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Sofianopoulou E, Kaptoge SK, Afzal S, Jiang T, Gill D, Gundersen TE, Bolton TR, Allara E, Arnold MG, Mason AM, Chung R, Pennells LAM, Shi F, Sun L, Willeit P, Forouhi NG, Langenberg C, Sharp SJ, Panico S, Engström G, Melander O, Tong TYN, Perez-Cornago A, Norberg M, Johansson I, Katzke V, Srour B, Sánchez MJ, Redondo-Sánchez D, Olsen A, Dahm CC, Overvad K, Brustad M, Skeie G, Moreno-Iribas C, Onland-Moret NC, van der Schouw YT, Tsilidis KK, Heath AK, Agnoli C, Krogh V, de Boer IH, Kobylecki CJ, Çolak Y, Zittermann A, Sundström J, Welsh P, Weiderpass E, Aglago EK, Ferrari P, Clarke R, Boutron MC, Severi G, MacDonald C, Providencia R, Masala G, Zamora-Ros R, Boer J, Verschuren WMM, Cawthon P, Schierbeck LL, Cooper C, Schulze MB, Bergmann MM, Hannemann A, Kiechl S, Brenner H, van Schoor NM, Albertorio JR, Sacerdote C, Linneberg A, Kårhus LL, Huerta JM, Imaz L, Joergensen C, Ben-Shlomo Y, Lundqvist A, Gallacher J, Sattar N, Wood AM, Wareham NJ, Nordestgaard BG, Di Angelantonio E, Danesh J, Butterworth AS, Burgess S. Estimating dose-response relationships for vitamin D with coronary heart disease, stroke, and all-cause mortality: observational and Mendelian randomisation analyses. Lancet Diabetes Endocrinol 2024; 12:e2-e11. [PMID: 38048800 PMCID: PMC7615586 DOI: 10.1016/s2213-8587(23)00287-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/05/2023] [Accepted: 09/27/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Randomised trials of vitamin D supplementation for cardiovascular disease and all-cause mortality have generally reported null findings. However, generalisability of results to individuals with low vitamin D status is unclear. We aimed to characterise dose-response relationships between 25-hydroxyvitamin D (25[OH]D) concentrations and risk of coronary heart disease, stroke, and all-cause mortality in observational and Mendelian randomisation frameworks. METHODS Observational analyses were undertaken using data from 33 prospective studies comprising 500 962 individuals with no known history of coronary heart disease or stroke at baseline. Mendelian randomisation analyses were performed in four population-based cohort studies (UK Biobank, EPIC-CVD, and two Copenhagen population-based studies) comprising 386 406 middle-aged individuals of European ancestries, including 33 546 people who developed coronary heart disease, 18 166 people who had a stroke, and 27 885 people who died. Primary outcomes were coronary heart disease, defined as fatal ischaemic heart disease (International Classification of Diseases 10th revision code I20-I25) or non-fatal myocardial infarction (I21-I23); stroke, defined as any cerebrovascular disease (I60-I69); and all-cause mortality. FINDINGS Observational analyses suggested inverse associations between incident coronary heart disease, stroke, and all-cause mortality outcomes with 25(OH)D concentration at low 25(OH)D concentrations. In population-wide genetic analyses, there were no associations of genetically predicted 25(OH)D with coronary heart disease (odds ratio [OR] per 10 nmol/L higher genetically-predicted 25(OH)D concentration 0·98, 95% CI 0·95-1·01), stroke (1·01, [0·97-1·05]), or all-cause mortality (0·99, 0·95-1·02). Null findings were also observed in genetic analyses for cause-specific mortality outcomes, and in stratified genetic analyses for all outcomes at all observed levels of 25(OH)D concentrations. INTERPRETATION Stratified Mendelian randomisation analyses suggest a lack of causal relationship for 25(OH)D concentrations with both cardiovascular and mortality outcomes for individuals at all levels of 25(OH)D. Our findings suggest that substantial reductions in mortality and cardiovascular morbidity due to long-term low-dose vitamin D supplementation are unlikely even if targeted at individuals with low vitamin D status. FUNDING British Heart Foundation, Medical Research Council, National Institute for Health Research, Health Data Research UK, Cancer Research UK, and International Agency for Research on Cancer.
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Affiliation(s)
- Emerging Risk Factors Collaboration/EPIC-CVD/Vitamin D Studies Collaboration
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
- Copenhagen General Population Study, Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Denmark
- Faculty of Health and Medical Sciences, Copenhagen University, Denmark
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Vitas Ltd, Oslo, Norway
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, UK
- BHF Centre of Research Excellence, School of Clinical Medicine, Addenbrooke’s Hospital, University of Cambridge, UK
- Department of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, Innsbruck, Austria
- Medical Research Council Epidemiology Unit, University of Cambridge, UK
- Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, Germany
- Dipartimento Di Medicina Clinica E Chirurgia, Federico II University, Italy
- Department of Clinical Sciences Malmö, Lund University, Sweden
- Department of Emergency and Internal Medicine, Skåne University Hospital, Malmö, Sweden
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, UK
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
- Department of Odontology, Umeå University, Sweden
- Department of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- EPIC Granada, Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health. University of Granada. Granada, Spain
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Public Health, Aarhus University, Denmark
- Department of Community Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Norway
- The Public Dental Health Service Competence Centre of Northern Norway (TkNN), Tromsø, Norway
- Epidemiology, Prevention and Promotion Health Service, Public Health Institute of Navarra, Spain
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Netherlands
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK
- School of Medicine, University of Ioannina, Greece
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy
- Department of Medicine, University of Washington, USA
- Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen, Ruhr University Bochum, Germany
- Department of Medical Sciences, Uppsala University, Sweden
- BHF Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- International Agency for Research on Cancer, France
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, Oxford, UK
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm U1018, Équipe "Exposome et Hérédité", CESP, Gustave Roussy, France
- Department of Statistics, Computer Science and Applications "G. Parenti" (DISIA), University of Florence, Italy
- Institute of Health Informatics Research, University College London, London, UK
- Institute for Cancer Research, Prevention and Clinical Network – ISPRO, Italy
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Centre for Nutrition and Health, National Institute for Public Health and the Environment (RIVM)
- Research Institute, California Pacific Medical Center, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
- Cardiology Department, Nordsjælland University Hospital, Hillerød, Denmark
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- Faculty of Medicine, University of Southampton, Southampton, UK
- German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, Germany
- Institute of Clinical Chemistry and Laboratory Medicine, DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine Greifswald, Germany
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
- VASCage, Research Centre on Vascular Ageing and Stroke, Innsbruck, Austria
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Network Aging Research, University of Heidelberg, Heidelberg, Germany
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Netherlands
- Coalition to End Loneliness, USA
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital, Turin, Italy
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Denmark
- Department of Epidemiology, Murcia Regional Health Council, Instituto Murciano de Investigación Biosanitaria-Arrixaca, Murcia, Spain
- Public Health Division of Bizkaia, Ministry of Health of the Basque Government, Spain
- Biodonostia Health Research Institute, Donostia-San Sebastian, Spain
- Steno Diabetes Center, Copenhagen, Denmark
- Population Health Sciences, University of Bristol, UK
- Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Psychiatry, University of Oxford, Oxford, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, UK
- The Alan Turing Institute, UK
- The Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen University Hospital
- Department of Human Genetics, Wellcome Sanger Institute, Hinxton, UK
- Medical Research Council Biostatistics Unit, University of Cambridge, UK
| | - Eleni Sofianopoulou
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
| | - Stephen K Kaptoge
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
| | - Shoaib Afzal
- Copenhagen General Population Study, Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Denmark
- Faculty of Health and Medical Sciences, Copenhagen University, Denmark
| | - Tao Jiang
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
| | - Dipender Gill
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | | | - Thomas R Bolton
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, UK
| | - Elias Allara
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, UK
| | - Matthew G Arnold
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
| | - Amy M Mason
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
| | - Ryan Chung
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
- BHF Centre of Research Excellence, School of Clinical Medicine, Addenbrooke’s Hospital, University of Cambridge, UK
| | - Lisa AM Pennells
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
| | - Fanchao Shi
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
| | - Luanluan Sun
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
| | - Peter Willeit
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
- Department of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, Innsbruck, Austria
| | - Nita G Forouhi
- Medical Research Council Epidemiology Unit, University of Cambridge, UK
| | - Claudia Langenberg
- Medical Research Council Epidemiology Unit, University of Cambridge, UK
- Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Stephen J Sharp
- Medical Research Council Epidemiology Unit, University of Cambridge, UK
| | - Salvatore Panico
- Dipartimento Di Medicina Clinica E Chirurgia, Federico II University, Italy
| | - Gunnar Engström
- Department of Clinical Sciences Malmö, Lund University, Sweden
| | - Olle Melander
- Department of Clinical Sciences Malmö, Lund University, Sweden
- Department of Emergency and Internal Medicine, Skåne University Hospital, Malmö, Sweden
| | - Tammy YN Tong
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, UK
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, UK
| | - Margareta Norberg
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | | | - Verena Katzke
- Department of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Bernard Srour
- Department of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - María José Sánchez
- EPIC Granada, Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health. University of Granada. Granada, Spain
| | - Daniel Redondo-Sánchez
- EPIC Granada, Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Anja Olsen
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Public Health, Aarhus University, Denmark
| | | | - Kim Overvad
- Department of Public Health, Aarhus University, Denmark
| | - Magritt Brustad
- Department of Community Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Norway
- The Public Dental Health Service Competence Centre of Northern Norway (TkNN), Tromsø, Norway
| | - Guri Skeie
- Department of Community Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Norway
| | - Conchi Moreno-Iribas
- The Public Dental Health Service Competence Centre of Northern Norway (TkNN), Tromsø, Norway
| | - N Charlotte Onland-Moret
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Netherlands
| | - Yvonne T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Netherlands
| | - Konstantinos K Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK
- School of Medicine, University of Ioannina, Greece
| | - Alicia K Heath
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK
| | - Claudia Agnoli
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy
| | - Ian H de Boer
- Department of Medicine, University of Washington, USA
| | - Camilla Jannie Kobylecki
- Copenhagen General Population Study, Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Denmark
| | - Yunus Çolak
- Copenhagen General Population Study, Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Denmark
| | - Armin Zittermann
- Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen, Ruhr University Bochum, Germany
| | | | - Paul Welsh
- BHF Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | | | | | | | - Robert Clarke
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, Oxford, UK
| | - Marie-Christine Boutron
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm U1018, Équipe "Exposome et Hérédité", CESP, Gustave Roussy, France
| | - Gianluca Severi
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm U1018, Équipe "Exposome et Hérédité", CESP, Gustave Roussy, France
- Department of Statistics, Computer Science and Applications "G. Parenti" (DISIA), University of Florence, Italy
| | - Conor MacDonald
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm U1018, Équipe "Exposome et Hérédité", CESP, Gustave Roussy, France
| | - Rui Providencia
- Institute of Health Informatics Research, University College London, London, UK
| | - Giovanna Masala
- Institute for Cancer Research, Prevention and Clinical Network – ISPRO, Italy
| | - Raul Zamora-Ros
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Jolanda Boer
- Centre for Nutrition and Health, National Institute for Public Health and the Environment (RIVM)
| | - WM Monique Verschuren
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Netherlands
- Centre for Nutrition and Health, National Institute for Public Health and the Environment (RIVM)
| | - Peggy Cawthon
- Research Institute, California Pacific Medical Center, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | | | - Cyrus Cooper
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Matthias B Schulze
- German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, Germany
| | - Manuela M Bergmann
- German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Anke Hannemann
- Institute of Clinical Chemistry and Laboratory Medicine, DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine Greifswald, Germany
| | - Stefan Kiechl
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
- VASCage, Research Centre on Vascular Ageing and Stroke, Innsbruck, Austria
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Network Aging Research, University of Heidelberg, Heidelberg, Germany
| | - Natasja M van Schoor
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Netherlands
| | | | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital, Turin, Italy
| | - Allan Linneberg
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Denmark
| | - Line L Kårhus
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Denmark
| | - José María Huerta
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, Instituto Murciano de Investigación Biosanitaria-Arrixaca, Murcia, Spain
| | - Liher Imaz
- Public Health Division of Bizkaia, Ministry of Health of the Basque Government, Spain
- Biodonostia Health Research Institute, Donostia-San Sebastian, Spain
| | | | | | | | - John Gallacher
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Naveed Sattar
- BHF Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Angela M Wood
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, UK
- BHF Centre of Research Excellence, School of Clinical Medicine, Addenbrooke’s Hospital, University of Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, UK
- The Alan Turing Institute, UK
| | | | - Børge G Nordestgaard
- Copenhagen General Population Study, Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Denmark
- Faculty of Health and Medical Sciences, Copenhagen University, Denmark
- The Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen University Hospital
| | - Emanuele Di Angelantonio
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, UK
- BHF Centre of Research Excellence, School of Clinical Medicine, Addenbrooke’s Hospital, University of Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, UK
| | - John Danesh
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, UK
- BHF Centre of Research Excellence, School of Clinical Medicine, Addenbrooke’s Hospital, University of Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, UK
- Department of Human Genetics, Wellcome Sanger Institute, Hinxton, UK
| | - Adam S Butterworth
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, UK
- BHF Centre of Research Excellence, School of Clinical Medicine, Addenbrooke’s Hospital, University of Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, UK
| | - Stephen Burgess
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
- BHF Centre of Research Excellence, School of Clinical Medicine, Addenbrooke’s Hospital, University of Cambridge, UK
- Medical Research Council Biostatistics Unit, University of Cambridge, UK
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Gaziano L, Sun L, Arnold M, Bell S, Cho K, Kaptoge SK, Song RJ, Burgess S, Posner DC, Mosconi K, Robinson-Cohen C, Mason AM, Bolton TR, Tao R, Allara E, Schubert P, Chen L, Staley JR, Staplin N, Altay S, Amiano P, Arndt V, Ärnlöv J, Barr EL, Björkelund C, Boer JM, Brenner H, Casiglia E, Chiodini P, Cooper JA, Coresh J, Cushman M, Dankner R, Davidson KW, de Jongh RT, Donfrancesco C, Engström G, Freisling H, de la Cámara AG, Gudnason V, Hankey GJ, Hansson PO, Heath AK, Hoorn EJ, Imano H, Jassal SK, Kaaks R, Katzke V, Kauhanen J, Kiechl S, Koenig W, Kronmal RA, Kyrø C, Lawlor DA, Ljungberg B, MacDonald C, Masala G, Meisinger C, Melander O, Moreno Iribas C, Ninomiya T, Nitsch D, Nordestgaard BG, Onland-Moret C, Palmieri L, Petrova D, Garcia JRQ, Rosengren A, Sacerdote C, Sakurai M, Santiuste C, Schulze MB, Sieri S, Sundström J, Tikhonoff V, Tjønneland A, Tong T, Tumino R, Tzoulaki I, van der Schouw YT, Monique Verschuren W, Völzke H, Wallace RB, Wannamethee SG, Weiderpass E, Willeit P, Woodward M, Yamagishi K, Zamora-Ros R, Akwo EA, Pyarajan S, Gagnon DR, Tsao PS, Muralidhar S, Edwards TL, Damrauer SM, Joseph J, Pennells L, Wilson PW, Harrison S, Gaziano TA, Inouye M, Baigent C, Casas JP, Langenberg C, Wareham N, Riboli E, Gaziano J, Danesh J, Hung AM, Butterworth AS, Wood AM, Di Angelantonio E. Mild-to-Moderate Kidney Dysfunction and Cardiovascular Disease: Observational and Mendelian Randomization Analyses. Circulation 2022; 146:1507-1517. [PMID: 36314129 PMCID: PMC9662821 DOI: 10.1161/circulationaha.122.060700] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 08/18/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND End-stage renal disease is associated with a high risk of cardiovascular events. It is unknown, however, whether mild-to-moderate kidney dysfunction is causally related to coronary heart disease (CHD) and stroke. METHODS Observational analyses were conducted using individual-level data from 4 population data sources (Emerging Risk Factors Collaboration, EPIC-CVD [European Prospective Investigation into Cancer and Nutrition-Cardiovascular Disease Study], Million Veteran Program, and UK Biobank), comprising 648 135 participants with no history of cardiovascular disease or diabetes at baseline, yielding 42 858 and 15 693 incident CHD and stroke events, respectively, during 6.8 million person-years of follow-up. Using a genetic risk score of 218 variants for estimated glomerular filtration rate (eGFR), we conducted Mendelian randomization analyses involving 413 718 participants (25 917 CHD and 8622 strokes) in EPIC-CVD, Million Veteran Program, and UK Biobank. RESULTS There were U-shaped observational associations of creatinine-based eGFR with CHD and stroke, with higher risk in participants with eGFR values <60 or >105 mL·min-1·1.73 m-2, compared with those with eGFR between 60 and 105 mL·min-1·1.73 m-2. Mendelian randomization analyses for CHD showed an association among participants with eGFR <60 mL·min-1·1.73 m-2, with a 14% (95% CI, 3%-27%) higher CHD risk per 5 mL·min-1·1.73 m-2 lower genetically predicted eGFR, but not for those with eGFR >105 mL·min-1·1.73 m-2. Results were not materially different after adjustment for factors associated with the eGFR genetic risk score, such as lipoprotein(a), triglycerides, hemoglobin A1c, and blood pressure. Mendelian randomization results for stroke were nonsignificant but broadly similar to those for CHD. CONCLUSIONS In people without manifest cardiovascular disease or diabetes, mild-to-moderate kidney dysfunction is causally related to risk of CHD, highlighting the potential value of preventive approaches that preserve and modulate kidney function.
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Affiliation(s)
- Liam Gaziano
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA (L.G., K.C., R.J.S., D.C.P., P.S., J.J., J.P.C., J.M.G.)
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care (L.G., L.S., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., T.R.B., E.A., L.C., J.R.S., P.W., L. Pennells, S.H., M.I., J.D., A.S.B., A.M.W., E.D.A.)
- Heart and Lung Research Institute, University of Cambridge, Cambridge UK (L.G., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., E.A., L. Pennells, M.I., J.D., A.S.B., A.M.W., E.D.A.)
| | - Luanluan Sun
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA (L.G., K.C., R.J.S., D.C.P., P.S., J.J., J.P.C., J.M.G.)
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care (L.G., L.S., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., T.R.B., E.A., L.C., J.R.S., P.W., L. Pennells, S.H., M.I., J.D., A.S.B., A.M.W., E.D.A.)
| | | | - Steven Bell
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA (L.G., K.C., R.J.S., D.C.P., P.S., J.J., J.P.C., J.M.G.)
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care (L.G., L.S., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., T.R.B., E.A., L.C., J.R.S., P.W., L. Pennells, S.H., M.I., J.D., A.S.B., A.M.W., E.D.A.)
- Heart and Lung Research Institute, University of Cambridge, Cambridge UK (L.G., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., E.A., L. Pennells, M.I., J.D., A.S.B., A.M.W., E.D.A.)
- Stroke Research Group, Department of Clinical Neurosciences (S. Bell), University of Cambridge, UK
- NIHR Blood and Transplant Research Unit in Donor Health and Behaviour (S. Bell, T.R.B., E.A., J.D., A.S.B., A.M.W., E.D.A.), University of Cambridge, UK
| | - Kelly Cho
- Division of Aging (K.C., S.P., J.P.C. J.M.G.), Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Stephen K. Kaptoge
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA (L.G., K.C., R.J.S., D.C.P., P.S., J.J., J.P.C., J.M.G.)
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care (L.G., L.S., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., T.R.B., E.A., L.C., J.R.S., P.W., L. Pennells, S.H., M.I., J.D., A.S.B., A.M.W., E.D.A.)
- Heart and Lung Research Institute, University of Cambridge, Cambridge UK (L.G., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., E.A., L. Pennells, M.I., J.D., A.S.B., A.M.W., E.D.A.)
| | - Rebecca J. Song
- Department of Epidemiology, Boston University School of Public Health, MA (R.J.S.)
| | - Stephen Burgess
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA (L.G., K.C., R.J.S., D.C.P., P.S., J.J., J.P.C., J.M.G.)
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care (L.G., L.S., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., T.R.B., E.A., L.C., J.R.S., P.W., L. Pennells, S.H., M.I., J.D., A.S.B., A.M.W., E.D.A.)
- BHF Centre of Research Excellence, School of Clinical Medicine, Addenbrooke’s Hospital (A.M.M., S. Burgess, J.D., A.M.W., A.S.B., E.D.A.)
- Heart and Lung Research Institute, University of Cambridge, Cambridge UK (L.G., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., E.A., L. Pennells, M.I., J.D., A.S.B., A.M.W., E.D.A.)
- Medical Research Council Biostatistics Unit (A.M.M., S. Burgess), University of Cambridge, UK
| | - Daniel C. Posner
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA (L.G., K.C., R.J.S., D.C.P., P.S., J.J., J.P.C., J.M.G.)
| | - Katja Mosconi
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA (L.G., K.C., R.J.S., D.C.P., P.S., J.J., J.P.C., J.M.G.)
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care (L.G., L.S., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., T.R.B., E.A., L.C., J.R.S., P.W., L. Pennells, S.H., M.I., J.D., A.S.B., A.M.W., E.D.A.)
- Heart and Lung Research Institute, University of Cambridge, Cambridge UK (L.G., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., E.A., L. Pennells, M.I., J.D., A.S.B., A.M.W., E.D.A.)
| | - Cassianne Robinson-Cohen
- Division of Nephrology, Department of Medicine (C.R.-C., E.A.A.), Vanderbilt University Medical Center, Nashville, TN
| | - Amy M. Mason
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care (L.G., L.S., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., T.R.B., E.A., L.C., J.R.S., P.W., L. Pennells, S.H., M.I., J.D., A.S.B., A.M.W., E.D.A.)
- BHF Centre of Research Excellence, School of Clinical Medicine, Addenbrooke’s Hospital (A.M.M., S. Burgess, J.D., A.M.W., A.S.B., E.D.A.)
- Heart and Lung Research Institute, University of Cambridge, Cambridge UK (L.G., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., E.A., L. Pennells, M.I., J.D., A.S.B., A.M.W., E.D.A.)
- Medical Research Council Biostatistics Unit (A.M.M., S. Burgess), University of Cambridge, UK
| | - Thomas R. Bolton
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care (L.G., L.S., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., T.R.B., E.A., L.C., J.R.S., P.W., L. Pennells, S.H., M.I., J.D., A.S.B., A.M.W., E.D.A.)
- NIHR Blood and Transplant Research Unit in Donor Health and Behaviour (S. Bell, T.R.B., E.A., J.D., A.S.B., A.M.W., E.D.A.), University of Cambridge, UK
| | - Ran Tao
- Department of Biostatistics (R. Tao), Vanderbilt University Medical Center, Nashville, TN
| | - Elias Allara
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care (L.G., L.S., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., T.R.B., E.A., L.C., J.R.S., P.W., L. Pennells, S.H., M.I., J.D., A.S.B., A.M.W., E.D.A.)
- Heart and Lung Research Institute, University of Cambridge, Cambridge UK (L.G., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., E.A., L. Pennells, M.I., J.D., A.S.B., A.M.W., E.D.A.)
- NIHR Blood and Transplant Research Unit in Donor Health and Behaviour (S. Bell, T.R.B., E.A., J.D., A.S.B., A.M.W., E.D.A.), University of Cambridge, UK
| | - Petra Schubert
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA (L.G., K.C., R.J.S., D.C.P., P.S., J.J., J.P.C., J.M.G.)
| | - Lingyan Chen
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care (L.G., L.S., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., T.R.B., E.A., L.C., J.R.S., P.W., L. Pennells, S.H., M.I., J.D., A.S.B., A.M.W., E.D.A.)
| | - James R. Staley
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care (L.G., L.S., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., T.R.B., E.A., L.C., J.R.S., P.W., L. Pennells, S.H., M.I., J.D., A.S.B., A.M.W., E.D.A.)
| | - Natalie Staplin
- Medical Research Council Population Health Research Unit, Clinical Trial Service Unit and Epidemiological Studies Unit (N.S., C.B.), Nuffield Department of Population Health, University of Oxford, UK
| | - Servet Altay
- Department of Cardiology, Trakya University School of Medicine, Edirne, Turkey (S.A.)
| | - Pilar Amiano
- Ministry of Health of the Basque Government, Sub Directorate for Public Health and Addictions of Gipuzkoa, San Sebastián, Spain (P.A.)
- Biodonostia Health Research Institute, Epidemiology of Chronic and Communicable Diseases Group, San Sebastián, Spain (P.A.)
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain (P.A., A.G.d.l.C., D.P., C. Santiuste)
| | - Volker Arndt
- Division of Clinical Epidemiology and Aging Research (V.A.), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Johan Ärnlöv
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA (L.G., K.C., R.J.S., D.C.P., P.S., J.J., J.P.C., J.M.G.)
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care (L.G., L.S., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., T.R.B., E.A., L.C., J.R.S., P.W., L. Pennells, S.H., M.I., J.D., A.S.B., A.M.W., E.D.A.)
- BHF Centre of Research Excellence, School of Clinical Medicine, Addenbrooke’s Hospital (A.M.M., S. Burgess, J.D., A.M.W., A.S.B., E.D.A.)
- Heart and Lung Research Institute, University of Cambridge, Cambridge UK (L.G., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., E.A., L. Pennells, M.I., J.D., A.S.B., A.M.W., E.D.A.)
- Medical Research Council Biostatistics Unit (A.M.M., S. Burgess), University of Cambridge, UK
- Stroke Research Group, Department of Clinical Neurosciences (S. Bell), University of Cambridge, UK
- NIHR Blood and Transplant Research Unit in Donor Health and Behaviour (S. Bell, T.R.B., E.A., J.D., A.S.B., A.M.W., E.D.A.), University of Cambridge, UK
- MRC Epidemiology Unit, School of Clinical Medicine (C.L., N.W.), University of Cambridge, UK
- Division of Aging (K.C., S.P., J.P.C. J.M.G.), Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
- Division of Cardiovascular Medicine (J.J., T.A.G.), Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
- Department of Epidemiology, Boston University School of Public Health, MA (R.J.S.)
- Division of Nephrology, Department of Medicine (C.R.-C., E.A.A.), Vanderbilt University Medical Center, Nashville, TN
- Department of Biostatistics (R. Tao), Vanderbilt University Medical Center, Nashville, TN
- Medical Research Council Population Health Research Unit, Clinical Trial Service Unit and Epidemiological Studies Unit (N.S., C.B.), Nuffield Department of Population Health, University of Oxford, UK
- Cancer Epidemiology Unit (T.T.), Nuffield Department of Population Health, University of Oxford, UK
- Department of Cardiology, Trakya University School of Medicine, Edirne, Turkey (S.A.)
- Ministry of Health of the Basque Government, Sub Directorate for Public Health and Addictions of Gipuzkoa, San Sebastián, Spain (P.A.)
- Biodonostia Health Research Institute, Epidemiology of Chronic and Communicable Diseases Group, San Sebastián, Spain (P.A.)
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain (P.A., A.G.d.l.C., D.P., C. Santiuste)
- Division of Clinical Epidemiology and Aging Research (V.A.), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Cancer Epidemiology (S.K.J., R.K., V.K.), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden (J.A., H.B.)
- School of Health and Social Studies, Dalarna University, Falun, Sweden (J.A.)
- Wellbeing & Preventable Chronic Diseases (WPCD) Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia (E.L.M.B.)
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia (E.L.M.B., M.I.)
- Institute of Medicine, School of Public Health and Community Medicine (C.B.), Sahlgrenska Academy, University of Gothenburg, Sweden
- Institute of Medicine, Department of Molecular and Clinical Medicine (P.-O.H., A.R.), Sahlgrenska Academy, University of Gothenburg, Sweden
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands (J.M.A.B., W.M.M.V.)
- Network Aging Research (NAR), Heidelberg University, Germany (H.B.)
- Studium Patavinum (E.C.), University of Padua, Italy
- Department of Medicine (V.T.), University of Padua, Italy
- Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Università degli Studi della Campania ‘Luigi Vanvitelli’, Caserta, Italy (P.C.)
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, UK (J.A.C.)
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.C.)
- Larner College of Medicine, The University of Vermont, Burlington (M.C.)
- The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel (R.D.)
- School of Public Health, Department of Epidemiology and Preventive Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel (R.D.)
- Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York, NY (R.D., K.W.D.)
- Amsterdam University Medical Centers, VUMC, the Netherlands (R.T.d.J.)
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità, Rome, Italy (C.D., L. Palmer)
- Department of Clinical Sciences, Malmö, Lund University, Sweden (G.E., O.M.)
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France (H.F., E.W.)
- 12 Octubre Hospital Research Institute, Madrid, Spain (A.G.d,l,C.)
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland and Icelandic Heart Association, Kopavogur, Iceland (V.G.)
- Medical School Faculty of Health & Medical Sciences, The University of Western Australia, Perth, WA, Australia (G.J.H.)
- Region Västra Götaland, Sahlgrenska University Hospital, Department of Medicine Geriatrics and Emergency Medicine/Östra, Gothenburg, Sweden (P.-O.H., A.R.)
- School of Public Health (A.K.H., I.T., E.R.), Imperial College London, UK
- The George Institute for Global Health (M.W.), Imperial College London, UK
- Department of Internal Medicine, Division of Nephrology and Transplantation, Erasmus MC, University Medical Center Rotterdam, the Netherlands (E.J.H.)
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan (H.I.)
- University of Eastern Finland (UEF), Kuopio, Finland (J.K.)
- Department of Neurology & Neurosurgery, Medical University of Innsbruck, Innsbruck, Austria (S.K.)
- Clinical Epidemiology Team, Institute of Health Economics, Medical University of Innsbruck, Innsbruck, Austria (S.K., P.W.)
- Institute of Epidemiology and Medical Biometry, University of Ulm, Germany (W.K.)
- Deutsches Herzzentrum München, Technische Universität München, Germany (W.K.)
- German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance (W.K.)
- School of Public Health, University of Washington, Seattle (R.A.K.)
- Danish Cancer Society Research Center, Copenhagen, Denmark (C.K., A.T.)
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, UK (D.A.L.)
- Population Health Science, Bristol Medical School, UK (D.A.L.)
- Department of Surgical and Perioperative sciences, Urology and Andrology, Umeå University, Sweden (B.L.)
- University Paris-Saclay, UVSQ, Inserm, Villejuif, France (C. MacDonald)
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy (G.M.)
- Helmholtz Zentrum München, Munich, Germany (C. Meisinger)
- Navarra Public Health Institute, IdiSNA, Pamplona, Spain (C.M.I.)
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Pamplona, Spain (C.M.I.)
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan (T.N.)
- London School of Hygiene & Tropical Medicine, UK (D.N.)
- Herlev and Gentofte Hospital (B.G.N.), Copenhagen University Hospital, Copenhagen, Denmark
- Frederiksberg Hospital B.G.N.), Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences (B.G.N.), University of Copenhagen, Denmark
- Department of Public Health (A.T.), University of Copenhagen, Denmark
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, the Netherlands (C.O.-M., Y.T.v.d.S., W.M.M.V.)
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain (D.P.)
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain (D.P.)
- Consejería de Sanidad del Principado de Asturias Oviedo, Asturias, Spain (J.R.Q.G.)
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital, Turin, Italy (C. Sacerdote)
- Department of Social and Environmental Medicine, Kanazawa Medical University, Uchinada, Japan (M.S.)
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Spain (C. Santiuste)
- German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (M.B.S.)
- German Center for Diabetes Research (DZD), Neuherberg, Germany (M.B.S.)
- Institute of Nutritional Science, University of Potsdam, Germany (M.B.S.)
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy (S.S.)
- Department of Medical Sciences, Uppsala University, Sweden (J.S.)
- Hyblean Association for Epidemiological Reserach AIRE - ONLUS, Ragusa, Italy (R.T.)
- Universitätsmedizin Greifswald, Institut für Community Medicine, Abteilung SHIP/ Klinisch-Epidemiologische Forschung, Germany (H.V.)
- College of Public Health, University of Iowa (R.B.W.)
- University College London, UK (S.G.W.)
- The George Institute for Global Health, Camperdown, NSW, Australia (M.W.)
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Japan (K.Y.)
- Unit of Nutrition and Cancer, Epidemiology Research Program, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat (Barcelona), Spain (R.Z.-R.)
- Center for Data and Computational Sciences, VA Boston Healthcare System, Boston, MA (S.P.)
- Department of Biostatistics, Boston University School of Public Health, MA (D.R.G.)
- VA Pal Alto Epidemiology Research and Information Center for Genomics, VA Palo Alto Health Care System, CA (P.S.T.)
- Medicine (Cardiovascular Medicine), Stanford University of School of Medicine, CA (P.S.T.)
- Office of Research and Development, Veterans Health Administration, Washington, DC (S.M.)
- Department of Veterans Affairs, Tennessee Valley Health Care System, Vanderbilt University, Nashville (T.L.E.)
- Medicine/Epidemiology, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN (T.L.E.)
- Department of Surgery, Corporal Michael Crescenz VA Medical Center and Perelman School of Medicine, University of Pennsylvania, Philadelphia (S.M.D.)
- Internal Medicine, VA Atlanta Healthcare System, Decatur, GA (P.W.F.W.)
- Emory University School of Medicine (Cardiology), Emory University, Atlanta, GA (P.W.F.W.)
- Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA (T.A.G.)
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, UK (M.I., J.D., A.S.B., A.M.W., E.D.A.)
- The Alan Turing Institute, London, UK (M.I.)
- Computational Medicine, Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Germany (C.L.)
- Department of Human Genetics, Wellcome Sanger Institute, Hinxton, UK (J.D.)
- Division of Nephrology & Hypertension, Department of Medicine, Tennessee Valley Health Care System and Vanderbilt University Medical Center, Nashville (A.M.H.)
- Cambridge Centre for AI in Medicine, UK (A.M.W.)
- Health Data Science Centre, Human Technopole, Milan, Italy (E.D.A.)
| | - Elizabeth L.M. Barr
- Wellbeing & Preventable Chronic Diseases (WPCD) Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia (E.L.M.B.)
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia (E.L.M.B., M.I.)
| | - Cecilia Björkelund
- Medical Research Council Population Health Research Unit, Clinical Trial Service Unit and Epidemiological Studies Unit (N.S., C.B.), Nuffield Department of Population Health, University of Oxford, UK
| | - Jolanda M.A. Boer
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands (J.M.A.B., W.M.M.V.)
| | - Hermann Brenner
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden (J.A., H.B.)
- Network Aging Research (NAR), Heidelberg University, Germany (H.B.)
| | | | - Paolo Chiodini
- Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Università degli Studi della Campania ‘Luigi Vanvitelli’, Caserta, Italy (P.C.)
| | - Jackie A. Cooper
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, UK (J.A.C.)
| | - Josef Coresh
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.C.)
| | - Mary Cushman
- Larner College of Medicine, The University of Vermont, Burlington (M.C.)
| | - Rachel Dankner
- The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel (R.D.)
- School of Public Health, Department of Epidemiology and Preventive Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel (R.D.)
- Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York, NY (R.D., K.W.D.)
| | - Karina W. Davidson
- Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York, NY (R.D., K.W.D.)
| | | | - Chiara Donfrancesco
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità, Rome, Italy (C.D., L. Palmer)
| | - Gunnar Engström
- Department of Clinical Sciences, Malmö, Lund University, Sweden (G.E., O.M.)
| | - Heinz Freisling
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France (H.F., E.W.)
| | - Agustín Gómez de la Cámara
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain (P.A., A.G.d.l.C., D.P., C. Santiuste)
- 12 Octubre Hospital Research Institute, Madrid, Spain (A.G.d,l,C.)
| | - Vilmundur Gudnason
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland and Icelandic Heart Association, Kopavogur, Iceland (V.G.)
| | - Graeme J. Hankey
- Medical School Faculty of Health & Medical Sciences, The University of Western Australia, Perth, WA, Australia (G.J.H.)
| | - Per-Olof Hansson
- Institute of Medicine, Department of Molecular and Clinical Medicine (P.-O.H., A.R.), Sahlgrenska Academy, University of Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Department of Medicine Geriatrics and Emergency Medicine/Östra, Gothenburg, Sweden (P.-O.H., A.R.)
| | - Alicia K. Heath
- School of Public Health (A.K.H., I.T., E.R.), Imperial College London, UK
| | - Ewout J. Hoorn
- Department of Internal Medicine, Division of Nephrology and Transplantation, Erasmus MC, University Medical Center Rotterdam, the Netherlands (E.J.H.)
| | - Hironori Imano
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan (H.I.)
| | - Simerjot K. Jassal
- Department of Cancer Epidemiology (S.K.J., R.K., V.K.), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Rudolf Kaaks
- Department of Cancer Epidemiology (S.K.J., R.K., V.K.), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Verena Katzke
- Department of Cancer Epidemiology (S.K.J., R.K., V.K.), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jussi Kauhanen
- University of Eastern Finland (UEF), Kuopio, Finland (J.K.)
| | - Stefan Kiechl
- Department of Neurology & Neurosurgery, Medical University of Innsbruck, Innsbruck, Austria (S.K.)
- Clinical Epidemiology Team, Institute of Health Economics, Medical University of Innsbruck, Innsbruck, Austria (S.K., P.W.)
| | - Wolfgang Koenig
- Institute of Epidemiology and Medical Biometry, University of Ulm, Germany (W.K.)
- Deutsches Herzzentrum München, Technische Universität München, Germany (W.K.)
- German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance (W.K.)
| | | | - Cecilie Kyrø
- Danish Cancer Society Research Center, Copenhagen, Denmark (C.K., A.T.)
| | - Deborah A. Lawlor
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, UK (D.A.L.)
- Population Health Science, Bristol Medical School, UK (D.A.L.)
| | - Börje Ljungberg
- Department of Surgical and Perioperative sciences, Urology and Andrology, Umeå University, Sweden (B.L.)
| | - Conor MacDonald
- University Paris-Saclay, UVSQ, Inserm, Villejuif, France (C. MacDonald)
| | - Giovanna Masala
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy (G.M.)
| | | | - Olle Melander
- Department of Clinical Sciences, Malmö, Lund University, Sweden (G.E., O.M.)
| | - Conchi Moreno Iribas
- Navarra Public Health Institute, IdiSNA, Pamplona, Spain (C.M.I.)
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Pamplona, Spain (C.M.I.)
| | - Toshiharu Ninomiya
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan (T.N.)
| | | | - Børge G. Nordestgaard
- Herlev and Gentofte Hospital (B.G.N.), Copenhagen University Hospital, Copenhagen, Denmark
- Frederiksberg Hospital B.G.N.), Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences (B.G.N.), University of Copenhagen, Denmark
| | - Charlotte Onland-Moret
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, the Netherlands (C.O.-M., Y.T.v.d.S., W.M.M.V.)
| | - Luigi Palmieri
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA (L.G., K.C., R.J.S., D.C.P., P.S., J.J., J.P.C., J.M.G.)
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care (L.G., L.S., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., T.R.B., E.A., L.C., J.R.S., P.W., L. Pennells, S.H., M.I., J.D., A.S.B., A.M.W., E.D.A.)
- BHF Centre of Research Excellence, School of Clinical Medicine, Addenbrooke’s Hospital (A.M.M., S. Burgess, J.D., A.M.W., A.S.B., E.D.A.)
- Heart and Lung Research Institute, University of Cambridge, Cambridge UK (L.G., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., E.A., L. Pennells, M.I., J.D., A.S.B., A.M.W., E.D.A.)
- Medical Research Council Biostatistics Unit (A.M.M., S. Burgess), University of Cambridge, UK
- Stroke Research Group, Department of Clinical Neurosciences (S. Bell), University of Cambridge, UK
- NIHR Blood and Transplant Research Unit in Donor Health and Behaviour (S. Bell, T.R.B., E.A., J.D., A.S.B., A.M.W., E.D.A.), University of Cambridge, UK
- MRC Epidemiology Unit, School of Clinical Medicine (C.L., N.W.), University of Cambridge, UK
- Division of Aging (K.C., S.P., J.P.C. J.M.G.), Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
- Division of Cardiovascular Medicine (J.J., T.A.G.), Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
- Department of Epidemiology, Boston University School of Public Health, MA (R.J.S.)
- Division of Nephrology, Department of Medicine (C.R.-C., E.A.A.), Vanderbilt University Medical Center, Nashville, TN
- Department of Biostatistics (R. Tao), Vanderbilt University Medical Center, Nashville, TN
- Medical Research Council Population Health Research Unit, Clinical Trial Service Unit and Epidemiological Studies Unit (N.S., C.B.), Nuffield Department of Population Health, University of Oxford, UK
- Cancer Epidemiology Unit (T.T.), Nuffield Department of Population Health, University of Oxford, UK
- Department of Cardiology, Trakya University School of Medicine, Edirne, Turkey (S.A.)
- Ministry of Health of the Basque Government, Sub Directorate for Public Health and Addictions of Gipuzkoa, San Sebastián, Spain (P.A.)
- Biodonostia Health Research Institute, Epidemiology of Chronic and Communicable Diseases Group, San Sebastián, Spain (P.A.)
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain (P.A., A.G.d.l.C., D.P., C. Santiuste)
- Division of Clinical Epidemiology and Aging Research (V.A.), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Cancer Epidemiology (S.K.J., R.K., V.K.), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden (J.A., H.B.)
- School of Health and Social Studies, Dalarna University, Falun, Sweden (J.A.)
- Wellbeing & Preventable Chronic Diseases (WPCD) Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia (E.L.M.B.)
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia (E.L.M.B., M.I.)
- Institute of Medicine, School of Public Health and Community Medicine (C.B.), Sahlgrenska Academy, University of Gothenburg, Sweden
- Institute of Medicine, Department of Molecular and Clinical Medicine (P.-O.H., A.R.), Sahlgrenska Academy, University of Gothenburg, Sweden
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands (J.M.A.B., W.M.M.V.)
- Network Aging Research (NAR), Heidelberg University, Germany (H.B.)
- Studium Patavinum (E.C.), University of Padua, Italy
- Department of Medicine (V.T.), University of Padua, Italy
- Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Università degli Studi della Campania ‘Luigi Vanvitelli’, Caserta, Italy (P.C.)
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, UK (J.A.C.)
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.C.)
- Larner College of Medicine, The University of Vermont, Burlington (M.C.)
- The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel (R.D.)
- School of Public Health, Department of Epidemiology and Preventive Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel (R.D.)
- Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York, NY (R.D., K.W.D.)
- Amsterdam University Medical Centers, VUMC, the Netherlands (R.T.d.J.)
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità, Rome, Italy (C.D., L. Palmer)
- Department of Clinical Sciences, Malmö, Lund University, Sweden (G.E., O.M.)
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France (H.F., E.W.)
- 12 Octubre Hospital Research Institute, Madrid, Spain (A.G.d,l,C.)
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland and Icelandic Heart Association, Kopavogur, Iceland (V.G.)
- Medical School Faculty of Health & Medical Sciences, The University of Western Australia, Perth, WA, Australia (G.J.H.)
- Region Västra Götaland, Sahlgrenska University Hospital, Department of Medicine Geriatrics and Emergency Medicine/Östra, Gothenburg, Sweden (P.-O.H., A.R.)
- School of Public Health (A.K.H., I.T., E.R.), Imperial College London, UK
- The George Institute for Global Health (M.W.), Imperial College London, UK
- Department of Internal Medicine, Division of Nephrology and Transplantation, Erasmus MC, University Medical Center Rotterdam, the Netherlands (E.J.H.)
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan (H.I.)
- University of Eastern Finland (UEF), Kuopio, Finland (J.K.)
- Department of Neurology & Neurosurgery, Medical University of Innsbruck, Innsbruck, Austria (S.K.)
- Clinical Epidemiology Team, Institute of Health Economics, Medical University of Innsbruck, Innsbruck, Austria (S.K., P.W.)
- Institute of Epidemiology and Medical Biometry, University of Ulm, Germany (W.K.)
- Deutsches Herzzentrum München, Technische Universität München, Germany (W.K.)
- German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance (W.K.)
- School of Public Health, University of Washington, Seattle (R.A.K.)
- Danish Cancer Society Research Center, Copenhagen, Denmark (C.K., A.T.)
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, UK (D.A.L.)
- Population Health Science, Bristol Medical School, UK (D.A.L.)
- Department of Surgical and Perioperative sciences, Urology and Andrology, Umeå University, Sweden (B.L.)
- University Paris-Saclay, UVSQ, Inserm, Villejuif, France (C. MacDonald)
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy (G.M.)
- Helmholtz Zentrum München, Munich, Germany (C. Meisinger)
- Navarra Public Health Institute, IdiSNA, Pamplona, Spain (C.M.I.)
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Pamplona, Spain (C.M.I.)
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan (T.N.)
- London School of Hygiene & Tropical Medicine, UK (D.N.)
- Herlev and Gentofte Hospital (B.G.N.), Copenhagen University Hospital, Copenhagen, Denmark
- Frederiksberg Hospital B.G.N.), Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences (B.G.N.), University of Copenhagen, Denmark
- Department of Public Health (A.T.), University of Copenhagen, Denmark
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, the Netherlands (C.O.-M., Y.T.v.d.S., W.M.M.V.)
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain (D.P.)
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain (D.P.)
- Consejería de Sanidad del Principado de Asturias Oviedo, Asturias, Spain (J.R.Q.G.)
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital, Turin, Italy (C. Sacerdote)
- Department of Social and Environmental Medicine, Kanazawa Medical University, Uchinada, Japan (M.S.)
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Spain (C. Santiuste)
- German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (M.B.S.)
- German Center for Diabetes Research (DZD), Neuherberg, Germany (M.B.S.)
- Institute of Nutritional Science, University of Potsdam, Germany (M.B.S.)
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy (S.S.)
- Department of Medical Sciences, Uppsala University, Sweden (J.S.)
- Hyblean Association for Epidemiological Reserach AIRE - ONLUS, Ragusa, Italy (R.T.)
- Universitätsmedizin Greifswald, Institut für Community Medicine, Abteilung SHIP/ Klinisch-Epidemiologische Forschung, Germany (H.V.)
- College of Public Health, University of Iowa (R.B.W.)
- University College London, UK (S.G.W.)
- The George Institute for Global Health, Camperdown, NSW, Australia (M.W.)
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Japan (K.Y.)
- Unit of Nutrition and Cancer, Epidemiology Research Program, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat (Barcelona), Spain (R.Z.-R.)
- Center for Data and Computational Sciences, VA Boston Healthcare System, Boston, MA (S.P.)
- Department of Biostatistics, Boston University School of Public Health, MA (D.R.G.)
- VA Pal Alto Epidemiology Research and Information Center for Genomics, VA Palo Alto Health Care System, CA (P.S.T.)
- Medicine (Cardiovascular Medicine), Stanford University of School of Medicine, CA (P.S.T.)
- Office of Research and Development, Veterans Health Administration, Washington, DC (S.M.)
- Department of Veterans Affairs, Tennessee Valley Health Care System, Vanderbilt University, Nashville (T.L.E.)
- Medicine/Epidemiology, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN (T.L.E.)
- Department of Surgery, Corporal Michael Crescenz VA Medical Center and Perelman School of Medicine, University of Pennsylvania, Philadelphia (S.M.D.)
- Internal Medicine, VA Atlanta Healthcare System, Decatur, GA (P.W.F.W.)
- Emory University School of Medicine (Cardiology), Emory University, Atlanta, GA (P.W.F.W.)
- Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA (T.A.G.)
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, UK (M.I., J.D., A.S.B., A.M.W., E.D.A.)
- The Alan Turing Institute, London, UK (M.I.)
- Computational Medicine, Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Germany (C.L.)
- Department of Human Genetics, Wellcome Sanger Institute, Hinxton, UK (J.D.)
- Division of Nephrology & Hypertension, Department of Medicine, Tennessee Valley Health Care System and Vanderbilt University Medical Center, Nashville (A.M.H.)
- Cambridge Centre for AI in Medicine, UK (A.M.W.)
- Health Data Science Centre, Human Technopole, Milan, Italy (E.D.A.)
| | - Dafina Petrova
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain (P.A., A.G.d.l.C., D.P., C. Santiuste)
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain (D.P.)
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain (D.P.)
| | | | - Annika Rosengren
- Institute of Medicine, Department of Molecular and Clinical Medicine (P.-O.H., A.R.), Sahlgrenska Academy, University of Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Department of Medicine Geriatrics and Emergency Medicine/Östra, Gothenburg, Sweden (P.-O.H., A.R.)
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital, Turin, Italy (C. Sacerdote)
| | - Masaru Sakurai
- Department of Social and Environmental Medicine, Kanazawa Medical University, Uchinada, Japan (M.S.)
| | - Carmen Santiuste
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain (P.A., A.G.d.l.C., D.P., C. Santiuste)
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Spain (C. Santiuste)
| | - Matthias B. Schulze
- German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (M.B.S.)
- German Center for Diabetes Research (DZD), Neuherberg, Germany (M.B.S.)
- Institute of Nutritional Science, University of Potsdam, Germany (M.B.S.)
| | - Sabina Sieri
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy (S.S.)
| | - Johan Sundström
- Department of Medical Sciences, Uppsala University, Sweden (J.S.)
| | | | - Anne Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark (C.K., A.T.)
- Department of Public Health (A.T.), University of Copenhagen, Denmark
| | - Tammy Tong
- Cancer Epidemiology Unit (T.T.), Nuffield Department of Population Health, University of Oxford, UK
| | - Rosario Tumino
- Hyblean Association for Epidemiological Reserach AIRE - ONLUS, Ragusa, Italy (R.T.)
| | - Ioanna Tzoulaki
- School of Public Health (A.K.H., I.T., E.R.), Imperial College London, UK
| | - Yvonne T. van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, the Netherlands (C.O.-M., Y.T.v.d.S., W.M.M.V.)
| | - W.M. Monique Verschuren
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands (J.M.A.B., W.M.M.V.)
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, the Netherlands (C.O.-M., Y.T.v.d.S., W.M.M.V.)
| | - Henry Völzke
- Universitätsmedizin Greifswald, Institut für Community Medicine, Abteilung SHIP/ Klinisch-Epidemiologische Forschung, Germany (H.V.)
| | | | | | - Elisabete Weiderpass
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France (H.F., E.W.)
| | - Peter Willeit
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care (L.G., L.S., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., T.R.B., E.A., L.C., J.R.S., P.W., L. Pennells, S.H., M.I., J.D., A.S.B., A.M.W., E.D.A.)
- Clinical Epidemiology Team, Institute of Health Economics, Medical University of Innsbruck, Innsbruck, Austria (S.K., P.W.)
| | - Mark Woodward
- The George Institute for Global Health, Camperdown, NSW, Australia (M.W.)
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Japan (K.Y.)
| | - Raul Zamora-Ros
- Unit of Nutrition and Cancer, Epidemiology Research Program, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat (Barcelona), Spain (R.Z.-R.)
| | - Elvis A. Akwo
- Division of Nephrology, Department of Medicine (C.R.-C., E.A.A.), Vanderbilt University Medical Center, Nashville, TN
| | - Saiju Pyarajan
- Division of Aging (K.C., S.P., J.P.C. J.M.G.), Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
- Center for Data and Computational Sciences, VA Boston Healthcare System, Boston, MA (S.P.)
| | - David R. Gagnon
- Department of Biostatistics, Boston University School of Public Health, MA (D.R.G.)
| | - Philip S. Tsao
- VA Pal Alto Epidemiology Research and Information Center for Genomics, VA Palo Alto Health Care System, CA (P.S.T.)
- Medicine (Cardiovascular Medicine), Stanford University of School of Medicine, CA (P.S.T.)
| | - Sumitra Muralidhar
- Office of Research and Development, Veterans Health Administration, Washington, DC (S.M.)
| | - Todd L. Edwards
- Department of Veterans Affairs, Tennessee Valley Health Care System, Vanderbilt University, Nashville (T.L.E.)
- Medicine/Epidemiology, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN (T.L.E.)
| | - Scott M. Damrauer
- Department of Surgery, Corporal Michael Crescenz VA Medical Center and Perelman School of Medicine, University of Pennsylvania, Philadelphia (S.M.D.)
| | - Jacob Joseph
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA (L.G., K.C., R.J.S., D.C.P., P.S., J.J., J.P.C., J.M.G.)
- Division of Cardiovascular Medicine (J.J., T.A.G.), Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Lisa Pennells
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care (L.G., L.S., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., T.R.B., E.A., L.C., J.R.S., P.W., L. Pennells, S.H., M.I., J.D., A.S.B., A.M.W., E.D.A.)
- Heart and Lung Research Institute, University of Cambridge, Cambridge UK (L.G., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., E.A., L. Pennells, M.I., J.D., A.S.B., A.M.W., E.D.A.)
| | - Peter W.F. Wilson
- Internal Medicine, VA Atlanta Healthcare System, Decatur, GA (P.W.F.W.)
- Emory University School of Medicine (Cardiology), Emory University, Atlanta, GA (P.W.F.W.)
| | - Seamus Harrison
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care (L.G., L.S., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., T.R.B., E.A., L.C., J.R.S., P.W., L. Pennells, S.H., M.I., J.D., A.S.B., A.M.W., E.D.A.)
| | - Thomas A. Gaziano
- Division of Cardiovascular Medicine (J.J., T.A.G.), Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
- Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA (T.A.G.)
| | - Michael Inouye
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care (L.G., L.S., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., T.R.B., E.A., L.C., J.R.S., P.W., L. Pennells, S.H., M.I., J.D., A.S.B., A.M.W., E.D.A.)
- Heart and Lung Research Institute, University of Cambridge, Cambridge UK (L.G., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., E.A., L. Pennells, M.I., J.D., A.S.B., A.M.W., E.D.A.)
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia (E.L.M.B., M.I.)
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, UK (M.I., J.D., A.S.B., A.M.W., E.D.A.)
- The Alan Turing Institute, London, UK (M.I.)
| | - Colin Baigent
- Institute of Medicine, School of Public Health and Community Medicine (C.B.), Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Juan P. Casas
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA (L.G., K.C., R.J.S., D.C.P., P.S., J.J., J.P.C., J.M.G.)
- Division of Aging (K.C., S.P., J.P.C. J.M.G.), Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Claudia Langenberg
- MRC Epidemiology Unit, School of Clinical Medicine (C.L., N.W.), University of Cambridge, UK
- Computational Medicine, Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Germany (C.L.)
| | - Nick Wareham
- MRC Epidemiology Unit, School of Clinical Medicine (C.L., N.W.), University of Cambridge, UK
| | - Elio Riboli
- The George Institute for Global Health (M.W.), Imperial College London, UK
| | - J.Michael Gaziano
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA (L.G., K.C., R.J.S., D.C.P., P.S., J.J., J.P.C., J.M.G.)
- Division of Aging (K.C., S.P., J.P.C. J.M.G.), Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - John Danesh
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care (L.G., L.S., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., T.R.B., E.A., L.C., J.R.S., P.W., L. Pennells, S.H., M.I., J.D., A.S.B., A.M.W., E.D.A.)
- BHF Centre of Research Excellence, School of Clinical Medicine, Addenbrooke’s Hospital (A.M.M., S. Burgess, J.D., A.M.W., A.S.B., E.D.A.)
- Heart and Lung Research Institute, University of Cambridge, Cambridge UK (L.G., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., E.A., L. Pennells, M.I., J.D., A.S.B., A.M.W., E.D.A.)
- NIHR Blood and Transplant Research Unit in Donor Health and Behaviour (S. Bell, T.R.B., E.A., J.D., A.S.B., A.M.W., E.D.A.), University of Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, UK (M.I., J.D., A.S.B., A.M.W., E.D.A.)
- Department of Human Genetics, Wellcome Sanger Institute, Hinxton, UK (J.D.)
| | - Adriana M. Hung
- Division of Nephrology & Hypertension, Department of Medicine, Tennessee Valley Health Care System and Vanderbilt University Medical Center, Nashville (A.M.H.)
| | - Adam S. Butterworth
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care (L.G., L.S., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., T.R.B., E.A., L.C., J.R.S., P.W., L. Pennells, S.H., M.I., J.D., A.S.B., A.M.W., E.D.A.)
- BHF Centre of Research Excellence, School of Clinical Medicine, Addenbrooke’s Hospital (A.M.M., S. Burgess, J.D., A.M.W., A.S.B., E.D.A.)
- Heart and Lung Research Institute, University of Cambridge, Cambridge UK (L.G., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., E.A., L. Pennells, M.I., J.D., A.S.B., A.M.W., E.D.A.)
- NIHR Blood and Transplant Research Unit in Donor Health and Behaviour (S. Bell, T.R.B., E.A., J.D., A.S.B., A.M.W., E.D.A.), University of Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, UK (M.I., J.D., A.S.B., A.M.W., E.D.A.)
| | - Angela M. Wood
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care (L.G., L.S., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., T.R.B., E.A., L.C., J.R.S., P.W., L. Pennells, S.H., M.I., J.D., A.S.B., A.M.W., E.D.A.)
- BHF Centre of Research Excellence, School of Clinical Medicine, Addenbrooke’s Hospital (A.M.M., S. Burgess, J.D., A.M.W., A.S.B., E.D.A.)
- Heart and Lung Research Institute, University of Cambridge, Cambridge UK (L.G., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., E.A., L. Pennells, M.I., J.D., A.S.B., A.M.W., E.D.A.)
- NIHR Blood and Transplant Research Unit in Donor Health and Behaviour (S. Bell, T.R.B., E.A., J.D., A.S.B., A.M.W., E.D.A.), University of Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, UK (M.I., J.D., A.S.B., A.M.W., E.D.A.)
- Cambridge Centre for AI in Medicine, UK (A.M.W.)
| | - Emanuele Di Angelantonio
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care (L.G., L.S., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., T.R.B., E.A., L.C., J.R.S., P.W., L. Pennells, S.H., M.I., J.D., A.S.B., A.M.W., E.D.A.)
- BHF Centre of Research Excellence, School of Clinical Medicine, Addenbrooke’s Hospital (A.M.M., S. Burgess, J.D., A.M.W., A.S.B., E.D.A.)
- Heart and Lung Research Institute, University of Cambridge, Cambridge UK (L.G., S. Bell, S.K.K., S. Burgess, K.M., A.M.M., E.A., L. Pennells, M.I., J.D., A.S.B., A.M.W., E.D.A.)
- NIHR Blood and Transplant Research Unit in Donor Health and Behaviour (S. Bell, T.R.B., E.A., J.D., A.S.B., A.M.W., E.D.A.), University of Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, UK (M.I., J.D., A.S.B., A.M.W., E.D.A.)
- Health Data Science Centre, Human Technopole, Milan, Italy (E.D.A.)
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