scholarly journals Association between female reproductive factors and gout: a nationwide population-based cohort study of 1 million postmenopausal women

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Yeonghee Eun ◽  
In-Young Kim ◽  
Kyungdo Han ◽  
Kyu Na Lee ◽  
Dong-Yun Lee ◽  
...  
Keyword(s):  
High Risk ◽  
Postmenopausal Women ◽  
Hormone Replacement ◽  
Reproductive Factors ◽  
Population Based ◽  
Claim Database ◽  
Increased Risk ◽  
Icd 10 ◽  
Endogenous Estrogen ◽  
Incident Cases

Abstract Background Previous studies have shown that the incidence and risk factors of gout differs according to sex. However, little research has been done on the association between reproductive factors and gout. We conducted an analysis of a large nationwide population-based cohort of postmenopausal women to determine whether there is an association between reproductive factors and the incidence of gout. Methods A total of 1,076,378 postmenopausal women aged 40–69 years who participated in national health screenings in 2009 were included in the study. The outcome was the occurrence of incident gout, which was defined using the ICD-10 code of gout (M10) in the claim database. Cox proportional hazard models were used for the analyses and stratified analyses according to body mass index (BMI) and the presence/absence of chronic kidney disease (CKD) were performed. Results The mean follow-up duration was 8.1 years, and incident cases of gout were 64,052 (incidence rate 7.31 per 1000 person-years). Later menarche, earlier menopause, and a shorter reproductive span were associated with a high risk of gout. No association between parity and gout incidence was observed. Use of oral contraceptives (OC) and hormone replacement therapy (HRT) were associated with an increased risk of gout. The association between reproductive factors and gout was not statistical significant in the high BMI group. The effects of OC and HRT usage on gout were not significant in the CKD group. Conclusion Shorter exposure to endogenous estrogen was associated with a high risk of gout. Conversely, exposure to exogenous estrogen such as OC and HRT was associated with an increased risk of gout.

scholarly journals OP0206 ASSOCIATION BETWEEN FEMALE REPRODUCTIVE FACTORS AND GOUT: NATIONWIDE POPULATION-BASED COHORT STUDY OF 1 MILLION POSTMENOPAUSAL WOMEN

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 124.2-124
Author(s):  
Y. Eun ◽  
I. Y. Kim ◽  
K. D. Han ◽  
K. Lee ◽  
S. Y. Kang ◽  
...  
Keyword(s):  
High Risk ◽  
Postmenopausal Women ◽  
Hormone Replacement ◽  
Reproductive Factors ◽  
Population Based ◽  
The Body ◽  
Claim Database ◽  
Increased Risk ◽  
Incident Cases ◽  
High Bmi

Background:Previous studies have shown that the incidence of gout differs according to gender, and its risk factors also differ according to gender. However, little research has been done on the association between reproductive factors and gout.Objectives:Our study attempted to determine whether there is an association between reproductive factors and the incidence of gout in a large nationwide population-based cohort of postmenopausal women.Methods:Postmenopausal women aged 40-69 who participated in national health screenings in 2009 were included in the study. Subjects who had been diagnosed with gout prior to medical examination were excluded from the study, and a total of 1,076,378 women were included in the study. Outcome was the occurrence of gout which was defined as a case of two outpatient visit or one hospitalization for gout using the ICD-10 code of gout (M10) in the claim database. The Cox proportional hazard model was used for the analysis, and stratified analysis according to the body mass index (BMI) and chronic kidney disease (CKD) was performed.Results:Mean follow-up duration was 8.1 years, and incident cases of gout were 64,052. Later menarche (adjusted HR 1.10, 95% CI 1.02-1.19 in >16 years, compared with ≤12 years), earlier menopause (adjusted HR 1.12 in <40 years, 1.06 in 40-45 years, 1.03 in 45-50 years, compared with 50-55 years), and shorter reproductive span (adjusted HR 1.10 in <30 years, 1.06 in 30-35 years, compared with ≥40 years) were associated with a high risk of gout. No association between parity and gout incidence was observed. Use of oral contraceptives (OC; adjusted HR 1.03 in <1 year, 1.05 ≥1 year, compared with non-user) and hormone replacement therapy (HRT; adjusted HR 1.16 in <2 years, 1.16 in 2-5 years, 1.18 in ≥5 years, compared with non-user) were associated with an increased risk of gout. The association between reproductive factors and gout remained in the trend without statistical significance in the low BMI group, but not in the high BMI group. The effects of use OC and HRT on gout were not significant in the CKD group.Conclusion:Shorter exposure to endogenous estrogen was associated with a high risk of gout. Conversely, exposure to exogenous estrogen such as OC and HRT was associated with an increase in gout risk. This association was not significant in subjects with high BMI or CKD.Disclosure of Interests:None declared

scholarly journals Menopausal factors and risk of seropositive rheumatoid arthritis in postmenopausal women: a nationwide cohort study of 1.36 million women

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yeonghee Eun ◽  
Keun Hye Jeon ◽  
Kyungdo Han ◽  
Dahye Kim ◽  
Hyungjin Kim ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Postmenopausal Women ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Hormone Replacement ◽  
Large Population ◽  
Reproductive Factors ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model

AbstractIn previous literature regarding development of rheumatoid arthritis (RA), female reproductive factors have been described as protective factors, risk factors, or irrelevant, leading to inconsistent results. The aim of this study was to investigate the effect of female reproductive factors on the incidence of seropositive RA. A large population-based retrospective cohort of the National Health Insurance Service data in South Korea was used. Postmenopausal women who participated in both cardiovascular and breast cancer screening in 2009 were included and followed until date of seropositive RA diagnosis, death, or December 31, 2018. Multivariable-adjusted Cox proportional hazards model was used to assess the association between reproductive factors and incident seropositive RA. Of 1,357,736 postmenopausal women, 6056 women were diagnosed with seropositive RA, and the incidence rate was 54.16 cases/100,000 person-years. Reproductive factors other than hormone replacement therapy (HRT) were not significantly associated with seropositive RA incidence. Postmenopausal women who used HRT ≥ 5 years were associated with a higher aHR of incident seropositive RA than never-users (aHR 1.25; 95% CI 1.09–1.44). Alcohol consumption less than 30 g per day (aHR 0.80; 95% CI 0.74–0.87), regular physical activity (aHR 0.90; 95% CI 0.84–0.97), diabetes mellitus (aHR 0.85; 95% CI 0.78–0.93), and cancer (aHR 0.77; 95% CI 0.64–0.92) were associated with lower risk of seropositive RA. Most female reproductive factors did not significantly affect the development of seropositive RA in postmenopausal women. Only HRT is associated with a small but significant increase in risk of seropositive RA.

scholarly journals POS0138 ALTERED RISK OF GOUT ACCORDING TO CHANGE OF METABOLIC PARAMETERS IN YOUNG ADULTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 281.1-281
Author(s):  
Y. Eun ◽  
I. Y. Kim ◽  
K. D. Han ◽  
S. Y. Kang ◽  
S. Lee ◽  
...  
Keyword(s):  
Young Adults ◽  
Population Based ◽  
Metabolic Parameters ◽  
Claim Database ◽  
Metabolic Parameter ◽  
Health Examination ◽  
Lifestyle Modifications ◽  
Kaplan Meier ◽  
Increased Risk ◽  
Icd 10

Background:Many studies have shown a link between gout and metabolic syndrome (MetS). It is well known that lifestyle modifications such as weight reduction and abstinence from alcohol are effective in the treatment of gout, but data are lacking on how exactly the change of metabolic parameters affects gout.Objectives:The purpose of this study was to investigate the relationship between gout risk and metabolic parameters in a nationwide population based young adult cohort, and to determine whether changes in metabolic parameters affect gout risk changes.Methods:Among adults aged 20-39 years who participated in national health check-up programs from 2009 to 2012, a total of 6,290,914 subjects were included in the study, excluding subjects who were previously diagnosed with gout. To determine the effect of changes in metabolic parameters on gout incidence, 2,701,138 subjects who participated in the health examination once more 2 years later were used for the analysis. Outcome was defined as the occurrence of gout, when the ICD-10 code (M10) was registered twice in the claim database. The Cox proportional hazard model and Kaplan Meier curve were used for the analysis.Results:The incidence rate of gout was higher in those with MetS compared to those without (10.1 vs. 3.6 per 1,000 person-years). The risk of gout in people with MetS was 85% higher (adjusted HR 1.85, 95% CI 1.83-1.87) and was more significant in men than in women (adjusted HR 1.88 in male and 1.56 in female). Each component of MetS was also associated with increased gout risk, and hypertriglyceridemia showed the highest adjusted HR. The greater the number of MetS components, the higher the gout risk. The risk of gout was 70% higher in those who had MetS consistently (adjusted HR 1.71, 95% CI 1.67-1.75) and 44% higher in those with newly developed MetS (adjusted HR 1.47, 95% CI 1.40-1.48) than those who did not have MetS at the two health examinations. Similar risk patterns were observed according to the change of each metabolic parameter. Among the metabolic parameters, the change in hypertriglyceridemia was associated with the greatest difference in the change in gout risk.Conclusion:In young adults, MetS was associated with a higher risk of gout, especially with more components, the higher the risk. Since the occurrence of MetS is associated with an increased risk of gout, prevention of MetS would be important to reduce gout incidence.Disclosure of Interests:None declared

scholarly journals Clinical Impact of Hormone Replacement Therapy on Atrial Fibrillation in Postmenopausal Women: A Nationwide Cohort Study

2021 ◽  
Vol 10 (23) ◽  
pp. 5497
Author(s):  
Jaehoon Lee ◽  
Yuntae Kim ◽  
Hyunji Park ◽  
Changsoo Kim ◽  
Sihyun Cho ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cohort Study ◽  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Postmenopausal Women ◽  
Hormone Replacement ◽  
Multivariable Analysis ◽  
National Sample ◽  
Population Based ◽  
Increased Risk

Individuals with atrial fibrillation (AF), especially women, have an increased risk of stroke and death. Although hormone replacement therapy (HRT) is widely used in postmenopausal women, the association between HRT use and AF risk is unclear. We aimed to investigate the association between various types of HRT and AF. This was a population-based retrospective cohort study from The Korean National Health Insurance Service-National Sample Cohort (2004–2015). Participants were aged 45–60 years and were free from cardiovascular disease and AF at baseline. Overall, 13,452 (64.03%) women had never received HRT, 5671 (26.99%) had received HRT, and 1885 (8.98%) were currently receiving HRT. In multivariable analysis, the relative hazards for AF were significantly higher among current users (p < 0.001) and lower among past users (p = 0.069). Current users—except those using estradiol-only HRT—had significantly elevated AF risk. Among past users, only estradiol plus progestin HRT users had a reduced AF risk after adjusting for covariates (p = 0.027). Ongoing HRT posed an increased risk of AF. The degree of risk varied based on the specific type of estrogen and progestins co-administration. These findings indicate that, with respect to AF risk, oral estradiol-containing HRT is superior to HRT containing oral conjugated equine estrogen or tibolone.

scholarly journals Melanoma is associated with an increased risk of bullous pemphigoid: a large population-based longitudinal study

2021 ◽  
Author(s):  
Khalaf Kridin ◽  
Jennifer E. Hundt ◽  
Ralf J. Ludwig ◽  
Kyle T. Amber ◽  
Dana Tzur Bitan ◽  
...  
Keyword(s):  
Bullous Pemphigoid ◽  
Statistical Significance ◽  
Large Population ◽  
Underlying Mechanism ◽  
Population Based ◽  
Control Subjects ◽  
Increased Risk ◽  
Bidirectional Association ◽  
History Of ◽  
Incident Cases

AbstractThe association between bullous pemphigoid (BP) and melanoma is yet to be investigated. We aimed to assess assess the bidirectional association between BP and melanoma and to delineate the epidemiological features of patients with both diagnoses. A population-based cohort study was performed comparing BP patients (n = 3924) with age-, sex- and ethnicity-matched control subjects (n = 19,280) with regard to incident cases of melanoma. A case–control design was additionally adopted to estimate the risk of BP in individuals with a preexisting diagnosis of melanoma. The prevalence of preexisting melanoma was higher in patients with BP than in control subjects (1.5% vs. 1.0%, respectively; P = 0.004). A history of melanoma confers a 50% increase in the risk of subsequent BP (OR 1.53; 95% CI 1.14–2.06). This risk was higher among males (OR 1.66; 95% CI 1.09–2.54) and individuals older than 80 years (OR 1.63; 95% CI 1.11–2.38), and persisted after adjustment for multiple putative confounders including PD-1/PDL-1 antagonists (adjusted OR 1.53; 95% CI 1.14–2.06). Conversely, the risk of melanoma among patients with BP was slightly elevated, but did not reach the level of statistical significance (adjusted HR 1.13; 95% CI 0.73–1.74). Patients with a dual diagnosis of BP and melanoma were older at the onset of BP and had lower body mass index. A history of melanoma is associated with a 50% increase in the incidence of subsequent BP. Physicians managing patients with both conditions should be aware of this association. Further research is warranted to reveal the underlying mechanism of these findings.

scholarly journals Adolescent cannabis use, baseline prodromal symptoms and the risk of psychosis

2018 ◽  
Vol 212 (4) ◽  
pp. 227-233 ◽  
Author(s):  
Antti Mustonen ◽  
Solja Niemelä ◽  
Tanja Nordström ◽  
Graham K. Murray ◽  
Pirjo Mäki ◽  
...  
Keyword(s):  
Substance Use ◽  
General Population ◽  
Birth Cohort ◽  
Psychotic Disorders ◽  
Temporal Order ◽  
Population Based ◽  
Cannabis Use ◽  
Prodromal Symptoms ◽  
Increased Risk ◽  
Icd 10

BackgroundThe association between cannabis use and the risk of psychosis has been studied extensively but the temporal order still remains controversial.AimsTo examine the association between cannabis use in adolescence and the risk of psychosis after adjustment for prodromal symptoms and other potential confounders.MethodThe sample (n = 6534) was composed of the prospective general population-based Northern Finland Birth Cohort of 1986. Information on prodromal symptoms of psychosis and cannabis use was collected using questionnaires at age 15–16 years. Participants were followed up for ICD-10 psychotic disorders until age 30 years using nationwide registers.ResultsThe risk of psychosis was elevated in individuals who had tried cannabis five times or more (hazard ratio, (HR) = 6.5, 95% CI 3.0–13.9). The association remained statistically significant even when adjusted for prodromal symptoms, other substance use and parental psychosis (HR = 3.0, 95% CI 1.1–8.0).ConclusionsAdolescent cannabis use is associated with increased risk of psychosis even after adjustment for baseline prodromal symptoms, parental psychosis and other substance use.Declaration of interestNone.

scholarly journals Metabolome-defined obesity and the risk of future diabetes and mortality

2021 ◽  
Author(s):  
Filip Ottosson ◽  
Einar Smith ◽  
Ulrika Ericson ◽  
Salvatore Di Somma ◽  
Paola Antonini ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Population Based ◽  
Normal Weight ◽  
Plasma Metabolites ◽  
Italian Population ◽  
Related Risk ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Future Diabetes

Background Obesity is a key risk factor for type 2 diabetes, however, up to 20% of patients are normal weight. Our aim was to identify metabolite patterns reproducibly predictive of BMI, and subsequently to test if lean individuals who carry an obese metabolome are at hidden high risk of obesity related diseases, such as diabetes. Methods We measured 109 metabolites in fasted plasma samples of 7663 individuals from two Swedish and one Italian population-based cohort. Ridge regression models were used to predict BMI using the plasma metabolites. Individuals with a predicted BMI either more than 5 kg/m2 higher (overestimated) or lower (underestimated) than their actual BMI were characterized as outliers and further investigated for obesity related risk factors and future risk of diabetes and mortality. Results The plasma metabolome could predict BMI in all cohorts (r2 = 0.48, 0.26 and 0.19). The overestimated group had a BMI similar to individuals correctly predicted as normal weight, similar waist circumference, were not more likely to change weight over time but had a 2 times higher risk of future diabetes and an 80 % increased risk of all-cause mortality. These associations remained after adjustments for obesity-related risk factors and lifestyle parameters. Conclusions We found that lean individuals with an obese metabolome, have an increased risk for diabetes and all-cause mortality compared to lean individuals with a healthy metabolome. Metabolomics may be used to identify hidden high-risk individuals, in order to initiate lifestyle and pharmacological interventions.

Cortisol plasma levels are associated with serotonin - 1A receptor binding in postmenopausal women

2011 ◽  
Vol 26 (S2) ◽  
pp. 933-933
Author(s):  
G. Kranz ◽  
A. Hahn ◽  
J. Ungersböck ◽  
U. Kaufmann ◽  
P. Stein ◽  
...  
Keyword(s):  
Postmenopausal Women ◽  
Receptor Binding ◽  
Plasma Levels ◽  
Hormone Replacement ◽  
Binding Potential ◽  
Serotonin 1A Receptor ◽  
Strong Negative Correlation ◽  
Logan Plot ◽  
Increased Risk ◽  
Relationship Of

IntroductionAlterations of the serotonin-1A receptor (5-HT1A) and the hypothalamic-pituitary-adrenal (HPA) axis have been reported in depression and anxiety disorders. We previously showed a strong negative correlation between cortisol plasma levels and 5-HT1A receptor binding potential (BP) in patients with social anxiety disorder but not in healthy controls using PET [1].ObjectivesTo investigate the relationship of cortisol and the 5-HT1A BP in postmenopausal women, a population that is at increased risk of suffering from depressive symptoms.MethodsSubjects: 19 postmenopausal women, aged 55.26 ± 4.98, medication free, no current substance abuse or hormone replacement therapy.PETDynamic measurements (50 frames, 90 min) were performed using the radioligand [carbonyl-11C]WAY100635 and a GE-Advance scanner. PET data were normalized to a ligand-specific template [2]. Regions-of-interest (ROI) were defined as given in [3]. TACs within ROIs were averaged and the 5-HT1A receptor BP was quantified using Logan-plot and PMOD 3.1. Measurement of total cortisol plasma levels was done using electrochemoluminescence.ResultsWe found negative correlations between cortisol and 5-HT1A BP in the midbrain (Spearman's rs = −0.54, p = 0.02), the median raphe nucleus (rs = −0.47, p = 0.04) and the nucleus accumbens (rs = −0.505, p = 0.03).ConclusionsIn line with our previous findings [1], the observed negative association between cortisol plasma levels and 5-HT1A BP might reflect an increased vulnerability for mood disorders in postmenopausal women.

The Genes and Genetics of Malignant Melanoma

2002 ◽  
Vol 6 (3) ◽  
pp. 229-235 ◽  
Author(s):  
Peter Gibbs ◽  
Benjamin M. R. Brady ◽  
William A. Robinson
Keyword(s):  
High Risk ◽  
Sun Exposure ◽  
Population Based ◽  
Uv Exposure ◽  
Molecular Defect ◽  
Clinical Variables ◽  
Red Hair ◽  
Increased Risk ◽  
History Of ◽  
Self Examination

Background: Population-based studies have identified several clinical variables associated with an increased risk of developing cutaneous melanoma that include phenotype, amount of and response to sun exposure, and family history. However, these observations are of limited relevance to clinical practice as the risk associated with each factor is individually modest and the characteristics of these variables lack precision when applied to a particular individual. Objective: To review the literature regarding recent advances made in the understanding of the genes and genetics of clinical variables associated with an increased risk of melanoma. Conclusion: Variants of the MC1R (melanocortin-1 receptor) have been identified as major determinants of high-risk phenotypes, such as red hair and pale skin, and the ability to tan in response to UV exposure. Several studies also suggest that such variants may increase melanoma risk independent of their contribution to phenotype. A strong genetic basis for both nevus density and size has been demonstrated and the link between nevi and the development of MM has become better defined. Finally, germline defects in several genes involved in cell cycle regulation, namely, p16 and CDK4, have been demonstrated in many familial melanoma kindreds. This progress has introduced the prospect of genetic testing as a means of identifying a limited number of high-risk individuals who can be targeted with regular screening and education regarding UV exposure and skin self-examination. Ultimately, through rational genetic therapy targeted to correcting the underlying molecular defect, altering the natural history of melanoma development may be possible.

scholarly journals Clinical significance of cerebral microbleeds on MRI: A comprehensive meta-analysis of risk of intracerebral hemorrhage, ischemic stroke, mortality, and dementia in cohort studies (v1)

2018 ◽  
Vol 13 (5) ◽  
pp. 454-468 ◽  
Author(s):  
Andreas Charidimou ◽  
Sara Shams ◽  
Jose R Romero ◽  
Jie Ding ◽  
Roland Veltkamp ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
High Risk ◽  
Intracerebral Hemorrhage ◽  
Meta Analysis ◽  
Population Based ◽  
Cerebral Microbleeds ◽  
Clinical Settings ◽  
Memory Clinic ◽  
Increased Risk ◽  
Stroke Death

Background Cerebral microbleeds can confer a high risk of intracerebral hemorrhage, ischemic stroke, death and dementia, but estimated risks remain imprecise and often conflicting. We investigated the association between cerebral microbleeds presence and these outcomes in a large meta-analysis of all published cohorts including: ischemic stroke/TIA, memory clinic, “high risk” elderly populations, and healthy individuals in population-based studies. Methods Cohorts (with > 100 participants) that assessed cerebral microbleeds presence on MRI, with subsequent follow-up (≥3 months) were identified. The association between cerebral microbleeds and each of the outcomes (ischemic stroke, intracerebral hemorrhage, death, and dementia) was quantified using random effects models of (a) unadjusted crude odds ratios and (b) covariate-adjusted hazard rations. Results We identified 31 cohorts ( n = 20,368): 19 ischemic stroke/TIA ( n = 7672), 4 memory clinic ( n = 1957), 3 high risk elderly ( n = 1458) and 5 population-based cohorts ( n = 11,722). Cerebral microbleeds were associated with an increased risk of ischemic stroke (OR: 2.14; 95% CI: 1.58–2.89 and adj-HR: 2.09; 95% CI: 1.71–2.57), but the relative increase in future intracerebral hemorrhage risk was greater (OR: 4.65; 95% CI: 2.68–8.08 and adj-HR: 3.93; 95% CI: 2.71–5.69). Cerebral microbleeds were an independent predictor of all-cause mortality (adj-HR: 1.36; 95% CI: 1.24–1.48). In three population-based studies, cerebral microbleeds were independently associated with incident dementia (adj-HR: 1.35; 95% CI: 1.00–1.82). Results were overall consistent in analyses stratified by different populations, but with different degrees of heterogeneity. Conclusions Our meta-analysis shows that cerebral microbleeds predict an increased risk of stroke, death, and dementia and provides up-to-date effect sizes across different clinical settings. These pooled estimates can inform clinical decisions and trials, further supporting cerebral microbleeds role as biomarkers of underlying subclinical brain pathology in research and clinical settings.

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