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Uchai S, Andersen LF, Johansson J, Hopstock LA, Hjartåker A. Dual-Energy X-Ray Absorptiometry Derived Adiposity Measures and Pre-Frailty/Frailty among Norwegian Adults: The Tromsø Study 2007-2015. J Nutr Health Aging 2023; 27:403-410. [PMID: 37357322 DOI: 10.1007/s12603-023-1920-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 04/06/2023] [Indexed: 06/27/2023]
Abstract
OBJECTIVES Aging is associated with changes in body composition. Excess adiposity among older adults has been linked with metabolic syndromes and aggravated age-associated decline in physical functioning. Few longitudinal studies have explored the association between dual-energy X-ray absorptiometry (DXA)-derived total as well as central adiposity measures and frailty. We examined the association of DXA-derived total and central adiposity with pre-frailty/frailty among Norwegian adults after 8 years of follow-up. DESIGN Prospective observational study. SETTING Community-dwelling adults from Tromsø, Norway. MEASUREMENTS Adiposity was defined by fat mass index (FMI) and visceral adipose tissue (VAT) mass assessed using DXA measures. Frailty status was assessed by low grip strength, slow walking speed, exhaustion, unintentional weight loss and low physical activity level. Pre-frail and frail participants at baseline were excluded. Sex-stratified multivariable logistic regression models were used to investigate the association. RESULTS Participants comprised 234 women (mean age 68 years) and 146 men (mean age 69 years) attending the population-based Tromsø Study in 2007-2008 (Tromsø6) and 2015-2016 (Tromsø7). At the end of follow-up, 25.6% of the women and 27.4% of the men were pre-frail/frail. Compared with women in the lowest tertiles, those in the highest tertile of baseline FMI (odds ratio [OR] 4.42, 95% confidence interval [CI] 1.88-10.35) and VAT mass (OR 2.47, 95% CI 1.10-5.50), respectively had higher odds for pre-frailty/frailty at follow-up. CONCLUSION We found a higher likelihood of pre-frailty/frailty in later years among women with general and central adiposity in adulthood, highlighting the importance of preventing excess adiposity for healthy aging.
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Affiliation(s)
- S Uchai
- Shreeshti Uchai, Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Norway, Postbox: 1046, Blindern, 0317 Oslo, Norway
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Hagen A, Eggen AE, Hanssen TA, Lappegard KT, Lochen ML, Njolstad I, Wilsgaard T, Hopstock LA. Time trends in cardiovascular risk factors across levels of education in a general population. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.104] [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: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Northern Norway Health Authority
Background
Favourable changes over time in population cardiovascular disease (CVD) risk has not benefitted all socioeconomic groups equally. Social inequality in health also exists in high-income countries with an egalitarian welfare system.
Purpose
We aimed to study CVD risk factors across educational groups over time in a Norwegian general population.
Methods
We used multivariable linear regression and generalised estimating equation models with age-adjusted means and proportions to examine CVD risk (smoking, physical activity level, obesity [body mass index ≥30 kg/m2], blood pressure, total- and low-density lipoprotein [LDL] cholesterol, and total risk of CVD [estimated 10-year risk with NORRISK 2]) across four levels of education: Primary/partly secondary up to 10 years of schooling, upper secondary, tertiary <4 years, tertiary ≥4 years in women and men aged 40-79 years attending a population-based study with two consecutive surveys in 2007-2008 (N=11,941) and 2015-2016 (N=20,322).
Results
In women, the difference between the lowest and the highest education level in risk factors in 2007-2008 versus 2015-2016 was for smoking 22.0 vs 19.2 percentage points (pp), obesity 8.7 vs 8.8 pp, sedentary physical activity level 10.5 vs 11.5 pp (p=0.012), systolic blood pressure 5.5 vs 3.4 mmHg (p=0.001), total cholesterol 0.2 mmol/L vs no difference (p<0.001), LDL cholesterol 0.3 vs 0.1 mmol/L (p<0.001), and total CVD risk 0.9 vs 1.8 (p<0.001), respectively. In men, the corresponding numbers were for smoking 20.1 vs 16.8 pp, obesity 9.9 vs 12.9 pp, sedentary physical activity level 10 vs 11.5 pp (p=0.027), systolic blood pressure 1.7 vs 1.7 mmHg, total cholesterol 0.2 mmol/L vs no difference (p<0.001), LDL cholesterol 0.1 mmol/L vs no difference (p<0.001), and total CVD risk 1.2 vs 0.9, respectively. No difference across educational levels and time regarding blood pressure or total- or LDL cholesterol in users of antihypertensives and lipid-lowering drugs was found, except for an educational difference in the first but not the second time period in female antihypertensive users.
Conclusion
We found a clinically relevant educational gap in CVD risk factors, with more favourable levels with higher education. Over time, the educational gap increased in physical activity in both sexes, and in total CVD risk in women. Further, the educational gap declined in blood lipids in both sexes, and in systolic blood pressure in women. While medication use seems to contribute to weaken the educational gradient in blood pressure and lipid levels, a stronger emphasis on lifestyle interventions is needed to reduce the educational inequalities in behavioural CVD risk factors.
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Affiliation(s)
- A Hagen
- Nordland Hospital, Department of Medicine, Bodo, Norway
| | - AE Eggen
- UiT The Arctic University of Norway, Department of Community Medicine, Tromso, Norway
| | - TA Hanssen
- UiT The Arctic University of Norway, Department of Health and Care Sciences, Tromso, Norway
| | - KT Lappegard
- Nordland Hospital, Department of Medicine, Bodo, Norway
| | - ML Lochen
- UiT The Arctic University of Norway, Department of Community Medicine, Tromso, Norway
| | - I Njolstad
- UiT The Arctic University of Norway, Department of Community Medicine, Tromso, Norway
| | - T Wilsgaard
- UiT The Arctic University of Norway, Department of Community Medicine, Tromso, Norway
| | - LA Hopstock
- UiT The Arctic University of Norway, Department of Community Medicine, Tromso, Norway
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Larsen AU, Hopstock LA, Jorde R, Grimnes G. No improvement of sleep from vitamin D supplementation: insights from a randomized controlled trial. Sleep Med X 2021; 3:100040. [PMID: 34881361 PMCID: PMC8567000 DOI: 10.1016/j.sleepx.2021.100040] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 11/11/2022] Open
Abstract
Background Vitamin D has been linked to sleep health in observational studies. Data from randomized controlled trials (RCTs) with vitamin D is scarce. Methods This study presents the results of a secondary analysis of 189 vitamin D insufficient participants (47.1% women) in a previously performed RCT, of which 92 were randomized to vitamin D (100,000 IU (2500 μg) as a bolus dose followed by 20,000 IU (500 μg) per week), and 97 to placebo. At baseline and after 4 months at the end of the study serum 25-hydroxyvitamin D (s-25(OH)D) was measured, and the study questionnaire assessing sleep duration, daytime sleepiness, and symptoms of insomnia, was completed. Results At baseline, mean s-25(OH)D was 35.0 ± 11.8 and 35.5 ± 13.3 nmol/L in the vitamin D and placebo groups, respectively. After four months, we found no statistically significant differences between the intervention groups in any of the assessed sleep outcomes, neither when stratified by sex, nor when performed in subgroups based on baseline or end of study s-25(OH)D level or presence of sleep complaints at baseline. Conclusions We were not able to demonstrate a significant effect of vitamin D supplementation on sleep in this vitamin D insufficient population. RCT investigating vitamin D for 4 months in participants with low vitamin D status. Vitamin D did not improve sleep duration, excessive daytime sleepiness or insomnia. The role of vitamin D in sleep health remains controversial.
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Affiliation(s)
- A U Larsen
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - L A Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - R Jorde
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - G Grimnes
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.,Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
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Kholmatova K, Kudryavtsev AV, Malyutina S, Hopstock LA, Cook S, Krettek A, Leon DA. Obesity prevalence and associations with socio-economic and behavioral factors in population-based studies in Russia and Norway, 2015–2017. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2615] [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: 11/12/2022] Open
Abstract
Abstract
Background
Obesity is an epidemic of XXI century, as its prevalence doubled during the last forty years. As Russia and Norway are countries with different life expectancy there could be differences in obesity and its correlates.
Purpose
To investigate and compare prevalence and socio-economic and behavioral factors associated with obesity in Russia and Norway with data from population-based studies.
Methods
We used multivariable logistic regression to examine associations of obesity (body mass index>30 kg/m2) with socio-economic factors (age, education, marital status, and poor financial situation defined as difficulty to afford clothes) and behavioral characteristics (smoking, alcohol use) in participants aged 40–69 years from the Know Your Heart study (Russia, 2015–2017, N=4 106) and the seventh Study (Norway, 2015–16, N=17 604). All results for covariates are mutually adjusted. Between-study comparisons of the associations of obesity with the same covariates were performed through investigation of their interactions with the “study” variable.
Results
The age-standardized prevalence of obesity was higher in Russia among women (36.8 vs 22.0%, p<0.001) and did not differ among men (26.7 vs 25.7%, p=0.224). In Russian women, obesity was positively associated with age of 50–69 years relative to 40–49 years (OR=2.5, 95% CI 2.0–3.1), no university education (OR=1.5, 95% CI 1.2–1.8), and poor financial situation (OR=1.5, 95% CI 1.2–1.9). In Norwegian women, obesity was negatively associated with the age of 50–69 years (OR=0.8, 95% CI 0.8–1.0), current smoking (OR=0.8, 95% CI 0.7–1.0) and drinking alcohol ≥2 times per week (OR=0.6, 95% CI 0.5–0.6), and positively associated with no university education (OR=1.5, 95% CI 1.3–1.7), previous smoking (OR=1.3, 95% CI 1.1–1.4), and drinking ≥5 alcohol drinks per occasion (OR=1.7, 95% CI 1.3–2.2). In Russian men, obesity was positively associated with living with spouse/partner (OR=1.5, 95% CI 1.1–2.2), drinking alcohol ≥2 times per week (OR=1.4, 95% CI 1.1–1.8), and negatively associated with current smoking (OR=0.6, 95% CI 0.4–0.8). In Norwegian men, obesity was positively associated with no university education (OR=1.4, 95% CI 1.2–1.6), previous smoking (OR=1.3, 95% CI 1.2–1.5), and drinking ≥5 alcohol drinks per occasion (OR=1.7, 95% CI 1.5–1.9), and negatively associated with current smoking (OR=0.8, 95% CI 0.7–1.0) and drinking alcohol ≥2 times per week (OR=0.7, 95% CI 0.6–0.7). Interactions with the “study” variable in women were significant for age, financial situation, frequency of alcohol use; in men - for living with spouse/partner, frequency of alcohol use, number of alcohol drinks taken per occasion.
Conclusion
The prevalence of obesity was higher in Russian compared to Norwegian women, but there was no difference between Russian and Norwegian men. There were different between-country patterns of the associations of obesity with the socio-economic and behavioral characteristics.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): The Know Your Heart study was a component of International Project on Cardiovascular Disease in Russia and funded by Wellcome Trust Strategic Award [100217], UiT The Arctic University of Norway, Norwegian Institute of Public Health, and Norwegian Ministry of Health and Care Services. The Tromsø Study was funded by UiT The Arctic University of Norway, Northern Norway Regional Health Authority, Norwegian Ministry of Health and Care Services, Norwegian Research Council, and various public and charity research funds in Norway. PhD scholarship and operational funds of the first author were provided by Northern State Medical University, Arkhangelsk, Russia and by UiT The Arctic University of Norway
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Affiliation(s)
- K Kholmatova
- Northern State Medical University, Arkhangelsk, Russian Federation
| | - A V Kudryavtsev
- Northern State Medical University, Arkhangelsk, Russian Federation
| | - S Malyutina
- Research institute of internal and preventive medicine branch of Institute of Cytology and Genetics, Novosibirsk, Russian Federation
| | - L A Hopstock
- UiT The Arctic University of Norway, Tromsø, Norway
| | - S Cook
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - A Krettek
- UiT The Arctic University of Norway, Tromsø, Norway
| | - D A Leon
- London School of Hygiene and Tropical Medicine, London, United Kingdom
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Cook S, Malyutina S, Hopstock LA, Kudryavtsev AV, Wilsgaard T, Voevoda M, Schirmer H, Bobrova N, Kholmatova K, Diez Benavente E, Leon DA. Understanding East-West differences in cardiovascular disease in Europe: Early findings of the Heart to Heart comparative population-based studies in Russia and Norway, 2015-2018. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Cook
- London School of Hygiene and Tropical Medicine, London, UK
| | - S Malyutina
- Novosibirsk State Medical University, Novosibirsk, Russia
| | - LA Hopstock
- UiT The Arctic University of Norway, Tromsø, Norway
| | | | - T Wilsgaard
- UiT The Arctic University of Norway, Tromsø, Norway
| | - M Voevoda
- Research Institute of Internal and Preventive Medicine, Branch of IC&G, SB RAS, Novosibirsk, Russia
| | - H Schirmer
- Akershus University Hospital, Oslo, Norway
| | - N Bobrova
- London School of Hygiene and Tropical Medicine, London, UK
| | - K Kholmatova
- Northern State Medical University, Arkhangelsk, Russia
| | | | - DA Leon
- London School of Hygiene and Tropical Medicine, London, UK
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Sharashova E, Wilsgaard T, Njolstad I, Mathiesen EB, Hopstock LA, Ball J, Gerdts E, Morseth B, Lochen ML. 6168Long-term systolic blood pressure trajectories predict risk of incident atrial fibrillation in a general population cohort study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.6168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- E Sharashova
- UiT The Arctic University of Norway, Department of Community Medicine, Tromso, Norway
| | - T Wilsgaard
- UiT The Arctic University of Norway, Department of Community Medicine, Tromso, Norway
| | - I Njolstad
- UiT The Arctic University of Norway, Department of Community Medicine, Tromso, Norway
| | - E B Mathiesen
- UiT The Arctic University of Norway, Department of Clinical Medicine, Tromso, Norway
| | - L A Hopstock
- UiT The Arctic University of Norway, Department of Health and Care Sciences, Tromso, Norway
| | - J Ball
- Baker IDI Heart and Diabetes Institute, Pre-Clinical Disease and Prevention, Melbourne, Australia
| | - E Gerdts
- University of Bergen, Department of Clinical Science, Bergen, Norway
| | - B Morseth
- UiT The Arctic University of Norway, School of Sport Sciences, Tromso, Norway
| | - M L Lochen
- UiT The Arctic University of Norway, Department of Community Medicine, Tromso, Norway
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Tiwari S, Løchen ML, Jacobsen BK, Hopstock LA, Nyrnes A, Njølstad I, Mathiesen EB, Arntzen KA, Ball J, Stewart S, Wilsgaard T, Schirmer H. Atrial fibrillation is associated with cognitive decline in stroke-free subjects: the Tromsø Study. Eur J Neurol 2017; 24:1485-1492. [DOI: 10.1111/ene.13445] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 09/01/2017] [Indexed: 11/28/2022]
Affiliation(s)
- S. Tiwari
- Department of Community Medicine; UiT The Arctic University of Norway; Tromsø
| | - M. L. Løchen
- Department of Community Medicine; UiT The Arctic University of Norway; Tromsø
| | - B. K. Jacobsen
- Department of Community Medicine; UiT The Arctic University of Norway; Tromsø
| | - L. A. Hopstock
- Department of Community Medicine; UiT The Arctic University of Norway; Tromsø
- Department of Health and Care Sciences; UiT The Arctic University of Norway; Tromsø
| | - A. Nyrnes
- Department of Geriatric Medicine; University Hospital of North Norway; Tromsø
| | - I. Njølstad
- Department of Community Medicine; UiT The Arctic University of Norway; Tromsø
| | - E. B. Mathiesen
- Department of Clinical Medicine; UiT The Arctic University of Norway; Tromsø
- Department of Neurology and Neurophysiology; University Hospital of North Norway; Tromsø Norway
| | - K. A. Arntzen
- Department of Clinical Medicine; UiT The Arctic University of Norway; Tromsø
| | - J. Ball
- Pre-Clinical Disease and Prevention; Baker Heart and Diabetes Institute; Melbourne
| | - S. Stewart
- Mary MacKillop Institute for Health Research; Australian Catholic University; Melbourne Australia
| | - T. Wilsgaard
- Department of Community Medicine; UiT The Arctic University of Norway; Tromsø
| | - H. Schirmer
- Department of Clinical Medicine; UiT The Arctic University of Norway; Tromsø
- Department of Cardiology; University Hospital of North Norway; Tromsø Norway
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