Integration of risk factors for Parkinson disease in 2 large longitudinal cohorts

ObjectiveTo prospectively examine how selected lifestyle factors and family history of Parkinson disease (PD) combine to determine overall PD risk.MethodsWe derived risk scores among 69,968 women in the Nurses' Health Study (NHS) (1984–2012) and 45,830 men in the Health Professionals Follow-up Study (HPFS) (1986–2012). Risk scores were computed for each individual based on the following factors previously associated with PD risk: total caffeine intake, smoking, physical activity, and family history of PD for the NHS, and additionally total flavonoid intake and dietary urate index for the HPFS. Hazard ratios were estimated using Cox proportional hazards models. In addition, we performed tests of interactions on both the multiplicative and additive scale between pairs of risk factors.ResultsWe documented 1,117 incident PD cases during follow-up. The adjusted hazard ratios comparing individuals in the highest category of the reduced risk score to those in the lowest category were 0.33 (95% confidence interval: 0.21, 0.49; ptrend < 0.0001) in the NHS and 0.18 (95% confidence interval: 0.10, 0.32; ptrend < 0.0001) in the HPFS. Results were similar when applying the risk scores computed by summing the predictors weighted by the log of their individual effect sizes on PD risk in these cohorts. Additive interaction was present between no family history of PD and caffeine in men and between caffeine and physical activity in women.ConclusionsOur results suggest that known protective factors for PD tend to have additive or superadditive effects, so that PD risk is very low in individuals with multiple protective risk factors.

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Association between pregravid physical activity and family history of stroke and risk of stillbirth: population-based cohort study

BMJ Open ◽

10.1136/bmjopen-2017-017034 ◽

2017 ◽

Vol 7 (8) ◽

pp. e017034

Author(s):

Grace M Egeland ◽

Grethe S Tell ◽

Øyvind Næss ◽

Jannicke Igland ◽

Kari Klungsøyr

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Cohort Study ◽

Family History ◽

Vigorous Activity ◽

Shortness Of Breath ◽

Light Physical Activity ◽

Increased Risk ◽

History Of

ObjectivesTo evaluate whether family history of disease and pregravid lifestyle and cardiovascular risk factors are associated with subsequent stillbirth delivery.DesignPrepregnancy cohort study.SettingCohort Norway regional health surveys (1994–2003) linked to Medical Birth Registry of Norway for deliveries through 2012.Participants13 497 singleton births (>22 weeks gestation) in 8478 women.Main outcome measureRisk of stillbirth evaluated by Poisson regression.ResultsMean (SD) length of follow-up was 5.5 (3.5) years. In analyses adjusting for baseline age and length of follow-up, ≥3 hours of baseline past-year vigorous physical activity per week (resulting in shortness of breath/sweating) was associated with increased risk of stillbirth compared with <1 hour/week of vigorous activity (incidence rate ratio, IRR 2.46; 95% CI 1.23 to 4.90). In contrast, baseline past-year light physical activity of ≥3 hours per week associated with reduced risk of stillbirth compared with <3 hours of light physical activity per week (IRR 0.53; 95% CI 0.30 to 0.93). A family history of stroke associated with increased risk of stillbirth delivery (IRR 2.53; 95% CI 1.06 to 6.01). Because overweight/obese women may experience shortness of breath and sweating with less physical exertion than normal weight women, a sensitivity analysis was conducted limited to women with a normal BMI (>18.5 and <25 kg/m2). Vigorous activity of ≥3 hours per week (IRR of 4.50; 95% CI 1.72 to 11.79) and a family history of stroke (IRR of 3.81; 95% CI 1.31 to 11.07) were more strongly related to stillbirth risk among women with a normal BMI than that observed for all women combined. Established risk factors also associated with stillbirth risk.ConclusionsThe study identified physical activity and family history of stroke as potential new risk factors for stillbirth delivery.

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Modifiable and Non-Modifiable Risk Factors for Atherothrombotic Ischemic Stroke among Subjects in the Malmö Diet and Cancer Study

Nutrients ◽

10.3390/nu13061952 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1952

Author(s):

Anna Johansson ◽

Isabel Drake ◽

Gunnar Engström ◽

Stefan Acosta

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Body Mass Index ◽

Ischemic Stroke ◽

Family History ◽

Diet Quality ◽

Alcohol Intake ◽

Modifiable Risk Factors ◽

History Of ◽

Diet And Cancer

Risk factors for ischemic stroke is suggested to differ by etiologic subtypes. The purpose of this study was to examine the associations between modifiable and non-modifiable risk factors and atherothrombotic stroke (i.e., excluding cardioembolic stroke), and to examine if the potential benefit of modifiable lifestyle factors differs among subjects with and without predisposing comorbidities. After a median follow-up of 21.2 years, 2339 individuals were diagnosed with atherothrombotic stroke out of 26,547 study participants from the Malmö Diet and Cancer study. Using multivariable Cox regression, we examined non-modifiable (demographics and family history of stroke), semi-modifiable comorbidities (hypertension, dyslipidemia, diabetes mellitus and atherosclerotic disease), and modifiable (smoking, body mass index, diet quality, physical activity, and alcohol intake) risk factors in relation to atherothrombotic stroke. Higher age, male gender, family history of stroke, and low educational level increased the risk of atherothrombotic stroke as did predisposing comorbidities. Non-smoking (hazard ratio (HR) = 0.62, 95% confidence interval (CI) 0.56–0.68), high diet quality (HR = 0.83, 95% CI 0.72–0.97) and high leisure-time physical activity (HR = 0.89, 95% CI 0.80–0.98) decreased the risk of atherothrombotic ischemic stroke independent of established risk factors, with non-significant associations with body mass index and alcohol intake. The effect of the lifestyle factors was independent of predisposing comorbidities at baseline. The adverse effects of several cardiovascular risk factors were confirmed in this study of atherothrombotic stroke. Smoking cessation, improving diet quality and increasing physical activity level is likely to lower risk of atherothrombotic stroke in the general population as well as in patient groups at high risk.

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Differing Contributions of Classical Risk Factors to Type 2 Diabetes in Multi-Ethnic Malaysian Populations

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15122813 ◽

2018 ◽

Vol 15 (12) ◽

pp. 2813

Author(s):

Noraidatulakma Abdullah ◽

Nor Abdul Murad ◽

John Attia ◽

Christopher Oldmeadow ◽

Mohd Kamaruddin ◽

...

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Type 2 Diabetes ◽

Family History ◽

Characteristic Curve ◽

Lifestyle Factors ◽

Predictive Utility ◽

Family History Of Diabetes ◽

History Of

The prevalence of type 2 diabetes is escalating rapidly in Asian countries, with the rapid increase likely attributable to a combination of genetic and lifestyle factors. Recent research suggests that common genetic risk variants contribute minimally to the rapidly rising prevalence. Rather, recent changes in dietary patterns and physical activity may be more important. This nested case-control study assessed the association and predictive utility of type 2 diabetes lifestyle risk factors in participants from Malaysia, an understudied Asian population with comparatively high disease prevalence. The study sample comprised 4077 participants from The Malaysian Cohort project and included sub-samples from the three major ancestral groups: Malay (n = 1323), Chinese (n = 1344) and Indian (n = 1410). Association of lifestyle factors with type 2 diabetes was assessed within and across ancestral groups using logistic regression. Predictive utility was quantified and compared between groups using the Area Under the Receiver-Operating Characteristic Curve (AUC). In predictive models including age, gender, waist-to-hip ratio, physical activity, location, family history of diabetes and average sleep duration, the AUC ranged from 0.76 to 0.85 across groups and was significantly higher in Chinese than Malays or Indians, likely reflecting anthropometric differences. This study suggests that obesity, advancing age, a family history of diabetes and living in a rural area are important drivers of the escalating prevalence of type 2 diabetes in Malaysia.

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Cardiovascular family history increases the risk of disease recurrence after a first myocardial infarction

European Heart Journal ◽

10.1093/ehjci/ehaa946.2979 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

A Wahrenberg ◽

P Magnusson ◽

R Kuja-Halkola ◽

H Habel ◽

K Hambraeus ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Family History ◽

Cardiovascular Events ◽

Cardiovascular Death ◽

Funding Source ◽

History Of ◽

First Time ◽

Early Family

Abstract Background Despite recent advances in secondary prevention, recurrent cardiovascular events are common after a myocardial infarction (MI). It has been reported that genetic risk scores may predict the risk of recurrent cardiovascular events. Although patient-derived family history is a composite of both genetic and environmental heritability of atherosclerotic cardiovascular disease (ASCVD), it is an easily accessible information compared to genetically based risk models but the association with recurrent events is unknown. Purpose To evaluate whether a register-verified family history of ASCVD is associated with recurrent cardiovascular events (rASCVD) in patients after a first-time MI. Methods We included patients with a first-time MI during 2005 – 2014, registered in the SWEDEHEART SEPHIA registry and without prior ASCVD. Follow-up was available until Dec 31st, 2018. Data on relatives, diagnoses and prescriptions were extracted from national registers. A family history of ASCVD was defined as a register-verified hospitalisation due to MI, angina with coronary revascularization procedures, stroke or cardiovascular death in any parent. Early history was defined as such an event before the age of 55 years in fathers and 65 years in mothers. The association between family history and a composite outcome including recurrent MI, angina requiring acute revascularization, ischaemic stroke and cardiovascular death during follow-up was studied with Cox proportional hazard regression with time from SEPHIA registry completion as underlying time-scale, adjusted for age with splines, gender and year of SEPHIA registry. Regression models were then further adjusted for hypertension, diabetes, smoking and for a subset of patients, LDL-cholesterol (LDL_C) at time of first event. Results Of 25,615 patients, 2.5% and 32.1% had an early and ever-occurring family history of ASCVD, respectively. Patients with early family history were significantly younger than other patients and were more likely to be current smokers and have a higher LDL-C (Median (IQR) 3.5 (1.1) vs 3.3 (1.1) mmol/L). In total, 3,971 (15.5%) patients experienced the outcome. Early family history of ASCVD was significantly associated with rASCVD (Hazard ratio (HR) 1.52, 95% confidence interval (CI) 1.23–1.87), and the effect was sustained when adjusted for cardiovascular risk factors (HR 1.48, 95% CI 1.20–1.83) and LDL-C (HR 1.35, 95% CI 1.04–1.74). Ever-occurring family history was weakly associated with ASCVD (HR 1.09, 95% CI 1.02 – 1.17) and the association remained unchanged with adjustments for risk factors. Conclusions Early family history of cardiovascular disease is a potent risk factor for recurrent cardiovascular events in a secondary prevention setting, independent of traditional risk factors including LDL-C. This is a novel finding and these patients may potentially benefit from intensified secondary preventive measures after a first-time MI. Funding Acknowledgement Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): This work was funded by grants from The Swedish Heart and Lung Association

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Parkinson’s disease determinants, prediction and gene–environment interactions in the UK Biobank

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2020-323646 ◽

2020 ◽

Vol 91 (10) ◽

pp. 1046-1054 ◽

Cited By ~ 2

Author(s):

Benjamin Meir Jacobs ◽

Daniel Belete ◽

Jonathan Bestwick ◽

Cornelis Blauwendraat ◽

Sara Bandres-Ciga ◽

...

Keyword(s):

Risk Factors ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Family History ◽

Genetic Risk ◽

Positive Family History ◽

Risk Scores ◽

Uk Biobank ◽

Gene Environment ◽

History Of

ObjectiveTo systematically investigate the association of environmental risk factors and prodromal features with incident Parkinson’s disease (PD) diagnosis and the interaction of genetic risk with these factors. To evaluate whether existing risk prediction algorithms are improved by the inclusion of genetic risk scores.MethodsWe identified individuals with an incident diagnosis of PD (n=1276) and controls (n=500 406) in UK Biobank. We determined the association of risk factors with incident PD using adjusted logistic regression models. We constructed polygenic risk scores (PRSs) using external weights and selected the best PRS from a subset of the cohort (30%). The PRS was used in a separate testing set (70%) to examine gene–environment interactions and compare predictive models for PD.ResultsStrong evidence of association (false discovery rate <0.05) was found between PD and a positive family history of PD, a positive family history of dementia, non-smoking, low alcohol consumption, depression, daytime somnolence, epilepsy and earlier menarche. Individuals with the highest 10% of PRSs had increased risk of PD (OR 3.37, 95% CI 2.41 to 4.70) compared with the lowest risk decile. A higher PRS was associated with earlier age at PD diagnosis and inclusion of the PRS in the PREDICT-PD algorithm led to a modest improvement in model performance. We found evidence of an interaction between the PRS and diabetes.InterpretationHere, we used UK Biobank data to reproduce several well-known associations with PD, to demonstrate the validity of a PRS and to demonstrate a novel gene–environment interaction, whereby the effect of diabetes on PD risk appears to depend on background genetic risk for PD.

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Risk factors of Parkinson disease

Neurology ◽

10.1212/wnl.0000000000010813 ◽

2020 ◽

Vol 95 (18) ◽

pp. e2500-e2508 ◽

Cited By ~ 1

Author(s):

Daniele Belvisi ◽

Roberta Pellicciari ◽

Andrea Fabbrini ◽

Matteo Costanzo ◽

Sara Pietracupa ◽

...

Keyword(s):

Risk Factors ◽

Cluster Analysis ◽

Family History ◽

Protective Factors ◽

Parkinson Disease ◽

Coffee Consumption ◽

Additive Interaction ◽

Logistic Regression Models ◽

Toxic Agents ◽

History Of

ObjectiveTo perform a simultaneous evaluation of potential risk/protective factors of Parkinson disease (PD) to identify independent risk/protective factors, to assess interaction among factors, and to determine whether identified risk factors predict etiologic subtypes of PD.MethodsWe designed a large case-control study assessing 31 protective/risk factors of PD, including environmental and lifestyle factors, comorbid conditions, and drugs. The study enrolled 694 patients with PD and 640 healthy controls from 6 neurologic centers. Data were analyzed by logistic regression models, additive interaction models, and cluster analysis.ResultsThe simultaneous assessment of 31 putative risk/protective factors of PD showed that only coffee consumption (odds ratio [OR] 0.6; 95% confidence interval [CI] 0.4–0.9), smoking (OR 0.7, 95% CI 0.6–0.9), physical activity (OR 0.8, 95% CI 0.7–0.9), family history of PD (OR 3.2, 95% CI 2.2–4.8), dyspepsia (OR 1.8, 95% CI 1.3–2.4), and exposure to pesticides (OR 2.3, 95% CI1.3–4.2), oils (OR 5.6, 95% CI 2.3–13.7), metals (OR 2.8, 95% CI 1.5–5.4), and general anesthesia (OR 6.1, 95% CI 2.9–12.7) were independently associated with PD. There was no evidence of interaction among risk/protective factors, but cluster analysis identified 4 subtypes with different risk factor profiles. In group 1, all patients had a family history of PD, while dyspepsia or exposure to toxic agents was present in 30% of patients. In groups 2 and 3, a family history of PD was lacking, while exposure to toxic agents (group 2) and dyspepsia (group 3) played major roles. Group 4 consisted of patients with no risk factors.ConclusionsThis study demonstrated that 9 factors independently modify PD risk by coexisting in the same patient rather than interacting with others. Our study suggests the need for future preventive strategies aimed at reducing the coexistence of different risk factors within the same participant.

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Relationship Between Insomnia, Depression, and Mortality: A 12-Year Follow-Up of Older Adults in the Community

International Psychogeriatrics ◽

10.1017/s1041610200006414 ◽

2000 ◽

Vol 12 (3) ◽

pp. 295-306 ◽

Cited By ~ 120

Author(s):

Lena Mallon ◽

Jan-Erik Broman ◽

Jerker Hetta

Keyword(s):

Risk Factors ◽

Older Adults ◽

Natural History ◽

Confidence Interval ◽

Odds Ratio ◽

Death Rate ◽

Mortality Data ◽

Total Death ◽

History Of

The purpose of the study was to investigate the natural history of insomnia and its association with depression and mortality. In 1983, 1,870 randomly selected subjects aged 45–65 years answered a questionnaire on sleep and health. Of the 1,604 survivors in 1995, 1,244 (77.6%) answered a new questionnaire with almost identical questions. Mortality data were collected for the 266 subjects that had died during the follow-up period. Chronic insomnia was reported by 36.0% of women and 25.4% of men (χ2 = 9.7; p < .01). About 75% of subjects with insomnia at baseline continued to have insomnia at follow-up. Insomnia in women predicted subsequent depression (odds ratio [OR] = 4.1; 95% confidence interval [CI] 2.1–7.2) but was not related to mortality. In men, insomnia predicted mortality (OR = 1.7; 95% CI 1.2–2.3), but after adjustment for an array of possible risk factors, this association was no longer significant. Men with depression at baseline had an adjusted total death rate that was 1.9 times higher than in the nondepressed men (95% CI: 1.2–3.0).

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Risk Factors for Growth of Unruptured Intracranial Aneurysms: Follow-up Study by Serial 0.5–T Magnetic Resonance Angiography

Neurosurgery ◽

10.1227/01.neu.0000217366.02567.d2 ◽

2006 ◽

Vol 58 (6) ◽

pp. 1047-1053 ◽

Cited By ~ 55

Author(s):

Nobuhiko Miyazawa ◽

Iwao Akiyama ◽

Zentaro Yamagata

Keyword(s):

Risk Factors ◽

Subarachnoid Hemorrhage ◽

Family History ◽

Unruptured Aneurysms ◽

Logistic Analysis ◽

Aneurysm Size ◽

History Of ◽

Aneurysm Growth ◽

Independent Risk Factors

Abstract OBJECTIVE: The independent risk factors for aneurysm growth were retrospectively investigated in 130 patients with unruptured aneurysms who were followed up by 0.5–T serial magnetic resonance angiography with stereoscopic images. METHODS: Age, sex, site of aneurysm, size of aneurysm, multiplicity of aneurysms, type of circle of Willis, length of follow-up period, cerebrovascular event, hypertension, diabetes, hyperlipidemia, smoking habit, and family history of subarachnoid hemorrhage were investigated using multiple logistic analysis. RESULTS: Fourteen patients (16 aneurysms) among the 130 patients (159 aneurysms) showed aneurysm growth (10.8%) during follow-up of 10 to 69 months (mean 29.3 ± 10.5 mo). Multiple logistic analysis disclosed that location on the middle cerebral artery (odds ratio [OR] 0.08, P < 0.01), multiplicity of aneurysms (OR 68.5, P < 0.01), aneurysm size of 5 mm or larger (OR 1.17, P = 0.05), and family history of subarachnoid hemorrhage (OR 10.9, P < 0.01) were independent risk factors. CONCLUSION: Location on the middle cerebral artery, multiplicity, aneurysm size of 5 mm or larger, and family history of subarachnoid hemorrhage are independent risk factors for aneurysm growth. These results may help to determine the treatment choice for unruptured aneurysms.

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Risk Factors for Early Recurrence of Gallstones in Patients Undergoing Laparoscopy Combined With Choledochoscopic Lithotomy: A Single-Center Prospective Study

Frontiers in Surgery ◽

10.3389/fsurg.2021.759390 ◽

2021 ◽

Vol 8 ◽

Author(s):

Bo Wang ◽

Anhua Huang ◽

Min Jiang ◽

Haidong Li ◽

Wenqing Bao ◽

...

Keyword(s):

Risk Factors ◽

Family History ◽

Prospective Study ◽

Cox Regression ◽

Univariate Analysis ◽

Gallbladder Wall ◽

Postoperative Recurrence ◽

Factors Associated ◽

History Of

Objective: For patients with gallstones, laparoscopy combined with choledochoscopic lithotomy is a therapeutic surgical option for preservation rather than the removal of the gallbladder. However, postoperative recurrence of gallstones is a key concern for both patients and surgeons. This prospective study was performed to investigate the risk factors for early postoperative recurrence of gallstones.Methods: The clinical data of 466 patients were collected. Each patient was followed up for up to 2 years. The first follow-up visit occurred 4 months after the operation, and a follow-up visit was carried out every 6 months thereafter. The main goal of each visit was to confirm the presence or absence of gallbladder stones. The factors associated with gallstone recurrence were analyzed by univariate analysis and Cox regression.Results: In total, 466 eligible patients were included in the study, and 438 patients (180 men and 258 women) completed the 2-year postoperative follow-up. The follow-up rate was 94.0%. Recurrence of gallstones was detected in 5.71% (25/438) of the patients. Univariate analysis revealed five risk factors for the recurrence of gallstones. Multivariate Cox regression analysis showed that multiple gallstones, a gallbladder wall thickness of ≥4 mm, and a family history of gallbladder stones were the three predictive factors for postoperative recurrence of gallstones (P < 0.05).Conclusion: The overall 2-year recurrence rate of gallstones after the operation was 5.71%. Multiple gallstones, a gallbladder wall thickness of ≥4 mm, and a family history of gallstones were the three risk factors associated with early postoperative recurrence of gallstones.

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The related risk factors of diabetic retinopathy in elderly patients with Type 2 diabetes mellitus: A cohort study

10.21203/rs.2.23535/v1 ◽

2020 ◽

Author(s):

Ying-Chu Chiu ◽

Tien-Lung Tsai ◽

Meiyin Su ◽

Tsan Yang ◽

Peng-Lin Tseng ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Family History ◽

Elderly Patients ◽

Betel Nut ◽

Family History Of Diabetes ◽

Related Risk ◽

History Of

Abstract Background: Diabetic retinopathy (DR) caused by small vessel disease was the main cause of blindness in person with diabetes, and it mainly occurred in patients with Type 2 diabetes mellitus (T2DM). Taiwan was one of the Asian countries with the highest prevalence rate of DR, there were only few studies for the risk of DR in patients with T2DM in Taiwan. According to some studies have shown DR was a major cause of blindness on elderly both in developed and other developing countries. The purpose was to investigate the related risk factors of DR in elderly patients with T2DM. Methods: During July 2010 to December 2017, 4010 T2DM patients without DR were preselected for this study, but 792 patients completed the continuously follow-up evaluation. Patients were invited to have an outpatient visit at least every three months, and they were asked to fill out a brief questionnaire and collect their blood samples. Additionally, statistical methods used independent sample T-test, Chi-square tests and logistic regression in univariate analysis to analyze the relationships between onset DR and each related factor; and finally the optimal multivariate logistic regression model would be determined by stepwise model selection. Results: Of the 792 effective samples, 611 patients (77.1%) progressed to DR and 181 patients (22.9%) did not get DR during the follow-up period. According to the results, the significant factors were women (OR, 2.20; 95%CI, 1.52-3.17), longer diabetic duration (OR, 1.05; 95% CI, 1.03-1.08), family history of diabetes (OR, 1.55; 95% CI: 1.09-2.21), higher concentration glycated hemoglobin (HbA1c) (OR, 1.27; 95% CI: 1.12-1.44), higher mean low density lipoprotein cholesterol (LDL-c) (OR, 1.01; 95% CI: 1.00-1.01), and chewing betel nut (OR, 2.85; 95% CI: 1.41-5.77). Conclusions: This prospective cohort study showed that gender, behavior of chewing betel nut, diabetic duration, family history of diabetes, HbA1c, and LDL-c, were important factors for the development of DR in elderly patients with T2DM. It suggested that those patients should well control their HbA1c and LDL-c and quit chewing betel nut to prevent from DR, especially for female patients with family history of diabetes and longer duration of diabetes.

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