1
|
Knol MJ, Poot RA, Evans TE, Satizabal CL, Mishra A, Sargurupremraj M, van der Auwera S, Duperron MG, Jian X, Hostettler IC, van Dam-Nolen DHK, Lamballais S, Pawlak MA, Lewis CE, Carrion-Castillo A, van Erp TGM, Reinbold CS, Shin J, Scholz M, Håberg AK, Kämpe A, Li GHY, Avinun R, Atkins JR, Hsu FC, Amod AR, Lam M, Tsuchida A, Teunissen MWA, Aygün N, Patel Y, Liang D, Beiser AS, Beyer F, Bis JC, Bos D, Bryan RN, Bülow R, Caspers S, Catheline G, Cecil CAM, Dalvie S, Dartigues JF, DeCarli C, Enlund-Cerullo M, Ford JM, Franke B, Freedman BI, Friedrich N, Green MJ, Haworth S, Helmer C, Hoffmann P, Homuth G, Ikram MK, Jack CR, Jahanshad N, Jockwitz C, Kamatani Y, Knodt AR, Li S, Lim K, Longstreth WT, Macciardi F, Mäkitie O, Mazoyer B, Medland SE, Miyamoto S, Moebus S, Mosley TH, Muetzel R, Mühleisen TW, Nagata M, Nakahara S, Palmer ND, Pausova Z, Preda A, Quidé Y, Reay WR, Roshchupkin GV, Schmidt R, Schreiner PJ, Setoh K, Shapland CY, Sidney S, St Pourcain B, Stein JL, Tabara Y, Teumer A, Uhlmann A, van der Lugt A, Vernooij MW, Werring DJ, Windham BG, Witte AV, Wittfeld K, Yang Q, Yoshida K, Brunner HG, Le Grand Q, Sim K, Stein DJ, Bowden DW, Cairns MJ, Hariri AR, Cheung CL, Andersson S, Villringer A, Paus T, Cichon S, Calhoun VD, Crivello F, Launer LJ, White T, Koudstaal PJ, Houlden H, Fornage M, Matsuda F, Grabe HJ, Ikram MA, Debette S, Thompson PM, Seshadri S, Adams HHH. Genetic variants for head size share genes and pathways with cancer. Cell Rep Med 2024:101529. [PMID: 38703765 DOI: 10.1016/j.xcrm.2024.101529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 09/18/2023] [Accepted: 04/04/2024] [Indexed: 05/06/2024]
Abstract
The size of the human head is highly heritable, but genetic drivers of its variation within the general population remain unmapped. We perform a genome-wide association study on head size (N = 80,890) and identify 67 genetic loci, of which 50 are novel. Neuroimaging studies show that 17 variants affect specific brain areas, but most have widespread effects. Gene set enrichment is observed for various cancers and the p53, Wnt, and ErbB signaling pathways. Genes harboring lead variants are enriched for macrocephaly syndrome genes (37-fold) and high-fidelity cancer genes (9-fold), which is not seen for human height variants. Head size variants are also near genes preferentially expressed in intermediate progenitor cells, neural cells linked to evolutionary brain expansion. Our results indicate that genes regulating early brain and cranial growth incline to neoplasia later in life, irrespective of height. This warrants investigation of clinical implications of the link between head size and cancer.
Collapse
Affiliation(s)
- Maria J Knol
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Raymond A Poot
- Department of Cell Biology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Tavia E Evans
- Department of Clinical Genetics, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Claudia L Satizabal
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, UT Health San Antonio, San Antonio, TX, USA; The Framingham Heart Study, Framingham, MA, USA; Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Aniket Mishra
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team VINTAGE, UMR 1219, Bordeaux, France
| | - Muralidharan Sargurupremraj
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, UT Health San Antonio, San Antonio, TX, USA
| | - Sandra van der Auwera
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany; German Centre of Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - Marie-Gabrielle Duperron
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team VINTAGE, UMR 1219, Bordeaux, France
| | - Xueqiu Jian
- Brown Foundation Institute of Molecular Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Isabel C Hostettler
- Stroke Research Centre, University College London, Institute of Neurology, London, UK; Department of Neurosurgery, Klinikum rechts der Isar, University of Munich, Munich, Germany; Neurosurgical Department, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Dianne H K van Dam-Nolen
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Sander Lamballais
- Department of Clinical Genetics, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Mikolaj A Pawlak
- Department of Neurology, Poznań University of Medical Sciences, Poznań, Poland; Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Cora E Lewis
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - Amaia Carrion-Castillo
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, the Netherlands
| | - Theo G M van Erp
- Clinical Translational Neuroscience Laboratory, Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, USA; Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, CA, USA
| | - Céline S Reinbold
- Department of Biomedicine, University of Basel, Basel, Switzerland; Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland; Institute of Computational Life Sciences, Zurich University of Applied Sciences, Wädenswil, Switzerland
| | - Jean Shin
- The Hospital for Sick Children, University of Toronto, Toronto, Canada; Departments of Physiology and Nutritional Sciences, University of Toronto, Toronto, Canada
| | - Markus Scholz
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany; LIFE Research Center for Civilization Disease, Leipzig, Germany
| | - Asta K Håberg
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Radiology and Nuclear Medicine, St. Olavs University Hospital, Trondheim, Norway
| | - Anders Kämpe
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Gloria H Y Li
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Reut Avinun
- Laboratory of NeuroGenetics, Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
| | - Joshua R Atkins
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia; Centre for Brain and Mental Health Research, Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Fang-Chi Hsu
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Alyssa R Amod
- Department of Child and Adolescent Psychiatry, TU Dresden, Dresden, Germany
| | - Max Lam
- North Region, Institute of Mental Health, Singapore, Singapore; Population and Global Health, LKC Medicine, Nanyang Technological University, Singapore, Singapore
| | - Ami Tsuchida
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team VINTAGE, UMR 1219, Bordeaux, France; Groupe d'imagerie neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR 5293, CNRS, CEA, Université de Bordeaux, Bordeaux, France
| | - Mariël W A Teunissen
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Neurology, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Nil Aygün
- Department of Genetics UNC Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Yash Patel
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
| | - Dan Liang
- Department of Genetics UNC Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Alexa S Beiser
- The Framingham Heart Study, Framingham, MA, USA; Department of Neurology, Boston University School of Medicine, Boston, MA, USA; Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Frauke Beyer
- Department of Neurology, Max Planck Institute for Cognitive and Brain Sciences, Leipzig, Germany; Collaborative Research Center 1052 Obesity Mechanisms, Faculty of Medicine, University of Leipzig, Leipzig, Germany; Day Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Joshua C Bis
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Daniel Bos
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - R Nick Bryan
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Robin Bülow
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Svenja Caspers
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany; Institute for Anatomy I, Medical Faculty & University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Gwenaëlle Catheline
- University of Bordeaux, CNRS, INCIA, UMR 5287, team NeuroImagerie et Cognition Humaine, Bordeaux, France; EPHE-PSL University, Bordeaux, France
| | - Charlotte A M Cecil
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Child and Adolescent Psychiatry, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Shareefa Dalvie
- Department of Child and Adolescent Psychiatry, TU Dresden, Dresden, Germany
| | - Jean-François Dartigues
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team SEPIA, UMR 1219, Bordeaux, France
| | - Charles DeCarli
- Department of Neurology and Center for Neuroscience, University of California at Davis, Sacramento, CA, USA
| | - Maria Enlund-Cerullo
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Folkhälsan Research Center, Helsinki, Finland
| | - Judith M Ford
- San Francisco Veterans Administration Medical Center, San Francisco, CA, USA; University of California, San Francisco, San Francisco, CA, USA
| | - Barbara Franke
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Psychiatry, Radboud University Medical Center, Nijmegen, the Netherlands; Donders Institute for Brain, Cognition, and Behaviour, Radboud University, Nijmegen, the Netherlands
| | - Barry I Freedman
- Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Nele Friedrich
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Melissa J Green
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia; Neuroscience Research Australia, Sydney, NSW, Australia
| | - Simon Haworth
- Bristol Dental School, University of Bristol, Bristol, UK
| | - Catherine Helmer
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team LEHA, UMR 1219, Bordeaux, France
| | - Per Hoffmann
- Department of Biomedicine, University of Basel, Basel, Switzerland; Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland; Institute of Human Genetics, University of Bonn Medical School, Bonn, Germany
| | - Georg Homuth
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Neurology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | | | - Neda Jahanshad
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck USC School of Medicine, Los Angeles, CA, USA
| | - Christiane Jockwitz
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany; Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Medical Faculty, Aachen, Germany
| | - Yoichiro Kamatani
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Annchen R Knodt
- Laboratory of NeuroGenetics, Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
| | - Shuo Li
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Keane Lim
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - W T Longstreth
- Department of Neurology, University of Washington, Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Fabio Macciardi
- Laboratory of Molecular Psychiatry, Department of Psychiatry and Human Behavior, School of Medicine, University of California, Irvine, Irvine, CA, USA
| | - Outi Mäkitie
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden; Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Folkhälsan Research Center, Helsinki, Finland
| | - Bernard Mazoyer
- Groupe d'imagerie neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR 5293, CNRS, CEA, Université de Bordeaux, Bordeaux, France; Centre Hospitalo-Universitaire de Bordeaux, Bordeaux, France
| | - Sarah E Medland
- Psychiatric Genetics, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia; School of Psychology, University of Queensland, Brisbane, QLD, Australia; Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Susumu Miyamoto
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Susanne Moebus
- Institute for Urban Public Health, University of Duisburg-Essen, Essen, Germany
| | - Thomas H Mosley
- Department of Medicine, Division of Geriatrics, University of Mississippi Medical Center, Jackson, MS, USA; Memory Impairment and Neurodegenerative Dementia (MIND) Center, Jackson, MS, USA
| | - Ryan Muetzel
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Child and Adolescent Psychiatry, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Thomas W Mühleisen
- Department of Biomedicine, University of Basel, Basel, Switzerland; Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany; C. and O. Vogt Institute for Brain Research, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Manabu Nagata
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Soichiro Nakahara
- Clinical Translational Neuroscience Laboratory, Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, USA; Unit 2, Candidate Discovery Science Labs, Drug Discovery Research, Astellas Pharma Inc, 21 Miyukigaoka, Tsukuba, Ibaraki 305-8585, Japan
| | - Nicholette D Palmer
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Zdenka Pausova
- The Hospital for Sick Children, University of Toronto, Toronto, Canada; Departments of Physiology and Nutritional Sciences, University of Toronto, Toronto, Canada
| | - Adrian Preda
- Department of Psychiatry, University of California, Irvine, Irvine, CA, USA
| | - Yann Quidé
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia; Neuroscience Research Australia, Sydney, NSW, Australia
| | - William R Reay
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia; Centre for Brain and Mental Health Research, Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Gennady V Roshchupkin
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Reinhold Schmidt
- Clinical Division of Neurogeriatrics, Department of Neurology, Medical University of Graz, Graz, Austria
| | | | - Kazuya Setoh
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Chin Yang Shapland
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, the Netherlands; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; Population Health Sciences, University of Bristol, Bristol, UK
| | - Stephen Sidney
- Kaiser Permanente Division of Research, Oakland, CA, USA
| | - Beate St Pourcain
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, the Netherlands; Donders Institute for Brain, Cognition, and Behaviour, Radboud University, Nijmegen, the Netherlands; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Jason L Stein
- Department of Genetics UNC Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Yasuharu Tabara
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Alexander Teumer
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany; Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Anne Uhlmann
- Department of Child and Adolescent Psychiatry, TU Dresden, Dresden, Germany
| | - Aad van der Lugt
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Meike W Vernooij
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - David J Werring
- Stroke Research Centre, University College London, Institute of Neurology, London, UK
| | - B Gwen Windham
- Department of Medicine, Division of Geriatrics, University of Mississippi Medical Center, Jackson, MS, USA; Memory Impairment and Neurodegenerative Dementia (MIND) Center, Jackson, MS, USA
| | - A Veronica Witte
- Department of Neurology, Max Planck Institute for Cognitive and Brain Sciences, Leipzig, Germany; Collaborative Research Center 1052 Obesity Mechanisms, Faculty of Medicine, University of Leipzig, Leipzig, Germany; Day Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Katharina Wittfeld
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany; German Centre of Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - Qiong Yang
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Kazumichi Yoshida
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Han G Brunner
- Department of Human Genetics, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Clinical Genetics MUMC+, GROW School of Oncology and Developmental Biology, and MHeNs School of Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Quentin Le Grand
- Bordeaux Population Health, University of Bordeaux, INSERM U1219, Bordeaux, France
| | - Kang Sim
- West Region, Institute of Mental Health, Singapore, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Dan J Stein
- Department of Child and Adolescent Psychiatry, TU Dresden, Dresden, Germany; SAMRC Unit on Risk and Resilience, University of Cape Town, Cape Town, South Africa
| | - Donald W Bowden
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Murray J Cairns
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia; Centre for Brain and Mental Health Research, Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Ahmad R Hariri
- Laboratory of NeuroGenetics, Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
| | - Ching-Lung Cheung
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Centre for Genomic Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Sture Andersson
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Arno Villringer
- Department of Neurology, Max Planck Institute for Cognitive and Brain Sciences, Leipzig, Germany; Day Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Tomas Paus
- Departments of Psychiatry and Neuroscience, Faculty of Medicine and Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montreal, QC, Canada; Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Sven Cichon
- Department of Biomedicine, University of Basel, Basel, Switzerland; Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland; Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
| | - Vince D Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS) {Georgia State, Georgia Tech, Emory}, Atlanta, GA, USA
| | - Fabrice Crivello
- Groupe d'imagerie neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR 5293, CNRS, CEA, Université de Bordeaux, Bordeaux, France
| | - Lenore J Launer
- Laboratory of Epidemiology, Demography, and Biometry, Intramural Research Program, National Institute of Aging, The National Institutes of Health, Bethesda, MD, USA
| | - Tonya White
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Child and Adolescent Psychiatry, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Peter J Koudstaal
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Henry Houlden
- Stroke Research Centre, University College London, Institute of Neurology, London, UK
| | - Myriam Fornage
- Brown Foundation Institute of Molecular Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA; Human Genetics Center, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Stéphanie Debette
- Bordeaux Population Health, University of Bordeaux, INSERM U1219, Bordeaux, France; Department of Neurology, Bordeaux University Hospital, Bordeaux, France
| | - Paul M Thompson
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck USC School of Medicine, Los Angeles, CA, USA
| | - Sudha Seshadri
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, UT Health San Antonio, San Antonio, TX, USA; The Framingham Heart Study, Framingham, MA, USA; Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Hieab H H Adams
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands; Latin American Brain Health (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile.
| |
Collapse
|
2
|
Splinter MJ, Velek P, Kieboom BCT, Ikram MA, de Schepper E, Ikram MK, Licher S. Healthcare avoidance during the early stages of the COVID-19 pandemic and all-cause mortality: a longitudinal community-based study. Br J Gen Pract 2024:BJGP.2023.0637. [PMID: 38697627 DOI: 10.3399/bjgp.2023.0637] [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] [Received: 12/04/2023] [Accepted: 03/14/2024] [Indexed: 05/05/2024] Open
Abstract
Background During the COVID-19 pandemic, global trends of reduced healthcare-seeking behaviour were observed. This raises concerns about the consequences of healthcare avoidance for population health. Aim To determine the association between healthcare avoidance during the early stages of the COVID-19 pandemic and all-cause mortality. Design and setting 32-month follow-up within the population-based Rotterdam Study, after sending a COVID-19 questionnaire at the onset of the pandemic in April 2020 to all non-institutionalised participants (response rate 73%). Method Cox proportional hazards models assessed the risk of all-cause mortality among respondents who avoided healthcare because of the COVID-19 pandemic. Mortality status was collected through municipality registries and medical records. Results Of 5656 respondents, one-fifth avoided healthcare due to the COVID-19 pandemic (N=1143). Compared to non-avoiders, those who avoided healthcare more often reported symptoms of depression (31.2% versus 12.3%) and anxiety (29.7% versus 12.2%), and more often valued their health as poor to fair (29.4% versus 10.1%). Healthcare avoiders had an increased adjusted risk of all-cause mortality (HR: 1.30; 95%CI 1.01-1.67), which remained nearly identical after adjustment for history of any non-communicable disease (1.20;0.93-1.54). However, this association attenuated after additional adjustment for mental and self-appreciated health factors (0.96;0.74-1.24). Conclusion We found an increased risk of all-cause mortality among individuals who avoided healthcare during COVID-19. These individuals were characterised by poor mental and physical self-appreciated health. Therefore, interventions should be targeted to these vulnerable individuals to safeguard their access to primary and specialist care in order to limit health disparities, inside and beyond healthcare crises.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Silvan Licher
- Erasmus Medical Center, Epidemiology, Rotterdam, Netherlands
- Erasmus MC, Rotterdam, Netherlands
| |
Collapse
|
3
|
Khan CF, Kamran Ikram M, Terzikhan N, Brusselle GG, Bos D. Revisiting the Clinical Interpretation of CT-Measured Pulmonary Artery-to-Aorta Ratio-The Rotterdam Study. Acad Radiol 2024:S1076-6332(24)00202-2. [PMID: 38637237 DOI: 10.1016/j.acra.2024.03.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 03/20/2024] [Accepted: 03/28/2024] [Indexed: 04/20/2024]
Abstract
RATIONALE The pulmonary artery (PA) diameter-to-aorta ratio (PA:A) ratio is a novel marker in cardiovascular imaging for detecting pulmonary hypertension. However, we question the effect of the varying aorta diameter on the ratio, which complicates the interpretation of the PA:A ratio. OBJECTIVE Investigate the variability of the PA:A ratio by examining the correlation between PA:A ratio and aorta diameter and by comparing the associations of the PA diameter, aorta diameters, and PA:A ratio. METHODS We included 2197 participants from the Rotterdam Study who underwent non-contrast multidetector computed tomography to measure the PA and aorta diameters. Pearson correlation coefficient was calculated between the PA:A ratio and aorta diameter. Multiple linear regression analyses were performed to compare the determinants of the individual diameters and PA:A ratio. RESULTS We found a statistically significant correlation between the PA:A ratio and aorta diameter (r = -0.38, p < 0.001). The PA diameter was statistically significantly associated with, height, weight, diastolic blood pressure, blood pressure medication, prevalence of atrial fibrillation, prevalence of heart failure, and prevalence of stroke (p < 0.05). Except for blood pressure medication, the PA:A ratio had similar determinants compared to the PA diameter but was also statistically significantly associated with sex, and systolic blood pressure (p < 0.05), which were statistically significantly associated with the aorta diameter (p < 0.05). CONCLUSION The PA:A ratio should not be interpreted without taking into account the variability of the individual components (PA and aorta diameter) according to the anthropomorphic and clinical characteristics.
Collapse
Affiliation(s)
- C F Khan
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Neurology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Natalie Terzikhan
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Guy G Brusselle
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Respiratory Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Daniel Bos
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
| |
Collapse
|
4
|
Melgarejo JD, Gurel K, Compton CR, Liu M, Guzman V, Assuras S, Levin BE, Elkind MSV, Ikram MK, Kavousi M, Ikram MA, Wright C, Crivello F, Laurent A, Tzourio C, Vernooij MW, Rundek T, Zhang Z, Bos D, Gutierrez J. Brain artery diameters and risk of dementia and stroke. Alzheimers Dement 2024; 20:2497-2507. [PMID: 38332543 PMCID: PMC11032539 DOI: 10.1002/alz.13712] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 12/22/2023] [Accepted: 12/27/2023] [Indexed: 02/10/2024]
Abstract
INTRODUCTION We tested the association of brain artery diameters with dementia and stroke risk in three distinct population-based studies using conventional T2-weighted brain magnetic resonance imaging (MRI) images. METHODS We included 8420 adults > 40 years old from three longitudinal population-based studies with brain MRI scans. We estimated and meta-analyzed the hazard ratios (HRs) of the brain and carotids and basilar diameters associated with dementia and stroke. RESULT Overall and carotid artery diameters > 95th percentile increased the risk for dementia by 1.74 (95% confidence interval [CI], 1.13-2.68) and 1.48 (95% CI, 1.12-1.96) fold, respectively. For stroke, meta-analyses yielded HRs of 1.59 (95% CI, 1.04-2.42) for overall arteries and 2.11 (95% CI, 1.45-3.08) for basilar artery diameters > 95th percentile. DISCUSSION Individuals with dilated brain arteries are at higher risk for dementia and stroke, across distinct populations. Our findings underline the potential value of T2-weighted brain MRI-based brain diameter assessment in estimating the risk of dementia and stroke.
Collapse
Affiliation(s)
- Jesus D. Melgarejo
- Department of EpidemiologyErasmus MC University Medical CenterRotterdamthe Netherlands
- Studies Coordinating CentreResearch Unit Hypertension and Cardiovascular EpidemiologyKU Leuven Department of Cardiovascular SciencesUniversity of LeuvenLeuvenBelgium
- Institute of NeuroscienceUniversity of Texas Rio Grande ValleyHarlingenTexasUSA
| | - Kursat Gurel
- Department of NeurologyVagelos College of Physicians and SurgeonsColumbia UniversityNew YorkNew YorkUSA
| | - Cassidy Rose Compton
- Department of NeurologyVagelos College of Physicians and SurgeonsColumbia UniversityNew YorkNew YorkUSA
| | - Minghua Liu
- Department of NeurologyVagelos College of Physicians and SurgeonsColumbia UniversityNew YorkNew YorkUSA
| | - Vanessa Guzman
- Department of NeurologyVagelos College of Physicians and SurgeonsColumbia UniversityNew YorkNew YorkUSA
| | - Stephanie Assuras
- Department of NeurologyVagelos College of Physicians and SurgeonsColumbia UniversityNew YorkNew YorkUSA
| | - Bonnie E. Levin
- Department of NeurologyMiller School of MedicineUniversity of MiamiMiamiFloridaUSA
| | - Mitchell S. V. Elkind
- Department of NeurologyVagelos College of Physicians and SurgeonsColumbia UniversityNew YorkNew YorkUSA
- Department of EpidemiologyMailman School of Public Health Columbia UniversityNew YorkNew YorkUSA
| | - M. Kamran Ikram
- Department of EpidemiologyErasmus MC University Medical CenterRotterdamthe Netherlands
- Department of NeurologyErasmus MC University Medical CenterRotterdamthe Netherlands
| | - Maryam Kavousi
- Department of EpidemiologyErasmus MC University Medical CenterRotterdamthe Netherlands
| | - M. Arfan Ikram
- Department of EpidemiologyErasmus MC University Medical CenterRotterdamthe Netherlands
| | - Clinton Wright
- National Institute of Neurological Disorders and StrokeNational Institutes of HealthBethesdaMarylandUSA
| | - Fabrice Crivello
- Institute of Neurodegenerative DiseasesUMR5293, Neurofunctional Imaging GroupBordeauxFrance
| | - Alexandre Laurent
- Institute of Neurodegenerative DiseasesUMR5293, Neurofunctional Imaging GroupBordeauxFrance
| | - Christophe Tzourio
- Bordeaux Population Health Research CenterInserm, University BordeauxBordeauxFrance
| | - Meike W. Vernooij
- Department of EpidemiologyErasmus MC University Medical CenterRotterdamthe Netherlands
- Department of Radiology and Nuclear MedicineErasmus MC University Medical CenterRotterdamthe Netherlands
| | - Tatjana Rundek
- Department of Public Health Sciences and Evelyn F. McKnight Brain InstituteMiller School of MedicineUniversity of MiamiMiamiFloridaUSA
| | - Zhen‐Yu Zhang
- Studies Coordinating CentreResearch Unit Hypertension and Cardiovascular EpidemiologyKU Leuven Department of Cardiovascular SciencesUniversity of LeuvenLeuvenBelgium
| | - Daniel Bos
- Department of EpidemiologyErasmus MC University Medical CenterRotterdamthe Netherlands
- Studies Coordinating CentreResearch Unit Hypertension and Cardiovascular EpidemiologyKU Leuven Department of Cardiovascular SciencesUniversity of LeuvenLeuvenBelgium
- Department of Radiology and Nuclear MedicineErasmus MC University Medical CenterRotterdamthe Netherlands
| | - Jose Gutierrez
- Department of NeurologyVagelos College of Physicians and SurgeonsColumbia UniversityNew YorkNew YorkUSA
| |
Collapse
|
5
|
Vom Hofe I, Stricker BH, Vernooij MW, Ikram MK, Ikram MA, Wolters FJ. Antidepressant use in relation to dementia risk, cognitive decline, and brain atrophy. Alzheimers Dement 2024. [PMID: 38561253 DOI: 10.1002/alz.13807] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 02/01/2024] [Accepted: 02/26/2024] [Indexed: 04/04/2024]
Abstract
INTRODUCTION We aimed to assess the effect of antidepressant use on dementia risk, cognitive decline, and brain atrophy. METHODS In this prospective cohort study, we included 5511 dementia-free participants (Mini-Mental State Examination [MMSE] > 25) of the Rotterdam study (57.5% women, mean age 70.6 years). Antidepressant use was extracted from pharmacy records from 1991 until baseline (2002-2008). Incident dementia was monitored from baseline until 2018, with repeated cognitive assessment and magnetic resonance imaging (MRI) every 4 years. RESULTS Compared to never use, any antidepressant use was not associated with dementia risk (hazard ratio [HR] 1.14, 95% confidence interval [CI] 0.92-1.41), or with accelerated cognitive decline or atrophy of white and gray matter. Compared to never use, dementia risk was somewhat higher with tricyclic antidepressants (HR 1.36, 95% CI 1.01-1.83) than with selective serotonin reuptake inhibitors (HR 1.12, 95% CI 0.81-1.54), but without dose-response relationships, accelerated cognitive decline, or atrophy in either group. DISCUSSION Antidepressant medication in adults without indication of cognitive impairment was not consistently associated with long-term adverse cognitive effects. HIGHLIGHTS Antidepressant medications are frequently prescribed, especially among older adults. In this study, antidepressant use was not associated with long-term dementia risk. Antidepressant use was not associated with cognitive decline or brain atrophy. Our results support safe prescription in an older, cognitively healthy population.
Collapse
Affiliation(s)
- Ilse Vom Hofe
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Bruno H Stricker
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Meike W Vernooij
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Radiology & Nuclear Medicine and Alzheimer Centre Erasmus MC, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Frank J Wolters
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Radiology & Nuclear Medicine and Alzheimer Centre Erasmus MC, Erasmus University Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
6
|
Berghout BP, Camarasa RY, Van Dam-Nolen DH, van der Lugt A, de Bruijne M, Koudstaal PJ, Ikram MK, Bos D. Burden of intracranial artery calcification in white patients with ischemic stroke. Eur Stroke J 2024:23969873241239787. [PMID: 38506452 DOI: 10.1177/23969873241239787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024] Open
Abstract
INTRODUCTION The diagnostic workup of stroke doesn't identify an underlying cause in two-fifths of ischemic strokes. Intracranial arteriosclerosis is acknowledged as a cause of stroke in Asian and Black populations, but is underappreciated as such in whites. We explored the burden of Intracranial Artery Calcification (IAC), a marker of intracranial arteriosclerosis, as a potential cause of stroke among white patients with recent ischemic stroke or TIA. PATIENTS AND METHODS Between December 2005 and October 2010, 943 patients (mean age 63.8 (SD ± 14.0) years, 47.9% female) were recruited, of whom 561 had ischemic stroke and 382 a TIA. CT-angiography was conducted according to stroke analysis protocols. The burden of IAC was quantified on these images, whereafter we assessed the presence of IAC per TOAST etiology underlying the stroke and assessed associations between IAC burden, symptom severity, and short-term functional outcome. RESULTS IAC was present in 62.4% of patients. Furthermore, IAC was seen in 84.8% of atherosclerotic strokes, and also in the majority of strokes with an undetermined etiology (58.5%). Additionally, patients with larger IAC burden presented with heavier symptoms (adjusted OR 1.56 (95% CI [1.06-2.29]), but there was no difference in short-term functional outcome (1.14 [0.80-1.61]). CONCLUSION IAC is seen in the majority of white ischemic stroke patients, aligning with findings from patient studies in other ethnicities. Furthermore, over half of patients with a stroke of undetermined etiology presented with IAC. Assessing IAC burden may help identify the cause in ischemic stroke of undetermined etiology, and could offer important prognostic information.
Collapse
Affiliation(s)
- Bernhard P Berghout
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Robin Yr Camarasa
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Dianne Hk Van Dam-Nolen
- Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Aad van der Lugt
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Marleen de Bruijne
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
| | - Peter J Koudstaal
- Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Daniel Bos
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
7
|
Bollemeijer JF, Zheng KJ, van der Meer AM, Ikram MK, Kavousi M, Brouwer WP, Luik AI, Chaker L, Xu Y, Gunn DA, Nijsten TEC, Pardo LM. Lifetime prevalence and associated factors of itch with skin conditions: Atopic dermatitis, psoriasis and dry skin in individuals aged over 50. Clin Exp Dermatol 2024:llae077. [PMID: 38501939 DOI: 10.1093/ced/llae077] [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] [Received: 12/15/2023] [Revised: 02/29/2024] [Accepted: 03/16/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND Itch, common in dermatological conditions, is often accompanied by psychological distress and reduced quality of life. However, research on the prevalence and associated factors of itch with skin conditions in general populations is limited. OBJECTIVES This cross-sectional study aimed to determine the lifetime prevalence of itch with skin conditions and identify its associated factors in middle-aged and elderly individuals. METHODS Participants from the Rotterdam Study, a population-based cohort, were interviewed to assess whether they had ever had an itchy skin condition, defining lifetime itch with skin conditions. Over 20 demographic, lifestyle, dermatological, and non-dermatological factors were collected. Multivariable logistic regression analysis explored associations between these factors and itch with skin conditions, reported as odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS 5,246 eligible participants (age range: 51-100, median age: 67, female: 56.0%) revealed a lifetime prevalence of 33.7% for itch with skin conditions. Female sex (OR (95% CI): 1.26 (1.11-1.43)), body mass index (1.02 (1.01-1.03)), self-reported and presence of atopic dermatitis (4.29 (3.74-4.92), and 1.97 (1.60-2.43)), self-reported and presence of psoriasis (2.31 (1.77-3.01), and 2.11 (1.55-2.87)), self-reported dry skin (1.95 (1.73-2.29)), self-reported asthma (1.40 (1.08-1.83)), renal impairment (1.45 (1.17-1.79)), and clinically relevant depressive and anxiety symptoms (1.85 (1.52-2.25), and 1.36 (1.11-1.66)) were significantly associated with it. CONCLUSIONS This study reveals a substantial one-third lifetime prevalence of itch with skin conditions in individuals aged over 50. Significant associations with diverse lifestyle, demographic, dermatological and, intriguingly, non-dermatological factors including renal impairment, imply additional contributors to itch induction or persistence in individuals with skin conditions.
Collapse
Affiliation(s)
- Juliette F Bollemeijer
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Kang J Zheng
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - M Kamran Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Willem P Brouwer
- Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Annemarie I Luik
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Trimbos Institute, The Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Layal Chaker
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Yanning Xu
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - David A Gunn
- Unilever Research and Development, Colworth Science Park, Sharnbrook, United Kingdom
| | - Tamar E C Nijsten
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Luba M Pardo
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
8
|
Lu Z, Nlapto N, Tilly MJ, Geurts S, Aribas E, Ikram MK, de Groot NMS, Kavousi M. Burden of cardiometabolic disorders and lifetime risk of new-onset atrial fibrillation among men and women: the Rotterdam Study. Eur J Prev Cardiol 2024:zwae045. [PMID: 38307013 DOI: 10.1093/eurjpc/zwae045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 01/14/2024] [Accepted: 01/21/2024] [Indexed: 02/04/2024]
Abstract
AIMS To examine the association between the burden of cardiometabolic disorders with new-onset AF and lifetime risk of AF incidence among men and women. METHODS 4,101 men and 5,421 women free of AF at baseline (1996 to 2008) from the population-based Rotterdam Study were included. Sex-specific Cox proportional hazards regression models were used to assess the association between the burden of cardiometabolic disorders and risk of new-onset AF. Remaining lifetime risk for AF was estimated at index ages of 55, 65, and 75 years up to age 108. RESULTS Mean age at baseline was 65.5 ± 9.4 years. Median follow-up time was 12.8 years. In the fully adjusted model, a stronger association was found between larger burden of cardiometabolic disorders and incident AF among women [hazard ratio (HR): 1.33 and 95% conference interval (CI): 1.22-1.46], compared to men [1.18 (1.08-1.29)] (P for sex-interaction <0.05). The lifetime risk for AF significantly increased with the number of cardiometabolic disorders among both sexes. At an index age of 55 years, the lifetime risks (95% CIs) for AF were 27.1% (20.8-33.4), 26.5% (22.8-30.5), 29.9% (26.7-33.2), 30.8% (25.7-35.8), and 33.3% (23.1-43.6) among men, for 0, 1, 2, 3, and ≥4 comorbid cardiometabolic disorders. Corresponding risks were15.8% (10.5-21.2), 23.0% (19.8-26.2), 29.7% (26.8-32.6), 26.2% (20.8-31.6), and 34.2% (17.3-51.1) among women. CONCLUSIONS We observed a significant combined impact of cardiometabolic disorders on AF risk, in particular among women. Participants with cardiometabolic multimorbidity had a significantly higher lifetime risk of AF, especially at a young index age.
Collapse
Affiliation(s)
- Zuolin Lu
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Noluthando Nlapto
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Martijn J Tilly
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Sven Geurts
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Elif Aribas
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Natasja M S de Groot
- Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| |
Collapse
|
9
|
Ikram MA, Kieboom BCT, Brouwer WP, Brusselle G, Chaker L, Ghanbari M, Goedegebure A, Ikram MK, Kavousi M, de Knegt RJ, Luik AI, van Meurs J, Pardo LM, Rivadeneira F, van Rooij FJA, Vernooij MW, Voortman T, Terzikhan N. The Rotterdam Study. Design update and major findings between 2020 and 2024. Eur J Epidemiol 2024; 39:183-206. [PMID: 38324224 DOI: 10.1007/s10654-023-01094-1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 12/14/2023] [Indexed: 02/08/2024]
Abstract
The Rotterdam Study is a population-based cohort study, started in 1990 in the district of Ommoord in the city of Rotterdam, the Netherlands, with the aim to describe the prevalence and incidence, unravel the etiology, and identify targets for prediction, prevention or intervention of multifactorial diseases in mid-life and elderly. The study currently includes 17,931 participants (overall response rate 65%), aged 40 years and over, who are examined in-person every 3 to 5 years in a dedicated research facility, and who are followed-up continuously through automated linkage with health care providers, both regionally and nationally. Research within the Rotterdam Study is carried out along two axes. First, research lines are oriented around diseases and clinical conditions, which are reflective of medical specializations. Second, cross-cutting research lines transverse these clinical demarcations allowing for inter- and multidisciplinary research. These research lines generally reflect subdomains within epidemiology. This paper describes recent methodological updates and main findings from each of these research lines. Also, future perspective for coming years highlighted.
Collapse
Affiliation(s)
- M Arfan Ikram
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands.
| | - Brenda C T Kieboom
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Willem Pieter Brouwer
- Department of Hepatology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Guy Brusselle
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands
- Department of Pulmonology, University Hospital Ghent, Ghent, Belgium
| | - Layal Chaker
- Department of Epidemiology, and Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Mohsen Ghanbari
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - André Goedegebure
- Department of Otorhinolaryngology and Head & Neck Surgery, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, and Department of Neurology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Rob J de Knegt
- Department of Hepatology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Annemarie I Luik
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Joyce van Meurs
- Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Luba M Pardo
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Fernando Rivadeneira
- Department of Medicine, and Department of Oral & Maxillofacial Surgery, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Frank J A van Rooij
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Meike W Vernooij
- Department of Epidemiology, and Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Natalie Terzikhan
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| |
Collapse
|
10
|
Mooldijk SS, Lu T, Waqas K, Chen J, Vernooij MW, Ikram MK, Zillikens MC, Ikram MA. Skin autofluorescence, reflecting accumulation of advanced glycation end products, and the risk of dementia in a population-based cohort. Sci Rep 2024; 14:1256. [PMID: 38218902 PMCID: PMC10787742 DOI: 10.1038/s41598-024-51703-6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 01/08/2024] [Indexed: 01/15/2024] Open
Abstract
Conditions such as hyperglycemia and oxidative stress lead to the formation of advanced glycation end products (AGEs), which are harmful compounds that have been implicated in dementia. Within the Rotterdam Study, we measured skin AGEs as skin autofluorescence, reflecting long-term accumulation of AGEs, and determined their association with the risk of dementia and with brain magnetic resonance imaging (MRI) measures. Skin autofluorescence was measured between 2013 and 2016 in 2922 participants without dementia. Of these, 1504 also underwent brain MRI, on which measures of brain atrophy and cerebral small vessel disease were assessed. All participants were followed for the incidence of dementia until 2020. Of 2922 participants (mean age 72.6 years, 57% women), 123 developed dementia. Higher skin autofluorescence (per standard deviation) was associated with an increased risk of dementia (hazard ratio 1.21 [95% confidence interval 1.01-1.46]) and Alzheimer's disease (1.19 [0.97-1.47]), independently of age and other studied potential confounders. Stronger effects were seen in apolipoprotein E (APOE) ε4 carriers (1.34 [0.98-1.82]) and in participants with diabetes (1.35 [0.94-1.94]). Participants with higher skin autofluorescence levels also had smaller total brain volumes and smaller hippocampus volumes on MRI, and they had more often lacunes. These results suggest that AGEs may be involved in dementia pathophysiology.
Collapse
Affiliation(s)
- Sanne S Mooldijk
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Tianqi Lu
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Komal Waqas
- Department of Internal Medicine, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jinluan Chen
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Meike W Vernooij
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
- Department of Neurology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - M Carola Zillikens
- Department of Internal Medicine, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
| |
Collapse
|
11
|
O’Keefe JH, Tintle NL, Harris WS, O’Keefe EL, Sala-Vila A, Attia J, Garg GM, Hure A, Bork CS, Schmidt EB, Venø SK, Chien KL, Chen YY(A, Egert S, Feldreich TR, Ärnlöv J, Lind L, Forouhi NG, Geleijnse JM, Pertiwi K, Imamura F, de Mello Laaksonen V, Uusitupa WM, Tuomilehto J, Laakso M, Lankinen MA, Laurin D, Carmichael PH, Lindsay J, Leander K, Laguzzi F, Swenson BR, Longstreth WT, Manson JE, Mora S, Cook NR, Marklund M, van Lent DM, Murphy R, Gudnason V, Ninomiya T, Hirakawa Y, Qian F, Sun Q, Hu F, Ardisson Korat AV, Risérus U, Lázaro I, Samieri C, Le Goff M, Helmer C, Steur M, Voortman T, Ikram MK, Tanaka T, Das JK, Ferrucci L, Bandinelli S, Tsai M, Guan W, Garg P, Verschuren WMM, Boer JMA, Biokstra A, Virtanen J, Wagner M, Westra J, Albuisson L, Yamagishi K, Siscovick DS, Lemaitre RN, Mozaffarian D. Omega-3 Blood Levels and Stroke Risk: A Pooled and Harmonized Analysis of 183 291 Participants From 29 Prospective Studies. Stroke 2024; 55:50-58. [PMID: 38134264 PMCID: PMC10840378 DOI: 10.1161/strokeaha.123.044281] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/30/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND The effect of marine omega-3 PUFAs on risk of stroke remains unclear. METHODS We investigated the associations between circulating and tissue omega-3 PUFA levels and incident stroke (total, ischemic, and hemorrhagic) in 29 international prospective cohorts. Each site conducted a de novo individual-level analysis using a prespecified analytical protocol with defined exposures, covariates, analytical methods, and outcomes; the harmonized data from the studies were then centrally pooled. Multivariable-adjusted HRs and 95% CIs across omega-3 PUFA quintiles were computed for each stroke outcome. RESULTS Among 183 291 study participants, there were 10 561 total strokes, 8220 ischemic strokes, and 1142 hemorrhagic strokes recorded over a median of 14.3 years follow-up. For eicosapentaenoic acid, comparing quintile 5 (Q5, highest) with quintile 1 (Q1, lowest), total stroke incidence was 17% lower (HR, 0.83 [CI, 0.76-0.91]; P<0.0001), and ischemic stroke was 18% lower (HR, 0.82 [CI, 0.74-0.91]; P<0.0001). For docosahexaenoic acid, comparing Q5 with Q1, there was a 12% lower incidence of total stroke (HR, 0.88 [CI, 0.81-0.96]; P=0.0001) and a 14% lower incidence of ischemic stroke (HR, 0.86 [CI, 0.78-0.95]; P=0.0001). Neither eicosapentaenoic acid nor docosahexaenoic acid was associated with a risk for hemorrhagic stroke. These associations were not modified by either baseline history of AF or prevalent CVD. CONCLUSIONS Higher omega-3 PUFA levels are associated with lower risks of total and ischemic stroke but have no association with hemorrhagic stroke.
Collapse
Affiliation(s)
- James H O’Keefe
- Saint Luke’s Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, MO
| | | | - William S Harris
- Fatty Acid Research Institute, Sioux Falls, SD
- University of South Dakota, Sioux Falls, SD
| | - Evan L O’Keefe
- Saint Luke’s Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, MO
| | - Aleix Sala-Vila
- Fatty Acid Research Institute, Sioux Falls, SD
- Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - John Attia
- The University of Newcastle, School of Biomedical Sciences and Pharmacy, Callaghan, Australia
| | - G Manohar Garg
- The University of Newcastle, School of Biomedical Sciences and Pharmacy, Callaghan, Australia
| | - Alexis Hure
- The University of Newcastle, School of Biomedical Sciences and Pharmacy, Callaghan, Australia
| | | | - Erik Berg Schmidt
- Aalborg University Hospital, Department of Clinical Medicine, Aalborg, Denmark
| | - Stine Krogh Venø
- Aalborg University Hospital, Department of Clinical Biochemistry, Aalborg, Denmark
| | - Kuo-Liong Chien
- National Taiwan University, Institute of Epidemiology and Preventive Medicine, Taipei Taiwan
| | - Yun-Yu (Amelia) Chen
- Taichung Veterans General Hospital, Department of Medical Research, Taichung, Taiwan
| | - Sarah Egert
- University of Bonn, Institute of Nutrition and Food Sciences and Nutritional Physiology, Bonn, Germany
| | | | - Johan Ärnlöv
- Karolinska Institutet, Division of Family Medicine and Primary Care, Department of Neurobiology Care Sciences & Society, Solna, Sweden
| | - Lars Lind
- Uppsala University, Department of Medical Sciences Cardiovascular Epidemiology, Uppsala, Sweden
| | - Nita G Forouhi
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Johanna M Geleijnse
- Wageningen University & Research, Division of Human Nutrition and Health, Wageningen, Netherlands
| | - Kamalita Pertiwi
- Wageningen University & Research, Division of Human Nutrition and Health, Wageningen, Netherlands
| | - Fumiaki Imamura
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Vanessa de Mello Laaksonen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - W Matti Uusitupa
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Jaakko Tuomilehto
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Markku Laakso
- University of Eastern Finland, School of Medicine, Department of Internal Medicine, Kuopio, Finland
| | - Maria Anneli Lankinen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Danielle Laurin
- CHU de Québec-Université Laval and VITAM Research Centers, Centre d’Excellence sur le Vieillissement de Québec, Québec, Canada
| | - Pierre-Hugues Carmichael
- CHU de Québec-Université Laval and VITAM Research Centers, Centre d’Excellence sur le Vieillissement de Québec, Québec, Canada
| | - Joan Lindsay
- University of Ottawa, School of Epidemiology and Public Health, Ottawa, Canada
| | - Karin Leander
- Karolinska Institutet, Institute of Environmental Medicine, Unit of Cardiovascular and Nutritional Epidemiology, Stockholm, Sweden
| | - Federica Laguzzi
- Karolinska Institutet, Institute of Environmental Medicine, Unit of Cardiovascular and Nutritional Epidemiology, Stockholm, Sweden
| | - Brenton R Swenson
- University of Washington, Cardiovascular Health Research Unit, Seattle, WA
| | - William T Longstreth
- University of Washington, Departments of Neurology and Epidemiology, Seattle, WA
| | - JoAnn E Manson
- Harvard Medical School, Department of Medicine, Brigham & Women’s Hospital, Boston, MA
| | - Samia Mora
- Harvard Medical School, Department of Medicine, Brigham & Women’s Hospital, Boston, MA
| | - Nancy R Cook
- Harvard Medical School, Department of Medicine, Brigham & Women’s Hospital, Boston, MA
| | - Matti Marklund
- The George Institute for Global Health, University of New South Wales, Newtown, NSW Australia; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland: and Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Debora Melo van Lent
- University of Texas, Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, San Antonio, TX
| | - Rachel Murphy
- University of British Columbia, Cancer Control Research, British Columbia Cancer, School of Population and Public Health, Vancouver, Canada
| | | | - Toshihara Ninomiya
- Kyushu University, Department of Epidemiology and Public Health and Center for Cohort Studies, Fukouka, Japan
| | - Yoichiro Hirakawa
- Kyushu University, Department of Epidemiology and Public Health and Center for Cohort Studies, Fukouka, Japan
| | - Frank Qian
- Harvard Medical School, T.H. Chan School of Public Health and Beth Deaconess Medical Center, Boston, MA
| | - Qi Sun
- Harvard Medical School, T.H. Chan School of Public Health and Channing Division of Network Medicine Brigham and Women’s Hospital, Boston, MA
| | - Frank Hu
- Harvard Medical School, T.H. Chan School of Public Health and Channing Division of Network Medicine Brigham and Women’s Hospital, Boston, MA
| | | | - Ulf Risérus
- Uppsala University, Department of Public Health and Caring Sciences Clinical Nutrition and Metabolism Unit, Uppsala, Sweden
| | - Iolanda Lázaro
- Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Cecilia Samieri
- University of Bordeaux, Bordeaux Population Health Research Centre, Bordeaux, France
| | - Mélanie Le Goff
- University of Bordeaux, Bordeaux Population Health Research Centre, Bordeaux, France
| | - Catherine Helmer
- University of Bordeaux, Bordeaux Population Health Research Centre, Bordeaux, France
| | - Marinka Steur
- University Medical Center Rotterdam, Department of Epidemiology, Rotterdam, The Netherlands
| | - Trudy Voortman
- University Medical Center Rotterdam, Department of Epidemiology, Rotterdam, The Netherlands
| | - M Kamran Ikram
- University Medical Center Rotterdam, Department of Epidemiology, Rotterdam, The Netherlands
| | - Toshiko Tanaka
- National Institute of Health, National Institute on Aging, Longitudinal Studies Section, Baltimore, MD
| | | | - Luigi Ferrucci
- National Institute of Health, National Institute on Aging, Longitudinal Studies Section, Baltimore, MD
| | | | - Michael Tsai
- University of Minnesota, Department of Laboratory Medicine and Pathology, Minneapolis, MN
| | - Weihua Guan
- University of Minnesota, Division of Biostatistics, Minneapolis, MN
| | - Parveen Garg
- University of Southern California, Department of Medicine, Cardiology, Los Angeles, CA
| | - WM Monique Verschuren
- National Institute for Public Health and the Environment Bilthoven, The Netherlands, Julius Center for Health Sciences and Primary Care and Centre for Nutrition, Prevention and Health Services, Utrecht, The Netherlands
| | - Jolanda MA Boer
- National Institute for Public Health and the Environment Bilthoven, The Netherlands
| | - Anneke Biokstra
- National Institute for Public Health and the Environment Bilthoven, The Netherlands
| | - Jyrki Virtanen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Michael Wagner
- University Hospital, Depts of Neurodegenerative Diseases and Geriatric Psychiatry and German Center for Neurodegenerative Diseases, Bonn, Germany
| | | | | | - Kazumasa Yamagishi
- University of Tsukubu, Department of Public Health Medicine, Tsukuba, Japan
| | - David S Siscovick
- New York Academy of Medicine, Department of Epidemiology, New York, New York
| | | | | |
Collapse
|
12
|
Acarsoy C, Ruiter R, Bos D, Ikram MK. No association between blood-based markers of immune system and migraine status: a population-based cohort study. BMC Neurol 2023; 23:445. [PMID: 38110925 PMCID: PMC10726636 DOI: 10.1186/s12883-023-03496-w] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 12/08/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND Although some evidence implicates the immune system in migraine attacks, its role during attack-free periods remains largely unexplored. Therefore, we assessed the association between the immune system and migraine status. METHODS From the population-based Rotterdam Study, we included 6593 participants who underwent blood sampling and migraine assessments. In the blood samples, we measured white blood-cell-based immune markers. As a marker for the innate immune system, granulocyte and platelet counts were determined, whereas lymphocyte counts were used as a marker for the adaptive immune system. Migraine was assessed using a validated questionnaire based on ICHD-2 criteria. We investigated associations between blood-cell counts and migraine using logistic regression models adjusting for age, sex and other variables. RESULTS Mean age of participants was 65.6 ± 11.2 years and 56.7% were female. The lifetime prevalence of migraine was 15.1% (995/6593). We found no statistically significant associations between granulocyte (odds ratio [OR] per standard deviation increase 1.01 95% Confidence Interval [CI]: 0.93-1.09), platelet (OR 1.01 CI: 0.94-1.09) or lymphocyte counts (OR 1.01 CI: 0.93-1.08) and migraine status. CONCLUSIONS Our results do not support an association between white blood-cell-based immunity markers and migraine status.
Collapse
Affiliation(s)
- Cevdet Acarsoy
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Rikje Ruiter
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Internal Medicine, Maasstad Hospital, Rotterdam, the Netherlands
| | - Daniel Bos
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
- Department of Neurology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
| |
Collapse
|
13
|
Magnussen C, Ojeda FM, Leong DP, Alegre-Diaz J, Amouyel P, Aviles-Santa L, De Bacquer D, Ballantyne CM, Bernabe-Ortiz A, Bobak M, Brenner H, Carrillo-Larco RM, de Lemos J, Dobson A, Dörr M, Donfrancesco C, Drygas W, Dullaart RP, Engström G, Ferrario MM, Ferrieres J, de Gaetano G, Goldbourt U, Gonzalez C, Grassi G, Hodge AM, Hveem K, Iacoviello L, Ikram MK, Irazola V, Jobe M, Jousilahti P, Kaleebu P, Kavousi M, Kee F, Khalili D, Koenig W, Kontsevaya A, Kuulasmaa K, Lackner KJ, Leistner DM, Lind L, Linneberg A, Lorenz T, Lyngbakken MN, Malekzadeh R, Malyutina S, Mathiesen EB, Melander O, Metspalu A, Miranda JJ, Moitry M, Mugisha J, Nalini M, Nambi V, Ninomiya T, Oppermann K, d’Orsi E, Pajak A, Palmieri L, Panagiotakos D, Perianayagam A, Peters A, Poustchi H, Prentice AM, Prescott E, Risérus U, Salomaa V, Sans S, Sakata S, Schöttker B, Schutte AE, Sepanlou SG, Sharma SK, Shaw JE, Simons LA, Söderberg S, Tamosiunas A, Thorand B, Tunstall-Pedoe H, Twerenbold R, Vanuzzo D, Veronesi G, Waibel J, Wannamethee SG, Watanabe M, Wild P, Yao Y, Zeng Y, Ziegler A, Blankenberg S. Global Effect of Modifiable Risk Factors on Cardiovascular Disease and Mortality. N Engl J Med 2023; 389:1273-1285. [PMID: 37632466 PMCID: PMC10589462 DOI: 10.1056/nejmoa2206916] [Citation(s) in RCA: 39] [Impact Index Per Article: 39.0] [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] [Indexed: 08/28/2023]
Abstract
BACKGROUND Five modifiable risk factors are associated with cardiovascular disease and death from any cause. Studies using individual-level data to evaluate the regional and sex-specific prevalence of the risk factors and their effect on these outcomes are lacking. METHODS We pooled and harmonized individual-level data from 112 cohort studies conducted in 34 countries and 8 geographic regions participating in the Global Cardiovascular Risk Consortium. We examined associations between the risk factors (body-mass index, systolic blood pressure, non-high-density lipoprotein cholesterol, current smoking, and diabetes) and incident cardiovascular disease and death from any cause using Cox regression analyses, stratified according to geographic region, age, and sex. Population-attributable fractions were estimated for the 10-year incidence of cardiovascular disease and 10-year all-cause mortality. RESULTS Among 1,518,028 participants (54.1% of whom were women) with a median age of 54.4 years, regional variations in the prevalence of the five modifiable risk factors were noted. Incident cardiovascular disease occurred in 80,596 participants during a median follow-up of 7.3 years (maximum, 47.3), and 177,369 participants died during a median follow-up of 8.7 years (maximum, 47.6). For all five risk factors combined, the aggregate global population-attributable fraction of the 10-year incidence of cardiovascular disease was 57.2% (95% confidence interval [CI], 52.4 to 62.1) among women and 52.6% (95% CI, 49.0 to 56.1) among men, and the corresponding values for 10-year all-cause mortality were 22.2% (95% CI, 16.8 to 27.5) and 19.1% (95% CI, 14.6 to 23.6). CONCLUSIONS Harmonized individual-level data from a global cohort showed that 57.2% and 52.6% of cases of incident cardiovascular disease among women and men, respectively, and 22.2% and 19.1% of deaths from any cause among women and men, respectively, may be attributable to five modifiable risk factors. (Funded by the German Center for Cardiovascular Research (DZHK); ClinicalTrials.gov number, NCT05466825.).
Collapse
Affiliation(s)
- Christina Magnussen
- University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Centre for Cardiovascular Disease (DZHK), Partner site Hamburg/Kiel/Luebeck, Hamburg, Germany
- Center for Population Health Innovation (POINT), University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Francisco M. Ojeda
- University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Center for Population Health Innovation (POINT), University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Darryl P. Leong
- Department of Medicine (Cardiology), McMaster University, Hamilton, Canada
| | - Jesus Alegre-Diaz
- Experimental Medicine Research Unit from the School of Medicine, National Autonomous University of Mexico (UNAM), Mexico City
| | - Philippe Amouyel
- Univ. Lille, Inserm, Centre Hosp. Univ Lille, Institut Pasteur de Lille, UMR1167 - RID-AGE LabEx DISTALZ - Risk factors and molecular determinants of aging-related diseases, F-59000 Lille, France
| | - Larissa Aviles-Santa
- Division of Clinical and Health Services Research, National Institute on Minority Health and Health Disparities at the National Institutes of Health, Bethesda, MD, USA
| | - Dirk De Bacquer
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | | | - Antonio Bernabe-Ortiz
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Martin Bobak
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany
| | - Rodrigo M. Carrillo-Larco
- Emory Global Diabetes Research Center and Hubert Department of Global Health Rollins School of Public Health, Emory University, Atlanta, USA
| | - James de Lemos
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, USA
| | - Annette Dobson
- School of Public Health, University of Queensland, Brisbane, QLD, Australia
| | - Marcus Dörr
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Disease (DZHK), Partner Site Greifswald, Greifswald, Germany Cardiovascular Disease (DZD), Site Greifswald, Greifswald, Germany
| | - Chiara Donfrancesco
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità-ISS, Rome, Italy
| | - Wojciech Drygas
- Department of Epidemiology, Cardiovascular Disease Prevention and Health Promotion, National Institute of Cardiology, Warsaw, Poland
- Lazarski University, Warsaw, Poland
| | - Robin P. Dullaart
- Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Gunnar Engström
- Lund University, Department of Clinical Sciences Malmö, Malmö, Sweden
| | - Marco M. Ferrario
- Research Center in Epidemiology and Preventive Medicine, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Jean Ferrieres
- Department of Cardiology, INSERM UMR 1295, Toulouse Rangueil University Hospital, 31059 Toulouse, France
| | - Giovanni de Gaetano
- Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli (IS), Italy
| | - Uri Goldbourt
- Tel Aviv University School of Public Health department of Epidemiology Tel Aviv University School of Public Health department of Epidemiology
| | - Clicerio Gonzalez
- Centro de Estudios en Diabetes AC. Centro de Investigacion en Salud Poblacional. Instituto Nacional de Salud Publica
| | - Guido Grassi
- Clinica Medica, University of Milano-Bicocca, Milan, Italy
| | - Allison M. Hodge
- Cancer Epidemiology Division, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria 3004, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria 3010, Australia
| | - Kristian Hveem
- HUNT Research Center, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Levanger, Norway
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Licia Iacoviello
- Research Center in Epidemiology and Preventive Medicine, Department of Medicine and Surgery, University of Insubria, Varese, Italy
- Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli (IS), Italy
| | - M. Kamran Ikram
- Departments of Neurology & Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Vilma Irazola
- Department of Chronic Diseases, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Modou Jobe
- MRC Unit The Gambia @ London School of Hygiene & Tropical Medicine, Banjul, The Gambia
| | - Pekka Jousilahti
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | | | - Maryam Kavousi
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Frank Kee
- Centre for Public Health, Queens University Belfast
| | - Davood Khalili
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Wolfgang Koenig
- German Centre for Cardiovascular Research (DZHK), partner site Munich Heart Alliance, Munich, Germany
- German Heart Centre, Technical University of Munich, Munich, Germany
- Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany
| | - Anna Kontsevaya
- National research center for therapy and preventive medicine of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Kari Kuulasmaa
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Karl J. Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- DZHK (German Center for Cardiovascular Research), partner site RhineMain, Mainz, Germany
| | - David M. Leistner
- University Heart & Vascular Center Frankfurt, Frankfurt/Main, Germany and German Centre for Cardiovascular Disease (DZHK), Partner site Rhein/Main, Frankfurt, Germany
| | - Lars Lind
- Department of Medical Sciences, Uppsala, Sweden
| | - Allan Linneberg
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Center for Clinical Research and Prevention, Bispebjerg/Frederiksberg Hospital, Copenhagen, Denmark
| | - Thiess Lorenz
- University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Centre for Cardiovascular Disease (DZHK), Partner site Hamburg/Kiel/Luebeck, Hamburg, Germany
- Center for Population Health Innovation (POINT), University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Magnus Nakrem Lyngbakken
- Department of Cardiology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway
- K.G. Jebsen Center for Cardiac Biomarkers, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Reza Malekzadeh
- Liver and Pancreaticobiliary Disease Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Disease Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sofia Malyutina
- Research Institute of Internal and Preventive Medicine, Branch of ‘Federal Research Center Institute of Cytology and Genetics’ (IC&G), Siberian Branch of RAS, Novosibirsk, Russia
| | - Ellisiv B. Mathiesen
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Olle Melander
- Lund University, Department of Clinical Sciences Malmö, Malmö, Sweden
| | - Andres Metspalu
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - J. Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Marie Moitry
- Department of Public health, Strasbourg University Hospital, University of Strasbourg, Strasbourg, France
| | | | - Mahdi Nalini
- Digestive Disease Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, Maryland, USA
| | - Vijay Nambi
- Michael E DeBakey Veterans Affairs hospital and Baylor College of Medicine, Houston, USA
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Karen Oppermann
- Medicine School, University of Passo Fundo, Passo Fundo, Rio Grande do Sul, Brazil
| | - Eleonora d’Orsi
- Department of Public Health, Postgraduate Program in Public Health, Federal University of Santa Catarina, Florianopolis, Brazil
| | - Andrzej Pajak
- Department of Epidemiology and Population Studies, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Poland
| | - Luigi Palmieri
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità-ISS, Rome, Italy
| | | | - Arokiasamy Perianayagam
- National Council of Applied Economic Research (NCAER), Delhi, India
- International Institute for Population Sciences, Mumbai, India
| | - Annette Peters
- German Centre for Cardiovascular Research (DZHK), partner site Munich Heart Alliance, Munich, Germany
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
- Chair of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Medical Faculty, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Hossein Poustchi
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Disease Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Andrew M. Prentice
- MRC Unit The Gambia @ London School of Hygiene & Tropical Medicine, Banjul, The Gambia
| | - Eva Prescott
- Department of Cardiology, Bispebjerg Hospital, University of Copenhagen, Denmark
| | - Ulf Risérus
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Veikko Salomaa
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Susana Sans
- Catalan Department of Health, Barcelona, Spain
| | - Satoko Sakata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany
| | - Aletta E. Schutte
- The School of Population Health, University of New South Wales; The George Institute for Global Health, Sydney, Australia
- Hypertension in Africa Research Team (HART), SAMRC Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Sadaf G. Sepanlou
- Digestive Disease Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sanjib Kumar Sharma
- Department of Internal Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | | | | | - Stefan Söderberg
- Department of Public Health and Clinical Medicine, University of Umea, Umea, Sweden
| | - Abdonas Tamosiunas
- Laboratory of Population Studies, Institute of Cardiology, Kaunas, Lithuania; Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Barbara Thorand
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research (DZD), Partner Munich-Neuherberg, Neuherberg, Germany
| | - Hugh Tunstall-Pedoe
- Cardiovascular Epidemiology Unit, Institute of Cardiovascular Research, University of Dundee, Dundee, Scotland, UK
| | - Raphael Twerenbold
- University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Centre for Cardiovascular Disease (DZHK), Partner site Hamburg/Kiel/Luebeck, Hamburg, Germany
- Center for Population Health Innovation (POINT), University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Giovanni Veronesi
- Research Center in Epidemiology and Preventive Medicine, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Julia Waibel
- University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Centre for Cardiovascular Disease (DZHK), Partner site Hamburg/Kiel/Luebeck, Hamburg, Germany
- Center for Population Health Innovation (POINT), University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S. Goya Wannamethee
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - Masafumi Watanabe
- Global Center of Excellence Program Study Group, Yamagata University School of Medicine, Yamagata, Japan
| | - Philipp Wild
- University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Yao Yao
- China Center for Health Development Studies, Peking University, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China
| | - Yi Zeng
- China Center for Health Development Studies, Peking University, Beijing, China
- Center for the Study of Aging and Human Development and Geriatrics Division, Medical School of Duke University, Durham, NC, US
| | - Andreas Ziegler
- University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Center for Population Health Innovation (POINT), University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Cardio-CARE, Davos, Switzerland
- School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Pietermaritzburg, South Africa
- Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Stefan Blankenberg
- University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Centre for Cardiovascular Disease (DZHK), Partner site Hamburg/Kiel/Luebeck, Hamburg, Germany
- Center for Population Health Innovation (POINT), University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Cardio-CARE, Davos, Switzerland
| |
Collapse
|
14
|
Xu Y, Derakhshan A, Hysaj O, Wildisen L, Ittermann T, Pingitore A, Abolhassani N, Medici M, Kiemeney LALM, Riksen NP, Dullaart RPF, Trompet S, Dörr M, Brown SJ, Schmidt B, Führer-Sakel D, Vanderpump MPJ, Muendlein A, Drexel H, Fink HA, Ikram MK, Kavousi M, Rhee CM, Bensenor IM, Azizi F, Hankey GJ, Iacoviello M, Imaizumi M, Ceresini G, Ferrucci L, Sgarbi JA, Bauer DC, Wareham N, Boelaert K, Bakker SJL, Jukema JW, Vaes B, Iervasi G, Yeap BB, Westendorp RGJ, Korevaar TIM, Völzke H, Razvi S, Gussekloo J, Walsh JP, Cappola AR, Rodondi N, Peeters RP, Chaker L. The optimal healthy ranges of thyroid function defined by the risk of cardiovascular disease and mortality: systematic review and individual participant data meta-analysis. Lancet Diabetes Endocrinol 2023; 11:743-754. [PMID: 37696273 PMCID: PMC10866328 DOI: 10.1016/s2213-8587(23)00227-9] [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: 05/08/2023] [Revised: 07/05/2023] [Accepted: 07/25/2023] [Indexed: 09/13/2023]
Abstract
BACKGROUND Reference intervals of thyroid-stimulating hormone (TSH) and free thyroxine (FT4) are statistically defined by the 2·5-97·5th percentiles, without accounting for potential risk of clinical outcomes. We aimed to define the optimal healthy ranges of TSH and FT4 based on the risk of cardiovascular disease and mortality. METHODS This systematic review and individual participant data (IPD) meta-analysis identified eligible prospective cohorts through the Thyroid Studies Collaboration, supplemented with a systematic search via Embase, MEDLINE (Ovid), Web of science, the Cochrane Central Register of Controlled Trials, and Google Scholar from Jan 1, 2011, to Feb 12, 2017 with an updated search to Oct 13, 2022 (cohorts found in the second search were not included in the IPD). We included cohorts that collected TSH or FT4, and cardiovascular outcomes or mortality for adults (aged ≥18 years). We excluded cohorts that included solely pregnant women, individuals with overt thyroid diseases, and individuals with cardiovascular disease. We contacted the study investigators of eligible cohorts to provide IPD on demographics, TSH, FT4, thyroid peroxidase antibodies, history of cardiovascular disease and risk factors, medication use, cardiovascular disease events, cardiovascular disease mortality, and all-cause mortality. The primary outcome was a composite outcome including cardiovascular disease events (coronary heart disease, stroke, and heart failure) and all-cause mortality. Secondary outcomes were the separate assessment of cardiovascular disease events, all-cause mortality, and cardiovascular disease mortality. We performed one-step (cohort-stratified Cox models) and two-step (random-effects models) meta-analyses adjusting for age, sex, smoking, systolic blood pressure, diabetes, and total cholesterol. The study was registered with PROSPERO, CRD42017057576. FINDINGS We identified 3935 studies, of which 53 cohorts fulfilled the inclusion criteria and 26 cohorts agreed to participate. We included IPD on 134 346 participants with a median age of 59 years (range 18-106) at baseline. There was a J-shaped association of FT4 with the composite outcome and secondary outcomes, with the 20th (median 13·5 pmol/L [IQR 11·2-13·9]) to 40th percentiles (median 14·8 pmol/L [12·3-15·0]) conveying the lowest risk. Compared with the 20-40th percentiles, the age-adjusted and sex-adjusted hazard ratio (HR) for FT4 in the 80-100th percentiles was 1·20 (95% CI 1·11-1·31) for the composite outcome, 1·34 (1·20-1·49) for all-cause mortality, 1·57 (1·31-1·89) for cardiovascular disease mortality, and 1·22 (1·11-1·33) for cardiovascular disease events. In individuals aged 70 years and older, the 10-year absolute risk of composite outcome increased over 5% for women with FT4 greater than the 85th percentile (median 17·6 pmol/L [IQR 15·0-18·3]), and men with FT4 greater than the 75th percentile (16·7 pmol/L [14·0-17·4]). Non-linear associations were identified for TSH, with the 60th (median 1·90 mIU/L [IQR 1·68-2·25]) to 80th percentiles (2·90 mIU/L [2·41-3·32]) associated with the lowest risk of cardiovascular disease and mortality. Compared with the 60-80th percentiles, the age-adjusted and sex-adjusted HR of TSH in the 0-20th percentiles was 1·07 (95% CI 1·02-1·12) for the composite outcome, 1·09 (1·05-1·14) for all-cause mortality, and 1·07 (0·99-1·16) for cardiovascular disease mortality. INTERPRETATION There was a J-shaped association of FT4 with cardiovascular disease and mortality. Low concentrations of TSH were associated with a higher risk of all-cause mortality and cardiovascular disease mortality. The 20-40th percentiles of FT4 and the 60-80th percentiles of TSH could represent the optimal healthy ranges of thyroid function based on the risk of cardiovascular disease and mortality, with more than 5% increase of 10-year composite risk identified for FT4 greater than the 85th percentile in women and men older than 70 years. We propose a feasible approach to establish the optimal healthy ranges of thyroid function, allowing for better identification of individuals with a higher risk of thyroid-related outcomes. FUNDING None.
Collapse
Affiliation(s)
- Yanning Xu
- Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, Netherlands; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Arash Derakhshan
- Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Ola Hysaj
- Institute of Primary Health Care, University of Bern, Bern, Switzerland
| | - Lea Wildisen
- Institute of Primary Health Care, University of Bern, Bern, Switzerland
| | - Till Ittermann
- Institute for Community Medicine, Clinical-Epidemiological Research, University Medicine Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research, Partner site Greifswald, Greifswald, Germany
| | | | | | - Marco Medici
- Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, Netherlands; Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | - Lambertus A L M Kiemeney
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department for Health Evidence, Nijmegen, Netherlands
| | - Niels P Riksen
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | - Robin P F Dullaart
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Stella Trompet
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, the Netherlands
| | - Marcus Dörr
- German Centre for Cardiovascular Research, Partner site Greifswald, Greifswald, Germany; Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Suzanne J Brown
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Börge Schmidt
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Dagmar Führer-Sakel
- Department of Endocrinology, Diabetes and Metabolism, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | | | - Axel Muendlein
- Vorarlberg Institute for Vascular Investigation and Treatment, Feldkirch, Austria
| | - Heinz Drexel
- Vorarlberg Institute for Vascular Investigation and Treatment, Feldkirch, Austria; Private University of the Principality of Liechtenstein, Triesen, Liechtenstein; Drexel University College of Medicine, Philadelphia, PA, USA
| | - Howard A Fink
- Geriatric Research Education and Clinical Center, VA Healthcare System, Minneapolis, MN, USA; Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands; Department of Neurology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Connie M Rhee
- Harold Simmons Center for Chronic Disease Research and Epidemiology, University of California Irvine School of Medicine, Orange, CA, USA
| | - Isabela M Bensenor
- Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Graeme J Hankey
- The University of Western Australia, Perth, WA, Australia; Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
| | - Massimo Iacoviello
- Cardiology Unit, Cardiothoracic Department, University Polyclinic Hospital of Bari, Bari, Italy
| | - Misa Imaizumi
- Department of Clinical Studies, Radiation Effects Research Foundation, Nagasaki, Japan
| | - Graziano Ceresini
- Department of Medicine and Surgery, Unit of Internal Medicine and Onco-Endocrinology, University Hospital of Parma, Parma, Italy
| | - Luigi Ferrucci
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, Baltimore, MD, USA
| | - José A Sgarbi
- Division of Endocrinology and Metabolism, Faculdade de Medicina de Marília, Marília, Brazil
| | - Douglas C Bauer
- Departments of Medicine, Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Nick Wareham
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Kristien Boelaert
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Stephan J L Bakker
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - J Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, the Netherlands; Netherlands Heart Institute, Utrecht, Netherlands
| | - Bert Vaes
- Department of Public Health and Primary Care, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Giorgio Iervasi
- National Research Council Institute of Clinical Physiology, Pisa, Italy
| | - Bu B Yeap
- The University of Western Australia, Perth, WA, Australia; Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, WA, Australia
| | - Rudi G J Westendorp
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Tim I M Korevaar
- Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Henry Völzke
- Institute for Community Medicine, Clinical-Epidemiological Research, University Medicine Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research, Partner site Greifswald, Greifswald, Germany
| | - Salman Razvi
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Jacobijn Gussekloo
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, the Netherlands; Department of Public Health and Primary Care, Leiden University Medical Center, the Netherlands
| | - John P Walsh
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA, Australia; The University of Western Australia, Perth, WA, Australia
| | - Anne R Cappola
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Nicolas Rodondi
- Institute of Primary Health Care, University of Bern, Bern, Switzerland; Department of General Internal Medicine, Inselspital, University of Bern, Switzerland
| | - Robin P Peeters
- Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Layal Chaker
- Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, Netherlands; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands.
| |
Collapse
|
15
|
de Crom TOE, Steur M, Ikram MK, Ikram MA, Voortman T. Plant-based dietary patterns and the risk of dementia: a population-based study. Age Ageing 2023; 52:afad178. [PMID: 37740899 PMCID: PMC10517714 DOI: 10.1093/ageing/afad178] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Indexed: 09/25/2023] Open
Abstract
BACKGROUND Plant-based dietary patterns are increasingly popular in western countries and are supported by many governments and health organisations for their potential beneficial role in the prevention of chronic diseases. Yet, the potential role of plant-based dietary patterns in the development of dementia remains unclear. OBJECTIVE To evaluate the association between plant-based dietary patterns and the risk of dementia. METHODS Dietary intake was measured at baseline in 9,543 dementia-free participants (mean age 64 years, birth years 1897-1960, 58% women) of the prospective population-based Rotterdam Study, using food frequency questionnaires. Based on these questionnaires, we calculated an overall plant-based dietary index (PDI), healthy PDI (hPDI) and unhealthy PDI (uPDI), with higher scores reflecting higher consumption of (any, healthy and unhealthy, respectively) plant-based foods and lower consumption of animal-based foods. We analysed the association of the PDIs with incident dementia using Cox proportional hazard models. RESULTS During a mean follow-up of 14.5 years, 1,472 participants developed dementia. Overall, the PDIs were not associated with the risk of dementia (hazard ratio [95% confidence interval] per 10-point increase: 0.99 [0.91-1.08] for PDI, 0.93 [0.86-1.01] for hPDI, 1.02 [0.94-1.10] for uPDI). However, among men and APOE ε4 carriers, a higher hPDI was linearly associated with a lower risk of dementia (0.86 [0.75-0.99] and 0.83 [0.73-0.95], respectively), while this association was U-shaped among APOE ε4 non-carriers (P value for non-linearity = 0.01). CONCLUSIONS We found no strong evidence for an overall association between plant-based eating and the risk of dementia. Our findings in stratified analyses warranted further investigation.
Collapse
Affiliation(s)
- Tosca O E de Crom
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Marinka Steur
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Neurology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
16
|
de Crom TOE, Blekkenhorst L, Vernooij MW, Ikram MK, Voortman T, Ikram MA. Dietary nitrate intake in relation to the risk of dementia and imaging markers of vascular brain health: a population-based study. Am J Clin Nutr 2023; 118:352-359. [PMID: 37536866 DOI: 10.1016/j.ajcnut.2023.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/16/2023] [Accepted: 05/22/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Nitric oxide is a free radical that can be produced from dietary nitrate and positively affects cardiovascular health. With cardiovascular health playing an important role in the etiology of dementia, we hypothesized a link between dietary nitrate intake and the risk of dementia. OBJECTIVES This study aimed to find the association of total, vegetable, and nonvegetable dietary nitrate intake with the risk of dementia and imaging markers of vascular brain health, such as total brain volume, global cerebral perfusion, white matter hyperintensity volume, microbleeds, and lacunar infarcts. METHODS Between 1990 and 2009, dietary intake was assessed using food-frequency questionnaires in 9543 dementia-free participants (mean age, 64 y; 58% female) from the prospective population-based Rotterdam Study. Participants were followed up for incidence dementia until January 2020. We used Cox models to determine the association between dietary nitrate intake and incident dementia. Using linear mixed models and logistic regression models, we assessed the association of dietary nitrate intake with changes in imaging markers across 3 consecutive examination rounds (mean interval between images 4.6 y). RESULTS Participants median dietary nitrate consumption was 85 mg/d (interquartile range, 55 mg/d), derived on average for 81% from vegetable sources. During a mean follow-up of 14.5 y, 1472 participants developed dementia. A higher intake of total and vegetable dietary nitrate was associated with a lower risk of dementia per 50-mg/d increase [hazard ratio (HR): 0.92; 95% confidence interval (CI): 0.87, 0.98; and HR: 0.92; 95% CI: 0.86, 0.97, respectively] but not with changes in neuroimaging markers. No association between nonvegetable dietary nitrate intake and the risk of dementia (HR: 1.15; 95% CI: 0.64, 2.07) or changes in neuroimaging markers were observed. CONCLUSIONS A higher dietary nitrate intake from vegetable sources was associated with a lower risk of dementia. We found no evidence that this association was driven by vascular brain health.
Collapse
Affiliation(s)
- Tosca O E de Crom
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Lauren Blekkenhorst
- Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Royal Perth Hospital Research Foundation, Perth, Western Australia, Australia
| | - Meike W Vernooij
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands; Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands; Department of Neurology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands.
| |
Collapse
|
17
|
Splinter MJ, Ikram MK, Helsper CW, Bindels PJE, de Schepper EIT, Licher S. Patient perspectives on telemedicine during the COVID-19 pandemic: a mixed-methods community-based study. BMC Health Serv Res 2023; 23:803. [PMID: 37501087 PMCID: PMC10375760 DOI: 10.1186/s12913-023-09794-w] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 07/07/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Detailed community-based perspectives on patient experiences with telemedicine are currently lacking, yet essential to assess clinical applicability of telemedicine during and beyond pandemics, alike COVID-19. The aim of this study was to expose patient perspectives on virtual compared to in-person consultations, including determinants of these preferences. METHODS We invited 5864 participants of the population-based Rotterdam Study to fill in a validated questionnaire using both close-ended and free-text questions. The questionnaire was sent on 30 July 2020, following a period of lockdowns and closures of non-essential workplaces. It assessed preferences for physician contact, healthcare utilisation, socioeconomic factors, and overall health. Those who experienced at least one virtual consultation (telephone or video call) between March 2020 and the beginning of July 2020 were asked whether those consultations were more, equally or less pleasant than in-person consultations, and to detail their experiences through free-text comments. These narrative data were examined using thematic analysis. RESULTS 4514 participants completed the questionnaire (response rate 77.0%, 58.7% women, mean age 70.8 ± 10.5 years). 1103 participants (24.4%) reported having had experience with virtual consultations. Half of these participants considered virtual consultations less pleasant than in-person consultations (N = 556; 50.4%), while 11.5% found it more pleasant. In total, we coded free-text comments of 752 participants. Prominent themes behind patient preferences for virtual or in-person consultations were lack of nonverbal communication, lack of physical examination, consultation scheduling, personal circumstances, and the presence of somatic and/or language barriers. CONCLUSIONS Based on the experiences of a large elderly patient population, we showed that preference for virtual or in-person consultations is dependent on personal and situational variety, and their interplay. Healthcare providers should consider patients' complex care needs and evaluate the potential added value of nonverbal communication and physical examination before scheduling a virtual consultation.
Collapse
Affiliation(s)
- Marije J Splinter
- Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, PO Box 2040, Rotterdam, 3000 CA, The Netherlands.
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, PO Box 2040, Rotterdam, 3000 CA, The Netherlands
- Department of Neurology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Charles W Helsper
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Patrick J E Bindels
- Department of General Practice, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Evelien I T de Schepper
- Department of General Practice, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Silvan Licher
- Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, PO Box 2040, Rotterdam, 3000 CA, The Netherlands
| |
Collapse
|
18
|
Berghout BP, Bos D, Koudstaal PJ, Ikram MA, Ikram MK. Risk of recurrent stroke in Rotterdam between 1990 and 2020: a population-based cohort study. Lancet Reg Health Eur 2023; 30:100651. [PMID: 37228392 PMCID: PMC10205482 DOI: 10.1016/j.lanepe.2023.100651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/25/2023] [Accepted: 04/25/2023] [Indexed: 05/27/2023]
Abstract
Background After an initial stroke, current clinical practice is aimed at preventing recurrent stroke. Thus far, population-based estimates on the risk of recurrent stroke remain scarce. Here we describe the risk of recurrent stroke in a population-based cohort study. Methods We included Rotterdam Study participants who developed a first-ever incident stroke during follow-up between 1990 until 2020. During further follow-up, these participants were monitored for the occurrence of a recurrent stroke. We determined stroke subtypes based on clinical and imaging information. We calculated ten-year overall and sex-specific cumulative incidences of first recurrent stroke. To reflect changing secondary preventive strategies employed in recent decades, we then calculated the risk of recurrent stroke within ten-year epochs based on first-ever stroke date (1990-2000, 2000-2010 and 2010-2020). Findings In total, 1701 participants (mean age 80.3 years, 59.8% women) from 14,163 community-living individuals suffered a first stroke between 1990 and 2020. Of these strokes, 1111 (65.3%) were ischaemic, 141 (8.3%) haemorrhagic, and 449 (26.4%) unspecified. During 6585.3 person-years of follow-up, 331 (19.5%) suffered a recurrent stroke, of which 178 (53.8%) were ischaemic, 34 (10.3%) haemorrhagic and 119 (36.0%) unspecified. Median time between first and recurrent stroke was 1.8 (interquartile range 0.5-4.6) years. Overall ten-year recurrence risk following first-ever stroke was 18.0% (95% CI 16.2%-19.8%), 19.3% (16.3%-22.3%) in men and 17.1% (14.8%-19.4%) in women. Recurrent stroke risk declined over time, with a ten-year risk of 21.4% (17.9%-24.9%) between 1990 and 2000 and 11.0% (8.3%-13.8%) between 2010 and 2020. Interpretation In this population-based study, almost one in five people with first-ever stroke suffered a recurrence within ten years of the initial stroke. Furthermore, recurrence risk declined between 2010 and 2020. Funding Netherlands Organization for Health Research and Development, EU's Horizon 2020 research programme and the Erasmus Medical Centre MRACE grant.
Collapse
Affiliation(s)
- Bernhard P. Berghout
- Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, Netherlands
- Department of Neurology, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - Daniel Bos
- Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - Peter J. Koudstaal
- Department of Neurology, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - M. Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - M. Kamran Ikram
- Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, Netherlands
- Department of Neurology, Erasmus University Medical Centre, Rotterdam, Netherlands
| |
Collapse
|
19
|
Cahalane R, Akyildiz A, Kavousi M, Vernooij MW, Ikram MK, Gijsen F, Bos D. Cross-Sectional Validation of a Novel Computed Tomography-Based Carotid Mean Calcium Density Measurement. J Am Heart Assoc 2023:e027866. [PMID: 37345790 DOI: 10.1161/jaha.122.027866] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Abstract
Background The purpose of this study was to validate a technique for measuring mean calcium density and to determine associations of cardiovascular risk factors with carotid calcium density. Methods and Results We performed a cross-sectional study in a random sample of 100 stroke-free participants from the population-based Rotterdam Study. The mean calcium density of the combined left and right carotid bifurcations was quantified with a threshold of 130 Hounsfield Units (HU) using a novel density technique. To validate the methodology, carotid calcium volumes acquired using the technique in the current study were compared with measurements computed using dedicated clinical software (semiautomatic technique based on a threshold of ≥130 HU). Next, we investigated the associations of participant demographics, total calcium volume, and known cardiovascular risk factors (hypertension, diabetes, hypercholesterolemia, obesity, and smoking status) with the newly derived mean carotid calcium density measurement using linear regression analyses. Calcium volumes obtained with the 2 methods showed a high agreement (intraclass correlation coefficient=0.99, P<0.001), underlining the validity of the density technique. The total calcium volume was statistically significantly associated with the mean calcium density (cardiovascular risk factors adjusted model (B: 0.48 [95% CI, 0.30-0.66], P<0.001). We also found an association between hypercholesterolemia and mean calcium density (0.46 [0.09-0.83], P=0.017). No other significant associations were found between participant demographics or cardiovascular risk factors and mean carotid calcium density. Conclusions We demonstrated the feasibility of a carotid calcium density measurement technique. The data warrant a subsequent longitudinal study to determine the association between carotid calcium density and the risk of cerebrovascular events.
Collapse
Affiliation(s)
- Rachel Cahalane
- Department of Biomedical Engineering Thoraxcentre, Erasmus MC Rotterdam The Netherlands
| | - Ali Akyildiz
- Department of Biomedical Engineering Thoraxcentre, Erasmus MC Rotterdam The Netherlands
- Department of Biomechanical Engineering Delft University of Technology Delft The Netherlands
| | - Maryam Kavousi
- Department of Epidemiology Erasmus MC Rotterdam The Netherlands
| | - Meike W Vernooij
- Department of Epidemiology Erasmus MC Rotterdam The Netherlands
- Department of Radiology and Nuclear Medicine Erasmus MC Rotterdam The Netherlands
| | - M Kamran Ikram
- Department of Epidemiology Erasmus MC Rotterdam The Netherlands
- Department of Neurology Erasmus MC Rotterdam The Netherlands
| | - Frank Gijsen
- Department of Biomedical Engineering Thoraxcentre, Erasmus MC Rotterdam The Netherlands
- Department of Biomechanical Engineering Delft University of Technology Delft The Netherlands
| | - Daniel Bos
- Department of Epidemiology Erasmus MC Rotterdam The Netherlands
- Department of Radiology and Nuclear Medicine Erasmus MC Rotterdam The Netherlands
| |
Collapse
|
20
|
Liew G, Xie J, Nguyen H, Keay L, Kamran Ikram M, McGeechan K, Klein BEK, Jin Wang J, Mitchell P, Klaver CCW, Lamoureux EL, Wong TY. Hypertensive retinopathy and cardiovascular disease risk: 6 population-based cohorts meta-analysis. Int J Cardiol Cardiovasc Risk Prev 2023; 17:200180. [PMID: 36936860 PMCID: PMC10020621 DOI: 10.1016/j.ijcrp.2023.200180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 02/13/2023] [Accepted: 02/22/2023] [Indexed: 03/07/2023]
Abstract
Background The cardiovascular risk associated with different levels of hypertensive retinopathy, including mild, remains unclear. We performed an individual participant meta-analysis from 6 population-based cohort studies to determine the relationship of hypertensive retinopathy with incident cardiovascular outcomes. Methods We identified cohort studies that objectively assessed hypertensive retinopathy from photographs, documented incident cardiovascular outcomes, and were population-based. Six studies contributed data from 11,013 individuals at baseline with 5-13 years follow-up. Participants were recruited if they had hypertension and did not have confounding conditions such as diabetic retinopathy. Main outcome measures were incident coronary heart disease (CHD), stroke and a composite endpoint of cardiovascular disease (CHD or stroke). Pooled estimates of incident risk ratios (IRR) were obtained after adjusting for age, gender, systolic blood pressure, serum total cholesterol, high density lipoprotein and smoking. Results Among eligible participants with hypertension and without diabetes, there were 1018/9662 (10.5%) incident CHD events, 708/11,013 (6.4%) incident stroke events and 1317/9378 (14.0%) incident CVD events. Mild hypertensive retinopathy was associated with increased risk of CVD (IRR 1.13, 95% CI 1.00 to 1.27) and CHD (IRR 1.17, 95% CI 1.02 to 1.34) but not stroke; moderate hypertensive retinopathy was associated with increased risk of CVD (IRR 1.25 95% CI 1.02 to 1.53) but not stroke or CHD individually. Conclusions In persons with hypertension, both mild and moderate hypertensive retinopathy were associated with higher CVD risk.
Collapse
Affiliation(s)
- Gerald Liew
- Centre for Vision Research, Department of Ophthalmology, The Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia
- Corresponding author. Centre for Vision Research, The Westmead Institute for Medical Research, The University of Sydney, 176 Hawkesbury Road, Westmead, NSW, 2145, Australia.
| | - Jing Xie
- Centre for Vision Research, Department of Ophthalmology, The Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Helen Nguyen
- Centre for Vision Research, Department of Ophthalmology, The Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Lisa Keay
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - M. Kamran Ikram
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Duke-NUS Graduate Medical School, National University of Singapore, Singapore
| | - Kevin McGeechan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Screening and Test Evaluation Program, School of Public Health, University of Sydney, Sydney, Australia
| | - Barbara EK. Klein
- Department of Ophthalmology & Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Jie Jin Wang
- Centre for Vision Research, Department of Ophthalmology, The Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia
- Screening and Test Evaluation Program, School of Public Health, University of Sydney, Sydney, Australia
| | - Paul Mitchell
- Centre for Vision Research, Department of Ophthalmology, The Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia
| | - Caroline CW. Klaver
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Ecosse L. Lamoureux
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Screening and Test Evaluation Program, School of Public Health, University of Sydney, Sydney, Australia
- Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
| | - Tien Y. Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Screening and Test Evaluation Program, School of Public Health, University of Sydney, Sydney, Australia
- Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
| |
Collapse
|
21
|
Xiao T, van der Velpen IF, Niessen WJ, Tilly MJ, Kavousi M, Ikram MA, Ikram MK, Vernooij MW. NT-proBNP and changes in cognition and global brain structure: the Rotterdam Study. Eur J Neurol 2023. [PMID: 37165557 DOI: 10.1111/ene.15859] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 05/02/2023] [Accepted: 05/06/2023] [Indexed: 05/12/2023]
Abstract
OBJECTIVE To investigate the association between NT-proBNP and changes in cognition and global brain structure. METHODS In the Rotterdam Study, baseline NT-proBNP was assessed at baseline from 1997 to 2008. Between 1997-2016, participants without dementia or stroke at baseline (n= 9,566) had repeated cognitive tests (every 3-6 years) for global cognitive function, executive cognitive function, fine manual dexterity, and memory. Magnetic resonance imaging of the brain was performed repeatedly at re-examination visits between 2005 and 2015 for 2,607 participants to obtain brain volumes, focal brain lesions, and white matter microstructural integrity as measures of brain structure. RESULTS Among 9,566 participants (mean age 65.1±9.8 years), 5,444 (56.9%) were women, and repeated measures of cognition were performed during a median follow-up time of 5.5 years (range = 1.1-17.9), of whom 2,607 participants completed at least one brain imaging scans. Higher levels of NT-proBNP were associated with a faster decline of scores in the global cognitive function (P value = 0.003), and the Word-Fluency test (P value = 0.003), but were not related to a steeper deterioration in brain volumes, global fractional anisotropy and mean diffusivity, as indicators of white matter microstructural integrity, or focal brain lesions. CONCLUSIONS Higher baseline NT-proBNP levels were associated with a faster decline in cognition, however, no association with global brain structure was found.
Collapse
Affiliation(s)
- Tian Xiao
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Isabelle F van der Velpen
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Wiro J Niessen
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Martijn J Tilly
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Meike W Vernooij
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
22
|
Xiao T, Ghatan S, Mooldijk SS, Trajanoska K, Oei L, Gomez MM, Ikram MK, Rivadeneira F, Ikram MA. Association of Bone Mineral Density and Dementia: The Rotterdam Study. Neurology 2023; 100:e2125-e2133. [PMID: 36948596 DOI: 10.1212/wnl.0000000000207220] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 02/09/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND & Objective: Low bone mineral density and dementia commonly co-occur in the elderly, with bone loss accelerating in dementia patients due to physical inactivity and poor nutrition. However, uncertainty persists over the extent to which bone loss already exists prior to the onset of dementia. Therefore, we investigated how dementia risk was affected by bone mineral density at various skeletal regions in community-dwelling older adults. METHODS In a prospective population-based cohort study, bone mineral density at the femoral neck, lumbar spine, and total body and the trabecular bone score were obtained using dual-energy X-ray absorptiometry (DXA) in 3,651 participants free from dementia between 2002-2005. Persons at risk of dementia were followed up until 1 January 2020. For analyses of the association between bone mineral density at baseline and the risk of incident dementia, we used Cox proportional-hazards regression analyses, adjusting for age, sex, educational attainment, physical activity, smoking status, body mass index, systolic blood pressure, diastolic blood pressure, cholesterol level, high-density lipoprotein cholesterol, history of comorbidities (stroke and diabetes mellitus), and APOE genotype. RESULTS Among the 3,651 participants (median age 72.3±10.0 years, 57.9% women), 688 (18.8%) developed incident dementia during a median of 11.1 years, of whom 528 (76.7%) developed Alzheimer's disease. During the whole follow-up, participants with lower bone mineral density at the femoral neck (per SD decrease) were more likely to develop all-cause dementia (Hazard ratio [HR] total follow-up: 1.12, 95% Confidential interval [CI]: 1.02-1.23) and Alzheimer's disease (HR total follow-up: 1.14, 95% CI: 1.02-1.28). Within the first ten years following baseline, the risk of dementia was greatest for groups with the lowest tertile of bone mineral density (femoral neck bone mineral density, HR0-10years 2.03; 95% CI, 1.39-2.96; total body bone mineral density, HR0-10years 1.42; 95% CI, 1.01-2.02; trabecular bone score, HR0-10years 1.59; 95% CI, 1.11-2.28). CONCLUSIONS In conclusion, participants with low femoral neck and total body bone mineral density and low trabecular bone score were more likely to develop dementia. Further studies should focus on the predictive ability of bone mineral density for dementia.
Collapse
Affiliation(s)
- Tian Xiao
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, The Netherlands
| | - Samuel Ghatan
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus MC University Medical Center Rotterdam, The Netherlands
| | - Sanne S Mooldijk
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, The Netherlands
| | - Katerina Trajanoska
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus MC University Medical Center Rotterdam, The Netherlands
| | - Ling Oei
- Department of Internal Medicine, Erasmus MC University Medical Center Rotterdam, The Netherlands
| | - M Medina Gomez
- Department of Internal Medicine, Erasmus MC University Medical Center Rotterdam, The Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, The Netherlands
- Department of Neurology, Erasmus MC University Medical Center Rotterdam, The Netherlands
| | - Fernando Rivadeneira
- Department of Internal Medicine, Erasmus MC University Medical Center Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, The Netherlands
| |
Collapse
|
23
|
Claus JJ, Berghout BBP, Ikram MK, Wolters FJ. Validity of stroke severity assessment using medical records in a population-based cohort. J Stroke Cerebrovasc Dis 2023; 32:106992. [PMID: 36801651 DOI: 10.1016/j.jstrokecerebrovasdis.2023.106992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 01/05/2023] [Accepted: 01/10/2023] [Indexed: 02/20/2023] Open
Abstract
OBJECTIVES Stroke severity is an important prognostic indicator of morbidity and mortality, but often not recorded outside of specialised stroke centres. We aimed to develop a scoring rule and validate standardised assessment of the National Institutes of Health Stroke Scale (NIHSS) from medical records. METHODS We developed a standardised assessment of the NIHSS from medical records. Four trained raters independently assessed the charts of 100 patients with first-ever stroke, randomly selected from the population-based Rotterdam Study cohort. Interrater agreement was determined using the intraclass correlation coefficient (ICC), and Fleiss' kappa for major versus minor stroke. We validated the scoring method against 29 prospective, clinical NIHSS ratings, using Kendall's tau and Cohen's kappa. RESULTS Of 100 included patients with stroke (mean age 80 years, 62% women), 71 (71%) were admitted to hospital and 9 (9%) were seen in outpatient clinic, whereas 20 (20%) were treated exclusively by their general practitioner or nursing home physician. Interrater agreement for retrospective, chart-based NIHSS ratings was excellent when assessed continuously (ICC: 0.90), and for minor versus major stroke (for NIHSS>3: κ=0.79, NIHSS>5: κ=0.78). Interrater agreement was good both for hospital-based and out-of-hospital settings (ICC: 0.97 and 0.75 respectively). Overall, assessment from medical records was in excellent agreement with prospective NIHSS ratings (τ=0.83; NIHSS>3: κ=0.93, and NIHSS>5: κ=0.93). However, for severe stroke (NIHSS>10) retrospective assessment tended to underestimate severity by 1-3 points on the NIHSS, which was accompanied by a somewhat lower interrater agreement for those more severe cases (NIHSS>10: κ=0.62). CONCLUSIONS Assessment of stroke severity according to the NIHSS on the basis of medical records is feasible and reliable in population-based cohorts of patients with stroke. These findings facilitate more individualised risk estimates in observational studies that lack prospective ascertainment of stroke severity.
Collapse
Affiliation(s)
- Jacqueline J Claus
- Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands; Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands; Department of Neurology, Erasmus MC, Rotterdam, the Netherlands
| | - Brian B P Berghout
- Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands; Department of Neurology, Erasmus MC, Rotterdam, the Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands; Department of Neurology, Erasmus MC, Rotterdam, the Netherlands
| | - Frank J Wolters
- Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands; Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands.
| |
Collapse
|
24
|
Arinze JT, Vinke EJ, Verhamme KMC, de Ridder MAJ, Stricker B, Ikram MK, Brusselle G, Vernooij MW. Chronic Cough-Related Differences in Brain Morphometry in Adults: A Population-Based Study. Chest 2023:S0012-3692(23)00187-3. [PMID: 36781103 DOI: 10.1016/j.chest.2023.02.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 10/15/2022] [Revised: 02/02/2023] [Accepted: 02/06/2023] [Indexed: 02/13/2023] Open
Abstract
BACKGROUND Individuals with cough hypersensitivity have increased central neural responses to tussive stimuli, which may result in maladaptive morphometric changes in the central cough processing systems. RESEARCH QUESTION Are the volumes of the brain regions implicated in cough hypersensitivity different in adults with chronic cough compared with adults without chronic cough? STUDY DESIGN AND METHODS Between 2009 and 2014, participants in the Rotterdam Study, a population-based cohort, underwent brain MRI and were interviewed for chronic cough, which was defined as daily coughing for at least 3 months. Regional brain volumes were quantified with the use of parcellation software. Based on literature review, we identified and studied seven brain regions that previously had been associated with altered functional brain activity in chronic cough. The relationship between chronic cough and regional brain volumes was investigated with the use of multivariable regression models. RESULTS Chronic cough was prevalent in 9.6% (No. = 349) of the 3,620 study participants (mean age, 68.5 ± 9.0 years; 54.6% women). Participants with chronic cough had significantly smaller anterior cingulate cortex volume than participants without chronic cough (mean difference, -126.16 mm3; 95% CI, -245.67 to -6.66; P = .039). Except for anterior cingulate cortex, there were no significant difference in the volume of other brain regions based on chronic cough status. The volume difference in the anterior cingulate cortex was more pronounced in the left hemisphere (mean difference, -88.11 mm3; 95% CI, -165.16 to -11.06; P = .025) and in men (mean difference, -242.58 mm3; 95% CI, -428.60 to -56.55; P = .011). INTERPRETATION Individuals with chronic cough have a smaller volume of the anterior cingulate cortex, which is a brain region involved in cough suppression. CLINICAL TRIAL REGISTRATION The Netherlands National Trial Registry (NTR; www.trialregister.nl) and the World Health Organization's International Clinical Trials Registry Platform (ICTRP; www.who.int/ictrp/network/primary/en/) under the joint catalogue number NTR6831.
Collapse
Affiliation(s)
- Johnmary T Arinze
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium; Department of Medical Informatics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Elisabeth J Vinke
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Radiology and Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Katia M C Verhamme
- Department of Medical Informatics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Maria A J de Ridder
- Department of Medical Informatics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Bruno Stricker
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - M K Ikram
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Guy Brusselle
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Respiratory Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Meike W Vernooij
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Radiology and Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.
| |
Collapse
|
25
|
Khan SR, Dalm VASH, Ikram MK, Peeters RP, van Hagen PM, Kavousi M, Chaker L. The Association of Serum Immunoglobulins with Risk of Cardiovascular Disease and Mortality: the Rotterdam Study. J Clin Immunol 2023; 43:769-779. [PMID: 36723716 PMCID: PMC10110646 DOI: 10.1007/s10875-023-01433-7] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 01/12/2023] [Indexed: 02/02/2023]
Abstract
PURPOSE Inflammation is implicated in cardiovascular disease (CVD), but the association of total serum immunoglobulin (Ig) A, G, and M with CVD across the whole spectrum of atherosclerosis in community-dwelling elderly is unknown. METHODS This study was embedded in the Rotterdam Study, an ongoing population-based cohort study. We performed Cox regression for the associations of Igs with incident atherosclerotic CVD (ACVD; composite of myocardial infarction, revascularization, and stroke), cardiovascular mortality, and all-cause mortality, and multinomial logistic regression for the association between Igs and coronary artery calcification (CAC) scores. We adjusted for age, sex, lifestyle, and cardiovascular risk factors and presented results per standard deviation increase. RESULTS We included 8767 participants (median age 62.2 years, 57% women). Higher IgG was associated with an increased ACVD risk (hazard ratio [HR]: 1.08; 95% confidence interval [95% CI]: 1.01-1.15). Higher IgA and IgG were associated with an increased cardiovascular mortality risk, mainly within Ig reference ranges, and with an increased all-cause mortality risk, although less marked. Higher IgA was associated with severe atherosclerosis, i.e., CAC score > 400 (odds ratio: 1.29; 95% CI: 1.03-1.62), while for higher IgG a trend was seen with severe atherosclerosis. CONCLUSION In middle-aged and older individuals from the general population, higher serum IgA and IgG, but not IgM, are associated with CVD, cardiovascular mortality, and severe atherosclerosis, particularly within Ig reference ranges and independent of serum C-reactive protein. Future studies are needed to elucidate potential causality of the reported associations.
Collapse
Affiliation(s)
- Samer R Khan
- Department of Internal Medicine, Division of Allergy & Clinical Immunology, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Epidemiology, Erasmus University Medical Center Rotterdam, Doctor Molewaterplein 50, 3015 GE, Rotterdam, the Netherlands
| | - Virgil A S H Dalm
- Department of Internal Medicine, Division of Allergy & Clinical Immunology, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Immunology, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, Doctor Molewaterplein 50, 3015 GE, Rotterdam, the Netherlands.,Department of Neurology, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Robin P Peeters
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, Doctor Molewaterplein 50, 3015 GE, Rotterdam, the Netherlands.,Department of Internal Medicine, Division of Endocrinology, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - P Martin van Hagen
- Department of Internal Medicine, Division of Allergy & Clinical Immunology, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Immunology, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, Doctor Molewaterplein 50, 3015 GE, Rotterdam, the Netherlands
| | - Layal Chaker
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, Doctor Molewaterplein 50, 3015 GE, Rotterdam, the Netherlands. .,Department of Internal Medicine, Division of Endocrinology, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands.
| |
Collapse
|
26
|
Abstract
BACKGROUND Exposure to air pollution has been suggested to increase the risk of dementia, but studies on this link often lack a detailed screening for dementia and data on important confounders. OBJECTIVE To determine the association of exposure to air pollution with the risk of dementia and cognitive decline in the population-based Rotterdam Study. METHODS Between 2009 and 2010, we determined air pollutant concentrations at participants residential addresses using land use regression models. Determined air pollutants include particulate matter <10μm (PM10) and <2.5μm (PM2.5), a proxy of elemental carbon (PM2.5 absorbance), nitrogen oxide (NOx), and nitrogen dioxide (NO2). As the individual air pollutant levels were highly correlated (r = 0.71-0.98), we computed a general marker covering all air pollutants based on a principal component analysis. We followed participants up for dementia until 2018 and determined cognitive performance during two subsequent examination rounds. Using Cox and linear mixed models, we related air pollution to dementia and cognitive decline. RESULTS Of the 7,511 non-demented participants at baseline, 545 developed dementia during a median follow-up of 7 years. The general marker of all air pollutants was not associated with the risk of dementia (hazard ratio [95% confidence interval]: 1.04 [0.95-1.15]), neither were the individual air pollutants. Also, the general marker of all air pollutants or the individual air pollutant levels were not associated with cognitive decline. CONCLUSION In this study, we found no clear evidence for an association between exposure to air pollution and the risk of dementia or cognitive decline.
Collapse
Affiliation(s)
- Tosca O.E. de Crom
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Bigina N.R. Ginos
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Anna Oudin
- Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - M. Kamran Ikram
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands,Department of Neurology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands,Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - M. Arfan Ikram
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands,Correspondence to: M. Arfan Ikram, Department of Epidemiology, Erasmus MC, PO Box 2040, 3000 CA Rotterdam, The Netherlands. E-mail:
| |
Collapse
|
27
|
Evans TE, Knol MJ, Schwingenschuh P, Wittfeld K, Hilal S, Ikram MA, Dubost F, van Wijnen KMH, Katschnig P, Yilmaz P, de Bruijne M, Habes M, Chen C, Langer S, Völzke H, Ikram MK, Grabe HJ, Schmidt R, Adams HHH, Vernooij MW. Determinants of Perivascular Spaces in the General Population: A Pooled Cohort Analysis of Individual Participant Data. Neurology 2023; 100:e107-e122. [PMID: 36253103 PMCID: PMC9841448 DOI: 10.1212/wnl.0000000000201349] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 08/19/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Perivascular spaces (PVS) are emerging markers of cerebral small vessel disease (CSVD), but research on their determinants has been hampered by conflicting results from small single studies using heterogeneous rating methods. In this study, we therefore aimed to identify determinants of PVS burden in a pooled analysis of multiple cohort studies using 1 harmonized PVS rating method. METHODS Individuals from 10 population-based cohort studies with adult participants from the Uniform Neuro-Imaging of Virchow-Robin Spaces Enlargement consortium and the UK Biobank were included. On MRI scans, we counted PVS in 4 brain regions (mesencephalon, hippocampus, basal ganglia, and centrum semiovale) according to a uniform and validated rating protocol, both manually and automated using a deep learning algorithm. As potential determinants, we considered demographics, cardiovascular risk factors, APOE genotypes, and other imaging markers of CSVD. Negative binomial regression models were used to examine the association between these determinants and PVS counts. RESULTS In total, 39,976 individuals were included (age range 20-96 years). The average count of PVS in the 4 regions increased from the age 20 years (0-1 PVS) to 90 years (2-7 PVS). Men had more mesencephalic PVS (OR [95% CI] = 1.13 [1.08-1.18] compared with women), but less hippocampal PVS (0.82 [0.81-0.83]). Higher blood pressure, particularly diastolic pressure, was associated with more PVS in all regions (ORs between 1.04-1.05). Hippocampal PVS showed higher counts with higher high-density lipoprotein cholesterol levels (1.02 [1.01-1.02]), glucose levels (1.02 [1.01-1.03]), and APOE ε4-alleles (1.02 [1.01-1.04]). Furthermore, white matter hyperintensity volume and presence of lacunes were associated with PVS in multiple regions, but most strongly with the basal ganglia (1.13 [1.12-1.14] and 1.10 [1.09-1.12], respectively). DISCUSSION Various factors are associated with the burden of PVS, in part regionally specific, which points toward a multifactorial origin beyond what can be expected from PVS-related risk factor profiles. This study highlights the power of collaborative efforts in population neuroimaging research.
Collapse
Affiliation(s)
- Tavia E Evans
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Maria J Knol
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Petra Schwingenschuh
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Katharina Wittfeld
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Saima Hilal
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - M Arfan Ikram
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Florian Dubost
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Kimberlin M H van Wijnen
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Petra Katschnig
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Pinar Yilmaz
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Marleen de Bruijne
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Mohamad Habes
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Christopher Chen
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Sönke Langer
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Henry Völzke
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - M Kamran Ikram
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Hans J Grabe
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Reinhold Schmidt
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Hieab H H Adams
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile.
| | - Meike W Vernooij
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| |
Collapse
|
28
|
Licher S, Wolters FJ, Pavlović J, Kavousi M, Leening MJG, Ikram MK, Ikram MA. Effects of Eligibility Criteria on Patient Selection and Treatment Implications from 10 Multidomain Dementia Prevention Trials: A Population-Based Study. Neuroepidemiology 2023; 57:14-24. [PMID: 36398446 PMCID: PMC10064383 DOI: 10.1159/000528120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 11/02/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Dementia prevention trials have so far shown little benefit of multidomain interventions against cognitive decline. Recruitment strategies in these trials often centre around dementia risk or cardiovascular risk profile, but it is uncertain whether this leads to inclusion of individuals who may benefit most from the intervention. We determined the effects of eligibility criteria on the recruitment of potential trial participants in the general population. METHODS In a systematic search until January 1, 2022, we identified all published and ongoing large (≥500 participants), phase-3 multidomain trials for the prevention of cognitive decline or dementia. We applied trial eligibility criteria to 5,381 participants of the population-based Rotterdam Study (mean age: 72 years, 58% women), to compare participant characteristics, predicted risk of cardiovascular disease, and dementia risk, between trial eligible and ineligible persons. RESULTS We identified 10 trials, of which 5 had been published (DR's EXTRA, FINGER, preDIVA, MAPT, and HATICE) and 5 are ongoing (US-POINTER, MIND-CHINA, MYB, AgeWell.de, and J-Mint). Among all Rotterdam Study participants, eligibility across published trials ranged from 48% for MAPT to 87% for preDIVA, in line with original trial reports. Variability in eligibility was wider for ongoing trials, from 1% for US-POINTER to over 94% for MYB trial. Over 70% of trial eligible individuals are recommended preventive intervention in routine care based on their cardiovascular risk, similar for lipid-lowering (71%) and blood pressure-lowering treatment (73%). Ten-year risks of dementia were similar for eligible compared to ineligible individuals (12 vs. 11%). CONCLUSION Multidomain dementia prevention trials fail to preferentially include those at the highest risk of dementia and mostly include individuals who qualify for interventions already on the basis of cardiovascular prevention guidelines. These findings call for better targeted enrolment of individuals for whom trial results can improve clinical decision-making.
Collapse
Affiliation(s)
- Silvan Licher
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Frank J Wolters
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jelena Pavlović
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Maarten J G Leening
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Cardiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Neurology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| |
Collapse
|
29
|
Khan SR, Yaqub A, Ikram MK, van Hagen PM, Peeters RP, Dalm VASH, Chaker L, Ikram MA. The association of serum immunoglobulins with cognition and dementia: the Rotterdam Study. J Neurol 2023; 270:423-432. [PMID: 36123443 DOI: 10.1007/s00415-022-11374-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 09/06/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Chronic inflammation is involved in the pathophysiology of dementia, but the association of serum immunoglobulins with dementia has been understudied and longitudinal data are currently lacking. We investigated the association of serum immunoglobulin (Ig) A, G, and M with cognition and dementia in a population-based cohort. METHODS This study was embedded in the Rotterdam Study. Participants with information on serum immunoglobulin levels, measured between 1997 and 2009, were followed for incident dementia until 2016. Assessment of cognitive function and dementia was performed according to validated tests and clinical criteria respectively. We studied the association between serum immunoglobulins with prevalent and incident dementia using logistic regression and Cox proportional hazards regression analyses respectively. We performed linear regression analyses to quantify the cross-sectional association of serum immunoglobulins with global cognition as well as separate cognitive tests. Analyses were adjusted for age, sex, lifestyle, and cardiovascular factors. RESULTS We included 8768 participants (median age of 62.2 years, 57% women, median follow-up 10.7 years). Overall, none of the immunoglobulins was associated with prevalent or incident dementia. Higher IgG levels were associated with lower scores of global cognition (adjusted standardized mean difference - 0.04; 95% confidence interval:- 0.06; - 0.02) and separate cognitive tests. CONCLUSION In middle-aged and older individuals from the general population, serum Igs were not associated with prevalent or incident dementia, which may imply that serum Igs are not involved in the pathophysiology of dementia. Although higher IgG levels were associated with worse cognitive function, studies with longitudinal data should exclude reverse causation.
Collapse
Affiliation(s)
- Samer R Khan
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Division of Allergy and Clinical Immunology, Department of Internal Medicine, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Amber Yaqub
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Neurology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - P Martin van Hagen
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Immunology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Robin P Peeters
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Division of Endocrinology, Department of Internal Medicine, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Virgil A S H Dalm
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Immunology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Layal Chaker
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Division of Endocrinology, Department of Internal Medicine, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
| |
Collapse
|
30
|
Acarsoy C, Fani L, Al-Hassany L, Berghout B, Koudstaal PJ, Maassen Van Den Brink A, Ikram MK, Bos D. Migraine and the risk of stroke in a middle-aged and elderly population: A prospective cohort study. Cephalalgia 2023; 43:3331024221132008. [PMID: 36622876 DOI: 10.1177/03331024221132008] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND It has been suggested that patients with migraine have a higher risk of stroke. Despite considerable research on this topic in younger populations, a clear answer is still lacking for older individuals. We studied the association between migraine and the risk of stroke in a middle-aged and elderly population. METHODS Within the ongoing prospective population-based Rotterdam Study, the presence of migraine was assessed using a validated questionnaire in a structured interview between 2006 and 2011, which formed the baseline. The association between migraine and the risk of stroke was analyzed using Cox proportional-hazards models with adjustments for age, sex, and cardiometabolic risk factors. RESULTS A total of 6925 (mean age 65.7 ± 11.3 years, 57.8% females) stroke-free participants were included. At baseline, 1030 (14.9%) participants had lifetime history of migraine. During a median follow-up of 6.2 years, 195 participants developed a stroke (163 ischemic stroke). Analyzing the association between migraine and stroke, we found a hazard ratio of 1.44 with a 95% confidence interval of 0.96-2.15. The results were similar for the ischemic stroke (HR 1.50, CI: 0.97-2.32). CONCLUSION Our data suggested an association between migraine and the risk of stroke in a middle-aged and elderly population, but this was not statistically significant.
Collapse
Affiliation(s)
- Cevdet Acarsoy
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Lana Fani
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Linda Al-Hassany
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Brian Berghout
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Neurology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Peter J Koudstaal
- Department of Neurology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | | | - M Kamran Ikram
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Neurology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Daniel Bos
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| |
Collapse
|
31
|
Holstege H, Hulsman M, Charbonnier C, Grenier-Boley B, Quenez O, Grozeva D, van Rooij JGJ, Sims R, Ahmad S, Amin N, Norsworthy PJ, Dols-Icardo O, Hummerich H, Kawalia A, Amouyel P, Beecham GW, Berr C, Bis JC, Boland A, Bossù P, Bouwman F, Bras J, Campion D, Cochran JN, Daniele A, Dartigues JF, Debette S, Deleuze JF, Denning N, DeStefano AL, Farrer LA, Fernández MV, Fox NC, Galimberti D, Genin E, Gille JJP, Le Guen Y, Guerreiro R, Haines JL, Holmes C, Ikram MA, Ikram MK, Jansen IE, Kraaij R, Lathrop M, Lemstra AW, Lleó A, Luckcuck L, Mannens MMAM, Marshall R, Martin ER, Masullo C, Mayeux R, Mecocci P, Meggy A, Mol MO, Morgan K, Myers RM, Nacmias B, Naj AC, Napolioni V, Pasquier F, Pastor P, Pericak-Vance MA, Raybould R, Redon R, Reinders MJT, Richard AC, Riedel-Heller SG, Rivadeneira F, Rousseau S, Ryan NS, Saad S, Sanchez-Juan P, Schellenberg GD, Scheltens P, Schott JM, Seripa D, Seshadri S, Sie D, Sistermans EA, Sorbi S, van Spaendonk R, Spalletta G, Tesi N, Tijms B, Uitterlinden AG, van der Lee SJ, Visser PJ, Wagner M, Wallon D, Wang LS, Zarea A, Clarimon J, van Swieten JC, Greicius MD, Yokoyama JS, Cruchaga C, Hardy J, Ramirez A, Mead S, van der Flier WM, van Duijn CM, Williams J, Nicolas G, Bellenguez C, Lambert JC. Exome sequencing identifies rare damaging variants in ATP8B4 and ABCA1 as risk factors for Alzheimer's disease. Nat Genet 2022; 54:1786-1794. [PMID: 36411364 PMCID: PMC9729101 DOI: 10.1038/s41588-022-01208-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 09/19/2022] [Indexed: 11/22/2022]
Abstract
Alzheimer's disease (AD), the leading cause of dementia, has an estimated heritability of approximately 70%1. The genetic component of AD has been mainly assessed using genome-wide association studies, which do not capture the risk contributed by rare variants2. Here, we compared the gene-based burden of rare damaging variants in exome sequencing data from 32,558 individuals-16,036 AD cases and 16,522 controls. Next to variants in TREM2, SORL1 and ABCA7, we observed a significant association of rare, predicted damaging variants in ATP8B4 and ABCA1 with AD risk, and a suggestive signal in ADAM10. Additionally, the rare-variant burden in RIN3, CLU, ZCWPW1 and ACE highlighted these genes as potential drivers of respective AD-genome-wide association study loci. Variants associated with the strongest effect on AD risk, in particular loss-of-function variants, are enriched in early-onset AD cases. Our results provide additional evidence for a major role for amyloid-β precursor protein processing, amyloid-β aggregation, lipid metabolism and microglial function in AD.
Collapse
Affiliation(s)
- Henne Holstege
- Genomics of Neurodegenerative Diseases and Aging, Human Genetics, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, the Netherlands.
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, the Netherlands.
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands.
- Delft Bioinformatics Lab, Delft University of Technology, Delft, the Netherlands.
| | - Marc Hulsman
- Genomics of Neurodegenerative Diseases and Aging, Human Genetics, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, the Netherlands.
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, the Netherlands.
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands.
- Delft Bioinformatics Lab, Delft University of Technology, Delft, the Netherlands.
| | - Camille Charbonnier
- Université Rouen Normandie, INSERM U1245 and CHU Rouen, Department of Genetics and CNRMAJ, Rouen, France
| | - Benjamin Grenier-Boley
- Université Lille, INSERM, Centre Hospitalier Universitaire Lille, Institut Pasteur de Lille, U1167-RID-AGE facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, Lille, France
| | - Olivier Quenez
- Université Rouen Normandie, INSERM U1245 and CHU Rouen, Department of Genetics and CNRMAJ, Rouen, France
| | - Detelina Grozeva
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics,, Division of Psychological Medicine and Clinical Neuroscience, School of Medicine, Cardiff University, Cardiff, UK
| | - Jeroen G J van Rooij
- Department of Neurology, Erasmus Medical Centre, Rotterdam, the Netherlands
- Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Rebecca Sims
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics,, Division of Psychological Medicine and Clinical Neuroscience, School of Medicine, Cardiff University, Cardiff, UK
| | - Shahzad Ahmad
- Department of Epidemiology, Erasmus Medical Centre, Rotterdam, the Netherlands
- Leiden Academic Centre for Drug Research, Leiden, the Netherlands
| | - Najaf Amin
- Department of Epidemiology, Erasmus Medical Centre, Rotterdam, the Netherlands
- Nuffield Department of Population Health Oxford University, Oxford, UK
| | - Penny J Norsworthy
- Medical Research Council Prion Unit at University College London, University College London Institute of Prion Diseases, London, UK
| | - Oriol Dols-Icardo
- Department of Neurology, II B Sant Pau, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- Biomedical Research Networking Center on Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
| | - Holger Hummerich
- Medical Research Council Prion Unit at University College London, University College London Institute of Prion Diseases, London, UK
| | - Amit Kawalia
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Philippe Amouyel
- Université Lille, INSERM, Centre Hospitalier Universitaire Lille, Institut Pasteur de Lille, U1167-RID-AGE facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, Lille, France
| | - Gary W Beecham
- The John P. Hussman Institute for Human Genomics, University of Miami, Miami, FL, USA
| | - Claudine Berr
- Université Montpellier, INSERM, Institute for Neurosciences of Montpellier, Montpellier, France
| | - Joshua C Bis
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Anne Boland
- Université Paris-Saclay, Commissariat à l'Énergie Atomique et aux Énergies Alternatives, Centre National de Recherche en Génomique Humaine Evry, Gif-sur-Yvette, France
| | - Paola Bossù
- Experimental Neuro-psychobiology Laboratory, Department of Clinical and Behavioral Neurology, Istituto di Ricovero e Cura a Carattere Scientifico Santa Lucia Foundation, Rome, Italy
| | - Femke Bouwman
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
| | - Jose Bras
- Department of Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA
- Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI, USA
| | - Dominique Campion
- Université Rouen Normandie, INSERM U1245 and CHU Rouen, Department of Genetics and CNRMAJ, Rouen, France
| | | | - Antonio Daniele
- Department of Neuroscience, Catholic University of Sacred Heart, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | | | - Stéphanie Debette
- Université Bordeaux, INSERM, Bordeaux Population Health Research Center, Bordeaux, France
- Department of Neurology, Bordeaux University Hospital, Bordeaux, France
| | - Jean-François Deleuze
- Université Paris-Saclay, Commissariat à l'Énergie Atomique et aux Énergies Alternatives, Centre National de Recherche en Génomique Humaine Evry, Gif-sur-Yvette, France
| | - Nicola Denning
- UKDRI Cardiff, School of Medicine, Cardiff University, Cardiff, UK
| | - Anita L DeStefano
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
- Framingham Heart Study, Framingham, MA, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Lindsay A Farrer
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Department of Epidemiology, Boston University, Boston, MA, USA
- Department of Medicine (Biomedical Genetics), Boston University, Boston, MA, USA
| | - Maria Victoria Fernández
- Neurogenomics and Informatics Center, Washington University School of Medicine, St Louis, MO, USA
- Psychiatry Department, Washington University School of Medicine, St Louis, MO, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine, St Louis, MO, USA
| | - Nick C Fox
- Dementia Research Centre, University College London Queen Square Institute of Neurology, London, UK
| | - Daniela Galimberti
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda, Ospedale Policlinico, Milan, Italy
- University of Milan, Milan, Italy
| | - Emmanuelle Genin
- Université Brest, INSERM, Etablissement Français du Sang, Centre Hospitalier Universitaire Brest, Unité Mixte de Recherche 1078, GGB, Brest, France
| | - Johan J P Gille
- Genome Diagnostics, Department of Human Genetics, VU University, AmsterdamUMC (location VUmc), Amsterdam, the Netherlands
| | - Yann Le Guen
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA
| | - Rita Guerreiro
- Department of Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA
- Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI, USA
| | - Jonathan L Haines
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH, USA
| | - Clive Holmes
- Clinical and Experimental Science, Faculty of Medicine, University of Southampton, Southampton, UK
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Iris E Jansen
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije University, Amsterdam, the Netherlands
| | - Robert Kraaij
- Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Marc Lathrop
- McGill University and Genome Quebec Innovation Centre, Montreal, Quebec, Canada
| | - Afina W Lemstra
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
| | - Alberto Lleó
- Department of Neurology, II B Sant Pau, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- Biomedical Research Networking Center on Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
| | - Lauren Luckcuck
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics,, Division of Psychological Medicine and Clinical Neuroscience, School of Medicine, Cardiff University, Cardiff, UK
| | - Marcel M A M Mannens
- Department of Human Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands
| | - Rachel Marshall
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics,, Division of Psychological Medicine and Clinical Neuroscience, School of Medicine, Cardiff University, Cardiff, UK
| | - Eden R Martin
- The John P. Hussman Institute for Human Genomics, University of Miami, Miami, FL, USA
- Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami, Miami, FL, USA
| | - Carlo Masullo
- Institute of Neurology, Catholic University of the Sacred Heart, Rome, Italy
| | - Richard Mayeux
- Taub Institute on Alzheimer's Disease and the Aging Brain, Department of Neurology, Columbia University, New York, NY, USA
- Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA
| | - Patrizia Mecocci
- Institute of Gerontology and Geriatrics, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Alun Meggy
- UKDRI Cardiff, School of Medicine, Cardiff University, Cardiff, UK
| | - Merel O Mol
- Department of Neurology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Kevin Morgan
- Human Genetics, School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Richard M Myers
- HudsonAlpha Institute for Biotechnology, Huntsville, AL, USA
| | - Benedetta Nacmias
- Department of Neuroscience, Psychology, Drug Research and Child Health University of Florence, Florence, Italy
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Adam C Naj
- Penn Neurodegeneration Genomics Center, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Valerio Napolioni
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA
- Genomic and Molecular Epidemiology Laboratory, School of Biosciences and Veterinary Medicine, University of Camerino, Camerino, Italy
| | - Florence Pasquier
- Université Lille, INSERM, Centre Hospitalier Universitaire Lille, UMR1172, Resources and Research Memory Center (MRRC) of Distalz, Licend, Lille, France
| | - Pau Pastor
- Fundació Docència i Recerca MútuaTerrassa and Movement Disorders Unit, Department of Neurology, University Hospital MútuaTerrassa, Barcelona, Spain
- Memory Disorders Unit, Department of Neurology, Hospital Universitari Mutua de Terrassa, Barcelona, Spain
| | - Margaret A Pericak-Vance
- The John P. Hussman Institute for Human Genomics, University of Miami, Miami, FL, USA
- Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami, Miami, FL, USA
| | - Rachel Raybould
- UKDRI Cardiff, School of Medicine, Cardiff University, Cardiff, UK
| | - Richard Redon
- Université de Nantes, Centre Hospitalier Universitaire Nantes, Centre National de la Recherche Scientifique, INSERM, l'institut du Thorax, Nantes, France
| | - Marcel J T Reinders
- Delft Bioinformatics Lab, Delft University of Technology, Delft, the Netherlands
| | - Anne-Claire Richard
- Université Rouen Normandie, INSERM U1245 and CHU Rouen, Department of Genetics and CNRMAJ, Rouen, France
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Fernando Rivadeneira
- Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Stéphane Rousseau
- Université Rouen Normandie, INSERM U1245 and CHU Rouen, Department of Genetics and CNRMAJ, Rouen, France
| | - Natalie S Ryan
- Dementia Research Centre, University College London Queen Square Institute of Neurology, London, UK
| | - Salha Saad
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics,, Division of Psychological Medicine and Clinical Neuroscience, School of Medicine, Cardiff University, Cardiff, UK
| | - Pascual Sanchez-Juan
- Biomedical Research Networking Center on Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
- Neurology Service, Marqués de Valdecilla University Hospital (University of Cantabria and IDIVAL), Santander, Spain
| | - Gerard D Schellenberg
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
| | - Jonathan M Schott
- Dementia Research Centre, University College London Queen Square Institute of Neurology, London, UK
| | - Davide Seripa
- Laboratory for Advanced Hematological Diagnostics, Department of Hematology and Stem Cell Transplant, Lecce, Italy
| | - Sudha Seshadri
- Framingham Heart Study, Framingham, MA, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Department of Psychiatry and Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, San Antonio, TX, USA
| | - Daoud Sie
- Genome Diagnostics, Department of Human Genetics, VU University, AmsterdamUMC (location VUmc), Amsterdam, the Netherlands
| | - Erik A Sistermans
- Genome Diagnostics, Department of Human Genetics, VU University, AmsterdamUMC (location VUmc), Amsterdam, the Netherlands
| | - Sandro Sorbi
- Department of Neuroscience, Psychology, Drug Research and Child Health University of Florence, Florence, Italy
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Resie van Spaendonk
- Genome Diagnostics, Department of Human Genetics, VU University, AmsterdamUMC (location VUmc), Amsterdam, the Netherlands
| | - Gianfranco Spalletta
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, Istituto di Ricovero e Cura a Carattere Scientifico Santa Lucia Foundation, Rome, Italy
| | - Niccolo' Tesi
- Genomics of Neurodegenerative Diseases and Aging, Human Genetics, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, the Netherlands
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
- Delft Bioinformatics Lab, Delft University of Technology, Delft, the Netherlands
| | - Betty Tijms
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, the Netherlands
| | - André G Uitterlinden
- Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Sven J van der Lee
- Genomics of Neurodegenerative Diseases and Aging, Human Genetics, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, the Netherlands
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
- Delft Bioinformatics Lab, Delft University of Technology, Delft, the Netherlands
| | - Pieter Jelle Visser
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, the Netherlands
| | - Michael Wagner
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Medical Faculty, Bonn, Germany
- German Center for Neurodegenerative Diseases, Bonn, Germany
| | - David Wallon
- Université Rouen Normandie, INSERM U1245 and CHU Rouen, Department of Neurology and CNRMAJ, Rouen, France
| | - Li-San Wang
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Aline Zarea
- Université Rouen Normandie, INSERM U1245 and CHU Rouen, Department of Neurology and CNRMAJ, Rouen, France
| | - Jordi Clarimon
- Department of Neurology, II B Sant Pau, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- Biomedical Research Networking Center on Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
| | - John C van Swieten
- Department of Neurology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Michael D Greicius
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA
| | - Jennifer S Yokoyama
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Carlos Cruchaga
- Neurogenomics and Informatics Center, Washington University School of Medicine, St Louis, MO, USA
- Psychiatry Department, Washington University School of Medicine, St Louis, MO, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine, St Louis, MO, USA
| | - John Hardy
- Reta Lila Weston Research Laboratories, Department of Molecular Neuroscience, University College London Institute of Neurology, London, UK
| | - Alfredo Ramirez
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Department of Psychiatry and Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, San Antonio, TX, USA
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Medical Faculty, Bonn, Germany
- German Center for Neurodegenerative Diseases, Bonn, Germany
- Cluster of Excellence Cellular Stress Responses in Aging-Associated Diseases, University of Cologne, Cologne, Germany
| | - Simon Mead
- Medical Research Council Prion Unit at University College London, University College London Institute of Prion Diseases, London, UK
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
| | - Cornelia M van Duijn
- Department of Epidemiology, Erasmus Medical Centre, Rotterdam, the Netherlands
- Nuffield Department of Population Health Oxford University, Oxford, UK
| | - Julie Williams
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics,, Division of Psychological Medicine and Clinical Neuroscience, School of Medicine, Cardiff University, Cardiff, UK
| | - Gaël Nicolas
- Université Rouen Normandie, INSERM U1245 and CHU Rouen, Department of Genetics and CNRMAJ, Rouen, France.
| | - Céline Bellenguez
- Université Lille, INSERM, Centre Hospitalier Universitaire Lille, Institut Pasteur de Lille, U1167-RID-AGE facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, Lille, France
| | - Jean-Charles Lambert
- Université Lille, INSERM, Centre Hospitalier Universitaire Lille, Institut Pasteur de Lille, U1167-RID-AGE facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, Lille, France.
| |
Collapse
|
32
|
Mooldijk SS, Lu T, Waqas K, Chen J, Vernooij MW, Ikram MK, Zillikens MC, Ikram MA. Skin advanced glycation end products and the risk of dementia. Alzheimers Dement 2022. [DOI: 10.1002/alz.061469] [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: 12/24/2022]
Affiliation(s)
| | - Tianqi Lu
- Erasmus MC University Medical Center Rotterdam Netherlands
| | - Komal Waqas
- Erasmus MC University Medical Center Rotterdam Netherlands
| | - Jinluan Chen
- Erasmus MC University Medical Center Rotterdam Netherlands
| | | | | | | | - M. Arfan Ikram
- Erasmus MC University Medical Center Rotterdam Netherlands
| |
Collapse
|
33
|
Mooldijk SS, de Crom TOE, Ikram MK, Ikram MA, Voortman T. Adiposity in the older population and the risk of dementia: The Rotterdam Study. Alzheimers Dement 2022; 19:2047-2055. [PMID: 36444569 DOI: 10.1002/alz.12888] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/24/2022] [Accepted: 10/26/2022] [Indexed: 12/03/2022]
Abstract
INTRODUCTION We determined associations of total and regional adiposity with incident dementia among older adults. METHODS Within the population-based Rotterdam Study, adiposity was measured as total, android, and gynoid fat mass using dual-energy X-ray absorptiometry in 3408 men and 4563 women, every 3 to 6 years between 2002 and 2016. Incident dementia was recorded until 2020. RESULTS Higher adiposity measures were associated with a decreased risk of dementia in both sexes. After excluding the first 5 years of follow-up, only the association of gynoid fat among women remained significant (hazard ratio 0.85 [95% confidence interval 0.75-0.97] per standard deviation increase). No major differences in trajectories of adiposity measures were observed between dementia cases and dementia-free controls. DISCUSSION Higher total and regional fat mass related to a decreased risk of dementia. These results may be explained by reverse causality, although a protective effect of adiposity cannot be excluded. HIGHLIGHTS Total and regional adiposity were assessed using dual-energy X-ray absorptiometry scans in 7971 older adults. All adiposity measures were associated with a decreased risk of dementia. The results suggest a beneficial effect of gynoid fat on the risk of dementia in women. Reverse causation and competing risk may explain these inverse associations.
Collapse
Affiliation(s)
- Sanne S. Mooldijk
- Department of Epidemiology Erasmus MC, University Medical Center Rotterdam the Netherlands
| | - Tosca O. E. de Crom
- Department of Epidemiology Erasmus MC, University Medical Center Rotterdam the Netherlands
| | - M. Kamran Ikram
- Department of Epidemiology Erasmus MC, University Medical Center Rotterdam the Netherlands
- Department of Neurology Erasmus MC, University Medical Center Rotterdam the Netherlands
| | - M. Arfan Ikram
- Department of Epidemiology Erasmus MC, University Medical Center Rotterdam the Netherlands
| | - Trudy Voortman
- Department of Epidemiology Erasmus MC, University Medical Center Rotterdam the Netherlands
- Division of Human Nutrition and Health Wageningen University & Research Wageningen the Netherlands
| |
Collapse
|
34
|
Velek P, Luik AI, Brusselle GGO, Stricker BC, Bindels PJE, Kavousi M, Kieboom BCT, Voortman T, Ruiter R, Ikram MA, Ikram MK, de Schepper EIT, Licher S. Sex-specific patterns and lifetime risk of multimorbidity in the general population: a 23-year prospective cohort study. BMC Med 2022; 20:304. [PMID: 36071423 PMCID: PMC9454172 DOI: 10.1186/s12916-022-02487-x] [Citation(s) in RCA: 4] [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] [Received: 04/25/2022] [Accepted: 07/14/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Multimorbidity poses a major challenge for care coordination. However, data on what non-communicable diseases lead to multimorbidity, and whether the lifetime risk differs between men and women are lacking. We determined sex-specific differences in multimorbidity patterns and estimated sex-specific lifetime risk of multimorbidity in the general population. METHODS We followed 6,094 participants from the Rotterdam Study aged 45 years and older for the occurrence of ten diseases (cancer, coronary heart disease, stroke, chronic obstructive pulmonary disease, depression, diabetes, dementia, asthma, heart failure, parkinsonism). We visualised participants' trajectories from a single disease to multimorbidity and the most frequent combinations of diseases. We calculated sex-specific lifetime risk of multimorbidity, considering multimorbidity involving only somatic diseases (1) affecting the same organ system, (2) affecting different organ systems, and (3) multimorbidity involving depression. RESULTS Over the follow-up period (1993-2016, median years of follow-up 9.2), we observed 6334 disease events. Of the study population, 10.3% had three or more diseases, and 27.9% had two or more diseases. The most frequent pair of co-occurring diseases among men was COPD and cancer (12.5% of participants with multimorbidity), the most frequent pair of diseases among women was depression and dementia (14.9%). The lifetime risk of multimorbidity was similar among men (66.0%, 95% CI: 63.2-68.8%) and women (65.1%, 95% CI: 62.5-67.7%), yet the risk of multimorbidity with depression was higher for women (30.9%, 95% CI: 28.4-33.5%, vs. 17.5%, 95% CI: 15.2-20.1%). The risk of multimorbidity with two diseases affecting the same organ is relatively low for both sexes (4.2% (95% CI: 3.2-5.5%) for men and 4.5% (95% CI: 3.5-5.7%) for women). CONCLUSIONS Two thirds of people over 45 will develop multimorbidity in their remaining lifetime, with women at nearly double the risk of multimorbidity involving depression than men. These findings call for programmes of integrated care to consider sex-specific differences to ensure men and women are served equally.
Collapse
Affiliation(s)
- Premysl Velek
- Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands. .,Department of General Practice, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands.
| | - Annemarie I Luik
- Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - University Medical Center, Rotterdam, The Netherlands
| | - Guy G O Brusselle
- Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium.,Department of Respiratory Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Bruno Ch Stricker
- Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Patrick J E Bindels
- Department of General Practice, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Brenda C T Kieboom
- Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands.,Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Rikje Ruiter
- Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Internal Medicine, Maasstad Hospital, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Neurology, Erasmus MC - University Medical Center, Rotterdam, The Netherlands
| | - Evelien I T de Schepper
- Department of General Practice, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Silvan Licher
- Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
| |
Collapse
|
35
|
Zhu F, Arshi B, Leening MJG, Aribas E, Ikram MA, Boersma E, Ikram MK, Kavousi M. Sex-specific added value of cardiac biomarkers for 10-year cardiovascular risk prediction. Eur J Prev Cardiol 2022; 29:1559-1567. [PMID: 35512434 DOI: 10.1093/eurjpc/zwac091] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/28/2022] [Accepted: 04/30/2022] [Indexed: 11/14/2022]
Abstract
AIMS To evaluate the sex-specific predictive value of N-terminal pro B-type natriuretic peptide (NT-proBNP), high sensitivity cardiac troponin T (hs-cTnT) and creatine kinase myocardial band (CK-MB) for 10-year risk prediction of coronary heart disease (CHD), stroke, heart failure (HF) and composite outcomes. METHODS Five-thousand four-hundred thirty individuals (mean age 68.6 years, 59.9% women) from the Rotterdam Study, with biomarker measurements between 1997 and 2001, were included. Participants were followed until 2015. We fitted 'basic' models using traditional cardiovascular risk factors. Improvements in c-statistics and net reclassification improvement (NRI) for events and non-events were calculated. RESULTS During a median follow-up of 14 years, 747 (13.8%), 563 (10.4%), and 664 (12.2%) participants were diagnosed with CHD, stroke, and HF, respectively. NT-proBNP improved the discriminative performance of the 'basic' model for all endpoints (c-statistic improvements ranging from 0.007 to 0.050) and provided significant event-NRI for HF (14.3% in women; 10.7% in men) and for stroke in men (9.3%). The addition of hs-cTnT increased c-statistic for CHD in women by 0.029 (95% CI, 0.011-0.047) and for HF in men by 0.034 (95% CI, 0.014-0.053), and provided significant event-NRI for CHD (10.3%) and HF (7.8%) in women, and for stroke (8.4%) in men. The added predictive value of CK-MB was limited. CONCLUSION NT-proBNP and hs-cTnT provided added predictive value for various cardiovascular outcomes above traditional risk factors. Sex differences were observed in the predictive performance of these biomarkers.
Collapse
Affiliation(s)
- Fang Zhu
- Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, PO Box 2040, Rotterdam, 3000 CA, The Netherlands
| | - Banafsheh Arshi
- Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, PO Box 2040, Rotterdam, 3000 CA, The Netherlands
| | - Maarten J G Leening
- Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, PO Box 2040, Rotterdam, 3000 CA, The Netherlands
- Department of Cardiology, Erasmus MC-University Medical Center Rotterdam, PO Box 2040, Rotterdam, 3000 CA, The Netherlands
| | - Elif Aribas
- Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, PO Box 2040, Rotterdam, 3000 CA, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, PO Box 2040, Rotterdam, 3000 CA, The Netherlands
| | - Eric Boersma
- Department of Cardiology, Erasmus MC-University Medical Center Rotterdam, PO Box 2040, Rotterdam, 3000 CA, The Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, PO Box 2040, Rotterdam, 3000 CA, The Netherlands
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, PO Box 2040, Rotterdam, 3000 CA, The Netherlands
| |
Collapse
|
36
|
Xiao T, van Kleef LA, Ikram MK, de Knegt RJ, Ikram MA. Association of Nonalcoholic Fatty Liver Disease and Fibrosis With Incident Dementia and Cognition: The Rotterdam Study. Neurology 2022; 99:e565-e573. [PMID: 35618435 PMCID: PMC9442616 DOI: 10.1212/wnl.0000000000200770] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 04/08/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Nonalcoholic fatty liver disease (NAFLD) might affect brain health via the so-called liver-brain axis. Whether this results in an increased risk for dementia remains unclear. Therefore, we investigated the association of NAFLD and fibrosis with incident dementia and cognition among the elderly. METHODS We performed longitudinal and cross-sectional analyses within the Rotterdam Study, an ongoing prospective cohort. Participants visiting between 1997 and 2002 with available fatty liver index (FLI) (set 1) or participants visiting between 2009 and 2014 with abdominal ultrasound (set 2) and liver stiffness (set 3) were included. Exclusion criteria were secondary causes for steatosis, prevalent dementia, and missing alcohol data. NAFLD was defined as FLI ≥60 or steatosis on ultrasound and fibrosis as liver stiffness ≥8.0 kPa. Dementia was defined according to the DSM-III-R. Associations between NAFLD, fibrosis, or liver stiffness and incident dementia were quantified using Cox regression. Finally, the association between NAFLD and cognitive function was assessed cross-sectionally. RESULTS Set 1 included 3,975 participants (age 70 years, follow-up 15.5 years), set 2 4,577 participants (age 69.9 years, follow-up 5.7 years), and set 3 3,300 participants (age 67.6 years, follow-up 5.6 years). NAFLD and fibrosis were consistently not associated with an increased risk for dementia (NAFLD based on ultrasound, hazard rate [HR] 0.84, 95% CI 0.61-1.16; NAFLD based on FLI, HR 0.92, 95% CI 0.69-1.22; fibrosis, HR 1.07, 95% CI 0.58-1.99) in fully adjusted models. Of interest, NAFLD was associated with a significantly decreased risk for incident dementia until 5 years after FLI assessment (HR 0.48; 95% CI 0.24-0.94). Moreover, NAFLD was not associated with worse cognitive function, covering several domains. CONCLUSIONS NAFLD and fibrosis were not associated with an increased risk for incident dementia, nor was NAFLD associated with impaired cognitive function. In contrast, NAFLD was even protective in the first 5 years of follow-up, hinting toward NAFLD regression before dementia onset. TRIAL REGISTRATION INFORMATION Clinical Trial Number: NTR6831.
Collapse
Affiliation(s)
- Tian Xiao
- From the Departments of Epidemiology (T.X., M.A.I.), Gastroenterology and Hepatology (L.K., R.D.K.), Neurology (M.K.I.), Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Laurens A van Kleef
- From the Departments of Epidemiology (T.X., M.A.I.), Gastroenterology and Hepatology (L.K., R.D.K.), Neurology (M.K.I.), Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - M Kamran Ikram
- From the Departments of Epidemiology (T.X., M.A.I.), Gastroenterology and Hepatology (L.K., R.D.K.), Neurology (M.K.I.), Erasmus MC University Medical Center, Rotterdam, the Netherlands.
| | - Robert J de Knegt
- From the Departments of Epidemiology (T.X., M.A.I.), Gastroenterology and Hepatology (L.K., R.D.K.), Neurology (M.K.I.), Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - M Arfan Ikram
- From the Departments of Epidemiology (T.X., M.A.I.), Gastroenterology and Hepatology (L.K., R.D.K.), Neurology (M.K.I.), Erasmus MC University Medical Center, Rotterdam, the Netherlands.
| |
Collapse
|
37
|
Waziry R, Hofman A, Ghanbari M, Tiemeier H, Ikram MA, Viswanathan A, Klap J, Ikram MK, Goudsmit J. Biological aging for risk prediction of first-ever intracerebral hemorrhage and cerebral infarction in advanced age. J Stroke Cerebrovasc Dis 2022; 31:106568. [PMID: 35749936 DOI: 10.1016/j.jstrokecerebrovasdis.2022.106568] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 10/12/2021] [Revised: 04/30/2022] [Accepted: 05/15/2022] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND AND OBJECTIVES successful interventions to prevent cerebrovascular disease and stroke require early identification of persons at risk before clinical manifestation of disease. The literature remains to be sparse on accessible plasma-based biomarkers for monitoring brain health and cerebrovascular disease in advanced age. We assessed the predictive value of biological age (BA) as an early indicator for cerebrovascular disease and risk of first-ever intracerebral hemorrhage (ICH) and cerebral infarction (CI) in advanced age and compared these relationships with chronological age (CA) and commonly used biomarkers including tau and Aβ40 and Aβ42. METHODS The study included Individuals who consented for blood draw and follow-up. We computed biological age using structural equation modelling. The criteria for the biomarkers included their representability of the various body systems; their availability in the Rotterdam study and their pre-hypothesized reflection of aging in other populations. The algorithm integrates biomarkers that represent six body systems involved in overall cerebrovascular health including metabolic function, cardiac function, lung function, kidney function, liver function, immunity, and inflammation. Time to event analysis was conducted using Cox-regression models. Prediction analysis was conducted using Harrel's C and Area under the receiver operating characteristic curve. RESULTS The sample included a total of 1699 individuals at baseline followed up over a median of 11 years. During a period of 15, 780 and 16, 172 person-years, a total of 17 first-ever intracerebral hemorrhage and 83 cerebral infarction cases occurred. In time-to-event analysis, BA showed higher magnitude of associations with ICH compared to CA (HRBA-ICH: 2.30, 95% CI: 1.20, 4.30; HRCA-ICH: 1.40, 95% CI: 0.76, 2.53) and higher precision with CI (HRBA-CI: 1.30, 95% CI: 1.01,1.75; HRCA-CI:1.90, 95% CI: 1.48, 2.66). BA outperformed CA for prediction of ICH (AUC: 0.68 vs 0.53; Harrel's C: 0.72 vs 0.53) and for CI (AUC:0.63 vs 0.62; Harrel's C: 0.68 vs 0.67). CONCLUSIONS Biological aging (delta biological aging) based on integrated physiology biomarkers provides a novel tool for monitoring and identification of persons at highest risk of cerebrovascular disease in advanced age with varying degrees of precision and magnitude for stroke subtypes. These variations are likely related to differences in pathophysiology of intracerebral hemorrhage and cerebral infarction. Wider validation and applicability require extension of these findings in other comparable samples and in clinical settings.
Collapse
Affiliation(s)
- Reem Waziry
- Columbia University Irving Medical Center, New York, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, United States; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
| | - Albert Hofman
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, United States
| | - Mohsen Ghanbari
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Henning Tiemeier
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, United States
| | - M A Ikram
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, United States; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Anand Viswanathan
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Harvard University, United States
| | - Jaco Klap
- Janssen Prevention Center, Leiden, the Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Neurology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Jaap Goudsmit
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, United States; World Without Disease Accelerator (WWDA), The Janssen Pharmaceutical Companies of Johnson & Johnson, Leiden, the Netherlands and Leyden Laboratories, Leiden, the Netherlands
| |
Collapse
|
38
|
Rueda-Ochoa OL, Bons LR, Zhu F, Rohde S, El Ghoul K, Budde RPJ, Ikram MK, Deckers JW, Vernooij MW, Franco OH, van der Lugt A, Bos D, Roos-Hesselink JW, Kavousi M. Thoracic Aortic Diameter and Cardiovascular Events and Mortality among Women and Men. Radiology 2022; 304:208-215. [PMID: 35412363 DOI: 10.1148/radiol.210861] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background Thoracic aortic diameter may have a role as a biomarker for major adverse cardiovascular events. Purpose To evaluate the sex-specific association of the diameters of the ascending (AA) and descending (DA) thoracic aorta with risk of stroke, coronary heart disease, heart failure, cardiovascular mortality, and all-cause mortality. Materials and Methods Study participants from the population-based Rotterdam Study who underwent multidetector-row CT between 2003 and 2006 were evaluated. Cox proportional hazard models were conducted to evaluate the associations of AA and DA diameters indexed and not indexed for body mass index (BMI) with cardiovascular events and mortality for men and women. Hazard ratios (HRs) were calculated per 1-unit greater SD of aortic diameters. Results A total of 2178 participants (mean age, 69 years; 55% women) were included. Mean follow-up was 9 years. Each 0.23-mm/(kg/m2) larger BMI-indexed AA diameter was associated with a 33% higher cardiovascular mortality risk in women (HR, 1.33; 95% CI: 1.03, 1.73). Each 0.16-mm/(kg/m2) larger BMI-indexed DA diameter was associated with a 38% higher risk of stroke (HR, 1.38; 95% CI: 1.07, 1.78) and with a 46% greater risk of cardiovascular mortality (HR, 1.46; 95% CI: 1.10, 1.94) in women. Larger BMI-indexed AA and DA diameters were associated with greater risk of all-cause mortality in both sexes. Conclusion Larger ascending and descending thoracic aortic diameters indexed by body mass index were associated with greater risk of adverse cardiovascular outcomes and mortality in women and men. Clinical trial registration no. NTR6831 © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Williams in this issue.
Collapse
Affiliation(s)
- Oscar L Rueda-Ochoa
- From the Departments of Epidemiology (O.L.R.O., F.Z., M.K.I., M.W.V., O.H.F., D.B., M.K.), Cardiology (L.R.B., S.R., K.E.G., J.W.D., J.W.R.H.), Radiology and Nuclear Medicine (R.P.J.B., M.W.V., A.v.d.L., D.B.), and Neurology (M.K.I.), Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Lidia R Bons
- From the Departments of Epidemiology (O.L.R.O., F.Z., M.K.I., M.W.V., O.H.F., D.B., M.K.), Cardiology (L.R.B., S.R., K.E.G., J.W.D., J.W.R.H.), Radiology and Nuclear Medicine (R.P.J.B., M.W.V., A.v.d.L., D.B.), and Neurology (M.K.I.), Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Fang Zhu
- From the Departments of Epidemiology (O.L.R.O., F.Z., M.K.I., M.W.V., O.H.F., D.B., M.K.), Cardiology (L.R.B., S.R., K.E.G., J.W.D., J.W.R.H.), Radiology and Nuclear Medicine (R.P.J.B., M.W.V., A.v.d.L., D.B.), and Neurology (M.K.I.), Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Sofie Rohde
- From the Departments of Epidemiology (O.L.R.O., F.Z., M.K.I., M.W.V., O.H.F., D.B., M.K.), Cardiology (L.R.B., S.R., K.E.G., J.W.D., J.W.R.H.), Radiology and Nuclear Medicine (R.P.J.B., M.W.V., A.v.d.L., D.B.), and Neurology (M.K.I.), Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Khalid El Ghoul
- From the Departments of Epidemiology (O.L.R.O., F.Z., M.K.I., M.W.V., O.H.F., D.B., M.K.), Cardiology (L.R.B., S.R., K.E.G., J.W.D., J.W.R.H.), Radiology and Nuclear Medicine (R.P.J.B., M.W.V., A.v.d.L., D.B.), and Neurology (M.K.I.), Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Ricardo P J Budde
- From the Departments of Epidemiology (O.L.R.O., F.Z., M.K.I., M.W.V., O.H.F., D.B., M.K.), Cardiology (L.R.B., S.R., K.E.G., J.W.D., J.W.R.H.), Radiology and Nuclear Medicine (R.P.J.B., M.W.V., A.v.d.L., D.B.), and Neurology (M.K.I.), Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands
| | - M Kamran Ikram
- From the Departments of Epidemiology (O.L.R.O., F.Z., M.K.I., M.W.V., O.H.F., D.B., M.K.), Cardiology (L.R.B., S.R., K.E.G., J.W.D., J.W.R.H.), Radiology and Nuclear Medicine (R.P.J.B., M.W.V., A.v.d.L., D.B.), and Neurology (M.K.I.), Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Jaap W Deckers
- From the Departments of Epidemiology (O.L.R.O., F.Z., M.K.I., M.W.V., O.H.F., D.B., M.K.), Cardiology (L.R.B., S.R., K.E.G., J.W.D., J.W.R.H.), Radiology and Nuclear Medicine (R.P.J.B., M.W.V., A.v.d.L., D.B.), and Neurology (M.K.I.), Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Meike W Vernooij
- From the Departments of Epidemiology (O.L.R.O., F.Z., M.K.I., M.W.V., O.H.F., D.B., M.K.), Cardiology (L.R.B., S.R., K.E.G., J.W.D., J.W.R.H.), Radiology and Nuclear Medicine (R.P.J.B., M.W.V., A.v.d.L., D.B.), and Neurology (M.K.I.), Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Oscar H Franco
- From the Departments of Epidemiology (O.L.R.O., F.Z., M.K.I., M.W.V., O.H.F., D.B., M.K.), Cardiology (L.R.B., S.R., K.E.G., J.W.D., J.W.R.H.), Radiology and Nuclear Medicine (R.P.J.B., M.W.V., A.v.d.L., D.B.), and Neurology (M.K.I.), Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Aad van der Lugt
- From the Departments of Epidemiology (O.L.R.O., F.Z., M.K.I., M.W.V., O.H.F., D.B., M.K.), Cardiology (L.R.B., S.R., K.E.G., J.W.D., J.W.R.H.), Radiology and Nuclear Medicine (R.P.J.B., M.W.V., A.v.d.L., D.B.), and Neurology (M.K.I.), Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Daniel Bos
- From the Departments of Epidemiology (O.L.R.O., F.Z., M.K.I., M.W.V., O.H.F., D.B., M.K.), Cardiology (L.R.B., S.R., K.E.G., J.W.D., J.W.R.H.), Radiology and Nuclear Medicine (R.P.J.B., M.W.V., A.v.d.L., D.B.), and Neurology (M.K.I.), Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Jolien W Roos-Hesselink
- From the Departments of Epidemiology (O.L.R.O., F.Z., M.K.I., M.W.V., O.H.F., D.B., M.K.), Cardiology (L.R.B., S.R., K.E.G., J.W.D., J.W.R.H.), Radiology and Nuclear Medicine (R.P.J.B., M.W.V., A.v.d.L., D.B.), and Neurology (M.K.I.), Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Maryam Kavousi
- From the Departments of Epidemiology (O.L.R.O., F.Z., M.K.I., M.W.V., O.H.F., D.B., M.K.), Cardiology (L.R.B., S.R., K.E.G., J.W.D., J.W.R.H.), Radiology and Nuclear Medicine (R.P.J.B., M.W.V., A.v.d.L., D.B.), and Neurology (M.K.I.), Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands
| |
Collapse
|
39
|
Shlobin NA, Volovici V, Ikram MK. Case-Control Studies in Neurosurgery: the Issue of Effect Estimates. World Neurosurg 2022; 163:e187-e191. [PMID: 35367643 DOI: 10.1016/j.wneu.2022.03.097] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/19/2022] [Accepted: 03/21/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Clinical research questions are commonly answered using a case-control design. The decision to use this design is usually justified due to low cost, feasibility, and ease of execution. However, the case-control design presents challenges in execution, selection of cases/controls, and interpretation of effect measures (odds ratios, among others). In this paper, we clarify for a neurosurgical audience the design and appropriate effect size measures obtained from case-control studies. METHODS A narrative review was conducted of published literature on the topic. The future implementation of such studies was discussed and highlighted with several examples from neurosurgical practice. RESULTS In a case-control design, participants are selected for a study based on their outcome status. Some participants have the outcome of interest (cases), whereas others do not (controls). Controls can be selected from a variety of sources, such as the general population, relatives/friends, or hospital patients without the disease under investigation. The most important criterion is that these controls come from the same study base as cases. Furthermore, it is essential to realize that measures of association obtained from a case-control study depend on the sampling strategy of the controls and, as such, have equivalent counterparts available from cohort studies. We delineate traditional case-control, case-cohort, and incidence-density sampled case-control studies and their applicability to common conditions encountered in daily neurosurgical practice (e.g. glioblastoma, aneurysms, and epilepsy). CONCLUSIONS Neurosurgeons must understand the types of case-control studies and their associated effect measures to properly conduct research and incorporate research findings into clinical practice.
Collapse
Affiliation(s)
- Nathan A Shlobin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Victor Volovici
- Department of Neurosurgery, Erasmus MC, Rotterdam, The Netherlands; Center for Medical Decision Making, Department of Public Health, Erasmus MC, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands; Department of Neurology, Erasmus MC, Rotterdam, The Netherlands
| |
Collapse
|
40
|
van der Toorn JE, Bos D, Ikram MK, Verwoert GC, van der Lugt A, Ikram MA, Vernooij MW, Kavousi M. Carotid Plaque Composition and Prediction of Incident Atherosclerotic Cardiovascular Disease. Circ Cardiovasc Imaging 2022; 15:e013602. [PMID: 35196868 DOI: 10.1161/circimaging.121.013602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Whether information on carotid plaque composition contributes to prediction of incident atherosclerotic cardiovascular disease (ASCVD) remains to be investigated. We determined the sex-specific added value of carotid plaque components for predicting incident ASCVD events, beyond traditional cardiovascular risk factors. METHODS Between 2007 and 2012, participants from the population-based Rotterdam Study with asymptomatic carotid wall thickening >2.5 mm on ultrasonography were invited for carotid magnetic resonance imaging. Among 1349 participants (mean age: 72 years [SD±9.3], 49.5% women) without cardiovascular disease, we assessed plaque thickness, luminal stenosis (>30%), presence of intraplaque hemorrhage, lipid-rich necrotic core, and calcification. Follow-up for ASCVD was complete until January 1, 2015. Using Cox proportional hazards models, we fitted sex-specific prediction models including traditional cardiovascular risk factors (base model). We extended the base model by single and simultaneous additions of plaque characteristics and calculated improvement of model performance by the C statistics. RESULTS During a median follow-up of 4.8 years, 60 men and 48 women developed ASCVD. In women, presence of intraplaque hemorrhage was associated with incident ASCVD (adjusted hazard ratio, 3.37 [95% CI, 1.81-6.25]). The C statistic (95% CI) improved from 0.73 (0.66-0.79) to 0.76 (0.70-0.83) after single addition of intraplaque hemorrhage to the base model. Simultaneous addition of plaque components, plaque thickness, and stenosis did not change the results. In men, only carotid stenosis was statistically significantly associated with incident ASCVD (adjusted hazard ratio, 1.75 [95% CI, 1.00-3.08]); yet, the association diminished after the addition of other plaque characteristics, and no improvements were observed in C statistics. CONCLUSIONS Presence of intraplaque hemorrhage contributes to the prediction of incident ASCVD in women, beyond traditional cardiovascular risk factors, other plaque components, plaque size, and stenosis.
Collapse
Affiliation(s)
- Janine E van der Toorn
- Department of Epidemiology (J.E.v.d.T., D.B., M.K.I., M.A.I., M.W.V., M.K.), Erasmus MC, University Medical Centre Rotterdam, The Netherlands.,Department of Radiology and Nuclear Medicine (J.E.v.d.T., D.B., A.v.d.L., M.W.V.), Erasmus MC, University Medical Centre Rotterdam, The Netherlands
| | - Daniel Bos
- Department of Epidemiology (J.E.v.d.T., D.B., M.K.I., M.A.I., M.W.V., M.K.), Erasmus MC, University Medical Centre Rotterdam, The Netherlands.,Department of Radiology and Nuclear Medicine (J.E.v.d.T., D.B., A.v.d.L., M.W.V.), Erasmus MC, University Medical Centre Rotterdam, The Netherlands
| | - M Kamran Ikram
- Department of Epidemiology (J.E.v.d.T., D.B., M.K.I., M.A.I., M.W.V., M.K.), Erasmus MC, University Medical Centre Rotterdam, The Netherlands.,Department of Neurology (M.K.I.), Erasmus MC, University Medical Centre Rotterdam, The Netherlands
| | - Germaine C Verwoert
- Department of Cardiology (G.C.V.), Erasmus MC, University Medical Centre Rotterdam, The Netherlands
| | - Aad van der Lugt
- Department of Epidemiology (J.E.v.d.T., D.B., M.K.I., M.A.I., M.W.V., M.K.), Erasmus MC, University Medical Centre Rotterdam, The Netherlands.,Department of Radiology and Nuclear Medicine (J.E.v.d.T., D.B., A.v.d.L., M.W.V.), Erasmus MC, University Medical Centre Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology (J.E.v.d.T., D.B., M.K.I., M.A.I., M.W.V., M.K.), Erasmus MC, University Medical Centre Rotterdam, The Netherlands
| | - Meike W Vernooij
- Department of Epidemiology (J.E.v.d.T., D.B., M.K.I., M.A.I., M.W.V., M.K.), Erasmus MC, University Medical Centre Rotterdam, The Netherlands.,Department of Radiology and Nuclear Medicine (J.E.v.d.T., D.B., A.v.d.L., M.W.V.), Erasmus MC, University Medical Centre Rotterdam, The Netherlands
| | - Maryam Kavousi
- Department of Epidemiology (J.E.v.d.T., D.B., M.K.I., M.A.I., M.W.V., M.K.), Erasmus MC, University Medical Centre Rotterdam, The Netherlands
| |
Collapse
|
41
|
Heshmatollah A, Fani L, Koudstaal PJ, Ghanbari M, Ikram MA, Ikram MK. Plasma Amyloid Beta, Total-Tau and Neurofilament Light Chain Levels and the Risk of Stroke: A Prospective Population-Based Study. Neurology 2022; 98:e1729-e1737. [PMID: 35232820 DOI: 10.1212/wnl.0000000000200004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 01/03/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES To unravel whether Alzheimer's disease-related pathology or neurodegeneration play a role in stroke etiology, we determined the effect of plasma levels amyloid β (Aβ), total-tau and neurofilament light chain (NfL) on risk of stroke and its subtypes. METHODS Between 2002 and 2005, we measured plasma Aβ40, Aβ42, total-tau, and NfL in 4,661 stroke-free participants from the population-based Rotterdam Study. We used Cox proportional-hazards models to determine the association between these markers with incident stroke for the entire cohort, per stroke subtype, and by median age, sex, Apolipoprotein E (APOE) ε4 carriership, and education. RESULTS After a mean follow-up of 10.8 ± 3.3 years, 379 participants suffered a first-ever stroke. Log2 total-tau at baseline showed a non-linear association with risk of any stroke and ischemic stroke: compared to the first (lowest) quartile the adjusted hazard ratio for the highest quartile total-tau was 1.68, 95% CI: 1.18-2.40 for any stroke. Log2 NfL was associated with an increased risk of any stroke (HR per SD increase 1.27, 95% CI: 1.12-1.44), ischemic stroke, and hemorrhagic stroke (HR 1.56, 95% CI: 1.14-2.12). Log2 Aβ40, Aβ42, and Aβ42/40 ratio levels were not associated with stroke risk.Discussion Participants with higher total-tau and NfL at baseline had a higher risk of stroke and several stroke subtypes. These findings support the role of markers of neurodegeneration in the etiology of stroke. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that higher plasma levels of total-tau and NfL are associated with an increased risk of subsequent stroke.
Collapse
Affiliation(s)
- Alis Heshmatollah
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands.,Department of Neurology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Lana Fani
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Peter J Koudstaal
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Mohsen Ghanbari
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands.,Department of Neurology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| |
Collapse
|
42
|
Fani L, Roa Dueñas O, Bos D, Vernooij MW, Klaver CCW, Ikram MK, Peeters RP, Ikram MA, Chaker L. Thyroid Status and Brain Circulation: The Rotterdam Study. J Clin Endocrinol Metab 2022; 107:e1293-e1302. [PMID: 34634119 PMCID: PMC8851919 DOI: 10.1210/clinem/dgab744] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Indexed: 11/28/2022]
Abstract
CONTEXT Whether thyroid dysfunction is related to altered brain circulation in the general population remains unknown. OBJECTIVE We determined the association of thyroid hormones with different markers of brain circulation within community-dwelling elderly people. METHODS This was a population-based study of 3 subcohorts of the Rotterdam Study, starting in 1989, 2000, and 2006. A total of 5142 participants (mean age, 63.8 years; 55.4% women), underwent venipuncture to measure serum thyroid-stimulating hormone (TSH) and free thyroxine (FT4). Between 2005 and 2015, all participants underwent phase-contrast brain magnetic resonance imaging to assess global brain perfusion (mL of blood flow/100 mL of brain/minute). Arteriolar retinal calibers were assessed using digitized images of stereoscopic fundus color transparencies in 3105 participants as markers of microcirculation. We investigated associations of TSH, FT4 with brain circulation measures using (non)linear regression models. RESULTS FT4 (in pmol/L) levels had an inverse U-shaped association with global brain perfusion, such that high and low levels of FT4 were associated with lower global brain perfusion than middle levels of FT4. The difference in global brain perfusion between high FT4 levels (25 pmol/L) and middle FT4 levels (FT4 = 15 pmol/L; P nonlinearity = .002) was up to -2.44 mL (95% CI -4.31; -0.56). Higher and lower levels of FT4, compared with middle FT4 levels, were associated with arteriolar retinal vessels (mean difference up to -2.46 µm, 95% CI -4.98; 0.05 for lower FT4). CONCLUSION These results suggest that thyroid dysfunction could lead to brain diseases such as stroke or dementia through suboptimal brain circulation that is potentially modifiable.
Collapse
Affiliation(s)
- Lana Fani
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Oscar Roa Dueñas
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Daniel Bos
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC, The Netherlands
| | - Meike W Vernooij
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC, The Netherlands
| | - Caroline C W Klaver
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Ophthalmology, Erasmus MC, the Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Neurology, Erasmus MC, The Netherlands
| | - Robin P Peeters
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus MC, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Layal Chaker
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus MC, The Netherlands
- Correspondence: Layal Chaker, MD, PhD, Department of Epidemiology, Erasmus MC University Medical Center, Dr. Molewaterplein 40, PO Box 2040, 3000CA Rotterdam, The Netherlands.
| |
Collapse
|
43
|
Yaqub A, Darweesh SKL, Dommershuijsen LJ, Vernooij MW, Ikram MK, Wolters FJ, Ikram MA. Risk factors, neuroimaging correlates and prognosis of the motoric cognitive risk syndrome: a population-based comparison with mild cognitive impairment. Eur J Neurol 2022; 29:1587-1599. [PMID: 35147272 PMCID: PMC9306517 DOI: 10.1111/ene.15281] [Citation(s) in RCA: 3] [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: 12/08/2021] [Accepted: 02/08/2022] [Indexed: 11/27/2022]
Abstract
Background and purpose This study was undertaken to compare risk factors, neuroimaging characteristics and prognosis between two clinical prodromes of dementia, namely, the motoric cognitive risk syndrome (MCRS) and mild cognitive impairment (MCI). Methods Between 2009 and 2015, dementia‐free participants of the population‐based Rotterdam Study were classified with a dementia prodrome if they had subjective cognitive complaints and scored >1 SD below the population mean of gait speed (MCRS) or >1.5 SD below the population mean of cognitive test scores (MCI). Using multinomial logistic regression models, we determined cross‐sectional associations of risk factors and structural neuroimaging markers with MCRS and MCI, followed by subdistribution hazard models, to determine risk of incident dementia until 2016. Results Of 3025 included participants (mean age = 70.4 years, 54.7% women), 231 had MCRS (7.6%), 132 had MCI (4.4%), and 62 (2.0%) fulfilled criteria for both. Although many risk factors were shared, a higher body mass index predisposed to MCRS, whereas male sex and hypercholesterolemia were associated with MCI only. Gray matter volumes, hippocampal volumes, white matter hyperintensities, and structural white matter integrity were worse in both MCRS and MCI. During a mean follow‐up of 3.9 years, 71 individuals developed dementia and 200 died. Five‐year cumulative risk of dementia was 7.0% (2.5%–11.5%) for individuals with MCRS, versus 13.3% (5.8%–20.8%) with MCI and only 2.3% (1.5%–3.1%) in unaffected individuals. Conclusions MCRS is associated with imaging markers of neurodegeneration and risk of dementia, even in the absence of MCI, highlighting the potential of motor function assessment in early risk stratification for dementia.
Collapse
Affiliation(s)
- Amber Yaqub
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Sirwan K L Darweesh
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.,Department of Neurology, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | - Meike W Vernooij
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.,Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.,Department of Neurology, Erasmus MC, Rotterdam, The Netherlands
| | - Frank J Wolters
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.,Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| |
Collapse
|
44
|
de Haan A, Ahmadizar F, van der Most PJ, Thio CHL, Kamali Z, Ani A, Ghanbari M, Chaker L, van Meurs J, Ikram MK, van Goor H, Bakker SJL, van der Harst P, Snieder H, Kavousi M, Pasch A, Eijgelsheim M, de Borst MH. Genetic Determinants of Serum Calcification Propensity and Cardiovascular Outcomes in the General Population. Front Cardiovasc Med 2022; 8:809717. [PMID: 35097025 PMCID: PMC8795369 DOI: 10.3389/fcvm.2021.809717] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 12/17/2021] [Indexed: 12/12/2022] Open
Abstract
Background:Serum calciprotein particle maturation time (T50), a measure of vascular calcification propensity, is associated with cardiovascular morbidity and mortality. We aimed to identify genetic loci associated with serum T50 and study their association with cardiovascular disease and mortality.Methods:We performed a genome-wide association study of serum T50 in 2,739 individuals of European descent participating in the Prevention of REnal and Vascular ENd-stage Disease (PREVEND) study, followed by a two-sample Mendelian randomization (MR) study to examine causal effects of T50 on cardiovascular outcomes. Finally, we examined associations between T50 loci and cardiovascular outcomes in 8,566 community-dwelling participants in the Rotterdam study.Results:We identified three independent genome-wide significant single nucleotide polymorphism (SNPs) in the AHSG gene encoding fetuin-A: rs4917 (p = 1.72 × 10−101), rs2077119 (p = 3.34 × 10−18), and rs9870756 (p = 3.10 × 10−8), together explaining 18.3% of variation in serum T50. MR did not demonstrate a causal effect of T50 on cardiovascular outcomes in the general population. Patient-level analyses revealed that the minor allele of rs9870756, which explained 9.1% of variation in T50, was associated with a primary composite endpoint of all-cause mortality or cardiovascular disease [odds ratio (95% CI) 1.14 (1.01–1.28)] and all-cause mortality alone [1.14 (1.00–1.31)]. The other variants were not associated with clinical outcomes. In patients with type 2 diabetes or chronic kidney disease, the association between rs9870756 and the primary composite endpoint was stronger [OR 1.40 (1.06–1.84), relative excess risk due to interaction 0.54 (0.01–1.08)].Conclusions:We identified three SNPs in the AHSG gene that explained 18.3% of variability in serum T50 levels. Only one SNP was associated with cardiovascular outcomes, particularly in individuals with type 2 diabetes or chronic kidney disease.
Collapse
Affiliation(s)
- Amber de Haan
- Division of Nephrology, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Fariba Ahmadizar
- Department of Epidemiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
- Julias Global Health, University Medical Center Utrecht, Utrecht, Netherlands
| | - Peter J. van der Most
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Chris H. L. Thio
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Zoha Kamali
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Department of Bioinformatics, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Ani
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Mohsen Ghanbari
- Department of Epidemiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Layal Chaker
- Department of Epidemiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
- Division of Endocrinology, Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Joyce van Meurs
- Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - M. Kamran Ikram
- Department of Epidemiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Neurology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Harry van Goor
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Stephan J. L. Bakker
- Division of Nephrology, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Pim van der Harst
- Department of Cardiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Harold Snieder
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Andreas Pasch
- Calciscon AG, Biel, Switzerland
- Institute for Physiology and Pathophysiology, Johannes Kepler University Linz, Linz, Austria
| | - Mark Eijgelsheim
- Division of Nephrology, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Martin H. de Borst
- Division of Nephrology, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- *Correspondence: Martin H. de Borst
| |
Collapse
|
45
|
de Crom TOE, Mooldijk SS, Ikram MK, Ikram MA, Voortman T. MIND diet and the risk of dementia: a population-based study. Alzheimers Res Ther 2022; 14:8. [PMID: 35022067 PMCID: PMC8756695 DOI: 10.1186/s13195-022-00957-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 12/30/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Adherence to the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet has been linked to a decreased risk of dementia, but reverse causality and residual confounding by lifestyle may partly account for this link. We aimed to address these issues by studying the associations over cumulative time periods, which may provide insight into possible reverse causality, and by using both historical and more contemporary dietary data as this could give insight into confounding since historical data may be less affected by lifestyle factors. METHODS In the population-based Rotterdam Study, dietary intake was assessed using validated food frequency questionnaires in 5375 participants between 1989 and 1993 (baseline I) and in a largely non-overlapping sample in 2861 participants between 2009 and 2013 (baseline II). We calculated the MIND diet score and studied its association with the risk of all-cause dementia, using Cox models. Incident all-cause dementia was recorded until 2018. RESULTS During a mean follow-up of 15.6 years from baseline I, 1188 participants developed dementia. A higher MIND diet score at baseline I was associated with a lower risk of dementia over the first 7 years of follow-up (hazard ratio (HR) [95% confidence interval (CI)] per standard deviation (SD) increase, 0.85 [0.74, 0.98]), but associations disappeared over longer follow-up intervals. The mean follow-up from baseline II was 5.9 years during which 248 participants developed dementia. A higher MIND diet score at baseline II was associated with a lower risk of dementia over every follow-up interval, but associations slightly attenuated over time (HR [95% CI] for 7 years follow-up per SD increase, 0.76 [0.66, 0.87]). The MIND diet score at baseline II was more strongly associated with the risk of dementia than the MIND diet score at baseline I. CONCLUSION Better adherence to the MIND diet is associated with a decreased risk of dementia within the first years of follow-up, but this may in part be explained by reverse causality and residual confounding by lifestyle. Further research is needed to unravel to which extent the MIND diet may affect the risk of dementia.
Collapse
Affiliation(s)
- Tosca O E de Crom
- Department of Epidemiology, Erasmus MC, University Medical Center, PO Box 2040, 3000, CA, Rotterdam, The Netherlands.
| | - Sanne S Mooldijk
- Department of Epidemiology, Erasmus MC, University Medical Center, PO Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus MC, University Medical Center, PO Box 2040, 3000, CA, Rotterdam, The Netherlands.,Department of Neurology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, University Medical Center, PO Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC, University Medical Center, PO Box 2040, 3000, CA, Rotterdam, The Netherlands.,Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| |
Collapse
|
46
|
Dommershuijsen LJ, Ruiter R, Erler NS, Rizopoulos D, Ikram MA, Ikram MK. Peripheral Immune Cell Numbers and C-Reactive Protein in Parkinson's Disease: Results from a Population-Based Study. J Parkinsons Dis 2022; 12:667-678. [PMID: 34897101 PMCID: PMC8925126 DOI: 10.3233/jpd-212914] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2023]
Abstract
BACKGROUND The immune system is known to be involved in Parkinson's disease (PD) pathogenesis, but the temporal relationship between peripheral immune responses and PD remains unknown. OBJECTIVE We determined the association between peripheral immune cell numbers, C-reactive protein (CRP), and prevalent as well as incident PD. METHODS This study was embedded in the population-based setting of the Rotterdam Study. We repeatedly measured peripheral immune cell numbers (differential leukocyte count and platelet count, granulocyte-to-lymphocyte ratio [GLR], platelet-to-lymphocyte ratio [PLR], and adapted systemic immune-inflammation index [adapted SII]) and CRP between 1990 and 2016. Participants were continuously followed-up for PD until 2018. We estimated the association of the markers with prevalent and incident PD using logistic regression models and joint models, respectively. Models were adjusted for age, sex, smoking, body mass index, and medication use. Odds ratios (OR) and hazard ratios (HR) are shown per doubling of the marker. RESULTS A total of 12,642 participants were included in this study. The mean age (standard deviation) was 65.1 (9.8) years and 57.5%were women. Participants with a higher lymphocyte count were less likely to have prevalent PD (adjusted OR: 0.34, 95%CI 0.17-0.68). Participants with a higher GLR, PLR, and adapted SII were more likely to have prevalent PD, but these effects were explained by the lymphocyte count. The peripheral immune cell numbers and CRP were not significantly associated with the risk of incident PD. CONCLUSION We found participants with a higher lymphocyte count to be less likely to have prevalent PD, but we did not find an association between peripheral immune cell numbers nor CRP and the risk of incident PD.
Collapse
Affiliation(s)
| | - Rikje Ruiter
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Nicole S. Erler
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
- Department of Biostatistics, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Dimitris Rizopoulos
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
- Department of Biostatistics, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - M. Arfan Ikram
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - M. Kamran Ikram
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
- Correspondence to: M. Kamran Ikram, MD, PhD, Erasmus MC University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands. Tel.: +31 107043488; E-mail:
| |
Collapse
|
47
|
Velek P, Splinter MJ, Ikram MK, Ikram MA, Leening MJG, van der Lei J, Hartman TO, Peters LL, Tange H, Rutten FH, van Weert H, Wolters FJ, Bindels PJE, Licher S, de Schepper EIT. Changes in the Diagnosis of Stroke and Cardiovascular Conditions in Primary Care During First 2 COVID-19 Waves in the Netherlands. Neurology 2021; 98:e564-e572. [PMID: 34965968 PMCID: PMC8829962 DOI: 10.1212/wnl.0000000000013145] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 07/05/2021] [Accepted: 11/23/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Although there is evidence of disruption in acute cerebrovascular and cardiovascular care during the COVID-19 pandemic, its downstream effect in primary care is less clear. We investigated how the pandemic affected utilization of cerebrovascular and cardiovascular care in general practices (GPs) and determined changes in GP-recorded diagnoses of selected cerebrovascular and cardiovascular outcomes. METHODS From electronic health records of 166,929 primary care patients aged 30 or over within the Rotterdam region, the Netherlands, we extracted the number of consultations related to cerebrovascular and cardiovascular care, and first diagnoses of selected cerebrovascular and cardiovascular risk factors (hypertension, diabetes, lipid disorders), conditions and events (angina, atrial fibrillation, TIA, myocardial infarction, stroke). We quantified changes in those outcomes during the first COVID-19 wave (March-May 2020) and thereafter (June-December 2020) by comparing them to the same period in 2016-2019. We also estimated the number of potentially missed diagnoses for each outcome. RESULTS The number of GP consultations related to cerebrovascular and cardiovascular care declined by 38% (0.62, 95% CI: 0.56-0.68) during the first wave, as compared to expected counts based on pre-pandemic levels. Substantial declines in the number of new diagnoses were observed for cerebrovascular events: 37% for TIA (0.63, 0.41-0.96), and 29% for stroke (0.71, 0.59 to 0.84), while no significant changes were observed for cardiovascular events (myocardial infarction (0.91, 0.74-1.14), angina (0.77, 0.48-1.25)). The counts across individual diagnoses recovered following June 2020, but the number of GP consultations related to cerebrovascular and cardiovascular care remained lower than expected also throughout the June-December period (0.93, 0.88-0.98). DISCUSSION While new diagnoses of acute cardiovascular events remained stable during the COVID19 pandemic, diagnoses of cerebrovascular events declined substantially compared to pre-pandemic levels, possibly due to incorrect perception of risk by patients. These findings emphasize the need to improve symptom recognition of cerebrovascular events among the general public and to encourage urgent presentation despite any physical distancing measures.
Collapse
Affiliation(s)
- Premysl Velek
- Department of Epidemiology, Erasmus MC - University Medical Centre Rotterdam, Rotterdam, The Netherlands .,Department of General Practice, Erasmus MC - University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Marije J Splinter
- Department of Epidemiology, Erasmus MC - University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus MC - University Medical Centre Rotterdam, Rotterdam, The Netherlands.,Department of Neurology, Erasmus MC - University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC - University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Maarten J G Leening
- Department of Epidemiology, Erasmus MC - University Medical Centre Rotterdam, Rotterdam, The Netherlands.,Department of Cardiology, Erasmus MC - University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Johan van der Lei
- Department of Medical Informatics, Erasmus MC - University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Tim Olde Hartman
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Lilian L Peters
- Department of General Practice & Elderly Medicine/ Midwifery Science, University Medical Centre Groningen, Groningen, The Netherlands.,Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Midwifery Science, AVAG, Amsterdam Public Health, The Netherlands
| | - Huibert Tange
- Department of Family Practice, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Frans H Rutten
- Department of General Practice, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Henk van Weert
- Department of General Practice, Amsterdam Public Health, Amsterdam Universities Medical Centre, Amsterdam, The Netherlands
| | - Frank J Wolters
- Department of Epidemiology, Erasmus MC - University Medical Centre Rotterdam, Rotterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus MC - University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Patrick J E Bindels
- Department of General Practice, Erasmus MC - University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Silvan Licher
- Department of Epidemiology, Erasmus MC - University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Evelien I T de Schepper
- Department of General Practice, Erasmus MC - University Medical Centre Rotterdam, Rotterdam, The Netherlands
| |
Collapse
|
48
|
Licher S, Wolters FJ, Pavlović J, Kavousi M, Leening MJG, Ikram MK, Ikram MA. Are we targeting the right population? Application of eligibility criteria of 10 dementia prevention trials to the general population. Alzheimers Dement 2021. [DOI: 10.1002/alz.050821] [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: 11/09/2022]
Affiliation(s)
- Silvan Licher
- Department of Epidemiology, Erasmus MC, Rotterdam, Netherlands Rotterdam Netherlands
| | - Frank J Wolters
- Department of Epidemiology, Erasmus University Medical Center Rotterdam Netherlands
| | - Jelena Pavlović
- Department of Epidemiology, Erasmus MC, Rotterdam, Netherlands Rotterdam Netherlands
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus MC, Rotterdam, Netherlands Rotterdam Netherlands
| | - Maarten JG Leening
- Department of Epidemiology, Erasmus MC, Rotterdam, Netherlands Rotterdam Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus MC Rotterdam Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, Rotterdam, Netherlands Rotterdam Netherlands
| |
Collapse
|
49
|
Khan SR, Yaqub A, Wolters FJ, Ikram MK, Dalm VA, Chaker L, Ikram MA. The association of serum immunoglobulins with cognition and dementia: The Rotterdam Study. Alzheimers Dement 2021. [DOI: 10.1002/alz.053612] [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: 11/10/2022]
Affiliation(s)
- Samer R. Khan
- Department of Epidemiology, Erasmus University Medical Center Rotterdam Netherlands
- Department of Internal Medicine, Division of Clinical Immunology, Erasmus University Medical Center Rotterdam Netherlands
| | - Amber Yaqub
- Department of Epidemiology, Erasmus University Medical Center Rotterdam Netherlands
| | - Frank J. Wolters
- Department of Epidemiology, Erasmus University Medical Center Rotterdam Netherlands
| | - M. Kamran Ikram
- Department of Neurology, Erasmus MC Rotterdam Netherlands
- Department of Epidemiology, Erasmus MC Rotterdam Netherlands
| | - Virgil A.S.H. Dalm
- Department of Internal Medicine, Division of Clinical Immunology, Erasmus University Medical Center Rotterdam Netherlands
- Department of Immunology, Erasmus University Medical Center Rotterdam Netherlands
| | - Layal Chaker
- Department of Epidemiology, Erasmus University Medical Center Rotterdam Netherlands
- Department of Internal Medicine, Division of Endocrinology, Erasmus University Medical Center Rotterdam Netherlands
| | - M. Arfan Ikram
- Department of Epidemiology, Erasmus MC Rotterdam Netherlands
| |
Collapse
|
50
|
van den Beukel TC, van der Toorn JE, Vernooij MW, Kavousi M, Akyildiz AC, de Jong PA, van der Lugt A, Ikram MK, Bos D. Morphological Subtypes of Intracranial Internal Carotid Artery Arteriosclerosis and the Risk of Stroke. Stroke 2021; 53:1339-1347. [PMID: 34802249 DOI: 10.1161/strokeaha.121.036213] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND PURPOSE Accumulating evidence highlights the existence of distinct morphological subtypes of intracranial carotid arteriosclerosis. So far, little is known on the prevalence of these subtypes and subsequent stroke risk in the general population. We determined the prevalence of morphological subtypes of intracranial arteriosclerosis and assessed the risk of stroke associated with these subtypes. METHODS Between 2003 and 2006, 2391 stroke-free participants (mean age 69.6, 51.7% women) from the population-based Rotterdam Study underwent noncontrast computed tomography to visualize calcification in the intracranial carotid arteries as a proxy for intracranial arteriosclerosis. Calcification morphology was evaluated according to a validated grading scale and categorized into intimal, internal elastic lamina (IEL), or mixed subtype. Follow-up for stroke was complete until January 1, 2016. We used multivariable Cox regression to assess associations of each subtype with incident stroke. RESULTS The prevalence of calcification was 82% of which 39% had the intimal subtype, 48% IEL subtype, and 13% a mixed subtype. During a median follow-up of 10.4 years, 155 participants had a stroke. All 3 subtypes were associated with a higher risk of stroke (adjusted hazard ratio [95% CI] for intimal: 2.11 [1.07-4.13], IEL: 2.66 [1.39-5.11], and mixed subtype 2.57 [1.18-5.61]). The association of the IEL subtype with stroke was strongest among older participants. The association of the intimal subtype with stroke was noticeably stronger in women than in men. CONCLUSIONS Calcification of the IEL was the most prevalent subtype of intracranial arteriosclerosis. All 3 subtypes were associated with an increased risk of stroke, with noticeable age and sex-specific differences.
Collapse
Affiliation(s)
- Tim C van den Beukel
- Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands. (T.C.v.d.B., J.E.v.d.T., M.W.V., M.K., M.K.I., D.B.).,Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands. (T.C.v.d.B., J.E.v.d.T., M.W.V., A.v.d.L., D.B.)
| | - Janine E van der Toorn
- Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands. (T.C.v.d.B., J.E.v.d.T., M.W.V., M.K., M.K.I., D.B.).,Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands. (T.C.v.d.B., J.E.v.d.T., M.W.V., A.v.d.L., D.B.)
| | - Meike W Vernooij
- Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands. (T.C.v.d.B., J.E.v.d.T., M.W.V., M.K., M.K.I., D.B.).,Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands. (T.C.v.d.B., J.E.v.d.T., M.W.V., A.v.d.L., D.B.)
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands. (T.C.v.d.B., J.E.v.d.T., M.W.V., M.K., M.K.I., D.B.)
| | - Ali C Akyildiz
- Department of Cardiology, Biomedical Engineering, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands. (A.C.A.).,Department of Biomedical Engineering, Delft, University of Technology, the Netherlands (A.C.A.)
| | - Pim A de Jong
- Department of Radiology and Nuclear Medicine, University Medical Center, Utrecht, the Netherlands (P.A.d.J.)
| | - Aad van der Lugt
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands. (T.C.v.d.B., J.E.v.d.T., M.W.V., A.v.d.L., D.B.)
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands. (T.C.v.d.B., J.E.v.d.T., M.W.V., M.K., M.K.I., D.B.).,Department of Neurology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands. (M.K.I.)
| | - Daniel Bos
- Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands. (T.C.v.d.B., J.E.v.d.T., M.W.V., M.K., M.K.I., D.B.).,Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands. (T.C.v.d.B., J.E.v.d.T., M.W.V., A.v.d.L., D.B.)
| |
Collapse
|