Individual testosterone decline and future mortality risk in men

Objective Male aging is characterized by a decline in testosterone (TS) levels with a substantial variability between subjects. However, it is unclear whether differences in age-related changes in TS are associated with general health. We investigated associations between mortality and intra-individual changes in serum levels of total TS, SHBG, free TS and LH during a ten-year period with up to 18 years of registry follow-up. Design 1167 men aged 30–60 years participating in the Danish Monitoring Trends and Determinants of Cardiovascular Disease (MONICA1) study and who had a follow-up examination ten years later (MONICA10) were included. From MONICA10, the men were followed up to 18 years (mean: 15.2 years) based on the information from national mortality registries via their unique personal ID numbers. Methods Cox proportional hazard models were used to investigate the association between intra-individual hormone changes and all-cause, CVD and cancer mortalities. Results A total of 421 men (36.1%) died during the follow-up period. Men with most pronounced decline in total TS (<10th percentile) had a higher all-cause mortality risk compared to men within the 10th to 90th percentile (hazard ratio (HR): 1.60; 95% confidence interval (CI): 1.08–2.36). No consistent associations were seen in cause-specific mortality analyses. Conclusion Our study showed that higher mortality rates were seen among the men who had the most pronounced age-related decline in TS, independent of their baseline TS levels.

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

Circulation ◽

10.1161/circ.143.suppl_1.p153 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

William Boyer ◽

Madison Brenton ◽

Allison Milano

Keyword(s):

Mortality Risk ◽

Mexican American ◽

Statistical Significance ◽

Significant Risk ◽

Proportional Hazard ◽

Cox Proportional Hazard ◽

All Cause Mortality ◽

Cox Proportional Hazard Models ◽

Physician Diagnosis ◽

Hispanic White

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

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

Journal of Diabetes Research ◽

10.1155/2017/8368513 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7

Author(s):

Yang Sun ◽

Anxin Wang ◽

Xiaoxue Liu ◽

Zhaoping Su ◽

Junjuan Li ◽

...

Keyword(s):

Cohort Study ◽

Prospective Cohort Study ◽

Mortality Risk ◽

Prospective Cohort ◽

Cox Proportional Hazard ◽

Baseline Mortality ◽

All Cause Mortality ◽

Cox Proportional Hazard Models ◽

Study Participants

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

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

Journal of Epidemiology & Community Health ◽

10.1136/jech-2020-214423 ◽

2020 ◽

pp. jech-2020-214423

Author(s):

Meg E Fluharty ◽

Rebecca Hardy ◽

George Ploubidis ◽

Benedetta Pongiglione ◽

David Bann

Keyword(s):

Social Class ◽

Mortality Risk ◽

Adult Life ◽

Premature Mortality ◽

Housing Tenure ◽

Proportional Hazard ◽

Birth Cohorts ◽

Cox Proportional Hazard ◽

All Cause Mortality ◽

Cox Proportional Hazard Models

IntroductionDisadvantaged socioeconomic position (SEP) in early and adult life has been repeatedly associated with premature mortality. However, it is unclear whether these inequalities differ across time, nor if they are consistent across different SEP indicators.MethodsBritish birth cohorts born in 1946, 1958 and 1970 were used, and multiple SEP indicators in early and adult life were examined. Deaths were identified via national statistics or notifications. Cox proportional hazard models were used to estimate associations between ridit scored SEP indicators and all-cause mortality risk—from 26 to 43 years (n=40 784), 26 to 58 years (n=35 431) and 26 to 70 years (n=5353).ResultsMore disadvantaged SEP was associated with higher mortality risk—magnitudes of association were similar across cohort and each SEP indicator. For example, HRs (95% CI) from 26 to 43 years comparing lowest to highest paternal social class were 2.74 (1.02 to 7.32) in 1946c, 1.66 (1.03 to 2.69) in 1958c, and 1.94 (1.20 to 3.15) in 1970c. Paternal social class, adult social class and housing tenure were each independently associated with mortality risk.ConclusionsSocioeconomic circumstances in early and adult life show persisting associations with premature mortality from 1971 to 2016, reaffirming the need to address socioeconomic factors across life to reduce inequalities in survival to older age.

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Plasma Lutein, a Nutritional Biomarker for Development of Advanced Age-Related Macular Degeneration: The Alienor Study

Nutrients ◽

10.3390/nu13062047 ◽

2021 ◽

Vol 13 (6) ◽

pp. 2047

Author(s):

Bénédicte M. J. Merle ◽

Audrey Cougnard-Grégoire ◽

Jean-François Korobelnik ◽

Wolfgang Schalch ◽

Stéphane Etheve ◽

...

Keyword(s):

Macular Degeneration ◽

High Performance ◽

Population Based ◽

Age Related Macular Degeneration ◽

Cox Proportional Hazard ◽

Age Related ◽

Cox Proportional Hazard Models ◽

Adjusted Model ◽

Reduced Risk

Lutein and zeaxanthin may lower the risk of age-related macular degeneration (AMD). We evaluated the associations of plasma lutein and zeaxanthin with the incidence of advanced AMD in the Alienor study (Antioxydants Lipides Essentiels Nutrition et Maladies Oculaires). Alienor study is a prospective population-based cohort of 963 residents of Bordeaux, France, who were 73 years or older at baseline (2006–2008). The present study included 609 participants with complete ophthalmologic and plasma carotenoids data. Examinations were performed every two years over an eight-year period (2006 to 2017). Plasma lutein and zeaxanthin were determined at baseline from fasting blood samples using high-performance liquid chromatography. Cox proportional hazard models were used to assess associations between plasma lutein, zeaxanthin, and their (total cholesterol (TC) + triglycerides (TG)) ratios with AMD. Among the 609 included participants, 54 developed advanced incident AMD during a median follow-up time of 7.6 years (range 0.7 to 10.4). Participants with higher plasma lutein had a reduced risk for incident advanced AMD in the fully adjusted model (HR = 0.63 per 1-SD increase (95% CI, 0.41–0.97), p = 0.03). A similar association was observed using the lutein/(TC + TG) ratio (HR = 0.59 (95% CI, 0.39–0.90), p = 0.01). No associations were evidenced for other carotenoids. Higher plasma lutein was associated with a 37% reduced risk of incident advanced AMD.

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Potato consumption and risk of pancreatic cancer in the HELGA cohort

British Journal Of Nutrition ◽

10.1017/s0007114518000788 ◽

2018 ◽

Vol 119 (12) ◽

pp. 1408-1415

Author(s):

Lene A. Åsli ◽

Tonje Braaten ◽

Anja Olsen ◽

Anne Tjønneland ◽

Kim Overvad ◽

...

Keyword(s):

Pancreatic Cancer ◽

Cancer Registries ◽

Glycaemic Index ◽

Proportional Hazard ◽

Cox Proportional Hazard ◽

Cox Proportional Hazard Models ◽

The Mean ◽

Potato Consumption ◽

Adjusted Model

AbstractPotatoes have been a staple food in many countries throughout the years. Potatoes have a high glycaemic index (GI) score, and high GI has been associated with several chronic diseases and cancers. Still, the research on potatoes and health is scarce and contradictive, and we identified no prospective studies that had investigated the association between potatoes as a single food and the risk of pancreatic cancer. The aim of this study was to prospectively investigate the association between potato consumption and pancreatic cancer among 114 240 men and women in the prospective HELGA cohort, using Cox proportional hazard models. Information on diet (validated FFQ’s), lifestyle and health was collected by means of a questionnaire, and 221 pancreatic cancer cases were identified through cancer registries. The mean follow-up time was 11·4 (95 % CI 0·3, 16·9) years. High consumption of potatoes showed a non-significantly higher risk of pancreatic cancer in the adjusted model (hazard ratio (HR) 1·44; 95 % CI 0·93, 2·22,Pfor trend0·030) when comparing the highestv.the lowest quartile of potato consumption. In the sex-specific analyses, significant associations were found for females (HR 2·00; 95 % CI 1·07, 3·72,Pfor trend0·020), but not for males (HR 1·01; 95 % CI 0·56, 1·84,Pfor trend0·34). In addition, we explored the associations by spline regression, and the absence of dose–response effects was confirmed. In this study, high potato consumption was not consistently associated with a higher risk of pancreatic cancer. Further studies with larger populations are needed to explore the possible sex difference.

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

Scientific Reports ◽

10.1038/s41598-020-72765-2 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Hirokazu Honda ◽

Miho Kimachi ◽

Noriaki Kurita ◽

Nobuhiko Joki ◽

Masaomi Nangaku

Keyword(s):

Mean Corpuscular Volume ◽

Japanese Patients ◽

Cubic Spline ◽

Hazard Models ◽

Proportional Hazard ◽

Corpuscular Volume ◽

Proportional Hazard Models ◽

Cox Proportional Hazard ◽

All Cause Mortality ◽

Cox Proportional Hazard Models

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

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Farming tasks and the development of rheumatoid arthritis in the agricultural health study

Occupational and Environmental Medicine ◽

10.1136/oemed-2018-105361 ◽

2019 ◽

pp. oemed-2018-105361 ◽

Cited By ~ 4

Author(s):

Christine G Parks ◽

Armando Meyer ◽

Laura E Beane Freeman ◽

Jonathan Hofmann ◽

Dale P Sandler

Keyword(s):

Rheumatoid Arthritis ◽

Self Report ◽

Health Study ◽

Proportional Hazard ◽

Agricultural Health ◽

Cox Proportional Hazard ◽

Hazard Ratios ◽

Cox Proportional Hazard Models ◽

Agricultural Health Study

ObjectivesFarming has been associated with rheumatoid arthritis (RA). Some studies have evaluated the effects of pesticides, but other agricultural exposures may also affect immune response.MethodsWe investigated non-pesticide agricultural exposures in relation to RA in licensed pesticide applicators (n=27 175, mostly male farmers) and their spouses (n=22 231) in the Agricultural Health Study (AHS) cohort (1993–1997) who completed at least one follow-up survey through 2015. Incident RA cases (n=229 applicators and 249 spouses) were identified based on self-report confirmed by use of disease-modifying antirheumatic drugs or medical records. Hazard Ratios (HRs) and 95% Confidence Intervals (CIs) were estimated by Cox proportional hazard models adjusting for applicator status, state, smoking, education and specific pesticide use, allowing estimates to vary by median age when hazards assumptions were not met.ResultsOverall, RA was associated with regularly applying chemical fertilisers (HR=1.50; 95% CI 1.11 to 2.02), using non-gasoline solvents (HR=1.40; 95% CI 1.09 to 1.80), and painting (HR=1.26; 95% CI 1.00 to 1.59). In older applicators (>62 years), RA was associated with driving combines (HR=2.46; 95% CI 1.05 to 5.78) and milking cows (HR=2.56; 95% CI 1.01 to 6.53). In younger participants (≤62 years), RA was inversely associated with raising animals as well as crops (HR=0.68; 95% CI 0.51 to 0.89 vs crops only). Associations with specific crops varied by age: some (eg, hay) were inversely associated with RA in younger participants, while others (eg, alfalfa) were associated with RA in older participants.ConclusionThese findings suggest several agricultural tasks and exposures may contribute to development of RA.

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Second-Hand Smoke As a Predictor of Smoking Cessation Among Lung Cancer Survivors

Journal of Clinical Oncology ◽

10.1200/jco.2013.50.9695 ◽

2014 ◽

Vol 32 (6) ◽

pp. 564-570 ◽

Cited By ~ 44

Author(s):

Lawson Eng ◽

Jie Su ◽

Xin Qiu ◽

Prakruthi R. Palepu ◽

Henrique Hon ◽

...

Keyword(s):

Lung Cancer ◽

Smoking Cessation ◽

Cancer Survivors ◽

Second Hand Smoke ◽

Proportional Hazard ◽

Cox Proportional Hazard ◽

Cox Proportional Hazard Models ◽

Peer Smoking ◽

After Cancer

Purpose Second-hand smoke (SHS; ie, exposure to smoking of friends and spouses in the household) reduces the likelihood of smoking cessation in noncancer populations. We assessed whether SHS is associated with cessation rates in lung cancer survivors. Patients and Methods Patients with lung cancer were recruited from Princess Margaret Cancer Centre, Toronto, ON, Canada. Multivariable logistic regression and Cox proportional hazard models evaluated the association of sociodemographics, clinicopathologic variables, and SHS with either smoking cessation or time to quitting. Results In all, 721 patients completed baseline and follow-up questionnaires with a mean follow-up time of 54 months. Of the 242 current smokers at diagnosis, 136 (56%) had quit 1 year after diagnosis. Exposure to smoking at home (adjusted odds ratio [aOR], 6.18; 95% CI, 2.83 to 13.5; P < .001), spousal smoking (aOR, 6.01; 95% CI, 2.63 to 13.8; P < .001), and peer smoking (aOR, 2.49; 95% CI, 1.33 to 4.66; P = .0043) were each associated with decreased rates of cessation. Individuals exposed to smoking in all three settings had the lowest chances of quitting (aOR, 9.57; 95% CI, 2.50 to 36.64; P < .001). Results were similar in time-to-quitting analysis, in which 68% of patients who eventually quit did so within 6 months after cancer diagnosis. Subgroup analysis revealed similar associations across early- and late-stage patients and between sexes. Conclusion SHS is an important factor associated with smoking cessation in lung cancer survivors of all stages and should be a key consideration when developing smoking cessation programs for patients with lung cancer.

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Prognosis of hemodialysis patients with progressive aortic stenosis: a prospective cohort study

Renal Replacement Therapy ◽

10.1186/s41100-021-00367-3 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Yoriko Horiguchi ◽

Kaoru Uemura ◽

Naoyoshi Aoyama ◽

Shinichi Nakajima ◽

Tomoki Asai ◽

...

Keyword(s):

Aortic Stenosis ◽

Cardiac Death ◽

Hazard Analysis ◽

Hemodialysis Patients ◽

Proportional Hazard ◽

Cardiac Events ◽

Cox Proportional Hazard ◽

Kaplan Meier ◽

All Cause Mortality

Abstract Background Whether progressive mild to moderate aortic stenosis in hemodialysis patients influences their prognosis has not been elucidated. This prospective cohort study explored whether progressive aortic stenosis predicted the rate of cardiac events and mortality in those patients. Methods A total of 283 consecutive hemodialysis patients (no aortic stenosis, 248; progressive aortic stenosis, 35) underwent echocardiography for assessment of aortic stenosis, with a median follow-up period of 4.1 years. Study endpoints were cardiac events, all-cause mortality, and cardiac death. Kaplan–Meier analysis and multivariate Cox proportional hazard analysis were performed to estimate cardiac events, all-cause mortality, and cardiac death. Results Cumulative cardiac event rate, all-cause mortality rate, and the rate of cardiac death at 3-year follow-up were 44.9%, 40.5%, and 26.4% in patients with progressive aortic stenosis and 22.1%, 19.0%, and 7.5% in those without aortic stenosis, respectively. Kaplan–Meier analysis demonstrated the cumulative rates of cardiac events and all-cause mortality. And cardiac death was significantly higher in patients with progressive aortic stenosis than in those without aortic stenosis. Multivariate Cox proportional hazard analysis revealed that progressive aortic stenosis was predictive of cardiac events (adjusted hazard ratio 2.47; 95% confidence interval 1.38–4.39) and cardiac death (adjusted hazard ratio 4.21; 95% confidence interval 2.10–8.46). Age, physical activity, C-reactive protein, and serum albumin levels—but not progressive aortic stenosis—predicted all-cause mortality. Conclusions The rates of cardiac events and cardiac death were higher in hemodialysis patients with progressive aortic stenosis than in those without aortic stenosis. Furthermore, progressive aortic stenosis predicted cardiac events and cardiac death. Compared with those without aortic stenosis, patients with progressive aortic stenosis had higher all-cause mortality, which was related to their comorbidities. Trial registration This study was retrospectively registered with University Hospital Medical Information Network Clinical Trials Registry (registration number, UMIN 000024023) at September 12th, 2016.

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

10.1101/2020.04.09.20059410 ◽

2020 ◽

Author(s):

Meg E Fluharty ◽

Rebecca Hardy ◽

George B. Ploubidis ◽

Benedetta Pongiglione ◽

David Bann

Keyword(s):

Social Class ◽

Mortality Risk ◽

Adult Life ◽

Premature Mortality ◽

Housing Tenure ◽

Proportional Hazard ◽

Birth Cohorts ◽

Proportional Hazard Models ◽

Cox Proportional Hazard ◽

Cox Proportional Hazard Models

AbstractIntroductionDisadvantaged socioeconomic position (SEP) in early and adult life has been repeatedly associated with premature mortality. However, it is unclear whether these inequalities differ across time, nor if they are consistent across different SEP indicators.MethodsBritish birth cohorts born in 1946, 1958 and 1970 were used, and multiple SEP indicators in early and adult life were examined. Deaths were identified via national statistics or notifications. Cox proportional hazard models were used to estimate associations between SEP indicators and mortality risk—from 26-43 (n=40,784), 26-58 (n=35,431), and 26-70 years (n=5,353).ResultsMore disadvantaged SEP was associated with higher mortality risk—magnitudes of association were similar across cohort and each SEP indicator. For example, hazards ratios (95% CI) between 26-43 years comparing lowest to highest father’s social class were 2.74 (1.02—7.32) in 1946c, 1.66 (1.03—2.69) in 1958c, and 1.94 (1.20—3.15) in 1970c. Childhood social class, adult social class, and housing tenure were each independently associated with mortality risk.ConclusionsSocioeconomic circumstances in early and adult life appear to have had persisting associations with premature mortality from 1971—2016. This reaffirms the need to address socioeconomic factors across life to reduce inequalities in survival to older age.

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