Abstract P153: Dose-Response Associations Between Physical Activity And All-Cause Mortality Among A Multi-Ethnic Sample With Diabetes: NHANES 1999-2006

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
William Boyer ◽  
Madison Brenton ◽  
Allison Milano
Keyword(s):  
Mortality Risk ◽  
Mexican American ◽  
Statistical Significance ◽  
Significant Risk ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
All Cause Mortality ◽  
Cox Proportional Hazard Models ◽  
Physician Diagnosis ◽  
Hispanic White

Introduction: Emerging evidence has suggested that those identifying as non-Hispanic white (NHW) or non-Hispanic black (NHB) have consistent and similar all-cause mortality risk reductions across dose of aerobic PA. In the same analyses, those identifying as Mexican American (MA) receive no protection from all-cause mortality across dose of aerobic PA. However, a single study has suggested that MAs meeting both the aerobic and muscular strengthening activity (MSA) recommendations have similar all-cause mortality risk reductions compared to NHW and NHB, highlighting the importance of MSA among MA. It is unknown, however, if these results translate to those who have diabetes. Hypothesis: NHW or NHB participants will have similar all-cause mortality risk reductions associated with aerobic PA independent of MSA participation. MA meeting both recommendations will have significant all-cause mortality risk reductions. Methods: The study sample (n=1,999) included adult (≥20 years of age) participants with diabetes from the 1999-2006 NHANES. Diabetes was defined as having one of the following: reported physician diagnosis, reported taking anti-hyperglycemic medication, or HbA1c ≥6.5%. PA was categorized into 6 categories based around the 2018 PA guidelines: category 1 (no aerobic PA and insufficient MSA), category 2 (insufficient aerobic PA and insufficient MSA), category 3 (active and insufficient MSA), category 4 (no aerobic PA and sufficient MSA), category 5 (insufficient aerobic PA and sufficient MSA), and category 6 (meeting both recommendations). Cox-proportional hazard models were used for all analyses. Results: A significant interaction (p<0.001) was found between categories of PA and race. Statistically significant risk reductions were found for categories 2,3 and 6 among NHW, and categories 2 and 3 among NHB; with a non-statistically significant risk reduction of 67% in category 6 (p=0.13) for NHB. A 45% reduction in risk was found among MA for category 6, however the estimate did not attain statistical significance (p=0.17). Conclusions: Similar to previous studies in those without diabetes, aerobic PA of any volume significantly reduced risk for all-cause mortality only among NHW and NHB with diabetes. While the risk reductions were clinically meaningful for both NHB and MA in category 6 compared to category 1, there was a lack of statistical significance. It is probable this may be, in part, influenced by a relatively low sample size within these two race-ethnic groups.

The Independent and Combined Effects of Aerobic Physical Activity and Muscular Strengthening Activity on All-Cause Mortality: An Analysis of Effect Modification by Race-Ethnicity

2020 ◽  
Vol 17 (9) ◽  
pp. 881-888
Author(s):  
William Boyer ◽  
James Churilla ◽  
Amy Miller ◽  
Trevor Gillum ◽  
Marshare Penny
Keyword(s):  
Physical Activity ◽  
Mexican American ◽  
Significant Risk ◽  
Potential Effect ◽  
Effect Modification ◽  
Health And Nutrition ◽  
All Cause Mortality ◽  
Cox Proportional Hazard Models ◽  
Race Ethnicity ◽  
Hispanic White

Background: The effects of aerobic physical activity (PA) and muscular strengthening activity (MSA) on all-cause mortality risk need further exploration among ethnically diverse populations. Purpose: To examine potential effect modification of race-ethnicity on meeting the PA guidelines and on all-cause mortality. Methods: The study sample (N = 14,384) included adults (20–79 y of age) from the 1999–2006 National Health and Nutrition Examination Survey. PA was categorized into 6 categories based on the 2018 PA guidelines: category 1 (inactive), category 2 (insufficient PA and no MSA), category 3 (active and no MSA), category 4 (no PA and sufficient MSA), category 5 (insufficient PA and sufficient MSA), and category 6 (meeting both recommendations). Race-ethnic groups examined included non-Hispanic white, non-Hispanic black, and Mexican American. Cox-proportional hazard models were used. Results: Significant risk reductions were found for categories 2, 3, and 6 for non-Hispanic white and non-Hispanic black. Among Mexican American, significant risk reductions were found in category 6. Conclusion: In support of the 2018 PA guidelines, meeting both the aerobic PA and MSA guidelines significantly reduced risk for all-cause mortality independent of race-ethnicity. The effects of aerobic PA alone seem to be isolated to non-Hispanic white and non-Hispanic black.

scholarly journals Individual testosterone decline and future mortality risk in men

2018 ◽  
Vol 178 (1) ◽  
pp. 121-128 ◽  
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.

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

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.

scholarly journals Low rather than high mean corpuscular volume is associated with mortality in Japanese patients under hemodialysis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Hirokazu Honda ◽  
Miho Kimachi ◽  
Noriaki Kurita ◽  
Nobuhiko Joki ◽  
Masaomi Nangaku
Keyword(s):  
Mean Corpuscular Volume ◽  
Japanese Patients ◽  
Cubic Spline ◽  
Hazard Models ◽  
Proportional Hazard ◽  
Corpuscular Volume ◽  
Proportional Hazard Models ◽  
Cox Proportional Hazard ◽  
All Cause Mortality ◽  
Cox Proportional Hazard Models

Abstract Recent studies have reported that high mean corpuscular volume (MCV) might be associated with mortality in patients with advanced chronic kidney disease (CKD). However, the question of whether a high MCV confers a risk for mortality in Japanese patients remains unclear. We conducted a longitudinal analysis of a cohort of 8571 patients using data derived from the Japan Dialysis Outcomes and Practice Patterns Study (J-DOPPS) phases 1 to 5. Associations of all-cause mortality, vascular events, and hospitalization due to infection with baseline MCV were examined via Cox proportional hazard models. Non-linear relationships between MCV and these outcomes were examined using restricted cubic spline analyses. Associations between time-varying MCV and these outcomes were also examined as sensitivity analyses. Cox proportional hazard models showed a significant association of low MCV (< 90 fL), but not for high MCV (102 < fL), with a higher incidence of all-cause mortality and hospitalization due to infection compared with 94 ≤ MCV < 98 fL (reference). Cubic spline analysis indicated a graphically U-shaped association between baseline MCV and all-cause mortality (p for non-linearity p < 0.001). In conclusion, a low rather than high MCV might be associated with increased risk for all-cause mortality and hospitalization due to infection among Japanese patients on hemodialysis.

Incidence of dementia: evidence for an effect modification by gender. The ILSA Study

2013 ◽  
Vol 25 (11) ◽  
pp. 1867-1876 ◽  
Author(s):  
Marianna Noale ◽  
Federica Limongi ◽  
Sabina Zambon ◽  
Gaetano Crepaldi ◽  
Stefania Maggi
Keyword(s):  
Risk Factors ◽  
Competing Risks ◽  
Depressive Symptomatology ◽  
Significant Risk ◽  
Effect Modification ◽  
Proportional Hazard ◽  
Proportional Hazard Models ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Models ◽  
Incidence Of Dementia

ABSTRACTBackground:Gender differences for incidence of dementia among elderly people have been usually investigated considering gender as a predictor and not as a stratification variable.Methods:Analyses were based on data collected by the Italian Longitudinal Study on Aging (ILSA), which enrolled 5,632 participants aged 65–84 years between 1992 and 2000. During a median follow-up of 7.8 years, there were 194 cases of incident dementia in the participants with complete data. Cox proportional hazard models for competing risks, stratified by sex, were defined to determine risk factors in relation to developing dementia.Results:The incidence rate of dementia increased from 5.57/1,000 person-years at 65–69 years of age to 30.06/1,000 person-years at 80–84 years. Cox proportional hazard models for competing risks of incidence of dementia and death revealed that, among men, significant risk factors were heart failure, Parkinson's disease, family history of dementia, mild depressive symptomatology and age, while triglycerides were associated with a lower risk of developing dementia. Significant risk factors in women were age, both mild and severe depressive symptomatology, glycemia ≥109 mg/dL, and a BMI < 24.1 kg/m2. Even as little as three years of schooling was found to be a significant protective factor against the incidence of dementia only for women.Conclusions:Our results suggest that there is an effect modification by gender in our study population in relation to the association between low education level, lipid profile, BMI, and glycemia and dementia.

scholarly journals Age of Initiation of Dual Tobacco Use and Binge Drinking among Youth (12–17 Years Old): Findings from the Population Assessment of Tobacco and Health (PATH) Study

2021 ◽  
Vol 18 (24) ◽  
pp. 12985
Author(s):  
Adriana Pérez ◽  
Arnold E. Kuk ◽  
Meagan A. Bluestein ◽  
Hui Min Shirlyn Sia ◽  
Baojiang Chen
Keyword(s):  
Binge Drinking ◽  
Tobacco Use ◽  
Proportional Hazard ◽  
Tobacco Products ◽  
The Public ◽  
Use Patterns ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Models ◽  
Race Ethnicity ◽  
Hispanic White

Earlier exposure to binge drinking and tobacco use is associated with higher odds of substance use disorders. Using national youth data from the PATH study, we prospectively estimate the age of initiating past 30-day use of (1) cigarettes, e-cigarettes, and binge drinking, and (2) cigarettes, cigarillos, and binge drinking. Cox proportional hazard models were used to estimate differences in the age of initiation by sex, race/ethnicity, and previous use of other tobacco products. By age 21, 4.4% (95% CI: 3.7–5.2) and 2.0% (95% CI: 1.2–2.8) of youth reported initiation of past 30-day use outcomes (1) and (2), respectively. After controlling for sex and previous use of other tobacco products, statistically significant differences in the age of initiation by race/ethnicity were found for each outcome: Hispanic and non-Hispanic Black youth were less likely than non-Hispanic White youth to initiate past 30-day use of both outcomes (1) and (2) at earlier ages. Although the initiation of both outcomes remained relatively low by age 21, these incidences represent 1.56 million and 700,000 youth, respectively. This study provides the public with evidence to identify the particular ages at which education campaigns may be most effective to prevent youth from initiating these three substances. Further research is needed to estimate the age of initiation of other dual tobacco use patterns with binge drinking.

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

2020 ◽  
Author(s):  
Meg E Fluharty ◽  
Rebecca Hardy ◽  
George B. Ploubidis ◽  
Benedetta Pongiglione ◽  
David Bann
Keyword(s):  
Social Class ◽  
Mortality Risk ◽  
Adult Life ◽  
Premature Mortality ◽  
Housing Tenure ◽  
Proportional Hazard ◽  
Birth Cohorts ◽  
Proportional Hazard Models ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Models

AbstractIntroductionDisadvantaged 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 SEP indicators and mortality risk—from 26-43 (n=40,784), 26-58 (n=35,431), and 26-70 years (n=5,353).ResultsMore disadvantaged SEP was associated with higher mortality risk—magnitudes of association were similar across cohort and each SEP indicator. For example, hazards ratios (95% CI) between 26-43 years comparing lowest to highest father’s social class were 2.74 (1.02—7.32) in 1946c, 1.66 (1.03—2.69) in 1958c, and 1.94 (1.20—3.15) in 1970c. Childhood social class, adult social class, and housing tenure were each independently associated with mortality risk.ConclusionsSocioeconomic circumstances in early and adult life appear to have had persisting associations with premature mortality from 1971—2016. This reaffirms the need to address socioeconomic factors across life to reduce inequalities in survival to older age.

scholarly journals Reduced Mortality with Ondansetron Use in SARS-CoV-2 Infected Inpatients

2021 ◽  
Author(s):  
Vafa Bayat ◽  
Russell Ryono ◽  
Steven Phelps ◽  
Eugene Geis ◽  
Farshid Sedghi ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Length Of Hospital Stay ◽  
Proportional Hazard ◽  
Lengths Of Stay ◽  
Cox Proportional Hazard ◽  
All Cause Mortality ◽  
Cox Proportional Hazard Models ◽  
At Risk Populations ◽  
Approved Drugs

Abstract Background The COVID-19 pandemic has led to a surge in clinical trials evaluating investigational and approved drugs. Retrospective analysis of drugs taken by COVID-19 inpatients provides key information on drugs associated with better or worse outcomes. Method We conducted a retrospective cohort study of 10,741 patients testing positive for SARS-CoV-2 infection within three days of admission to compare risk of 30-day all-cause mortality in patients receiving ondansetron using multivariate Cox proportional-hazard models. All-cause mortality, length of hospital stay, adverse events such as ischemic cerebral infarction, and subsequent positive COVID-19 tests were measured. Results Administration of ≥8 mg ondansetron within 48 hours of admission was correlated with an adjusted hazard ratio for 30-day all-cause mortality of 0.55 (95% CI 0.42–0.70, p&lt;0.001) and 0.52 (95% CI 0.31–0.87, p=0.012) for all and ICU-admitted patients, respectively. Decreased lengths of stay (9.2 vs. 11.6, p&lt;0.001), frequencies of subsequent positive SARS-CoV-2 tests (53.6% vs. 75.0%, p=0.01), and long-term risks of ischemic cerebral ischemia (3.2% vs. 6.1%, p&lt;0.001) were also noted. Conclusions If confirmed by prospective clinical trials, our results suggest ondansetron, a safe, widely available drug, could be used to decrease morbidity and mortality in at-risk populations.

scholarly journals Changes in Proteinuria on the Risk of All-Cause Mortality in People with Diabetes or Prediabetes: A Prospective Cohort Study

2017 ◽  
Vol 2017 ◽  
pp. 1-7
Author(s):  
Yang Sun ◽  
Anxin Wang ◽  
Xiaoxue Liu ◽  
Zhaoping Su ◽  
Junjuan Li ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Mortality Risk ◽  
Prospective Cohort ◽  
Cox Proportional Hazard ◽  
Baseline Mortality ◽  
All Cause Mortality ◽  
Cox Proportional Hazard Models ◽  
Study Participants

Background. Proteinuria has been related to all-cause mortality, showing regression or progression. However, few studies have focused on the relationship between proteinuria changes and all-cause mortality. The main purpose of this paper is to examine the associations between proteinuria changes and all-cause mortality in people with diabetes or prediabetes. Methods. Dipstick proteinuria at baseline and a 2-year follow-up were determined in the participants attending the Kailuan prospective cohort study. Participants were then divided into three categories: elevated proteinuria, stable proteinuria, and reduced proteinuria. Four Cox proportional hazard models were built to access the relations of proteinuria changes to all-cause mortality, adjusting for other confounding covariates. Results. A total of 17,878 participants were finally included in this study. There were 1193 deaths after a median follow-up of 6.69 years. After adjusting for major covariates and proteinuria at baseline, mortality risk was significantly associated with elevated proteinuria (hazard ratio (HR): 1.54, 95% confidence interval (CI): 1.33–1.79) and reduced proteinuria (HR: 0.70, 95% CI: 0.55–0.89), compared to those with stable proteinuria. Conclusion. Proteinuria changes were independently associated with mortality risk in either diabetic or prediabetic population.

scholarly journals Multiple Dimensions of Perceived Discrimination, Race-Ethnicity, and Mortality Risk Among Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 581-581
Author(s):  
Ryon Cobb
Keyword(s):  
Mortality Risk ◽  
Perceived Discrimination ◽  
Later Life ◽  
Proportional Hazard ◽  
Vital Status ◽  
Cox Proportional Hazard ◽  
Multiple Dimensions ◽  
Risk Of Mortality ◽  
Cox Proportional Hazard Models ◽  
Everyday Discrimination

Abstract The present study utilized data from the Health and Retirement Study (N=12,988) to investigate the joint consequences of multiple dimensions of perceived discrimination on mortality risk. Perceived discrimination is based on responses from the 2006/2008 HRS waves and included everyday discrimination, the number of attributed reasons for everyday discrimination, and major lifetime discrimination. Vital status was obtained from the National Death Index and reports from key household informants (spanning 2006–2016). Cox proportional hazard models were used to estimate the risk of mortality. During the observation period, 3,494 deaths occurred. Only the number of attributed reasons for discrimination predicted mortality risk when all discrimination measures were estimated in the same model (Hazard Ratio [HR]=1.09; 95%, Confidence Interval [CI]=1.05 - 1.14), holding all else constant. Overall, the number of attributed reasons for everyday discrimination is a particularly salient risk factor for mortality in later life.

Sign in / Sign up

Export Citation Format

Share Document