Lung metastases at the initial diagnosis of high-grade osteosarcoma: prevalence, risk factors and prognostic factors. A large population-based cohort study

Abstract Background: Although diabetes, low body mass index (BMI) and high blood lipid are established risk factors for active tuberculosis, the joint effect of diabetes, BMI and blood lipid is unclear. Methods: We conducted a population-based census in eastern China including 40,311 individuals. We investigated risk factors for incident tuberculosis by excluding tuberculosis at baseline and linking all participants to the Infectious Disease Reporting Management System and Tuberculosis Management Information System of Nanjing City. Follow-up for incident tuberculosis occurred ten years. We matched participants using unique health identity card numbers, name, age, birthdate, and address. We constructed Cox Proportional hazard models adjusting for age, sex, smoking, alcohol use.Results: After ten years follow-up, 143 individuals progressed to tuberculosis. In participants with BMI>24 kg/m2, diagnosed diabetics with fasting blood-glucose (FBG)≥7.0mmol/L showed nearly three-fold increased risk of active TB (HR=3.78, 95%CI: 1.32-10.79, P=0.007), and FBG ≥7.0mmol/L was associated with more than three-fold higher risk of active TB(HR=3.16, 95%CI:1.37-7.28, P=0.007). Among high blood lipid levels, undiagnosed diabetics was related to increase the high risk of TB (HR=3.04, 95%CI: 1.03-8.95, P=0.044) and FBG ≥7.0mmol/L increased nearly two-fold higher risk of TB (HR=2.66, 95%CI: 1.13-6.30, P=0.026). In the linear dose-response analysis, the hazard of TB increased with FBG (with a 1-unit (1-mmol/L) increase in FBG, the hazard of TB increased by 15% (95% CI, 3%–29%). Discussion: In this large population-based cohort study in a medium tuberculosis burden region, we found that diabetes increases the hazard of tuberculosis disease and diabetics with poor glycemic control aggravated this relationship especially in individuals with high level of blood lipid.

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Childhood food insecurity and incident asthma: A population-based cohort study of children in Ontario, Canada

PLoS ONE ◽

10.1371/journal.pone.0252301 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0252301

Author(s):

Kristin K. Clemens ◽

Britney Le ◽

Alexandra M. Ouédraogo ◽

Constance Mackenzie ◽

Marlee Vinegar ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Food Security ◽

Food Insecurity ◽

Large Population ◽

Population Based ◽

Household Food Security ◽

Asthma Diagnosis ◽

Increased Risk ◽

Incident Asthma

Background Childhood food insecurity has been associated with prevalent asthma in cross-sectional studies. Little is known about the relationship between food insecurity and incident asthma. Methods We used administrative databases linked with the Canadian Community Health Survey, to conduct a retrospective cohort study of children <18 years in Ontario, Canada. Children without a previous diagnosis of asthma who had a household response to the Household Food Security Survey Module (HFSSM) were followed until March 31, 2018 for new asthma diagnoses using a validated administrative coding algorithm. We used multivariable Cox proportional hazard models to examine the association between food insecurity and incident asthma, and adjusted models sequentially for clinical and clinical/socioeconomic risk factors. As additional analyses, we examined associations by HFSSM respondent type, severity of food insecurity, and age of asthma diagnosis. Moreover, we assessed for interaction between food security and child’s sex, household smoking status, and maternal asthma on the risk of incident asthma. Results Among the 27,746 included children, 5.1% lived in food insecure households. Over a median of 8.34 years, the incidence of asthma was 7.33/1000 person-years (PY) among food insecure children and 5.91/1000 PY among food secure children (unadjusted hazard ratio [HR] 1.24, 95% CI 1.00 to 1.54, p = 0.051). In adjusted analyses associations were similar (HR 1.16, 95% CI 0.91 to 1.47, p = 0.24 adjusted for clinical risk factors, HR 1.24, 95% CI 0.97 to 1.60, p = 0.09 adjusted for clinical/socioeconomic factors). Associations did not qualitatively change by HFSSM respondent type, severity of food insecurity, and age of asthma diagnosis. There was no evidence of interaction in our models. Conclusions Food insecure children have numerous medical and social challenges. However, in this large population-based study, we did not observe that childhood food insecurity was associated with an increased risk of incident asthma when adjusted for important clinical and socioeconomic confounders.

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