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Li J, Sesso HD, Kim E, Manson JE, Friedenberg G, Clar A, Copeland T, Shadyab AH, Wactawski-Wende J, Tinker L, Liu S. Cocoa Extract Supplementation and Risk of Type 2 Diabetes: The Cocoa Supplement and Multivitamin Outcomes Study (COSMOS) Randomized Clinical Trial. Diabetes Care 2023; 46:2278-2284. [PMID: 37816167 DOI: 10.2337/dc23-1012] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 09/22/2023] [Indexed: 10/12/2023]
Abstract
OBJECTIVE Observational studies have indicated that cocoa flavanol supplementation may be a promising strategy for type 2 diabetes (T2D) prevention. We aimed to directly evaluate its clinical efficacy in a large randomized clinical trial (RCT). RESEARCH DESIGN AND METHOD The Cocoa Supplement and Multivitamin Outcomes Study (COMSOS) was a 2 × 2 factorial RCT performed from June 2015 to December 2020 that tested cocoa extract and a multivitamin for the prevention of cardiovascular disease (CVD) and cancer. A total of 21,442 U.S. adults free of CVD and recent cancer, including 12,666 women aged ≥65 years and 8,776 men aged ≥60 years, were randomly assigned to receive cocoa extract [500 mg/day cocoa flavanols, including 80 mg (-)-epicatechin] or placebo. In this study, we included 18,381 participants without diabetes at enrollment and examined the effect of cocoa extract supplementation on incident self-reported T2D in intention-to-treat analyses. RESULTS During a median follow-up of 3.5 years, 801 incident T2D cases were reported. Compared with placebo, taking a cocoa extract supplement did not reduce T2D (adjusted hazard ratio 1.04, 95% CI 0.91-1.20, P = 0.58). Stratification analyses showed that the effect of cocoa extract supplementation was not significantly modified by sex, race, BMI, smoking, physical activity, dietary quality, flavanol status at baseline, or randomized multivitamin assignment. CONCLUSIONS Middle-aged and older adults taking a cocoa extract supplement for a median of 3.5 years did not reduce their risk of incident T2D. Further studies of cocoa extract supplementation beginning earlier in adulthood and in populations with different background diets are warranted.
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Affiliation(s)
- Jie Li
- Department of Epidemiology and Center for Global Cardiometabolic Health, School of Public Health, Brown University, Providence, RI
- Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Howard D Sesso
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Eunjung Kim
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA
| | - JoAnn E Manson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Georgina Friedenberg
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA
| | - Allison Clar
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA
| | - Trisha Copeland
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA
| | - Aladdin H Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA
| | - Jean Wactawski-Wende
- School of Public Health and Health Professions, University at Buffalo, Buffalo, NY
| | - Lesley Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Simin Liu
- Department of Epidemiology and Center for Global Cardiometabolic Health, School of Public Health, Brown University, Providence, RI
- Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
- Department of Medicine, The Warrant Alpert School of Medicine, Brown University, Providence, RI
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Guirette M, Lan J, McKeown N, Brown MR, Chen H, DE Vries PS, Kim H, Rebholz CM, Morrison AC, Bartz TM, Fretts AM, Guo X, Lemaitre RN, Liu CT, Noordam R, DE Mutsert R, Rosendaal FR, Wang CA, Beilin L, Mori TA, Oddy WH, Pennell CE, Chai JF, Whitton C, VAN Dam RM, Liu J, Tai ES, Sim X, Neuhouser ML, Kooperberg C, Tinker L, Franceschini N, Huan T, Winkler TW, Bentley AR, Gauderman WJ, Heerkens L, Tanaka T, van Rooij J, Munroe PB, Warren HR, Voortman T, Chen H, Rao DC, Levy D, Ma J. Genome-Wide Interaction Analysis with DASH Diet Score Identified Novel Loci for Systolic Blood Pressure. medRxiv 2023:2023.11.10.23298402. [PMID: 37986948 PMCID: PMC10659476 DOI: 10.1101/2023.11.10.23298402] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
Objective We examined interactions between genotype and a Dietary Approaches to Stop Hypertension (DASH) diet score in relation to systolic blood pressure (SBP). Methods We analyzed up to 9,420,585 biallelic imputed single nucleotide polymorphisms (SNPs) in up to 127,282 individuals of six population groups (91% of European population) from the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium (CHARGE; n=35,660) and UK Biobank (n=91,622) and performed European population-specific and cross-population meta-analyses. Results We identified three loci in European-specific analyses and an additional four loci in cross-population analyses at P for interaction < 5e-8. We observed a consistent interaction between rs117878928 at 15q25.1 (minor allele frequency = 0.03) and the DASH diet score (P for interaction = 4e-8; P for heterogeneity = 0.35) in European population, where the interaction effect size was 0.42±0.09 mm Hg (P for interaction = 9.4e-7) and 0.20±0.06 mm Hg (P for interaction = 0.001) in CHARGE and the UK Biobank, respectively. The 1 Mb region surrounding rs117878928 was enriched with cis-expression quantitative trait loci (eQTL) variants (P = 4e-273) and cis-DNA methylation quantitative trait loci (mQTL) variants (P = 1e-300). While the closest gene for rs117878928 is MTHFS, the highest narrow sense heritability accounted by SNPs potentially interacting with the DASH diet score in this locus was for gene ST20 at 15q25.1. Conclusion We demonstrated gene-DASH diet score interaction effects on SBP in several loci. Studies with larger diverse populations are needed to validate our findings.
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Affiliation(s)
- Mélanie Guirette
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Jessie Lan
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Nicola McKeown
- Programs of Nutrition, Department of Health Sciences, Sargent College of Health & Rehabilitation Sciences, Boston University, Boston, MA, USA
| | - Michael R Brown
- Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Han Chen
- Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Paul S DE Vries
- Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Hyunju Kim
- Cardiovascular Health Research Unit, Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Casey M Rebholz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Alanna C Morrison
- Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Traci M Bartz
- Cardiovascular Health Research Unit, Departments of Biostatistics and Medicine, University of Washington, Seattle, WA, USA
| | - Amanda M Fretts
- Cardiovascular Health Research Unit, Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Xiuqing Guo
- The Lundquist Institute at Harbor-UCLA, Torrance, CA, USA
| | - Rozenn N Lemaitre
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Ching-Ti Liu
- Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Raymond Noordam
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands
| | - Renée DE Mutsert
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Carol A Wang
- School of Medicine and Public Health, University of Newcastle, NSW, Australia
- Hunter Medical Research Institute, NSW, Australia
| | - Lawrence Beilin
- Medical School, Royal Perth Hospital Unit, University of Western Australia, Crawley, Western Australia, Australia
| | - Trevor A Mori
- Medical School, Royal Perth Hospital Unit, University of Western Australia, Crawley, Western Australia, Australia
| | - Wendy H Oddy
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia Saw Swee Hock, School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Craig E Pennell
- School of Medicine and Public Health, University of Newcastle, NSW, Australia
- Hunter Medical Research Institute, NSW, Australia
| | - Jin Fang Chai
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Clare Whitton
- School of Population Health, Curtin University, Perth, Western Australia, Australia
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore
| | - Rob M VAN Dam
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Jianjun Liu
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore
| | - E Shyong Tai
- School of Population Health, Curtin University, Perth, Western Australia, Australia
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Xueling Sim
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Charles Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Lesley Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Nora Franceschini
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Tianxiao Huan
- Framingham Heart Study and Population Sciences Branch, NHLBI, Framingham, MA, USA
| | - Thomas W Winkler
- Department of Genetic Epidemiology, University of Regensburg; Regensburg, Germany
| | - Amy R Bentley
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - W James Gauderman
- Division of Biostatistics, Department of Population and Public Health Sciences, University of Southern California; CA, USA
| | - Luc Heerkens
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - Toshiko Tanaka
- Longitudinal Studies Section, National Institute on Aging, Baltimore, MD, USA
| | - Jeroen van Rooij
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Patricia B Munroe
- Centre of Clinical Pharmacology & Precision Medicine, William Harvey Research Institute, Barts and The London Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Helen R Warren
- Centre of Clinical Pharmacology & Precision Medicine, William Harvey Research Institute, Barts and The London Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Honglei Chen
- Department of Epidemiology and Biostatistics College of Human Medicine, Michigan State University, East Lansing, Michigan, USA
| | - D C Rao
- Center for Biostatistics and Data Science, Institute for Informatics, Data Science, and Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - Daniel Levy
- Framingham Heart Study and Population Sciences Branch, NHLBI, Framingham, MA, USA
| | - Jiantao Ma
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
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Tobias DK, Manning AK, Wessel J, Raghavan S, Westerman KE, Bick AG, Dicorpo D, Whitsel EA, Collins J, Correa A, Cupples LA, Dupuis J, Goodarzi MO, Guo X, Howard B, Lange LA, Liu S, Raffield LM, Reiner AP, Rich SS, Taylor KD, Tinker L, Wilson JG, Wu P, Carson AP, Vasan RS, Fornage M, Psaty BM, Kooperberg C, Rotter JI, Meigs J, Manson JE. Clonal Hematopoiesis of Indeterminate Potential (CHIP) and Incident Type 2 Diabetes Risk. Diabetes Care 2023; 46:1978-1985. [PMID: 37756531 PMCID: PMC10620536 DOI: 10.2337/dc23-0805] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 08/07/2023] [Indexed: 09/29/2023]
Abstract
OBJECTIVE Clonal hematopoiesis of indeterminate potential (CHIP) is an aging-related accumulation of somatic mutations in hematopoietic stem cells, leading to clonal expansion. CHIP presence has been implicated in atherosclerotic coronary heart disease (CHD) and all-cause mortality, but its association with incident type 2 diabetes (T2D) is unknown. We hypothesized that CHIP is associated with elevated risk of T2D. RESEARCH DESIGN AND METHODS CHIP was derived from whole-genome sequencing of blood DNA in the National Heart, Lung, and Blood Institute Trans-Omics for Precision Medicine (TOPMed) prospective cohorts. We performed analysis for 17,637 participants from six cohorts, without prior T2D, cardiovascular disease, or cancer. We evaluated baseline CHIP versus no CHIP prevalence with incident T2D, including associations with DNMT3A, TET2, ASXL1, JAK2, and TP53 variants. We estimated multivariable-adjusted hazard ratios (HRs) and 95% CIs with adjustment for age, sex, BMI, smoking, alcohol, education, self-reported race/ethnicity, and combined cohorts' estimates via fixed-effects meta-analysis. RESULTS Mean (SD) age was 63.4 (11.5) years, 76% were female, and CHIP prevalence was 6.0% (n = 1,055) at baseline. T2D was diagnosed in n = 2,467 over mean follow-up of 9.8 years. Participants with CHIP had 23% (CI 1.04, 1.45) higher risk of T2D than those with no CHIP. Specifically, higher risk was for TET2 (HR 1.48; CI 1.05, 2.08) and ASXL1 (HR 1.76; CI 1.03, 2.99) mutations; DNMT3A was nonsignificant (HR 1.15; CI 0.93, 1.43). Statistical power was limited for JAK2 and TP53 analyses. CONCLUSIONS CHIP was associated with higher incidence of T2D. CHIP mutations located on genes implicated in CHD and mortality were also related to T2D, suggesting shared aging-related pathology.
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Affiliation(s)
- Deirdre K. Tobias
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
- Nutrition Department, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Alisa K. Manning
- Broad Metabolism Program, Broad Institute of MIT and Harvard, Cambridge, MA
- Harvard Medical School, Boston, MA
- Clinical and Translational Epidemiology Unit, Mongan Institute, Massachusetts General Hospital, Boston, MA
| | - Jennifer Wessel
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Department of Medicine, School of Medicine, and Diabetes Translational Research Center, Indiana University, Indianapolis, IN
| | - Sridharan Raghavan
- Department of Biomedical Informatics, University of Colorado Anschutz Medical Campus, and Department of Epidemiology, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Kenneth E. Westerman
- Broad Metabolism Program, Broad Institute of MIT and Harvard, Cambridge, MA
- Harvard Medical School, Boston, MA
- Clinical and Translational Epidemiology Unit, Mongan Institute, Massachusetts General Hospital, Boston, MA
| | - Alexander G. Bick
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN
| | - Daniel Dicorpo
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Eric A. Whitsel
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Jason Collins
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Adolfo Correa
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS
| | - L. Adrienne Cupples
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Josée Dupuis
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Mark O. Goodarzi
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Xiuqing Guo
- Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA
| | | | - Leslie A. Lange
- Department of Biomedical Informatics, University of Colorado Anschutz Medical Campus, and Department of Epidemiology, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Simin Liu
- Center for Global Cardiometabolic Health, Brown University, Providence, RI
| | - Laura M. Raffield
- Department of Genetics, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Alex P. Reiner
- Department of Epidemiology, University of Washington, Seattle, WA
| | - Stephen S. Rich
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA
| | - Kent D. Taylor
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA
| | - Lesley Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA
| | - James G. Wilson
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Peitao Wu
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - April P. Carson
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS
| | - Ramachandran S. Vasan
- Section of Preventive Medicine and Epidemiology, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA
- University of Texas School of Public Health, San Antonio, TX
| | - Myriam Fornage
- Brown Foundation Institute of Molecular Medicine for the Prevention of Human Diseases, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX
| | - Bruce M. Psaty
- Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle, WA
| | - Charles Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA
| | - Jerome I. Rotter
- Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA
| | - James Meigs
- Department of Medicine, Harvard Medical School, and Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA
| | - JoAnn E. Manson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
- Epidemiology Department, Harvard T.H. Chan School of Public Health, Boston, MA
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Kaptoge S, Seshasai SRK, Sun L, Walker M, Bolton T, Spackman S, Ataklte F, Willeit P, Bell S, Burgess S, Pennells L, Altay S, Assmann G, Ben-Shlomo Y, Best LG, Björkelund C, Blazer DG, Brenner H, Brunner EJ, Dagenais GR, Cooper JA, Cooper C, Crespo CJ, Cushman M, D'Agostino RB, Daimon M, Daniels LB, Danker R, Davidson KW, de Jongh RT, Donfrancesco C, Ducimetiere P, Elders PJM, Engström G, Ford I, Gallacher I, Bakker SJL, Goldbourt U, de La Cámara G, Grimsgaard S, Gudnason V, Hansson PO, Imano H, Jukema JW, Kabrhel C, Kauhanen J, Kavousi M, Kiechl S, Knuiman MW, Kromhout D, Krumholz HM, Kuller LH, Laatikainen T, Lowler DA, Meyer HE, Mukamal K, Nietert PJ, Ninomiya T, Nitsch D, Nordestgaard BG, Palmieri L, Price JF, Ridker PM, Sun Q, Rosengren A, Roussel R, Sakurai M, Salomaa V, Schöttker B, Shaw JE, Strandberg TE, Sundström J, Tolonen H, Tverdal A, Verschuren WMM, Völzke H, Wagenknecht L, Wallace RB, Wannamethee SG, Wareham NJ, Wassertheil-Smoller S, Yamagishi K, Yeap BB, Harrison S, Inouye M, Griffin S, Butterworth AS, Wood AM, Thompson SG, Sattar N, Danesh J, Di Angelantonio E, Tipping RW, Russell S, Johansen M, Bancks MP, Mongraw-Chaffin M, Magliano D, Barr ELM, Zimmet PZ, Knuiman MW, Whincup PH, Willeit J, Willeit P, Leitner C, Lawlor DA, Ben-Shlomo Y, Elwood P, Sutherland SE, Hunt KJ, Cushman M, Selmer RM, Haheim LL, Ariansen I, Tybjaer-Hansen A, Frikkle-Schmidt R, Langsted A, Donfrancesco C, Lo Noce C, Balkau B, Bonnet F, Fumeron F, Pablos DL, Ferro CR, Morales TG, Mclachlan S, Guralnik J, Khaw KT, Brenner H, Holleczek B, Stocker H, Nissinen A, Palmieri L, Vartiainen E, Jousilahti P, Harald K, Massaro JM, Pencina M, Lyass A, Susa S, Oizumi T, Kayama T, Chetrit A, Roth J, Orenstein L, Welin L, Svärdsudd K, Lissner L, Hange D, Mehlig K, Salomaa V, Tilvis RS, Dennison E, Cooper C, Westbury L, Norman PE, Almeida OP, Hankey GJ, Hata J, Shibata M, Furuta Y, Bom MT, Rutters F, Muilwijk M, Kraft P, Lindstrom S, Turman C, Kiyama M, Kitamura A, Yamagishi K, Gerber Y, Laatikainen T, Salonen JT, van Schoor LN, van Zutphen EM, Verschuren WMM, Engström G, Melander O, Psaty BM, Blaha M, de Boer IH, Kronmal RA, Sattar N, Rosengren A, Nitsch D, Grandits G, Tverdal A, Shin HC, Albertorio JR, Gillum RF, Hu FB, Cooper JA, Humphries S, Hill- Briggs F, Vrany E, Butler M, Schwartz JE, Kiyama M, Kitamura A, Iso H, Amouyel P, Arveiler D, Ferrieres J, Gansevoort RT, de Boer R, Kieneker L, Crespo CJ, Assmann G, Trompet S, Kearney P, Cantin B, Després JP, Lamarche B, Laughlin G, McEvoy L, Aspelund T, Thorsson B, Sigurdsson G, Tilly M, Ikram MA, Dorr M, Schipf S, Völzke H, Fretts AM, Umans JG, Ali T, Shara N, Davey-Smith G, Can G, Yüksel H, Özkan U, Nakagawa H, Morikawa Y, Ishizaki M, Njølstad I, Wilsgaard T, Mathiesen E, Sundström J, Buring J, Cook N, Arndt V, Rothenbacher D, Manson J, Tinker L, Shipley M, Tabak AG, Kivimaki M, Packard C, Robertson M, Feskens E, Geleijnse M, Kromhout D. Life expectancy associated with different ages at diagnosis of type 2 diabetes in high-income countries: 23 million person-years of observation. Lancet Diabetes Endocrinol 2023; 11:731-742. [PMID: 37708900 PMCID: PMC7615299 DOI: 10.1016/s2213-8587(23)00223-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 07/14/2023] [Accepted: 07/14/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND The prevalence of type 2 diabetes is increasing rapidly, particularly among younger age groups. Estimates suggest that people with diabetes die, on average, 6 years earlier than people without diabetes. We aimed to provide reliable estimates of the associations between age at diagnosis of diabetes and all-cause mortality, cause-specific mortality, and reductions in life expectancy. METHODS For this observational study, we conducted a combined analysis of individual-participant data from 19 high-income countries using two large-scale data sources: the Emerging Risk Factors Collaboration (96 cohorts, median baseline years 1961-2007, median latest follow-up years 1980-2013) and the UK Biobank (median baseline year 2006, median latest follow-up year 2020). We calculated age-adjusted and sex-adjusted hazard ratios (HRs) for all-cause mortality according to age at diagnosis of diabetes using data from 1 515 718 participants, in whom deaths were recorded during 23·1 million person-years of follow-up. We estimated cumulative survival by applying age-specific HRs to age-specific death rates from 2015 for the USA and the EU. FINDINGS For participants with diabetes, we observed a linear dose-response association between earlier age at diagnosis and higher risk of all-cause mortality compared with participants without diabetes. HRs were 2·69 (95% CI 2·43-2·97) when diagnosed at 30-39 years, 2·26 (2·08-2·45) at 40-49 years, 1·84 (1·72-1·97) at 50-59 years, 1·57 (1·47-1·67) at 60-69 years, and 1·39 (1·29-1·51) at 70 years and older. HRs per decade of earlier diagnosis were similar for men and women. Using death rates from the USA, a 50-year-old individual with diabetes died on average 14 years earlier when diagnosed aged 30 years, 10 years earlier when diagnosed aged 40 years, or 6 years earlier when diagnosed aged 50 years than an individual without diabetes. Using EU death rates, the corresponding estimates were 13, 9, or 5 years earlier. INTERPRETATION Every decade of earlier diagnosis of diabetes was associated with about 3-4 years of lower life expectancy, highlighting the need to develop and implement interventions that prevent or delay the onset of diabetes and to intensify the treatment of risk factors among young adults diagnosed with diabetes. FUNDING British Heart Foundation, Medical Research Council, National Institute for Health and Care Research, and Health Data Research UK.
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5
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Feng X, Wu WYY, Onwuka JU, Haider Z, Alcala K, Smith-Byrne K, Zahed H, Guida F, Wang R, Bassett JK, Stevens V, Wang Y, Weinstein S, Freedman ND, Chen C, Tinker L, Nøst TH, Koh WP, Muller D, Colorado-Yohar SM, Tumino R, Hung RJ, Amos CI, Lin X, Zhang X, Arslan AA, Sánchez MJ, Sørgjerd EP, Severi G, Hveem K, Brennan P, Langhammer A, Milne RL, Yuan JM, Melin B, Johansson M, Robbins HA, Johansson M. Lung cancer risk discrimination of prediagnostic proteomics measurements compared with existing prediction tools. J Natl Cancer Inst 2023; 115:1050-1059. [PMID: 37260165 PMCID: PMC10483263 DOI: 10.1093/jnci/djad071] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 04/05/2023] [Accepted: 04/08/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND We sought to develop a proteomics-based risk model for lung cancer and evaluate its risk-discriminatory performance in comparison with a smoking-based risk model (PLCOm2012) and a commercially available autoantibody biomarker test. METHODS We designed a case-control study nested in 6 prospective cohorts, including 624 lung cancer participants who donated blood samples at most 3 years prior to lung cancer diagnosis and 624 smoking-matched cancer free participants who were assayed for 302 proteins. We used 470 case-control pairs from 4 cohorts to select proteins and train a protein-based risk model. We subsequently used 154 case-control pairs from 2 cohorts to compare the risk-discriminatory performance of the protein-based model with that of the Early Cancer Detection Test (EarlyCDT)-Lung and the PLCOm2012 model using receiver operating characteristics analysis and by estimating models' sensitivity. All tests were 2-sided. RESULTS The area under the curve for the protein-based risk model in the validation sample was 0.75 (95% confidence interval [CI] = 0.70 to 0.81) compared with 0.64 (95% CI = 0.57 to 0.70) for the PLCOm2012 model (Pdifference = .001). The EarlyCDT-Lung had a sensitivity of 14% (95% CI = 8.2% to 19%) and a specificity of 86% (95% CI = 81% to 92%) for incident lung cancer. At the same specificity of 86%, the sensitivity for the protein-based risk model was estimated at 49% (95% CI = 41% to 57%) and 30% (95% CI = 23% to 37%) for the PLCOm2012 model. CONCLUSION Circulating proteins showed promise in predicting incident lung cancer and outperformed a standard risk prediction model and the commercialized EarlyCDT-Lung.
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Affiliation(s)
- Xiaoshuang Feng
- Genomic Epidemiology Branch, International Agency for Research on Cancer, Lyon, France
| | - Wendy Yi-Ying Wu
- Department of Radiation Sciences, Oncology, Umea University, Umea, Sweden
| | | | - Zahra Haider
- Department of Radiation Sciences, Oncology, Umea University, Umea, Sweden
| | - Karine Alcala
- Genomic Epidemiology Branch, International Agency for Research on Cancer, Lyon, France
| | | | - Hana Zahed
- Genomic Epidemiology Branch, International Agency for Research on Cancer, Lyon, France
| | - Florence Guida
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer, Lyon, France
| | - Renwei Wang
- Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - Julie K Bassett
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Victoria Stevens
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Ying Wang
- American Cancer Society, Atlanta, GA, USA
| | - Stephanie Weinstein
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Neal D Freedman
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Chu Chen
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Lesley Tinker
- Women’s Health Initiative Clinical Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Therese Haugdahl Nøst
- Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
| | - Woon-Puay Koh
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore, Singapore
| | - David Muller
- Division of Genetic Medicine, Imperial College London School of Public Health, London, UK
| | - Sandra M Colorado-Yohar
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Research Group on Demography and Health, National Faculty of Public Health, University of Antioquia, Medellín, Colombia
| | - Rosario Tumino
- Hyblean Association for Epidemiological Research, AIRE ONLUS Ragusa, Ragusa, Italy
| | - Rayjean J Hung
- Prosserman Centre for Population Health Research, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Christopher I Amos
- Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, TX, USA
| | - Xihong Lin
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Department of Statistics, Harvard University, Cambridge, MA, USA
| | - Xuehong Zhang
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Alan A Arslan
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Maria-Jose Sánchez
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- Instituto de Investigación Biosanitaria ib, Granada, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Elin Pettersen Sørgjerd
- HUNT Research Centre, Department of Public Health and Nursing, Norwegian University of Science and Technology, Levanger, Norway
| | | | - Kristian Hveem
- HUNT Research Centre, Department of Public Health and Nursing, Norwegian University of Science and Technology, Levanger, Norway
| | - Paul Brennan
- Genomic Epidemiology Branch, International Agency for Research on Cancer, Lyon, France
| | - Arnulf Langhammer
- HUNT Research Centre, Department of Public Health and Nursing, Norwegian University of Science and Technology, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Roger L Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, VIC, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
| | - Jian-Min Yuan
- Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Beatrice Melin
- Department of Radiation Sciences, Oncology, Umea University, Umea, Sweden
| | - Mikael Johansson
- Department of Radiation Sciences, Oncology, Umea University, Umea, Sweden
| | - Hilary A Robbins
- Genomic Epidemiology Branch, International Agency for Research on Cancer, Lyon, France
| | - Mattias Johansson
- Genomic Epidemiology Branch, International Agency for Research on Cancer, Lyon, France
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6
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Albanes D, Alcala K, Alcala N, Amos CI, Arslan AA, Bassett JK, Brennan P, Cai Q, Chen C, Feng X, Freedman ND, Guida F, Hung RJ, Hveem K, Johansson M, Johansson M, Koh WP, Langhammer A, Milne RL, Muller D, Onwuka J, Sørgjerd EP, Robbins HA, Sesso HD, Severi G, Shu XO, Sieri S, Smith-Byrne K, Stevens V, Tinker L, Tjønneland A, Visvanathan K, Wang Y, Wang R, Weinstein S, Yuan JM, Zahed H, Zhang X, Zheng W. The blood proteome of imminent lung cancer diagnosis. Nat Commun 2023; 14:3042. [PMID: 37264016 PMCID: PMC10235023 DOI: 10.1038/s41467-023-37979-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 04/05/2023] [Indexed: 06/03/2023] Open
Abstract
Identification of risk biomarkers may enhance early detection of smoking-related lung cancer. We measured between 392 and 1,162 proteins in blood samples drawn at most three years before diagnosis in 731 smoking-matched case-control sets nested within six prospective cohorts from the US, Europe, Singapore, and Australia. We identify 36 proteins with independently reproducible associations with risk of imminent lung cancer diagnosis (all p < 4 × 10-5). These include a few markers (e.g. CA-125/MUC-16 and CEACAM5/CEA) that have previously been reported in studies using pre-diagnostic blood samples for lung cancer. The 36 proteins include several growth factors (e.g. HGF, IGFBP-1, IGFP-2), tumor necrosis factor-receptors (e.g. TNFRSF6B, TNFRSF13B), and chemokines and cytokines (e.g. CXL17, GDF-15, SCF). The odds ratio per standard deviation range from 1.31 for IGFBP-1 (95% CI: 1.17-1.47) to 2.43 for CEACAM5 (95% CI: 2.04-2.89). We map the 36 proteins to the hallmarks of cancer and find that activation of invasion and metastasis, proliferative signaling, tumor-promoting inflammation, and angiogenesis are most frequently implicated.
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7
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Vieyra G, Hankinson SE, Oulhote Y, Vandenberg LN, Tinker L, Manson JE, Shadyab AH, Thomson CA, Bao W, Allison M, Odegaard AO, Reeves KW. Association between urinary phthalate biomarker concentrations and adiposity among postmenopausal women. Environ Res 2023; 222:115356. [PMID: 36706896 PMCID: PMC9974871 DOI: 10.1016/j.envres.2023.115356] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 01/18/2023] [Accepted: 01/23/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Obesity is a leading risk factor for chronic diseases, potentially related to excess abdominal adiposity. Phthalates are environmental chemicals that have been suggested to act as obesogens, driving obesity risk. For the associations between phthalates and adiposity, prior studies have focused primarily on body mass index. We hypothesize that more refined measures of adiposity and fat distribution may provide greater insights into these associations given the role of central adiposity in chronic disease risk. OBJECTIVES To evaluate associations between urinary phthalate biomarkers and both visceral and subcutaneous adipose tissue (VAT and SAT) among postmenopausal women enrolled in the Women's Health Initiative (WHI). METHODS We included 1125 WHI participants with available, coincident measurements of urinary phthalate biomarkers (baseline, year 3) and VAT and SAT (baseline, year 3, year 6). VAT and SAT measurements were estimated from DXA scans. Multilevel mixed-effects models estimated the prospective associations between urinary phthalate biomarkers at baseline and VAT and SAT three years later. RESULTS In multivariable adjusted models, we observed positive associations between some phthalate biomarkers, including the sum of di-isobutyl phthalate (ΣDiBP) biomarkers, MCNP, and ΣDEHP, with VAT three years later. For example, we observed positive associations between concentrations of ΣDiBP and VAT (Q4 vs Q1 β = 7.15, 95% CI -1.76-16.06; Q3 vs Q1 β = 10.94, 95% CI 3.55-18.33). Associations were generally attenuated but remained significant after additional adjustment for SAT. MBzP was positively associated with SAT. Other phthalate biomarkers investigated (MEP, MCOP, MCPP, ΣDBP) were not significantly associated with VAT or SAT. DISCUSSION Based on robust measures of adiposity, this study provides supportive evidence that higher urinary concentrations of select phthalate compounds were associated with higher VAT levels over time in postmenopausal women. Efforts to replicate these findings are needed.
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Affiliation(s)
- Gabriela Vieyra
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA, USA
| | - Susan E Hankinson
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA, USA
| | - Youssef Oulhote
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA, USA
| | - Laura N Vandenberg
- Department of Environmental Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Lesley Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Aladdin H Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA
| | - Cynthia A Thomson
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Wei Bao
- Institute of Public Health, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Matthew Allison
- Department of Family Medicine, Division of Preventive Medicine, University of California San Diego, La Jolla, CA, USA
| | - Andrew O Odegaard
- Department of Epidemiology and Biostatistics, University of California Irvine, Irvine, CA, USA
| | - Katherine W Reeves
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA, USA.
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8
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Tobias DK, Manning A, Wessel J, Raghavan S, Westerman K, Bick AG, Dicorpo D, Whitsel EA, Collins JM, Dupuis J, Goodarzi MO, Howard BV, Lange L, Liu S, Raffield LM, Reiner AP, Rich SS, Tinker L, Wilson J, Carson AP, Vasan R, Kooperberg C, Rotter JI, Meigs J, Manson JE. Abstract 66: Clonal Hematopoiesis of Indeterminate Potential and Incident Type 2 Diabetes Risk. Circulation 2023. [DOI: 10.1161/circ.147.suppl_1.66] [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:
Clonal hematopoiesis of indeterminate potential (CHIP) is an aging-related accumulation of somatic mutations in hematopoietic stem cells, leading to clonal expansion. CHIP presence has been implicated in elevated risks for coronary heart disease (CHD) and death, but its association with incident type 2 diabetes (T2D) is unknown.
Hypothesis:
We hypothesized that CHIP is associated with elevated risk of incident T2D.
Methods:
CHIP was derived from whole genome sequencing of blood DNA in NHLBI Trans-omics for Precision Medicine (TOPMed) cohorts. We analyzed 17,637 participants without prior T2D, cardiovascular disease, or cancer at blood draw, with prospective follow-up for incident T2D. We evaluated baseline prevalence of CHIP vs. no CHIP with incident T2D risk using Cox regression. We also investigated CHIP variants previously related to CHD:
DNMT3A
,
TET2
,
ASXL1
,
JAK2
, and
TP53
. We estimated multivariable-adjusted hazard ratios and 95% confidence intervals (HR [CI]) adjusted for age, sex, body mass index, smoking, alcohol, and education. We combined cohort estimates via fixed effects meta-analysis.
Results:
On average, participants were age 63.4 years (SD=11.5) and 76% female. Prevalence of CHIP was 6.0% (1,055) at baseline. There were 2,467 incident T2D cases over mean=9.8 years follow-up. Compared to those without a mutation, having CHIP was associated with a 23% higher T2D risk, both overall (combined HR=1.23; 95% CI=1.04, 1.45), and among those with CHD-related CHIP mutations (87% of total CHIP): HR=1.23 (1.03, 1.46). Although those with CHIP mutations of
TET2
(HR=1.48; 1.05, 2.08) and
ASXL1
(HR=1.76; 1.03, 2.99) had larger elevations in T2D risk, and
DNMT3A
was suggestive of increased T2D risk (HR=1.15; 0.93, 1.43), statistical power was limited for
JAK2
and
TP53
mutation analyses.
Conclusions:
CHIP was associated with higher incidence of T2D. CHIP mutations located on loci previously implicated in aging and CHD were also related to T2D, suggesting shared pathology of atherosclerosis and T2D.
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Affiliation(s)
| | | | - Jennifer Wessel
- IU Richard M. Fairbanks Sch of Public Health, Indianapolis, IN
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9
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Vieyra G, Hankinson SE, Oulhote Y, Vandenberg L, Tinker L, Mason J, Shadyab AH, Wallace R, Arcan C, Chen JC, Reeves KW. Dietary patterns and urinary phthalate exposure among postmenopausal women of the Women's Health Initiative. Environ Res 2023; 216:114727. [PMID: 36356671 PMCID: PMC10363918 DOI: 10.1016/j.envres.2022.114727] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 10/10/2022] [Accepted: 11/01/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Phthalates are endocrine-disrupting chemicals linked to a higher risk of numerous chronic health outcomes. Diet is a primary source of exposure, but prior studies exploring associations between dietary patterns and phthalate exposure are limited. OBJECTIVES We evaluated the associations between dietary patterns and urinary phthalate biomarkers among a subset of postmenopausal women participating in the Women's Health Initiative (WHI). METHODS We included WHI participants selected for a nested case-control study of phthalates and breast cancer (N = 1240). Dietary intake was measured via self-administered food frequency questionnaires at baseline and year-3. We used these data to calculate scores for alignment with the Dietary Approach to Stop Hypertension (DASH), alternative Mediterranean (aMed), and Dietary Inflammatory Index (DII) diets. We measured 13 phthalate metabolites and creatinine in 2-3 urine samples per participant collected over 3-years when all participants were cancer-free. We fit multivariable generalized estimating equation models to estimate the cross-sectional associations. RESULTS DASH and aMed dietary scores were inversely associated with the sum of di(2-Ethylhexyl) phthalate (-6.48%, 95% CI -9.84, -3.00; -5.23%, 95% CI -8.73, -1.60) and DII score was positively associated (9.00%, 95% CI 5.04, 13.11). DASH and aMed scores were also inversely associated with mono benzyl phthalate and mono-3-carboxypropyl phthalate. DII scores were positively associated with mono benzyl phthalate and the sum of di-n-butyl phthalate. DISCUSSION Higher dietary alignment with DASH and aMed dietary patterns were significantly associated with lower concentrations of certain phthalate biomarkers, while an inflammatory diet pattern was associated with higher phthalate biomarker concentrations. These findings suggest that dietary patterns high in fruits, vegetables, and low-fat foods and low in processed foods may be useful in avoiding exposure to phthalates.
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Affiliation(s)
- Gabriela Vieyra
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA, 01003, USA.
| | - Susan E Hankinson
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA, 01003, USA
| | - Youssef Oulhote
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA, 01003, USA
| | - Laura Vandenberg
- Department of Environmental Health Sciences, University of Massachusetts Amherst, Amherst, Ma, 01003, USA
| | - Lesley Tinker
- Department of Cancer Prevention, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, 98109, USA
| | - JoAnn Mason
- Department of Medicine, Brigham and Women's Hospital, and Epidemiology, Harvard T.H. Chan School, Boston, MA, 02115, USA
| | - Aladdin H Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA
| | - Robert Wallace
- Department of Epidemiology and Internal Medicine, University of Iowa, USA
| | - Chrisa Arcan
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, USA
| | - J C Chen
- Department of Population & Public Health Sciences and Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Katherine W Reeves
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA, 01003, USA.
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10
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Lin JY, Larson J, Schoenberg J, Sepulveda A, Tinker L, Wheeler M, Albert C, Manson JE, Wells G, Martin LW, Froelicher V, LaMonte M, Kooperberg C, Hlatky MA, Greenland P, Stefanick ML, Perez MV. Serial 7-Day Electrocardiogram Patch Screening for AF in High-Risk Older Women by the CHARGE-AF Score. JACC Clin Electrophysiol 2022; 8:1523-1534. [PMID: 36543503 PMCID: PMC9986967 DOI: 10.1016/j.jacep.2022.08.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 06/30/2022] [Revised: 08/04/2022] [Accepted: 08/05/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Asymptomatic atrial fibrillation (AF) is associated with an increased risk of stroke. The yield of serial electrocardiographic (ECG) screening for AF is unknown. OBJECTIVES The aim of this study was to determine the frequency of AF detected by serial, 7-day ECG patch screenings in older women identified as having an elevated risk of AF according to the CHARGE (Cohorts for Heart and Aging Research in Genomic Epidemiology)-AF clinical prediction score. METHODS Postmenopausal women with a 5-year predicted risk of new-onset AF ≥5% according to CHARGE-AF were recruited from the ongoing WHISH (Women's Health Initiative Strong and Healthy) randomized trial of a physical activity intervention. Participants with AF at baseline by self-report or medical records review were excluded. Screening with 7-day ECG patch monitors was performed at baseline, 6 months, and 12 months from study enrollment. RESULTS On baseline monitoring, 2.5% of the cohort had AF detected, increasing to 3.7% by 6 months and 4.9% cumulatively by 12 months. Yield of patch screening was higher among participants with a higher (≥10%) CHARGE-AF score: 4.2% had AF detected at baseline, 5.9% at 6 months, and 7.2% at 12 months. Most participants with patch-identified AF never had a clinical diagnosis of AF (36 of 46 [78%]). CONCLUSIONS Older women with an elevated CHARGE-AF score had a high prevalence of AF on 7-day ECG patch screening. Serial screening over 12 months substantially increased the detection of AF. These data can be useful in helping identify high-risk participants for enrollment in future studies of the management of asymptomatic AF.(Women's Health Initiative Silent Atrial Fibrillation Recording Study [WHISH STAR]; NCT05366803.).
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Affiliation(s)
- Jeffrey Y Lin
- Department of Medicine, Stanford University, Stanford, California, USA
| | - Joseph Larson
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Jenny Schoenberg
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | | | - Lesley Tinker
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Matthew Wheeler
- Department of Medicine, Stanford University, Stanford, California, USA
| | - Christine Albert
- Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - JoAnn E Manson
- Brigham and Women's Hospital, Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Gretchen Wells
- Department of Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Lisa W Martin
- Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Victor Froelicher
- Department of Medicine, Stanford University, Stanford, California, USA
| | - Mike LaMonte
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, New York, USA
| | | | - Mark A Hlatky
- Department of Medicine, Stanford University, Stanford, California, USA
| | - Philip Greenland
- Department of Medicine, Northwestern University, Evanston, Illinois, USA
| | | | - Marco V Perez
- Department of Medicine, Stanford University, Stanford, California, USA.
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11
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Li J, Glenn AJ, Yang Q, Ding D, Zheng L, Bao W, Beasley J, LeBlanc E, Lo K, Manson JE, Philips L, Tinker L, Liu S. Dietary Protein Sources, Mediating Biomarkers, and Incidence of Type 2 Diabetes: Findings From the Women's Health Initiative and the UK Biobank. Diabetes Care 2022; 45:1742-1753. [PMID: 35713602 PMCID: PMC9346982 DOI: 10.2337/dc22-0368] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [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] [Received: 02/21/2022] [Accepted: 05/03/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Whether and how dietary protein intake is linked to type 2 diabetes (T2D) remains unclear. The aim of this study was to investigate the associations of protein intake with development of T2D and the potential mediating roles of T2D biomarkers. RESEARCH DESIGN AND METHODS We included 108,681 postmenopausal women without T2D at baseline from the Women's Health Initiative (WHI) (primary cohort) and 34,616 adults without T2D from the U.K. Biobank (UKB) (replication cohort). Cox proportional hazard models were used for estimation of protein-T2D associations. Mediation analysis was performed to assess the mediating roles of biomarkers in case-control studies nested in the WHI. RESULTS In the WHI, 15,842 incident T2D cases were identified during a median follow-up of 15.8 years. Intake of animal protein was associated with increased T2D risk (hazard ratio in comparing the highest to the lowest quintile = 1.31 [95% CI 1.24-1.37]) and plant protein with decreased risk (0.82 [0.78-0.86]). Intakes of red meat, processed meat, poultry, and eggs were associated with increased T2D risk and whole grains with decreased risk. Findings from the UKB were similar. These findings were materially attenuated after additional adjustment for BMI. Substituting 5% energy from plant protein for animal protein was associated with 21% decreased T2D risk (0.79 [0.74-0.84]), which was mediated by levels of hs-CRP, interleukin-6, leptin, and SHBG. CONCLUSIONS Findings from these two large prospective cohorts support the notion that substituting plant protein for animal protein may decrease T2D risk mainly by reducing obesity-related inflammation.
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Affiliation(s)
- Jie Li
- Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Department of Epidemiology and Center for Global Cardiometabolic Health, School of Public Health, Brown University, Providence, RI
| | - Andrea J Glenn
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Qingling Yang
- Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ding Ding
- Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Lingling Zheng
- Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Wei Bao
- Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Jeannette Beasley
- Division of General Internal Medicine and Clinical Innovation, New York University Langone Health, New York, NY
| | - Erin LeBlanc
- Kaiser Permanente Center for Health Research, Portland, OR
| | - Kenneth Lo
- Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong Special Administrative Region, China
| | - JoAnn E Manson
- Brigham and Women's Hospital, Harvard Medical School, and Harvard T.H. Chan School of Public Health, Boston, MA
| | | | - Lesley Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Simin Liu
- Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Department of Epidemiology and Center for Global Cardiometabolic Health, School of Public Health, Brown University, Providence, RI.,Departments of Surgery and Medicine, The Warren Alpert Medical School, Brown University, Providence, RI
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12
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Zhao L, Coday M, Garcia D, Li X, Lopez-Pentecost M, Manson J, McGlynn K, Mossavar-Rahmani Y, Naughton M, Saquib N, Sesso H, Shadyab A, Simon M, Snetselaar L, Tabung F, Tinker L, Tobias D, VoPham T, Zhang X. Association Between Sugar-Sweetened Beverage Intake and Liver Cancer Risk in the Women's Health Initiative. Curr Dev Nutr 2022. [PMCID: PMC9193518 DOI: 10.1093/cdn/nzac052.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objectives Intake of sugar-sweetened beverage (SSB), a postulated risk factor for obesity, diabetes, and cardiovascular disease, may drive insulin resistance and inflammation which are strongly implicated in liver carcinogenesis. However, evidence on the association between SSB intake and liver cancer is scarce. We hypothesized that higher SSB intake would be associated with a greater risk of liver cancer. Methods We included 90,504 women aged 50–79 years from the Women's Health Initiative Observational Study and Clinical Trials excluding Dietary Modification Trial participants. SSB intake was defined as the sum of soft drinks and fruit drinks (1 serving = one 12 fl. oz can or 355 ml), which was assessed by a validated food frequency questionnaire administered at baseline between 1993 and 1998. Incident liver cancers were reported by self-administered questionnaires and further confirmed by medical record review. Cox proportional hazards regression models were used to estimate multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) with adjustment for age, race and ethnicity, education, alcohol intake, smoking status, body mass index, non-steroidal anti-inflammatory drug use, physical activity, total caloric intake, and history of diabetes. Results After a median of 18.7 years follow-up, 205 women had confirmed liver cancer. Approximately 7.3% of women consumed ≥ 1 serving/day of SSB. Higher SSB intake was associated with a 78% greater risk of liver cancer (HR ≥1/day vs never to < 3/month = 1.78, 95%CI = 1.09–2.95, P linear trend = 0.007) as compared to intake of < 3 servings/month. Non-statistically significant positive associations with liver cancer were observed for fruit drinks (HR ≥1/day vs never to < 3/month = 1.55, 95%CI = 0.88–2.75) and soft drinks (HR ≥1/day vs never to < 3/month = 1.73, 95%CI = 0.76–3.94). Results were similar after further adjustment for coffee/tea intake, or history of liver diseases, or when liver cancer cases diagnosed within the first 2 years of follow-up or those with history of diabetes were excluded. Conclusions Our findings suggest SSB as a potential modifiable risk factor for liver cancer in postmenopausal women. Studies in men and diverse populations are needed to examine these associations more comprehensively. Funding Sources The WHI study is funded by the National Institute of Health.
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Affiliation(s)
| | - Mace Coday
- University of Tennessee Health Science Center
| | - David Garcia
- University of Arizona, Mel and Enid Zuckerman College of Public Health
| | - Xinyi Li
- Harvard T.H. Chan School of Public Health
| | | | - JoAnn Manson
- Brigham and Women's Hospital and Harvard Medical School & Harvard T.H. Chan School of Public Health
| | | | | | | | | | - Howard Sesso
- Brigham and Women's Hospital, Harvard Medical School & Harvard T.H. Chan School of Public Health
| | - Aladdin Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California
| | | | | | - Fred Tabung
- The Ohio State University, College of Medicine, Comprehensive Cancer Center-James Cancer Hospital, Solove Research Institute & College of Public Health
| | | | - Deirdre Tobias
- Brigham and Women's Hospital, Harvard Medical School & Harvard T.H. Chan School of Public Health
| | - Trang VoPham
- Fred Hutchinson Cancer Research Center & University of Washington School of Public Health
| | - Xuehong Zhang
- Brigham and Women's Hospital and Harvard Medical School & Harvard T.H. Chan School of Public Health
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13
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Glenn A, Lo K, Jenkins D, Boucher B, Hanley A, Kendall C, Shadyab A, Tinker L, Chessler S, Howard B, Liu S, Sievenpiper J. Greater Adherence to the Portfolio Diet Is Associated with Lower Incidence of Type 2 Diabetes in the Women's Health Initiative. Curr Dev Nutr 2021. [DOI: 10.1093/cdn/nzab053_027] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objectives
To assess the association of the plant-based cholesterol-lowering diet, the Portfolio Diet, with incident type 2 diabetes in women.
Methods
We followed 147,732 postmenopausal women initially free of diabetes in the Women's Health Initiative (WHI) Clinical Trials and Observational Study from 1993 through 2017. Adherence to the Portfolio Diet was assessed using an a priori diet index based on six food categories (high in plant protein [soy & pulses], nuts, viscous fiber, plant sterols and monounsaturated fat, and low in saturated fat) that were previously found to lower cardiovascular risk factors in the Portfolio Diet trials. We used Cox proportional-hazard models to estimate hazard ratios (HRs) and 95% confidence intervals (CI) of the association of adherence to a Portfolio Diet score with incident type 2 diabetes, adjusting for potential confounders (demographics, lifestyle behaviors, and medical history). The Portfolio Diet score was cumulatively assessed at baseline and year three using a validated food frequency questionnaire. Type 2 diabetes diagnosis was ascertained by self-reported medication use.
Results
There were 14,096 cases of incident type 2 diabetes over a mean follow-up of 14.3 years. In the fully adjusted models, adherence to the Portfolio Diet score was associated with a lower risk of incident type 2 diabetes (HR, 0.88, CIs, 0.83, 0.93; P for trend < 0.001), comparing the highest to lowest quartiles of adherence. Results remained similar across subgroup analyses (age, body mass index, family history of diabetes, and ethnicity) and several sensitivity analyses.
Conclusions
Among postmenopausal women, higher adherence to the Portfolio Diet was associated with lower incident type 2 diabetes. These findings are the first to show that the Portfolio Diet may be associated with a lower risk of type 2 diabetes and warrants further investigation.
Funding Sources
The WHI was funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, and the U.S. Department of Health and Human Services. AJG was supported by the Banting & Best Diabetes Centre Tamarack Graduate Award in Diabetes Research, the Peterborough K.M. Hunter Charitable Foundation Graduate Award, and an Ontario Graduate Scholarship. JLS was funded by a Diabetes Canada Clinician Scientist Award.
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14
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Binder AM, Tinker L, Wallace R, Manson JE, Qi L, Bhatti P, Whitsel EA, LaCroix AZ, Horvath S. Abstract PS7-28: Association between epigenetic age acceleration and postmenopausal breast cancer risk in the Women’s Health Initiative. Cancer Res 2021. [DOI: 10.1158/1538-7445.sabcs20-ps7-28] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Earlier age of menopause and bilateral oophorectomy are associated with accelerated biologic aging based on epigenetic clocks. While these relationships suggest women with greater epigenetic age acceleration (AgeAccel) might be at a reduced risk of postmenopausal breast cancer, prior studies conflict with this theory. We hypothesized this paradox may be attributable to an interaction between epigenetic and reproductive aging on cancer risk. We evaluated this premise among 5,044 postmenopausal women in the Women’s Health Initiative (WHI) Observational Study and Clinical Trial with AgeAccel estimated in whole blood. Among a subset of 1,135 of these women, estradiol (E2) and sex hormone-binding globulin were assayed in baseline serum samples. For WHI participants with DNA methylation assays, we modeled the log odds of incident postmenopausal breast cancer during follow-up as a function of AgeAccel, adjusting for age at menopause, race/ethnicity, age at WHI screening, bilateral oophorectomy, nulliparity, alcohol consumption, smoking, body mass index, duration of postmenopausal hormone therapy use, exercise, clinical trial arm, and hysterectomy status at baseline. We repeated this analysis among the subset of participants with DNA methylation and E2 assays, and appraised the degree to which bioavailable E2 levels contributed to the observed association between AgeAccel and incident postmenopausal breast cancer. Finally, we evaluated whether bioavailable E2 levels modified the relationship between AgeAccel and cancer risk. Generalized estimating equations were used to model associations with AgeAccel, integrating repeated measures among a subset of participants and using inverse probability weights to account for sample selection probabilities. Based on our fully adjusted models, increased extrinsic AgeAccel was associated with decreased odds of incident postmenopausal invasive breast cancer during follow-up. This association was consistent among the subset of participants with E2 assays, and robust to adjustment for bioavailable E2 concentration. We found the inverse relationship between extrinsic AgeAccel and incident breast cancer was strongest among white non-Hispanic women with low levels of bioavailable E2. This study represents the largest investigation of the association between AgeAccel and postmenopausal breast cancer risk, and the first evaluation of how bioavailable E2 levels may influence this relationship. Our analyses inform our understanding of the relationship between the epigenetic and reproductive aging process, and the potential implications for postmenopausal breast cancer risk.
Citation Format: Alexandra M. Binder, Lesley Tinker, Robert Wallace, JoAnn E. Manson, Lihong Qi, Parveen Bhatti, Eric A. Whitsel, Andrea Z. LaCroix, Steve Horvath. Association between epigenetic age acceleration and postmenopausal breast cancer risk in the Women’s Health Initiative [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS7-28.
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Affiliation(s)
- Alexandra M. Binder
- 1Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI
| | - Lesley Tinker
- 2Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Robert Wallace
- 3Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA
| | - JoAnn E. Manson
- 4Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Lihong Qi
- 5Department of Public Health Sciences, University of California Davis, Davis, CA
| | - Parveen Bhatti
- 6Cancer Control Research, BC Cancer, Vancouver, BC, Canada
| | - Eric A. Whitsel
- 7Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Andrea Z. LaCroix
- 8Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA
| | - Steve Horvath
- 9Department of Human Genetics and Department of Biostatistics, University of California Los Angeles, Los Angeles, CA
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15
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Cleland SC, Domalpally A, Liu Z, Pak JW, Blodi BA, Bailey S, Gehrs K, Wallace R, Tinker L, Mares JA. Reticular Pseudodrusen Characteristics and Associations in the Carotenoids in Age-Related Eye Disease Study 2 (CAREDS2), an Ancillary Study of the Women's Health Initiative. Ophthalmol Retina 2021; 5:721-729. [PMID: 33387684 DOI: 10.1016/j.oret.2020.12.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 12/23/2020] [Indexed: 01/09/2023]
Abstract
PURPOSE To determine the prevalence and morphologic features of reticular pseudodrusen (RPD) and their association with participant demographics and age-related macular degeneration (AMD) status in the Carotenoids in Age-Related Eye Disease Study 2 (CAREDS2) sample, an ancillary study of the Women's Health Initiative Observational Study. DESIGN Cross-sectional, multicenter, natural history study. PARTICIPANTS Nine hundred and twenty-seven eyes from 466 postmenopausal women 69 to 101 years of age. METHODS Multimodal imaging, including spectral-domain (SD) OCT and infrared reflectance (IR), were used to identify RPD characteristics, including location (within or outside the 6-mm diameter circle centered at the macula), presence of peripapillary RPD, pattern of RPD, and RPD area. Age-related macular degeneration features from SD OCT, IR, and color photographs also were assessed and AMD severity was categorized. MAIN OUTCOME MEASURES Reticular pseudodrusen prevalence using SD OCT and IR imaging and AMD status. RESULTS Reticular pseudodrusen were present in 130 eyes (14% of eyes, 16% of participants), with increasing prevalence with age: 7% in those younger than 78 years, 14% in those 78 to 83 years of age, and 30% in those older than 83 years. Using clinical classification of AMD with color photography, RPD were seen in 2.4% of eyes with no AMD or aging changes, 11.5% in early AMD, 25.1% in intermediate AMD, and 51.1% in late AMD. Mean RPD area was 17.4 mm2 (standard deviation, 14.7 mm2). Ribbon morphologic RPD (53%) was more common than dot morphologic RPD (36%). Reticular pseudodrusen mostly were located both within and outside the 6-mm circle with primarily superior retinal distribution. Reticular pseudodrusen were visualized with corresponding color fundus photography in only 38 eyes (4% of total eyes). Participants with and without RPD had a visual acuity±standard error of 77.9 ± 1.4 letters and 81.3 ± 0.4 letters, respectively (P = 0.02). CONCLUSIONS The prevalence of RPD in CAREDS2 increased with age and was associated with AMD severity. Reticular pseudodrusen were detected in eyes without other features of AMD and could represent an earlier disease state. Multimodal imaging with SD OCT and IR has significantly greater sensitivity for visualizing RPD than color fundus photography.
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Affiliation(s)
- Spencer C Cleland
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin
| | - Amitha Domalpally
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin.
| | - Zhe Liu
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin
| | - Jeong W Pak
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin
| | - Barbara A Blodi
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin
| | - Steven Bailey
- Department of Ophthalmology, Oregon Health & Science University, Casey Eye Institute, Portland, Oregon
| | - Karen Gehrs
- Department of Ophthalmology & Visual Sciences, University of Iowa Hospital & Clinics, Iowa City, Iowa
| | - Robert Wallace
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa
| | - Lesley Tinker
- Division of Public Health Sciences, Department of Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Julie A Mares
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin
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16
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Jin Q, Shi N, Aroke D, Joseph J, Donneyong M, Adesanya T, Conwell D, Hart P, Spees C, Clinton S, Cruz-Monserrate Z, Brasky T, Jackson R, Tinker L, Liu S, Phillips L, Shadyab A, Nassir R, Bao W, Tabung F. The Insulinemic, Inflammatory, and Glycemic Potential of the Diet in Relation to Risk of Type 2 Diabetes. Curr Dev Nutr 2020. [DOI: 10.1093/cdn/nzaa061_048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objectives
Dietary patterns that promote chronic systemic inflammation, hyperinsulinemia, or hyperglycemia may influence type 2 diabetes (T2D) risk. We evaluated an empirical dietary index for hyperinsulinemia (EDIH), empirical dietary inflammatory pattern (EDIP), glycemic index (GI), and glycemic load (GL), and risk of T2D among US postmenopausal women. EDIH and EDIP assess the insulinemic or inflammatory potential of habitual diets, irrespective of macronutrient content, and are based on plasma concentrations of insulin response or inflammatory biomarkers, respectively. The GI and GL assess postprandial glycemic potential based on carbohydrate content of the diet.
Methods
We calculated dietary scores from baseline food frequency questionnaires among 73,495 participants aged 50–79 years in the Women's Health Initiative Observational Study and Clinical Trials. We used multivariable-adjusted Cox regression to estimate hazard ratios (HR) and 95% confidence intervals (95% CI) for risk of T2D according to quintiles of dietary scores.
Results
There were 11,009 incident cases of T2D during a median 13.3 years of follow-up. In multivariable-adjusted analyses, participants in the highest dietary score quintiles (consuming the most hyperinsulinemic, proinflammatory, or hyperglycemic diets) were at highest risk of T2D compared to those in the lowest quintiles: EDIH: HR, 1.54(1.37, 1.74); Ptrend < .0001; EDIP: HR, 1.45 (1.29, 1.64); Ptrend < .0001). GI and GL were not associated with T2D risk: GI: HR, 0.99 (0.88, 1.12); Ptrend = 0.94; GL: HR, 0.98 (0.85, 1.12); Ptrend = 0.32. In subgroup analyses, associations of EDIH and EDIP with T2D risk were stronger among overweight or obese than normal-weight women (Pinteraction: EDIH = 0.02, EDIP = 0.003), and findings did not significantly vary by race/ethnicity.
Conclusions
In this large sample of postmenopausal women, hyperinsulinemic, and pro-inflammatory dietary patterns were associated with higher risk of T2D, more so among overweight and obese women, whereas dietary glycemic potential was not associated with T2D risk.
Funding Sources
NCI grant # R00CA207736 and the WHI program is funded by NHLBI grant #s HHSN268201600018C, HHSN268201600001C, HHSN268201600002C, HHSN268201600003C, and HHSN268201600004C.
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Affiliation(s)
- Qi Jin
- Interdisciplinary Ph.D. Program in Nutrition, The Ohio State University, Columbus, OH; Ohio State University Comprehensive Cancer Center – James
| | - Ni Shi
- Ohio State University Comprehensive Cancer Center – James
| | - Desmond Aroke
- Ohio State University Comprehensive Cancer Center – James
| | - Joshua Joseph
- College of Medicine, The Ohio State University Wexner Medical Center
| | | | - Timothy Adesanya
- College of Medicine, The Ohio State University Wexner Medical Center
| | - Darwin Conwell
- College of Medicine, The Ohio State University Wexner Medical Center; Ohio State University Comprehensive Cancer Center – James
| | - Philip Hart
- Ohio State University Comprehensive Cancer Center – James; College of Medicine, The Ohio State University Wexner Medical Center
| | - Colleen Spees
- Ohio State University Comprehensive Cancer Center – James; College of Medicine, The Ohio State University Wexner Medical Center
| | - Steven Clinton
- Ohio State University Comprehensive Cancer Center – James; College of Medicine, The Ohio State University Wexner Medical Center
| | - Zobeida Cruz-Monserrate
- Ohio State University Comprehensive Cancer Center – James; College of Medicine, The Ohio State University Wexner Medical Center
| | - Theodore Brasky
- Ohio State University Comprehensive Cancer Center – James; College of Medicine, The Ohio State University Wexner Medical Center
| | - Rebecca Jackson
- Ohio State University Comprehensive Cancer Center – James; College of Medicine, The Ohio State University Wexner Medical Center
| | - Lesley Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center
| | - Simin Liu
- Department of Epidemiology, Brown University
| | | | - Aladdin Shadyab
- Department of Family Medicine and Public Health, School of Medicine, University of California San Diego
| | - Rami Nassir
- School of Medicine, Umm Al-Qura'a University, Mecca, Saudi Arabia
| | | | - Fred Tabung
- Ohio State University Comprehensive Cancer Center – James; College of Medicine, The Ohio State University Wexner Medical Center
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17
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Chen G, Mossavar-Rahmani Y, Xue X, Haring B, Shadyab A, Allison M, Liu S, Tinker L, Saquib N, Coday M, Shikany J, Neuhouser M, Snetselaar L, Horn LV, Rohan T, Wassertheil-Smoller S, Kaplan R, Qi Q. Dietary Pattern Indices and Incident Peripheral Arterial Disease in Women: A Prospective Cohort Study. Curr Dev Nutr 2020. [DOI: 10.1093/cdn/nzaa046_013] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objectives
We aimed to evaluate diet quality as reflected by multiple a priori dietary pattern indices in relation to incident PAD.
Methods
We included 138,506 US postmenopausal women aged 50–79 years without known PAD at baseline (1993–1998) of the Women's Health Initiative. Score of 4 dietary pattern indices, including the alternate Mediterranean diet (aMED) index, the alternate Healthy Eating Index (AHEI)-2010, the Dietary Approaches to Stop Hypertension (DASH) diet index, and the Healthy Eating Index (HEI)-2015, were derived using data collected by a validated food frequency questionnaire. Incident cases of symptomatic PAD in the lower extremities were ascertained and adjudicated through March 2019 by reviewing medical record. Hazard ratios (HR) and 95% confidence interval (CI) were estimated using Cox proportional hazards models, with adjustment for multiple potential confounders including known risk factors for PAD (i.e., smoking, high blood pressure, dyslipidemia, and diabetes).
Results
During a median 18.6 years of follow-up, 1036 incident cases of PAD were identified. All 4 dietary pattern indices were inversely associated with risk of PAD. The multivariable-adjusted HRs (95% CI) comparing the highest with the lowest score quartiles were 0.74 (0.61–0.91) for aMED index (P-trend across quartile = 0.010), 0.79 (0.65–0.95) for AHEI-2010 (P-trend < 0.001), 0.66 (0.55–0.80) for DASH index (P-trend < 0.001), and 0.68 (0.56–0.82) for HEI-2015 (P-trend < 0.001). Among major foods/nutrients contributing to these dietary patterns, intakes of whole grains (top vs. bottom quartile, HR = 0.81; P-trend = 0.01), legumes (HR = 0.77; P-trend = 0.004), dietary fiber (HR = 0.78; P-trend = 0.01), and vegetable protein (HR = 0.76; P-trend = 0.006) were associated with lower risk of PAD, whereas intakes of red meat (HR = 1.38; P-trend = 0.003), processed meat (HR = 1.36; P-trend = 0.004), and regular soft drinks (HR = 1.26; P-trend = 0.01) were associated with higher risk.
Conclusions
Adherence to various recommended dietary patterns is associated with lower risk of PAD in a nationwide cohort of US postmenopausal women. Our findings may extend the range of cardiovascular diseases that are potentially preventable by adopting a healthy dietary pattern.
Funding Sources
National Heart, Lung, and Blood Institute; and National Institute of Diabetes and Digestive and Kidney Diseases.
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Affiliation(s)
| | | | | | | | | | | | - Simin Liu
- Department of Epidemiology, Brown University
| | - Lesley Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center
| | | | - Mace Coday
- University of Tennessee Health Science Center
| | - James Shikany
- Depatment of Medicine, University of Alabama Birmingham
| | | | | | | | | | | | | | - Qibin Qi
- Albert Einstein College of Medicine
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18
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Zhang X, Tu W, Manson JE, Tinker L, Liu S, Cauley JA, Qi L, Mouton C, Martin LW, Hou L, Song Y. Racial/Ethnic Differences in 25-Hydroxy Vitamin D and Parathyroid Hormone Levels and Cardiovascular Disease Risk Among Postmenopausal Women. J Am Heart Assoc 2020; 8:e011021. [PMID: 30764690 PMCID: PMC6405652 DOI: 10.1161/jaha.118.011021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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] [Indexed: 12/27/2022]
Abstract
Background Recent evidence suggests that racial/ethnic differences in circulating levels of free or bioavailable 25‐hydroxy vitamin D (25[OH]D) rather than total 25(OH)D may explain apparent racial disparities in cardiovascular disease (CVD). We prospectively examined black‐white differences in the associations of total, free, and bioavailable 25(OH)D, vitamin D–binding protein, and parathyroid hormone levels at baseline with incident CVD (including nonfatal myocardial infarction, nonfatal stroke, and CVD death) in postmenopausal women. Methods and Results We conducted a case‐cohort study among 79 705 postmenopausal women, aged 50 to 79 years, who were free of CVD at baseline in the WHI‐OS (Women's Health Initiative Observational Study). A subcohort of 1300 black and 1500 white participants were randomly chosen as controls; a total of 550 black and 1500 white women who developed incident CVD during a mean follow‐up of 11 years were chosen as cases. We directly measured total 25(OH)D, vitamin D–binding protein, albumin, parathyroid hormone, and calculated free and bioavailable 25(OH)D. Weighted Cox proportional hazards models were used to examine their associations with CVD risk. Although vitamin D–binding protein and total, free, and bioavailable 25(OH)D were not significantly associated with CVD risk in black or white women, a significant positive association between parathyroid hormone and CVD risk persisted in white women (hazard ratio comparing the highest quartile with the lowest, 1.37; 95% CI, 1.06–1.77) but not in black women (hazard ratio comparing the highest quartile with the lowest, 1.12; 95% CI, 0.79–1.58), independent of total, free, and bioavailable 25(OH)D or vitamin D–binding protein. Conclusions Circulating levels of vitamin D biomarkers are not related to CVD risk in either white or black women. Higher parathyroid hormone levels may be an independent risk factor for CVD in white women.
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Affiliation(s)
- Xi Zhang
- 1 Department of Epidemiology Indiana University Richard M. Fairbanks School of Public Health Indianapolis IN
| | - Wanzhu Tu
- 2 Department of Biostatistics Indiana University School of Medicine Indianapolis IN
| | - JoAnn E Manson
- 3 Division of Preventive Medicine Department of Medicine Brigham and Women's Hospital Harvard Medical School Boston MA.,4 Department of Epidemiology Harvard T. H. Chan School of Public Health Boston MA
| | - Lesley Tinker
- 5 Public Health Division Fred Hutchinson Cancer Research Center Seattle WA
| | - Simin Liu
- 6 School of Public Health Brown University Providence RI.,7 The Warren Alpert School of Medicine Brown University Providence RI
| | - Jane A Cauley
- 8 Department of Epidemiology University of Pittsburgh, Graduate School of Public Health Pittsburgh PA
| | - Lihong Qi
- 9 Department of Public Health Sciences University of California Davis CA
| | | | - Lisa W Martin
- 11 Division of Cardiology School of Medicine and Health Sciences George Washington University Washington DC
| | - Lifang Hou
- 12 Department of Preventive Medicine Feinberg School of Medicine Northwestern University Chicago IL
| | - Yiqing Song
- 1 Department of Epidemiology Indiana University Richard M. Fairbanks School of Public Health Indianapolis IN
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19
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Díaz Santana MV, Hankinson SE, Bigelow C, Sturgeon SR, Zoeller RT, Tinker L, Manson JAE, Calafat AM, Meliker JR, Reeves KW. Urinary concentrations of phthalate biomarkers and weight change among postmenopausal women: a prospective cohort study. Environ Health 2019; 18:20. [PMID: 30866962 PMCID: PMC6417117 DOI: 10.1186/s12940-019-0458-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 02/22/2019] [Indexed: 05/20/2023]
Abstract
BACKGROUND Some phthalates are endocrine disrupting chemicals used as plasticizers in consumer products, and have been associated with obesity in cross-sectional studies, yet prospective evaluations of weight change are lacking. Our objective was to evaluate associations between phthalate biomarker concentrations and weight and weight change among postmenopausal women. METHODS We performed cross-sectional (N = 997) and longitudinal analyses (N = 660) among postmenopausal Women's Health Initiative participants. We measured 13 phthalate metabolites and creatinine in spot urine samples provided at baseline. Participants' weight and height measured at in-person clinic visits at baseline, year 3, and year 6 were used to calculate body mass index (BMI). We fit multivariable multinomial logistic regression models to explore cross-sectional associations between each phthalate biomarker and baseline BMI category. We evaluated longitudinal associations between each biomarker and weight change using mixed effects linear regression models. RESULTS In cross-sectional analyses, urinary concentrations of some biomarkers were positively associated with obesity prevalence (e.g. sum of di (2-ethylhexyl) phthalate metabolites [ΣDEHP] 4th vs 1st quartile OR = 3.29, 95% CI 1.80-6.03 [p trend< 0.001] vs normal). In longitudinal analyses, positive trends with weight gain between baseline and year 3 were observed for mono-(2-ethyl-5-oxohexyl) phthalate, monoethyl phthalate (MEP), mono-hydroxybutyl phthalate, and mono-hydroxyisobutyl phthalate (e.g. + 2.32 kg [95% CI 0.93-3.72] for 4th vs 1st quartile of MEP; p trend < 0.001). No statistically significant associations were observed between biomarkers and weight gain over 6 years. CONCLUSIONS Certain phthalates may contribute to short-term weight gain among postmenopausal women.
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Affiliation(s)
- Mary V. Díaz Santana
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, 411 Arnold House, 715 North Pleasant Street, Amherst, MA 01003 USA
| | - Susan E. Hankinson
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, 411 Arnold House, 715 North Pleasant Street, Amherst, MA 01003 USA
| | - Carol Bigelow
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, 411 Arnold House, 715 North Pleasant Street, Amherst, MA 01003 USA
| | - Susan R. Sturgeon
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, 411 Arnold House, 715 North Pleasant Street, Amherst, MA 01003 USA
| | - R. Thomas Zoeller
- Department of Biology, University of Massachusetts Amherst, Amherst, MA USA
| | - Lesley Tinker
- Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA USA
| | - Jo Ann E. Manson
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, and the Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Antonia M. Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Jaymie R. Meliker
- Program in Public Health, Department of Family Population and Preventive Medicine, Stony Brook University, Stony Brook, USA
| | - Katherine W. Reeves
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, 411 Arnold House, 715 North Pleasant Street, Amherst, MA 01003 USA
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20
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Reeves KW, Santana MD, Manson JE, Hankinson SE, Zoeller RT, Bigelow C, Hou L, Wactawski-Wende J, Liu S, Tinker L, Calafat AM. Predictors of urinary phthalate biomarker concentrations in postmenopausal women. Environ Res 2019; 169:122-130. [PMID: 30447499 PMCID: PMC6347530 DOI: 10.1016/j.envres.2018.10.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 10/03/2018] [Accepted: 10/23/2018] [Indexed: 05/21/2023]
Abstract
BACKGROUND Phthalates are ubiquitous endocrine disrupting chemicals present in a wide variety of consumer products. However, the personal characteristics associated with phthalate exposure are unclear. OBJECTIVES We sought to describe personal, behavioral, and reproductive characteristics associated with phthalate metabolite concentrations in an ongoing study nested within the Women's Health Initiative (WHI). MATERIALS AND METHODS We measured thirteen phthalate metabolites in two or three archived urine samples collected in 1993-2001 from each of 1257 WHI participants (2991 observations). We fit multivariable generalized estimating equation models to predict urinary biomarker concentrations from personal, behavioral, and reproductive characteristics. RESULTS Older age was predictive of lower concentrations of monobenzyl phthalate (MBzP), mono-carboxyoctyl phthalate (MCOP), mono-3-carboxypropyl phthalate (MCPP), and the sum of di-n-butyl phthalate metabolites (ΣDBP). Phthalate metabolite concentrations varied by race/region, with generally higher concentrations observed among non-Whites and women from the West region. Higher neighborhood socioeconomic status predicted lower MBzP concentrations, and higher education predicted lower monoethyl phthalate (MEP) and higher concentrations of the sum of metabolites of di-isobutyl phthalate (ΣDiBP). Overweight/obesity predicted higher MBzP, MCOP, monocarboxynonyl phthalate (MCNP), MCPP, and the sum of metabolites of di(2-ethylhexyl) phthalate (ΣDEHP) and lower MEP concentrations. Alcohol consumption predicted higher concentrations of MEP and ΣDBP, while current smokers had higher ΣDBP concentrations. Better diet quality as assessed by Healthy Eating Index 2005 scores predicted lower concentrations of MBzP, ΣDiBP, and ΣDEHP. CONCLUSION Factors predictive of lower biomarker concentrations included increased age and healthy behaviors (e.g. lower alcohol intake, lower body mass index, not smoking, higher quality diet, and moderate physical activity). Racial group (generally higher among non-Whites) and geographic regions (generally higher in Northeast and West compared to South regions) also were predictive of phthalate biomarker concentrations.
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Affiliation(s)
- Katherine W Reeves
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA, USA.
| | - Mary Díaz Santana
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA, USA
| | - JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, and the Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Susan E Hankinson
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA, USA
| | - R Thomas Zoeller
- Department of Biology, University of Massachusetts Amherst, Amherst, MA, USA
| | - Carol Bigelow
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA, USA
| | - Lifang Hou
- Center for Population Epigenetics, Robert H. Lurie Comprehensive Cancer Center and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Simin Liu
- Center for Global Cardiometabolic Health and Departments of Epidemiology, Medicine, and Surgery, Brown University, Providence, RI, USA
| | - Lesley Tinker
- Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Antonia M Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
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21
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Reeves KW, Díaz Santana M, Manson JE, Hankinson SE, Zoeller RT, Bigelow C, Sturgeon SR, Spiegelman D, Tinker L, Luo J, Chen B, Meliker J, Bonner MR, Cote ML, Cheng TYD, Calafat AM. Urinary Phthalate Biomarker Concentrations and Postmenopausal Breast Cancer Risk. J Natl Cancer Inst 2019; 111:1059-1067. [PMID: 30629220 PMCID: PMC6792088 DOI: 10.1093/jnci/djz002] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 11/28/2018] [Accepted: 01/02/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Growing laboratory and animal model evidence supports the potentially carcinogenic effects of some phthalates, chemicals used as plasticizers in a wide variety of consumer products, including cosmetics, medications, and vinyl flooring. However, prospective data on whether phthalates are associated with human breast cancer risk are lacking. METHODS We conducted a nested case-control study within the Women's Health Initiative (WHI) prospective cohort (n = 419 invasive case subjects and 838 control subjects). Control subjects were matched 2:1 to case subjects on age, enrollment date, follow-up time, and WHI study group. We quantified 13 phthalate metabolites and creatinine in two or three urine samples per participant over one to three years. Multivariable conditional logistic regression analysis was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for breast cancer risk associated with each phthalate biomarker up to 19 years of follow-up. RESULTS Overall, we did not observe statistically significant positive associations between phthalate biomarkers and breast cancer risk in multivariable analyses (eg, 4th vs 1st quartile of diethylhexyl phthalate, OR = 1.03, 95% CI = 0.91 to 1.17). Results were generally similar in analyses restricted to disease subtypes, to nonusers of postmenopausal hormone therapy, stratified by body mass index, or to case subjects diagnosed within three, five, or ten years. CONCLUSIONS In the first prospective analysis of phthalates and postmenopausal breast cancer, phthalate biomarker concentrations did not result in an increased risk of developing invasive breast cancer.
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Affiliation(s)
- Katherine W Reeves
- Correspondence to: Katherine W. Reeves, PhD, MPH, Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, 411 Arnold House, 715 North Pleasant Street, Amherst, MA 01003 (e-mail: )
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22
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Zaslavsky O, Zelber-Sagi S, Shikany JM, Orchard T, Wallace R, Snetselaar L, Tinker L. Anatomy of the Mediterranean Diet and Mortality Among Older Women with Frailty. J Nutr Gerontol Geriatr 2018; 37:269-281. [PMID: 30118645 DOI: 10.1080/21551197.2018.1496217] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 10/28/2022]
Abstract
We examined individual components of the Mediterranean Diet (Med) and evaluated their relative contribution to mortality rates in older women with frailty. A sample (N = 10,431) included Women's Health Initiative Observational Study participants aged 65-84 y with complete frailty diagnostic criteria and dietary data. Frailty was assessed with modified Fried's criteria, and dietary data were collected through food frequency questionnaire. Over a mean follow-up of 12.4 y (range 3-21.0), 3,259 (31.2%) deaths occurred. Crude death rates demonstrated a decrease in mortality with higher intake of individual Med components. However, in the mutually adjusted models, most Med components on their own were not significantly associated with mortality. Exceptions were vegetables, nuts, and whole grains. A higher intake of vegetables, nuts, and whole grains were associated with a significantly decreased hazard of mortality, by 9% (P = 0.02), 13% (P < 0.001), and 17% (P < 0.001), respectively. The relative contribution of these components to diet mortality associations were 21%, 42%, and 57% for vegetables, nuts, and whole grains, respectively. Subgroup analyses by chronic morbidity, smoking status, or excluding women with early death did not substantially change these results.
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Affiliation(s)
- Oleg Zaslavsky
- a School of Nursing , University of Washington , Seattle , Washington, USA
| | - Shira Zelber-Sagi
- b Faculty of Health Science and Social Welfare , University of Haifa , Haifa , Israel
| | - James M Shikany
- c Division of Preventive Medicine , University of Alabama , Birmingham , Alabama , USA
| | - Tonya Orchard
- d College of Education and Human Ecology , Ohio State University , Columbus , Ohio USA
| | - Robert Wallace
- e College of Public Health , University of Iowa , Iowa City , Iowa , USA
| | - Linda Snetselaar
- e College of Public Health , University of Iowa , Iowa City , Iowa , USA
| | - Lesley Tinker
- f Public Health Sciences , Fred Hutchinson Cancer Research Center , Seattle , Washington , USA
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23
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Greenberg JA, Manson JE, Neuhouser ML, Tinker L, Eaton C, Johnson KC, Shikany JM. Chocolate intake and heart disease and stroke in the Women's Health Initiative: a prospective analysis. Am J Clin Nutr 2018; 108:41-48. [PMID: 29931040 PMCID: PMC6862600 DOI: 10.1093/ajcn/nqy073] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 10/19/2017] [Accepted: 03/21/2018] [Indexed: 12/21/2022] Open
Abstract
Background Three recent meta-analyses found significant prospective inverse associations between chocolate intake and cardiovascular disease risk. Evidence from these meta-analyses suggests that such inverse associations may only apply to elderly individuals or those with pre-existing major chronic disease. Objective We assessed the association between habitual chocolate intake and subsequent incident coronary heart disease (CHD) and stroke, and the potential effect of modification by age. Design We conducted multivariable Cox regression analyses using data from 83,310 postmenopausal women free of baseline pre-existing major chronic disease in the prospective Women's Health Initiative cohort. Chocolate intake was assessed using a food-frequency questionnaire. Physician-adjudicated events or deaths were ascertained up to 30 September 2013. Results After exclusions, there were 3246 CHD and 2624 stroke events or deaths, representing incidence rates of 3.9% and 3.2% during 1,098,091 and 1,101,022 person-years (13.4 y), respectively. We found no association between consumption of chocolate and risk of CHD (P for linear trend = 0.94) or stroke (P = 0.24). The results for CHD and stroke combined were similar (P = 0.30), but were significantly modified by age (P for interaction = 0.02). For women age <65 y at baseline, those who ate 1 oz (28.35 g) of chocolate <1/mo, 1 to <1.5/mo, 1.5 to <3.5/mo, 3.5/mo to <3/wk, and ≥3/wk had HRs (95% CIs) of 1.00 (referent), 1.17 (1.00, 1.36), 1.05 (0.90, 1.22), 1.09 (0.94, 1.25), and 1.27 (1.09, 1.49), respectively (P for linear trend = 0.005). No association was apparent for older women. Conclusion We observed no association between chocolate intake and risk of CHD, stroke, or both combined in participants free of pre-existing major chronic disease. The relation for both combined was modified by age, with a significant positive linear trend and an increased risk in the highest quintile of chocolate consumption among women age <65 y. This trial was registered at clinicaltrials.gov as NCT03453073.
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Affiliation(s)
- James A Greenberg
- Department of Health and Nutrition Sciences, Brooklyn College of the City University of New York, Brooklyn, NY,Address correspondence to JAG (e-mail: )
| | - JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Lesley Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Charles Eaton
- Department of Family Medicine and Epidemiology, Alpert Medical School, Brown University, Providence, RI
| | - Karen C Johnson
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN
| | - James M Shikany
- Department of Medicine, Division of Preventive Medicine, University of Alabama, Birmingham, AL
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24
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White DL, Hoogeveen RC, Chen L, Richardson P, Ravishankar M, Shah P, Tinker L, Rohan T, Whitsel EA, El-Serag HB, Jiao L. A prospective study of soluble receptor for advanced glycation end products and adipokines in association with pancreatic cancer in postmenopausal women. Cancer Med 2018; 7:2180-2191. [PMID: 29573228 PMCID: PMC5943487 DOI: 10.1002/cam4.1426] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 01/30/2018] [Accepted: 02/09/2018] [Indexed: 12/23/2022] Open
Abstract
Advanced glycation end products (AGEs) dysregulate adipokines and induce inflammation by binding to their adipocyte receptor (RAGE). Soluble RAGE (sRAGE) prevents AGEs/RAGE signaling. We performed a nested case–control study of the association between sRAGE, adipokines, and incident pancreatic cancer risk in the prospective Women's Health Initiative Study. We individually matched controls (n = 802) to cases (n = 472) on age, race, and blood draw date. We evaluated serum concentrations of sRAGE, adiponectin, leptin, monocyte chemotactic protein 1 (MCP1), and plasminogen activator inhibitor‐1 (PAI1) using immunoassay. We used conditional logistic regression model to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for pancreatic cancer over biomarker quartiles (Q1–Q4). We used principal component analysis to create two composite biomarkers and performed a confirmatory factor analysis to examine the association between composite biomarker scores (CBS) and pancreatic cancer risk. Baseline serum sRAGE concentrations were inversely associated with pancreatic cancer risk (aORQ4 vs. Q1 = 0.70, 95% CI: 0.50–0.99). High MCP1 (aOR Q4 vs. Q1 = 2.55, 95% CI: 1.41–4.61) and the higher CBS including MCP1, PAI1, and leptin (aORQ4 vs. Q1 = 1.82, 95% CI = 1.04–3.18) were also associated with increased pancreatic cancer risk among women with BMI <25 kg/m2 (P values for interaction <0.05). We found an inverse association between prediagnostic sRAGE concentrations and risk of incident pancreatic cancer in postmenopausal women. A proinflammatory CBS was associated with increased risk only in women with normal BMI. MCP1 was not modulated by sRAGE.
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Affiliation(s)
- Donna L White
- Department of Medicine, Baylor College of Medicine, Houston, Texas.,Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, Texas.,Texas Medical Center Digestive Disease Center, Houston, Texas.,Dan L. Duncan Cancer Center at Baylor College of Medicine, Houston, Texas.,Center for Translational Research on Inflammatory Diseases (CTRID), Michael E. DeBakey VA Medical Center, Houston, Texas
| | - Ron C Hoogeveen
- Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Liang Chen
- Department of Medicine, Baylor College of Medicine, Houston, Texas.,Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, Texas
| | - Peter Richardson
- Department of Medicine, Baylor College of Medicine, Houston, Texas.,Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, Texas
| | | | - Preksha Shah
- Department of Medicine, Baylor College of Medicine, Houston, Texas.,Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, Texas
| | - Lesley Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Thomas Rohan
- Albert Einstein College of Medicine, Bronx, New York
| | - Eric A Whitsel
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Hashem B El-Serag
- Department of Medicine, Baylor College of Medicine, Houston, Texas.,Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, Texas.,Texas Medical Center Digestive Disease Center, Houston, Texas.,Dan L. Duncan Cancer Center at Baylor College of Medicine, Houston, Texas
| | - Li Jiao
- Department of Medicine, Baylor College of Medicine, Houston, Texas.,Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, Texas.,Texas Medical Center Digestive Disease Center, Houston, Texas.,Dan L. Duncan Cancer Center at Baylor College of Medicine, Houston, Texas.,Center for Translational Research on Inflammatory Diseases (CTRID), Michael E. DeBakey VA Medical Center, Houston, Texas
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25
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Reeves KW, Diaz SM, Hankinson SE, Bigelow C, Zoeller RT, Manson J, Spiegelman D, Tinker L. Phthalate Metabolites and Postmenopausal Breast Cancer Risk. Cancer Epidemiol Biomarkers Prev 2018. [DOI: 10.1158/1055-9965.epi-18-0052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Mounting laboratory and animal model evidence supports the potentially carcinogenic effects of phthalates, chemicals used as plasticizers in a wide variety of consumer products (e.g., cosmetics, medications, vinyl flooring). Phthalate metabolites (PMs) are measurable in nearly 100% of the U.S. population, though levels vary widely, and also have been reported in human breast milk. However, prospective data on whether phthalates affect human breast cancer risk is lacking. Methods We conducted a nested case-control study within the Women's Health Initiative (WHI) prospective cohort (N = 419 invasive cases and 838 matched controls). Controls were matched 2:1 on age, enrollment date, follow-up time, and study group (WHI clinical trial or observational study). We measured a panel of thirteen PMs and creatinine in two or three urine samples per participant over 1 to 3 years. Multivariable conditional logistic regression analysis was used to estimate risk ratios and 95% confidence intervals (RR, 95% CI) for breast cancer risk associated with each PM, with incorporation of measurement error correction approaches to account for the moderate within-participant variability of PMs. Results Overall, we did not observe statistically significant associations between individual PMs and breast cancer risk in analyses adjusted for matching factors, creatinine, body mass index, smoking status, and race/ethnicity: e.g., mono-2-ethylhexyl phthalate (MEHP; p trend = 0.31; e.g., RR 0.91, 95% CI, 0.62–1.33), monoethyl phthalate (MEP; p trend = 0.16; e.g., RR 0.80, 95% CI, 0.55–1.16 for 4th quartile vs. 1st quartile), monohydroxy-isobutyl phthalate (MHiBP; p trend = 0.11; e.g., RR 0.78, 95% CI, 0.51–1.18 for 4th quartile vs. 1st quartile, and monobenzyl phthalate (MBzP; p trend = 0.11; e.g., RR 0.86, 95% CI, 0.57–1.28 for 4th quartile vs. 1st quartile). Conclusions These results indicate that urinary phthalate metabolite levels are not related to increased breast cancer risk. However, some phthalate metabolites may be associated with decreased risk, possibly through anti-estrogenic actions. Future analyses will explore grouping metabolites by parent phthalate and also will separately evaluate breast cancer risk by tumor estrogen receptor status and explore potential effect modification.
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Newcomb PA, Adams SV, Mayer S, Passarelli MN, Tinker L, Lane D, Chlebowski RT, Crandall CJ. Postmenopausal Fracture History and Survival After Reproductive Cancer Diagnosis. JNCI Cancer Spectr 2018; 2:pky001. [PMID: 31355356 PMCID: PMC6643753 DOI: 10.1093/jncics/pky001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 08/14/2017] [Revised: 12/13/2017] [Accepted: 01/03/2018] [Indexed: 12/26/2022] Open
Abstract
Background Postmenopausal bone fracture's have been proposed as a marker of lifetime estrogen exposure and have been associated with decreased risk of breast and endometrial cancer. It is plausible that prediagnostic fractures may be related to survival of estrogen-sensitive cancers. Methods We evaluated a cohort of breast (n = 6411), endometrial (n = 1127), and ovarian (n = 658) cancer cases diagnosed between 1992 and 2010 while participating in the Women’s Health Initiative. Postmenopausal fracture history was assessed from baseline reports of fractures after age 55 years and incident fractures that occurred at least one year prior to cancer diagnosis during study follow-up. Using Cox regression, we compared women with and without a history of fractures with respect to overall and cancer-specific survival. Estimates were adjusted for participant factors, including hormone therapy use; hormone receptor status was not included in our analysis. Results Among women with breast cancer, a history of prediagnostic fractures at any site was associated with poorer overall survival (hazard ratio [HR] = 1.22, 95% confidence interval [CI] = 1.05 to 1.43). A history of hip, forearm, or spine fractures, or hip fracture alone, was associated with increased risk of mortality (HR = 1.26, 95% CI = 1.01 to 1.58, and HR = 2.05, 95% CI = 1.27 to 3.32, respectively). Fracture history was associated neither with cancer-specific survival among breast cancer survivors, nor with overall or disease-specific mortality among endometrial and ovarian cancer survivors. Conclusions Postmenopausal breast cancer patients with a history of fractures, especially of the hip, are more likely to die of any cause than breast cancer survivors without a fracture history. Identifying and intervening in fracture risk factors should be standard of care for all women diagnosed with breast cancer.
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Affiliation(s)
- Polly A Newcomb
- Department of Epidemiology, University of Washington, Seattle, WA.,Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Scott V Adams
- Department of Epidemiology, University of Washington, Seattle, WA.,Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Sophie Mayer
- Department of Epidemiology, University of Washington, Seattle, WA.,Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Michael N Passarelli
- Department of Epidemiology, University of Washington, Seattle, WA.,Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Hanover, NH
| | - Lesley Tinker
- Department of Epidemiology, University of Washington, Seattle, WA
| | - Dorothy Lane
- Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, NY
| | - Rowan T Chlebowski
- Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, CA
| | - Carolyn J Crandall
- Department of Medicine, University of California, Los Angeles, Los Angeles, CA
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27
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Auerbach BJ, Littman AJ, Tinker L, Larson J, Krieger J, Young B, Neuhouser M. Associations of 100% fruit juice versus whole fruit with hypertension and diabetes risk in postmenopausal women: Results from the Women's Health Initiative. Prev Med 2017; 105:212-218. [PMID: 28888824 PMCID: PMC5653413 DOI: 10.1016/j.ypmed.2017.08.031] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [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: 04/25/2017] [Revised: 08/22/2017] [Accepted: 08/27/2017] [Indexed: 12/13/2022]
Abstract
The objective of this study was to determine whether consumption of 100% fruit juice as compared to whole fruit is associated with increased risk of hypertension or diabetes. We analyzed postmenopausal women in the United States enrolled in the Women's Health Initiative between 1993 and 1998. Whole fruit and 100% fruit juice intake were assessed by baseline food frequency questionnaire. Standardized questionnaires assessed outcomes every 6-12months during a mean 7.8years of follow-up. Cox regression estimated hazard ratios (HR) and 95% confidence intervals (CI) for incident hypertension (n=36,314 incident cases/80,539 total participants) and diabetes (n=11,488 incident cases/114,219 total participants). In multivariable analyses there was no significant association comparing the highest to lowest quintiles of 100% fruit juice consumption (8oz/day compared to none) and incident hypertension (HR 1.00, 95% CI 0.97-1.03) or diabetes (HR 0.96, 95% CI 0.90-1.03). There was also no significant association between whole fruit consumption (2.4servings/day compared to 0.3servings/day) and incident hypertension (HR 1.02, 95% CI 0.98-1.05) or diabetes (HR 1.03, 95% CI 0.96-1.10). Consuming moderate amounts of 100% fruit juice or whole fruit was not significantly associated with risk of hypertension or diabetes among postmenopausal US women.
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Affiliation(s)
- Brandon J Auerbach
- Department of Epidemiology, University of Washington, Seattle, WA, United States.
| | - Alyson J Littman
- Department of Epidemiology, University of Washington, Seattle, WA, United States; VA Puget Sound Health Care System, Seattle, WA, United States; Northwest VA Health Services Research & Development Center of Excellence, Seattle, WA, United States
| | - Lesley Tinker
- Women's Health Initiative Clinical Coordinating Center, Seattle, WA, United States; Fred Hutchinson Cancer Research Center, Seattle, WA, United States
| | - Joseph Larson
- Women's Health Initiative Clinical Coordinating Center, Seattle, WA, United States; Fred Hutchinson Cancer Research Center, Seattle, WA, United States
| | - James Krieger
- Division of General Internal Medicine and Department of Health Services, University of Washington, Seattle, United States; Healthy Food America, Seattle, WA, United States
| | - Bessie Young
- VA Puget Sound Health Care System, Seattle, WA, United States; Northwest VA Health Services Research & Development Center of Excellence, Seattle, WA, United States; Division of Nephrology and Department of Epidemiology, University of Washington, Seattle, WA, United States
| | - Marian Neuhouser
- Department of Epidemiology, University of Washington, Seattle, WA, United States; Women's Health Initiative Clinical Coordinating Center, Seattle, WA, United States; Fred Hutchinson Cancer Research Center, Seattle, WA, United States
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28
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Jiao L, Chen L, White DL, Tinker L, Chlebowski RT, Van Horn LV, Richardson P, Lane D, Sangi-Haghpeykar H, El-Serag HB. Low-fat Dietary Pattern and Pancreatic Cancer Risk in the Women's Health Initiative Dietary Modification Randomized Controlled Trial. J Natl Cancer Inst 2017; 110:4085218. [PMID: 28922784 DOI: 10.1093/jnci/djx117] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [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] [Received: 01/03/2017] [Accepted: 05/05/2017] [Indexed: 12/13/2022] Open
Abstract
Background Observational studies suggest that diet may influence pancreatic cancer risk. We investigated the effect of a low-fat dietary intervention on pancreatic cancer incidence. Methods The Women's Health Initiative Dietary Modification (WHI-DM) trial is a randomized controlled trial conducted in 48 835 postmenopausal women age 50 to 79 years in the United States between 1993 and 1998. Women were randomly assigned to the intervention group (n = 19 541), with the goal of reducing total fat intake and increasing intake of vegetables, fruits, and grains, or to the usual diet comparison group (n = 29 294). The intervention concluded in March 2005. We evaluated the effect of the intervention on pancreatic cancer incidence with the follow-up through 2014 using the log-rank test and multivariable Cox proportional hazards regression model. All statistical tests were two-sided. Results In intention-to-treat analyses including 46 200 women, 92 vs 165 pancreatic cancer cases were ascertained in the intervention vs the comparison group (P = .23). The multivariable hazard ratio (HR) of pancreatic cancer was 0.86 (95% confidence interval [CI] = 0.67 to 1.11). Risk was statistically significantly reduced among women with baseline body mass indexes (BMIs) of 25 kg/m2 or higher (HR = 0.71, 95% CI = 0.53 to 0.96), but not among women with BMIs of less than 25 kg/m2 (HR = 1.62, 95% CI = 0.97 to 2.71, Pinteraction = .01). Conclusions A low-fat dietary intervention was associated with reduced pancreatic cancer incidence in women who were overweight or obese in the WHI-DM trial. Caution needs to be taken in interpreting the findings based on subgroup analyses.
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Affiliation(s)
- Li Jiao
- Department of Medicine, Department of Obstetrics and Gynecology, and Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX; Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, TX; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA; Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Family, Population and Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, NY; Texas Medical Center Digestive Disease Center, Houston, TX; Center for Translational Research on Inflammatory Diseases (CTRID), Michael E. DeBakey VA Medical Center, Houston, TX; City of Hope National Medical Center, Duarte, CA
| | - Liang Chen
- Department of Medicine, Department of Obstetrics and Gynecology, and Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX; Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, TX; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA; Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Family, Population and Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, NY; Texas Medical Center Digestive Disease Center, Houston, TX; Center for Translational Research on Inflammatory Diseases (CTRID), Michael E. DeBakey VA Medical Center, Houston, TX; City of Hope National Medical Center, Duarte, CA
| | - Donna L White
- Department of Medicine, Department of Obstetrics and Gynecology, and Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX; Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, TX; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA; Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Family, Population and Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, NY; Texas Medical Center Digestive Disease Center, Houston, TX; Center for Translational Research on Inflammatory Diseases (CTRID), Michael E. DeBakey VA Medical Center, Houston, TX; City of Hope National Medical Center, Duarte, CA
| | - Lesley Tinker
- Department of Medicine, Department of Obstetrics and Gynecology, and Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX; Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, TX; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA; Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Family, Population and Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, NY; Texas Medical Center Digestive Disease Center, Houston, TX; Center for Translational Research on Inflammatory Diseases (CTRID), Michael E. DeBakey VA Medical Center, Houston, TX; City of Hope National Medical Center, Duarte, CA
| | - Rowan T Chlebowski
- Department of Medicine, Department of Obstetrics and Gynecology, and Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX; Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, TX; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA; Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Family, Population and Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, NY; Texas Medical Center Digestive Disease Center, Houston, TX; Center for Translational Research on Inflammatory Diseases (CTRID), Michael E. DeBakey VA Medical Center, Houston, TX; City of Hope National Medical Center, Duarte, CA
| | - Linda V Van Horn
- Department of Medicine, Department of Obstetrics and Gynecology, and Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX; Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, TX; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA; Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Family, Population and Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, NY; Texas Medical Center Digestive Disease Center, Houston, TX; Center for Translational Research on Inflammatory Diseases (CTRID), Michael E. DeBakey VA Medical Center, Houston, TX; City of Hope National Medical Center, Duarte, CA
| | - Peter Richardson
- Department of Medicine, Department of Obstetrics and Gynecology, and Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX; Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, TX; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA; Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Family, Population and Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, NY; Texas Medical Center Digestive Disease Center, Houston, TX; Center for Translational Research on Inflammatory Diseases (CTRID), Michael E. DeBakey VA Medical Center, Houston, TX; City of Hope National Medical Center, Duarte, CA
| | - Dorothy Lane
- Department of Medicine, Department of Obstetrics and Gynecology, and Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX; Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, TX; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA; Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Family, Population and Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, NY; Texas Medical Center Digestive Disease Center, Houston, TX; Center for Translational Research on Inflammatory Diseases (CTRID), Michael E. DeBakey VA Medical Center, Houston, TX; City of Hope National Medical Center, Duarte, CA
| | - Haleh Sangi-Haghpeykar
- Department of Medicine, Department of Obstetrics and Gynecology, and Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX; Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, TX; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA; Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Family, Population and Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, NY; Texas Medical Center Digestive Disease Center, Houston, TX; Center for Translational Research on Inflammatory Diseases (CTRID), Michael E. DeBakey VA Medical Center, Houston, TX; City of Hope National Medical Center, Duarte, CA
| | - Hashem B El-Serag
- Department of Medicine, Department of Obstetrics and Gynecology, and Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX; Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, TX; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA; Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Family, Population and Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, NY; Texas Medical Center Digestive Disease Center, Houston, TX; Center for Translational Research on Inflammatory Diseases (CTRID), Michael E. DeBakey VA Medical Center, Houston, TX; City of Hope National Medical Center, Duarte, CA
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Jia G, Royse K, Tang H, Li D, Chen L, Tinker L, Petersen G, Klein A, Richardson P, White D, Sangi-Haghapeykar H, El-Serag HB, Jiao L. Abstract LB-160: Genetic variations in the AGEs/AGER pathway and risk of pancreatic cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-lb-160] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Chronic inflammation is implicated in pancreatic cancer carcinogenesis. Advanced glycation end-products (AGEs), which are rich in cooked red meat and cigarette smoke, can perpetuate inflammation by binding to the receptor for advanced glycation end products (AGER, also known as RAGE). We hypothesized that genetic variation of the AGEs/AGER pathway affects pancreatic cancer risk by modulating chronic inflammation.
Methods: We conducted a two-stage case-control study to examine the association between 96 single nucleotide polymorphisms (SNPs) in 21 genes (GLO1, MSR1, PINK1, KIF17, AGPAT1, AKR1B1, DDOST, CD36, SCARB1, AGER, APP, HMGB1, S100A8, S100B, S100P, S100A12, MMP9, ADAM10, PPARG, NOTCH4, and PDGF) of the AGEs/AGER pathway and risk of pancreatic cancer. The discovery study was conducted in 672 pancreatic cancer cases and 1361 controls ascertained from the Women’s Health Initiative (WHI) Study matched on age, race/ethnicity and study arm. The validation study was conducted in a PANC4 pooled hospital-based case-control study of 1,034 women cases and 989 women controls. A pooled analysis of 1706 cases and 2350 controls was also performed. SNP data were obtained or imputed from the previously performed GWASs. Pancreatic cancer risk was calculated as odds ratios (ORs) and 95% confidence intervals (Cis) using logistic regression models adjusting for age, race/ethnicity, body mass index (BMI), type 2 diabetes, and smoking using an additive genetic model. The potential interaction between individual SNP and red meat intake and cigarette smoking was examined. A false discovery rate (FDR) adjusted q value < 0.20 was considered statistically significant in the pooled analyses. We also conducted logistic-Kernel machine (LKM) test to examine the association between sets of SNP and risk of pancreatic cancer in the pooled dataset.
Results: We identified 11 SNPs with raw P values < 0.10 in the discovery stage in the WHI study. However, none of the SNPs was validated in the validation and pooled dataset. The LKM test showed that sets of SNPs in CD36 (P = 9.3E-10), GLO1(P =2.0E-7), and DDOST (P = 2.5E-4) were significantly associated with pancreatic cancer risk. We found an interaction effect between the GLO1 SNP rs6932648 and smoking status (never versus ever) in the WHI study (P for interaction = 0.01) and the pooled dataset (P for interaction = 0.049). In the pooled dataset, the variant T allele of rs6932648 (MAF = 0.12) was associated with increased risk of pancreatic cancer among ever smokers (additive OR = 1.26, 95% CI: 1.02-1.55), but not among never smokers (additive OR = 0.94, 95% CI: 0.78-1.14), compared with the C allele.
Summary and Conclusion: We did not observe significant association between any of 96 single SNP and pancreatic cancer risk. However, we found combined set of SNPs in the GLO1, DDOST, and CD36 genes were associated with risk of pancreatic cancer. GLO SNP rs6932648 may modify the association between smoking and risk of pancreatic cancer. GLO1, DDOST, and CD36 are involved in detoxification or clearance of AGEs compounds. Further investigation of AGEs and receptors systems in pancreatic cancer is warranted.
Citation Format: Guochong Jia, Kathryn Royse, Hongwei Tang, Donghui Li, Liang Chen, Lesley Tinker, Gloria Petersen, Alison Klein, Peter Richardson, Donna White, Haleh Sangi-Haghapeykar, Hashem B. El-Serag, Li Jiao. Genetic variations in the AGEs/AGER pathway and risk of pancreatic cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr LB-160. doi:10.1158/1538-7445.AM2017-LB-160
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Affiliation(s)
| | | | | | - Donghui Li
- 3UT-MD Anderson Cancer Center, Houston, TX
| | - Liang Chen
- 2Baylor College of Medicine, Houston, TX
| | - Lesley Tinker
- 4Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | - Alison Klein
- 6Johns Hopkins School of Medicine, Baltimore, MD
| | | | | | | | | | - Li Jiao
- 2Baylor College of Medicine, Houston, TX
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Greenberg JA, Manson JE, Tinker L, Neuhouser ML, Garcia L, Vitolins MZ, Phillips LS. Chocolate intake and diabetes risk in postmenopausal American women. Eur J Clin Nutr 2017; 71:1088-1093. [DOI: 10.1038/ejcn.2017.36] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 02/20/2017] [Accepted: 02/25/2017] [Indexed: 01/01/2023]
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Cespedes Feliciano EM, Tinker L, Manson JE, Allison M, Rohan T, Zaslavsky O, Waring ME, Asao K, Garcia L, Rosal M, Neuhouser ML. Change in Dietary Patterns and Change in Waist Circumference and DXA Trunk Fat Among Postmenopausal Women. Obesity (Silver Spring) 2016; 24:2176-84. [PMID: 27548405 PMCID: PMC5039062 DOI: 10.1002/oby.21589] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 05/05/2016] [Accepted: 05/23/2016] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To examine whether changes in diet quality predict changes in central adiposity among postmenopausal women. METHODS At baseline and 3-year follow-up, Women's Health Initiative Observational Study participants completed food frequency questionnaires, and waist circumference was measured (WC, n = 67,175). In a subset, trunk fat was measured via dual-energy X-ray absorptiometry (DXA, n = 4,254). Using multivariable linear regression, 3-year changes in dietary patterns (Healthy Eating Index-2010, Alternate Healthy Eating Index-2010, Alternate Mediterranean Diet, and Dietary Approaches to Stop Hypertension) were examined as predictors of concurrent changes in WC and, secondarily, DXA. RESULTS Mean (SD) age and 3-year changes in weight and WC were 63 (7) years, 0.52 (4.26) kg, and 0.94 (6.65) cm. A 10% increase in any dietary pattern score, representing improved diet quality, was associated with 0.07 to 0.43 cm smaller increase in WC over 3 years (all P < 0.05). After adjusting for weight change, associations attenuated to 0.02 to 0.10 cm but remained statistically significant for all patterns except Alternate Mediterranean Diet. Results were similar for DXA trunk fat. CONCLUSIONS Three-year improvements in diet quality are modestly protective against gain in WC and partially explained by lesser weight gain. Achieving and maintaining a healthful diet after menopause may protect against gains in central adiposity.
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Affiliation(s)
| | - Lesley Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - JoAnn E Manson
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Matthew Allison
- Department of Family and Preventive Medicine, University of San Diego School of Medicine, San Diego, California, USA
| | - Thomas Rohan
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Oleg Zaslavsky
- Biobehavioral Nursing and Health Systems, University of Washington School of Nursing, Seattle, Washington, USA
| | - Molly E Waring
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA
- Department of Obstetrics & Gynecology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Keiko Asao
- Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Lorena Garcia
- Department of Public Health Sciences, University of California, Davis, Davis, California, USA
| | - Milagros Rosal
- Department of Behavioral Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
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White DL, Hoogeveen R, Royse K, Chen L, Tinker L, Rohan T, Whitsel E, B. El-Serag H, Jiao L. Abstract LB-382: A prospective study of soluble receptor for advanced glycation end products and adiponectin and pancreatic cancer in postmenopausal women. Cancer Res 2016. [DOI: 10.1158/1538-7445.am2016-lb-382] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Obesity is a recognized pancreatic cancer risk factor. Obesity-associated chronic inflammation and insulin resistance as well as western diet are associated with increased circulating levels of advanced glycation end products (AGEs) levels. When AGEs bind to their receptor (RAGE) on adipocytes, an inflammatory cascade is triggered and dysregulation of adipokines can occur. Soluble RAGE (sRAGE) mitigates this negative effect by acting as a decoy receptor for AGEs. In a nested case-control study in the prospective Women's Health Initiative study, we assessed the association between baseline levels of sRAGE and adiponectin and pancreatic cancer risk in post-menopausal women. Medical, lifestyle, diet data, anthropometric measurements and fasting blood were collected at baseline (1993-98). Serum sRAGE and adiponectin levels were immunoassay measured. With an average follow-up 14 years (thru 8/2013), we identified 494 incident cases with pancreatic cancer. Two controls were matched to each case by age, ethnicity, trial assignment and blood draw time (± 6 mos.). Multivariable conditional logistic regression analysis was used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for associations between sRAGE and adiponectin levels (quartile, Q) and pancreatic cancer after adjusting for waist-hip-ratio, diabetes, and dietary intake of alcohol, protein, saturated fat and carbohydrates. A total of 7.6% cases and 6.3% controls were current smokers. sRAGE was correlated with adiponectin among controls(r = 0.17, P <0.001). Higher sRAGE levels were associated with reduced risk of pancreatic cancer (aOR = 0.71, 95% CI: 0.56-0.90, P = 0.004 with sRAGE assessed as a continuous variable; aOR (Q4 vs Q1) = 0.75, 95% CI: 0.54-1.06, with P = 0.02 for trend across quartiles). Adiponectin was not associated with pancreatic cancer risk when assessed as a continuous variable (aOR = 1.008, 95% CI: 0.98-1.02); however, women with highest adiponectin levels had reduced risk of pancreatic cancer (aOR Q4 vs Q1 = 0.73, 95% CI: 0.51-1.04, P = 0.06 for trend). Women with higher levels of both sRAGE and adiponectin (above their respective medians) had greatest risk reduction (aOR = 0.59, 95% CI: 0.42-0.82) compared with women with lower levels of both biomarkers(P for interaction = 0.15). Consistent with our prior work in Finnish male smokers, we found an inverse association between pre-diagnostic sRAGE and risk of incident pancreatic cancer. We also identified a potential effect modification of adiponectin by sRAGE in postmenopausal women. The role of the RAGE pathway in obesity-related pancreatic cancer needs further investigation.
Citation Format: Donna L. White, Ron Hoogeveen, Kathryn Royse, Liang Chen, Lesley Tinker, Tom Rohan, Eric Whitsel, Hashem B. El-Serag, Li Jiao. A prospective study of soluble receptor for advanced glycation end products and adiponectin and pancreatic cancer in postmenopausal women. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr LB-382.
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Affiliation(s)
| | | | | | - Liang Chen
- 1Baylor College of Medicine, Houston, TX
| | - Lesley Tinker
- 2Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Tom Rohan
- 3Albert Einstein Cancer Center, Bronx, NY
| | | | | | - Li Jiao
- 1Baylor College of Medicine, Houston, TX
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Ma Y, Persuitte GM, Andrews C, Hovey KM, LaMonte MJ, Culver AL, Manson JE, Phillips LS, Liu S, Eaton C, Martin LW, Howard BV, Balasubramanian R, Bird CE, Ockene IS, Sturgeon SR, Ockene JK, Tinker L, Nassir R, Rossouw J. Impact of incident diabetes on atherosclerotic cardiovascular disease according to statin use history among postmenopausal women. Eur J Epidemiol 2016; 31:747-61. [PMID: 27188186 DOI: 10.1007/s10654-016-0153-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 09/19/2015] [Accepted: 04/26/2016] [Indexed: 01/30/2023]
Abstract
To compare impact of incident diabetes on atherosclerotic cardiovascular disease (ASCVD) risk among postmenopausal women according to statin use. Prospective data from 120,499 postmenopausal women without prevalent diabetes or cardiovascular disease at baseline from the Women's Health Initiative were used. Incident diabetes was self-reported annually and defined as treatment with pills or injectable medication for diabetes. Current statin use was determined at enrollment and years 1, 3, 6, 9 and 13.5 in the three clinical trial arms, and at baseline, year 3, and 13.5 for the observational study. The primary outcome was incident ASCVD events, self-reported annually and adjudicated by blinded local and central physicians. Incident diabetes and statin use status were fitted as time-varying covariates in Cox regression models to assess ASCVD risk during an average follow-up of 13.6 years. For those not on statins at the time of diabetes diagnosis, there was a 42 % increased risk of ASCVD [hazard ratio (HR) 1.42, 95 % CI 1.28-1.58] among women with incident diabetes versus those without diabetes. Among women on statins, there was a 39 % increased risk of ASCVD (HR 1.39, 95 % CI 1.12-1.74) in women with incident diabetes versus those without diabetes. The increased ASCVD risk due to diabetes was similar between women before or after initiating statins (P = 0.89). Whether diabetes was diagnosed before or after statin use did not alter the increased risk of ASCVD associated with diabetes. Mitigating the increased incidence of diabetes in statin users could increase the ASCVD benefit-to-risk ratio of statins.
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Affiliation(s)
- Yunsheng Ma
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA.
| | | | - Christopher Andrews
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, 48105, USA
| | - Kathleen M Hovey
- Department of Epidemiology and Environmental Health, State University of New York at Buffalo, Buffalo, NY, 14214, USA
| | - Michael J LaMonte
- Department of Epidemiology and Environmental Health, State University of New York at Buffalo, Buffalo, NY, 14214, USA
| | - Annie L Culver
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - JoAnn E Manson
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | | | - Simin Liu
- School of Public Health, Brown University, Providence, RI, 02903, USA
| | - Charles Eaton
- Department of Family Medicine, School of Medicine, Brown University, Providence, RI, 02912, USA
| | - Lisa W Martin
- Division of Cardiology, School of Medicine and Health Sciences, George Washington University, Washington, DC, 20037, USA
| | | | - Raji Balasubramanian
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA, 01003, USA
| | | | - Ira S Ockene
- Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, 01655, USA
| | - Susan R Sturgeon
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA, 01003, USA
| | - Judith K Ockene
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - Lesley Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, 98109, USA
| | - Rami Nassir
- Department of Biochemistry and Molecular Medicine, University of California Davis, Davis, CA, 95616, USA
| | - Jacques Rossouw
- Women's Health Initiative Branch, National Heart, Lung, and Blood Institute, Bethesda, MD, 20892, USA
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Ho GYF, Zheng SL, Cushman M, Perez-Soler R, Kim M, Xue X, Wang T, Schlecht NF, Tinker L, Rohan TE, Wassertheil-Smoller S, Wallace R, Chen C, Xu J, Yu H. Associations of Insulin and IGFBP-3 with Lung Cancer Susceptibility in Current Smokers. J Natl Cancer Inst 2016; 108:djw012. [PMID: 27071409 DOI: 10.1093/jnci/djw012] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 01/19/2016] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The epidermal growth factor receptor (EGFR) signaling network is involved in lung carcinogenesis. This study examined whether ligands that activate or suppress the EGFR signaling network were associated with lung cancer risk in ever smokers. METHODS A nested case-control study within the Women's Health Initiative assessed baseline plasma levels of insulin, insulin-like growth factor (IGF)-1, insulin-like growth factor binding protein (IGFBP)-3, interleukin (IL)-6, hepatocyte growth factor (HGF), and nerve growth factor (NGF) in 1143 ever-smoking lung cancer cases and 1143 controls. Leptin was measured as an adiposity biomarker. Conditional logistic regression was used in data analyses. RESULTS Leptin was inversely associated with lung cancer risk (odds ratio [ORcontinuous] per Ln [pg/mL] = 0.85, 95% confidence interval [CI] = 0.74 to 0.98). After adjusting for adiposity and other risk factors, null associations were found for IL-6, HGF, and NGF. In current smokers, but not former smokers, high insulin levels were associated with increased lung cancer risk (OR for 4th quartile vs others [ORq4] = 2.06, 95% CI = 1.30 to 3.26) whereas IGFBP-3 had a linear inverse association (ORcontinuous per μg/mL = 0.64, 95% CI = 0.41 to 0.98). The insulin association was consistent across subgroups defined by body mass index and histological type, but the IGFBP-3 association was specific to small cell lung cancer. There was a modest positive association between IGF-1 and lung cancer risk in current smokers (ORq4 = 1.44, 95% CI = 0.90 to 2.29). CONCLUSIONS Independent of obesity, high insulin levels but reduced levels of IGFBP-3 were associated with increased lung cancer risk in current smokers.
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Affiliation(s)
- Gloria Y F Ho
- Affiliations of authors:Department of Occupational Medicine, Epidemiology & Prevention, Feinstein Institute for Medical Research, Northwell Health; Hofstra-Northwell School of Medicine , Great Neck, NY (GYFH); Department of Epidemiology and Population Health (GYFH, MK, XX, TW, NFS, TER, SWS) and Department of Medicine (RPS, NFS), Albert Einstein College of Medicine, Bronx, NY; Center for Genomics and Personalized Medicine Research, Wake Forest University , Winston-Salem, NC (SLZ); Departments of Medicine & Pathology, University of Vermont , Burlington, VT (MC); Public Health Sciences Division, Fred Hutchinson Cancer Research Center , Seattle, WA (LT, CC); Department of Epidemiology, College of Public Health, University of Iowa , Iowa City, IA (RW); NorthShore University HealthSystem , Evanston, IL (JX); University of Hawaii Cancer Center , Honolulu, HI (HY)
| | - Siqun L Zheng
- Affiliations of authors:Department of Occupational Medicine, Epidemiology & Prevention, Feinstein Institute for Medical Research, Northwell Health; Hofstra-Northwell School of Medicine , Great Neck, NY (GYFH); Department of Epidemiology and Population Health (GYFH, MK, XX, TW, NFS, TER, SWS) and Department of Medicine (RPS, NFS), Albert Einstein College of Medicine, Bronx, NY; Center for Genomics and Personalized Medicine Research, Wake Forest University , Winston-Salem, NC (SLZ); Departments of Medicine & Pathology, University of Vermont , Burlington, VT (MC); Public Health Sciences Division, Fred Hutchinson Cancer Research Center , Seattle, WA (LT, CC); Department of Epidemiology, College of Public Health, University of Iowa , Iowa City, IA (RW); NorthShore University HealthSystem , Evanston, IL (JX); University of Hawaii Cancer Center , Honolulu, HI (HY)
| | - Mary Cushman
- Affiliations of authors:Department of Occupational Medicine, Epidemiology & Prevention, Feinstein Institute for Medical Research, Northwell Health; Hofstra-Northwell School of Medicine , Great Neck, NY (GYFH); Department of Epidemiology and Population Health (GYFH, MK, XX, TW, NFS, TER, SWS) and Department of Medicine (RPS, NFS), Albert Einstein College of Medicine, Bronx, NY; Center for Genomics and Personalized Medicine Research, Wake Forest University , Winston-Salem, NC (SLZ); Departments of Medicine & Pathology, University of Vermont , Burlington, VT (MC); Public Health Sciences Division, Fred Hutchinson Cancer Research Center , Seattle, WA (LT, CC); Department of Epidemiology, College of Public Health, University of Iowa , Iowa City, IA (RW); NorthShore University HealthSystem , Evanston, IL (JX); University of Hawaii Cancer Center , Honolulu, HI (HY)
| | - Roman Perez-Soler
- Affiliations of authors:Department of Occupational Medicine, Epidemiology & Prevention, Feinstein Institute for Medical Research, Northwell Health; Hofstra-Northwell School of Medicine , Great Neck, NY (GYFH); Department of Epidemiology and Population Health (GYFH, MK, XX, TW, NFS, TER, SWS) and Department of Medicine (RPS, NFS), Albert Einstein College of Medicine, Bronx, NY; Center for Genomics and Personalized Medicine Research, Wake Forest University , Winston-Salem, NC (SLZ); Departments of Medicine & Pathology, University of Vermont , Burlington, VT (MC); Public Health Sciences Division, Fred Hutchinson Cancer Research Center , Seattle, WA (LT, CC); Department of Epidemiology, College of Public Health, University of Iowa , Iowa City, IA (RW); NorthShore University HealthSystem , Evanston, IL (JX); University of Hawaii Cancer Center , Honolulu, HI (HY)
| | - Mimi Kim
- Affiliations of authors:Department of Occupational Medicine, Epidemiology & Prevention, Feinstein Institute for Medical Research, Northwell Health; Hofstra-Northwell School of Medicine , Great Neck, NY (GYFH); Department of Epidemiology and Population Health (GYFH, MK, XX, TW, NFS, TER, SWS) and Department of Medicine (RPS, NFS), Albert Einstein College of Medicine, Bronx, NY; Center for Genomics and Personalized Medicine Research, Wake Forest University , Winston-Salem, NC (SLZ); Departments of Medicine & Pathology, University of Vermont , Burlington, VT (MC); Public Health Sciences Division, Fred Hutchinson Cancer Research Center , Seattle, WA (LT, CC); Department of Epidemiology, College of Public Health, University of Iowa , Iowa City, IA (RW); NorthShore University HealthSystem , Evanston, IL (JX); University of Hawaii Cancer Center , Honolulu, HI (HY)
| | - Xiaonan Xue
- Affiliations of authors:Department of Occupational Medicine, Epidemiology & Prevention, Feinstein Institute for Medical Research, Northwell Health; Hofstra-Northwell School of Medicine , Great Neck, NY (GYFH); Department of Epidemiology and Population Health (GYFH, MK, XX, TW, NFS, TER, SWS) and Department of Medicine (RPS, NFS), Albert Einstein College of Medicine, Bronx, NY; Center for Genomics and Personalized Medicine Research, Wake Forest University , Winston-Salem, NC (SLZ); Departments of Medicine & Pathology, University of Vermont , Burlington, VT (MC); Public Health Sciences Division, Fred Hutchinson Cancer Research Center , Seattle, WA (LT, CC); Department of Epidemiology, College of Public Health, University of Iowa , Iowa City, IA (RW); NorthShore University HealthSystem , Evanston, IL (JX); University of Hawaii Cancer Center , Honolulu, HI (HY)
| | - Tao Wang
- Affiliations of authors:Department of Occupational Medicine, Epidemiology & Prevention, Feinstein Institute for Medical Research, Northwell Health; Hofstra-Northwell School of Medicine , Great Neck, NY (GYFH); Department of Epidemiology and Population Health (GYFH, MK, XX, TW, NFS, TER, SWS) and Department of Medicine (RPS, NFS), Albert Einstein College of Medicine, Bronx, NY; Center for Genomics and Personalized Medicine Research, Wake Forest University , Winston-Salem, NC (SLZ); Departments of Medicine & Pathology, University of Vermont , Burlington, VT (MC); Public Health Sciences Division, Fred Hutchinson Cancer Research Center , Seattle, WA (LT, CC); Department of Epidemiology, College of Public Health, University of Iowa , Iowa City, IA (RW); NorthShore University HealthSystem , Evanston, IL (JX); University of Hawaii Cancer Center , Honolulu, HI (HY)
| | - Nicolas F Schlecht
- Affiliations of authors:Department of Occupational Medicine, Epidemiology & Prevention, Feinstein Institute for Medical Research, Northwell Health; Hofstra-Northwell School of Medicine , Great Neck, NY (GYFH); Department of Epidemiology and Population Health (GYFH, MK, XX, TW, NFS, TER, SWS) and Department of Medicine (RPS, NFS), Albert Einstein College of Medicine, Bronx, NY; Center for Genomics and Personalized Medicine Research, Wake Forest University , Winston-Salem, NC (SLZ); Departments of Medicine & Pathology, University of Vermont , Burlington, VT (MC); Public Health Sciences Division, Fred Hutchinson Cancer Research Center , Seattle, WA (LT, CC); Department of Epidemiology, College of Public Health, University of Iowa , Iowa City, IA (RW); NorthShore University HealthSystem , Evanston, IL (JX); University of Hawaii Cancer Center , Honolulu, HI (HY)
| | - Lesley Tinker
- Affiliations of authors:Department of Occupational Medicine, Epidemiology & Prevention, Feinstein Institute for Medical Research, Northwell Health; Hofstra-Northwell School of Medicine , Great Neck, NY (GYFH); Department of Epidemiology and Population Health (GYFH, MK, XX, TW, NFS, TER, SWS) and Department of Medicine (RPS, NFS), Albert Einstein College of Medicine, Bronx, NY; Center for Genomics and Personalized Medicine Research, Wake Forest University , Winston-Salem, NC (SLZ); Departments of Medicine & Pathology, University of Vermont , Burlington, VT (MC); Public Health Sciences Division, Fred Hutchinson Cancer Research Center , Seattle, WA (LT, CC); Department of Epidemiology, College of Public Health, University of Iowa , Iowa City, IA (RW); NorthShore University HealthSystem , Evanston, IL (JX); University of Hawaii Cancer Center , Honolulu, HI (HY)
| | - Thomas E Rohan
- Affiliations of authors:Department of Occupational Medicine, Epidemiology & Prevention, Feinstein Institute for Medical Research, Northwell Health; Hofstra-Northwell School of Medicine , Great Neck, NY (GYFH); Department of Epidemiology and Population Health (GYFH, MK, XX, TW, NFS, TER, SWS) and Department of Medicine (RPS, NFS), Albert Einstein College of Medicine, Bronx, NY; Center for Genomics and Personalized Medicine Research, Wake Forest University , Winston-Salem, NC (SLZ); Departments of Medicine & Pathology, University of Vermont , Burlington, VT (MC); Public Health Sciences Division, Fred Hutchinson Cancer Research Center , Seattle, WA (LT, CC); Department of Epidemiology, College of Public Health, University of Iowa , Iowa City, IA (RW); NorthShore University HealthSystem , Evanston, IL (JX); University of Hawaii Cancer Center , Honolulu, HI (HY)
| | - Sylvia Wassertheil-Smoller
- Affiliations of authors:Department of Occupational Medicine, Epidemiology & Prevention, Feinstein Institute for Medical Research, Northwell Health; Hofstra-Northwell School of Medicine , Great Neck, NY (GYFH); Department of Epidemiology and Population Health (GYFH, MK, XX, TW, NFS, TER, SWS) and Department of Medicine (RPS, NFS), Albert Einstein College of Medicine, Bronx, NY; Center for Genomics and Personalized Medicine Research, Wake Forest University , Winston-Salem, NC (SLZ); Departments of Medicine & Pathology, University of Vermont , Burlington, VT (MC); Public Health Sciences Division, Fred Hutchinson Cancer Research Center , Seattle, WA (LT, CC); Department of Epidemiology, College of Public Health, University of Iowa , Iowa City, IA (RW); NorthShore University HealthSystem , Evanston, IL (JX); University of Hawaii Cancer Center , Honolulu, HI (HY)
| | - Robert Wallace
- Affiliations of authors:Department of Occupational Medicine, Epidemiology & Prevention, Feinstein Institute for Medical Research, Northwell Health; Hofstra-Northwell School of Medicine , Great Neck, NY (GYFH); Department of Epidemiology and Population Health (GYFH, MK, XX, TW, NFS, TER, SWS) and Department of Medicine (RPS, NFS), Albert Einstein College of Medicine, Bronx, NY; Center for Genomics and Personalized Medicine Research, Wake Forest University , Winston-Salem, NC (SLZ); Departments of Medicine & Pathology, University of Vermont , Burlington, VT (MC); Public Health Sciences Division, Fred Hutchinson Cancer Research Center , Seattle, WA (LT, CC); Department of Epidemiology, College of Public Health, University of Iowa , Iowa City, IA (RW); NorthShore University HealthSystem , Evanston, IL (JX); University of Hawaii Cancer Center , Honolulu, HI (HY)
| | - Chu Chen
- Affiliations of authors:Department of Occupational Medicine, Epidemiology & Prevention, Feinstein Institute for Medical Research, Northwell Health; Hofstra-Northwell School of Medicine , Great Neck, NY (GYFH); Department of Epidemiology and Population Health (GYFH, MK, XX, TW, NFS, TER, SWS) and Department of Medicine (RPS, NFS), Albert Einstein College of Medicine, Bronx, NY; Center for Genomics and Personalized Medicine Research, Wake Forest University , Winston-Salem, NC (SLZ); Departments of Medicine & Pathology, University of Vermont , Burlington, VT (MC); Public Health Sciences Division, Fred Hutchinson Cancer Research Center , Seattle, WA (LT, CC); Department of Epidemiology, College of Public Health, University of Iowa , Iowa City, IA (RW); NorthShore University HealthSystem , Evanston, IL (JX); University of Hawaii Cancer Center , Honolulu, HI (HY)
| | - Jianfeng Xu
- Affiliations of authors:Department of Occupational Medicine, Epidemiology & Prevention, Feinstein Institute for Medical Research, Northwell Health; Hofstra-Northwell School of Medicine , Great Neck, NY (GYFH); Department of Epidemiology and Population Health (GYFH, MK, XX, TW, NFS, TER, SWS) and Department of Medicine (RPS, NFS), Albert Einstein College of Medicine, Bronx, NY; Center for Genomics and Personalized Medicine Research, Wake Forest University , Winston-Salem, NC (SLZ); Departments of Medicine & Pathology, University of Vermont , Burlington, VT (MC); Public Health Sciences Division, Fred Hutchinson Cancer Research Center , Seattle, WA (LT, CC); Department of Epidemiology, College of Public Health, University of Iowa , Iowa City, IA (RW); NorthShore University HealthSystem , Evanston, IL (JX); University of Hawaii Cancer Center , Honolulu, HI (HY)
| | - Herbert Yu
- Affiliations of authors:Department of Occupational Medicine, Epidemiology & Prevention, Feinstein Institute for Medical Research, Northwell Health; Hofstra-Northwell School of Medicine , Great Neck, NY (GYFH); Department of Epidemiology and Population Health (GYFH, MK, XX, TW, NFS, TER, SWS) and Department of Medicine (RPS, NFS), Albert Einstein College of Medicine, Bronx, NY; Center for Genomics and Personalized Medicine Research, Wake Forest University , Winston-Salem, NC (SLZ); Departments of Medicine & Pathology, University of Vermont , Burlington, VT (MC); Public Health Sciences Division, Fred Hutchinson Cancer Research Center , Seattle, WA (LT, CC); Department of Epidemiology, College of Public Health, University of Iowa , Iowa City, IA (RW); NorthShore University HealthSystem , Evanston, IL (JX); University of Hawaii Cancer Center , Honolulu, HI (HY)
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Cespedes EM, Hu FB, Tinker L, Rosner B, Redline S, Garcia L, Hingle M, Van Horn L, Howard BV, Levitan EB, Li W, Manson JE, Phillips LS, Rhee JJ, Waring ME, Neuhouser ML. Multiple Healthful Dietary Patterns and Type 2 Diabetes in the Women's Health Initiative. Am J Epidemiol 2016; 183:622-33. [PMID: 26940115 DOI: 10.1093/aje/kwv241] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 09/04/2015] [Indexed: 02/07/2023] Open
Abstract
The relationship between various diet quality indices and risk of type 2 diabetes (T2D) remains unsettled. We compared associations of 4 diet quality indices--the Alternate Mediterranean Diet Index, Healthy Eating Index 2010, Alternate Healthy Eating Index 2010, and the Dietary Approaches to Stop Hypertension (DASH) Index--with reported T2D in the Women's Health Initiative, overall, by race/ethnicity, and with/without adjustment for overweight/obesity at enrollment (a potential mediator). This cohort (n = 101,504) included postmenopausal women without T2D who completed a baseline food frequency questionnaire from which the 4 diet quality index scores were derived. Higher scores on the indices indicated a better diet. Cox regression was used to estimate multivariate hazard ratios for T2D. Pearson coefficients for correlation among the indices ranged from 0.55 to 0.74. Follow-up took place from 1993 to 2013. During a median 15 years of follow-up, 10,815 incident cases of T2D occurred. For each diet quality index, a 1-standard-deviation higher score was associated with 10%-14% lower T2D risk (P < 0.001). Adjusting for overweight/obesity at enrollment attenuated but did not eliminate associations to 5%-10% lower risk per 1-standard-deviation higher score (P < 0.001). For all 4 dietary indices examined, higher scores were inversely associated with T2D overall and across racial/ethnic groups. Multiple forms of a healthful diet were inversely associated with T2D in these postmenopausal women.
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Carbone L, Johnson KC, Huang Y, Pettinger M, Thomas F, Cauley J, Crandall C, Tinker L, LeBoff MS, Wactawski-Wende J, Bethel M, Li W, Prentice R. Sodium Intake and Osteoporosis. Findings From the Women's Health Initiative. J Clin Endocrinol Metab 2016; 101:1414-21. [PMID: 26863423 PMCID: PMC4880174 DOI: 10.1210/jc.2015-4017] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In this large, prospective, observational cohort study of postmenopausal women in the WHI, Cox proportional hazard regression models showed that sodium intake at or near recommended levels is not likely to impact bone metabolism.
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Affiliation(s)
- Laura Carbone
- Department of Medicine, Division of Rheumatology (L.C., M.B.), Medical College of Georgia-Augusta University and Charlie Norwood Veterans Affairs Medical Center (L.C., M.B.), Augusta, GA 30912; Department of Preventive Medicine (K.C.J., F.T.), University of Tennessee Health Science Center, Memphis, Tennessee 38163; Division of Public Health Sciences (Y.H., M.P., L.T., R.P.), Fred Hutchinson Cancer Research Center, Seattle, Washington 98109; Department of Epidemiology (J.C.), Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania 15261; David Geffen School of Medicine (C.C.), University of California, Los Angeles, Los Angeles, California 90095; Department of Medicine (M.S.L.), Harvard University, Brigham and Women's Hospital, Boston, Massachusetts 02115; Department of Epidemiology and Environmental Health (J.W.-W.), University at Buffalo, The State University of New York, Buffalo, New York 14214; and Division of Preventive and Behavioral Medicine (W.L.), University of Massachusetts Medical School, Worcester, Massachusetts 01655
| | - Karen C Johnson
- Department of Medicine, Division of Rheumatology (L.C., M.B.), Medical College of Georgia-Augusta University and Charlie Norwood Veterans Affairs Medical Center (L.C., M.B.), Augusta, GA 30912; Department of Preventive Medicine (K.C.J., F.T.), University of Tennessee Health Science Center, Memphis, Tennessee 38163; Division of Public Health Sciences (Y.H., M.P., L.T., R.P.), Fred Hutchinson Cancer Research Center, Seattle, Washington 98109; Department of Epidemiology (J.C.), Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania 15261; David Geffen School of Medicine (C.C.), University of California, Los Angeles, Los Angeles, California 90095; Department of Medicine (M.S.L.), Harvard University, Brigham and Women's Hospital, Boston, Massachusetts 02115; Department of Epidemiology and Environmental Health (J.W.-W.), University at Buffalo, The State University of New York, Buffalo, New York 14214; and Division of Preventive and Behavioral Medicine (W.L.), University of Massachusetts Medical School, Worcester, Massachusetts 01655
| | - Ying Huang
- Department of Medicine, Division of Rheumatology (L.C., M.B.), Medical College of Georgia-Augusta University and Charlie Norwood Veterans Affairs Medical Center (L.C., M.B.), Augusta, GA 30912; Department of Preventive Medicine (K.C.J., F.T.), University of Tennessee Health Science Center, Memphis, Tennessee 38163; Division of Public Health Sciences (Y.H., M.P., L.T., R.P.), Fred Hutchinson Cancer Research Center, Seattle, Washington 98109; Department of Epidemiology (J.C.), Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania 15261; David Geffen School of Medicine (C.C.), University of California, Los Angeles, Los Angeles, California 90095; Department of Medicine (M.S.L.), Harvard University, Brigham and Women's Hospital, Boston, Massachusetts 02115; Department of Epidemiology and Environmental Health (J.W.-W.), University at Buffalo, The State University of New York, Buffalo, New York 14214; and Division of Preventive and Behavioral Medicine (W.L.), University of Massachusetts Medical School, Worcester, Massachusetts 01655
| | - Mary Pettinger
- Department of Medicine, Division of Rheumatology (L.C., M.B.), Medical College of Georgia-Augusta University and Charlie Norwood Veterans Affairs Medical Center (L.C., M.B.), Augusta, GA 30912; Department of Preventive Medicine (K.C.J., F.T.), University of Tennessee Health Science Center, Memphis, Tennessee 38163; Division of Public Health Sciences (Y.H., M.P., L.T., R.P.), Fred Hutchinson Cancer Research Center, Seattle, Washington 98109; Department of Epidemiology (J.C.), Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania 15261; David Geffen School of Medicine (C.C.), University of California, Los Angeles, Los Angeles, California 90095; Department of Medicine (M.S.L.), Harvard University, Brigham and Women's Hospital, Boston, Massachusetts 02115; Department of Epidemiology and Environmental Health (J.W.-W.), University at Buffalo, The State University of New York, Buffalo, New York 14214; and Division of Preventive and Behavioral Medicine (W.L.), University of Massachusetts Medical School, Worcester, Massachusetts 01655
| | - Fridjtof Thomas
- Department of Medicine, Division of Rheumatology (L.C., M.B.), Medical College of Georgia-Augusta University and Charlie Norwood Veterans Affairs Medical Center (L.C., M.B.), Augusta, GA 30912; Department of Preventive Medicine (K.C.J., F.T.), University of Tennessee Health Science Center, Memphis, Tennessee 38163; Division of Public Health Sciences (Y.H., M.P., L.T., R.P.), Fred Hutchinson Cancer Research Center, Seattle, Washington 98109; Department of Epidemiology (J.C.), Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania 15261; David Geffen School of Medicine (C.C.), University of California, Los Angeles, Los Angeles, California 90095; Department of Medicine (M.S.L.), Harvard University, Brigham and Women's Hospital, Boston, Massachusetts 02115; Department of Epidemiology and Environmental Health (J.W.-W.), University at Buffalo, The State University of New York, Buffalo, New York 14214; and Division of Preventive and Behavioral Medicine (W.L.), University of Massachusetts Medical School, Worcester, Massachusetts 01655
| | - Jane Cauley
- Department of Medicine, Division of Rheumatology (L.C., M.B.), Medical College of Georgia-Augusta University and Charlie Norwood Veterans Affairs Medical Center (L.C., M.B.), Augusta, GA 30912; Department of Preventive Medicine (K.C.J., F.T.), University of Tennessee Health Science Center, Memphis, Tennessee 38163; Division of Public Health Sciences (Y.H., M.P., L.T., R.P.), Fred Hutchinson Cancer Research Center, Seattle, Washington 98109; Department of Epidemiology (J.C.), Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania 15261; David Geffen School of Medicine (C.C.), University of California, Los Angeles, Los Angeles, California 90095; Department of Medicine (M.S.L.), Harvard University, Brigham and Women's Hospital, Boston, Massachusetts 02115; Department of Epidemiology and Environmental Health (J.W.-W.), University at Buffalo, The State University of New York, Buffalo, New York 14214; and Division of Preventive and Behavioral Medicine (W.L.), University of Massachusetts Medical School, Worcester, Massachusetts 01655
| | - Carolyn Crandall
- Department of Medicine, Division of Rheumatology (L.C., M.B.), Medical College of Georgia-Augusta University and Charlie Norwood Veterans Affairs Medical Center (L.C., M.B.), Augusta, GA 30912; Department of Preventive Medicine (K.C.J., F.T.), University of Tennessee Health Science Center, Memphis, Tennessee 38163; Division of Public Health Sciences (Y.H., M.P., L.T., R.P.), Fred Hutchinson Cancer Research Center, Seattle, Washington 98109; Department of Epidemiology (J.C.), Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania 15261; David Geffen School of Medicine (C.C.), University of California, Los Angeles, Los Angeles, California 90095; Department of Medicine (M.S.L.), Harvard University, Brigham and Women's Hospital, Boston, Massachusetts 02115; Department of Epidemiology and Environmental Health (J.W.-W.), University at Buffalo, The State University of New York, Buffalo, New York 14214; and Division of Preventive and Behavioral Medicine (W.L.), University of Massachusetts Medical School, Worcester, Massachusetts 01655
| | - Lesley Tinker
- Department of Medicine, Division of Rheumatology (L.C., M.B.), Medical College of Georgia-Augusta University and Charlie Norwood Veterans Affairs Medical Center (L.C., M.B.), Augusta, GA 30912; Department of Preventive Medicine (K.C.J., F.T.), University of Tennessee Health Science Center, Memphis, Tennessee 38163; Division of Public Health Sciences (Y.H., M.P., L.T., R.P.), Fred Hutchinson Cancer Research Center, Seattle, Washington 98109; Department of Epidemiology (J.C.), Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania 15261; David Geffen School of Medicine (C.C.), University of California, Los Angeles, Los Angeles, California 90095; Department of Medicine (M.S.L.), Harvard University, Brigham and Women's Hospital, Boston, Massachusetts 02115; Department of Epidemiology and Environmental Health (J.W.-W.), University at Buffalo, The State University of New York, Buffalo, New York 14214; and Division of Preventive and Behavioral Medicine (W.L.), University of Massachusetts Medical School, Worcester, Massachusetts 01655
| | - Meryl Susan LeBoff
- Department of Medicine, Division of Rheumatology (L.C., M.B.), Medical College of Georgia-Augusta University and Charlie Norwood Veterans Affairs Medical Center (L.C., M.B.), Augusta, GA 30912; Department of Preventive Medicine (K.C.J., F.T.), University of Tennessee Health Science Center, Memphis, Tennessee 38163; Division of Public Health Sciences (Y.H., M.P., L.T., R.P.), Fred Hutchinson Cancer Research Center, Seattle, Washington 98109; Department of Epidemiology (J.C.), Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania 15261; David Geffen School of Medicine (C.C.), University of California, Los Angeles, Los Angeles, California 90095; Department of Medicine (M.S.L.), Harvard University, Brigham and Women's Hospital, Boston, Massachusetts 02115; Department of Epidemiology and Environmental Health (J.W.-W.), University at Buffalo, The State University of New York, Buffalo, New York 14214; and Division of Preventive and Behavioral Medicine (W.L.), University of Massachusetts Medical School, Worcester, Massachusetts 01655
| | - Jean Wactawski-Wende
- Department of Medicine, Division of Rheumatology (L.C., M.B.), Medical College of Georgia-Augusta University and Charlie Norwood Veterans Affairs Medical Center (L.C., M.B.), Augusta, GA 30912; Department of Preventive Medicine (K.C.J., F.T.), University of Tennessee Health Science Center, Memphis, Tennessee 38163; Division of Public Health Sciences (Y.H., M.P., L.T., R.P.), Fred Hutchinson Cancer Research Center, Seattle, Washington 98109; Department of Epidemiology (J.C.), Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania 15261; David Geffen School of Medicine (C.C.), University of California, Los Angeles, Los Angeles, California 90095; Department of Medicine (M.S.L.), Harvard University, Brigham and Women's Hospital, Boston, Massachusetts 02115; Department of Epidemiology and Environmental Health (J.W.-W.), University at Buffalo, The State University of New York, Buffalo, New York 14214; and Division of Preventive and Behavioral Medicine (W.L.), University of Massachusetts Medical School, Worcester, Massachusetts 01655
| | - Monique Bethel
- Department of Medicine, Division of Rheumatology (L.C., M.B.), Medical College of Georgia-Augusta University and Charlie Norwood Veterans Affairs Medical Center (L.C., M.B.), Augusta, GA 30912; Department of Preventive Medicine (K.C.J., F.T.), University of Tennessee Health Science Center, Memphis, Tennessee 38163; Division of Public Health Sciences (Y.H., M.P., L.T., R.P.), Fred Hutchinson Cancer Research Center, Seattle, Washington 98109; Department of Epidemiology (J.C.), Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania 15261; David Geffen School of Medicine (C.C.), University of California, Los Angeles, Los Angeles, California 90095; Department of Medicine (M.S.L.), Harvard University, Brigham and Women's Hospital, Boston, Massachusetts 02115; Department of Epidemiology and Environmental Health (J.W.-W.), University at Buffalo, The State University of New York, Buffalo, New York 14214; and Division of Preventive and Behavioral Medicine (W.L.), University of Massachusetts Medical School, Worcester, Massachusetts 01655
| | - Wenjun Li
- Department of Medicine, Division of Rheumatology (L.C., M.B.), Medical College of Georgia-Augusta University and Charlie Norwood Veterans Affairs Medical Center (L.C., M.B.), Augusta, GA 30912; Department of Preventive Medicine (K.C.J., F.T.), University of Tennessee Health Science Center, Memphis, Tennessee 38163; Division of Public Health Sciences (Y.H., M.P., L.T., R.P.), Fred Hutchinson Cancer Research Center, Seattle, Washington 98109; Department of Epidemiology (J.C.), Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania 15261; David Geffen School of Medicine (C.C.), University of California, Los Angeles, Los Angeles, California 90095; Department of Medicine (M.S.L.), Harvard University, Brigham and Women's Hospital, Boston, Massachusetts 02115; Department of Epidemiology and Environmental Health (J.W.-W.), University at Buffalo, The State University of New York, Buffalo, New York 14214; and Division of Preventive and Behavioral Medicine (W.L.), University of Massachusetts Medical School, Worcester, Massachusetts 01655
| | - Ross Prentice
- Department of Medicine, Division of Rheumatology (L.C., M.B.), Medical College of Georgia-Augusta University and Charlie Norwood Veterans Affairs Medical Center (L.C., M.B.), Augusta, GA 30912; Department of Preventive Medicine (K.C.J., F.T.), University of Tennessee Health Science Center, Memphis, Tennessee 38163; Division of Public Health Sciences (Y.H., M.P., L.T., R.P.), Fred Hutchinson Cancer Research Center, Seattle, Washington 98109; Department of Epidemiology (J.C.), Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania 15261; David Geffen School of Medicine (C.C.), University of California, Los Angeles, Los Angeles, California 90095; Department of Medicine (M.S.L.), Harvard University, Brigham and Women's Hospital, Boston, Massachusetts 02115; Department of Epidemiology and Environmental Health (J.W.-W.), University at Buffalo, The State University of New York, Buffalo, New York 14214; and Division of Preventive and Behavioral Medicine (W.L.), University of Massachusetts Medical School, Worcester, Massachusetts 01655
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Washington DL, Gray K, Hoerster KD, Katon JG, Cochrane BB, LaMonte MJ, Weitlauf JC, Groessl E, Bastian L, Vitolins MZ, Tinker L. Trajectories in Physical Activity and Sedentary Time Among Women Veterans in the Women's Health Initiative. Gerontologist 2016; 56 Suppl 1:S27-39. [PMID: 26768390 PMCID: PMC5881621 DOI: 10.1093/geront/gnv676] [Citation(s) in RCA: 8] [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: 07/26/2015] [Accepted: 10/28/2015] [Indexed: 11/12/2022] Open
Abstract
PURPOSE OF THE STUDY Trajectories of physical activity (PA) and sedentary time (ST) after military separation are likely important determinants of women's health outcomes later in life, because low PA and high ST are known contributors to premature mortality risk. Our objective was to compare longitudinal trajectories of recreational PA and ST between Veteran and non-Veteran postmenopausal women from the Women's Health Initiative (WHI). DESIGN AND METHODS Women Veteran (n = 3,719) and non-Veteran (n = 141,800) WHI participants were included. Self-reported participation in recreational PA, converted to metabolic equivalent (MET)-hours/week, was prospectively assessed over 8 years. Self-reported ST, defined as hours/day sitting or lying down, was collected at baseline and at Years 3 and 6. Generalized estimating equations were used to compare trajectories of PA and ST between Veterans and non-Veterans, adjusted for demographics and lifestyle behaviors. RESULTS Veterans had higher baseline PA than non-Veterans (13.2 vs 12.5 MET-hours/week, p = .03). PA declined for both groups, with a steeper decline among Veterans (change/visit year -0.19 vs -0.02 MET-hours/week; interaction p < .001). At baseline, Veterans and non-Veterans had similar levels of ST (107.2 vs 105.9 hours/week, p = 0.42). Over time, ST remained stable among Veterans but declined slightly among non-Veterans (change/visit year -0.19 vs -0.49 hours/week; interaction p = .01). IMPLICATIONS The less favorable longitudinal trajectories of PA and ST we observed for women Veterans may contribute to worse health among these individuals later in life. Understanding barriers to enhancing PA and reducing ST in women Veterans could lead to more effective approaches to intervening on these health behaviors.
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Affiliation(s)
- Donna L Washington
- VA Health Services Research and Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, California. Geffen School of Medicine, University of California Los Angeles.
| | - Kristen Gray
- VA Puget Sound Health Care System, Health Services Research and Development, Seattle. Department of Health Services, University of Washington School of Public Health, Seatle
| | - Katherine D Hoerster
- VA Puget Sound Health Care System, Health Services Research and Development, Seattle. Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seatle
| | - Jodie G Katon
- VA Puget Sound Health Care System, Health Services Research and Development, Seattle. Department of Health Services, University of Washington School of Public Health, Seatle. Women's Health Services, VA Office of Patient Care
| | - Barbara B Cochrane
- University of Washington School of Nursing, Seatle. Fred Hutchinson Cancer Research Center
| | - Michael J LaMonte
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, State University of New York at Buffalo
| | - Julie C Weitlauf
- VA Palo Alto Health Care System, Sierra Pacific MIRECC and Center for Innovation to Implementation. Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine
| | - Erik Groessl
- VA San Diego Health Services Research and Development Unit, California. Department of Family and Preventive Medicine, University of California San Diego
| | | | - Mara Z Vitolins
- Department of Epidemiology and Prevention, Wake Forest University Health Sciences, Winston-Salem
| | - Lesley Tinker
- University of Washington School of Nursing, Seatle. Fred Hutchinson Cancer Research Center
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Newcomb PA, Adams SV, Passarelli MN, Lane D, Li W, Chlebowski RT, Crandall C, Tinker L. Fractures in association with breast and endometrial cancer survival in the Women’s Health Initiative. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.3_suppl.148] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
148 Background: Postmenopausal fracture rates appear to be an integrated marker of usual estrogen levels and have been associated with decreased risk of breast and endometrial cancer. The association between fractures and cancer mortality has been difficult to assess, as fractures are a consequence of both the pathological process and the treatment of cancer. Due to the reduced proliferative effects of the hormonal milieu, pre-diagnosis fractures may be a hallmark of decreased cancer mortality. Methods: We evaluated a cohort of breast (N = 6,458) and endometrial (N = 1,138) cancer cases who were diagnosed with cancer during the Women’s Health Initiative (WHI; 1992-2010). Fracture history was assessed by combining baseline reports of fractures prior to WHI and after age 50; with fractures ascertained during WHI follow-up, but prior to cancer diagnosis. We used Cox proportional hazards models based on time since cancer diagnosis to estimate hazard ratios (HR) with 95% confidence intervals for overall and cancer-specific mortality, comparing women with prior fractures to those without fractures. Clinical factors, including bisphosphonate and hormone use, were in the model. Results: Among breast cancer cases, during the average 6.2 years of follow-up, 1,464 had a prior fracture and 905 deaths occurred (415 due to breast cancer). Among endometrial cancer cases, during follow-up, 267 had a prior fracture and 192 deaths occurred (83 due to endometrial cancer). Any pre-diagnosis fracture was associated with increased all-cause mortality (breast HR: 1.39 (1.20, 1.62); endometrial HR: 1.41 (1.02, 1.95)). Among breast cancer cases, the strongest association was with hip fracture (HR: 2.76 (1.80, 4.25)). Associations with cancer-specific mortality were similar in direction and magnitude, but did not reach statistical significance. Conclusions: A history of pre-diagnostic fractures was associated with increased overall but not cancer-specific mortality. Fracture history may be indicative of frailty or other co-morbidities. Breast and endometrial cancer cases with a fracture history may benefit from concurrent supportive care to mediate risk of death due to co-morbid health conditions.
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Affiliation(s)
| | - Scott V. Adams
- Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | - Dorothy Lane
- State University of New York, Stony Brook, Stony Brook, NY
| | - Wenjun Li
- University of Massachusetts Medical Center, Wooster, MA
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Meyers KJ, Liu Z, Millen AE, Iyengar SK, Blodi BA, Johnson E, Snodderly DM, Klein ML, Gehrs KM, Tinker L, Sarto GE, Robinson J, Wallace RB, Mares JA. Joint Associations of Diet, Lifestyle, and Genes with Age-Related Macular Degeneration. Ophthalmology 2015; 122:2286-94. [PMID: 26354764 PMCID: PMC4714866 DOI: 10.1016/j.ophtha.2015.07.029] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [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] [Received: 08/25/2014] [Revised: 07/23/2015] [Accepted: 07/27/2015] [Indexed: 02/07/2023] Open
Abstract
PURPOSE Unhealthy lifestyles have been associated with increased odds for age-related macular degeneration (AMD). Whether this association is modified by genetic risk for AMD is unknown and was investigated. DESIGN Interactions between healthy lifestyles AMD risk genotypes were studied in relation to the prevalence of AMD, assessed 6 years later. PARTICIPANTS Women 50 to 79 years of age in the Carotenoids in Age-Related Eye Disease Study with exposure and AMD data (n=1663). METHODS Healthy lifestyle scores (0-6 points) were assigned based on Healthy Eating Index scores, physical activity (metabolic equivalent of task hours/week), and smoking pack years assessed in 1994 and 1998. Genetic risk was based on Y402H in complement factor H (CFH) and A69S in age-related maculopathy susceptibility locus 2 (ARMS2). Additive and multiplicative interactions in odds ratios were assessed using the synergy index and a multiplicative interaction term, respectively. MAIN OUTCOME MEASURES AMD presence and severity were assessed from grading of stereoscopic fundus photographs taken in 2001-2004. AMD was present in 337 women, 91% of whom had early AMD. RESULTS The odds of AMD were 3.3 times greater (95% confidence interval [CI], 1.8-6.1) in women with both low healthy lifestyle score (0-2) and high-risk CFH genotype (CC), relative to those who had low genetic risk (TT) and high healthy lifestyle scores (4-6). There were no significant additive (synergy index [SI], 1.08; 95% CI, 0.70-1.67) or multiplicative (Pinteraction=0.94) interactions in the full sample. However, when limiting the sample to women with stable diets before AMD assessment (n=728) the odds for AMD associated with low healthy lifestyle scores and high-risk CFH genotype were strengthened (odds ratio, 4.6; 95% CI, 1.8-11.6) and the synergy index was significant (SI, 1.34; 95% CI, 1.05-1.70). Adjusting for dietary lutein and zeaxanthin attenuated, and therefore partially explained, the joint association. There were no significant additive or multiplicative interactions for ARMS2 and lifestyle score. CONCLUSIONS Having unhealthy lifestyles and 2 CFH risk alleles increased AMD risk (primarily in the early stages), in an or additive or greater (synergistic) manner. However, unhealthy lifestyles increased AMD risk regardless of AMD risk genotype.
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Affiliation(s)
- Kristin J Meyers
- Department of Ophthalmology and Visual Sciences, McPherson Eye Research Institute, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Zhe Liu
- Department of Ophthalmology and Visual Sciences, McPherson Eye Research Institute, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Amy E Millen
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, New York
| | - Sudha K Iyengar
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio
| | - Barbara A Blodi
- Department of Ophthalmology and Visual Sciences, McPherson Eye Research Institute, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Elizabeth Johnson
- Jean Mayer USDA Human Nutrition, Research Center on Aging, Tufts University, Boston, Massachusetts
| | - D Max Snodderly
- Department of Neuroscience, University of Texas, Austin, Texas
| | - Michael L Klein
- Casey Eye Institute, Department of Ophthalmology, Oregon Health & Science University, Portland, Oregon
| | - Karen M Gehrs
- Department of Ophthalmology & Visual Sciences, University of Iowa Hospital & Clinics, Iowa City, Iowa
| | - Lesley Tinker
- Department of Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Gloria E Sarto
- Department of Obstetrics & Gynecology, School of Medicine & Public Health, University of Wisconsin, Madison, Wisconsin
| | - Jennifer Robinson
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa
| | - Robert B Wallace
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa
| | - Julie A Mares
- Department of Ophthalmology and Visual Sciences, McPherson Eye Research Institute, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
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Rao P, Millen AE, Meyers KJ, Liu Z, Voland R, Sondel S, Tinker L, Wallace RB, Blodi BA, Binkley N, Sarto G, Robinson J, LeBlanc E, Mares JA. The Relationship Between Serum 25-Hydroxyvitamin D Levels and Nuclear Cataract in the Carotenoid Age-Related Eye Study (CAREDS), an Ancillary Study of the Women's Health Initiative. Invest Ophthalmol Vis Sci 2015; 56:4221-30. [PMID: 26132781 DOI: 10.1167/iovs.15-16835] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
PURPOSE To investigate the relationship between serum 25-hydroxyvitamin D (25[OH]D) levels and nuclear cataract among participants of the Carotenoids in Age-Related Eye Disease Study (CAREDS), an ancillary study of the Women's Health Initiative (WHI) Observational Study (OS). METHODS Nuclear cataract was assessed from slit lamp photographs (2001-2004) taken 6 years after collecting serum analyzed for 25(OH)D levels at WHI baseline (1994-1998) in 1278 CAREDS participants age 50 to 79 years. Multivariate (age, iris color, smoking, pulse pressure) odds ratios (ORs) for nuclear cataract (nuclear opacities > level 4 or cataract extraction) by quintiles of serum 25(OH)D were estimated using logistic regression. RESULTS No significant association was observed between serum 25(OH)D and nuclear cataract among women of all ages (age-adjusted OR [95% confidence interval (CI)] 0.97 [0.65-1.45]). However, there was a significant age interaction (P for interaction = 0.04). There were no significant associations in the women 70 years or older. In women younger than 70 years, we observed an inverse association between serum 25(OH)D and nuclear cataract (multivariate adjusted ORs [95% CI] 0.54 [0.29-0.99] and 0.66 [0.36-1.20] for quintiles 4 and 5 vs. 1, respectively; P = 0.03). Further adjustment for 25(OH)D determinants (body mass index, vitamin D intake, and UVB exposure) attenuated this association. CONCLUSIONS Serum 25(OH)D levels were unrelated to nuclear opacities in this study sample. However, exploratory analyses suggest a protective association in women younger than 70 years. Further investigations of the relationship between vitamin D and nuclear lens opacities are warranted.
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Affiliation(s)
- Prethy Rao
- Department of Ophthalmology and Visual Sciences University of Wisconsin, Madison, Wisconsin, United States
| | - Amy E Millen
- Department of Social and Preventive Medicine, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, New York, United States
| | - Kristin J Meyers
- Department of Ophthalmology and Visual Sciences University of Wisconsin, Madison, Wisconsin, United States
| | - Zhe Liu
- Department of Ophthalmology and Visual Sciences University of Wisconsin, Madison, Wisconsin, United States
| | - Rickie Voland
- Department of Ophthalmology and Visual Sciences University of Wisconsin, Madison, Wisconsin, United States
| | - Sheri Sondel
- Department of Ophthalmology and Visual Sciences University of Wisconsin, Madison, Wisconsin, United States
| | - Lesley Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States
| | - Robert B Wallace
- Department of Epidemiology, University of Iowa, Iowa City, Iowa, United States
| | - Barbara A Blodi
- Department of Ophthalmology and Visual Sciences University of Wisconsin, Madison, Wisconsin, United States
| | - Neil Binkley
- Department of Medicine, University of Wisconsin, Madison, Wisconsin, United States
| | - Gloria Sarto
- Department of Obstetrics and Gynecology, University of Wisconsin, Madison, Wisconsin, United States
| | - Jennifer Robinson
- Department of Epidemiology, University of Iowa, Iowa City, Iowa, United States
| | - Erin LeBlanc
- Kaiser Permanente Center for Health Research, Portland, Oregon, United States
| | - Julie A Mares
- Department of Ophthalmology and Visual Sciences University of Wisconsin, Madison, Wisconsin, United States
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Chen L, Duan Z, Tinker L, Sangi-Haghpeykar H, Strickler H, Ho G, Rohan T, Gunter M, Logsdon C, White D, Royse K, El-Serag H, Jiao L. Abstract 937: Soluble receptor for advanced glycation end-products is a player in obesity-related colorectal cancer. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-937] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Insulin resistance, adiposity, and chronic inflammation contribute to colorectal cancer (CRC) development. Nϵ-(carboxymethyl)-lysine (CML) is a well-characterized type of advanced glycation end product (AGE). It can bind to the receptor for AGEs (RAGE) and trigger insulin resistance and sustained chronic inflammation. Soluble RAGE (sRAGE) mitigates the detrimental effect of RAGE by acting as a decoy receptor for its ligands. In a case-cohort study within the Women's Health Initiative Observational study, we examined the association between CML-AGE, sRAGE and risk of CRC among 447 cases and 802 subcohort controls. Information on lifestyle, anthropometry, medical history, and diet were collected at baseline. Levels of CML-AGE and sRAGE were measured by ELISA using fasting blood collected at baseline. Circulating levels of adipokines, insulin, glucose, estradiol, and C-reactive protein were previously measured for the study subjects. Multivariate Cox proportional hazard regression model accounting for the case-cohort design was used to estimate hazard ratio (HR) and 95% confidence interval (CI) for CRC according to quartile (Q) of biomarkers with adjustment for age, race, waist circumstance, smoking, family history of colorectal cancer, NASID, energy intake, physical activity, alcohol consumption, saturated fat intake, available carbohydrate intake, hypertension, hormone replacement therapy, calcium, folate equivalent, red meat, insulin, and adiponectin. Average participant follow-up was 7.8 years. Among 802 subcohort controls, CML-AGE and sRAGE were both significantly inversely correlated with BMI, waist circumference, serum insulin, glucose, and leptin, but positively correlated with adiponectin (P values < 0.05). sRAGE levels were inversely associated with CRC (HRQ2 vs Q1:0.53; 95% CI: 0.31-0.90; HRQ4 vs Q1: 0.81; 95% CI: 0.46-1.42) (Ptrend = 0.95). This inverse association was evident among women who had BMI ≥ 25 kg/m2 (HRQ2 vs Q1: 0.49; 95% CI: 0.25-0.99; HRQ4 vs Q1: 0.43, 95% CI: 0.19-0.97) (Ptrend = 0.22), but not among women with normal BMI (BMI < 25) (HRQ4 vs Q1: 1.72, 95% CI:0.53-5.55) (P value for interaction was 0.01). CML-AGE was not associated with CRC risk (HRQ4 vs Q1: 0.78, 95% CI: 0.48-1.37) (Ptrend = 0.18). We found pre-diagnostic sRAGE levels were inversely associated with risk of CRC among overweight and obese postmenopausal women. This study identifed the RAGE pathway as a potential etiological factor in obesity-associated CRC.
Citation Format: Liang Chen, Zhigang Duan, Lesley Tinker, Haleh Sangi-Haghpeykar, Howard Strickler, Gloria Ho, Thomas Rohan, Marc Gunter, Craig Logsdon, Donna White, Kathryn Royse, Hashem El-Serag, Li Jiao. Soluble receptor for advanced glycation end-products is a player in obesity-related colorectal cancer. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 937. doi:10.1158/1538-7445.AM2015-937
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Affiliation(s)
- Liang Chen
- 1Baylor College of Medicine, Houston, TX
| | | | | | | | | | - Gloria Ho
- 4Albert Einstein College of Medicine, Bronx, NY
| | | | - Marc Gunter
- 5Imperial College London, London, United Kingdom
| | | | | | | | | | - Li Jiao
- 1Baylor College of Medicine, Houston, TX
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Ginsberg RL, Tinker L, Liu J, Gray J, Sangi-Haghpeykar H, Manson JE, Margolis KL. Prevalence and correlates of body image dissatisfaction in postmenopausal women. Women Health 2015. [DOI: 10.1080/03630242.2015.1074636] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bhupathiraju S, Tinker L, Dubowitz T, Johnson K, Seguin R, Manson J, Hu F. Quantity and Variety in Fruit and Vegetable Intake and Cardiovascular Disease (CVD) Risk: The Women's Health Initiative (WHI). FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.260.2] [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: 11/11/2022]
Affiliation(s)
| | | | | | | | | | - JoAnn Manson
- MedicineBrigham and Women's HospBostonMAUnited States
| | - Frank Hu
- NutritionHarvard Schl of Public HealthBostonMAUnited States
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Greenberg JA, Manson JE, Buijsse B, Wang L, Allison MA, Neuhouser ML, Tinker L, Waring ME, Isasi CR, Martin LW, Thomson CA. Chocolate-candy consumption and 3-year weight gain among postmenopausal U.S. women. Obesity (Silver Spring) 2015; 23:677-83. [PMID: 25644711 PMCID: PMC4351742 DOI: 10.1002/oby.20983] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 11/12/2014] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To test the hypothesis that greater chocolate-candy intake is associated with more weight gain in postmenopausal women. METHODS A prospective cohort study involved 107,243 postmenopausal American women aged 50-79 years (mean = 60.7) at enrollment in the Women's Health Initiative, with 3-year follow-up. Chocolate-candy consumption was assessed by food frequency questionnaire, and body weight was measured. Linear mixed models, adjusted for demographic, socio economic, anthropomorphic, and behavioral variables, were used to test our main hypotheses. RESULTS Compared with women who ate a 1 oz (∼28 g) serving of chocolate candy <1 per month, those who ate this amount 1 per month to <1 per week, 1 per week to < 3 per week and ≥3 per week showed greater 3-year prospective weight gains (kg) of 0.76 (95% CI: 0.66, 0.85), 0.95 (0.84, 1.06), and 1.40 (1.27, 1.53), respectively, (P for linear trend<0.0001). Each additional 1 oz/day was associated with a greater 3-year weight gain (kg) of 0.92 (0.80, 1.05). The weight gain in each chocolate-candy intake level increased as BMI increased above the normal range (18.5-25 kg/m(2)), and was inversely associated with age. CONCLUSIONS Greater chocolate-candy intake was associated with greater prospective weight gain in this cohort of postmenopausal women.
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Affiliation(s)
- James A Greenberg
- Brooklyn College of the City University of New York, Brooklyn, New York, USA
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Chan KHK, Huang YT, Meng Q, Wu C, Reiner A, Sobel EM, Tinker L, Lusis AJ, Yang X, Liu S. Shared molecular pathways and gene networks for cardiovascular disease and type 2 diabetes mellitus in women across diverse ethnicities. Circ Cardiovasc Genet 2014; 7:911-9. [PMID: 25371518 DOI: 10.1161/circgenetics.114.000676] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Although cardiovascular disease (CVD) and type 2 diabetes mellitus (T2D) share many common risk factors, potential molecular mechanisms that may also be shared for these 2 disorders remain unknown. METHODS AND RESULTS Using an integrative pathway and network analysis, we performed genome-wide association studies in 8155 blacks, 3494 Hispanic American, and 3697 Caucasian American women who participated in the national Women's Health Initiative single-nucleotide polymorphism (SNP) Health Association Resource and the Genomics and Randomized Trials Network. Eight top pathways and gene networks related to cardiomyopathy, calcium signaling, axon guidance, cell adhesion, and extracellular matrix seemed to be commonly shared between CVD and T2D across all 3 ethnic groups. We also identified ethnicity-specific pathways, such as cell cycle (specific for Hispanic American and Caucasian American) and tight junction (CVD and combined CVD and T2D in Hispanic American). In network analysis of gene-gene or protein-protein interactions, we identified key drivers that included COL1A1, COL3A1, and ELN in the shared pathways for both CVD and T2D. These key driver genes were cross-validated in multiple mouse models of diabetes mellitus and atherosclerosis. CONCLUSIONS Our integrative analysis of American women of 3 ethnicities identified multiple shared biological pathways and key regulatory genes for the development of CVD and T2D. These prospective findings also support the notion that ethnicity-specific susceptibility genes and process are involved in the pathogenesis of CVD and T2D.
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Affiliation(s)
- Kei Hang K Chan
- From the Department of Epidemiology (K.H.K.C., Y.-T.H., S.L.) and Division of Endocrinology, Department of Medicine (S.L.), Warren Alpert Medical School of Brown University, Providence, RI; Department of Integrative Biology and Physiology (K.H.K.C., Q.M., X.Y.), Department of Human Genetics (E.M.S.), Department of Medicine/Division of Cardiology, David Geffen School of Medicine (A.J.L.), and Departments of Medicine and Obstetrics and Gynecology, David Geffen School of Medicine (S.L.), University of California Los Angeles; Biostatistics Division (C.W.), Public Health Sciences Division (L.T.), Fred Hutchinson Cancer Research Center, Seattle, WA; and Department of Epidemiology, University of Washington, Seattle (A.R.)
| | - Yen-Tsung Huang
- From the Department of Epidemiology (K.H.K.C., Y.-T.H., S.L.) and Division of Endocrinology, Department of Medicine (S.L.), Warren Alpert Medical School of Brown University, Providence, RI; Department of Integrative Biology and Physiology (K.H.K.C., Q.M., X.Y.), Department of Human Genetics (E.M.S.), Department of Medicine/Division of Cardiology, David Geffen School of Medicine (A.J.L.), and Departments of Medicine and Obstetrics and Gynecology, David Geffen School of Medicine (S.L.), University of California Los Angeles; Biostatistics Division (C.W.), Public Health Sciences Division (L.T.), Fred Hutchinson Cancer Research Center, Seattle, WA; and Department of Epidemiology, University of Washington, Seattle (A.R.)
| | - Qingying Meng
- From the Department of Epidemiology (K.H.K.C., Y.-T.H., S.L.) and Division of Endocrinology, Department of Medicine (S.L.), Warren Alpert Medical School of Brown University, Providence, RI; Department of Integrative Biology and Physiology (K.H.K.C., Q.M., X.Y.), Department of Human Genetics (E.M.S.), Department of Medicine/Division of Cardiology, David Geffen School of Medicine (A.J.L.), and Departments of Medicine and Obstetrics and Gynecology, David Geffen School of Medicine (S.L.), University of California Los Angeles; Biostatistics Division (C.W.), Public Health Sciences Division (L.T.), Fred Hutchinson Cancer Research Center, Seattle, WA; and Department of Epidemiology, University of Washington, Seattle (A.R.)
| | - Chunyuan Wu
- From the Department of Epidemiology (K.H.K.C., Y.-T.H., S.L.) and Division of Endocrinology, Department of Medicine (S.L.), Warren Alpert Medical School of Brown University, Providence, RI; Department of Integrative Biology and Physiology (K.H.K.C., Q.M., X.Y.), Department of Human Genetics (E.M.S.), Department of Medicine/Division of Cardiology, David Geffen School of Medicine (A.J.L.), and Departments of Medicine and Obstetrics and Gynecology, David Geffen School of Medicine (S.L.), University of California Los Angeles; Biostatistics Division (C.W.), Public Health Sciences Division (L.T.), Fred Hutchinson Cancer Research Center, Seattle, WA; and Department of Epidemiology, University of Washington, Seattle (A.R.)
| | - Alexander Reiner
- From the Department of Epidemiology (K.H.K.C., Y.-T.H., S.L.) and Division of Endocrinology, Department of Medicine (S.L.), Warren Alpert Medical School of Brown University, Providence, RI; Department of Integrative Biology and Physiology (K.H.K.C., Q.M., X.Y.), Department of Human Genetics (E.M.S.), Department of Medicine/Division of Cardiology, David Geffen School of Medicine (A.J.L.), and Departments of Medicine and Obstetrics and Gynecology, David Geffen School of Medicine (S.L.), University of California Los Angeles; Biostatistics Division (C.W.), Public Health Sciences Division (L.T.), Fred Hutchinson Cancer Research Center, Seattle, WA; and Department of Epidemiology, University of Washington, Seattle (A.R.)
| | - Eric M Sobel
- From the Department of Epidemiology (K.H.K.C., Y.-T.H., S.L.) and Division of Endocrinology, Department of Medicine (S.L.), Warren Alpert Medical School of Brown University, Providence, RI; Department of Integrative Biology and Physiology (K.H.K.C., Q.M., X.Y.), Department of Human Genetics (E.M.S.), Department of Medicine/Division of Cardiology, David Geffen School of Medicine (A.J.L.), and Departments of Medicine and Obstetrics and Gynecology, David Geffen School of Medicine (S.L.), University of California Los Angeles; Biostatistics Division (C.W.), Public Health Sciences Division (L.T.), Fred Hutchinson Cancer Research Center, Seattle, WA; and Department of Epidemiology, University of Washington, Seattle (A.R.)
| | - Lesley Tinker
- From the Department of Epidemiology (K.H.K.C., Y.-T.H., S.L.) and Division of Endocrinology, Department of Medicine (S.L.), Warren Alpert Medical School of Brown University, Providence, RI; Department of Integrative Biology and Physiology (K.H.K.C., Q.M., X.Y.), Department of Human Genetics (E.M.S.), Department of Medicine/Division of Cardiology, David Geffen School of Medicine (A.J.L.), and Departments of Medicine and Obstetrics and Gynecology, David Geffen School of Medicine (S.L.), University of California Los Angeles; Biostatistics Division (C.W.), Public Health Sciences Division (L.T.), Fred Hutchinson Cancer Research Center, Seattle, WA; and Department of Epidemiology, University of Washington, Seattle (A.R.)
| | - Aldons J Lusis
- From the Department of Epidemiology (K.H.K.C., Y.-T.H., S.L.) and Division of Endocrinology, Department of Medicine (S.L.), Warren Alpert Medical School of Brown University, Providence, RI; Department of Integrative Biology and Physiology (K.H.K.C., Q.M., X.Y.), Department of Human Genetics (E.M.S.), Department of Medicine/Division of Cardiology, David Geffen School of Medicine (A.J.L.), and Departments of Medicine and Obstetrics and Gynecology, David Geffen School of Medicine (S.L.), University of California Los Angeles; Biostatistics Division (C.W.), Public Health Sciences Division (L.T.), Fred Hutchinson Cancer Research Center, Seattle, WA; and Department of Epidemiology, University of Washington, Seattle (A.R.)
| | - Xia Yang
- From the Department of Epidemiology (K.H.K.C., Y.-T.H., S.L.) and Division of Endocrinology, Department of Medicine (S.L.), Warren Alpert Medical School of Brown University, Providence, RI; Department of Integrative Biology and Physiology (K.H.K.C., Q.M., X.Y.), Department of Human Genetics (E.M.S.), Department of Medicine/Division of Cardiology, David Geffen School of Medicine (A.J.L.), and Departments of Medicine and Obstetrics and Gynecology, David Geffen School of Medicine (S.L.), University of California Los Angeles; Biostatistics Division (C.W.), Public Health Sciences Division (L.T.), Fred Hutchinson Cancer Research Center, Seattle, WA; and Department of Epidemiology, University of Washington, Seattle (A.R.).
| | - Simin Liu
- From the Department of Epidemiology (K.H.K.C., Y.-T.H., S.L.) and Division of Endocrinology, Department of Medicine (S.L.), Warren Alpert Medical School of Brown University, Providence, RI; Department of Integrative Biology and Physiology (K.H.K.C., Q.M., X.Y.), Department of Human Genetics (E.M.S.), Department of Medicine/Division of Cardiology, David Geffen School of Medicine (A.J.L.), and Departments of Medicine and Obstetrics and Gynecology, David Geffen School of Medicine (S.L.), University of California Los Angeles; Biostatistics Division (C.W.), Public Health Sciences Division (L.T.), Fred Hutchinson Cancer Research Center, Seattle, WA; and Department of Epidemiology, University of Washington, Seattle (A.R.).
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Qiao Y, Tinker L, Olendzki BC, Hébert JR, Balasubramanian R, Rosal MC, Hingle M, Song Y, Schneider KL, Liu S, Sims S, Ockene JK, Sepavich DM, Shikany JM, Persuitte G, Ma Y. Racial/ethnic disparities in association between dietary quality and incident diabetes in postmenopausal women in the United States: the Women's Health Initiative 1993-2005. Ethn Health 2014; 19:328-47. [PMID: 23697968 PMCID: PMC3883944 DOI: 10.1080/13557858.2013.797322] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
OBJECTIVE To examine the association of dietary quality and risk of incident diabetes overall and by race/ethnicity among postmenopausal women enrolled in the Women's Health Initiative (WHI). RESEARCH METHODS AND PROCEDURES The WHI recruited 161,808 postmenopausal women between 1993 and 1998, and followed them until 2005. Incident diabetes was determined annually over an average of 7.6 years from enrollment. At baseline, all participants completed a Food Frequency Questionnaire (FFQ). Dietary quality was assessed by the Alternate Healthy Eating Index (AHEI), calculated from the baseline FFQ responses. RESULTS There were 10,307 incident cases of self-reported treated diabetes over 1,172,761 person-years of follow-up. Most participants did not meet the AHEI dietary goals; that is, only 0.1% of women met or exceeded the recommended consumption of vegetables, and few (17.3%) met or exceeded the recommended level for total fiber. After adjusting for potential confounders, women in the highest quintile of the AHEI score were 24% less likely to develop diabetes relative to women in the lowest quintile of AHEI [hazard ratio (HR)=0.76 (95% CI: 0.70-0.82)]. This association was observed in Whites [HR=0.74 (95% CI: 0.68-0.82)] and Hispanics [HR=0.68 (95% CI: 0.46-0.99)], but not in Blacks [HR=0.85 (95% CI: 0.69-1.05)] or Asians [HR=0.88 (95% CI: 0.57-1.38)]. CONCLUSION These findings support a protective role of healthful eating choices in reducing the risk of developing diabetes, after adjusting for other lifestyle factors, in White and Hispanic postmenopausal women. Future studies are needed to investigate the relationship between dietary quality and risk of diabetes among Blacks and Asians in relationship to other lifestyle factors.
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Affiliation(s)
- Yongxia Qiao
- School of public health, Shanghai Jiaotong University, Shanghai 200025, China; Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655
| | - Lesley Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109
| | - Barbara C. Olendzki
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655
| | - James R. Hébert
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208
| | - Raji Balasubramanian
- Division of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA 01003
| | - Milagros C. Rosal
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655
| | - Melanie Hingle
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ 85721
| | - Yiqing Song
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA 02215
| | - Kristin L. Schneider
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655
| | - Simin Liu
- Department of Epidemiology, University of California, Los Angeles School of Public Health, Los Angeles, CA 90095
| | - Stacy Sims
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA 94305
| | - Judith K. Ockene
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655
| | - Deidre M. Sepavich
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655
| | - James M. Shikany
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL 35294
| | - Gioia Persuitte
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655
| | - Yunsheng Ma
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655
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47
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Stern JH, Grant AS, Thomson CA, Tinker L, Hale L, Brennan KM, Woods NF, Chen Z. Short sleep duration is associated with decreased serum leptin, increased energy intake and decreased diet quality in postmenopausal women. Obesity (Silver Spring) 2014; 22:E55-61. [PMID: 24347344 PMCID: PMC4008703 DOI: 10.1002/oby.20683] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 12/13/2013] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Short sleep duration induces hormonal perturbations contributing to hyperphagia, insulin resistance, and obesity. The majority of these studies are conducted in young adults. This analysis in a large (n = 769) sample of postmenopausal women (median age 63 years) sought to (a) confirm that sleep duration and sleep quality are negatively correlated with circulating leptin concentrations and (b) to examine the relationship between self-reported sleep, dietary energy intake, and diet quality, as well as, investigate the role of leptin in these associations. METHODS Sleep duration/quality, insomnia, and dietary intake were determined via self-report. Blood samples were collected following an overnight fast to assess serum leptin concentration. All analyses were adjusted for total body fat mass. RESULTS Women reporting ≤6 hr sleep/night had lower serum leptin concentrations than those reporting ≥8 hr sleep (P = 0.04). Furthermore, those with ≤6 hr sleep/night reported higher dietary energy intake (P = 0.01) and lower diet quality (P = 0.04) than the reference group (7 hr sleep/night). Women sleeping ≥8 hr also reported lower diet quality than the reference group (P = 0.02). Importantly, serum leptin did not confound these associations. CONCLUSIONS These results provide evidence that sleep duration is inversely associated with serum leptin and dietary energy intake in postmenopausal women.
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Affiliation(s)
- Jennifer H. Stern
- The University of Arizona Cancer Center, Tucson, Arizona
- Corresponding Author: Jennifer H. Stern, Ph.D., Cancer Center Division, University of Arizona, Tucson, AZ 85724, USA, Tel.,: 1-520-626-6478; Fax: 1-520-626-5348,
| | | | | | | | - Lauren Hale
- Department of Preventive Medicine, State University of New York, Stony Brook
| | | | | | - Zhao Chen
- College of Public Health, The University of Arizona
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48
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Catsburg C, Gunter MJ, Chen C, Cote ML, Kabat GC, Nassir R, Tinker L, Wactawski-Wende J, Page DL, Rohan TE. Insulin, estrogen, inflammatory markers, and risk of benign proliferative breast disease. Cancer Res 2014; 74:3248-58. [PMID: 24755474 DOI: 10.1158/0008-5472.can-13-3514] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Women with benign proliferative breast disease (BPBD) are at increased risk for developing breast cancer. Evidence suggests that accumulation of adipose tissue can influence breast cancer development via hyperinsulinemia, increased estrogen, and/or inflammation. However, there are limited data investigating these pathways with respect to risk of BPBD. We evaluated serologic markers from these pathways in a case-control study of postmenopausal women nested within the Women's Health Initiative Clinical Trial. Cases were the 667 women who developed BPBD during follow-up, and they were matched to 1,321 controls. Levels of insulin, estradiol, C-reactive protein (CRP), and adiponectin were measured in fasting serum collected at baseline. Conditional logistic regression models were used to estimate ORs for the association of each factor with BPBD risk. Among nonusers of hormone therapy, fasting serum insulin was associated with a statistically significant increase in risk of BPBD (OR for highest vs. lowest quartile = 1.80; 95% confidence interval, CI, 1.16-2.79; Ptrend = 0.003) as were levels of estradiol (OR for highest vs. lowest tertile = 1.89; 95% CI, 1.26-2.83; Ptrend = 0.02) and CRP (OR for highest vs. lowest quartile = 2.46; 95% CI, 1.59-3.80; Ptrend < 0.001). Baseline adiponectin level was inversely associated with BPBD risk (OR for highest vs. lowest quartile = 0.47; 95% CI, 0.31-0.71; Ptrend < 0.001). These associations persisted after mutual adjustment, but were not observed among users of either estrogen alone or of estrogen plus progestin hormone therapy. Our results indicate that serum levels of estrogen, insulin, CRP, and adiponectin are independent risk factors for BPBD and suggest that the estrogen, insulin, and inflammation pathways are associated with the early stages of breast cancer development.
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Affiliation(s)
- Chelsea Catsburg
- Authors' Affiliations: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx; Department of Social and Preventive Medicine, University at Buffalo, The State University of New York, Buffalo, New York; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; Population Studies and Prevention Program, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan; Department of Public Health Sciences, University of California - Davis, Davis, California; Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee; and Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Marc J Gunter
- Authors' Affiliations: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx; Department of Social and Preventive Medicine, University at Buffalo, The State University of New York, Buffalo, New York; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; Population Studies and Prevention Program, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan; Department of Public Health Sciences, University of California - Davis, Davis, California; Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee; and Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Chu Chen
- Authors' Affiliations: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx; Department of Social and Preventive Medicine, University at Buffalo, The State University of New York, Buffalo, New York; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; Population Studies and Prevention Program, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan; Department of Public Health Sciences, University of California - Davis, Davis, California; Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee; and Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Michele L Cote
- Authors' Affiliations: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx; Department of Social and Preventive Medicine, University at Buffalo, The State University of New York, Buffalo, New York; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; Population Studies and Prevention Program, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan; Department of Public Health Sciences, University of California - Davis, Davis, California; Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee; and Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Geoffrey C Kabat
- Authors' Affiliations: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx; Department of Social and Preventive Medicine, University at Buffalo, The State University of New York, Buffalo, New York; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; Population Studies and Prevention Program, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan; Department of Public Health Sciences, University of California - Davis, Davis, California; Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee; and Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Rami Nassir
- Authors' Affiliations: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx; Department of Social and Preventive Medicine, University at Buffalo, The State University of New York, Buffalo, New York; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; Population Studies and Prevention Program, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan; Department of Public Health Sciences, University of California - Davis, Davis, California; Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee; and Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Lesley Tinker
- Authors' Affiliations: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx; Department of Social and Preventive Medicine, University at Buffalo, The State University of New York, Buffalo, New York; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; Population Studies and Prevention Program, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan; Department of Public Health Sciences, University of California - Davis, Davis, California; Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee; and Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Jean Wactawski-Wende
- Authors' Affiliations: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx; Department of Social and Preventive Medicine, University at Buffalo, The State University of New York, Buffalo, New York; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; Population Studies and Prevention Program, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan; Department of Public Health Sciences, University of California - Davis, Davis, California; Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee; and Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - David L Page
- Authors' Affiliations: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx; Department of Social and Preventive Medicine, University at Buffalo, The State University of New York, Buffalo, New York; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; Population Studies and Prevention Program, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan; Department of Public Health Sciences, University of California - Davis, Davis, California; Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee; and Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Thomas E Rohan
- Authors' Affiliations: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx; Department of Social and Preventive Medicine, University at Buffalo, The State University of New York, Buffalo, New York; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; Population Studies and Prevention Program, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan; Department of Public Health Sciences, University of California - Davis, Davis, California; Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee; and Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
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49
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Rehm C, Tinker L, LaCroix A, Wang C, Drewnowski A. Diet cost and risk of diabetes: does diet cost mediate the association between socioeconomic status and diabetes risk? (LB355). FASEB J 2014. [DOI: 10.1096/fasebj.28.1_supplement.lb355] [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: 11/11/2022]
Affiliation(s)
- Colin Rehm
- Center for Public Health Nutrition University of WashingtonSeattleWAUnited States
| | - Lesley Tinker
- Fred Hutchinson Cancer Research CenterSeattleWAUnited States
| | - Andrea LaCroix
- Fred Hutchinson Cancer Research CenterSeattleWAUnited States
| | - Ching‐Yun Wang
- Fred Hutchinson Cancer Research CenterSeattleWAUnited States
| | - Adam Drewnowski
- Center for Public Health Nutrition University of WashingtonSeattleWAUnited States
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50
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Tasevska N, Midthune D, Tinker L, Neuhouser M, Beasley J, Van Horn L, Lampe J, Potischman N, Prentice R, Kipnis V. Performance of Food Frequency Questionnaire, 4‐d food record and 24‐h dietary recall to measure total sugars (TS) against the urinary TS biomarker in postmenopausal women (36.4). FASEB J 2014. [DOI: 10.1096/fasebj.28.1_supplement.36.4] [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: 11/11/2022]
Affiliation(s)
- Natasha Tasevska
- Arizona State UniversityPhoenixAZUnited States
- National Cancer InstituteBETHESDAMDUnited States
| | | | - Lesley Tinker
- Fred Hutchinson Cancer Research CenterSeattleWAUnited States
| | | | | | | | - Johanna Lampe
- Fred Hutchinson Cancer Research CenterSeattleWAUnited States
| | | | - Ross Prentice
- Fred Hutchinson Cancer Research CenterSeattleWAUnited States
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