Serum cotinine and adverse cardiovascular outcomes: a cross-sectional secondary analysis of the nuMoM2b Heart Health Study

2021 ◽  
Author(s):  
Lauren Theilen ◽  
Rebecca McNeil ◽  
Shannon Hunter ◽  
William Grobman ◽  
Colette Parker ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Smoking Status ◽  
Cardiovascular Outcomes ◽  
Reproductive Age ◽  
Self Report ◽  
Health Study ◽  
Chronic Hypertension ◽  
Heart Health ◽  
Serum Cotinine ◽  
Cross Sectional

Objective: Women with adverse pregnancy outcomes (APOs) have increased risks for cardiovascular disease. Smoking is a source of confounding that may be difficult to assess by self-report. We aimed to estimate odds of cardiovascular outcomes by smoking status using serum cotinine versus self-report and to assess whether the association between APOs and cardiovascular outcomes varies by smoking status. Study Design: We conducted a cross-sectional study of the nuMoM2b Heart Health Study wherein women attended an in-person visit 2-7 years following their first pregnancy. The exposure was smoking status, determined by self-report and by serum cotinine levels. Outcomes included incident chronic hypertension, metabolic syndrome, and dyslipidemia. Multivariable logistic regression estimated odds ratios for each outcome by smoking status. Results: Of the 4,392 women with serum cotinine measured, 3,610 were categorized as nonsmokers, 62 as having secondhand smoke exposure, and 720 as smokers. After adjustment for APOs, smoking defined by serum cotinine levels was associated with metabolic syndrome (adjusted odds ratio (aOR) 1.52, 95% confidence interval (CI) 1.21, 1.91) and dyslipidemia (aOR 1.28, 95% CI 1.01, 1.62). When stratified by nicotine exposure, nonsmokers with an APO in their index pregnancy had higher odds of stage 1 (aOR 1.64, 95% CI 1.32, 2.03) and stage 2 hypertension (aOR 2.92, 95% CI 2.17, 3.93), metabolic syndrome (aOR 1.76, 95% CI 1.42, 2.18), and dyslipidemia (aOR 1.55, 95% CI 1.25, 1.91) relative to women with no APO. Similar findings were obtained using self-report to define smoking exposure. Conclusion: Smoking and APOs are independently associated with subsequent cardiovascular outcomes in reproductive-age women. Smoking is associated with metabolic syndrome and dyslipidemia, whether smoking status is obtained by serum cotinine or self-report. Among nonsmokers, a history of APO is associated with hypertension, metabolic syndrome, and dyslipidemia compared to women without APOs.

scholarly journals Metabolic syndrome may be associated with a lower prevalence of iron deficiency in Ecuadorian women of reproductive age

2021 ◽  
Vol 10 ◽  
Author(s):  
Melisa A. Muñoz-Ruiz ◽  
Laura I. González-Zapata ◽  
Victoria Abril-Ulloa ◽  
Diego A. Gaitán-Charry
Keyword(s):  
Metabolic Syndrome ◽  
Prevalence Ratio ◽  
Population Level ◽  
Reproductive Age ◽  
Fe Deficiency ◽  
Lower Prevalence ◽  
Women Of Reproductive Age ◽  
Nutrition Survey ◽  
Cross Sectional ◽  
Total Prevalence

Abstract The present study aimed to assess the associations of the stages of Fe deficiency (Fe deficiency without anaemia (ID) and Fe-deficiency anaemia (IDA)) and anaemia with metabolic syndrome (MetS) in Ecuadorian women. A cross-sectional study was conducted in 5894 women aged 20–59 years, based on data from the 2012 Ecuadorian National Health and Nutrition Survey. The sample was stratified by age. A χ2 test was used to assess the possible associations of ID, IDA and anaemia with MetS. The prevalence ratio (PR) for each stage of Fe deficiency and anaemia was estimated considering women without MetS as a reference. The total prevalence of MetS, ID, IDA and anaemia was 32⋅3 % (se 0⋅6), 6⋅2 % (se 0⋅3), 7⋅1 % (se 0⋅3) and 5⋅0 % (se 0⋅3), respectively. In women aged 20–29, 30–39 and 40–49 years, MetS was associated with a lower prevalence of ID (PR (95 % CI; P-value)): 0⋅17 (0⋅06, 0⋅46; P < 0⋅001), 0⋅69 (0⋅48, 0⋅99; P = 0⋅044) and 0⋅44 (0⋅29, 0⋅67; P < 0⋅001), respectively. In women aged 50–59 years, MetS was associated with IDA and anaemia (PR (95 % CI; P-value)): 0⋅12 (0⋅02, 0⋅96; P = 0⋅026) and 0⋅22 (0⋅07, 0⋅64; P = 0⋅002), respectively. In conclusion, Ecuadorian women of reproductive age with MetS have a lower prevalence of ID compared with those without MetS. Furthermore, the MetS and IDA coexist at the population level. These findings require an analysis from a dietary pattern approach, which could provide key elements for developing public policies that simultaneously address all forms of malnutrition.

scholarly journals Development of a health literacy scale for preconception care: a study of the reproductive age population in Japan

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maiko Suto ◽  
Haruhiko Mitsunaga ◽  
Yuka Honda ◽  
Eri Maeda ◽  
Erika Ota ◽  
...  
Keyword(s):  
Health Literacy ◽  
Online Survey ◽  
Preconception Care ◽  
Population Based ◽  
Living Environment ◽  
Reproductive Age ◽  
Self Report ◽  
Healthy Weight ◽  
Cross Sectional ◽  
Behavioral Skills

Abstract Background Preconception care aims to improve both maternal and child health in the short as well as long term, along with providing health benefits to adolescents, women, and men, whether or not they plan to become parents. However, there is limited evidence regarding the effectiveness of interventions for improving preconception health in population-based settings. To accumulate evidence in this field, this study focused on the concept of health literacy, and aimed to develop a self-report health literacy scale in Japanese, focusing on preconception care. Methods We conducted a cross-sectional online survey. Participants were recruited from December 2019 to February 2020 from the registered members of a web-based research company. Participants were Japanese men and women aged 16–49 (n = 2000). A factor analysis was conducted to select both factors and items for health-related behavior and skills (33 initial items were generated), along with an item response theory analysis to examine how the 16 items were related to people’s knowledge of preconception care. Results We developed a 6-factor (including “appropriate medical examinations,” “appropriate diet,” “stress coping,” “healthy weight,” “safe living environment,” and “vaccinations”), 25-item behavior and skills scale, as well as a 13-item knowledge scale, to evaluate participants’ health literacy around preconception care. A shortened version, consisting of 17 items, was also prepared from the 25 items. The reliability coefficients of total scores and each factor of the behavior and skills scale were comparatively high, with weak-to-moderate correlation between behavior and skills and knowledge. Conclusions The new scale will, ideally, provide information on the current state of preconception care health literacy of the general population. In addition, this scale, which consists of both behavioral/skills and knowledge dimensions, should help support the effective implementation of risk assessment programs and interventions aimed at promoting behavioral changes using a population-based approach. Future studies using different question/administration formats for diverse populations, and considering respondents’ opinions on health literacy scales should be effective in improving this scale.

scholarly journals Association of hand and arm disinfection with asthma control in US nurses

2018 ◽  
Vol 75 (5) ◽  
pp. 378-381 ◽  
Author(s):  
Orianne Dumas ◽  
Raphäelle Varraso ◽  
Krislyn M Boggs ◽  
Alexis Descatha ◽  
Paul K Henneberger ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Asthma Control ◽  
Smoking Status ◽  
Cross Sectional Study ◽  
Health Study ◽  
Asthma Control Test ◽  
Cross Sectional ◽  
Occupational Risk Factor ◽  
Race Ethnicity ◽  
Female Nurses

ObjectivesTo investigate the association between occupational exposure to disinfectants/antiseptics used for hand hygiene and asthma control in nurses.MethodsIn 2014, we invited female nurses with asthma drawn from the Nurses’ Health Study II to complete two supplemental questionnaires on their occupation and asthma (cross-sectional study, response rate: 80%). Among 4055 nurses (mean age: 59 years) with physician-diagnosed asthma and asthma medication use in the past year, we examined asthma control, as defined by the Asthma Control Test (ACT). Nurses were asked about the daily frequency of hand hygiene tasks: ‘wash/scrub hands with disinfectants/hand sanitizers’ (hand hygiene) and ‘wash/scrub arms with disinfecting products’ (surrogate of surgical hand/arm antisepsis). Analyses were adjusted for age, race, ethnicity, smoking status and body mass index.ResultsNurses with partly controlled asthma (ACT: 20–24, 50%) and poorly controlled asthma (ACT ≤19, 18%) were compared with nurses with controlled asthma (ACT=25, 32%). In separate models, both hand and arm hygiene were associated with poorly controlled asthma. After mutual adjustment, only arm hygiene was associated with poorly controlled asthma: OR (95% CI) for <1 time/day, 1.38 (1.06 to 1.80); ≥1 time/day, 1.96 (1.52 to 2.51), versus never. We observed a consistent dose–response relationship between frequency of arm hygiene tasks (never to >10 times/day) and poor asthma control. Associations persisted after further adjustment for surfaces/instruments disinfection tasks.ConclusionsFrequency of hand/arm hygiene tasks in nurses was associated with poor asthma control. The results suggest an adverse effect of products used for surgical hand/arm antisepsis. This potential new occupational risk factor for asthma warrants further study.

scholarly journals Impact of COVID-19 restrictions on alcohol consumption behaviours

BJPsych Open ◽  
2021 ◽  
Vol 7 (5) ◽  
Author(s):  
Emily O. C. Palmer ◽  
William Trender ◽  
Robin J. Tyacke ◽  
Adam Hampshire ◽  
Anne Lingford-Hughes
Keyword(s):  
Alcohol Consumption ◽  
Smoking Status ◽  
Psychiatric Morbidity ◽  
Group Analysis ◽  
Coefficient Matrix ◽  
Self Report ◽  
Depression And Anxiety ◽  
Cross Sectional ◽  
Drinking To Cope ◽  
Audit Score

Background We aimed to evaluate how coronavirus (COVID-19) restrictions had altered individual's drinking behaviours, including consumption, hangover experiences, and motivations to drink, and changing levels of depression and anxiety. Method We conducted an online cross-sectional self-report survey. Whole group analysis compared pre- versus post-COVID restrictions. A correlation coefficient matrix evaluated the associations between all outcome scores. Self-report data was compared with Alcohol Use Disorders Identification Test (AUDIT) scores from the 2014 Adult Psychiatric Morbidity Survey. Multiple linear modelling (MLM) was calculated to identify factors associated with increasing AUDIT scores and post-restriction AUDIT scores. Results In total, 346 individuals completed the survey, of which 336 reported drinking and were therefore analysed. After COVID-19 restrictions 23.2% of respondents reported an increased AUDIT score, and 60.1% a decreased score. AUDIT score change was positively correlated with change in depression (P < 0.01, r = 0.15), anxiety (P < 0.01, r = 0.15) and drinking to cope scores (P < 0.0001, r = 0.35). MLM revealed that higher AUDIT scores were associated with age, mental illness, lack of a garden, self-employed or furloughed individuals, a confirmed COVID-19 diagnosis and smoking status. Conclusions COVID-19 restrictions decreased alcohol consumption for the majority of individuals in this study. However, a small proportion increased their consumption; this related to drinking to cope and increased depression and anxiety.

scholarly journals Prevalence of Metabolic Syndrome and Its Determinants in the Middle-aged and Elderly Population in A Southern Coastal Region, Iran (the PERSIAN Cohort Study): A Cross-sectional Study

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Ghazal Zoghi ◽  
Azim Nejatizadeh ◽  
Mehdi Shahmoradi ◽  
Zahra Ghaemmaghami ◽  
Masoumeh Kheirandish
Keyword(s):  
Metabolic Syndrome ◽  
Rural Areas ◽  
Central Obesity ◽  
Multiple Correspondence Analysis ◽  
Smoking Status ◽  
Binary Logistic Regression Analysis ◽  
Related Factors ◽  
Cross Sectional ◽  
Screening Programs ◽  
The Government

Background: Metabolic syndrome (MetS) criteria are different but interconnected cardiovascular risk factors, including dysglycemia, hypertension, abdominal obesity, and dyslipidemia. Objectives: We aimed to determine the prevalence of MetS, its components, and related factors in the south coastal area of Iran, Bandare-Kong non-communicable diseases (BKNCD). Methods: This population-based study was performed on the baseline data from participants of BKNCD, which has recruited participants from Bandare Kong city, one of the 18 distinct geographical areas included in the prospective epidemiological research studies in Iran (Persian). MetS was diagnosed based on the National Cholesterol Education Program (NCEP) criteria and the Iranian-specific cut-off for waist circumference (≥ 95 cm). The socioeconomic status (SES) was estimated by multiple correspondence analysis (MCA) based on participants’ different properties. Results: Of 3,927 participants included in this study, 2,230 (56.8%) were female. Age-standardized prevalence of MetS was 34.5%. The most common MetS component was central obesity (45.1%), followed by decreased high-density lipoprotein (42.6%), elevated fasting plasma glucose (39.9%), elevated triglyceride (37.7%), and increased blood pressure (37.5%). Besides, 84.7% of the subjects displayed at least one component of MetS. Binary logistic regression analysis revealed that women aged 65 - 70 years were at higher risk of having MetS compared to those aged 35 - 39 years (aOR = 12.37, 95% CI 7.54 - 20.30, P < 0.001). Also, living in rural areas was a risk for MetS in women (aOR = 1.55, 95% CI 1.18 - 2.03, P = 0.002). Employment and education were protective against MetS in women. Being overweight significantly increased the risk of MetS in both men and women. Obesity was more problematic for men (aOR = 16.66, 95% CI 11.65 - 23.81, P < 0.001) compared to women (aOR = 10.43, 95% CI 7.82 - 13.90, P < 0.001). Marital status, education, smoking status, and SES did not significantly predict MetS in men. Conclusions: A high prevalence of MetS was observed in this study, emphasizing central obesity, high TG, and low HDL. This calls on the government authorities to establish screening programs to identify individuals with a lower number of abnormal MetS components to prevent them from developing MetS and the resultant cardiovascular complications.

Validity of Self-Reported Periodontitis in Japanese Adults: The Japan Public Health Center–Based Prospective Study for the Next-Generation Oral Health Study

2020 ◽  
Vol 32 (6-7) ◽  
pp. 346-353 ◽  
Author(s):  
Masayuki Ueno ◽  
Taichi Shimazu ◽  
Norie Sawada ◽  
Shoichiro Tsugane ◽  
Yoko Kawaguchi
Keyword(s):  
Sex Education ◽  
Smoking Status ◽  
The Self ◽  
Self Report ◽  
Health Study ◽  
Age Group ◽  
Periodontal Health ◽  
Japanese Adults ◽  
Severe Periodontitis ◽  
Health Related

This study evaluated the validity of self-reported periodontitis measures among 2404 Japanese adults aged 40 to 75 years. A self-administered questionnaire survey and a clinical periodontal examination were conducted from 2013 through 2016. The self-reported periodontitis questions included 3 sociodemographic, 3 health, and 5 periodontal health–related items. Based on the clinical case definition of periodontitis, 26.5% of participants were found to be periodontally healthy, 2.7% had mild periodontitis, 55.2% moderate periodontitis, and 15.6% severe periodontitis. No single self-reported question demonstrated satisfactory validity in predicting the presence or absence of periodontitis. The predictive ability in mild and/or moderate periodontitis was poor even after combining multiple sociodemographic, health, and periodontal health-related questions. In severe periodontitis, the model including age, sex, education level, smoking status, diabetes history, body mass index, informed by a dentist, gingival bleeding, calculus deposit, and tooth mobility, presented moderate predictive performance (C-statistic: 0.676, sensitivity: 65.2%, and specificity: 61.1%). An age-stratified analysis on severe periodontitis showed that sensitivity was higher, and specificity was lower in older age group (60-75 years) than younger age group (40-59 years). Further refinement of questions in the self-report is required to increase the accuracy of the prediction of clinical periodontitis.

Active smoking, secondhand smoke exposure and serum cotinine levels among Cheyenne River Sioux communities in context of a Tribal Public Health Policy

2019 ◽  
pp. tobaccocontrol-2019-055056
Author(s):  
Elena R. O'Donald ◽  
Curtis P. Miller ◽  
Rae O'Leary ◽  
Jennifer Ong ◽  
Bernadette Pacheco ◽  
...  
Keyword(s):  
American Indians ◽  
Secondhand Smoke ◽  
Smoking Status ◽  
Statistical Modelling ◽  
Tobacco Consumption ◽  
Health Study ◽  
Serum Cotinine ◽  
Free Air ◽  
Shs Exposure ◽  
Cheyenne River

IntroductionAmerican Indians and Alaska Natives face disproportionately high rates of smoking and secondhand smoke (SHS) exposure. The Cheyenne River Sioux Tribe (CRST) is among the few Tribal Nations controlling commercial tobacco exposures in public and work places. We had an opportunity to explore effects of the new commercial tobacco-free policy (implemented in 2015) in an environmental health study (2014–2016) that collected information about commercial tobacco use and SHS prevalence and examined predictor variables of serum cotinine concentrations.MethodsSelf-reported survey data were used in quantile regression statistical modelling to explore changes in cotinine levels, based on smoking status, smokeless tobacco consumption and SHS exposure.ResultsFrom enrolled 225 adults, 51% (N=114) were current smokers. Among 88 non-tobacco users, 35 (40%) reported current SHS exposure. Significant differences in cotinine median concentrations were found among participants with and without current SHS exposure. Extremely high cotinine concentrations (~100 times larger than the median) were detected in some non-tobacco users. After implementing the new smoke-free air Tribal policy, cotinine decreased in participants with intermediate (3–15 ng/mL, non-tobacco users with SHS exposure) and high (>15 ng/mL, mainly tobacco users) cotinine levels showing association with an abatement of opportunities for SHS exposure. Significant predictors of cotinine levels were sampling year, current smoking and tobacco chewing. No gender differences were observed in cotinine.ConclusionsOur results show decrease in cotinine concentrations in CRST participants since implementation of their ‘Smoke-Free Clean Air Act’ in 2015.

Breakfast consumption is inversely associated with metabolic syndrome in a sample of Iranian adults

2020 ◽  
Author(s):  
Elnaz Lorzadeh ◽  
Zohreh Sadat Sangsefidi ◽  
Masoud Mirzaei ◽  
Mahdieh Hosseinzadeh
Keyword(s):  
Metabolic Syndrome ◽  
Logistic Regression ◽  
Dietary Habits ◽  
Adult Population ◽  
Middle Eastern ◽  
Population Based ◽  
Cross Sectional Study ◽  
Health Study ◽  
Cross Sectional ◽  
Breakfast Consumption

Abstract Background: Central obesity, insulin resistance, dyslipidemia and hypertension are the core components of metabolic syndrome (MetS) which is coincident with unhealthy dietary habits in the Middle-Eastern countries. The aim of this study was to explore the association between dietary habits and metabolic syndrome of adult population living in Yazd Greater Area, Iran. Methods: This is a cross-sectional study which uses the data of a population-based cohort study on Iranian adults, known as Yazd Health Study (YaHS). The relationship between dietary habits and metabolic syndrome among adults (n= 2896) were analyzed using multiple logistic regression method. Results: Outcomes from logistic regression examining show that breakfast consumption has a significant inverse effect on the occurrence of metabolic syndrome after adjustment for age, education level, physical activity statue, history of chronic diseases and smoking (odds ratio (OR)= 0.38, 95% confidence interval (CI)= 0.14, 0.97). This effect remains significant even after adjustment for body mass index (BMI) and reveals that odds of having MetS is 69 % lower in breakfast consumers in contrast to non-consumers (OR=0.31, 95% CI= 0.11, 0.87). However, no significant relationship was observed between other dietary habits and MetS after adjustment for all potential confounders Conclusions: This study revealed that eating breakfast has an inverse relationship with metabolic syndrome. Finding out stronger evidence in relation between dietary habits and metabolic syndrome, more researches especially population-based cohort studies are needed to be conducted.

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