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Menassa M, Wesenhagen K, Stronks K, Franco OH, Verschuren W, Picavet H. Individual mental health patterns and the role of lifestyle among ageing adults over 20 years - the Doetinchem Cohort Study. Arch Gerontol Geriatr 2023; 115:105222. [PMID: 37839196 DOI: 10.1016/j.archger.2023.105222] [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: 06/09/2023] [Revised: 10/03/2023] [Accepted: 10/05/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVE We explored the prevalence of individual mental health patterns and the role of lifestyle factors over 20 years. STUDY DESIGN We used data from the Doetinchem Cohort Study (1995-2019), a population-based study amongst adults (26-90 years) examined every five years in the Netherlands. Participants were classified in five pre-defined mental health patterns (persistent good, persistent poor, worsening, improving, varying) over 20 years (five rounds) using the MHI-5 questionnaire. BMI, sleep, smoking, alcohol consumption, and physical activity were dichotomised as healthy/unhealthy based on guidelines. The role of lifestyle at baseline (t1), 20 years later (t5), and longitudinally over 20 years (using pre-defined patterns) was explored using logistic regression. RESULTS Most participants had good mental health at t1 (85 %) and t5 (88 %). Over 20 years, 67 % followed a persistent good mental health pattern, 30 % a changing pattern, and 3 % a persistent poor pattern. Persistent poor and changing patterns were associated with unhealthy sleep and smoking at t1, t5, and with the 20-year unhealthy patterns. Persistent poor mental health was associated with stable unhealthy and changing sleep (OR=5.58(2.48-12.54) and OR=2.07(1.14-3.74), respectively), and with stable unhealthy and changing smoking (OR=3.35(1.58-7.11) and OR=2.53(1.40-4.57), respectively). Changing mental health was associated with changing (OR=1.54(1.26-1.88) and OR=1.64(1.30-2.07), respectively) and stable unhealthy (OR=1.80(1.23-2.64) and OR=2.24(1.60-3.14), respectively) sleep and smoking, respectively. CONCLUSIONS Persistent good and changing mental health patterns were more common than poor mental health in adults and were associated with smoking and sleep. Clarifying the underlying mechanisms and directionality between mental health and lifestyle could improve interventions.
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Affiliation(s)
- M Menassa
- Institute of Social and Preventive Medicine, University of Bern, Mittelstrasse 43, Bern 3012, Switzerland; Graduate School for Health Sciences, University of Bern, Bern, Switzerland; Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
| | - Kej Wesenhagen
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, the Netherlands
| | - K Stronks
- Department of Public and Occupational Health, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - O H Franco
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Wmm Verschuren
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Hsj Picavet
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, the Netherlands
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Eser P, Gonzalez-Jaramillo N, Weber S, Femiano R, Werner C, Casanova F, Bano A, Franco OH, Wilhelm M. Comparison of the 2010 and 2020 World Health Organization guidelines on physical activity in patients with percutaneous coronary interventions early after hospital discharge. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Swiss heart foundation
Background
Physical activity (PA) is inversely associated with mortality and adverse outcome in patients with cardiovascular disease, and can be objectively measured by accelerometry. In 2020, the World Health Organization (WHO) has updated their recommendations on PA for adults including those with chronic conditions, omitting the 10 min bout criterion.[1] The aim of this study was to determine the proportions of cardiac patients immediately after hospital discharge from percutaneous coronary interventions (PCI) who fulfil the old [2] and updated WHO PA criteria, and compare the results with established step-based cut-off values.
Methods
Patients after PCI for acute or chronic coronary syndrome with a maximal age of 80 and eligible for ambulatory cardiac rehabilitation were recruited for this observational single centre study. They were provided with a wrist-worn tri-axial accelerometer without display that recorded movement data starting from the day following hospital discharge for the subsequent 18 days. Acceleration data was analysed with the widely used free GGIR package. The proportions of patients fulfilling recommendations for moderate to vigorous PA (MVPA) were determined according to the 2010 and 2020 WHO guidelines as well as 7,500 [3] and 10,000 steps.[4]
Results
159 patients (41%) participated in this study. Data from 135 patients (85%), who had at least 7 days of ≥12 h wear-time were included in the analyses. Their median age was 62 (1st quartile 56, 3rd quartile 68), 22 (16%) were women, and 15 and 120 patients had a CCS and ACS, respectively. Their median wear time was 18 (16, 18) days. 102 (75.6%) had at least 30 min of MVPA on an average day and hence fulfilled the 2020 WHO guidelines. When MVPA was determined using the 2010 WHO guidelines, which only counted MVPA of bouts of at least 10 min, only 23 patients (17.8%) achieved at least 30 min of MVPA on an average day (Figure 1). 67.4% of our patients achieved ≥7,500 steps/d and 71 patients (52.6%) performed ≥10,000 steps/d.
Conclusion
In cardiac patients early after PCI most of the MVPA was accumulated in bouts shorter than 10 min. Applying the 2010 and 2020 WHO PA criteria to objectively measured PA led to a fourfold discrepancy. The 7,500 step cut-off corresponded with the 2020 WHO recommendations. Since achievement of intensity- or step-based cut-offs is greatly dependent on device type, wearing location, data sampling and analysis, it is currently poorly defined and not suited for patient classification and counselling. The clinical implication of this observation will be assessed in a cardiovascular outcome analysis.
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Affiliation(s)
- P Eser
- Preventive Cardiology & Sports Medicine, University Clinic for Cardiology, University Hospital Berne, Berne, Switzerland
| | - N Gonzalez-Jaramillo
- University of Bern, Institute for Social and Preventive Medicine, Bern, Switzerland
| | - S Weber
- University of Bern, Institute for Social and Preventive Medicine, Bern, Switzerland
| | - R Femiano
- University of Bern, Institute for Social and Preventive Medicine, Bern, Switzerland
| | - C Werner
- Swiss Federal Institute of Technology Zurich (ETH Zurich), Rehabilitation Engineering Laboratory, Zurich, Switzerland
| | - F Casanova
- Preventive Cardiology & Sports Medicine, University Clinic for Cardiology, University Hospital Berne, Berne, Switzerland
| | - A Bano
- University of Bern, Institute for Social and Preventive Medicine, Bern, Switzerland
| | - OH Franco
- University of Bern, Institute for Social and Preventive Medicine, Bern, Switzerland
| | - M Wilhelm
- Preventive Cardiology & Sports Medicine, University Clinic for Cardiology, University Hospital Berne, Berne, Switzerland
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Bassetti CLA, Endres M, Sander A, Crean M, Subramaniam S, Carvalho V, Di Liberto G, Franco OH, Pijnenburg Y, Leonardi M, Boon P. The EAN Brain Health Strategy: One Brain, One Life, One Approach. Eur J Neurol 2022; 29:2559-2566. [PMID: 35538709 DOI: 10.1111/ene.15391] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/03/2022] [Accepted: 05/06/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Brain health is essential for health, well-being productivity and creativity across the entire life. Its definition goes beyond the absence of disease embracing all cognitive, emotional, behavioural and social functions which are necessary to cope with life situations. METHODS The EAN Brain Health Strategy responds to the high and increasing burden of neurological disorders. It aims to develop a non-disease, non-age centred holistic and positive approach ('one brain, one life, one approach') to prevent neurological disorders (e.g., Alzheimer's disease and other dementias, stroke, epilepsy, headache/migraine, Parkinson's disease, multiple sclerosis, sleep disorders, brain cancer) but also to preserve brain health and promote recovery after brain damage. RESULTS The pillars of the EAN Brain Health strategy are: 1) Contribute to a global and international Brain Health approach (together with national and subspecialty societies, other medical societies, WHO, WFN, patients' organizations, industry, and other stakeholders); 2) Supporting the 47 European national societies, healthcare and policymakers in the implementation of integrated and people-centred campaigns; 3) Fostering Research (e.g. on prevention of neurological disorders, determinants and assessments of brain health), 4) Promoting Education of students, neurologists, general practitioners, other medical specialists and health professionals, patients, caregivers, and general public; 5) Raising public awareness of neurological disorders and brain health. CONCLUSIONS By adopting this 'one brain, one life, one approach' strategy in cooperation with partner societies, international organisations, and policymakers, a significant number of neurological disorders may be prevented while enhancing the overall well-being of individuals by maintaining brain health through the life course.
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Affiliation(s)
- C L A Bassetti
- Department of Neurology, University of Bern, Bern, Switzerland
| | - M Endres
- Department of Neurology with Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - A Sander
- The European Academy of Neurology, Vienna, Austria
| | - M Crean
- The European Academy of Neurology, Vienna, Austria
| | | | - V Carvalho
- Department of Neurosciences and Mental Health, Hospital de Santa Maria, Lisboa, Portugal
| | - G Di Liberto
- Division of Neurology, Department of Clinical Neurosciences, University Hospital of Lausanne, University of Lausanne, Lausanne, Switzerland
| | - O H Franco
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Yolande Pijnenburg
- Department of Neurology, Alzheimer Center, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - M Leonardi
- Fondazione IRCCS Instituto Neurologico C. Besta, Milan, Italy
| | - P Boon
- Department of Neurology, 4Brain, Institute for Neuroscience, Reference Center for Refractory Epilepsy, Ghent University Hospital, Ghent, Belgium
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Raguindin PF, Stoyanov J, Eriks I, Stucki G, Jordan X, Schubert M, Franco OH, Muka T, Glisic M. Changes in cardiometabolic risk factors during inpatient rehabilitation of traumatic spinal cord injury from a multicenter Swiss Spinal Cord Injury Cohort (SwiSCI). Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Cardiometabolic health has a growing relevance in spinal cord injury (SCI) considering the increasing survival and aging population. We explored longitudinal changes in cardiometabolic risk profile and examined whether injury characteristics could be a non-modifiable risk factor for individuals with SCI in subacute phase of the injury.
Methods
We used the data from a multicenter Swiss Spinal Cord Injury Cohort (SwiSCI) study and included adults with traumatic SCI (TSCI) without cardiometabolic diseases and diabetes at baseline. We included individuals with available data on admission and prior to discharge from first SCI rehabilitation. Blood pressure, lipid profile, fasting glucose, waist circumference (WC), weight, and body mass index (BMI) were compared according to the injury level (tetraplegia-TP vs paraplegia-PP) and completeness (motor complete-COM vs incomplete-INC). We used multivariable linear regression for cross-sectional analysis and linear mixed models for longitudinal analysis, adjusting for age, sex, lifestyle factors, medication-use, and injury characteristics. We performed age- (above and below median age) and sex-stratified analyses. Sensitivity analyses were also performed by removing systemic steroid-use (proxy for acute injury), adjusting for opioid-use (medication side-effect) and adjusting further for BMI and WC.
Results
We analyzed 258 individuals with TSCI (110 TP and 148 PP, 122 COM and 136 INC). Median age was 50 years (IQR 32–60), with 76.36% (n=197) of the population being male. The median rehabilitation duration was 5.5 months (IQR 3.2–7.1). On admission, the fully-adjusted models showed higher baseline weight, systolic BP, diastolic BP and triglycerides in PP than TP. Systolic BP, diastolic BP, HDL, HDL/LDL were higher in INC than COM. In the overall population, we observed increases in cholesterol, HDL, and HDL/LDL ratio over rehabilitation period. Individuals with PP had a higher increase in BMI as compared to TT, while no differences were detected when comparing INC and COM injury (Table 1–3). Results from sensitivity analyses were generally in line with the overall findings; however, at baseline, there was some indication that lipid profile may be different in COM and INC injury. In sex-stratified longitudinal analysis, triglycerides were higher in females PP than TP, and diastolic BP was higher in females with INC than COM. For age-stratified longitudinal analysis, elderly with PP have higher triglycerides than younger adults.
Conclusion
We reported changes in BMI and lipid profile during the inpatient rehabilitation of individuals with traumatic SCI and without history of cardiovascular diseases and diabetes. Injury characteristics may not be an independent risk factor for subacute phase, but maybe important in specific subgroups, like in women and in the elderly (>50 years old).
Funding Acknowledgement
Type of funding sources: None. MethodsResults
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Affiliation(s)
- P F Raguindin
- Institute of Social and Preventive Medicine. University of Bern, Bern, Switzerland
| | - J Stoyanov
- Swiss Paraplegic Research, Notwill, Switzerland
| | - I Eriks
- Swiss Paraplegic Center, Nottwil, Switzerland
| | - G Stucki
- Swiss Paraplegic Research, Notwill, Switzerland
| | - X Jordan
- Clinique Romande de Réadaptation, Sion, Switzerland
| | - M Schubert
- University Hospital Balgrist, Zurich, Switzerland
| | - O H Franco
- Institute of Social and Preventive Medicine. University of Bern, Bern, Switzerland
| | - T Muka
- Institute of Social and Preventive Medicine. University of Bern, Bern, Switzerland
| | - M Glisic
- Swiss Paraplegic Research, Notwill, Switzerland
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Roa Diaz ZM, Asllanaj E, Amin HA, Rojas LZ, Nano J, Ikram MA, Drenos F, Franco OH, Pazoki R, Marques-Vidal P, Voortman T, Muka T. Causal and observational evidence on the role of early menopause in hypertension. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Blood pressure has been suggested as potential factor contributing to the increased risk of cardiovascular disease observed in women experiencing early menopause (<45 years). However, whether the association between early menopause and hypertension is causal remains unclear (1,2).
Purpose
To evaluate the observational and causal association between age at natural menopause (ANM) and blood pressure (BP) traits in Caucasian women.
Methods
Cross-sectional and one-sample Mendelian randomization (MR) study was conducted in 4451 postmenopausal women from two different cohort studies. Hypertension was defined as a systolic BP (SBP) ≥140 mmHg, and/or diastolic BP (DBP) ≥90 mmHg, and/or the use of antihypertensive medication. Multivariable linear and logistic regressions were implemented in the observational analysis. We calculated a weighted genetic risk score with 54 variants associated with ANM (GRS-ANM) (3). The genetic variants were previously identified in a genome wide association study (4), after that we implemented two-stage least squares in the one-sample MR. Estimates from all cohorts were pooled through meta-analysis
Results
The pooled analysis across cohorts showed early menopause, compared to menopause between 50–54 years, to be associated with lower DBP (β=−1.31 mmHg, 95% CI: −2.43; −0.18), while no association was found between other ANM categories and DBP. Similarly, the pooled analysis of both cohorts did not show an association of ANM with SBP, neither as a continuous variable nor by category. One year of later onset of menopause was associated with higher odds of developing hypertension (Odds ratio (OR): 1.02, 95% CI: 1:00; 1.04) while no association was found for the ANM categories and hypertension (Table 1). Results of the evaluation of MR assumption, supported their compliance, the GRS-ANM was associated with observed ANM and explained between 1.4% and 3.4% of the ANM variance in the included cohorts, F statistic values were among 11.15 and 40.63 (Figure 1). We found no association between GRS-ANM and SBP, DBP or hypertension (Table 1).
Conclusion
The present study does not support the hypothesis that early onset of menopause is associated with higher BP.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): The CoLaus study was and is supported by research grants from GlaxoSmithKline, the Faculty of Biology and Medicine of Lausanne, and the Swiss National Science Foundation (grants 33CSCO-122661, 33CS30-139468 and 33CS30-148401).Zayne M. Roa-Díaz has received funding from the European Union's Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 801076, through the SSPH+ Global PhD Fellowship Programme in Public Health Sciences (GlobalP3HS) of the Swiss School of Public Health.
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Affiliation(s)
- Z M Roa Diaz
- Institute of Social and Preventive Medicine. University of Bern, Bern, Switzerland
| | - E Asllanaj
- Erasmus University Medical Centre, Department of Epidemiology, Rotterdam, Netherlands (The)
| | - H A Amin
- Brunel University, Department of Life Sciences, College of Health and Life Sciences, Uxbridge, United Kingdom
| | - L Z Rojas
- Cardiovascular Foundation of Colombia, Nursing Research and Knowledge Development Group GIDCEN, Bucaramanga, Colombia
| | - J Nano
- Helmholtz Center Munich, Institute of Epidemiology, Neuherberg, Germany
| | - M A Ikram
- Erasmus University Medical Centre, Department of Epidemiology, Rotterdam, Netherlands (The)
| | - F Drenos
- Brunel University, Department of Life Sciences, College of Health and Life Sciences, Uxbridge, United Kingdom
| | - O H Franco
- Institute of Social and Preventive Medicine. University of Bern, Bern, Switzerland
| | - R Pazoki
- Brunel University, Department of Life Sciences, College of Health and Life Sciences, Uxbridge, United Kingdom
| | - P Marques-Vidal
- Lausanne University Hospital (CHUV) and University of Lausanne, Department of Medicine, Internal Medicine, Laussane, Switzerland
| | - T Voortman
- Erasmus University Medical Centre, Department of Epidemiology, Rotterdam, Netherlands (The)
| | - T Muka
- Institute of Social and Preventive Medicine. University of Bern, Bern, Switzerland
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Raguindin PF, Cardona I, Muka T, Lambrinoudaki I, Gebhard C, Franco OH, Marques-Vidal P, Glisic M. Does transition through menopause affect cardiovascular disease risk factors? Results from a population-based cohort (CoLaus study). Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Menopause has been associated with adverse cardiovascular disease (CVD) risk profile, yet it is unclear whether the changes in CVD risk factors differ by reproductive stage independently of underlying aging trajectories. We examined whether reproductive stages are differently associated with changes in cardiovascular risk factors.
Methods
This is a prospective population-based cohort study. We used data from women at baseline and follow-up (mean 5.5 years). We classified women into (i) premenopausal, (ii) menopausal transition, (iii) early (≤5 years), and (iv) late (>5 years) postmenopausal by comparing their menstruation status at baseline and follow-up. In the cross-sectional analysis, we compared CVD risk factors at baseline across different reproductive stages using multivariable linear regression models. In the longitudinal analysis, we used multivariable linear mixed models. We used premenopausal women as a reference category and adjusted our analyses for age, medications, hormone replacement therapy, lifestyle, body mass index (BMI) at baseline and follow-up.
Results
We used the data from 2,558 women aged 35–75 years. At baseline, compared to premenopausal women, (i) transition and early postmenopausal groups had higher HDL, (ii) early- and late postmenopausal women had higher BMI, total cholesterol, adiponectin, and interleukin-6 levels, and (iii) all other women groups had higher diastolic blood pressure and glucose levels, while no differences were observed in the other CVD risk factors. At follow-up, women across the four reproductive categories showed an increase in BMI, total cholesterol, triglycerides, and fasting glucose compared to baseline. However, linear mixed models showed that, the changes in CVD risk factors were not significantly different in the other three menopausal categories compared to premenopausal women. When using age as a predictor variable and adjusting for menopause status, most of the CVD risk factors increased, while interleukin 6 and interleukin 1b decreased with advancing age. The estimates did not change when the analyses were restricted to women who did not report hormone therapy-use.
Conclusion
The current study suggests that women have a worsening of cardiovascular risk profile as they age, and although menopausal women may have higher levels of cardiovascular risk factors compared to premenopausal women at any given time, the five year changes in cardiovascular risk factors may not depend on menopausal status per se. More studies are still needed to disentangle the contribution of age and menopause in postmenopausal CVD risk, and other pathways not explored in this study.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): COLAUS was supported by a research grants from GlaxoSmithKline and the Swiss National Science Foundation and
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Affiliation(s)
- P F Raguindin
- Institute of Social and Preventive Medicine. University of Bern, Bern, Switzerland
| | - I Cardona
- Institute of Social and Preventive Medicine. University of Bern, Bern, Switzerland
| | - T Muka
- Institute of Social and Preventive Medicine. University of Bern, Bern, Switzerland
| | - I Lambrinoudaki
- National & Kapodistrian University of Athens Medical School, University of Athens, Athens, Greece
| | - C Gebhard
- University Hospital Zurich, Zurich, Switzerland
| | - O H Franco
- Institute of Social and Preventive Medicine. University of Bern, Bern, Switzerland
| | - P Marques-Vidal
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - M Glisic
- Institute of Social and Preventive Medicine. University of Bern, Bern, Switzerland
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Pérez-Galarza J, Baldeón L, Franco OH, Muka T, Drexhage HA, Voortman T, Freire WB. Prevalence of overweight and metabolic syndrome, and associated sociodemographic factors among adult Ecuadorian populations: the ENSANUT-ECU study. J Endocrinol Invest 2021; 44:63-74. [PMID: 32430865 PMCID: PMC7796886 DOI: 10.1007/s40618-020-01267-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 04/18/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Obesity and metabolic syndrome (MetS) are key risk factors for type 2 diabetes and cardiovascular disease. Little information exists on the prevalence of obesity and MetS in Latin America and specifically in Ecuador. We aimed to estimate the prevalence of overweight, obesity, and MetS among adults in Ecuador. METHODS We analyzed data from a nation-wide population-based survey in Ecuador (ENSANUT-ECU) among 10,318 participants (3684 men, 6634 women; age range: 18-59 years) conducted in 2012. Data related to residential location (urban versus rural), altitude (< 500, 500-1500 or > 1500 m above sea level (MASL)), region (highland, coast, amazon, or Galápagos), and socioeconomic status were collected. BMI, waist circumference, blood lipids, glucose, and blood pressure were measured by trained fieldworkers following standardized procedures. RESULTS The age-standardized prevalence of overweight was 39.5%; 22.3% was obese; and 31.2% had MetS. The prevalence of obesity, low HDL-cholesterol, and abdominal obesity were higher in women than in men, whereas men had a higher prevalence of hypertension (p < 0.05). Sex differences were not observed regarding the prevalence of combined MetS. Prevalence of both obesity and MetS was higher in urban areas, at low altitude regions (coast and Galapagos), and at high socioeconomic status (all p < 0.05). CONCLUSIONS Prevalence of obesity and MetS in Ecuador are high. There are important demographic differences in the prevalence of MetS between Ecuadorian subpopulations that requires targeted research and prevention efforts, to hold and reduce the current public health problem of metabolic disorders.
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Affiliation(s)
- J Pérez-Galarza
- Instituto de Investigación en Biomedicina (INBIOMED), Universidad Central del Ecuador, Quito, Ecuador.
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
| | - L Baldeón
- Instituto de Investigación en Biomedicina (INBIOMED), Universidad Central del Ecuador, Quito, Ecuador
| | - O H Franco
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - T Muka
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - H A Drexhage
- Department of Immunology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - T Voortman
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - W B Freire
- Instituto de Investigación y Nutrición, Universidad San Francisco de Quito, Quito, Ecuador
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Bundo M, de Schrijver E, Federspiel A, Luterbacher J, Franco OH, Müller T, Vicedo-Cabrera AM. Impact of ambient temperature on mental health in Bern, Switzerland: a time-series study. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Previous studies suggest that people with mental disorders are more vulnerable to increased ambient temperatures (AT). In Switzerland, neuropsychiatric diseases contribute up to 35.1% of the total burden of disease. This burden could possibly increase in the future under current climate change scenarios, if no appropriate public health measures were implemented. However, there is lack of evidence on the impact of AT on mental health in Switzerland.
Objective
This study aimed to investigate the short-term association between AT and mental health hospitalizations in Bern, Switzerland.
Methods
From 1973 to 2010, we collected individual data on daily hospitalizations for mental disorders (71,931) from the University Hospital of Psychiatry and Psychotherapy in Bern. We used population-weighted daily mean AT for the canton of Bern derived from the 2.2-km gridded weather data provided by MeteoSwiss. We applied conditional Poisson regression with distributed lag linear models to assess the association and to account for delayed effects up to 3 days after the exposure. We conducted stratified analysis and by age, sex and diagnosis.
Results
The overall risk of hospitalizations increased linearly by 3.0% (95% CI: 0.0%, 6.0%) for every 10C°C-increase in mean daily AT. No differences in risk estimates were found across sex (3.0% in males (95% CI: 0%, 7.0%) and 4.0% in females (95% CI: 0%, 8.0%)) and age groups (≥ 45 years old: 4.0% (95% CI: 0%, 9.0%) and <45 years old: 3.0% (95% CI 0%, 7%)). Larger association estimates were found for schizophrenia (10.0%; 95% CI 4%, 16%), while no association was found for substance abuse (0.0%; 95% CI -7.0%, 6.0%).
Conclusions
Our preliminary findings suggest that increasing AT are associated with an increased risk in hospitalizations due to mental disorders in Bern. Specific public health policies should be urgently implemented in order to protect this vulnerable population sub-group from the challenges of climate change.
Key messages
Increased ambient temperatures are associated with an increased risk in hospitalizations due to mental health disorders. Specific health policies should be implement to protect mental health patients from the challenges of climate change.
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Affiliation(s)
- M Bundo
- Climate Change and Health, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Climate Change and Health, Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - E de Schrijver
- Climate Change and Health, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Climate Change and Health, Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - A Federspiel
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - J Luterbacher
- Department of Geography, Justus Liebig University Giessen, Giessen, Germany
- Centre for International Development and Environmental Resea, Justus Liebig University Giessen, Giessen, Germany
| | - O H Franco
- Cardiometabolic Health, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - T Müller
- Privatklinik Meiringen, Meiringen, Switzerland
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - A M Vicedo-Cabrera
- Climate Change and Health, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Climate Change and Health, Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
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9
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Rueda-Ochoa OL, Rojas Sanchez LZ, Ikram MA, Deckers JW, Franco OH, Rizopoulos D, Kavousi M. P796Intensive blood pressure treatment significantly increases visit-to-visit systolic blood pressure variability. A randomized clinical trial. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Intensive blood pressure lowering is increasingly gaining attention. Besides higher baseline blood pressure, visit-to-visit variability has showed association with target organ damage and major adverse cardiovascular outcomes in multiple medical reports.
Purpose
Our aim was to assess the effect of intensive treatment on systolic blood pressure (SBP) visit-to-visit variability in the SPRINT trial population during follow-up.
Methods
We included 9068 SPRINT participants with 128139 repeated SBP measurements. Participants were randomly assigned to intensive (SBP <120 mmHg) vs standard treatment (SBP between 135–139 mmHg). The primary outcome was a composite outcome of myocardial infarction, other acute coronary syndromes, acute decompensated heart failure, stroke, and cardiovascular mortality. We calculated the coefficient of variation (CV) and standard deviation (SD), taking into account all SBP measurements prior to the SPRINT primary outcome. Comparison of CV between intensive and standard treatment in the total SPRINT population and among different subgroups was made.
Results
CVs in intensive treatment groups were higher in total population and in all groups under study (See table). While second and third CV quartile showed a larger tendency to increase the risk for the primary SPRINT outcome in the intensive treatment compared to the standard treatment group, fourth CV quartiles were significantly associated with increase in primary SPRINT outcome in both intensive and standard treatment groups.
Coefficient of variation in SPRINT trial Group Intensive treatment Standard treatment Total population 9.80 (3.22)* 8.52 (2.96) Females 10.46 (3.29)* 9.18 (3.15) Black person 9.99 (3.38)* 8.82 (3.15) Prevalence CKD 10.14 (3.22)* 9.12 (3.06) Prevalence CVD 10.28 (3.32)* 8.93 (3.23) ≥75 year 10.40 (3.18)* 9.01 (3.07) SAEs 10.30 (3.39)* 9.08 (3.13) (CKD: chronic kidney disease; CVD: cardiovascular disease; SAEs: serious adverse events. *P<0.05).
Conclusions
Intensive blood pressure treatment significantly increases SBP visit-to-visit variability in total SPRINT population and in all subgroups under study. Additional longitudinal studies with long-term follow-up are warranted to evaluate the impact of increases in SBP visit-to-visit variability due to intensive treatment on risk of major cardiovascular events.
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Affiliation(s)
- O L Rueda-Ochoa
- Industrial University of Santander, Department of Basic Sciences, Bucaramanga, Colombia
| | - L Z Rojas Sanchez
- Industrial University of Santander, School of Nursing, Bucaramanga, Colombia
| | - M A Ikram
- Erasmus Medical Center, Department of Epidemiology, Rotterdam, Netherlands (The)
| | - J W Deckers
- Erasmus Medical Center, Department of Epidemiology, Rotterdam, Netherlands (The)
| | - O H Franco
- University of Bern, Institute of Social and Preventive Medicine (ISPM), Bern, Switzerland
| | - D Rizopoulos
- Erasmus Medical Center, Department of Epidemiology, Rotterdam, Netherlands (The)
| | - M Kavousi
- Erasmus Medical Center, Department of Epidemiology, Rotterdam, Netherlands (The)
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10
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Rueda Ochoa OL, Bons LR, Rohde S, Ghoud KEL, Budde R, Ikram MK, Deckers JW, Vernooij MW, Franco OH, Van Der Lugt A, Roos-Hesselink JW, Bos D, Kavousi M. P1818Descending aortic thoracic diameter: a risk marker for major adverse cardiovascular outcomes in women. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Thoracic aortic diameters have been associated with cardiovascular risk factors and atherosclerosis. However, limited evidence regarding the role of thoracic aortic diameters as risk markers for major cardiovascular outcomes among women and men exist.
Purpose
To evaluate the independent associations between crude and indexed ascending and descending aortic (AA and DA) diameters with major cardiovascular outcomes among women and men and to provide optimal cutoff values associated with increased cardiovascular risk.
Methods and results
2178 women and men ≥55 years from the prospective population-based Rotterdam Study underwent multi-detector CT scan of thorax. Crude diameters of the AA and DA were measured and indexed by height, weight, body surface area (BSA) and body mass index (BMI). Incidence of stroke, coronary heart disease (CHD), heart failure (HF), cardiovascular and all-cause mortality were evaluated during 13 years of follow-up.
Weight-, BSA-, or BMI-indexed AA diameters showed significant associations with total or cardiovascular mortality in both sexes and height-indexed values showed association with HF in women. Crude AA diameters were associated with stroke in men and HF in women. For DA, crude and almost all indexed diameters showed significant associations with either stroke, HF, cardiovascular or total mortality in women. Only weight-, BSA- and BMI-indexed values were associated with total mortality in men. For crude DA diameter, the risk for stroke increased significantly at the 75th percentile among men while the risks for HF and cardiovascular mortality increased at the 75th and 85th percentiles respectively in women.
Conclusions
Our study suggests a role for descending thoracic aortic diameter as a marker for increased cardiovascular risk, in particular for stroke, heart failure and cardiovascular mortality among women. The cut points for increased risk for several of cardiovascular outcomes were below the 95th percentile of the distribution of aortic diameters.
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Affiliation(s)
- O L Rueda Ochoa
- Industrial University of Santander, Department of Basic Sciences, Bucaramanga, Colombia
| | - L R Bons
- Erasmus Medical Center, Department of Cardiology, Rotterdam, Netherlands (The)
| | - S Rohde
- Erasmus Medical Center, Department of Cardiology, Rotterdam, Netherlands (The)
| | - K E L Ghoud
- Erasmus Medical Center, Department of Cardiology, Rotterdam, Netherlands (The)
| | - R Budde
- Erasmus Medical Center, Department of Radiology and Nuclear medicine, Rotterdam, Netherlands (The)
| | - M K Ikram
- Erasmus Medical Center, Department of Neurology, Rotterdam, Netherlands (The)
| | - J W Deckers
- Erasmus Medical Center, Department of Cardiology, Rotterdam, Netherlands (The)
| | - M W Vernooij
- Erasmus Medical Center, Department of Radiology and Nuclear medicine, Rotterdam, Netherlands (The)
| | - O H Franco
- University of Bern, Institute of Social and Preventive Medicine (ISPM), Bern, Switzerland
| | - A Van Der Lugt
- Erasmus Medical Center, Department of Radiology and Nuclear medicine, Rotterdam, Netherlands (The)
| | - J W Roos-Hesselink
- Erasmus Medical Center, Department of Cardiology, Rotterdam, Netherlands (The)
| | - D Bos
- Erasmus Medical Center, Department of Epidemiology, Rotterdam, Netherlands (The)
| | - M Kavousi
- Erasmus Medical Center, Department of Epidemiology, Rotterdam, Netherlands (The)
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11
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Bano A, Chaker L, Mattace-Raso FUS, Peeters RP, Franco OH. P3414Differences in total life expectancy and life expectancy with and without non-communicable diseases within the reference range of thyroid function. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Variations in thyroid function within the reference ranges are associated with an increased risk of diseases and death. However, the impact of thyroid function on life expectancy (LE) and the number of years lived with and without non-communicable diseases (NCD) remains unknown.
Purpose
We aimed to investigate the association of thyroid function with total LE and LE with and without NCD among euthyroid subjects.
Methods
Participants of the Rotterdam Study without known thyroid disease and with thyroid-stimulating hormone (TSH) and free thyroxine (FT4) levels within the reference ranges were eligible. NCD were defined as the presence of cardiovascular disease, diabetes mellitus type 2, or cancer. We used multistate life tables to calculate the total LE and LE with and without NCD among TSH and FT4 tertiles, in men and women. LE estimates were obtained using prevalence, incidence rates and hazard ratios for three transitions (healthy to NCD, healthy to death and NCD to death). Analyses were adjusted for sociodemographic and cardiovascular risk factors.
Results
The mean (standard deviation) age of 7644 participants was 64.5 (9.7) years and 52.2% were women. Over a median follow-up of 8 years, we observed 1396 incident NCD events and 1422 deaths. Compared with those in the lowest tertile, men and women in the highest TSH tertile lived 1.5 (95% confidence interval [CI], 0.8; 2.3) and 1.5 (95% CI, 0.8; 2.2) years longer, respectively; of which 1.4 (95% CI, 0.5; 2.3) and 1.3 (95% CI, 0.3; 2.1) years with NCD. Compared with those in the lowest tertile, the difference in LE for men and women in the highest FT4 tertile was −3.7 (95% CI, −5.1 to −2.2) and −3.3 (95% CI, −4.7; −1.9), respectively; of which −1.8 (95% CI, −3.1 to −0.7) and −2.0 (95% CI, −3.4 to −0.7) years without NCD.
Life expectancy in TSH and FT4 tertiles
Conclusions
There are meaningful differences in total LE, LE with and without NCD within the reference ranges of thyroid function. People with low-normal thyroid function live more years with and without NCD than those with high-normal thyroid function. These findings support a reevaluation of the current reference ranges of thyroid function.
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Affiliation(s)
- A Bano
- Institute of Social and Preventive Medicine. University of Bern, Bern, Switzerland
| | - L Chaker
- Erasmus Medical Center, Departments of Internal Medicine and Epidemiology. Academic Center for Thyroid Diseases, Rotterdam, Netherlands (The)
| | - F U S Mattace-Raso
- Erasmus Medical Center, Section of Geriatric Medicine, Rotterdam, Netherlands (The)
| | - R P Peeters
- Erasmus Medical Center, Departments of Internal Medicine and Epidemiology. Academic Center for Thyroid Diseases, Rotterdam, Netherlands (The)
| | - O H Franco
- Institute of Social and Preventive Medicine. University of Bern, Bern, Switzerland
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12
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Bons LR, Rueda Ochoa OL, Rohde S, El Ghoul K, Budde RPJ, Vernooij MW, Franco OH, Van Der Lugt A, Roos-Hesselink JW, Kavousi M, Bos D. P6039Diameters of the thoracic aorta and their association with mortality in the general population. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- L R Bons
- Erasmus Medical Center, Cardiology, Rotterdam, Netherlands
| | - O L Rueda Ochoa
- Erasmus Medical Center, Epidemiology, Rotterdam, Netherlands
| | - S Rohde
- Erasmus Medical Center, Cardiology, Rotterdam, Netherlands
| | - K El Ghoul
- Erasmus Medical Center, Cardiology, Rotterdam, Netherlands
| | - R P J Budde
- Erasmus Medical Center, Radiology and Nuclear Medicine, Rotterdam, Netherlands
| | - M W Vernooij
- Erasmus Medical Center, Epidemiology, Rotterdam, Netherlands
| | - O H Franco
- Erasmus Medical Center, Epidemiology, Rotterdam, Netherlands
| | - A Van Der Lugt
- Erasmus Medical Center, Radiology and Nuclear Medicine, Rotterdam, Netherlands
| | | | - M Kavousi
- Erasmus Medical Center, Epidemiology, Rotterdam, Netherlands
| | - D Bos
- Erasmus Medical Center, Radiology and Nuclear Medicine, Rotterdam, Netherlands
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13
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Rueda Ochoa OL, Milkas AN, Fournier S, Muller O, Cicarrelli G, Xaplanteris P, Van Rooij F, Ikram MA, Wyffels E, Vanderheyden M, Bartunek J, Franco OH, Barbato E, De Bruyne B, Kavousi M. P3649Evaluating the 10-year survival after an FFR-guided strategy in patients with proximal isolated stenosis in the left anterior descending coronary artery: impact of control selection. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- O L Rueda Ochoa
- Industrial University of Santander, Department of Basic Sciences, Bucaramanga, Colombia
| | - A N Milkas
- Naval Hospital of Athens, Cardiology, Athens, Greece
| | - S Fournier
- Erasmus Medical Center, Department of Epidemiology, Rotterdam, Netherlands
| | - O Muller
- University of Lausanne, Department of Cardiology, Lausanne, Switzerland
| | | | | | - F Van Rooij
- Erasmus Medical Center, Department of Epidemiology, Rotterdam, Netherlands
| | - M A Ikram
- Erasmus Medical Center, Department of Epidemiology, Rotterdam, Netherlands
| | - E Wyffels
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - M Vanderheyden
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - J Bartunek
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - O H Franco
- Erasmus Medical Center, Department of Epidemiology, Rotterdam, Netherlands
| | - E Barbato
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | | | - M Kavousi
- Erasmus Medical Center, Department of Epidemiology, Rotterdam, Netherlands
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14
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Bons LR, Rueda Ochoa OR, Rohde S, El Ghoul K, Budde RPJ, Vernooij MW, Franco OH, Van Der Lugt A, Roos-Hesselink JW, Kavousi M, Bos D. P4548Diameters of the thoracic aorta: Gender-specific references ranges and association with body size and atherosclerotic factors. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- L R Bons
- Erasmus Medical Center, Cardiology, Rotterdam, Netherlands
| | - O R Rueda Ochoa
- Erasmus Medical Center, Epidemiology, Rotterdam, Netherlands
| | - S Rohde
- Erasmus Medical Center, Cardiology, Rotterdam, Netherlands
| | - K El Ghoul
- Erasmus Medical Center, Cardiology, Rotterdam, Netherlands
| | - R P J Budde
- Erasmus Medical Center, Radiology and Nuclear Medicine, Rotterdam, Netherlands
| | - M W Vernooij
- Erasmus Medical Center, Epidemiology, Rotterdam, Netherlands
| | - O H Franco
- Erasmus Medical Center, Epidemiology, Rotterdam, Netherlands
| | - A Van Der Lugt
- Erasmus Medical Center, Radiology and Nuclear Medicine, Rotterdam, Netherlands
| | | | - M Kavousi
- Erasmus Medical Center, Epidemiology, Rotterdam, Netherlands
| | - D Bos
- Erasmus Medical Center, Epidemiology, Rotterdam, Netherlands
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15
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Mujaj B, Bos D, Vernooij MW, Lugt AV, Muka T, Kavousi M, Staessen JA, Franco OH. 4983Serum insulin levels are associated with plaque composition in the carotid artery: the Rotterdam study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.4983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- B Mujaj
- Erasmus Medical Center, Department of Epidemiology, Rotterdam, Netherlands
| | - D Bos
- Erasmus Medical Center, Department of Radiology and Nuclear Medicine, Rotterdam, Netherlands
| | - M W Vernooij
- Erasmus Medical Center, Department of Radiology and Nuclear Medicine, Rotterdam, Netherlands
| | - A V Lugt
- Erasmus Medical Center, Department of Radiology and Nuclear Medicine, Rotterdam, Netherlands
| | - T Muka
- Erasmus Medical Center, Department of Epidemiology, Rotterdam, Netherlands
| | - M Kavousi
- Erasmus Medical Center, Department of Epidemiology, Rotterdam, Netherlands
| | - J A Staessen
- KU Leuven, Unit Hypertension and Cardiovascular Epidemiology, Leuven, Belgium
| | - O H Franco
- Erasmus Medical Center, Department of Epidemiology, Rotterdam, Netherlands
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16
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Koolhaas CM, Dhana K, van Rooij FJA, Schoufour JD, Hofman A, Franco OH. Physical Activity Types and Health-Related Quality of Life among Middle-Aged and Elderly Adults: The Rotterdam Study. J Nutr Health Aging 2018; 22:246-253. [PMID: 29380852 DOI: 10.1007/s12603-017-0902-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [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] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Physical activity (PA) is associated with health-related quality of life (HRQL). The specific PA types that provide beneficial effects in an older population remain unclear. We assessed the association of total PA, walking, cycling, domestic work, sports and gardening with HRQL in middle-aged and elderly adults. DESIGN Cross-sectional study. SETTING Rotterdam, the Netherlands. PARTICIPANTS 5,554 participants, with a mean age of 69 years. MEASUREMENTS Total PA was categorized in five groups to evaluate the dose-response effect of PA and specific PA types were categorized in tertiles. HRQL was measured with the EuroQoL 5-dimension. The outcome of every HRQL domain (i.e. mobility, self-care, daily activities, pain and mood) was expressed as having any problems versus not having problems. Logistic and linear regression analyses were used, adjusting for confounders, to examine associations of total PA and PA types with HRQL domains. RESULTS In both middle-aged (<65 years) and elderly adults (>65 years), we found a dose-response association between total PA and better HRQL (i.e. lower odds of having problems in HRQL domains). In the middle-aged, sports was the only PA type associated with lower odds of having problems with all HRQL domains. In the elderly, all PA types were associated with less problems with HRQL domains, but cycling contributed most to the beneficial effect. CONCLUSIONS Total PA was associated with better HRQL. Sports and cycling were the activity types that contributed most to this association in the middle-aged and elderly, respectively. Since PA levels tend to decline with aging, cycling and sports should be promoted with the aim to improve HRQL.
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Affiliation(s)
- C M Koolhaas
- Chantal M. Koolhaas, MSc, Department of Epidemiology - Erasmus University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands, Tel. +31 10 7043484,
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17
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Sanders MGH, Pardo LM, Franco OH, Ginger RS, Nijsten T. Prevalence and determinants of seborrhoeic dermatitis in a middle-aged and elderly population: the Rotterdam Study. Br J Dermatol 2017; 178:148-153. [PMID: 28856679 DOI: 10.1111/bjd.15908] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND Seborrhoeic dermatitis is a chronic relapsing inflammatory skin disease with unclear pathophysiological mechanisms. OBJECTIVES To establish which lifestyle and physiological determinants are associated with seborrhoeic dermatitis. METHODS Seborrhoeic dermatitis was diagnosed by a trained physician during a full-body skin examination within the Rotterdam Study, a prospective population-based cohort study in middle-aged and elderly people. The current design is a comparative cross-sectional study embedded in the Rotterdam Study. Potential factors were identified from the literature and analysed in a multivariable logistic regression, including: age, sex, obesity, skin colour, stress, depression, education level, hypertension, climate, xerosis cutis, alcohol and tobacco use. RESULTS Of the 5498 participants, 788 participants were diagnosed with seborrhoeic dermatitis (14·3%). We found associations between seborrhoeic dermatitis and male sex [adjusted odds ratio (OR) 2·09, 95% confidence interval (CI) 1·77-2·47], darker skin (adjusted OR 0·39, 95% CI 0·22-0·69), season (summer vs. winter: adjusted OR 0·63, 95% CI 0·48-0·82) and generalized xerosis cutis (adjusted OR 1·41, 95% CI 1·11-1·80). CONCLUSIONS Seborrhoeic dermatitis is one of the most common inflammatory dermatoses in middle-aged and elderly individuals, especially during winter. Men, and people with a light and dry skin were most likely to have seborrhoeic dermatitis.
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Affiliation(s)
- M G H Sanders
- Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - L M Pardo
- Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - O H Franco
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - R S Ginger
- Unilever Research and Development, Colworth Science Park, Sharnbrook, U.K
| | - T Nijsten
- Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands
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18
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de Jonge EAL, Koromani F, Hofman A, Uitterlinden AG, Franco OH, Rivadeneira F, Kiefte-de Jong JC. Dietary acid load, trabecular bone integrity, and mineral density in an ageing population: the Rotterdam study. Osteoporos Int 2017; 28:2357-2365. [PMID: 28405729 PMCID: PMC5524850 DOI: 10.1007/s00198-017-4037-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 03/31/2017] [Indexed: 11/25/2022]
Abstract
UNLABELLED We studied the relation between a diet that is high in acid-forming nutrients (e.g. proteins) and low in base-forming nutrients (e.g. potassium) and bone structure. We showed a negative relation, which was more prominent if proteins were of animal rather than of vegetable origin and if intake of dietary fibre was high. INTRODUCTION Studies on dietary acid load (DAL) and fractures have shown inconsistent results. Associations between DAL, bone mineral density (BMD) and trabecular bone integrity might play a role in these inconsistencies and might be influenced by renal function and dietary fibre intake. Therefore, our aim was to study (1) associations of DAL with BMD and with the trabecular bone score (TBS) and (2) the potential influence of renal function and dietary fibre in these associations. METHODS Dutch individuals aged 45 years and over (n = 4672) participating in the prospective cohort of the Rotterdam study were included. Based on food frequency questionnaires, three indices of DAL were calculated: the net endogenous acid production (NEAP) and the ratios of vegetable or animal protein and potassium (VegPro/K and AnPro/K). Data on lumbar spinal TBS and BMD were derived from dual-energy X-ray absorptiometry measurements. RESULTS Independent of confounders, NEAP and AnPro/K, but not VegPro/K, were associated with low TBS (standardized β (95%) = -0.04 (-0.07, -0.01) and -0.08 (-0.11, -0.04)) but not with BMD. Associations of AnPro/K and VegPro/K with TBS were non-linear and differently shaped. Unfavourable associations between NEAP, BMD and TBS were mainly present in subgroups with high fibre intake. CONCLUSIONS High NEAP was associated with low TBS. Associations of AnPro/K and VegPro/K and TBS were non-linear and differently shaped. No significant associations of DAL with BMD were observed, nor was there any significant interaction between DAL and renal function. Mainly in participants with high intake of dietary fibre, DAL might be detrimental to bone.
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Affiliation(s)
- E A L de Jonge
- Department of Epidemiology, Erasmus Medical University Centre, Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus Medical University Centre, Rotterdam, The Netherlands
| | - F Koromani
- Department of Epidemiology, Erasmus Medical University Centre, Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus Medical University Centre, Rotterdam, The Netherlands
| | - A Hofman
- Department of Epidemiology, Erasmus Medical University Centre, Rotterdam, The Netherlands
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - A G Uitterlinden
- Department of Epidemiology, Erasmus Medical University Centre, Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus Medical University Centre, Rotterdam, The Netherlands
| | - O H Franco
- Department of Epidemiology, Erasmus Medical University Centre, Rotterdam, The Netherlands
| | - F Rivadeneira
- Department of Internal Medicine, Erasmus Medical University Centre, Rotterdam, The Netherlands
| | - J C Kiefte-de Jong
- Department of Epidemiology, Erasmus Medical University Centre, Rotterdam, The Netherlands.
- Department of Global Public Health, Leiden University College, The Hague, The Netherlands.
- Department of Paediatrics, Erasmus MC, Rotterdam, The Netherlands.
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19
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van den Bouwhuijsen QJA, Vernooij MW, Verhaaren BFJ, Vrooman HA, Niessen WJ, Krestin GP, Ikram MA, Franco OH, van der Lugt A. Carotid Plaque Morphology and Ischemic Vascular Brain Disease on MRI. AJNR Am J Neuroradiol 2017; 38:1776-1782. [PMID: 28705824 DOI: 10.3174/ajnr.a5288] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 04/27/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Vulnerable carotid plaque components are reported to increase the risk of cerebrovascular events. Yet, the relation between plaque composition and subclinical ischemic brain disease is not known. We studied, in the general population, the association between carotid atherosclerotic plaque characteristics and ischemic brain disease on MR imaging. MATERIALS AND METHODS From the population-based Rotterdam Study, 951 participants underwent both carotid MR imaging and brain MR imaging. The presence of intraplaque hemorrhage, lipid core, and calcification and measures of plaque size was assessed in both carotid arteries. The presence of plaque characteristics in relation to lacunar and cortical infarcts and white matter lesion volume was investigated and adjusted for cardiovascular risk factors. Stratified analyses were conducted to explore effect modification by sex. Additional analyses were conducted per carotid artery in relation to vascular brain disease in the ipsilateral hemisphere. RESULTS Carotid intraplaque hemorrhage was significantly associated with the presence of cortical infarcts (OR, 1.9; 95% confidence interval, 1.1-3.3). None of the plaque characteristics were related to the presence of lacunar infarcts. Calcification was the only characteristic that was associated with higher white matter lesion volume. There was no significant interaction by sex. CONCLUSIONS The presence of carotid intraplaque hemorrhage on MR imaging is independently associated with MR imaging-defined cortical infarcts, but not with lacunar infarcts. Plaque calcification, but not vulnerable plaque components, is related to white matter lesion volume.
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Affiliation(s)
- Q J A van den Bouwhuijsen
- From the Departments of Epidemiology (Q.J.A.v.d.B., M.W.V., B.F.J.V., M.A.I., O.H.F.).,Radiology (Q.J.A.v.d.B., M.W.V., H.A.V., W.J.N., G.P.K., M.A.I., A.v.d.L.)
| | - M W Vernooij
- From the Departments of Epidemiology (Q.J.A.v.d.B., M.W.V., B.F.J.V., M.A.I., O.H.F.).,Radiology (Q.J.A.v.d.B., M.W.V., H.A.V., W.J.N., G.P.K., M.A.I., A.v.d.L.)
| | - B F J Verhaaren
- From the Departments of Epidemiology (Q.J.A.v.d.B., M.W.V., B.F.J.V., M.A.I., O.H.F.)
| | - H A Vrooman
- Radiology (Q.J.A.v.d.B., M.W.V., H.A.V., W.J.N., G.P.K., M.A.I., A.v.d.L.).,Medical Informatics (H.A.V., W.J.N.), Erasmus MC, Rotterdam, the Netherlands
| | - W J Niessen
- Radiology (Q.J.A.v.d.B., M.W.V., H.A.V., W.J.N., G.P.K., M.A.I., A.v.d.L.).,Medical Informatics (H.A.V., W.J.N.), Erasmus MC, Rotterdam, the Netherlands
| | - G P Krestin
- Radiology (Q.J.A.v.d.B., M.W.V., H.A.V., W.J.N., G.P.K., M.A.I., A.v.d.L.)
| | - M A Ikram
- From the Departments of Epidemiology (Q.J.A.v.d.B., M.W.V., B.F.J.V., M.A.I., O.H.F.).,Radiology (Q.J.A.v.d.B., M.W.V., H.A.V., W.J.N., G.P.K., M.A.I., A.v.d.L.)
| | - O H Franco
- From the Departments of Epidemiology (Q.J.A.v.d.B., M.W.V., B.F.J.V., M.A.I., O.H.F.)
| | - A van der Lugt
- Radiology (Q.J.A.v.d.B., M.W.V., H.A.V., W.J.N., G.P.K., M.A.I., A.v.d.L.)
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20
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Amin N, Jovanova O, Adams HHH, Dehghan A, Kavousi M, Vernooij MW, Peeters RP, de Vrij FMS, van der Lee SJ, van Rooij JGJ, van Leeuwen EM, Chaker L, Demirkan A, Hofman A, Brouwer RWW, Kraaij R, Willems van Dijk K, Hankemeier T, van Ijcken WFJ, Uitterlinden AG, Niessen WJ, Franco OH, Kushner SA, Ikram MA, Tiemeier H, van Duijn CM. Exome-sequencing in a large population-based study reveals a rare Asn396Ser variant in the LIPG gene associated with depressive symptoms. Mol Psychiatry 2017; 22:537-543. [PMID: 27431295 DOI: 10.1038/mp.2016.101] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 04/19/2016] [Accepted: 04/20/2016] [Indexed: 11/09/2022]
Abstract
Despite a substantial genetic component, efforts to identify common genetic variation underlying depression have largely been unsuccessful. In the current study we aimed to identify rare genetic variants that might have large effects on depression in the general population. Using high-coverage exome-sequencing, we studied the exonic variants in 1265 individuals from the Rotterdam study (RS), who were assessed for depressive symptoms. We identified a missense Asn396Ser mutation (rs77960347) in the endothelial lipase (LIPG) gene, occurring with an allele frequency of 1% in the general population, which was significantly associated with depressive symptoms (P-value=5.2 × 10-08, β=7.2). Replication in three independent data sets (N=3612) confirmed the association of Asn396Ser (P-value=7.1 × 10-03, β=2.55) with depressive symptoms. LIPG is predicted to have enzymatic function in steroid biosynthesis, cholesterol biosynthesis and thyroid hormone metabolic processes. The Asn396Ser variant is predicted to have a damaging effect on the function of LIPG. Within the discovery population, carriers also showed an increased burden of white matter lesions (P-value=3.3 × 10-02) and a higher risk of Alzheimer's disease (odds ratio=2.01; P-value=2.8 × 10-02) compared with the non-carriers. Together, these findings implicate the Asn396Ser variant of LIPG in the pathogenesis of depressive symptoms in the general population.
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Affiliation(s)
- N Amin
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - O Jovanova
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - H H H Adams
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.,Department of Radiology, Erasmus MC, Rotterdam, The Netherlands
| | - A Dehghan
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - M Kavousi
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - M W Vernooij
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.,Department of Radiology, Erasmus MC, Rotterdam, The Netherlands
| | - R P Peeters
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.,Rotterdam Thyroid Center, Erasmus MC, Rotterdam, The Netherlands.,Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - F M S de Vrij
- Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands
| | - S J van der Lee
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - J G J van Rooij
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - E M van Leeuwen
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - L Chaker
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.,Rotterdam Thyroid Center, Erasmus MC, Rotterdam, The Netherlands.,Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - A Demirkan
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.,Department of Human Genetics, Leiden University Medical Center, RC Leiden, The Netherlands
| | - A Hofman
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - R W W Brouwer
- Center for Biomics, Department of Cell Biology, Erasmus MC, Rotterdam, The Netherlands
| | - R Kraaij
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - K Willems van Dijk
- Department of Human Genetics, Leiden University Medical Center, RC Leiden, The Netherlands.,Division of Endocrinology, Department of Medicine, Leiden University Medical Center, RC Leiden, The Netherlands
| | - T Hankemeier
- Leiden Academic Center for Drug Research, Division of Analytical Biosciences, Leiden University, Leiden, The Netherlands.,The Netherlands Metabolomics Centre, Leiden University, Leiden, The Netherlands
| | - W F J van Ijcken
- Center for Biomics, Department of Cell Biology, Erasmus MC, Rotterdam, The Netherlands
| | - A G Uitterlinden
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.,Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - W J Niessen
- Departments of Radiology and Medical Informatics, Erasmus MC, Rotterdam, The Netherlands.,Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - O H Franco
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - S A Kushner
- Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands
| | - M A Ikram
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.,Department of Radiology, Erasmus MC, Rotterdam, The Netherlands
| | - H Tiemeier
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - C M van Duijn
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
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21
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Brouwer-Brolsma EM, van Woudenbergh GJ, Oude Elferink SJWH, Singh-Povel CM, Hofman A, Dehghan A, Franco OH, Feskens EJM. Intake of different types of dairy and its prospective association with risk of type 2 diabetes: The Rotterdam Study. Nutr Metab Cardiovasc Dis 2016; 26:987-995. [PMID: 27692560 DOI: 10.1016/j.numecd.2016.08.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 07/22/2016] [Accepted: 08/03/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIMS The prevalence of type 2 diabetes (T2DM) is increasing. Several studies have suggested a beneficial effect of several major dairy nutrients on insulin production and sensitivity. Conversely, harmful effects have been suggested as well. This study aimed to investigate the impact of the full-range of dairy products and its association with incidence T2DM in Dutch adults aged ≥55 years participating in the Rotterdam Study. METHODS AND RESULTS Dairy intake was assessed with a validated FFQ, including total, skimmed, semi-skimmed, full-fat, fermented, and non-fermented dairy, and subclasses of these product groups. Verified prevalent and incident diabetes were documented. Cox proportional hazards regression and spline regression were used to analyse data, adjusting for age, sex, alcohol, smoking, education, physical activity, body mass index, intake of total energy, energy-adjusted meat, and energy-adjusted fish intake. Median total dairy intake was 398 g/day (IQR 259-559 g/day). Through 9.5 ± 4.1 years of follow-up, 393 cases of incident T2DM were reported. Cox and spline regression did not point towards associations of total dairy consumption, dairy consumption based on fat content, non-fermented or fermented dairy consumption, or individual dairy product consumption with incident T2DM. The HR for total dairy intake and T2DM was 0.93 (95% CI: 0.70-1.23) in the upper quartile (P-for trend 0.76). CONCLUSIONS This prospective cohort study did not point towards an association between dairy consumption and T2DM.
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Affiliation(s)
- E M Brouwer-Brolsma
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
| | - G J van Woudenbergh
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | | | | | - A Hofman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Netherlands Consortium for Healthy Ageing, Netherlands Genomics Initiative, The Hague, The Netherlands
| | - A Dehghan
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Netherlands Consortium for Healthy Ageing, Netherlands Genomics Initiative, The Hague, The Netherlands
| | - O H Franco
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Netherlands Consortium for Healthy Ageing, Netherlands Genomics Initiative, The Hague, The Netherlands
| | - E J M Feskens
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
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22
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Sonneveld MAH, Kavousi M, Ikram MA, Hofman A, Rueda Ochoa OL, Turecek PL, Franco OH, Leebeek FWG, de Maat MPM. Low ADAMTS-13 activity and the risk of coronary heart disease - a prospective cohort study: the Rotterdam Study. J Thromb Haemost 2016; 14:2114-2120. [PMID: 27559008 DOI: 10.1111/jth.13479] [Citation(s) in RCA: 28] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Indexed: 12/28/2022]
Abstract
Essentials An association between ADAMTS-13 and coronary heart disease (CHD) has been suggested. 5688 participants ≥ 55 years from the Rotterdam Study without a history of CHD were included. Over a median follow-up time of 9.7 years, 456 individuals suffered from CHD. Low ADAMTS-13 activity was associated with an increased CHD risk. SUMMARY Background The metalloprotease ADAMTS-13 cleaves high-molecular-weight von Willebrand factor multimers into smaller, less procoagulant forms. Low ADAMTS-13 activity is associated with an increased risk of ischemic stroke but its pathogenic role in coronary heart disease (CHD) is unclear. Objectives We aimed to determine the association between ADAMTS-13 activity and the risk of CHD in a large prospective population-based cohort study. Methods A total of 5688 participants of the Rotterdam Study, a population-based cohort study involving individuals aged ≥ 55 years without a history of CHD, were included. ADAMTS-13 activity was measured by the FRETS-VWF73 assay and VWF:Ag levels by ELISA. We assessed the association between ADAMTS-13 activity, VWF:Ag levels and CHD using Cox proportional hazard regression analysis, adjusting for cardiovascular risk factors. Results Over a median follow-up time of 9.7 years, 456 individuals suffered from CHD. A low ADAMTS-13 activity (quartile 1) was associated with an increased CHD risk (HR 1.42, 95% CI 1.07-1.89) compared with the reference highest quartile. Conclusions Low ADAMTS-13 activity is associated with an increased risk of CHD in the elderly, independently of VWF and established cardiovascular risk factors.
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Affiliation(s)
- M A H Sonneveld
- Department of Hematology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - M Kavousi
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - M A Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Neurology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - A Hofman
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - O L Rueda Ochoa
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- School of Medicine, Faculty of Health, Universidad Industrial de Santander, Bucaramanga, Colombia
| | | | - O H Franco
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - F W G Leebeek
- Department of Hematology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - M P M de Maat
- Department of Hematology, Erasmus University Medical Center, Rotterdam, the Netherlands
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23
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Gazibara T, den Dekker HT, de Jongste JC, McGrath JJ, Eyles DW, Burne TH, Reiss IK, Franco OH, Tiemeier H, Jaddoe VWV, Duijts L. Associations of maternal and fetal 25-hydroxyvitamin D levels with childhood lung function and asthma: the Generation R Study. Clin Exp Allergy 2016; 46:337-46. [PMID: 26399470 DOI: 10.1111/cea.12645] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 07/31/2015] [Accepted: 08/20/2015] [Indexed: 12/23/2022]
Abstract
BACKGROUND Exposure to low levels of vitamin D in fetal life might be a risk factor for childhood asthma. OBJECTIVE We examined whether 25-hydroxyvitamin D levels in mid-gestation and at birth were associated with higher airway resistance and inflammation, and increased risks of wheezing and asthma in school-age children. METHODS We performed a population-based prospective cohort study among 3130 mothers and their children. Maternal blood samples in mid-gestation and umbilical cord blood samples at birth were used to determine 25-hydroxyvitamin D levels. At age of 6, airway resistance (Rint) was measured by interrupter technique and airway inflammation by fractional exhaled nitric oxide (FENO) using NIOX chemiluminescence analyser. Wheezing and asthma were prospectively assessed by annual questionnaires until age 6. RESULTS Maternal levels of 25-hydroxyvitamin D in mid-gestation were not associated with Rint, FeNO, wheezing patterns, or asthma. Children in the lowest tertile of 25-hydroxyvitamin D levels at birth had a higher Rint (Z-score (95% confidence interval [95% CI]): -0.42 (-0.84, -0.01), P-value for trend< 0.05), compared to those in the highest tertile group. The effect estimate attenuated when child's current 25-hydroxyvitamin D level was taken into account [Z-score (95% CI): -0.55 (-1.08, 0.01)]. CONCLUSION AND CLINICAL RELEVANCE Low levels of 25-hydroxyvitamin D at birth were associated with a higher airway resistance in childhood. Additional adjustment for child's current 25-hydroxyvitamin D level reduced the effect size of the association. Further studies are needed to replicate these findings and to examine mechanisms underlying the observed association and the long-term consequences.
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Affiliation(s)
- T Gazibara
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Division of Respiratory Medicine, Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - H T den Dekker
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Division of Respiratory Medicine, Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - J C de Jongste
- Division of Respiratory Medicine, Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - J J McGrath
- Queensland Brain Institute, The University of Queensland, Brisbane, Qld, Australia.,Queensland Centre for Mental Health Research, Park Centre for Mental Health, Wacol, Brisbane, Qld, Australia
| | - D W Eyles
- Queensland Brain Institute, The University of Queensland, Brisbane, Qld, Australia.,Queensland Centre for Mental Health Research, Park Centre for Mental Health, Wacol, Brisbane, Qld, Australia
| | - T H Burne
- Queensland Brain Institute, The University of Queensland, Brisbane, Qld, Australia.,Queensland Centre for Mental Health Research, Park Centre for Mental Health, Wacol, Brisbane, Qld, Australia
| | - I K Reiss
- Division of Neonatology, Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - O H Franco
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - H Tiemeier
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Psychiatry, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - V W V Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - L Duijts
- Division of Respiratory Medicine, Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Division of Neonatology, Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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24
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Nano J, Muka T, Cepeda M, Voortman T, Dhana K, Brahimaj A, Dehghan A, Franco OH. Association of circulating total bilirubin with the metabolic syndrome and type 2 diabetes: A systematic review and meta-analysis of observational evidence. Diabetes Metab 2016; 42:389-397. [PMID: 27396752 DOI: 10.1016/j.diabet.2016.06.002] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 05/30/2016] [Accepted: 06/02/2016] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Emerging evidence suggests that bilirubin levels might be associated with the metabolic syndrome (MetS) and type 2 diabetes (T2D), although the nature of the association remains unclear. DESIGN This systematic review and meta-analysis investigated the relationship between total plasma bilirubin and the risk of MetS and T2D. DATA SOURCES Relevant studies were identified using five databases (Embase, Medline [Ovid], Web of Science, PubMed, Cochrane Central and Google Scholar), with the last search done on 21 October 2015. Study references were checked and authors contacted to identify additional studies. STUDY SELECTION Randomized controlled trials, and cohort, case-control and cross-sectional studies of adults examining the association between blood bilirubin levels and MetS and T2D were included, irrespective of language and date of publication. Abstract and full-text selection was done by two independent reviewers, with a third reviewer available in case of disagreement. DATA EXTRACTION Data were extracted by two independent reviewers using a predesigned data collection form. MAIN OUTCOMES AND MEASURES MetS and T2D. METHODS Summary estimates were obtained by random-effects meta-analysis. RESULTS Of the 2313 searched references, 16 observational studies (11 cross-sectional, two prospective, one that was both cross-sectional and prospective, two retrospective and one national survey) met our inclusion criteria. Overall, data were available for 175,911 non-overlapping participants, including 7414 MetS cases and 9406 T2D cases. In the meta-analysis of seven cross-sectional studies, the pooled odds ratio (95% confidence interval) for MetS in a comparison of extreme tertiles of serum bilirubin levels was 0.70 (95% CI: 0.62, 0.78), whereas no significant association was found for the pooled estimated relative risk between two prospective studies (0.57, 95% CI: 0.11, 2.94). The corresponding estimate was 0.77 (95% CI: 0.67, 0.87) for T2D from four cross-sectional studies. CONCLUSION The available evidence, mainly from cross-sectional studies, supports an inverse association of bilirubin levels with adverse metabolic outcomes. Large-scale prospective studies are now needed to establish whether bilirubin levels may be useful in the prevention of MetS and T2D.
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Affiliation(s)
- J Nano
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - T Muka
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - M Cepeda
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - T Voortman
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - K Dhana
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - A Brahimaj
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - A Dehghan
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - O H Franco
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
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25
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Jovanova O, Luik AI, Leening MJG, Noordam R, Aarts N, Hofman A, Franco OH, Dehghan A, Tiemeier H. The long-term risk of recognized and unrecognized myocardial infarction for depression in older men. Psychol Med 2016; 46:1951-1960. [PMID: 26996221 DOI: 10.1017/s0033291716000544] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND The association between myocardial infarction (MI) and depression is well described. Yet, the underlying mechanisms are unclear and the contribution of psychological factors is uncertain. We aimed to determine the risk of recognized (RMI) and unrecognized (UMI) myocardial infections on depression, as both have a similar impact on cardiovascular health but differ in psychological epiphenomena. METHOD Participants of the Rotterdam Study, 1823 men aged ⩾55 years, were followed for the occurrence of depression. RMI and UMI were ascertained using electrocardiography and medical history at baseline. We determined the strength of the association of RMI and UMI with mortality, and we studied the relationship of RMI and UMI with depressive symptoms and the occurrence of major depression. RESULTS The risk of mortality was similar in men with RMI [adjusted hazard ratio (aHR) 1.71, 95% confidence interval (CI) 1.45-2.03] and UMI (aHR 1.58, 95% CI 1.27-1.97). Men with RMI had on average [unstandardized regression coefficient (B) 1.14, 95% CI 0.07-2.21] higher scores for depressive symptoms. By contrast, we found no clear association between UMI and depressive symptoms (B 0.55, 95% CI -0.51 to 1.62) in men. Analysis including occurrence of major depression as the outcome were consistent with the pattern of association. CONCLUSION The discrepant association of RMI and UMI with mortality compared to depression suggests that the psychological burden of having experienced an MI contributes to the long-term risk of depression.
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Affiliation(s)
- O Jovanova
- Department of Epidemiology,Erasmus MC, University Medical Center Rotterdam,Rotterdam,The Netherlands
| | - A I Luik
- Department of Epidemiology,Erasmus MC, University Medical Center Rotterdam,Rotterdam,The Netherlands
| | - M J G Leening
- Department of Epidemiology,Erasmus MC, University Medical Center Rotterdam,Rotterdam,The Netherlands
| | - R Noordam
- Department of Epidemiology,Erasmus MC, University Medical Center Rotterdam,Rotterdam,The Netherlands
| | - N Aarts
- Department of Epidemiology,Erasmus MC, University Medical Center Rotterdam,Rotterdam,The Netherlands
| | - A Hofman
- Department of Epidemiology,Erasmus MC, University Medical Center Rotterdam,Rotterdam,The Netherlands
| | - O H Franco
- Department of Epidemiology,Erasmus MC, University Medical Center Rotterdam,Rotterdam,The Netherlands
| | - A Dehghan
- Department of Epidemiology,Erasmus MC, University Medical Center Rotterdam,Rotterdam,The Netherlands
| | - H Tiemeier
- Department of Epidemiology,Erasmus MC, University Medical Center Rotterdam,Rotterdam,The Netherlands
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26
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Muka T, Nano J, Voortman T, Braun KVE, Ligthart S, Stranges S, Bramer WM, Troup J, Chowdhury R, Dehghan A, Franco OH. The role of global and regional DNA methylation and histone modifications in glycemic traits and type 2 diabetes: A systematic review. Nutr Metab Cardiovasc Dis 2016; 26:553-566. [PMID: 27146363 DOI: 10.1016/j.numecd.2016.04.002] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 04/04/2016] [Accepted: 04/04/2016] [Indexed: 02/08/2023]
Abstract
BACKGROUND New evidence suggests the potential involvement of epigenetic mechanisms in type 2 diabetes (T2D) as a crucial interface between the effects of genetic predisposition and environmental influences. AIM To systematically review studies investigating the association between epigenetic marks (DNA methylation and histone modifications) with T2D and glycemic traits (glucose and insulin levels, insulin resistance measured by HOMA-IR). METHOD AND RESULTS Six bibliographic databases (Embase.com, Medline (Ovid), Web-of-Science, PubMed, Cochrane Central and Google Scholar) were screened until 28th August 2015. We included randomized controlled trials, cohort, case-control and cross-sectional studies in humans that examined the association between epigenetic marks (global, candidate or genome-wide methylation of DNA and histone modifications) with T2D, glucose and insulin levels and insulin metabolism. Of the initially identified 3879 references, 53 articles, based on 47 unique studies met our inclusion criteria. Overall, data were available on 10,823 participants, with a total of 3358 T2D cases. There was no consistent evidence for an association between global DNA-methylation with T2D, glucose, insulin and insulin resistance. The studies reported epigenetic regulation of several candidate genes for diabetes susceptibility in blood cells, muscle, adipose tissue and placenta to be related with T2D without any general overlap between them. Histone modifications in relation to T2D were reported only in 3 observational studies. CONCLUSIONS AND RELEVANCE Current evidence supports an association between epigenetic marks and T2D. However, overall evidence is limited, highlighting the need for further larger-scale and prospective investigations to establish whether epigenetic marks may influence the risk of developing T2D.
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Affiliation(s)
- T Muka
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - J Nano
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - T Voortman
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - K V E Braun
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - S Ligthart
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - S Stranges
- Department of Population Health, Luxembourg Institute of Health, Luxembourg
| | - W M Bramer
- Medical Library, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - J Troup
- Research and Development, Metagenics, Inc, USA
| | - R Chowdhury
- Department of Public Health & Primary Care, Cardiovascular Epidemiology Unit, University of Cambridge, Cambridge, CB1 8RN, United Kingdom
| | - A Dehghan
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - O H Franco
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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Wen K, Nguyen NT, Hofman A, Ikram MA, Franco OH. Migraine is associated with better cognition in the middle‐aged and elderly: the Rotterdam Study. Eur J Neurol 2016; 23:1510-6. [DOI: 10.1111/ene.13066] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 05/13/2016] [Indexed: 11/26/2022]
Affiliation(s)
- K. Wen
- Department of Epidemiology Erasmus MC University Medical Center Rotterdam The Netherlands
| | - N. T. Nguyen
- Department of Epidemiology Erasmus MC University Medical Center Rotterdam The Netherlands
| | - A. Hofman
- Department of Epidemiology Erasmus MC University Medical Center Rotterdam The Netherlands
| | - M. A. Ikram
- Department of Epidemiology Erasmus MC University Medical Center Rotterdam The Netherlands
- Department of Radiology Erasmus MC University Medical Center Rotterdam The Netherlands
| | - O. H. Franco
- Department of Epidemiology Erasmus MC University Medical Center Rotterdam The Netherlands
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Voortman T, Braun KVE, Kiefte-de Jong JC, Jaddoe VWV, Franco OH, van den Hooven EH. Protein intake in early childhood and body composition at the age of 6 years: The Generation R Study. Int J Obes (Lond) 2016; 40:1018-25. [PMID: 26975442 DOI: 10.1038/ijo.2016.29] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 01/06/2016] [Accepted: 01/13/2016] [Indexed: 01/02/2023]
Abstract
BACKGROUND Previous studies suggest that high protein intake in infancy leads to a higher body mass index (BMI) in later childhood. We examined the associations of total, animal and vegetable protein intake in early childhood with detailed measures of body composition at the age of 6 years. METHODS This study was performed in 2911 children participating in a population-based cohort study. Protein intake at the age of 1 year was assessed with a validated food-frequency questionnaire and was adjusted for total energy intake. At the children's age of 6 years, we measured their anthropometrics and body fat (with dual-energy X-ray absorptiometry). We calculated age- and sex-specific s.d. scores for BMI, fat mass index (FMI) and fat-free mass index (FFMI). RESULTS After adjustment for confounders, a 10 g per day higher total protein intake at 1 year of age was associated with a 0.05 s.d. (95% confidence interval (CI) 0.00, 0.09) higher BMI at age 6. This association was fully driven by a higher FMI (0.06 s.d. (95%CI 0.01, 0.11)) and not FFMI (-0.01 s.d. (95%CI -0.06, 0.05)). The associations of protein intake with FMI at 6 years remained significant after adjustment for BMI at the age of 1 year. Additional analyses showed that the associations of protein intake with FMI were stronger in girls than in boys (P for interaction=0.03), stronger among children who had catch-up growth in the first year of life (P for interaction<0.01) and stronger for intake of animal protein (both dairy and non-dairy protein) than protein from vegetable sources. CONCLUSIONS Our results suggest that high protein intake in early childhood is associated with higher body fat mass, but not fat-free mass. Future studies are needed to investigate whether these changes persist into adulthood and to examine the optimal range of protein intake for infants and young children.
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Affiliation(s)
- T Voortman
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - K V E Braun
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - J C Kiefte-de Jong
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Leiden University College, The Hague, The Netherlands
| | - V W V Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - O H Franco
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - E H van den Hooven
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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Miliku K, Voortman T, Franco OH, McGrath JJ, Eyles DW, Burne TH, Hofman A, Tiemeier H, Jaddoe VWV. Vitamin D status during fetal life and childhood kidney outcomes. Eur J Clin Nutr 2015; 70:629-34. [PMID: 26695721 DOI: 10.1038/ejcn.2015.216] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 09/28/2015] [Accepted: 11/09/2015] [Indexed: 12/18/2022]
Abstract
BACKGROUND/OBJECTIVES Maternal vitamin D deficiency during pregnancy may influence offspring kidney health. We aimed to examine the associations of 25-hydroxyvitamin D (25(OH)D) blood levels during fetal life with kidney outcomes at school age. SUBJECTS/METHODS This study was embedded in a population-based prospective cohort study among 4212 mother-child pairs. We measured maternal second trimester (18-25 weeks) and fetal cord blood (at birth) 25(OH)D levels. At a median age of 6.0 years, we measured children's combined kidney volume, glomerular filtration rate (eGFR) from creatinine and cystatin C serum levels, and microalbuminuria from albumin and creatinine urine levels. RESULTS Of all mothers, 21.9% had severely deficient levels (25(OH)D <25.0 nmol/l), 25.7% had deficient levels (25.0-49.9 nmol/l), 25% had sufficient levels (50.0-74.9 nmol/l) and 27.4% had optimal levels (⩾75.0 nmol/l). Maternal 25(OH)D levels were not consistently associated with childhood combined kidney volume. Higher maternal 25(OH)D levels were associated with lower childhood eGFR (difference -0.94 ml/min per 1.73 m(2) (95% confidence interval, -1.73; -0.15) per 1 standard deviation (s.d.) increase in 25(OH)D). Maternal 25(OH)D levels were not associated with microalbuminuria. Cord blood 25(OH)D levels were not associated with childhood kidney outcomes. The associations of maternal 25(OH)D levels with childhood eGFR were partly explained by childhood vitamin D status. CONCLUSIONS Our findings suggest that maternal 25(OH)D levels during pregnancy may influence childhood kidney outcomes. These results should be considered hypothesis generating. Further studies are needed to replicate the observations, to examine the underlying mechanisms and to identify the long-term clinical consequences.
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Affiliation(s)
- K Miliku
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - T Voortman
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - O H Franco
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - J J McGrath
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia.,Queensland Centre for Mental Health Research, Park Centre for Mental Health, Brisbane, Queensland, Australia
| | - D W Eyles
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia.,Queensland Centre for Mental Health Research, Park Centre for Mental Health, Brisbane, Queensland, Australia
| | - T H Burne
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia.,Queensland Centre for Mental Health Research, Park Centre for Mental Health, Brisbane, Queensland, Australia
| | - A Hofman
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - H Tiemeier
- 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
| | - V W V Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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de Jonge EAL, Kiefte-de Jong JC, Campos-Obando N, Booij L, Franco OH, Hofman A, Uitterlinden AG, Rivadeneira F, Zillikens MC. Dietary vitamin A intake and bone health in the elderly: the Rotterdam Study. Eur J Clin Nutr 2015; 69:1360-8. [PMID: 26373964 DOI: 10.1038/ejcn.2015.154] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 07/07/2015] [Accepted: 08/03/2015] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES High vitamin A intake may be associated with a decreased bone mineral density (BMD) and increased risk of fractures. Our objectives were to study whether dietary intake of vitamin A (total, retinol or beta-carotene) is associated with BMD and fracture risk and if associations are modified by body mass index (BMI) and vitamin D. SUBJECTS/METHODS Participants were aged 55 years and older (n=5288) from the Rotterdam Study, a population-based prospective cohort. Baseline vitamin A and D intake was measured by a food frequency questionnaire. BMD was measured by dual-energy X-ray absorptiometry at four visits between baseline (1989-1993) and 2004. Serum vitamin D was assessed in a subgroup (n=3161). Fracture incidence data were derived from medical records with a mean follow-up time of 13.9 years. RESULTS Median intake of vitamin A ranged from 684 retinol equivalents (REs)/day (quintile 1) to 2000 REs/day (quintile 5). After adjustment for confounders related to lifestyle and socioeconomic status, BMD was significantly higher in subjects in the highest quintile of total vitamin A (mean difference in BMD (95% confidence interval (CI))=11.53 (0.37-22.7) mg/cm(2)) and retinol intake (mean difference in BMD (95% CI)=12.57 (1.10-24.05) mg/cm(2)) than in the middle quintile. Additional adjustment for BMI diluted these associations. Fracture risk was reduced in these subjects. Significant interaction was present between intake of retinol and overweight (BMI >25 kg/m(2)) in relation to fractures (P for interaction =0.05), but not BMD. Stratified analysis showed that these favourable associations with fracture risk were only present in overweight subjects (BMI >25 kg/m(2)). No effect modification by vitamin D intake or serum levels was observed. CONCLUSIONS Our results suggest a plausible favourable relation between high vitamin A intake from the diet and fracture risk in overweight subjects, whereas the association between vitamin A and BMD is mainly explained by BMI.
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Affiliation(s)
- E A L de Jonge
- Erasmus MC, Department of Internal Medicine, Rotterdam, The Netherlands.,Erasmus MC, Department of Epidemiology, Rotterdam, The Netherlands
| | - J C Kiefte-de Jong
- Erasmus MC, Department of Epidemiology, Rotterdam, The Netherlands.,Department of Global Public Health, Leiden University College, The Hague, The Netherlands
| | - N Campos-Obando
- Erasmus MC, Department of Internal Medicine, Rotterdam, The Netherlands
| | - L Booij
- Erasmus MC, Department of Internal Medicine, Rotterdam, The Netherlands
| | - O H Franco
- Erasmus MC, Department of Epidemiology, Rotterdam, The Netherlands
| | - A Hofman
- Erasmus MC, Department of Epidemiology, Rotterdam, The Netherlands
| | - A G Uitterlinden
- Erasmus MC, Department of Internal Medicine, Rotterdam, The Netherlands.,Erasmus MC, Department of Epidemiology, Rotterdam, The Netherlands
| | - F Rivadeneira
- Erasmus MC, Department of Internal Medicine, Rotterdam, The Netherlands
| | - M C Zillikens
- Erasmus MC, Department of Internal Medicine, Rotterdam, The Netherlands
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Daan NMP, Jaspers L, Koster MPH, Broekmans FJM, de Rijke YB, Franco OH, Laven JSE, Kavousi M, Fauser BCJM. Androgen levels in women with various forms of ovarian dysfunction: associations with cardiometabolic features. Hum Reprod 2015; 30:2376-86. [PMID: 26269538 DOI: 10.1093/humrep/dev195] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 07/23/2015] [Indexed: 01/28/2023] Open
Abstract
STUDY QUESTION Are differences in androgen levels among women with various forms of ovarian dysfunction associated with cardiometabolic abnormalities? SUMMARY ANSWER Androgen levels differed substantially between women with and without ovarian dysfunction, and increased androgen levels were associated with impaired cardiometabolic features in all women irrespective of their clinical condition. WHAT IS KNOWN ALREADY Sex steroid hormones play important roles in the development of cardiovascular diseases (CVD). Extremes of low as well as high androgen levels have been associated with increased CVD risk in both men and women. STUDY DESIGN, SIZE, DURATION This cross-sectional study included 680 women with polycystic ovary syndrome (PCOS), premature ovarian insufficiency (POI), natural post-menopausal women (NM), or regular menstrual cycles (RC) (170 women per group). PARTICIPANTS/MATERIALS, SETTING, METHODS Measurements of serum testosterone, androstenedione and dehydroepiandrosterone sulfate were performed using liquid chromatography-tandem mass spectrometry. Assessments were taken of body mass index (BMI), blood pressure, lipid profiles, glucose, insulin and SHBG, and the bioactive fraction of circulating testosterone was calculated using the free androgen index (FAI). MAIN RESULTS AND THE ROLE OF CHANCE PCOS women were hyperandrogenic [median FAI = 4.9 (IQR 3.6-7.4)], and POI women were hypoandrogenic [FAI = 1.2 (0.8-1.7)], compared with RC women [FAI = 1.7 (1.1-2.8)], after adjustment for age, ethnicity, smoking and BMI (P < 0.001). After adjustment for age, there were no significant differences in androgens between POI and NM (P = 0.15) women and between NM and RC (P = 0.27) women, the latter indicating that chronological aging rather than ovarian aging influences the differences between pre- and post-menopausal women. A high FAI was associated with elevated triglycerides (β log FAI for PCOS: 0.45, P < 0.001, POI: 0.25, P < 0.001, NM: 0.20, P = 0.002), insulin (β log FAI for PCOS: 0.77, POI: 0.44, NM: 0.40, all P < 0.001), HOMA-IR (β log FAI for PCOS: 0.82, POI: 0.46, NM: 0.47, all P < 0.001) and mean arterial pressure (β log FAI for PCOS: 0.05, P = 0.002, POI: 0.07, P < 0.001, NM: 0.04, P = 0.04) in all women; with increased glucose (β log FAI for PCOS: 0.05, P = 0.003, NM: 0.07, P < 0.001) and decreased high-density lipoprotein (β log FAI for PCOS: -0.23, P < 0.001, NM: -0.09, P = 0.03) in PCOS and NM women; and with increased low-density lipoprotein (β log FAI for POI: 0.083, P = 0.041) in POI women. Adjustment for BMI attenuated the observed associations. Associations between FAI and cardiometabolic features were the strongest in PCOS women, even after adjustment for BMI. LIMITATIONS, REASONS FOR CAUTION Associations between androgen levels and cardiometabolic features were assessed in PCOS, POI and NM women only, due to a lack of available data in RC women. Due to the cross-sectional design of the current study, the potential associations between androgen levels and actual future cardiovascular events could not be assessed. WIDER IMPLICATIONS OF THE FINDINGS This study affirms the potent effect of androgens on cardiometabolic features, indicating that androgens should indeed be regarded as important denominators of women's health. Future research regarding the role of androgens in the development of CVD and potential modulatory effects of BMI is required. STUDY FUNDING/COMPETING INTERESTS N.M.P.D. is supported by the Dutch Heart Foundation (grant number 2013T083). L.J. and O.H.F. work in ErasmusAGE, a center for aging research across the life course, funded by Nestlé Nutrition (Nestec Ltd), Metagenics Inc. and AXA. M.K. is supported by the AXA Research Fund. Nestlé Nutrition (Nestec Ltd), Metagenics Inc. and AXA had no role in the design and conduct of the study; the collection, management, analysis and interpretation of the data; or the preparation, review or approval of the manuscript. J.S.E.L. has received fees and grant support from the following companies (in alphabetical order): Ferring, Merck-Serono, Merck Sharpe & Dome, Organon, Schering Plough and Serono. In the last 5 years, B.C.J.M.F. has received fees and grant support from the following companies (in alphabetic order); Actavis, COGI, Euroscreen, Ferring, Finox, Genovum, Gedeon-Richter, Merck-Serono, OvaScience, Pantharei Bioscience, PregLem, Roche, Uteron and Watson laboratories. With regard to potential conflicts of interest, there is nothing further to disclose.
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Affiliation(s)
- N M P Daan
- Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, HP F05.126, PO Box 85500, 3584 CX Utrecht, The Netherlands
| | - L Jaspers
- Department of Epidemiology, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - M P H Koster
- Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, HP F05.126, PO Box 85500, 3584 CX Utrecht, The Netherlands
| | - F J M Broekmans
- Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, HP F05.126, PO Box 85500, 3584 CX Utrecht, The Netherlands
| | - Y B de Rijke
- Department of Clinical Chemistry, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - O H Franco
- Department of Epidemiology, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - J S E Laven
- Department of Obstetrics and Gynecology, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - M Kavousi
- Department of Epidemiology, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - B C J M Fauser
- Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, HP F05.126, PO Box 85500, 3584 CX Utrecht, The Netherlands
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Gishti O, Jaddoe VWV, Duijts L, Franco OH, Hofman A, Ikram MK, Gaillard R. Influence of breastfeeding on retinal vessel calibers in school-age children. The Generation R Study. Eur J Clin Nutr 2015; 70:72-7. [DOI: 10.1038/ejcn.2015.113] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 03/26/2015] [Accepted: 04/24/2015] [Indexed: 11/10/2022]
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de Vries PS, Kavousi M, Ligthart S, Uitterlinden AG, Hofman A, Franco OH, Dehghan A. Incremental predictive value of 152 single nucleotide polymorphisms in the 10-year risk prediction of incident coronary heart disease: the Rotterdam Study. Int J Epidemiol 2015; 44:682-8. [DOI: 10.1093/ije/dyv070] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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van den Hooven EH, Heppe DHM, Kiefte-de Jong JC, Medina-Gomez C, Moll HA, Hofman A, Jaddoe VWV, Rivadeneira F, Franco OH. Infant dietary patterns and bone mass in childhood: the Generation R Study. Osteoporos Int 2015; 26:1595-604. [PMID: 25792489 PMCID: PMC4428841 DOI: 10.1007/s00198-015-3033-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 01/08/2015] [Indexed: 12/13/2022]
Abstract
UNLABELLED Early life nutrition affects peak bone mass attainment. In this prospective cohort study, children with high adherence to a "dairy and whole grains" pattern in infancy had higher bone mineral density at the age of 6 years. Although the observed effects are small, our study provides insight into mechanisms linking early nutrition to bone acquisition in childhood. INTRODUCTION Nutrition in early life may affect peak bone mass attainment. Previous studies on childhood nutrition and skeletal health mainly focused on individual nutrients, which does not consider the cumulative effects of nutrients. We investigated the associations between dietary patterns in infancy and childhood bone health. METHODS This study included 2850 children participating in a population-based prospective cohort study. Dietary information was obtained from a food frequency questionnaire at the age of 13 months. Using principal component analysis, three major dietary patterns were extracted, explaining in total 30% of the variation in dietary intake. At the age of 6 years, a total body dual-energy X-ray absorptiometry (DXA) scan was performed, and bone mineral density (BMD), bone mineral content (BMC), area-adjusted BMC (aBMC), and bone area (BA) were analyzed. RESULTS Higher adherence score to a "dairy and whole grains" pattern was positively associated with BMD and aBMC, but not with BMC and BA. Accordingly, children in the highest quartile of the "dairy and whole grains" pattern had higher BMD (difference 3.98 mg/cm(2), 95% confidence interval (CI) 0.36 to 7.61) and aBMC (difference 4.96 g, 95% CI 1.27 to 8.64) than children in the lowest quartile. Stratification for vitamin D supplementation showed that the positive associations between the "dairy and whole grains" pattern and bone outcomes were only observed in children who did not receive vitamin D supplementation. A "potatoes, rice, and vegetables" and a "refined grains and confectionery" pattern were not consistently associated with bone outcomes. CONCLUSIONS An infant dietary pattern characterized by high intakes of dairy and cheese, whole grains, and eggs is positively associated with bone development in childhood. Further research is needed to investigate the consequences for bone health in later life.
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Affiliation(s)
- E H van den Hooven
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands,
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Vitezova A, Zillikens MC, van Herpt TTW, Sijbrands EJG, Hofman A, Uitterlinden AG, Franco OH, Kiefte-de Jong JC. Vitamin D status and metabolic syndrome in the elderly: the Rotterdam Study. Eur J Endocrinol 2015; 172:327-35. [PMID: 25468955 DOI: 10.1530/eje-14-0580] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE The effects of vitamin D in the elderly are inconsistent. The aim of this study was to evaluate the association between vitamin D status and the metabolic syndrome (MetS) in the elderly, as well as between vitamin D status and the components of MetS (i.e. serum glucose, triglycerides (TG), HDL cholesterol (HDL-C), waist circumference (WC), and blood pressure (BP)). METHODS The study was embedded in the Rotterdam Study, a population-based cohort of middle-aged and elderly adults. We analyzed data from 3240 people (median age 71.2 years) who did not have type 2 diabetes mellitus at baseline. RESULTS We found higher 25-hydroxyvitamin D (25(OH)D) concentrations associated with lower prevalence of MetS (odds ratio (OR); 95% CI: 0.61; 0.49, 0.77 for adequate levels (≥75 nmol/l) vs deficiency (<50 nmol/l). In addition, in analysis of the individual components, the ORs for adequate vs deficient vitamin D levels were: 0.66 (95% CI 0.53, 0.83) for elevated WC, 0.67 (95% CI 0.52, 0.86) for reduced HDL-C, 0.69 (95% CI 0.54, 0.88) for elevated TG, and 0.80 (95% CI 0.65, 0.99) for elevated fasting glucose. Vitamin D was not associated with elevated blood pressure, and ORs for adequacy vs deficiency were 0.82 (95% CI 0.65, 1.03). CONCLUSION Higher 25(OH)D concentrations in the elderly are associated with lower prevalence of MetS and, in particular, with more beneficial HDL-C, TG, WC, and serum glucose. Since the prevalence of vitamin D deficiency is common worldwide and its risk increases with age, if causality is proven, benefits of improving vitamin D status among the elderly may be great.
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Affiliation(s)
- A Vitezova
- Departments of Epidemiology, Internal Medicine, Erasmus MCUniversity Medical Center, Rotterdam, The Netherlands
| | - M C Zillikens
- Departments of Epidemiology, Internal Medicine, Erasmus MCUniversity Medical Center, Rotterdam, The Netherlands
| | - T T W van Herpt
- Departments of Epidemiology, Internal Medicine, Erasmus MCUniversity Medical Center, Rotterdam, The Netherlands
| | - E J G Sijbrands
- Departments of Epidemiology, Internal Medicine, Erasmus MCUniversity Medical Center, Rotterdam, The Netherlands
| | - A Hofman
- Departments of Epidemiology, Internal Medicine, Erasmus MCUniversity Medical Center, Rotterdam, The Netherlands
| | - A G Uitterlinden
- Departments of Epidemiology, Internal Medicine, Erasmus MCUniversity Medical Center, Rotterdam, The Netherlands
| | - O H Franco
- Departments of Epidemiology, Internal Medicine, Erasmus MCUniversity Medical Center, Rotterdam, The Netherlands
| | - J C Kiefte-de Jong
- Departments of Epidemiology, Internal Medicine, Erasmus MCUniversity Medical Center, Rotterdam, The Netherlands
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Leermakers ETM, Felix JF, Erler NS, Ćerimagić A, Wijtzes AI, Hofman A, Raat H, Moll HA, Rivadeneira F, Jaddoe VWV, Franco OH, Kiefte-de Jong JC. Sugar-containing beverage intake in toddlers and body composition up to age 6 years: the Generation R study. Eur J Clin Nutr 2015; 69:314-21. [PMID: 25649238 DOI: 10.1038/ejcn.2015.2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 12/20/2014] [Accepted: 12/23/2014] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVE Intake of sugar-containing beverages (SCBs) has been associated with higher body mass index (BMI) in childhood. The potential effect of SCB intake during infancy is unclear. We examined the association of SCB intake at 13 months with BMI development until 6 years and body composition at age 6 years. SUBJECTS/METHODS This study included 2371 Dutch children from a population-based prospective cohort study. SCB intake at 13 months was assessed using a Food Frequency Questionnaire with validation against 24-h recalls and was standardized for total energy. BMI was calculated from repeated weight and height measurements, and age- and sex-specific s.d. scores were calculated. Adiposity was measured using Dual-energy X-ray absorptiometry. RESULTS In girls, higher SCB intake at 13 months was significantly associated with higher BMI at ages 2, 3, 4 and 6 years (at age 6 years BMI (s.d. score) increase 0.11 (95% confidence interval (CI) +0.00; 0.23), high versus low intake). We observed a tendency towards higher android/gynoid fat ratio in girls with high intake (s.d. increase 0.14 (95% CI -0.02; 0.29), versus low intake) but not with body fat percentage. In boys, there was no association with BMI or body composition, but boys with high SCB intake at 13 months were taller at age 6 years (s.d. increase 0.14 (95% CI +0.00; 0.27), versus low intake). CONCLUSIONS Higher SCB intake at 13 months was associated with higher BMI up to age 6 years in girls but not in boys. Our results imply that the unfavorable effects of SCB intake start early in life and that dietary advice regarding limiting SCB intake should already be given early in life.
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Affiliation(s)
- E T M Leermakers
- 1] Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands [2] The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - J F Felix
- 1] Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands [2] The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands [3] Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - N S Erler
- 1] Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands [2] Department of Biostatistics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - A Ćerimagić
- Medical Faculty, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - A I Wijtzes
- 1] The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands [2] Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - A Hofman
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - H Raat
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - H A Moll
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - F Rivadeneira
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - V W V Jaddoe
- 1] Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands [2] The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands [3] Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - O H Franco
- 1] Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands [2] The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - J C Kiefte-de Jong
- 1] Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands [2] Leiden University College, The Hague, The Netherlands
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de Bruijn RFAG, Portegies MLP, Leening MJG, Bos MJ, Hofman A, van der Lugt A, Niessen WJ, Vernooij MW, Franco OH, Koudstaal PJ, Ikram MA. Subclinical cardiac dysfunction increases the risk of stroke and dementia: The Rotterdam Study. Neurology 2015; 84:833-40. [DOI: 10.1212/wnl.0000000000001289] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Portegies MLP, Kavousi M, Leening MJG, Bos MJ, van den Meiracker AH, Hofman A, Franco OH, Koudstaal PJ, Ikram MA. N-terminal pro-B-type natriuretic peptide and the risk of stroke and transient ischaemic attack: the Rotterdam Study. Eur J Neurol 2015; 22:695-701. [DOI: 10.1111/ene.12633] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 10/27/2014] [Indexed: 01/15/2023]
Affiliation(s)
- M. L. P. Portegies
- Department of Epidemiology; Erasmus MC University Medical Center; Rotterdam The Netherlands
- Department of Neurology; Erasmus MC University Medical Center; Rotterdam The Netherlands
| | - M. Kavousi
- Department of Epidemiology; Erasmus MC University Medical Center; Rotterdam The Netherlands
| | - M. J. G. Leening
- Department of Epidemiology; Erasmus MC University Medical Center; Rotterdam The Netherlands
- Department of Cardiology; Erasmus MC University Medical Center; Rotterdam The Netherlands
| | - M. J. Bos
- Department of Epidemiology; Erasmus MC University Medical Center; Rotterdam The Netherlands
| | - A. H. van den Meiracker
- Department of Internal Medicine; Erasmus MC University Medical Center; Rotterdam The Netherlands
| | - A. Hofman
- Department of Epidemiology; Erasmus MC University Medical Center; Rotterdam The Netherlands
| | - O. H. Franco
- Department of Epidemiology; Erasmus MC University Medical Center; Rotterdam The Netherlands
| | - P. J. Koudstaal
- Department of Neurology; Erasmus MC University Medical Center; Rotterdam The Netherlands
| | - M. A. Ikram
- Department of Epidemiology; Erasmus MC University Medical Center; Rotterdam The Netherlands
- Department of Neurology; Erasmus MC University Medical Center; Rotterdam The Netherlands
- Department of Radiology; Erasmus MC University Medical Center; Rotterdam The Netherlands
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Gaillard R, Steegers EAP, Franco OH, Hofman A, Jaddoe VWV. Maternal weight gain in different periods of pregnancy and childhood cardio-metabolic outcomes. The Generation R Study. Int J Obes (Lond) 2014; 39:677-85. [PMID: 25287752 DOI: 10.1038/ijo.2014.175] [Citation(s) in RCA: 106] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Revised: 09/21/2014] [Accepted: 09/26/2014] [Indexed: 11/09/2022]
Abstract
BACKGROUND Excessive gestational weight gain seems to be associated with offspring cardio-metabolic risk factors. Little is known about the critical periods of gestational weight gain. We examined the associations of maternal weight gain in different periods of pregnancy with childhood cardio-metabolic risk factors. METHODS In a population-based prospective cohort study from early pregnancy onwards among 5908 mothers and their children, we obtained maternal prepregnancy weight and weight in early, mid and late pregnancy. At the age of 6 years (median: 72.6 months; 95% range: 67.9, 95.8), we measured childhood body mass index (BMI), total body and abdominal fat distribution, blood pressure and blood levels of lipids, insulin and c-peptide. RESULTS Overall, the associations of maternal prepregnancy weight with childhood outcomes were stronger than the associations of maternal gestational weight gain. Independent from maternal prepregnancy weight and weight gain in other periods, higher weight gain in early pregnancy was associated with higher childhood BMI, total fat mass, android/gynoid fat mass ratio, abdominal subcutaneous fat mass and systolic blood pressure (P-values<0.05). Independent associations of maternal weight gain in early pregnancy with childhood abdominal preperitoneal fat mass, insulin and c-peptide were of borderline significance. Higher weight gain in mid pregnancy was independently associated with higher childhood BMI, total and abdominal subcutaneous fat mass and systolic blood pressure (P-values<0.05). The associations for childhood cardio-metabolic outcomes attenuated after adjustment for childhood BMI. Weight gain in late pregnancy was not associated with childhood outcomes. Higher weight gain in early, but not in mid or late pregnancy, was associated with increased risks of childhood overweight and clustering of cardio-metabolic risk factors (odds ratio (OR) 1.19 (95% confidence interval (CI): 1.10, 1.29) and OR 1.20 (95% CI: 1.07, 1.35) per standard deviation increase in early gestational weight gain, respectively). CONCLUSIONS Higher weight gain in early pregnancy is associated with an adverse cardio-metabolic profile in offspring. This association is largely mediated by childhood adiposity.
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Affiliation(s)
- R Gaillard
- 1] The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands [2] Department of Pediatrics, Erasmus Medical Center, Rotterdam, The Netherlands [3] Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - E A P Steegers
- Department of Obstetrics and Gynaecology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - O H Franco
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - A Hofman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - V W V Jaddoe
- 1] The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands [2] Department of Pediatrics, Erasmus Medical Center, Rotterdam, The Netherlands [3] Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
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Turin TC, Matsushita K, Coresh J, Arima H, Chadban SJ, Cirillo M, Djurdjev O, Green JA, Irie F, Ix JH, Kovesdy CP, Ohkubo T, Shankar A, Wen CP, De Jong PE, Iseki K, Stengel B, Gansevoort RT, De Nicola L, Donfrancesco C, Minutolo R, Iacoviello L, Zoccali C, Gesualdo L, Conte G, Vanuzzo D, Giampaoli S, Gorriz JL, Molina-Vila P, Nieto J, Bover J, Martinez-Castelao A, Martinde Francisco AL, Barril G, Del Pino MD, Escudero V, Coresh J, Matsushita K, Sang Y, Ballew SH, Appel LJ, Green JA, Heine GH, Inker LA, Ishani A, Marks A, Shalev V, Turin TC, Iseki K, Levey AS, Sedaghat S, Mattace-Raso FUS, Uitterlinden AG, Hoorn EJ, Hofman A, Ikram MA, Franco OH, Dehghan A. CKD EPIDEMIOLOGY. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Gishti O, Gaillard R, Durmuş B, Hofman A, Duijts L, Franco OH, Jaddoe VWV. Infant diet and metabolic outcomes in school-age children. The Generation R Study. Eur J Clin Nutr 2014; 68:1008-15. [PMID: 24781689 DOI: 10.1038/ejcn.2014.81] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 03/19/2014] [Accepted: 03/26/2014] [Indexed: 11/09/2022]
Abstract
BACKGROUND Breastfeeding duration is associated with the risks of cardio-metabolic diseases in adulthood. We examined the associations of infant feeding patterns with metabolic outcomes in children and whether any association was explained by family-based socio-demographic, maternal lifestyle-related or childhood factors. SUBJECTS/METHODS We performed a population-based prospective cohort study in 3417 children to examine the associations of breastfeeding duration and exclusivity and age at introduction of solid foods with blood levels of lipids, insulin and C-peptide and risk of clustering of cardio-metabolic risk factors at the median age of 6.0 years (90% range 5.7-6.8). RESULTS We observed that, in the models only adjusted for child's age and sex, ever breastfeeding was not associated with childhood blood levels of lipids but was associated with higher insulin and C-peptide concentrations (P-value<0.05). Breastfeeding duration and exclusivity were not consistently associated with metabolic outcomes. Early introduction of solid foods was associated with higher levels of total cholesterol (P-value<0.05) but not with high-density lipoprotein and low-density lipoprotein cholesterol, triglycerides and insulin levels. Shorter breastfeeding duration and exclusive breastfeeding were associated with increased risks of clustering of cardio-metabolic risk factors. After additional adjustment for family, maternal and childhood factors, none of these associations remained significant. CONCLUSIONS In conclusion, we found no consistent associations of infant feeding patterns with metabolic outcomes at school age, after taking into account family-based socio-demographic, maternal lifestyle-related or childhood factors. Whether infant diet composition influences metabolic outcomes in later life should be further studied.
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Affiliation(s)
- O Gishti
- 1] Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands [2] Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands [3] Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - R Gaillard
- 1] Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands [2] Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands [3] Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - B Durmuş
- Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - A Hofman
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - L Duijts
- 1] Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands [2] Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - O H Franco
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - V W V Jaddoe
- 1] Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands [2] Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands [3] Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
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Oei L, Campos-Obando N, Dehghan A, Oei EHG, Stolk L, van Meurs JBJ, Hofman A, Uitterlinden AG, Franco OH, Zillikens MC, Rivadeneira F. Dissecting the relationship between high-sensitivity serum C-reactive protein and increased fracture risk: the Rotterdam Study. Osteoporos Int 2014; 25:1247-54. [PMID: 24337661 DOI: 10.1007/s00198-013-2578-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Accepted: 11/11/2013] [Indexed: 10/25/2022]
Abstract
UNLABELLED Serum high-sensitivity C-reactive protein (CRP) is an inflammatory biomarker. We investigated the relationship between CRP and bone health in the Rotterdam Study. Serum high-sensitivity CRP was associated with fracture risk and lower femoral neck bending strength. Mendelian randomization analyses did not yield evidence for this relationship being causal. INTRODUCTION Inflammatory diseases are associated with bone pathology, reflected in a higher fracture risk. Serum high-sensitivity CRP is an inflammatory biomarker. We investigated the relationship between CRP and bone mineral density (BMD), hip bone geometry, and incident fractures in the Rotterdam Study, a prospective population-based cohort. METHODS At baseline, serum high-sensitivity CRP was measured. A weighted genetic risk score was compiled for CRP based on published studies (29 polymorphisms; Illumina HumanHap550 Beadchip genotyping and HapMap imputation). Regression models were reported per standard deviation increase in CRP adjusted for sex, age, and BMI. Complete data was available for 6,386 participants, of whom 1,561 persons sustained a fracture (mean follow-up, 11.6 years). RESULTS CRP was associated with a risk for any type of fracture [hazard ratio (HR) = 1.06; 95 % confidence interval (CI), 1.02-1.11], hip fractures (HR = 1.09; 1.02-1.17) and vertebral fractures [odds ratio (OR) = 1.34; 1.14-1.58]. An inverse relationship between CRP levels and section modulus (-0.011 cm(3); -0.020 to -0.003 cm(3)) was observed. The combined genetic risk score of CRP single nucleotide polymorphisms (SNPs) was associated with serum CRP levels (p = 9 × 10(-56)), but not with fracture risk (HR = 1.00; 0.99-1.00; p = 0.23). CONCLUSIONS Serum high-sensitivity CRP is associated with fracture risk and lower bending strength. Mendelian randomization analyses did not yield evidence for this relationship being causal. Future studies might reveal what factors truly underlie the relationship between CRP and fracture risk.
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Affiliation(s)
- L Oei
- Department of Internal Medicine, Erasmus MC, P.O. Box 2040 ee5-79, 3000 CA, Rotterdam, The Netherlands
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Hoeven TA, Leening MJG, Bindels PJ, Castaño-Betancourt M, van Meurs JB, Franco OH, Kavousi M, Hofman A, Ikram MA, Witteman JCM, Bierma-Zeinstra SM. Disability and not osteoarthritis predicts cardiovascular disease: a prospective population-based cohort study. Ann Rheum Dis 2014; 74:752-6. [DOI: 10.1136/annrheumdis-2013-204388] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Hoeven TA, Leening MJG, Bindels PJ, Van Meurs JB, Franco OH, Kavousi M, Ikram MA, Hofman A, Witteman JCM, Bierma-Zeinstra SM. Are osteoarthritis patients at high risk of cardiovascular disease? Results from a large prospective population-based cohort study. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Selwaness M, Van Den Bouwhuijsen Q, Van Onkelen RS, Hofman A, Franco OH, Witteman J, Wentzel JJ, Van Der Lugt A. Atherosclerotic plaque in the left carotid artery is more vulnerable than at the contralateral side. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p2412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Leening MJG, Heeringa J, Krijthe BP, Deckers JW, Franco OH, Hofman A, Roos-Hesselink JW, Witteman JCM, Stricker BHCH. New onset atrial fibrillation and long-term risk of heart failure in the general population: the Rotterdam study. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p4094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Selwaness M, Van Den Bouwhuijsen Q, Mattace-Raso FUS, Verwoert GC, Hofman A, Franco OH, Van Der Lugt A, Witteman J, Wentzel JJ. Arterial stiffness is associated with carotid intraplaque hemorrhage in the general population: the Rotterdam study. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p2411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Baena C, Olandoski M, Younge JO, Buitrago-Lopez DA, Darweesh S, Campos N, Sedaghat S, Faria-Neto JR, Chowdhury R, Franco OH. Effects of lifestyle-related interventions on blood pressure in the low and middle income countries: systematic review and meta-analysis. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p1423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Moreira E, Felix JF, Tiede H, Leening MJG, Loth DW, Krijthe BP, Stricker BH, Hofman A, Ghofrani HA, Franco OH. Prevalence and determinants of pulmonary hypertension in the general population: results from a prospective population-based cohort study. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Jørgensen T, Capewell S, Prescott E, Allender S, Sans S, Zdrojewski T, De Bacquer D, De Sutter J, Franco OH, Løgstrup S, Volpe M, Malyutina S, Verschuren WMM. [Population-level changes to promote cardiovascular health]. Vnitr Lek 2012; 58:943-954. [PMID: 23427953] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Cardiovascular diseases (CVD) cause 1.8 million premature (<75 years) death annually in Europe. The majority of these deaths are preventable with the most efficient and cost-effective approach being on the population level. The aim of this position paper is to assist authorities in selecting the most adequate management strategies to prevent CVD. DESIGN AND METHODS Experts reviewed and summarized the published evidence on the major modifiable CVD risk factors: food, physical inactivity, smoking, and alcohol. Population-based preventive strategies focus on fiscal measures (e.g. taxation), national and regional policies (e.g. smoke-free legislation), and environmental changes (e.g. availability of alcohol). RESULTS Food is a complex area, but several strategies can be effective in increasing fruit and vegetables and lowering intake of salt, saturated fat, trans-fats, and free sugars. Tobacco and alcohol can be regulated mainly by fiscal measures and national policies, but local availability also plays a role. Changes in national policies and the built environment will integrate physical activity into daily life. CONCLUSION Societal changes and commercial influences have led to the present unhealthy environment, in which default option in life style increases CVD risk. A challenge for both central and local authorities is, therefore, to ensure healthier defaults. This position paper summarizes the evidence and recommends a number of structural strategies at international, national, and regional levels that in combination can substantially reduce CVD.
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Affiliation(s)
- T Jørgensen
- Vyzkumne stredisko pro otazky prevence a zdravi Glostrup, Dansko.
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