scholarly journals Mucosal healing and the risk of serious infections in patients with celiac disease

2017 ◽  
Vol 6 (1) ◽  
pp. 55-62 ◽  
Author(s):  
Louise Emilsson ◽  
Benjamin Lebwohl ◽  
Peter HR Green ◽  
Joseph A Murray ◽  
Karl Mårild ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Cox Regression ◽  
Villous Atrophy ◽  
Pneumococcal Infection ◽  
Mucosal Healing ◽  
Medical Attention ◽  
Hazard Ratios ◽  
Serious Infection ◽  
Increased Risk

Background Patients with celiac disease (CD) are at increased risk of certain infections, but it is unknown if mucosal healing influences this risk. Methods We collected data on 29,096 individuals with CD (equal to villous atrophy) through Sweden’s 28 pathology departments undergoing biopsy 1969–2008. Through the Swedish Patient Register we obtained information on any infection and specifically sepsis, streptococcal infection, influenza, Clostridium difficile, herpes zoster and pneumococcal infection up until December 2009. We used Cox regression to calculate hazard ratios (HRs) for the risk of future diagnosis of infection according to mucosal healing on follow-up biopsy (persistent villous atrophy vs mucosal healing). Results Of 5598 CD individuals with no record of any infections before follow-up biopsy, 45% had persistent villous atrophy, 619 (24%) of them had a later infection, compared to 579 (19%) in those with mucosal healing ( p < 0.01); the yearly incidence was 2.1% in both groups. Adjusting for age, sex, calendar period, time between biopsies and education, persistent villous atrophy was however not associated with later infection overall (HR = 0.99; 95% CI = 0.88–1.11) or with any of the specific infections. Conclusions In CD, mucosal healing does not influence the risk of serious infection requiring hospital-based medical attention.

scholarly journals Pregnancy, pregnancy loss and the risk of diabetes in Chinese women: findings from the China Kadoorie Biobank

2019 ◽  
Vol 35 (3) ◽  
pp. 295-303
Author(s):  
Sanne A. E. Peters ◽  
◽  
Ling Yang ◽  
Yu Guo ◽  
Yiping Chen ◽  
...  
Keyword(s):  
Pregnancy Loss ◽  
Cox Regression ◽  
Chinese Women ◽  
Later Life ◽  
Induced Abortion ◽  
Hazard Ratios ◽  
Increased Risk ◽  
History Of ◽  
Incident Cases

AbstractPregnancy and pregnancy loss may be associated with increased risk of diabetes in later life. However, the evidence is inconsistent and sparse, especially among East Asians where reproductive patterns differ importantly from those in the West. We examined the associations of pregnancy and pregnancy loss (miscarriage, induced abortion, and still birth) with the risk of incident diabetes in later life among Chinese women. In 2004–2008, the nationwide China Kadoorie Biobank recruited 302 669 women aged 30–79 years from 10 (5 urban, 5 rural) diverse localities. During 9.2 years of follow-up, 7780 incident cases of diabetes were recorded among 273,383 women without prior diabetes and cardiovascular disease at baseline. Cox regression yielded multiple-adjusted hazard ratios (HRs) for the risk of diabetes associated with pregnancy and pregnancy loss. Overall, 99% of women had been pregnant, of whom 10%, 53%, and 6% reported having a history of miscarriage, induced abortion, and stillbirth, respectively. Among ever pregnant women, each additional pregnancy was associated with an adjusted HR of 1.04 (95% CI 1.03; 1.06) for diabetes. Compared with those without pregnancy loss, women with a history of pregnancy loss had an adjusted HR of 1.07 (1.02; 1.13) and the HRs increased with increasing number of pregnancy losses, irrespective of the number of livebirths; the adjusted HR was 1.03 (1.00; 1.05) for each additional pregnancy loss. The strength of the relationships differed marginally by type of pregnancy loss. Among Chinese women, a higher number of pregnancies and pregnancy losses were associated with a greater risk of diabetes.

Headache as a risk factor for dementia: A prospective population-based study

Cephalalgia ◽  
2013 ◽  
Vol 34 (5) ◽  
pp. 327-335 ◽  
Author(s):  
Knut Hagen ◽  
Eystein Stordal ◽  
Mattias Linde ◽  
Timothy J Steiner ◽  
John-Anker Zwart ◽  
...  
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Cox Regression ◽  
Subsequent Development ◽  
Population Based ◽  
Health Study ◽  
Cox Regression Analysis ◽  
Hazard Ratios ◽  
Increased Risk

Background Headache has not been established as a risk factor for dementia. The aim of this study was to determine whether any headache was associated with subsequent development of vascular dementia (VaD), Alzheimer’s disease (AD) or other types of dementia. Methods This prospective population-based cohort study used baseline data from the Nord-Trøndelag Health Study (HUNT 2) performed during 1995–1997 and, from the same Norwegian county, a register of cases diagnosed with dementia during 1997–2010. Participants aged ≥20 years who responded to headache questions in HUNT 2 were categorized (headache free; with any headache; with migraine; with nonmigrainous headache). Hazard ratios (HRs) for later inclusion in the dementia register were estimated using Cox regression analysis. Results Of 51,383 participants providing headache data in HUNT 2, 378 appeared in the dementia register during the follow-up period. Compared to those who were headache free, participants with any headache had increased risk of VaD ( n = 63) (multivariate-adjusted HR = 2.3, 95% CI 1.4–3.8, p = 0.002) and of mixed dementia (VaD and AD ( n = 52)) (adjusted HR = 2.0, 95% CI 1.1–3.5, p = 0.018). There was no association between any headache and later development of AD ( n = 180). Conclusion In this prospective population-based cohort study, any headache was a risk factor for development of VaD.

scholarly journals PHASES Score for Prediction of Intracranial Aneurysm Growth

Stroke ◽  
2015 ◽  
Vol 46 (5) ◽  
pp. 1221-1226 ◽  
Author(s):  
Daan Backes ◽  
Mervyn D.I. Vergouwen ◽  
Andreas T. Tiel Groenestege ◽  
A. Stijntje E. Bor ◽  
Birgitta K. Velthuis ◽  
...  
Keyword(s):  
Intracranial Aneurysm ◽  
Cox Regression ◽  
Continuous Variable ◽  
Aneurysm Rupture ◽  
Hazard Ratios ◽  
Unruptured Intracranial Aneurysms ◽  
Increased Risk ◽  
Risk Of Rupture ◽  
Aneurysm Growth

Background and Purpose— Growth of an intracranial aneurysm occurs in around 10% of patients at 2-year follow-up imaging and may be associated with aneurysm rupture. We investigated whether PHASES, a score providing absolute risks of aneurysm rupture based on 6 easily retrievable risk factors, also predicts aneurysm growth. Methods— In a multicenter cohort of patients with unruptured intracranial aneurysms and follow-up imaging with computed tomography angiography or magnetic resonance angiography, we performed univariable and multivariable Cox regression analyses for the predictors of the PHASES score at baseline, with aneurysm growth as outcome. We calculated hazard ratios and corresponding 95% confidence intervals (CI), with the PHASES score as continuous variable and after division into quartiles. Results— We included 557 patients with 734 unruptured aneurysms. Eighty-nine (12%) aneurysms in 87 patients showed growth during a median follow-up of 2.7 patient-years (range 0.5–10.8). Per point increase in PHASES score, hazard ratio for aneurysm growth was 1.32 (95% CI, 1.22–1.43). With the lowest quartile of the PHASES score (0–1) as reference, hazard ratios were for the second (PHASES 2–3) 1.07 (95% CI, 0.49–2.32), the third (PHASES 4) 2.29 (95% CI, 1.05–4.95), and the fourth quartile (PHASES 5–14) 2.85 (95% CI, 1.43–5.67). Conclusions— Higher PHASES scores were associated with an increased risk of aneurysm growth. Because higher PHASES scores also predict aneurysm rupture, our findings suggest that aneurysm growth can be used as surrogate outcome measure of aneurysm rupture in follow-up studies on risk prediction or interventions aimed to reduce the risk of rupture.

scholarly journals Risk of Primary Adrenal Insufficiency in Patients with Celiac Disease

2007 ◽  
Vol 92 (9) ◽  
pp. 3595-3598 ◽  
Author(s):  
Peter Elfström ◽  
Scott M. Montgomery ◽  
Olle Kämpe ◽  
Anders Ekbom ◽  
Jonas F. Ludvigsson
Keyword(s):  
Celiac Disease ◽  
Odds Ratio ◽  
Cox Regression ◽  
Conditional Logistic Regression ◽  
Positive Association ◽  
Study Entry ◽  
Risk Increase ◽  
Hazard Ratios ◽  
Increased Risk ◽  
General Population Cohort

Abstract Objectives: Earlier research has suggested a positive association between Addison’s disease (AD) and celiac disease (CD). We have here investigated the risk of AD in individuals with CD from a general population cohort. Methods: Through the Swedish national registers we identified 14,366 individuals with a diagnosis of CD (1964–2003) and 70,095 reference individuals matched for age, sex, calendar year, and county of residence. We used Cox regression to estimate hazard ratios (HRs) for subsequent AD. Analyses were restricted to individuals with more than 1 yr of follow-up and without AD prior to study entry or within 1 yr after study entry. Conditional logistic regression estimated the odds ratio for CD in individuals with prior AD. Results: There was a statistically significantly positive association between CD and subsequent AD [HR = 11.4; 95% confidence interval (CI) = 4.4–29.6]. This risk increase was seen in both children and adults and did not change with adjustment for diabetes mellitus or socioeconomic status. When we restricted reference individuals to inpatients, the adjusted HR for AD was 4.6 (95% CI = 1.9–11.4). Individuals with prior AD were at increased risk of CD (odds ratio = 8.6; 95% CI = 3.4–21.8). Conclusions: This study found a highly increased risk of AD in individuals with CD. This relationship was independent of temporal sequence. We therefore recommend that individuals with AD should be screened for CD. We also suggest an increased awareness of AD in individuals with CD.

scholarly journals Increased Risk of Systemic Lupus Erythematosus in 29,000 Patients with Biopsy-verified Celiac Disease

2012 ◽  
Vol 39 (10) ◽  
pp. 1964-1970 ◽  
Author(s):  
JONAS F. LUDVIGSSON ◽  
ALBERTO RUBIO-TAPIA ◽  
VAIDEHI CHOWDHARY ◽  
JOSEPH A. MURRAY ◽  
JULIA F. SIMARD
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Celiac Disease ◽  
General Population ◽  
Lupus Erythematosus ◽  
Cox Regression ◽  
Villous Atrophy ◽  
Case Series ◽  
Excess Risk ◽  
Systemic Lupus ◽  
Increased Risk

Objective.To investigate a possible association between celiac disease (CD) and systemic lupus erythematosus (SLE). Case series have indicated a possible association, but population-based studies are lacking.Methods.We compared the risk of SLE in 29,048 individuals with biopsy-verified CD (villous atrophy, Marsh 3) from Sweden’s 28 pathology departments with that in 144,352 matched individuals from the general population identified through the Swedish Total Population Register. SLE was defined as having at least 2 records of SLE in the Swedish Patient Register. We used Cox regression to estimate hazard ratios (HR) for SLE.Results.During followup, 54 individuals with CD had an incident SLE. This corresponded to an HR of 3.49 (95% CI 2.48−4.90), with an absolute risk of 17/100,000 person-years and an excess risk of 12/100,000. Beyond 5 years of followup, the HR for SLE was 2.54 (95% CI 1.57−4.10). While SLE was predominantly female, we found similar risk estimates in men and women. When we restricted our outcome to individuals who also had a dispensation for a medication used in SLE, the HR was 2.43 (95% CI 1.22−4.87). The HR for having 2 records of SLE diagnoses, out of which at least 1 had occurred in a department of rheumatology, nephrology/dialysis, internal medicine, or pediatrics, was 2.87 (95% CI 1.97−4.17).Conclusion.Individuals with CD were at a 3-fold increased risk of SLE compared to the general population. Although this excess risk remained more than 5 years after CD diagnosis, absolute risks were low.

scholarly journals 751Investigation of the obesity paradox in kidney cancer: mystifying association or myth?

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Alicia Heath ◽  
Joanna Clasen ◽  
Elio Riboli ◽  
Ghislaine Scelo ◽  
David Muller
Keyword(s):  
Kidney Cancer ◽  
Cox Regression ◽  
Obesity Paradox ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Incidence And Mortality ◽  
All Cause Mortality ◽  
Using Data ◽  
Restricted Cubic Splines

Abstract Background An “obesity paradox” has been reported in kidney cancer, whereby obesity is a risk factor, yet appears to be associated with better survival. To evaluate this paradox, we investigated the association between pre-diagnostic adiposity and renal cell carcinoma (RCC) incidence and mortality. Methods Using data from 363,521 men and women in the European Prospective Investigation into Cancer and Nutrition (EPIC), Cox regression models yielded confounder-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for RCC incidence and mortality in relation to BMI modelled continuously and using restricted cubic splines. RCC-specific and all-cause mortality were evaluated among cases. Results During a mean follow-up of 14.9 years, 936 incident RCC cases were identified, 383 of whom died (278 due to RCC). Each 5 kg/m2 increment in BMI was associated with 27% and 46% higher RCC incidence and mortality (HRs=1.27, 95% CI 1.18-1.37 and 1.46, 95% CI 1.28-1.66, respectively). Comparing a BMI of 35 with 22 kg/m2, HRs for RCC incidence and mortality were 1.88 (95% CI 1.54-2.30) and 2.37 (95% CI 1.68-3.35), respectively. Among RCC cases, HRs per 5 kg/m2 increment in BMI were 1.22 (95% CI 1.07-1.41) for RCC-specific mortality and 1.18 (95% CI 1.04-1.34) for all-cause mortality. Similar, positive linear associations were evident for waist circumference and waist-to-hip ratio. Conclusions Obesity was associated with increased RCC incidence and mortality, and worse prognosis among cases. Key messages The kidney cancer-obesity paradox does not appear to be real. Higher adiposity is associated with an increased risk of incident and fatal RCC.

scholarly journals Risk of hypersensitivity pneumonitis and interstitial lung diseases among pigeon breeders

2016 ◽  
Vol 48 (3) ◽  
pp. 818-825 ◽  
Author(s):  
Christine Cramer ◽  
Vivi Schlünssen ◽  
Elisabeth Bendstrup ◽  
Zara Ann Stokholm ◽  
Jesper Medom Vestergaard ◽  
...  
Keyword(s):  
Lung Diseases ◽  
Hypersensitivity Pneumonitis ◽  
Cox Regression ◽  
Interstitial Lung Diseases ◽  
Protective Measures ◽  
National Patient Registry ◽  
Hazard Ratios ◽  
Increased Risk ◽  
National Patient

We studied the risk of hypersensitivity pneumonitis and other interstitial lung diseases (ILDs) among pigeon breeders.This is a retrospective follow-up study from 1980 to 2013 of 6920 pigeon breeders identified in the records of the Danish Racing Pigeon Association. They were compared with 276 800 individually matched referents randomly drawn from the Danish population. Hospital based diagnoses of hypersensitivity pneumonitis and other ILDs were identified in the National Patient Registry 1977–2013. Stratified Cox regression analyses estimated the hazard ratios (HR) of hypersensitivity pneumonitis and other ILDs adjusted for occupation, residence and redeemed prescription of medication with ILDs as a possible side-effect. Subjects were censored at death, emigration or a diagnosis of connective tissue disease.The overall incidence rate of ILD was 77.4 per 100 000 person-years among the pigeon breeders and 50.0 among the referents. This difference corresponded to an adjusted HR of 1.56 (95% CI 1.26–1.94). The adjusted HRs of hypersensitivity pneumonitis and other ILDs for pigeon breeders were 14.36 (95% CI 8.10–25.44) and 1.33 (95% CI 1.05–1.69), respectively.This study shows an increased risk of ILD among pigeon breeders compared with the referent population. Protective measures are recommended even though ILD leading to hospital contact remains rare among pigeon breeders.

Abstract MP78: Progression of Valvular Calcification and Risk of Incident Stroke: The Multi-ethnic Study of Atherosclerosis (MESA)

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Oluwaseun Fashanu ◽  
Anas Bizanti ◽  
Ahmad Al-Abdouh ◽  
Di Zhao ◽  
Matthew J Budoff ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Stroke Risk ◽  
Cox Regression ◽  
The United States ◽  
Cvd Risk ◽  
Valvular Calcification ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Annular Calcification

Introduction: Stroke is a leading cause of morbidity and mortality in the United States. Identification of individuals at risk for stroke is important for implementation of preventive therapies. Prevalent valvular calcification (VC) has been shown to be associated with stroke but less is known about associations of VC progression with stroke. Methods: Progression (interval increase >0 Agatston units/year) of aortic valvular calcification (AVC) and mitral annular calcification (MAC) was assessed by two cardiac CTs over a median of 2.4 years. We determined the risk of adjudicated total and ischemic stroke using Cox regression adjusted for cardiovascular disease (CVD) risk factors. Results: We studied 5,606 multiethnic participants (39.6% White, 26.9% Black, 21.4% Hispanic, 12.2% Chinese) free of baseline CVD enrolled in MESA. Baseline mean ± SD age was 62 ± 10 years; 53% were women; 12% had prevalent AVC and 9% prevalent MAC at the baseline visit; 83% had no progression of VC, 14%, progression at one site (AVC or MAC), and 3% progression at both sites (AVC and MAC) at follow-up. Over a median of 12 years, 214 total and 170 ischemic strokes occurred. The number of sites with VC progression (range 0-2) was not associated with total and ischemic stroke (all p>0.05). We found MAC progression to be associated with increased risk of total stroke [adjusted hazard ratios (95% CI) 1.59 (1.11 - 2.27)] and ischemic stroke [1.64 (1.10 - 2.43)] in the whole cohort (model 3) and after further adjustment for baseline coronary artery calcification (model 4) ( Table ). Results remained significant for total stroke risk after excluding participants with interim atrial fibrillation or coronary heart disease [1.60 (1.01 - 2.54)]. In women, AVC progression was associated with ischemic stroke [1.87 (1.04 - 3.36)] (p-for-interaction=0.03). Conclusion: Progression of MAC over 2.4 years is associated with increased risk of total and ischemic stroke, and in women, AVC progression with higher ischemic stroke risk.

Insomnia among elderly men and risk of prostate cancer.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 78-78 ◽  
Author(s):  
Lara Sigurdardottir ◽  
Unnur Anna Valdimarsdottir ◽  
Lorelei Mucci ◽  
Katja Fall ◽  
Jennifer R. Rider ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Sleep Disturbances ◽  
Potential Role ◽  
Cox Regression ◽  
Positive Association ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Biological Explanation ◽  
Underlying Mechanisms

78 Background: While a large number of studies have reported a positive association between sleep disruption and breast cancer, little is known about its potential role in prostate cancer. Methods: Within the prospective AGES-Reykjavik cohort study, we followed 2102 men from 2002-2006 until the end of 2009. The men answered questions on sleep disturbances, which were combined in various ways to reflect onset and/or maintenance insomnia. Information on the occurrence of prostate cancer was obtained through record-linkages across the Icelandic Cancer and Causes of Death Registers. We used Cox regression models with 95% confidence intervals [CIs] to estimate age- and multivariable adjusted hazard ratios [HR] of prostate cancer by symptoms of insomnia. Results: During follow-up, 135 men (6,4%) were diagnosed with prostate cancer. Compared to men without insomnia, men with severe onset and maintenance insomnia and very severe insomnia were at increased risk of total prostate cancer with HR 1.9 (CI 1.2, 3.0) and 2.2 (CI 1.3, 3.8), respectively. For advanced prostate cancer, the corresponding HRs were 2.3 (CI 0.9-6.2) and 3.7 (CI 1.4-9.9), respectively. Conclusions: These data suggest that insomnia may confer an increased risk of prostate cancer. Reduced melatonin levels represent a plausible biological explanation, although additional studies using biomarkers and longer follow-up times are needed to further clarify the underlying mechanisms.

Masticatory Capacity and Mortality: The Preventive and Clinical Investigation Center (IPC) Cohort Study

2019 ◽  
Vol 99 (2) ◽  
pp. 152-158 ◽  
Author(s):  
C. Darnaud ◽  
F. Thomas ◽  
N. Danchin ◽  
P. Boutouyrie ◽  
P. Bouchard
Keyword(s):  
Cancer Mortality ◽  
Cox Regression ◽  
Clinical Investigation ◽  
Missing Teeth ◽  
Masticatory Efficiency ◽  
Hazard Ratios ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Adjusted Model

Poor oral health (OH) has been associated with mortality, but the association between OH components and mortality remains imprecise. The present observational study aimed to investigate if there is an association between oral masticatory efficiency and cardiovascular (CV) mortality in a large French subject cohort. The study was based on a cohort of 85,830 subjects aged between 16 and 94 y at recruitment. The follow-up extended from 2001 to 2014 and the mean follow-up was 8.06 ± 2.73 y. The number of deaths totaled 1,670. Full-mouth examinations were performed. Dental plaque, dental calculus, gingival inflammation, missing teeth, and masticatory units were recorded. Masticatory units represent the number of natural or prosthetic opposing premolars and molar pairs and can be considered an accurate indicator for masticatory efficiency. Causes of death were ascertained from death certificates. Cox regression analyses were used to calculate hazard ratios (HRs). In the fully adjusted model, the number of masticatory units <5 is associated with an HR of 1.72 (95% confidence interval [CI], 1.54 to 1.91) for all-cause mortality, HR of 1.41 (95% CI, 1.01 to 1.99) for CV mortality, HR of 1.76 (95% CI, 1.44 to 2.15) for cancer mortality, and HR of 1.85 (95% CI, 1.55 to 2.20) for non-CV and noncancer mortality. Significant statistical associations with the other oral variables were also found for all-cause mortality, cancer mortality, and non-CV and noncancer mortality in the adjusted models. Our study indicates that after full adjustment, all oral parameters are associated with all-cause, cancer, and non-CV and noncancer mortality. However, the low number of masticatory units is associated with an increased risk of CV mortality. We highlight the association of masticatory units and CV mortality.

Sign in / Sign up

Export Citation Format

Share Document