Abstract P442: Periodontal Disease is Associated With Risk of Incident Diabetes Among Non-obese Individuals

Background: Strong evidence suggests that diabetes is a risk factor for periodontal disease and that periodontal disease, once established in the diabetic state, then contributes to worsened glycemic control. Recent studies suggest that periodontal disease is also associated with diabetes development. Hypothesis: Incident Type 2 Diabetes (T2D) rates will be higher among participants with baseline periodontal disease vs. those with periodontal health. The relationship is modified by Body Mass Index (BMI). Methods: We included 5586 diabetes-free eligible participants (aged 52-75 years) from Visit 4 (1996-1999) of The Atherosclerosis Risk in Communities (ARIC) Study. Participants received full-mouth periodontal exams and periodontal disease status was classified using Periodontal Profile Classes (PPC-Stages). T2D was defined based on participant-self report of physician diagnosis during annual telephone follow-ups. Time-to-event was computed from baseline through 2018. Competing risk, multivariable Cox proportional hazard models examined T2D and All-Cause Mortality risk according to baseline periodontal disease status. We tested the interaction with BMI. Multivariable adjustment was performed for race/center, age, gender, smoking and education. Results: Participants were mean age (SD) 62.4 (5.6), 55.0% female, 16.7% African American. During the average 21.1 years of follow-up there were 1,359 incident T2D cases and 1,531 deaths. Cumulative incidence rates were 24.3% and 27.4% for T2D and deaths, respectively. Among underweight participants, the hazard ratios[95%Cis] for incident diabetes among severe periodontitis or severe tooth loss (vs. periodontally healthy) were 1.84[1.14-2.96] and 2.29[1.57-3.33], respectively. Hazard ratios[95%Cis] among normal weight participants were 1.54[1.06-2.23] and 1.88[1.41-2.51], respectively. There were no significant associations with T2D in obese participants (p for interaction = 0.06. Conclusion: Severe periodontal disease was associated with a modestly increased risk for T2D among a multi-racial community-based sample. Two periodontal disease stages in the PPC-Stages index system are significantly associated with increased risk for incident diabetes. This periodontal disease-associated risk is modified by BMI levels and only associated with incident diabetes in study participants with lower BMI.

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Age-specific diabetes risk by the number of metabolic syndrome components: a Korean nationwide cohort study

Diabetology & Metabolic Syndrome ◽

10.1186/s13098-019-0509-8 ◽

2019 ◽

Vol 11 (1) ◽

Author(s):

Min-Kyung Lee ◽

Kyungdo Han ◽

Hyuk-Sang Kwon

Keyword(s):

Metabolic Syndrome ◽

Incidence Rates ◽

Diabetes Risk ◽

South Korean ◽

Hazard Ratios ◽

Increased Risk ◽

History Of ◽

Korean National Health Insurance ◽

Study Participants ◽

Metabolic Syndrome Components

Abstract Background Metabolic syndrome is associated with an increased risk of diabetes. This study investigated the associations between the number of metabolic syndrome components and diabetes risk by age, sex and BMI. Methods Data for 19,475,643 participants ≥ 20 years old with no history of diabetes were obtained between 2009 and 2012 and were accessed using the South Korean National Health Insurance Service. Metabolic syndrome was defined according to the modified criteria of the National Cholesterol Education Program Adult Treatment Panel III. We assessed the risk of diabetes according to the number of metabolic syndrome components after stratifying the study participants into groups by age (20–39, 46–64, ≥ 65 years), sex, and BMI (below or above 25). Results During an average of 5.13 years of follow-up, the incidence rates of diabetes increased with the number of metabolic syndrome components. Age and BMI gradually increased with the number of metabolic syndrome components. The multivariable-adjusted hazard ratios (HRs) for incident diabetes were 1.401, 1.862, 2.47, 3.164 and 4.501 for participants with one through five components, respectively, compared with those without metabolic syndrome components. The risk of diabetes was 1.79-, 2.18-, and 3.05-times higher for participants ≥ 65 years; 2.57-, 3.45-, and 5.18-times higher for participants 40–64 years; and 2.55-, 3.89-, and 6.31-times higher for participants 20–39 years of age with three through five components, respectively, compared to those with no components. There was no difference in the risk of diabetes between men and women. The HRs were 5.63 for participants with a BMI ≥ 25 and 3.98 for those with a BMI < 25 among individuals with five components. Conclusions The risk of diabetes was more strongly associated with the number of metabolic syndrome components among younger adults. In addition, the risk of diabetes across the number of metabolic syndrome components was greater in participants with a BMI ≥ 25.

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Increased Risk of Retinal Vasculitis in Patients With Systemic Lupus Erythematosus: A Nationwide Population-Based Cohort Study

Frontiers in Medicine ◽

10.3389/fmed.2021.739883 ◽

2021 ◽

Vol 8 ◽

Author(s):

Xiao-Huan Chen ◽

Jia-Cheng Shi ◽

James Cheng-Chung Wei ◽

Hsin-Hua Chen ◽

Han-You Mo

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Retinal Vasculitis ◽

Population Based ◽

Incidence Rates ◽

Sensitivity Analyses ◽

Systemic Lupus ◽

Hazard Ratios ◽

Increased Risk ◽

Study Participants

Objectives: To evaluate the relationship between systemic lupus erythematosus (SLE) and the risk of retinal vasculitis (RV) using a population-based database.Methods: Using the 1997–2013 Taiwanese National Health Insurance Database, we identified newly diagnosed SLE patients between 2001 and 2012 as the SLE group. We matched the SLE group with non-SLE individuals selected from a representative one million sample of the population in a 1:20 ratio for age, sex, and the year of the index date. After adjusting for potential confounders, including urbanization of the patient's residence, the level of the payroll-related insured amount, and selected comorbidities, we examined the association between SLE and the risk of RV using the Cox proportional hazard model shown as hazard ratios (HRs) with 95% confidence intervals (CIs). Sensitivity analyses were conducted using various definitions of RV.Results: We included 11,586 patients with SLE and 231,720 matched non-SLE individuals. The mean age of the study participants was 36.7 ± 16.9 years, and the female-to-male ratio was 6.8:1. The incidence rates of RV were 56.39 cases per 100,000 person-years and 2.45 cases per 100,000 person-years, respectively. After adjusting for potential confounders, the incidence rate of RV in the SLE cohort was 22.99 times higher than that in the non-SLE cohort (56.39 vs. 2.45 per 100,000 person-years). The adjusted HR for RV in the SLE group was 23.61 (95% CI, 14.94–37.32). The results remained robust in the sensitivity analysis.Conclusion: This nationwide population-based study revealed that SLE patients had a significantly higher risk of RV than non-SLE individuals.

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PERIODONTAL DISEASE STATUS, KNOWLEDGE, ATTITUDE, PRACTICE AND TREATMENT NEEDS OF PREGNANT WOMEN

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2018.6.18 ◽

2018 ◽

Vol 8 (6) ◽

pp. 138-144

Author(s):

Thien Nguyen Duc ◽

Tai Tran Tan

Keyword(s):

Periodontal Disease ◽

Pregnant Women ◽

Oral Hygiene ◽

Disease Status ◽

Incidence Rates ◽

Gestation Period ◽

Treatment Needs ◽

Cross Sectional ◽

Mean Values ◽

The Mean

Background: Periodontal disease is a prominent and important issue of public health, especially in pregnant women. The objective of this study is to describe the clinical characteristics; learn knowledge, attitudes, practice oral hygiene and assess the need for treatment of periodontal disease in pregnant women. Subjects and Methods: A cross-sectional study of 210 pregnant women who visited the Department of Obstetrics and Gynecology at the Hue University of Medicine and Pharmacy Hospital. Clinical examination and interview questions on knowledge, attitudes and practice of oral care for all subjects. Results: The incidence of gingivitis was 100%, with mild gingivitis of 4,3% and moderate gingivitis of 95.7%. There was a difference in incidence rates of gingivitis in the gestational period (p<0.001). The incidence of periodontitis is 17.6% and there is no difference in gestational age (p>0.05). The mean values of GI and BOP indices differed by gestation period (p<0.05) and PD, OHI-S, PlI have statistically significant relationship with gestation period (p>0.05). The incidence of periodontal disease is 80.5%; The percentage of pregnant women who abstain from brushing their teeth after birth is 61.4%. Prevalence of brushing once a day: 7.1%; Twice a day: 70.5% and 3 times daily: 22.4%; The mean values of GI, PD, BOP, OHI-S and PlI were inversely proportional to the number of brushing (p<0.001). The rate of dental hygiene is just 3.3%; The rate of oral hygiene, dental plaque and plaque removal was 94,3%; The proportion of subjects required for intensive treatment is 2.4%. Conclusion: Periodontal disease, especially for pregnant women, is high. It is necessary to educate the knowledge, attitudes and practice of proper oral hygiene and to better meet the demand for periodontal disease treatment for pregnant women. Key words: Periodontal disease, pregnant women, knowledge, attitude, practice for oral hygiene, treatment needs

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An Assessment of Serum Cholesterol level and BMI in Women: Study in Several Private Chambers in Mymensingh

Community Based Medical Journal ◽

10.3329/cbmj.v8i2.55766 ◽

2019 ◽

Vol 8 (2) ◽

pp. 4-9

Author(s):

Nahid Bintay Ansary ◽

Arup Ratan Paul ◽

Md Mahamudur Rahman ◽

Maria Hussain ◽

Rubiat Naznin

Keyword(s):

Cardiovascular Disease ◽

Health Status ◽

Cholesterol Level ◽

Serum Cholesterol ◽

Serum Cholesterol Level ◽

Normal Weight ◽

Cholesterol Levels ◽

Increased Risk ◽

The Mean ◽

Study Participants

The increased risk of cardiovascular disease associated with higher serum cholesterol levels in middle-aged persons has been established, but there have been few studies conducted regarding the issues in Mymensingh. For evaluation of serum cholesterol and BMI in women of Mymensingh, across-sectional studywas conducted in several private chambers in the districts of Mymensingh, Bangladesh during the period from January 2017 to December 2017. A total of 48 Female patients participated in the study. In the study, participants were aged between 18 to 29 years of age. The study suggested that the serum cholesterol was below 4.99 were 15(31.25%), 5.00 to 6.49 were 13(26.08%) and above 6.50 were 20 (41.67%), the Mean ± SD was 4.45 (0.76). The health status according to BMI showed that 12.50% (n=6) of the participants were underweight <18.49, majority 50.00% (n=24) of the population were from normal weight range (18.5-24.9), 16.67% (n=8) of the participants were overweight and 20.83 %( n=10) of the participants were obese >30. The Mean ± SD was 18.93± (3.68). Measurement of BMI and Serum Cholesterol levels can help doctors to treat patients properly for reducing the burden of death in our country. CBMJ 2019 July: Vol. 08 No. 02 P: 4-9

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Supper Timing and Cardiovascular Mortality: The Japan Collaborative Cohort Study

Nutrients ◽

10.3390/nu13103389 ◽

2021 ◽

Vol 13 (10) ◽

pp. 3389

Author(s):

Jingyun Tang ◽

Jia-Yi Dong ◽

Ehab S. Eshak ◽

Renzhe Cui ◽

Kokoro Shirai ◽

...

Keyword(s):

Hemorrhagic Stroke ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Stroke Mortality ◽

Hazard Ratios ◽

Risk Of Mortality ◽

Increased Risk ◽

Study Participants

Evidence on the role of supper timing in the development of cardiovascular disease (CVD) is limited. In this study, we examined the associations between supper timing and risks of mortality from stroke, coronary heart disease (CHD), and total CVD. A total of 28,625 males and 43,213 females, aged 40 to 79 years, free from CVD and cancers at baseline were involved in this study. Participants were divided into three groups: the early supper group (before 8:00 p.m.), the irregular supper group (time irregular), and the late supper group (after 8:00 p.m.). Cox proportional hazards regression models were used to calculate hazard ratios (HRs) for stroke, CHD, and total CVD according to the supper time groups. During the 19-year follow-up, we identified 4706 deaths from total CVD. Compared with the early supper group, the multivariable HR of hemorrhagic stroke mortality for the irregular supper group was 1.44 (95% confidence interval [CI]: 1.05–1.97). There was no significant association between supper timing and the risk of mortality from other types of stroke, CHD, and CVD. We found that adopting an irregular supper timing compared with having dinner before 8:00 p.m. was associated with an increased risk of hemorrhagic stroke mortality.

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Abstract P060: Plasma Osteocalcin And Incident Diabetes Mellitus: The Atherosclerosis Risk In Communities (ARIC) Study

Circulation ◽

10.1161/circ.143.suppl_1.p060 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Jeffrey R Misialek ◽

Elizabeth R Stremke ◽

Elizabeth Selvin ◽

Sanaz Sedaghat ◽

James S Pankow ◽

...

Keyword(s):

Diabetes Mellitus ◽

Cox Regression ◽

Self Report ◽

Incident Diabetes ◽

Blood Levels ◽

Total Plasma ◽

Phone Calls ◽

Increased Risk ◽

Primary Model

Introduction: Diabetes is a major risk factor for cardiovascular disease. Osteocalcin is a vitamin K-dependent, bone-derived hormone that functions as an endocrine regulator of energy metabolism, male fertility, and cognition. Early studies of endocrine effects of osteocalcin have shown that genomic deletion of osteocalcin in mice resulted in a diabetic phenotype (i.e. glucose intolerance, and insulin resistance). However, results from clinical studies have shown mixed associations between blood levels of osteocalcin and risk of incident type 2 diabetes mellitus. Hypothesis: Lower values of plasma osteocalcin would be associated with an increased risk of diabetes. Methods: A total of 11,557 ARIC participants without diabetes at baseline were followed from ARIC visit 3 (1993-1995) through 2018. Diabetes cases were identified through self-report on annual and semi-annual follow-up phone calls. Plasma osteocalcin data was measured using an aptamer-based proteomic profiling platform (SomaLogic). We used Cox regression to evaluate the association of quintiles of plasma osteocalcin and incident diabetes. The primary model adjusted for age, sex, and race-center. Results: Participants were age 60 ± 5.6 years at visit 3, 56% identified as female, 21% identified as Black. There were 3,031 incident diabetes cases over a median follow-up of 17.9 years. Mean ± SD was 10.053 ± 0.775. When comparing the highest quintile of plasma osteocalcin (values 10.42 to 14.66) to the lowest quintile (values 9.03 to 9.52), there was no association with incident diabetes (HRs [95% CIs]: 0.92 [0.81, 1.02]). There was also no significant trend across the quintiles (p = 0.19). Results were similar when adjusting for additional potential confounders, and when limiting the follow-up time to 10 years. Conclusions: These data do not support the hypothesis that total plasma osteocalcin, as measured by Somalogic proteomic panel, is a biomarker associated with diabetes risk. It is possible that total plasma or serum osteocalcin and/or other isoforms of osteocalcin protein (i.e. gamma carboxylated or uncarboxylated osteocalcin) measured via other validated methodologies may be linked to diabetes.

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O8D.7 The effect of right truncation bias on biomechanical factor risk estimates for CTS

Occupational and Environmental Medicine ◽

10.1136/oem-2019-epi.206 ◽

2019 ◽

Vol 76 (Suppl 1) ◽

pp. A76.3-A77

Author(s):

Carisa Harris-Adamson ◽

Ellen Eisen ◽

David Rempel ◽

Fred Gerr ◽

Stephen Bao ◽

...

Keyword(s):

Incidence Rates ◽

Occupational Illness ◽

Risk Estimates ◽

Hazard Ratios ◽

Exposed Workers ◽

Accurate Dose ◽

Tlv For Hal ◽

Study Participants ◽

Right Truncation ◽

Biomechanical Factors

Carpal tunnel syndrome (CTS) is a potentially disabling occupational illness with high incidence rates in certain occupations. Prospective workplace studies have identified associations between personal, psychosocial and biomechanical factors and incident CTS. However, biased estimates of association due to the healthy worker survivor effect (HWSE) have not been fully investigated. The HWSE results in left truncation bias when affected workers are lost from the population of more highly exposed workers before study participants are sampled. Right truncation bias occurs when affected workers are lost disproportionately from higher exposure strata after enrollment in a prospective cohort study. This study evaluated the effects of right truncation bias on risk estimates for biomechanical factors.Between 2001 and 2010 five research groups in the US conducted coordinated prospective studies of incident CTS among workers from various industries. Hazard ratios (HR) were estimated using Cox proportional regression analyses with adjustment for personal and workplace psychosocial factors. Inverse probability censoring weight (IPCW) values were created using a cross-validated approach analogous to the lasso method for variable selection and parameter regularization. The weighting model predicted the probability of exit from the cohort in the next 3 months.The final models included 2520 workers and 166 incident CTS cases. IPCW models with adjustment for right truncation bias were used to predict incident CTS. Effect size estimates for the workplace biomechanical factors of Peak Force, HAL Scale, Forceful Repetition Rate and the ACGIH TLV for HAL increased by 11% to 71% in comparison to models without adjustment for right truncation bias. After adjusting for right truncation bias the predicted incidence of CTS in highly exposed workers increased up to 3-fold.Bias from symptomatic workers disproportionately leaving the workplace was identified in this cohort. Adjusting for this bias has likely produced more accurate dose-response relationships than those previously reported.

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Thrombophilia and Cardiovascular Risk Factors On the Absolute Risk of First and Recurrent Venous Thrombosis. Results From a Retrospective Family Cohort Study Involving 2097 Relatives.

Blood ◽

10.1182/blood.v114.22.2974.2974 ◽

2009 ◽

Vol 114 (22) ◽

pp. 2974-2974

Author(s):

Anja B.U. MÄkelburg ◽

Saskia Middeldorp ◽

Karly Hamulyàk ◽

Martin Prins ◽

Harry R Büller ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Absolute Risk ◽

Normal Weight ◽

Overweight And Obesity ◽

Hazard Ratios ◽

Increased Risk ◽

Recurrent Vte

Abstract Abstract 2974 Poster Board II-951 Introduction: Arterial and venous thromboembolism (VTE) share or seem to share cardiovascular risk factors such as older age, overweight and obesity, and possibly also hypertension, diabetes mellitus, dyslipidemia, and smoking. Little is known if subjects with common thrombophilia, (i.e. factor V Leiden, prothrombin G20210A or high factor VIII levels) are at higher risk of first or recurrent VTE due to cardiovascular risk factors. For subjects with rare thrombophilia (i.e. antithrombin, protein C or protein S deficiency), or non-carriers of thrombophilia no information is currently available whether contribution of cardiovascular risk factors increases the risk of first or recurrent VTE. Methods: In a multi-center retrospective cohort study of families with thrombophilia, we performed a post-hoc analysis to identify if relatives with rare thrombophilia, common thrombophilia, and relatives without one of these thrombophilic defects were at increased risk of first or recurrent VTE due to cardiovascular risk factors. Known cardiovascular risk factors were recorded: hypertension, hyperlipidemia, the presence of diabetes mellitus, smoking habits and overweight/obesity defined by body mass index (BMI) ≥25-30 kg/m2 or ≥30 kg/m2, respectively. Observation time for first VTE started at the age of 15, and for recurrent VTE on the date when initial anticoagulant treatment was withdrawn. Observation time ended on the date of first VTE or recurrence, respectively, or at date of enrollment. First, the absolute risk of first VTE for cardiovascular risk factors was calculated for the whole cohort. Sensitivity analyses were performed to assess the effect of idiopathic or provoked classification of initial thrombotic event and type of event (deep vein thrombosis or pulmonary embolism). When a positive association was found, a further stratification was subsequently made to analyze whether relatives with rare, common, or no thrombophilia influenced these risks. A Cox-proportional hazards model was used to evaluate risks between groups for adjustments of age and sex. Results: Of a total of 2097 relatives, 55% were female, 180 (12%) had first VTE at a median age of 35 years and 52 (2%) had a recurrence at a median age of 40 years. Of relatives, 20% had hypertension, 13% dyslipidemia, 5% diabetes mellitus, 22% were previous smokers, 35% were overweight and 15% were obese. Point estimates of adjusted hazard ratios in relatives with hypertension, hyperlipidemia, diabetes mellitus or previous smokers, compared to their reference groups ranged between 0.9 and 1.1 and were not statistically significant. Relatives with VTE were heavier than relatives without VTE (mean BMI 27.0 vs 25.5 kg/m2, P< 0.001); adjusted hazard ratio for each 1-point increase in BMI was 1.035 (95% CI, 1.010-1.066). Absolute risk of first VTE in normal weight, overweight or obese subjects was 0.16% (95% CI, 0.12-0.20), 0.20% (95% CI, 0.16-0.25), and 0.26% (95% CI, 0.19-0.36), respectively. Sensitivity analyses did not change these outcomes. Annual incidences of first VTE in non-carriers of thrombophilia, common thrombophilia carriers and rare thrombophilia carriers were 0.04%, 0.20% and 0.97%. In the non-carrier group, adjusted hazard ratios for first VTE in overweight or obese relatives were 6.1 (95% CI, 1.3-28.1) and 6.7 (95% CI, 1.2-37.6), compared to non-carriers of normal weight. In common thrombophilia carriers these risks were 1.7 (95% CI, 1.0-2.9) and 2.1 (95% CI, 1.2-3.8) fold increased. In rare thrombophilia carriers, overweight or obesity was not associated with an increased risk of first VTE (adjusted hazard ratios 0.8; 95% CI, 0.5-1.4 and 0.8; 95% CI, 0.4-1.7, respectively). For recurrence, overweight and obese relatives with common or rare thrombophilia seemed to have a slightly higher risk of recurrence than normal weight relatives, but the overall 10 year recurrence rate in both groups was similar. Conclusion: Venous thrombotic risk increases with increasing BMI in non-carriers and common thrombophilia carriers. This effect is overruled in carriers of rare thrombophilia, where a deficiency itself irrespective of BMI apparently is sufficient to generate very high risk of thrombosis. Overweight and obesity seemed to increase the risk of recurrence in carriers of both common and rare thrombophilia. Other cardiovascular risk factors did not increase the risk of VTE in this thrombophilic family cohort. Disclosures: No relevant conflicts of interest to declare.

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Prediction of incident diabetes mellitus by baseline IGF1 levels

Acta Endocrinologica ◽

10.1530/eje-10-0963 ◽

2011 ◽

Vol 164 (2) ◽

pp. 223-229 ◽

Cited By ~ 40

Author(s):

Harald Jörn Schneider ◽

Nele Friedrich ◽

Jens Klotsche ◽

Sabine Schipf ◽

Matthias Nauck ◽

...

Keyword(s):

Diabetes Mellitus ◽

Metabolic Parameters ◽

Incident Diabetes ◽

Large Prospective Study ◽

Prospective Cohort Studies ◽

Hazard Ratios ◽

Increased Risk ◽

Hba1c Levels

ObjectiveIGF1 is associated with metabolic parameters and involved in glucose metabolism. Low-IGF1 has been implicated in the etiology of glucose intolerance and subjects with pathological causes of either low- or high-IGF1 are at risk of diabetes. We hypothesized that both low- and high-IGF1 levels increase the risk of diabetes and aimed to assess the role of IGF1 in the risk of developing diabetes in a large prospective study.DesignAn analysis of two prospective cohort studies, the DETECT study and SHIP.MethodsWe measured IGF1 levels in 7777 nondiabetic subjects and assessed incident diabetes mellitus during follow-up.ResultsThere were 464 cases of incident diabetes during 32 229 person-years (time of follow-up in the DETECT study and SHIP: 4.5 and 5 years respectively). There was no heterogeneity between both studies (P>0.4). The hazard ratios (HRs) of incident diabetes in subjects with IGF1 levels below the 10th or above the 90th age- and sex-specific percentile, compared to subjects with intermediate IGF1 levels, were 1.44 (95% confidence interval (CI) 1.07–1.94) and 1.55 (95% CI 1.06–2.06) respectively, after multiple adjustment. After further adjustment for metabolic parameters, the HR for low-IGF1 became insignificant. Analysis of IGF1 quintiles revealed a U-shaped association of IGF1 with risk of diabetes. Results remained similar after exclusion of patients with onset of new diabetes within 1 year or with borderline glucose or HbA1c levels at baseline.ConclusionsSubjects with low- or high-IGF1 level are at increased risk of developing diabetes.

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Citrus Consumption and Risk of Cutaneous Malignant Melanoma

Journal of Clinical Oncology ◽

10.1200/jco.2014.57.4111 ◽

2015 ◽

Vol 33 (23) ◽

pp. 2500-2508 ◽

Cited By ~ 42

Author(s):

Shaowei Wu ◽

Jiali Han ◽

Diane Feskanich ◽

Eunyoung Cho ◽

Meir J. Stampfer ◽

...

Keyword(s):

Malignant Melanoma ◽

Cutaneous Malignant Melanoma ◽

Dietary Factors ◽

Self Report ◽

Health Study ◽

Naturally Occurring ◽

Hazard Ratios ◽

Increased Risk ◽

Apparent Association

Purpose Citrus products are widely consumed foods that are rich in psoralens and furocoumarins, a group of naturally occurring chemicals with potential photocarcinogenic properties. We prospectively evaluated the risk of cutaneous malignant melanoma associated with citrus consumption. Methods A total of 63,810 women in the Nurses' Health Study (1984 to 2010) and 41,622 men in the Health Professionals Follow-Up Study (1986 to 2010) were included. Dietary information was repeatedly assessed every 2 to 4 years during follow-up. Incident melanoma cases were identified through self-report and confirmed by pathologic records. Results Over 24 to 26 years of follow-up, we documented 1,840 incident melanomas. After adjustment for other risk factors, the pooled multivariable hazard ratios for melanoma were 1.00 for overall citrus consumption < twice per week (reference), 1.10 (95% CI, 0.94 to 1.30) for two to four times per week, 1.26 (95% CI, 1.08 to 1.47) for five to six times per week, 1.27 (95% CI, 1.09 to 1.49) for once to 1.5 times per day, and 1.36 (95% CI, 1.14 to 1.63) for ≥ 1.6 times per day (Ptrend < .001). Among individual citrus products, grapefruit showed the most apparent association with risk of melanoma, which was independent of other lifestyle and dietary factors. The pooled multivariable hazard ratio for melanoma comparing the extreme consumption categories of grapefruit (≥ three times per week v never) was 1.41 (95% CI, 1.10 to 1.82; Ptrend < .001). Conclusion Citrus consumption was associated with an increased risk of malignant melanoma in two cohorts of women and men. Nevertheless, further investigation is needed to confirm our findings and explore related health implications.

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