Anthropometric changes and risk of diabetes: are there sex differences? A longitudinal study of Alberta’s Tomorrow Project

ObjectivesTo characterise the sex-specific difference in the association between anthropometric changes and risk of diabetes in the general population in Canada.Setting and participantsFrom 2000 to 2008, Alberta’s Tomorrow Project (ATP) invited Alberta’s residents aged 35–69 years to a prospective cohort study. A total of 19 655 diabetes-free ATP participants having anthropometrics measured at the baseline and follow-ups were included.Design and outcome measuresA longitudinal study design was used to examine the association between anthropometric changes and risk of diabetes and the sex difference in this association. Changes in weight, body mass index (BMI), waist circumference (WC) and waist-hip-ratio (WHR) were calculated as the difference between baseline and follow-up measures. Diabetes cases were identified using the Canadian National Diabetes Surveillance System algorithm with administrative healthcare data (2000–2015) linked to the ATP cohort. The sex-specific association between anthropometric changes and incidence of diabetes were examined by multivariable Cox regression models.ResultsChanges in weight, BMI, WC and WHR over time were positively associated with incidence of diabetes in both men and women. The sex difference in risk of diabetes associated with 1 standard deviation (SD) increase in anthropometrics was 0.07 (95% CI −0.02 to 0.14) for weight, 0.08 (95% CI −0.03 to 0.17) for BMI, 0.07 (95% CI −0.02 to 0.15) for WC and 0.09 (95% CI 0.03 to 0.13) for WHR. Similar results were found in sex difference in the associations with changes per 5% and changes per categories (5% loss, ±5%, 5% gain).ConclusionsThe positive association between anthropometric changes and risk of diabetes was generally stronger in men than in women. However, this sex-specific difference of approximately 10% of the total risk associated with anthropometric changes had limited significance. For population-based public health programmes aiming to control obesity and incidence of diabetes, it may not be necessary to set up sex-specific goals for anthropometric reduction.

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Effects of marital status on overall and cancer-specific survival in laryngeal cancer patients: a population-based study

Scientific Reports ◽

10.1038/s41598-020-80698-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Zhao Ding ◽

Deshun Yu ◽

Hefeng Li ◽

Yueming Ding

Keyword(s):

Marital Status ◽

Cancer Patients ◽

Laryngeal Cancer ◽

Cox Regression ◽

Group Analysis ◽

Population Based ◽

Cancer Specific Survival ◽

Cox Regression Analysis ◽

Prognostic Effect ◽

The Difference

AbstractMarital status has long been recognized as an important prognostic factor for many cancers, however its’ prognostic effect for patients with laryngeal cancer has not been fully examined. We retrospectively analyzed 8834 laryngeal cancer patients in the Surveillance Epidemiology and End Results database from 2004 to 2010. Patients were divided into four groups: married, widowed, single, and divorced/separated. The difference in overall survival (OS) and cancer-specific survival (CSS) of the various marital subgroups were calculated using the Kaplan–Meier curve. Multivariate Cox regression analysis screened for independent prognostic factors. Propensity score matching (PSM) was also conducted to minimize selection bias. We included 8834 eligible patients (4817 married, 894 widowed, 1732 single and 1391 divorced/separated) with laryngeal cancer. The 5-year OS and CSS of married, widowed, single, and separated/divorced patients were examined. Univariate and multivariate analyses found marital status to be an independent predictor of survival. Subgroup survival analysis showed that the OS and CSS rates in widowed patients were always the lowest in the various American Joint Committee on Cancer stages, irrespective of sex. Widowed patients demonstrated worse OS and CSS in the 1:1 matched group analysis. Among patients with laryngeal cancer, widowed patients represented the highest-risk group, with the lowest OS and CSS.

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The Importance of Metabolic Syndrome Status for the Risk of Non-Viral Hepatocellular Carcinoma: A Nationwide Population-Based Study

10.21203/rs.3.rs-1072970/v1 ◽

2021 ◽

Author(s):

Yuri Cho ◽

Eun Ju Cho ◽

Jeong-Ju Yoo ◽

Young Chang ◽

Goh Eun Chung ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Metabolic Syndrome ◽

Cox Regression ◽

Positive Association ◽

Population Based ◽

Cox Regression Analysis ◽

Hazard Ratios ◽

Development Data ◽

Baseline Status ◽

Korean National Health Insurance

Abstract The positive association between metabolic syndrome (MetS) and hepatocellular carcinoma (HCC) has been suggested. However, no studies have yet looked at how the risk of developing HCC varies with changes in MetS status. Therefore, we aimed to investigate the association between changes in MetS and subsequent HCC development. Data were obtained from the Korean National Health Insurance Service. 5,975,308 individuals who participated in health screenings both in 2009–2010 and 2011–2012 were included. Subjects were divided into four groups according to change in MetS status during the two-year interval screening (from 2009 to 2011): sustained non-MetS, transition to MetS, transition to non-MetS, and sustained MetS. Cox regression analysis was used to examine the hazard ratios of HCC. During a median of 7.3 years follow-up, 25,880 incident HCCs were identified. Compared to the sustained non-MetS group, age, sex, smoking, alcohol, regular exercise, and body mass index-adjusted hazard ratios (95% confidence interval) for HCC development were 1.01 (0.97–1.05) for the transition to MetS group; 1.05 (1.003–1.09) for the transition to non-Met group; and 1.07 (1.03–1.10) for the sustained MetS group. Stratified analyses according to age, sex, smoking, alcohol intake, exercise, diabetes mellitus, hypertension, dyslipidemia, and chronic kidney disease showed similar results. A significantly increased HCC risk was observed in the sustained MetS and transition to non-MetS groups. The baseline status of MetS was associated with the risk of HCC development. Strategies to improve MetS, especially targeting insulin resistance might prevent HCC development.

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Stomach Cancer and Exposure to Talc Powder without Asbestos via Chinese Herbal Medicine: A Population-Based Cohort Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16050717 ◽

2019 ◽

Vol 16 (5) ◽

pp. 717 ◽

Cited By ~ 3

Author(s):

Che-Jui Chang ◽

Yao-Hsu Yang ◽

Pau-Chung Chen ◽

Hsin-Yi Peng ◽

Yi-Chia Lu ◽

...

Keyword(s):

Cohort Study ◽

Stomach Cancer ◽

Cox Regression ◽

Oral Intake ◽

Positive Association ◽

Population Based ◽

Hazard Ratio ◽

Cumulative Exposure ◽

Increased Risk ◽

Dose Response Effect

The present investigation was designed to explore the risk of stomach cancer by oral intake of talc powder without asbestos. We conducted a population-based cohort study on a randomly sampled cohort from Taiwan’s health insurance database, with population of 1,000,000. The study participants were followed up through 2013. The outcome event of interest was the diagnosis of stomach cancer. The exposure of interest was the prescription of talc powder. Cox regression analyses were performed respectively. There were 584,077 persons without talc exposure and 21,575 talc users, 1849 diagnosed with stomach cancer. Persons with exposure of talc had a higher hazard ratio of stomach cancer (adjusted hazard ratio, 2.13; 95% confidence interval (CI), 1.54–2.94; p < 0.001). Classification by cumulative exposure of talc yielded adjusted hazard ratios of stomach cancer of 1.58 (95% CI, 0.79–3.17; p = 0.19) and 2.30 (95% CI, 1.48–3.57; p < 0.001) among persons with high (>21 g) and medium (6–21 g) exposure of talc, as compared to the low-exposure counterparts. Our data demonstrated positive association between increased risk of stomach cancer and oral intake of talc without asbestos. Despite the absence of dose-response effect, there might be a link between stomach cancer and talc.

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Regulation of PGLYRP1 and TREM-1 during Progression and Resolution of Gingival Inflammation

JDR Clinical & Translational Research ◽

10.1177/2380084419844937 ◽

2019 ◽

Vol 4 (4) ◽

pp. 352-359 ◽

Cited By ~ 9

Author(s):

A. Silbereisen ◽

A.K. Hallak ◽

G.G. Nascimento ◽

T. Sorsa ◽

G.N. Belibasakis ◽

...

Keyword(s):

Positive Association ◽

Population Based ◽

Enzyme Linked Immunosorbent Assay ◽

Gingival Inflammation ◽

Multilevel Regression ◽

Significant Positive Association ◽

Peptidoglycan Recognition Protein ◽

Whole Saliva ◽

Proinflammatory Responses ◽

The Difference

Introduction: The triggering receptor expressed on myeloid cells 1 (TREM-1) signaling pathway is stimulated by bacteria and, together with its putative ligand peptidoglycan recognition protein 1 (PGLYRP1), propagates proinflammatory responses. Objectives: We aimed to evaluate the TREM-1/PGLYRP1/interleukin (IL)–1β regulation in response to biofilm accumulation and removal in an experimental human gingivitis model. Methods: The study (n = 42 participants, mean age: 23.8 ± 3.7 y) comprised a recruitment step (day –14) followed by experimentally induced biofilm formation (induction [I] phase, day 0 to +21) and a 2-wk resolution (R) phase (day +21 to +35). Plaque was recorded by the Modified Quigley and Hein Plaque Index (TQHPI), while records of gingival inflammation were based on the Modified Gingival Index (MGI). Unstimulated whole saliva supernatants (n = 210, 5 time points) were tested for TREM-1, PGLYRP1, and IL-1β by enzyme-linked immunosorbent assay. Results: During the I-phase, concentrations of all analytes showed a tendency for downregulation at day +7 compared to day 0. TREM-1 (P = 0.019) and PGLYRP1 (P = 0.007) increased significantly between day +7 and day +21. Although all analyte levels decreased during the R-phase, the difference was not significant except TREM-1 being at borderline significance (P = 0.058). Moreover, TREM-1, PGLYRP1, and IL-1β showed significant positive correlations (P < 0.0001) with each other. The study participants were grouped into “fast” and “slow” responders based on clinical gingival inflammation scores. At each time point, fast responders showed significantly higher concentrations of TREM-1 (P < 0.025), PGLYRP1 (P < 0.007), and IL-1β (P < 0.025) compared to slow responders. Mixed-effects multilevel regression analyses revealed that PGLYRP1 (P = 0.047) and IL-1β (P = 0.005) showed a significant positive association with the MGI scores. Conclusion: The study demonstrated that TREM-1 and PGLYRP1 are regulated in response to biofilm accumulation and removal, and fast responders demonstrated higher levels of these analytes compared to slow responders. Knowledge Transfer Statement: The results of this study demonstrated the suitability of salivary TREM-1 and PGLYRP1 to reflect biofilm accumulation and removal and PGLYRP1 to monitor the progression and resolution of inflammation in gingivitis-susceptible individuals (fast responders). Combined with conventional risk factors, the molecular toolbox proposed here should be further validated in future studies to confirm whether it can be used for population-based monitoring and prevention of gingivitis.

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A Retrospective Cohort Study of Risk of Gallbladder Disease in Acute Cerebral Infarction Patients

Journal of the Korean Neurological Association ◽

10.17340/jkna.2020.1.3 ◽

2020 ◽

Vol 38 (1) ◽

pp. 16-24

Author(s):

Suk-Hee Lee ◽

Seongheon Kim ◽

Jae-Won Jang ◽

Seung-Hwan Lee ◽

Young-Ju Kim

Keyword(s):

Cerebral Infarction ◽

Liver Diseases ◽

Cox Regression ◽

Gallbladder Disease ◽

Population Based ◽

Exposed Group ◽

Acute Cerebral Infarction ◽

Control Group ◽

Mortality And Morbidity ◽

The Difference

Background: Gallbladder diseases after acute cerebral infarction are relatively rare, but could have a serious impact on mortality and morbidity of patients. The purpose of this study was to investigate the risk of gallbladder disease in patients with acute cerebral infarction.Methods: This study analyzed a population-based matched cohort constructed using National Health Insurance Service-Senior cohort dataset in South Korea. Subjects after acute cerebral infarction during 2002-2015 were identified as the exposed group, and up to four individual matched for age, sex, and index years were as the controls. The difference of the risk of gallbladder disease between the exposed and control group was evaluated using Cox regression adjusting for hypertension, diabetes, liver diseases, and the modified Charlson Comorbidity Index (mCCI). The risk of gallbladder disease of the exposed group was evaluated using Cox regression analyses to identify the risk factors.Results: The occurrence of the gallbladder disease was significantly associated with the acute cerebral infarction (<i>p</i><0.0001). The presence of acute cerebral infarction was associated with a higher risk of gallbladder disease (adjusted hazard ratio=1.44, 95% confidence interval=1.26-1.66). The subjects with higher CCI showed higher risk of gallbladder disease. Among acute cerebral infarction patients, the oldest group, subjects having liver diseases, or subjects with the mCCI higher than two were found significant on the risk of gallbladder disease.Conclusions: Our study showed that the acute cerebral infarction has a significant association with gallbladder disease. These results suggested that the possibility of developing of gallbladder disease in patients with acute cerebral infarction should be considered.

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Occupational and leisure-time physical activity and risk of disability pension: prospective data from the HUNT Study, Norway

Occupational and Environmental Medicine ◽

10.1136/oemed-2017-104320 ◽

2017 ◽

Vol 75 (1) ◽

pp. 23-28 ◽

Cited By ~ 9

Author(s):

Marius Steiro Fimland ◽

Gunnhild Vie ◽

Andreas Holtermann ◽

Steinar Krokstad ◽

Tom Ivar Lund Nilsen

Keyword(s):

Physical Activity ◽

Mental Disorders ◽

Musculoskeletal Disorders ◽

Disability Pension ◽

Leisure Time ◽

Cox Regression ◽

Leisure Time Physical Activity ◽

Positive Association ◽

Population Based ◽

Physical Work

ObjectivesTo prospectively investigate the association between occupational physical activity (OPA) and disability pension due to musculoskeletal cause, mental cause or any cause. We also examined the combined association of OPA and leisure-time physical activity (LTPA) with disability pension.MethodsA population-based cohort study in Norway on 32 362 persons aged 20–65 years with questionnaire data on OPA and LTPA that were followed up for incident disability pension through the National Insurance Database. We used Cox regression to estimate adjusted HRs with 95% CIs.ResultsDuring a follow-up of 9.3 years, 3837 (12%) received disability pension. Compared with people with mostly sedentary work, those who performed much walking, much walking and lifting, and heavy physical work had HRs of 1.26 (95% CI 1.16 to 1.38), 1.44 (95% CI 1.32 to 1.58) and 1.48 (95% CI 1.33 to 1.70), respectively. These associations were stronger for disability pension due to musculoskeletal disorders, whereas there was no clear association between OPA and risk of disability pension due to mental disorders. People with high OPA and low LTPA had a HR of 1.77 (95% CI 1.58 to 1.98) for overall disability pension and HR of 2.56 (95% CI 2.10 to 3.11) for disability pension due to musculoskeletal disorders, versus low OPA and high LTPA.ConclusionsWe observed a positive association between OPA and risk of disability pension due to all causes and musculoskeletal disorders, but not for mental disorders. Physical activity during leisure time reduced some, but not all of the unfavourable effect of physically demanding work on risk of disability pension.

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Comparison of risk factors for ischemic stroke and coronary events in a population-based cohort

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-02344-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Iram Faqir Muhammad ◽

Yan Borné ◽

Suneela Zaigham ◽

Martin Söderholm ◽

Linda Johnson ◽

...

Keyword(s):

Risk Factors ◽

Ischemic Stroke ◽

Inflammatory Markers ◽

Cox Regression ◽

Population Based ◽

Cox Regression Analysis ◽

Hazard Ratios ◽

The Difference ◽

Coronary Events ◽

Traditional Risk Factors

Abstract Background Although coronary events (CE) and ischemic stroke share many risk factors, there are also some important differences. The aim of this paper was to assess the association of risk factors in relation to incident CE and ischemic stroke and to evaluate the heterogeneity in patterns of risk factors between the two outcomes. Method Traditional risk factors and inflammatory markers associated with coronary events and ischemic stroke were measured in the Malmö Diet and Cancer Cohort (MDCS, n = 26 519), where a total of 2270 incident ischemic stroke and 3087 incident CE occurred during a mean follow up time 19 ± 6 years, and in relation to inflammatory markers in the cardiovascular sub-cohort (MDC-CV, n = 4795). Cox regression analysis was used to obtain hazard ratios. A modified Lunn-McNeil competing risk analysis was conducted to assess the significance of any differences in risk profiles of these outcomes. Results Most cardiovascular risk factors were associated both with incident CE and ischemic stroke. However, current smoking, ApoB, low ApoA1, male sex and education level of ≤ 9 years of schooling were preferentially associated with CE compared to ischemic stroke. Conversely, age showed a stronger association with ischemic stroke than with CE. Conclusion CE and ischemic stroke have broadly similar risk factors profiles. However, there are some important differential associations, as well as substantial differences in the magnitude of the association. These could reflect the distinct biology of atherogenesis in different vascular beds. The difference in the determinants highlights the importance of looking at CE and ischemic stroke, two manifestations of cardiovascular disease, separately.

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Time to secondary progression in patients with multiple sclerosis who were treated with first generation immunomodulating drugs

Multiple Sclerosis Journal ◽

10.1177/1352458512463764 ◽

2012 ◽

Vol 19 (6) ◽

pp. 765-774 ◽

Cited By ~ 41

Author(s):

H Tedeholm ◽

J Lycke ◽

B Skoog ◽

V Lisovskaja ◽

J Hillert ◽

...

Keyword(s):

First Generation ◽

Cox Regression ◽

Disease Onset ◽

Population Based ◽

Time Interval ◽

Period Effect ◽

Disease Modifying Drugs ◽

Cox Regression Analysis ◽

Immunomodulating Therapy ◽

The Difference

Background: It is currently unknown whether early immunomodulatory treatment in relapsing–remitting MS (RRMS) can delay the transition to secondary progression (SP). Objective: To compare the time interval from onset to SP in patients with RRMS between a contemporary cohort, treated with first generation disease modifying drugs (DMDs), and a historical control cohort. Methods: We included a cohort of contemporary RRMS patients treated with DMDs, obtained from the Swedish National MS Registry (disease onset between 1995–2004, n = 730) and a historical population-based incidence cohort (onset 1950–64, n = 186). We retrospectively analyzed the difference in time to SP, termed the “period effect” within a 12-year survival analysis, using Kaplan-Meier and Cox regression analysis. Results: We found that the “period” affected the entire severity spectrum. After adjusting for onset features, which were weaker in the contemporary material, as well as the therapy initiation time, the DMD-treated patients still exhibited a longer time to SP than the controls (hazard ratios: men, 0.32; women, 0.53). Conclusion: Our results showed there was a longer time to SP in the contemporary subjects given DMD. Our analyses suggested that this effect was not solely driven by the inclusion of benign cases, and it was at least partly due to the long-term immunomodulating therapy given.

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Association Between Body Weight Change In Late Life And Risk Of Dementia: A Population-based Cohort Study

Innovation in Aging ◽

10.1093/geroni/igab046.2432 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 645-646

Author(s):

Jie Guo ◽

Anna Marseglia ◽

Ying Shang ◽

Abigail Dove ◽

Giulia Grande ◽

...

Keyword(s):

Weight Change ◽

Cox Regression ◽

Late Life ◽

Population Based ◽

National Study ◽

Bodyweight Loss ◽

Weight Changes ◽

Incident Dementia ◽

The Difference

Abstract Background: Adiposity in midlife is a modifiable risk factor for dementia. However, the effect of adiposity in late-life on dementia remains unclear. We investigated the association of body mass index (BMI) and weight changes after age 60 with the incident dementia. Methods: Within the Swedish National Study on Aging and Care-Kungsholmen, 1,673 dementia-free participants with data on BMI/weight both at baseline and the 6-year follow-up were followed to detect subsequent incident dementia cases. BMI change was assessed as the percentage of the difference between BMI at baseline and the initial 6-year follow-up and categorized into large (>10%) or moderate (5–10%) loss, stable (≤5%), and moderate (5–10%) or large (>10%) gain. Weight change (difference between weight at baseline and the 6-year follow-up) was categorized into large (>7.5 kg) or moderate (2.5–7.5 kg) loss, stable (≤2.5 kg), and moderate (2.5–7.5 kg) or large (> 7.5 kg) gain. Dementia was diagnosed following the DSM-IV criteria. Data were analyzed using Cox regression models. Results: During the follow-up (median 5.78 years), 102 incident dementia cases developed. BMI/weight change showed U-shaped associations with dementia. Compared with stable BMI, the hazard ratios (95% confidence intervals) of dementia were 2.93 (1.72−4.91) for large BMI loss and 2.61 (1.09−5.54) for large BMI gain. Similar results were observed for a large weight loss (2.92 [1.67−5.07]) or gain (2.95 [1.16−6.53]). These associations became stronger among participants carrying an ApoE ɛ4 allele. Conclusion: Both large bodyweight loss and gain are associated with a higher risk of dementia, especially among ApoE ɛ4 carriers.

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Does Hospitalization Predict the Disease Course in Ulcerative Colitis? Prevalence and Predictors of Hospitalization and Re- Hospitalization in Ulcerative Colitis in a Population-based Inception Cohort (2000-2012)

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld.2014.1121.243.pag ◽

2015 ◽

Vol 24 (3) ◽

pp. 287-292 ◽

Cited By ~ 5

Author(s):

Petra A. Golovics ◽

Laszlo Lakatos ◽

Michael D. Mandel ◽

Barbara D. Lovasz ◽

Zsuzsanna Vegh ◽

...

Keyword(s):

Ulcerative Colitis ◽

Cox Regression ◽

Diagnostic Procedures ◽

Population Based ◽

Disease Course ◽

Inception Cohort ◽

Disease Extent ◽

Cox Regression Analysis ◽

Hospitalization Rates

Background & Aims: Limited data are available on the hospitalization rates in population-based studies. Since this is a very important outcome measure, the aim of this study was to analyze prospectively if early hospitalization is associated with the later disease course as well as to determine the prevalence and predictors of hospitalization and re-hospitalization in the population-based ulcerative colitis (UC) inception cohort in the Veszprem province database between 2000 and 2012. Methods: Data of 347 incident UC patients diagnosed between January 1, 2000 and December 31, 2010 were analyzed (M/F: 200/147, median age at diagnosis: 36, IQR: 26-50 years, follow-up duration: 7, IQR 4-10 years). Both in- and outpatient records were collected and comprehensively reviewed. Results: Probabilities of first UC-related hospitalization were 28.6%, 53.7% and 66.2% and of first re-hospitalization were 23.7%, 55.8% and 74.6% after 1-, 5- and 10- years of follow-up, respectively. Main UC-related causes for first hospitalization were diagnostic procedures (26.7%), disease activity (22.4%) or UC-related surgery (4.8%), but a significant percentage was unrelated to IBD (44.8%). In Kaplan-Meier and Cox-regression analysis disease extent at diagnosis (HR extensive: 1.79, p=0.02) or at last follow-up (HR: 1.56, p=0.001), need for steroids (HR: 1.98, p<0.001), azathioprine (HR: 1.55, p=0.038) and anti-TNF (HR: 2.28, p<0.001) were associated with the risk of UC-related hospitalization. Early hospitalization was not associated with a specific disease phenotype or outcome; however, 46.2% of all colectomies were performed in the year of diagnosis. Conclusion: Hospitalization and re-hospitalization rates were relatively high in this population-based UC cohort. Early hospitalization was not predictive for the later disease course.

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