Lipids and All-Cause Mortality among Older Adults: A 12-Year Follow-Up Study

This is a 12-year follow-up cohort study with 800 people (60–85 years old). The association between lipid disorders and mortality was analysed by Cox proportional hazard adjusted model. All-cause mortality was considered the dependent variable, and lipid disorders as independent variables: total cholesterol (TC) >200 and <170 mg/dl, HDL-c <35 and 40, LDL-c >100 and 130, and triglycerides (TG) >50. An initial analysis of all subjects was performed and a second was carried out after having excluded individuals with a body mass index (BMI) <20 kg/m2or mortality in ≤2 years. The mortality showed a positive association with low TC and a negative association with high TC and high LDL-c. After the exclusion of underweight and premature mortality, there was a positive association only with TC <170 mg/dl (HR = 1.36, CI95%: 1.02–1.82). The data did not show a higher risk with high levels of TC, LDL-c, and TG. However, they showed higher mortality among older adults with low TC.

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Potato consumption and risk of pancreatic cancer in the HELGA cohort

British Journal Of Nutrition ◽

10.1017/s0007114518000788 ◽

2018 ◽

Vol 119 (12) ◽

pp. 1408-1415

Author(s):

Lene A. Åsli ◽

Tonje Braaten ◽

Anja Olsen ◽

Anne Tjønneland ◽

Kim Overvad ◽

...

Keyword(s):

Pancreatic Cancer ◽

Cancer Registries ◽

Glycaemic Index ◽

Proportional Hazard ◽

Cox Proportional Hazard ◽

Cox Proportional Hazard Models ◽

The Mean ◽

Potato Consumption ◽

Adjusted Model

AbstractPotatoes have been a staple food in many countries throughout the years. Potatoes have a high glycaemic index (GI) score, and high GI has been associated with several chronic diseases and cancers. Still, the research on potatoes and health is scarce and contradictive, and we identified no prospective studies that had investigated the association between potatoes as a single food and the risk of pancreatic cancer. The aim of this study was to prospectively investigate the association between potato consumption and pancreatic cancer among 114 240 men and women in the prospective HELGA cohort, using Cox proportional hazard models. Information on diet (validated FFQ’s), lifestyle and health was collected by means of a questionnaire, and 221 pancreatic cancer cases were identified through cancer registries. The mean follow-up time was 11·4 (95 % CI 0·3, 16·9) years. High consumption of potatoes showed a non-significantly higher risk of pancreatic cancer in the adjusted model (hazard ratio (HR) 1·44; 95 % CI 0·93, 2·22,Pfor trend0·030) when comparing the highestv.the lowest quartile of potato consumption. In the sex-specific analyses, significant associations were found for females (HR 2·00; 95 % CI 1·07, 3·72,Pfor trend0·020), but not for males (HR 1·01; 95 % CI 0·56, 1·84,Pfor trend0·34). In addition, we explored the associations by spline regression, and the absence of dose–response effects was confirmed. In this study, high potato consumption was not consistently associated with a higher risk of pancreatic cancer. Further studies with larger populations are needed to explore the possible sex difference.

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Prognosis of hemodialysis patients with progressive aortic stenosis: a prospective cohort study

Renal Replacement Therapy ◽

10.1186/s41100-021-00367-3 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Yoriko Horiguchi ◽

Kaoru Uemura ◽

Naoyoshi Aoyama ◽

Shinichi Nakajima ◽

Tomoki Asai ◽

...

Keyword(s):

Aortic Stenosis ◽

Cardiac Death ◽

Hazard Analysis ◽

Hemodialysis Patients ◽

Proportional Hazard ◽

Cardiac Events ◽

Cox Proportional Hazard ◽

Kaplan Meier ◽

All Cause Mortality

Abstract Background Whether progressive mild to moderate aortic stenosis in hemodialysis patients influences their prognosis has not been elucidated. This prospective cohort study explored whether progressive aortic stenosis predicted the rate of cardiac events and mortality in those patients. Methods A total of 283 consecutive hemodialysis patients (no aortic stenosis, 248; progressive aortic stenosis, 35) underwent echocardiography for assessment of aortic stenosis, with a median follow-up period of 4.1 years. Study endpoints were cardiac events, all-cause mortality, and cardiac death. Kaplan–Meier analysis and multivariate Cox proportional hazard analysis were performed to estimate cardiac events, all-cause mortality, and cardiac death. Results Cumulative cardiac event rate, all-cause mortality rate, and the rate of cardiac death at 3-year follow-up were 44.9%, 40.5%, and 26.4% in patients with progressive aortic stenosis and 22.1%, 19.0%, and 7.5% in those without aortic stenosis, respectively. Kaplan–Meier analysis demonstrated the cumulative rates of cardiac events and all-cause mortality. And cardiac death was significantly higher in patients with progressive aortic stenosis than in those without aortic stenosis. Multivariate Cox proportional hazard analysis revealed that progressive aortic stenosis was predictive of cardiac events (adjusted hazard ratio 2.47; 95% confidence interval 1.38–4.39) and cardiac death (adjusted hazard ratio 4.21; 95% confidence interval 2.10–8.46). Age, physical activity, C-reactive protein, and serum albumin levels—but not progressive aortic stenosis—predicted all-cause mortality. Conclusions The rates of cardiac events and cardiac death were higher in hemodialysis patients with progressive aortic stenosis than in those without aortic stenosis. Furthermore, progressive aortic stenosis predicted cardiac events and cardiac death. Compared with those without aortic stenosis, patients with progressive aortic stenosis had higher all-cause mortality, which was related to their comorbidities. Trial registration This study was retrospectively registered with University Hospital Medical Information Network Clinical Trials Registry (registration number, UMIN 000024023) at September 12th, 2016.

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Positive Association of Dietary Inflammatory Index with Incidence of Cardiovascular Disease: Findings from a Korean Population-Based Prospective Study

Nutrients ◽

10.3390/nu12020588 ◽

2020 ◽

Vol 12 (2) ◽

pp. 588

Author(s):

Imran Khan ◽

Minji Kwon ◽

Nitin Shivappa ◽

James R. Hébert ◽

Mi Kyung Kim

Keyword(s):

Cardiovascular Disease ◽

Positive Association ◽

Population Based ◽

Proportional Hazard ◽

Dietary Inflammatory Index ◽

Cvd Risk ◽

Inflammatory Index ◽

Cox Proportional Hazard ◽

Increased Risk

Recently, diets with higher inflammatory potentials based on the dietary inflammatory index (DII®) have been shown to be associated with increased cardiovascular disease (CVD) risk in the general population. We aimed to prospectively investigate the association between the DII and CVD risk in the large Korean Genome and Epidemiology Study_Health Examination (KoGES_HEXA) cohort comprised of 162,773 participants (men 55,070; women 107,703). A validated semi-quantitative food frequency questionnaire (SQ-FFQ) was used to calculate the DII score. Statistical analyses were performed by using a multivariable Cox proportional hazard model. During the mean follow-up of 7.4 years, 1111 cases of CVD were diagnosed. Higher DII score was associated with increased risk of CVD in men (hazard ratio [HR]Quintile 5 vs. 1 1.43; 95% CI 1.04–1.96) and in women (HRQuintile 5 vs. 1 1.19; 95% CI 0.85–1.67), although not significant for women. The risk of CVD was significantly higher in physically inactive men (HRQuintile 5 vs. 1 1.80; 95% CI 1.03–3.12), obese men (HRQuintile 5 vs. 1 1.77; 95% CI 1.13–2.76) and men who smoked (HRQuintile 5 vs. 1 1.60; 95% CI 1.10–2.33), respectively. The risk of developing stroke was significantly higher for men (HRQuintile 5 vs. 1 2.06; 95% CI 1.07–3.98; p = 0.003), but not for women. A pro-inflammatory diet, as indicated by higher DII scores, was associated with increased risk of CVD and stroke among men.

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Individual testosterone decline and future mortality risk in men

Acta Endocrinologica ◽

10.1530/eje-17-0280 ◽

2018 ◽

Vol 178 (1) ◽

pp. 121-128 ◽

Cited By ~ 6

Author(s):

Stine A Holmboe ◽

Niels E Skakkebæk ◽

Anders Juul ◽

Thomas Scheike ◽

Tina K Jensen ◽

...

Keyword(s):

Mortality Risk ◽

Serum Levels ◽

Proportional Hazard ◽

Cox Proportional Hazard ◽

Age Related ◽

National Mortality ◽

All Cause Mortality ◽

Specific Mortality ◽

Cox Proportional Hazard Models

Objective Male aging is characterized by a decline in testosterone (TS) levels with a substantial variability between subjects. However, it is unclear whether differences in age-related changes in TS are associated with general health. We investigated associations between mortality and intra-individual changes in serum levels of total TS, SHBG, free TS and LH during a ten-year period with up to 18 years of registry follow-up. Design 1167 men aged 30–60 years participating in the Danish Monitoring Trends and Determinants of Cardiovascular Disease (MONICA1) study and who had a follow-up examination ten years later (MONICA10) were included. From MONICA10, the men were followed up to 18 years (mean: 15.2 years) based on the information from national mortality registries via their unique personal ID numbers. Methods Cox proportional hazard models were used to investigate the association between intra-individual hormone changes and all-cause, CVD and cancer mortalities. Results A total of 421 men (36.1%) died during the follow-up period. Men with most pronounced decline in total TS (<10th percentile) had a higher all-cause mortality risk compared to men within the 10th to 90th percentile (hazard ratio (HR): 1.60; 95% confidence interval (CI): 1.08–2.36). No consistent associations were seen in cause-specific mortality analyses. Conclusion Our study showed that higher mortality rates were seen among the men who had the most pronounced age-related decline in TS, independent of their baseline TS levels.

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Predictors of peritoneal dialysis associated peritonitis; application of the zero-inflated negative binomial model

Journal of Nephropathology ◽

10.15171/jnp.2019.36 ◽

2019 ◽

Vol 8 (4) ◽

pp. 36-36

Author(s):

Shahrokh Ezzatzadegan Jahromi ◽

Faisal Ahmed ◽

Saeedeh Pourahmad ◽

Jamshid Roozbeh ◽

Iraj Najafi ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Negative Binomial ◽

P Value ◽

Proportional Hazard ◽

School Of Education ◽

Coagulase Negative Staphylococci ◽

Free Survival ◽

Cox Proportional Hazard ◽

Adjusted Model

Introduction: Peritonitis is the main cause of morbidity and dropout from peritoneal dialysis (PD) program. Objectives: We aimed to determine risk factors predisposing to PD-associated peritonitis. Patients and Methods: As a retrospective cohort research, on 235 PD individuals with 4277 patientmonths of follow up, 170 episodes of peritonitis was reported in 93 patients. Data were extracted from medical records using a template. Standard as well as zero-inflated negative binominal regression was used to model the association between patients’ characteristics and the peritonitis rate. Cox-proportional hazard (PH) adjusted model was used to determine the effect of factors on the peritonitis-free survival. Results: With a mean (SD) body mass index (BMI) of 18.7(3.4) kg/m2, 109 (46.4%) of them were male. With a median (95% CI) follow-up time of 19 (16 to 36) months, the rate of peritonitis was 0.48 episode per patient-year. The most common micro-organism detected was coagulase-negative staphylococci (n=54; 31.7%). The only variable which was associated with a higher rate of peritonitis was BMI (rate ratio [RR]: 1.07; 95% CI 1.01 to 1.14; P value=0.031). Comparing to patients with lower education, patients with higher than elementary school of education had higher peritonitisfree survival (with hazard ratio [HR]=0.51; 95%CI 0.33-0.79, P value=0.003) and higher chance of having no peritonitis [odds ratio (OR):1.97; 95% CI 1.08 to 3.59; P value=0.029]. Conclusion: Peritonitis is still a major concern in PD patients. BMI was a risk factor for higher peritonitis rate. Higher education level was associated with lower peritonitis-free survival and higher chance of having no peritonitis.

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Socioeconomic inequalities across life and premature mortality from 1971 to 2016: findings from three British birth cohorts born in 1946, 1958 and 1970

Journal of Epidemiology & Community Health ◽

10.1136/jech-2020-214423 ◽

2020 ◽

pp. jech-2020-214423

Author(s):

Meg E Fluharty ◽

Rebecca Hardy ◽

George Ploubidis ◽

Benedetta Pongiglione ◽

David Bann

Keyword(s):

Social Class ◽

Mortality Risk ◽

Adult Life ◽

Premature Mortality ◽

Housing Tenure ◽

Proportional Hazard ◽

Birth Cohorts ◽

Cox Proportional Hazard ◽

All Cause Mortality ◽

Cox Proportional Hazard Models

IntroductionDisadvantaged socioeconomic position (SEP) in early and adult life has been repeatedly associated with premature mortality. However, it is unclear whether these inequalities differ across time, nor if they are consistent across different SEP indicators.MethodsBritish birth cohorts born in 1946, 1958 and 1970 were used, and multiple SEP indicators in early and adult life were examined. Deaths were identified via national statistics or notifications. Cox proportional hazard models were used to estimate associations between ridit scored SEP indicators and all-cause mortality risk—from 26 to 43 years (n=40 784), 26 to 58 years (n=35 431) and 26 to 70 years (n=5353).ResultsMore disadvantaged SEP was associated with higher mortality risk—magnitudes of association were similar across cohort and each SEP indicator. For example, HRs (95% CI) from 26 to 43 years comparing lowest to highest paternal social class were 2.74 (1.02 to 7.32) in 1946c, 1.66 (1.03 to 2.69) in 1958c, and 1.94 (1.20 to 3.15) in 1970c. Paternal social class, adult social class and housing tenure were each independently associated with mortality risk.ConclusionsSocioeconomic circumstances in early and adult life show persisting associations with premature mortality from 1971 to 2016, reaffirming the need to address socioeconomic factors across life to reduce inequalities in survival to older age.

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Accelerometer-Determined Physical Activity and All-Cause Mortality in a National Prospective Cohort Study of Adults Post-Acute Stroke

American Journal of Health Promotion ◽

10.1177/0890117117720061 ◽

2017 ◽

Vol 32 (1) ◽

pp. 24-27 ◽

Cited By ~ 10

Author(s):

Paul D. Loprinzi ◽

Ovuokerie Addoh

Keyword(s):

Physical Activity ◽

Self Report ◽

Proportional Hazard ◽

Health And Nutrition ◽

Cox Proportional Hazard ◽

All Cause Mortality ◽

Objectively Measured ◽

Objectively Measured Physical Activity ◽

Physician Diagnosis

Purpose: No epidemiological study has examined the association of objectively measured physical activity with all-cause mortality among adults who have had a stroke, which was the purpose of this study. Design: Prospective. Setting: National Health and Nutrition Examination Survey 2003 to 2006. Participants: One hundred eighty-four patients with stroke. Measures: Physical activity assessed via accelerometry (ActiGraph 7164), with stroke assessed via self-report of physician diagnosis. Mortality was assessed via linkage with the National Death Index, with follow-up through 2011. Analysis: Cox proportional hazard model. Results: The median follow-up period was 71.96 months, with 13 241 person-months; 53 deaths occurred during this follow-up period. After adjustments, for every 60 min/d increase in total physical activity, adults who have had a stroke had a 28% (hazard ratio = 0.72; 95% confidence interval: 0.59-0.88) reduced risk of all-cause mortality. Conclusion: Physical activity among stroke survivors is inversely associated with all-cause mortality.

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Low serum parathyroid hormone is a risk factor for peritonitis episodes in incident peritoneal dialysis patients: a retrospective study

BMC Nephrology ◽

10.1186/s12882-021-02241-0 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Yuqi Yang ◽

Jingjing Da ◽

Yi Jiang ◽

Jing Yuan ◽

Yan Zha

Keyword(s):

Risk Factor ◽

Peritoneal Dialysis ◽

Parathyroid Hormone ◽

Proportional Hazard ◽

Serum Parathyroid Hormone ◽

Cox Proportional Hazard ◽

Cox Proportional Hazard Regression ◽

Gram Negative Organisms ◽

Serum Pth

Abstract Background Serum parathyroid hormone (PTH) levels have been reported to be associated with infectious mortality in peritoneal dialysis (PD) patients. Peritonitis is the most common and fatal infectious complication, resulting in technique failure, hospital admission and mortality. Whether PTH is associated with peritonitis episodes remains unclear. Methods We examined the association of PTH levels and peritonitis incidence in a 7-year cohort of 270 incident PD patients who were maintained on dialysis between January 2012 and December 2018 using Cox proportional hazard regression analyses. Patients were categorized into three groups by serum PTH levels as follows: low-PTH group, PTH < 150 pg/mL; middle-PTH group, PTH 150-300 pg/mL; high-PTH group, PTH > 300 pg/mL. Results During a median follow-up of 29.5 (interquartile range 16–49) months, the incidence rate of peritonitis was 0.10 episodes per patient-year. Gram-positive organisms were the most common causative microorganisms (36.2%), and higher percentage of Gram-negative organisms was noted in patients with low PTH levels. Low PTH levels were associated with older age, higher eGFR, higher hemoglobin, calcium levels and lower phosphate, alkaline phosphatase levels. After multivariate adjustment, lower PTH levels were identified as an independent risk factor for peritonitis episodes [hazard ratio 1.643, 95% confidence interval 1.014–2.663, P = 0.044]. Conclusions Low PTH levels are independently associated with peritonitis in incident PD patients.

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Height in Adolescence as a Risk Factor for Glioma Subtypes: a Nationwide Retrospective Cohort Study of 2.2 Million Subjects

Neuro-Oncology ◽

10.1093/neuonc/noab049 ◽

2021 ◽

Author(s):

Roi Tschernichovsky ◽

Lior H Katz ◽

Estela Derazne ◽

Matan Ben-Zion Berliner ◽

Maya Simchoni ◽

...

Keyword(s):

Risk Factor ◽

Statistical Significance ◽

Positive Association ◽

High Grade Glioma ◽

Low Grade ◽

Cox Proportional Hazard ◽

Cox Proportional Hazard Models ◽

Glioma Risk ◽

Incident Cases

Abstract Background Gliomas manifest in a variety of histological phenotypes with varying aggressiveness. The etiology of glioma remains largely unknown. Taller stature in adulthood has been linked with glioma risk. The aim of this study was to discern whether this association can be detected in adolescence. Methods The cohort included 2,223,168 adolescents between the ages of 16-19. Anthropometric measurements were collected at baseline. Incident cases of glioma were extracted from the Israel National Cancer Registry over a follow-up period spanning 47,635,745 person-years. Cox proportional hazard models were used to estimate the hazard ratio for glioma and glioma subtypes according to height, body mass index (BMI) and sex. Results 1,195 patients were diagnosed with glioma during the study period. Mean(SD) age at diagnosis was 38.1 (11.7) years. Taller adolescent height (per 10cm increase) was positively associated with the risk for glioma of any type (HR 1.15; p=0.002). The association was retained in subgroup analyses for low-grade glioma (HR 1.17; p=0.031), high-grade glioma (HR 1.15; p=0.025), oligodendroglioma (HR 1.31; p=0.015), astrocytoma (HR 1.12; p=0.049), and a category of presumed IDH-mutated glioma (HR 1.17; p=0.013). There was a trend towards a positive association between height and glioblastoma, however this had borderline statistical significance (HR: 1.15; p=0.07). After stratification of the cohort by sex, height remained a risk factor for men, but not for women. Conclusions The previously - established association between taller stature in adulthood and glioma risk can be traced back to adolescence. The magnitude of association differs by glioma subtype.

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Dietary and lifestyle inflammatory scores are associated with increased risk of metabolic syndrome in Iranian adults

Diabetology & Metabolic Syndrome ◽

10.1186/s13098-021-00648-1 ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Hossein Farhadnejad ◽

Karim Parastouei ◽

Hosein Rostami ◽

Parvin Mirmiran ◽

Fereidoun Azizi

Keyword(s):

Metabolic Syndrome ◽

Positive Association ◽

Population Based ◽

Population Based Study ◽

Logistic Regression Models ◽

Increased Risk ◽

Confounding Variables ◽

Adjusted Model ◽

Diet And Lifestyle

Abstract Background In the current study, we aimed to investigate the association of dietary inflammation scores (DIS) and lifestyle inflammation scores (LIS) with the risk of metabolic syndrome (MetS) in a prospective population-based study. Methods A total of 1625 participants without MetS were recruited from among participants of the Tehran Lipid and Glucose Study(2006–2008) and followed a mean of 6.1 years. Dietary data of subjects were collected using a food frequency questionnaire at baseline to determine LIS and DIS. Multivariable logistic regression models, were used to calculate the odds ratio (ORs) and 95 % confidence interval (CI) of MetS across tertiles of DIS and LIS. Results Mean ± SD age of individuals (45.8 % men) was 37.5 ± 13.4 years. Median (25–75 interquartile range) DIS and LIS for all participants was 0.80 (− 2.94, 3.64) and 0.48 (− 0.18, − 0.89), respectively. During the study follow-up, 291 (17.9 %) new cases of MetS were identified. Based on the age and sex-adjusted model, a positive association was found between LIS (OR = 7.56; 95% CI 5.10–11.22, P for trend < 0.001) and risk of MetS, however, the association of DIS and risk of MetS development was not statistically significant (OR = 1.30;95% CI 0.93–1.80, P for trend = 0.127). In the multivariable model, after adjustment for confounding variables, including age, sex, body mass index, physical activity, smoking, and energy intake, the risk of MetS is increased across tertiles of DIS (OR = 1.59; 95% CI 1.09–2.33, P for trend = 0.015) and LIS(OR = 8.38; 95% CI 5.51–12.7, P for trend < 0.001). Conclusions The findings of the current study showed that greater adherence to LIS and DIS, determined to indicate the inflammatory potential of diet and lifestyle, are associated with increased the risk of MetS.

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