Total Mortality by Transferrin Saturation Levels: Two General Population Studies and a Metaanalysis

BACKGROUND There is evidence for increased mortality in patients with clinically overt hereditary hemochromatosis. Whether increased transferrin saturation (TS), as a proxy for iron overload is associated with increased mortality in the general population is largely unknown. METHODS We examined mortality according to baseline TS in 2 Danish population–based follow-up studies (the Copenhagen General Population Study and the Copenhagen City Heart Study) comprising a total of 45 159 individuals, of whom 4568 died during up to 18 years of follow-up, and in a metaanalysis comprising the present studies and an additional general population study. RESULTS In combined studies, the cumulative survival was reduced in individuals with TS ≥50% vs <50% (log-rank P < 0.0001). Multifactorially adjusted hazard ratios for total mortality for TS ≥50% vs <50% were 1.4 (95% CI 1.2–1.6; P < 0.001) overall, 1.3 (1.1–1.6; P = 0.003) in men, and 1.5 (1.1–2.0; P = 0.005) in women. Results were similar if the 2 studies were considered separately. A stepwise increased risk of total mortality was observed for stepwise increasing levels of TS (log-rank P < 0.0001), with the highest risk conferred by TS ≥80% vs TS <20% with a hazard ratio of 2.2 (1.4–3.3; P < 0.001). The population-attributable risk for total mortality in the combined studies in individuals with TS ≥50% vs <50% was 0.8%. In metaanalysis, the odds ratio for total mortality for TS ≥50% vs <50% was 1.3 (1.2–1.5; P < 0.001) under the fixed-effects model. CONCLUSIONS Individuals in the general population with TS ≥50% vs <50% have an increased risk of premature death.

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Increased Ferritin Concentration and Risk of Atrial Fibrillation and Heart Failure in Men and Women: Three Studies of the Danish General Population Including 35799 Individuals

Clinical Chemistry ◽

10.1373/clinchem.2018.292763 ◽

2019 ◽

Vol 65 (1) ◽

pp. 180-188

Author(s):

Lise Fischer Mikkelsen ◽

Børge G Nordestgaard ◽

Peter Schnohr ◽

Christina Ellervik

Keyword(s):

Heart Failure ◽

Atrial Fibrillation ◽

General Population ◽

Population Study ◽

Fixed Effects ◽

Odds Ratios ◽

General Population Study ◽

Ferritin Concentration ◽

Men And Women ◽

Increased Risk

Abstract BACKGROUND Moderately increased plasma ferritin, as a biomarker of iron overload, has been associated with higher rates of cardiovascular death and heart failure. However, the association of moderately increased plasma ferritin with risk of atrial fibrillation in the general population is unknown. METHODS We examined the association of plasma ferritin concentrations with risk of atrial fibrillation and heart failure in metaanalyses of 35799 men and women from 3 studies of the Danish general population: the Copenhagen City Heart Study, the Danish General Suburban Population Study, and the Copenhagen General Population Study. RESULTS Multivariable adjusted fixed effects odds ratios for atrial fibrillation were 1.23 (95% CI, 1.05–1.44; P = 0.005) in men for ferritin concentration ≥300 μg/L vs <300 μg/L, 1.13 (95% CI, 0.93–1.38; P = 0.22) in women for ≥200 μg/L vs <200 μg/L, and 1.19 (95% CI, 1.06–1.35; P = 0.005) in both sexes combined (Psex interaction = 0.52). Corresponding fixed effects odds ratios for heart failure were 1.16 (95% CI, 0.98–1.37; P = 0.08) in men, 0.86 (95% CI, 0.67–1.10; P = 0.23) in women, and 1.05 (95% CI, 0.91–1.21; P = 0.45) in both sexes combined (Psex interaction = 0.05). Multivariable adjusted fixed effects odds ratio for atrial fibrillation per step increase in ferritin concentrations was 1.13 (95% CI, 1.06–1.21; Ptrend = 0.0005) in both sexes combined (Psex interaction = 0.59); the corresponding value for heart failure was 1.03 (95% CI, 0.95–1.11; Ptrend = 0.47) (Psex interaction = 0.08). In sensitivity analyses, there was no evidence of U-shaped relationships between plasma ferritin concentrations and risk of atrial fibrillation or heart failure in men or women. CONCLUSIONS Increased ferritin concentration is associated with increased risk of atrial fibrillation in the general population.

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Association of Blood Eosinophil and Blood Neutrophil Counts with Asthma Exacerbations in the Copenhagen General Population Study

Clinical Chemistry ◽

10.1373/clinchem.2016.267450 ◽

2017 ◽

Vol 63 (4) ◽

pp. 823-832 ◽

Cited By ~ 19

Author(s):

Signe Vedel-Krogh ◽

Sune Fallgaard Nielsen ◽

Peter Lange ◽

Jørgen Vestbo ◽

Børge Grønne Nordestgaard

Keyword(s):

General Population ◽

Disease Severity ◽

Population Study ◽

Blood Eosinophil ◽

Blood Neutrophil ◽

General Population Study ◽

Asthma Exacerbations ◽

Increased Risk ◽

Blood Neutrophils ◽

Eosinophil Counts

Abstract BACKGROUND Blood eosinophil count is a marker of eosinophilic airway inflammation and disease severity in asthma. However, blood neutrophil count might also be associated with disease severity. We tested the hypothesis that high blood eosinophil and neutrophil counts are both associated with the risk of asthma exacerbations among individuals with asthma from the general population. METHODS From the Copenhagen General Population Study with 81351 participants, we included 4838 with self-reported asthma. We recorded baseline blood eosinophil and neutrophil counts, and asthma exacerbations during follow-up in 2003–2011, defined as moderate (short-course treatment of prednisolone) or severe (hospitalization). RESULTS The multivariable-adjusted incidence rate ratios (IRRs) were 1.28 (95% CI, 1.06–1.55) for moderate exacerbations and 1.55 (1.20–2.00) for severe exacerbations for individuals with blood eosinophil counts >0.29 × 109/L (highest tertile) vs individuals with blood eosinophil counts <0.18 × 109/L (lowest tertile). For blood neutrophils, the multivariable-adjusted IRRs were 2.14 (1.74–2.63) for moderate exacerbations and 1.18 (0.89–1.55) for severe exacerbations for individuals with blood neutrophil counts >4.85 × 109/L (highest tertile) vs individuals with blood neutrophil counts <3.77 × 109/L (lowest tertile). Blood eosinophil and neutrophil counts interacted on moderate exacerbations (P = 3 × 10−4), but not on severe exacerbations. CONCLUSIONS High blood eosinophil counts are associated with an increased risk of both moderate and severe asthma exacerbations, while high blood neutrophil counts are associated with an increased risk of moderate, but not severe exacerbations.

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Increased Risk for Other Cancers in Addition to Breast Cancer for CHEK2*1100delC Heterozygotes Estimated From the Copenhagen General Population Study

Journal of Clinical Oncology ◽

10.1200/jco.2015.63.3594 ◽

2016 ◽

Vol 34 (11) ◽

pp. 1208-1216 ◽

Cited By ~ 50

Author(s):

Charlotte Näslund-Koch ◽

Børge G. Nordestgaard ◽

Stig E. Bojesen

Keyword(s):

Breast Cancer ◽

General Population ◽

Population Study ◽

Cell Cycle Checkpoint ◽

Loss Of Function ◽

General Population Study ◽

Chek2 1100Delc ◽

Hazard Ratios ◽

Increased Risk ◽

Age And Sex

Purpose CHEK2 is a cell cycle checkpoint regulator, and the CHEK2*1100delC germline mutation leads to loss of function and increased breast cancer risk. It seems plausible that this mutation could also predispose to other cancers. Therefore, we tested the hypothesis that CHEK2*1100delC heterozygosity is associated with increased risk for other cancers in addition to breast cancer in the general population. Patients and Methods We examined 86,975 individuals from the Copenhagen General Population Study, recruited from 2003 through 2010. The participants completed a questionnaire on health and lifestyle, were examined physically, had blood drawn for DNA extraction, were tested for presence of CHEK2*1100delC using Taqman assays and sequencing, and were linked over 1943 through 2011 to the Danish Cancer Registry. Incidences and risks of individual cancer types, including breast cancer, were calculated using Kaplan-Meier estimates, Fine and Gray competing-risks regressions, and stratified analyses with interaction tests. Results Among 86,975 individuals, 670 (0.8%) were CHEK2*1100delC heterozygous, 2,442 developed breast cancer, and 6,635 developed other cancers. The age- and sex-adjusted hazard ratio for CHEK2*1100delC heterozygotes compared with noncarriers was 2.08 (95% CI, 1.51 to 2.85) for breast cancer and 1.45 (95% CI, 1.15 to 1.82) for other cancers. When stratifying for sex, the age-adjusted hazard ratios for other cancers were 1.54 (95% CI, 1.08 to 2.18) for women and 1.37 (95% CI, 1.01 to 1.85) for men (sex difference: P = .63). For CHEK2*1100delC heterozygotes compared with noncarriers, the age- and sex-adjusted hazard ratios were 5.76 (95% CI, 2.12 to 15.6) for stomach cancer, 3.61 (95% CI, 1.33 to 9.79) for kidney cancer, 3.45 (95% CI, 1.09 to 10.9) for sarcoma, and 1.60 (95% CI, 1.00 to 2.56) for prostate cancer. Conclusion CHEK2*1100delC heterozygosity is associated with 15% to 82% increased risk for at least some cancers in addition to breast cancer. This information may be useful in clinical counseling of patients with this loss-of-function mutation.

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Triglycerides and remnant cholesterol associated with risk of aortic valve stenosis: Mendelian randomization in the Copenhagen General Population Study

European Heart Journal ◽

10.1093/eurheartj/ehaa172 ◽

2020 ◽

Vol 41 (24) ◽

pp. 2288-2299 ◽

Cited By ~ 4

Author(s):

Morten Kaltoft ◽

Anne Langsted ◽

Børge G Nordestgaard

Keyword(s):

Aortic Valve ◽

General Population ◽

Aortic Valve Stenosis ◽

Population Study ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

General Population Study ◽

Plasma Triglycerides ◽

Increased Risk ◽

Remnant Cholesterol

Abstract Aims We tested the hypothesis that higher levels of plasma triglycerides and remnant cholesterol are observationally and genetically associated with increased risk of aortic valve stenosis. Methods and results We included 108 559 individuals from the Copenhagen General Population Study. Plasma triglycerides, remnant cholesterol (total cholesterol minus low-density lipoprotein and high-density lipoprotein cholesterol), and 16 genetic variants causing such increased or decreased levels were determined. Incident aortic valve stenosis occurred in 1593 individuals. Observationally compared to individuals with triglycerides <1 mmol/L (<89 mg/dL), the multifactorially adjusted hazard ratio for aortic valve stenosis was 1.02 [95% confidence interval (CI) 0.87–1.19] for individuals with triglycerides of 1.0–1.9 mmol/L (89–176 mg/dL), 1.22 (1.02–1.46) for 2.0–2.9 mmol/L (177–265 mg/dL), 1.40 (1.11–1.77) for 3.0–3.9 mmol/L (266–353 mg/dL), 1.29 (0.88–1.90) for 4.0–4.9 mmol/L (354–442 mg/dL), and 1.52 (1.02–2.27) for individuals with triglycerides ≥5 mmol/L (≥443 mg/dL). By age 85, the cumulative incidence of aortic valve stenosis was 5.1% for individuals with plasma triglycerides <2.0 mmol/L (77 mg/dL), 6.5% at 2.0–4.9 mmol/L (177–442 mg/dL), and 8.2% for individuals with plasma triglycerides ≥5.0 mmol/L (443 mg/dL). The corresponding values for remnant cholesterol categories were 4.8% for <0.5 mmol/L (19 mg/dL), 5.6% for 0.5–1.4 mmol/L (19–57 mg/dL), and 7.4% for ≥1.5 mmol/L (58 mg/dL). Genetically, compared to individuals with allele score 13–16, odds ratios for aortic valve stenosis were 1.30 (95% CI 1.20–1.42; Δtriglycerides +12%; Δremnant cholesterol +11%) for allele score 17–18, 1.41 (1.31–1.52; +25%; +22%) for allele score 19–20, and 1.51 (1.22–1.86; +51%; +44%) for individuals with allele score 21–23. Conclusion Higher triglycerides and remnant cholesterol were observationally and genetically associated with increased risk of aortic valve stenosis.

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The Association between Circulating Inflammatory Markers and Metabolic Syndrome: A General Population Study

Blood ◽

10.1182/blood-2018-99-120356 ◽

2018 ◽

Vol 132 (Supplement 1) ◽

pp. 4305-4305

Author(s):

Kasper Mønsted Pedersen ◽

Sabrina Cordua ◽

Hans Carl Hasselbalch ◽

Christina Ellervik

Keyword(s):

Metabolic Syndrome ◽

General Population ◽

Chronic Inflammation ◽

Population Study ◽

Inflammatory Diseases ◽

Density Lipoprotein ◽

Metabolic Disturbances ◽

General Population Study ◽

The Metabolic Syndrome ◽

Increased Risk

Abstract INTRODUCTION Chronic inflammation has recently been proposed as the driving force for the development of the Philadelphia chromosome-negative myeloproliferative neoplasms (MPNs). Chronic inflammation is associated with various metabolic disturbances and may also contribute to the massive comorbidity burden in MPNs, which include e.g. inflammatory bowel diseases (Crohn's disease and ulcerative colitis) and polymyalgia rheumatica. Accordingly, MPNs have also been described as "inflammatory diseases". The metabolic syndrome has so far not been shown to be prevalent in patients with MPNs although the chronic inflammatory state might induce insulin resistance as in other chronic inflammatory diseases. If MPNs indeed are preceded by a chronic inflammatory drive eliciting persistent leukocytosis, monocytosis and thrombocytosis, and ultimately clonal myeloproliferation it is intriguing to consider if MPNs and metabolic syndrome share common pathways. If so, an MPN-phenotype might be expected to be associated with metabolic syndrome in the background population. Therefore, in this study, we tested the association between circulating inflammatory markers (CIMs), a phenotypical presentation of MPNs (e.g. erythrocytosis, leukocytosis, and thrombocytosis), and the metabolic syndrome in a general population study. METHODS Data sources In this cross-sectional study, we used data from 20,872 individuals from the Danish General Suburban Population Study (GESUS). Individuals were invited between January 2010 and October 2013 and data were collected through questionnaires, health examinations, and biochemical measurements. Analyses We analyzed eight CIMs (leukocytes, neutrophils, monocytes, thrombocytes, erythrocytes, hematocrit, hemoglobin, and high-sensitive CRP) and their linear association with indicators of the metabolic syndrome (according to a modified version of the US National Cholesterol Education Program Adult Treatment Panel III): HbA1c, non-fasting plasma glucose, body mass index, blood pressure, cholesterol, low-density lipoprotein, high-density lipoprotein, and triglycerides. With logistic regression, we calculated odds ratios (ORs) of metabolic syndrome in individuals with increased levels of CIMs compared to individuals with normal levels based on current Danish reference ranges. RESULTS In general, there was a positive correlation between most CIMs and indicators of the metabolic syndrome both in the age-sex-adjusted and multivariable linear regression analyses. In the age-sex-adjusted logistic regression analyses, increased levels of all CIMs were associated with increased prevalence of dyslipidemia (OR: 1.4-2.2), hypertension (OR: 1.3-3.1), diabetes mellitus (OR: 1.5-3.4), obesity (1.4-4.6), and the metabolic syndrome (OR: 1.4-2.8). However, neutrophils and thrombocytes were not significant when it came to hypertension and diabetes mellitus, respectively (Table 1). DISCUSSION & CONCLUSION In this study we examined the association between different CIMs and a wide variety of metabolic changes. To our knowledge it is the first comprehensive epidemiological study linking the phenotypical presentation of MPNs in a general population of more than 20.000 individuals with a broad spectrum of metabolic disturbances. With chronic inflammation being proposed as a trigger and consequence of both MPNs and metabolic syndrome and considering the results in the present study it is intriguing to postulate chronic inflammation as the common denominator in both metabolic syndrome leading to MPNs and MPNs leading to metabolic syndrome(Figure 1). It is of great clinical interest to investigate if an increased risk of metabolic syndrome exists in e.g. a cohort of MPN patients and whether people with incident metabolic syndrome have increased risk of MPNs and second cancer. An increased prevalence of a wide variety of metabolic disturbances following increased CIMs could potentially, if similar results are found in the MPN population, support a future change in the MPN-risk stratification. Amongst the tested CIMs only thrombocytes (> 1500 Mia/L) are currently used as a risk factor. In conclusion, elevated levels of CIMs were associated with an increased prevalence of metabolic disturbances. Our results substantiate the need for similar studies in MPN patients, being characterized by chronic inflammation and elevated cell counts. Disclosures Hasselbalch: Novartis: Research Funding.

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Hemochromatosis mutations in the general population: iron overload progression rate

Blood ◽

10.1182/blood-2003-10-3564 ◽

2004 ◽

Vol 103 (8) ◽

pp. 2914-2919 ◽

Cited By ~ 123

Author(s):

Rolf Værn Andersen ◽

Anne Tybjærg-Hansen ◽

Merete Appleyard ◽

Henrik Birgens ◽

Børge Grønne Nordestgaard

Keyword(s):

General Population ◽

Iron Overload ◽

Hereditary Hemochromatosis ◽

Transferrin Saturation ◽

Progression Rate ◽

Male And Female ◽

Heart Study ◽

C282y Homozygosity ◽

Copenhagen City Heart Study

Abstract The progression rate of iron overload in hereditary hemochromatosis in individuals in the general population is unknown. We therefore examined in the general population iron overload progression rate in C282Y homozygotes. Using a cohort study of the Danish general population, The Copenhagen City Heart Study, we genotyped 9174 individuals. The 23 C282Y homozygotes identified were matched to 2 subjects each of 5 other HFE genotypes with respect to sex, age, and alcohol consumption. As a function of biologic age, transferrin saturation increased from 50% to 70% from 25 to 85 years of age and from 70% to 80% from 35 to 80 years of age in female and male C282Y homozygotes, respectively. Equivalently, ferritin levels increased from 100 to 500 μg/L and decreased from 800 to 400 μg/L in female and male C282Y homozygotes. As a function of 25 years follow-up irrespective of age, transferrin saturation and ferritin levels increased slightly in male and female C282Y homozygotes. None of the C282Y homozygotes developed clinically overt hemochromatosis. In conclusion, individuals in the general population with C282Y homozygosity at most demonstrate modest increases in transferrin saturation and ferritin levels, and clinically overt hemochromatosis is rare. Therefore, C282Y homozygotes identified during population screening, and not because of clinically overt hemochromatosis, at most need to be screened for manifestations of hemochromatosis every 10 to 20 years. (Blood. 2004;103: 2914-2919)

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Increased Rheumatoid Factor and Deep Venous Thrombosis: 2 Cohort Studies of 54628 Individuals from the General Population

Clinical Chemistry ◽

10.1373/clinchem.2014.233296 ◽

2015 ◽

Vol 61 (2) ◽

pp. 349-359 ◽

Cited By ~ 8

Author(s):

Christine L Meyer-Olesen ◽

Sune F Nielsen ◽

Børge G Nordestgaard

Keyword(s):

General Population ◽

Rheumatic Disease ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Rheumatoid Factor ◽

General Population Study ◽

Autoimmune Rheumatic Disease ◽

Hazard Ratios ◽

Increased Risk

Abstract BACKGROUND The risk of deep venous thrombosis is increased in patients with rheumatoid arthritis. We tested the hypothesis that increased concentrations of rheumatoid factor are associated with increased risk of deep venous thrombosis in individuals without autoimmune rheumatic disease in the general population. METHODS We included 54628 participants from the Copenhagen City Heart Study (1981–83) and the Copenhagen General Population Study (2004–12), all with a measured concentration of IgM rheumatoid factor and without autoimmune rheumatic disease or venous thromboembolism. The main outcome was incident deep venous thrombosis. There were no losses to follow-up. RESULTS During 368381 person-years, 670 individuals developed deep venous thrombosis. A rheumatoid factor concentration ≥ vs <110 IU/mL showed the strongest association with deep venous thrombosis, with multivariable adjusted hazard ratios of 9.0 (95% CI 3.1–26) for 1-year follow-up, 4.3 (2.2–8.5) for 5-year follow-up, and 3.1 (1.7–5.6) for up to 32 years of follow-up. Compared with rheumatoid factor concentrations <15 IU/mL, the multivariable adjusted hazard ratios for deep venous thrombosis during maximum follow-up were 1.3 (1.0–1.5) for 15–29 IU/mL, 1.7 (1.0–2.8) for 30–59 IU/mL, 2.4 (1.3–4.3) for 60–119 IU/mL, and 3.0 (1.6–5.6) for ≥120 IU/mL (trend P = 6 × 10−7). Results were similar in the 2 studies separately. Obese men and women age >60 years with rheumatoid factor concentrations ≥120 IU/mL had 10% and 8% 5-year risk of deep venous thrombosis. CONCLUSIONS Increased rheumatoid factor in the general population was associated with up to 3-fold increased long-term risk and up to 9-fold increased 1-year risk of deep venous thrombosis.

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Increased Baseline C-Reactive Protein Concentrations Are Associated with Increased Risk of Infections: Results from 2 Large Danish Population Cohorts

Clinical Chemistry ◽

10.1373/clinchem.2015.249680 ◽

2016 ◽

Vol 62 (2) ◽

pp. 335-342 ◽

Cited By ~ 7

Author(s):

Jeppe Zacho ◽

Thomas Benfield ◽

Anne Tybjærg-Hansen ◽

Børge G Nordestgaard

Keyword(s):

Infectious Disease ◽

General Population ◽

Population Study ◽

C Reactive Protein ◽

Cross Sectional ◽

General Population Study ◽

Gram Negative ◽

Reactive Protein ◽

Increased Risk ◽

General Population Cohort

AbstractBACKGROUNDThe acute-phase reactant C-reactive protein (CRP) increases rapidly during an infection. We tested the hypothesis that chronic low-level increases in CRP are associated with an increased risk of infectious disease.METHODSWe studied 9660 individuals from a prospective general population cohort, including 3592 in whom infectious disease developed, and another 60 896 individuals from a cross-sectional general population study, of whom 13 332 developed infectious disease; 55% were women, and the mean age was 57 years. Hospital diagnoses of infections in 1977–2010 were based on International Classification of Diseases–coded discharge records from the national Danish Patient Registry. We measured CRP concentrations and conducted genotyping for 4 CRP polymorphisms that increase CRP. Individuals with CRP >10 mg/L were excluded because of possible ongoing infection at the time of testing.RESULTSIndividuals with CRP >3 mg/L had 1.2 and 1.7 times increased risk of infectious disease, in the prospective general population cohort and the cross-sectional general population study, respectively, compared with individuals with CRP <1 mg/L. In the combined populations, individuals in the highest CRP tertile (compared with the lowest) had an increased risk of bacterial diseases (hazard ratio 1.7, 95% CI 1.6–1.8), but not viral, mycosis, and parasitic diseases. The increased risk was mainly carried by pneumonia, sepsis, and particularly gram-negative infections. None of the genotype combinations examined conferred an increased risk of infectious disease.CONCLUSIONSChronic low-level CRP increases were associated with increased risk of bacterial infections, gram-negative infections in particular. Genotypes associated with increases in CRP were not associated with increased risk of infection.

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Low high-density lipoprotein and increased risk of several cancers: 2 population-based cohort studies including 116,728 individuals

Journal of Hematology & Oncology ◽

10.1186/s13045-020-00963-6 ◽

2020 ◽

Vol 13 (1) ◽

Cited By ~ 1

Author(s):

Kasper Mønsted Pedersen ◽

Yunus Çolak ◽

Stig Egil Bojesen ◽

Børge Grønne Nordestgaard

Keyword(s):

General Population ◽

Population Study ◽

Density Lipoprotein ◽

Hdl Cholesterol ◽

Apolipoprotein A1 ◽

General Population Study ◽

Heart Study ◽

Increased Risk ◽

Low Hdl ◽

Copenhagen City Heart Study

Abstract Background Increasing evidence suggests that high-density lipoprotein (HDL) may play a role in cancer development. We tested the hypothesis that low HDL levels are associated with increased risk of cancer. Methods Individuals from two population-based cohorts, the Copenhagen General Population Study (2003–2015, N = 107 341), and the Copenhagen City Heart Study (1991–1994, N = 9387) were followed prospectively until end of 2016 to assess low plasma HDL cholesterol and apolipoprotein A1 as risk factors for cancer using Cox proportional hazard regression. Results During up to 25 years follow-up, we observed 8748 cancers in the Copenhagen General Population Study and 2164 in the Copenhagen City Heart Study. In the Copenhagen General Population Study and compared to individuals with HDL cholesterol ≥ 2.0 mmol/L (≥ 77 mg/dL), multivariable adjusted hazard ratios (HRs) for any cancer were 1.13 (95% confidence interval 1.04–1.22) for individuals with HDL cholesterol of 1.5–1.99 mmol/L (58–77 mg/dL), 1.18 (1.08–1.30) for HDL cholesterol of 1.0–1.49 mmol/L (39–58 mg/dL), and 1.29 (1.12–1.48) for individuals with HDL cholesterol < 1.0 mmol/L (< 39 mg/dL). Correspondingly, compared to individuals with apolipoprotein A1 ≥ 190 mg/dL, HRs for any cancer were 1.06 (0.96–1.17) for individuals with apolipoprotein A1 of 160–189 mg/dL, 1.18 (1.07–1.30) for apolipoprotein A1 of 130–159 mg/dL, and 1.28 (1.13–1.46) for individuals with apolipoprotein A1 < 130 mg/dL. Among 27 cancer types, low HDL cholesterol and/or apolipoprotein A1 were associated with increased risk of multiple myeloma, myeloproliferative neoplasm, non-Hodgkin lymphoma, breast cancer, lung cancer, and nervous system cancer. Results were overall similar in women and men separately, and in the Copenhagen City Heart Study. Conclusions Low HDL levels were associated with increased risk of several cancers. Increased risk was most pronounced for hematological and nervous system cancer, and to a minor extent for breast and respiratory cancer.

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Occupational lifting and risk of hypertension, stratified by use of anti-hypertensives, physical activity and age - a prospective cohort study

10.21203/rs.3.rs-61037/v1 ◽

2020 ◽

Author(s):

Mette Korshøj ◽

Harald Hannerz ◽

Ruth Frikke-Schmidt ◽

Jacob Louis Marott ◽

Peter Schnohr ◽

...

Keyword(s):

Physical Activity ◽

General Population ◽

Population Study ◽

Cardiovascular Health ◽

Leisure Time Physical Activity ◽

Cross Sectional ◽

General Population Study ◽

Logistic Regression Models ◽

Prospective Association

Abstract Background Prevalence of hypertension varies across occupations, maybe due to differences in exposure to occupational lifting. This study investigated associations between occupational lifting and hypertension, stratified by use of anti-hypertensives, leisure time physical activity (LTPA), occupational physical activity (OPA) and age.Methods Data from the Copenhagen General Population Study were included. The Copenhagen General Population Study was approved by the local ethical committee (H-KF-01-144/01), and all participation were conducted in accordance with the declaration of Helsinki. Multivariable logistic regression models, adjusted for sex, age, BMI, smoking, school education, mental stress and baseline blood pressure (BP), were applied to estimate: the (i) cross-sectional association (n=67,363) between occupational lifting and hypertension (using anti-hypertensives or BP ≥140/≥90 mmHg), (ii) prospective association (n=7,020) between occupational lifting and risk of an above median change in systolic BP (baseline to follow-up) and/or a shift from no use to use of anti-hypertensives, among the included population and stratified by use of anti-hypertensives, LTPA, OPA and age.Results Cross-sectionally, heavy occupational lifting lowered hypertension risk. Mean baseline BP, showed that the higher the level of LTPA the lower mean BP across all levels of OPA were, but only among those not using anti-hypertensives. The prospective analysis showed occupational lifting to increase the risk of hypertension, among workers aged ≥ 50 years, or reporting light to moderate LTPA. Conclusions This study finds positive associations between occupational lifting and risk for hypertension among workers aged ≥ 50 years. Further research on the association between occupational lifting and precursors of cardiovascular disease are needed before recommendations for occupational lifting and cardiovascular health can be established.

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