T2DM) were the strongest risk factors associated with plaque, followed by systolic blood pressure, total cholesterol, body mass index and family history of myocardial infarct. Low educational level was also strongly and independently associated with plaque. CCA-IMT shared the same risk factors except for a non-significant association with T2DM and family history of myocardial infarction (MI). Participants with T2DM had greater plaque prevalence, 2-fold higher in those <50 years and 17-30% greater in age groups 50-54 to 60-64, and more significant plaques (moderate or severe) were the difference in prevalence was 24% in age group 50-54 and ≥60% in older age groups, compared with non-T2DM. CONCLUSIONS Carotid plaque and CCA-IMT have mostly common determinants. However, T2DM and family history of MI were associated with plaque but not with CCA-IMT. Greater prevalence and more severe plaques in individuals with T2DM raise the concern that with increasing prevalence of T2DM we may expect an increase in atherosclerosis and its consequences.
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Affiliation(s)
- Ran Sturlaugsdottir
- Icelandic Heart Association, Kopavogur, Iceland
- University of Iceland, Reykjavik, Iceland
| | - Thor Aspelund
- Icelandic Heart Association, Kopavogur, Iceland
- University of Iceland, Reykjavik, Iceland
| | - Gudlaug Bjornsdottir
- Icelandic Heart Association, Kopavogur, Iceland
- University of Iceland, Reykjavik, Iceland
| | | | | | | | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, Iceland
- University of Iceland, Reykjavik, Iceland
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9
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Thorgeirsson TE, Steinberg S, Reginsson GW, Bjornsdottir G, Rafnar T, Jonsdottir I, Helgadottir A, Gretarsdottir S, Helgadottir H, Jonsson S, Matthiasson SE, Gislason T, Tyrfingsson T, Gudbjartsson T, Isaksson HJ, Hardardottir H, Sigvaldason A, Kiemeney LA, Haugen A, Zienolddiny S, Wolf HJ, Franklin WA, Panadero A, Mayordomo JI, Hall IP, Rönmark E, Lundbäck B, Dirksen A, Ashraf H, Pedersen JH, Masson G, Sulem P, Thorsteinsdottir U, Gudbjartsson DF, Stefansson K. A rare missense mutation in CHRNA4 associates with smoking behavior and its consequences. Mol Psychiatry 2016; 21:594-600. [PMID: 26952864 PMCID: PMC5414061 DOI: 10.1038/mp.2016.13] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 12/17/2015] [Accepted: 01/04/2016] [Indexed: 11/22/2022]
Abstract
Using Icelandic whole-genome sequence data and an imputation approach we searched for rare sequence variants in CHRNA4 and tested them for association with nicotine dependence. We show that carriers of a rare missense variant (allele frequency=0.24%) within CHRNA4, encoding an R336C substitution, have greater risk of nicotine addiction than non-carriers as assessed by the Fagerstrom Test for Nicotine Dependence (P=1.2 × 10(-4)). The variant also confers risk of several serious smoking-related diseases previously shown to be associated with the D398N substitution in CHRNA5. We observed odds ratios (ORs) of 1.7-2.3 for lung cancer (LC; P=4.0 × 10(-4)), chronic obstructive pulmonary disease (COPD; P=9.3 × 10(-4)), peripheral artery disease (PAD; P=0.090) and abdominal aortic aneurysms (AAAs; P=0.12), and the variant associates strongly with the early-onset forms of LC (OR=4.49, P=2.2 × 10(-4)), COPD (OR=3.22, P=2.9 × 10(-4)), PAD (OR=3.47, P=9.2 × 10(-3)) and AAA (OR=6.44, P=6.3 × 10(-3)). Joint analysis of the four smoking-related diseases reveals significant association (P=6.8 × 10(-5)), particularly for early-onset cases (P=2.1 × 10(-7)). Our results are in agreement with functional studies showing that the human α4β2 isoform of the channel containing R336C has less sensitivity for its agonists than the wild-type form following nicotine incubation.
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Affiliation(s)
- T E Thorgeirsson
- deCODE genetics/Amgen, Reykjavik, Iceland,deCODE genetics/Amgen, Sturlugata 8, Reykjavik IS-101, Iceland. E-mail: or
| | | | | | | | - T Rafnar
- deCODE genetics/Amgen, Reykjavik, Iceland
| | - I Jonsdottir
- deCODE genetics/Amgen, Reykjavik, Iceland,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | | | | | | | - S Jonsson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland,Department of Respiratory Medicine, Landspitali University Hospital, Reykjavik, Iceland
| | | | - T Gislason
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland,Department of Respiratory Medicine, Landspitali University Hospital, Reykjavik, Iceland
| | - T Tyrfingsson
- SAA National Center of Addiction Medicine, Reykjavik, Iceland
| | - T Gudbjartsson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland,Department of Cardiothoracic Surgery, Landspitali University Hospital, Reykjavik, Iceland
| | - H J Isaksson
- Department of Pathology, Landspitali University Hospital, Reykjavik, Iceland
| | - H Hardardottir
- Department of Respiratory Medicine, Landspitali University Hospital, Reykjavik, Iceland
| | - A Sigvaldason
- Department of Respiratory Medicine, Landspitali University Hospital, Reykjavik, Iceland
| | - L A Kiemeney
- Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands,Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A Haugen
- Department for the Chemical and Biological Work Environment, National Institute of Occupational Health, Oslo, Norway
| | - S Zienolddiny
- Department for the Chemical and Biological Work Environment, National Institute of Occupational Health, Oslo, Norway
| | - H J Wolf
- Community & Behavioral Health, Colorado School of Public Health, University of Colorado Denver, Aurora, CO, USA
| | - W A Franklin
- Department of Pathology, University of Colorado Denver, Aurora, CO, USA
| | - A Panadero
- Division of Medical Oncology, Hospital Ciudad de Coria, Coria, Spain
| | - J I Mayordomo
- Division of Medical Oncology, University of Colorado School of Medicine, Denver, CO, USA
| | - I P Hall
- Division of Respiratory Medicine, Queens Medical Centre, University of Nottingham, Nottingham, UK
| | - E Rönmark
- The OLIN studies, Department of Medicine, Sunderby Central Hospital of Norrbotten, Luleå, Sweden,Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | - B Lundbäck
- The OLIN studies, Department of Medicine, Sunderby Central Hospital of Norrbotten, Luleå, Sweden,Krefting Research Centre, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - A Dirksen
- Department of Respiratory Medicine, Gentofte Hospital, Copenhagen University, Hellerup, Denmark
| | - H Ashraf
- Department of Respiratory Medicine, Gentofte Hospital, Copenhagen University, Hellerup, Denmark,Centre for Diagnostic Imaging—Thoracic Section, Akershus University Hospital, Loerenskog, Norway
| | - J H Pedersen
- Department of Thoracic Surgery RT, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - G Masson
- deCODE genetics/Amgen, Reykjavik, Iceland
| | - P Sulem
- deCODE genetics/Amgen, Reykjavik, Iceland
| | | | | | - K Stefansson
- deCODE genetics/Amgen, Reykjavik, Iceland,Faculty of Medicine, University of Iceland, Reykjavik, Iceland,deCODE genetics/Amgen, Sturlugata 8, Reykjavik IS-101, Iceland. E-mail: or
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10
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Sturlaugsdottir R, Aspelund T, Sigurdsson S, Thorsson B, Bjornsdottir G, Gudnason V. Cardiovascular risk factors association with total plaque area and progression in a general population: The refine-reykjavik study. Atherosclerosis 2015. [DOI: 10.1016/j.atherosclerosis.2015.04.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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11
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Bessadottir M, Egilsson M, Einarsdottir E, Bjornsdottir G, Magnusdottir I, Omarsdottir S, Ogmundsdottir H. 869 The lichen compound usnic acid disturbs mitochondrial function and induces autophagy in cancer cells. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)71663-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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12
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Brennan PF, Moore SM, Bjornsdottir G, Jones J, Visovsky C, Rogers M. HeartCare: an Internet-based information and support system for patient home recovery after coronary artery bypass graft (CABG) surgery. J Adv Nurs 2001; 35:699-708. [PMID: 11529972 DOI: 10.1046/j.1365-2648.2001.01902.x] [Citation(s) in RCA: 94] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
HeartCare is an Internet-based information and support service for patients recovering at home from coronary artery bypass graft (CABG) surgery. The system is designed to meet the nursing challenges in health information to support needs of CABG patients. HeartCare (a) provides information and support, tailored to patients' individual and changing recovery needs during CABG recovery, (b) makes recovery information more accessible for timely use by patients, and (c) extends the scope of nursing services to CABG patients from hospital through home. An ongoing randomized controlled study is underway to evaluate the clinical outcomes of patients' use of the HeartCare system and to examine its acceptance as a usable resource for postCABG patients who have limited previous computer experience.
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Affiliation(s)
- P F Brennan
- Moehlman Bascan Professor of Nursing and Engineering, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA.
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13
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Bjornsdottir G. Online social support for individuals concerned with heart disease: observing gender differences. Proc AMIA Symp 1999:681-5. [PMID: 10566446 PMCID: PMC2232629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
Using a theoretical framework of social support, and content analysis, the content and pattern of support in messages posted in a 4-week period on a commercial health network for individuals concerned with heart disease were observed and described. Special consideration was given to identifying gender differences.
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