Association of Urinary Prostaglandin E2 Metabolite and Mortality among Adults

Abstract Background Prostaglandins play a critical role in inflammatory response. It has become widely accepted that chronic inflammation is a driving force behind many chronic diseases, such as cancers and cardiovascular diseases, the major causes of death in the world today. The studies on the association between biomarkers of inflammation and mortality are limited. Methods To investigate the association of urinary PGE-M, a stable end-product of prostaglandin E2 (PGE2) with overall and cause-specific mortality and examine potential effect modifiers, we obtained urinary PGE-M levels of 2,927 non-cancerous adults from our previous case-control studies nested in the Shanghai Women’s Health Study and Shanghai Men’s Health Study, two cohort studies conducted in Shanghai, China. We collected mortality data and modifiable factors associated with urinary PGE-M were obtained from the parent cohort studies. Results Using linear regression models, we found that high urinary PGE-M levels were significantly associated with low education, heaving smoking, old age at urine collection, and abdominal obesity. Using Cox proportional hazards models, we found that increase (per standard deviation) of urinary PGE-M levels were significantly associated with overall mortality (adjusted hazard ratio = 1.19, 95% confidence interval: 1.07, 1.33) and particularly deaths from cardiometabolic diseases (adjusted hazard ratio = 1.27, 95% confidence interval: 1.11, 1.44). The increased death risks persisted across different time intervals during the follow-up and were stronger among participants who were younger than 60 (P = 0.0014 for all- cause mortality and P = 0.007 for deaths from cardiometabolic diseases) at urine collection or perhaps among those who had higher education. Conclusions High urinary PGE-M levels were associated with a significantly increased risk of all causes of death and particularly deaths from cardiometabolic diseases. Improving lifestyles, e.g., stopping smoking and controlling body weight, would help decrease mortality through decreasing over-production of PGE2.

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Cognitive stimulation in the workplace, plasma proteins, and risk of dementia: three analyses of population cohort studies

BMJ ◽

10.1136/bmj.n1804 ◽

2021 ◽

pp. n1804

Author(s):

Mika Kivimäki ◽

Keenan A Walker ◽

Jaana Pentti ◽

Solja T Nyberg ◽

Nina Mars ◽

...

Keyword(s):

Confidence Interval ◽

Cohort Studies ◽

Hazard Ratio ◽

Cognitive Stimulation ◽

Adjusted Hazard Ratio ◽

Job Exposure Matrix ◽

People With Dementia ◽

Dementia Risk ◽

Stimulation Group

AbstractObjectivesTo examine the association between cognitively stimulating work and subsequent risk of dementia and to identify protein pathways for this association.DesignMulticohort study with three sets of analyses.SettingUnited Kingdom, Europe, and the United States.ParticipantsThree associations were examined: cognitive stimulation and dementia risk in 107 896 participants from seven population based prospective cohort studies from the IPD-Work consortium (individual participant data meta-analysis in working populations); cognitive stimulation and proteins in a random sample of 2261 participants from one cohort study; and proteins and dementia risk in 13 656 participants from two cohort studies.Main outcome measuresCognitive stimulation was measured at baseline using standard questionnaire instruments on active versus passive jobs and at baseline and over time using a job exposure matrix indicator. 4953 proteins in plasma samples were scanned. Follow-up of incident dementia varied between 13.7 to 30.1 years depending on the cohort. People with dementia were identified through linked electronic health records and repeated clinical examinations.ResultsDuring 1.8 million person years at risk, 1143 people with dementia were recorded. The risk of dementia was found to be lower for participants with high compared with low cognitive stimulation at work (crude incidence of dementia per 10 000 person years 4.8 in the high stimulation group and 7.3 in the low stimulation group, age and sex adjusted hazard ratio 0.77, 95% confidence interval 0.65 to 0.92, heterogeneity in cohort specific estimates I2=0%, P=0.99). This association was robust to additional adjustment for education, risk factors for dementia in adulthood (smoking, heavy alcohol consumption, physical inactivity, job strain, obesity, hypertension, and prevalent diabetes at baseline), and cardiometabolic diseases (diabetes, coronary heart disease, stroke) before dementia diagnosis (fully adjusted hazard ratio 0.82, 95% confidence interval 0.68 to 0.98). The risk of dementia was also observed during the first 10 years of follow-up (hazard ratio 0.60, 95% confidence interval 0.37 to 0.95) and from year 10 onwards (0.79, 0.66 to 0.95) and replicated using a repeated job exposure matrix indicator of cognitive stimulation (hazard ratio per 1 standard deviation increase 0.77, 95% confidence interval 0.69 to 0.86). In analysis controlling for multiple testing, higher cognitive stimulation at work was associated with lower levels of proteins that inhibit central nervous system axonogenesis and synaptogenesis: slit homologue 2 (SLIT2, fully adjusted β −0.34, P<0.001), carbohydrate sulfotransferase 12 (CHSTC, fully adjusted β −0.33, P<0.001), and peptidyl-glycine α-amidating monooxygenase (AMD, fully adjusted β −0.32, P<0.001). These proteins were associated with increased dementia risk, with the fully adjusted hazard ratio per 1 SD being 1.16 (95% confidence interval 1.05 to 1.28) for SLIT2, 1.13 (1.00 to 1.27) for CHSTC, and 1.04 (0.97 to 1.13) for AMD.ConclusionsThe risk of dementia in old age was found to be lower in people with cognitively stimulating jobs than in those with non-stimulating jobs. The findings that cognitive stimulation is associated with lower levels of plasma proteins that potentially inhibit axonogenesis and synaptogenesis and increase the risk of dementia might provide clues to underlying biological mechanisms.

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Abstract WP347: Clopidogrel Plus Aspirin in Patients With Different Types of Single Small Subcortical Infarction_Subgroup Analysis of CHANCE Trial

Stroke ◽

10.1161/str.47.suppl_1.wp347 ◽

2016 ◽

Vol 47 (suppl_1) ◽

Author(s):

Yilong Wang ◽

Xiaomeng Yang ◽

Jing Jing ◽

Xingquan Zhao ◽

Liping Liu ◽

...

Keyword(s):

Confidence Interval ◽

Recurrent Stroke ◽

Final Analysis ◽

Hazard Ratio ◽

Adjusted Hazard Ratio ◽

Parent Artery ◽

Bleeding Events ◽

Intention To Treat ◽

Different Types ◽

Aspirin Group

Objective: We aim to investigate the effects and safety of clopidogrel plus aspirin in patients with different types of single small subcortical infarction(SSSI) in the Clopidogrel in High-risk patients with Acute Non-disabling Cerebrovascular Events (CHANCE) trial. Methods: In this subgroup analysis, SSSI was defined as single DWI lesion of ≤2.0 cm and SSSI with stenosis of any degree of the parent artery was regarded as a SSSI+PAD. We assessed the interaction of the treatment effects of clopidogrel plus aspirin versus aspirin alone among patients with and without PAD. Efficacy was assessed by intention to treat analysis and safety was assessed in the on-treatment population. Results: A total of 338 patients with SSSI were included in the final analysis,105 with SSSI+PAD and 233 SSSI-PAD. In SSSI+PAD patients, 10.9% (5/46) had recurrent stroke in the clopidogrel-aspirin group as compared to 13.6% (8/59) in the aspirin group (adjusted hazard ratio, 0.66; 95% confidence interval, 0.20-2.20; P=0.50). In SSSI-PAD patients, 8.9% (11/124) had recurrent stroke in the clopidogrel-aspirin group as compared 7.3% (8/109) in the aspirin group (adjusted hazard ratio, 1.64; 95% confidence interval, 0.61- 4.38; P=0.32). The number of bleeding events was similar between the clopidogrel-aspirin group and aspirin group regardless of SSSI+PAD or SSSI-PAD. Conclusions: Although dual antiplatelet therapy did not significantly reduce the risk of recurrent stroke than aspirin alone in patients with SSSI. It was potentially beneficial to the patients with SSSI+PAD. Dual antiplatelet treatment did not increase the risk of bleeding in patients with any kind of SSSI.

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Maternal and child gluten intake and risk of type 1 diabetes: The Norwegian Mother and Child Cohort Study

10.1101/19001883 ◽

2019 ◽

Author(s):

Nicolai A Lund-Blix ◽

German Tapia ◽

Karl Mårild ◽

Anne Lise Brantsaeter ◽

Pål R Njølstad ◽

...

Keyword(s):

Type 1 Diabetes ◽

Cohort Study ◽

Confidence Interval ◽

Population Based ◽

Hazard Ratio ◽

Adjusted Hazard Ratio ◽

Pregnancy Cohort ◽

Increased Risk ◽

Mother And Child

ABSTRACTOBJECTIVETo examine the association between maternal and child gluten intake and risk of type 1 diabetes in children.DESIGNPregnancy cohortSETTINGPopulation-based, nation-wide study in NorwayPARTICIPANTS86,306 children in The Norwegian Mother and Child Cohort Study born from 1999 through 2009, followed to April 15, 2018.MAIN OUTCOME MEASURESClinical type 1 diabetes, ascertained in a nation-wide childhood diabetes registry. Hazard ratios were estimated using Cox regression for the exposures maternal gluten intake up to week 22 of pregnancy and child’s gluten intake when the child was 18 months old.RESULTSDuring a mean follow-up of 12.3 years (range 0.7-16.0), 346 children (0.4%) developed type 1 diabetes (incidence rate 32.6 per 100,000 person-years). The average gluten intake was 13.6 grams/day for mothers during pregnancy, and 8.8 grams/day for the child at 18 months of age. Maternal gluten intake in mid-pregnancy was not associated with the development of type 1 diabetes in the child (adjusted hazard ratio 1.02 (95% confidence interval 0.73 to 1.43) per 10 grams/day increase in gluten intake). However, the child’s gluten intake at 18 months of age was associated with an increased risk of later developing type 1 diabetes (adjusted hazard ratio 1.46 (95% confidence interval 1.06 to 2.01) per 10 grams/day increase in gluten intake).CONCLUSIONSThis study suggests that the child’s gluten intake at 18 months of age, and not the maternal intake during pregnancy, could increase the risk of type 1 diabetes in the child.WHAT IS ALREADY KNOWN ON THIS TOPICA national prospective cohort study from Denmark found that a high maternal gluten intake during pregnancy could increase the risk of type 1 diabetes in the offspring (adjusted hazard ratio 1.31 (95% confidence interval 1.001 to 1.72) per 10 grams/day increase in gluten intake). No studies have investigated the relation between the amount of gluten intake by both the mother during pregnancy and the child in early life and risk of developing type 1 diabetes in childhood.WHAT THIS STUDY ADDSIn this prospective population-based pregnancy cohort with 86,306 children of whom 346 developed type 1 diabetes we found that the child’s gluten intake at 18 months of age was associated with the risk of type 1 diabetes (adjusted hazard ratio 1.46 (95% confidence interval 1.06 to 2.01) per 10 grams/day increase in gluten intake). This study suggests that the child’s gluten intake at 18 months of age, and not the maternal intake during pregnancy, could increase the child’s risk of type 1 diabetes.

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Association between maternal gluten intake and type 1 diabetes in offspring: national prospective cohort study in Denmark

BMJ ◽

10.1136/bmj.k3547 ◽

2018 ◽

pp. k3547 ◽

Cited By ~ 14

Author(s):

Julie C Antvorskov ◽

Thorhallur I Halldorsson ◽

Knud Josefsen ◽

Jannet Svensson ◽

Charlotta Granström ◽

...

Keyword(s):

Type 1 Diabetes ◽

Cohort Study ◽

Confidence Interval ◽

Prospective Cohort Study ◽

Food Frequency Questionnaire ◽

Prospective Cohort ◽

Hazard Ratio ◽

Adjusted Hazard Ratio ◽

Food Frequency

Abstract Objective To examine the association between prenatal gluten exposure and offspring risk of type 1 diabetes in humans. Design National prospective cohort study. Setting National health information registries in Denmark. Participants Pregnant Danish women enrolled into the Danish National Birth Cohort, between January 1996 and October 2002, Main outcome measures Maternal gluten intake, based on maternal consumption of gluten containing foods, was reported in a 360 item food frequency questionnaire at week 25 of pregnancy. Information on type 1 diabetes occurrence in the participants’ children, from 1 January 1996 to 31 May 2016, were obtained through registry linkage to the Danish Registry of Childhood and Adolescent Diabetes. Results The study comprised 101 042 pregnancies in 91 745 women, of whom 70 188 filled out the food frequency questionnaire. After correcting for multiple pregnancies, pregnancies ending in abortions, stillbirths, lack of information regarding the pregnancy, and pregnancies with implausibly high or low energy intake, 67 565 pregnancies (63 529 women) were included. The average gluten intake was 13.0 g/day, ranging from less than 7 g/day to more than 20 g/day. The incidence of type 1 diabetes among children in the cohort was 0.37% (n=247) with a mean follow-up period of 15.6 years (standard deviation 1.4). Risk of type 1 diabetes in offspring increased proportionally with maternal gluten intake during pregnancy (adjusted hazard ratio 1.31 (95% confidence interval 1.001 to 1.72) per 10 g/day increase of gluten). Women with the highest gluten intake versus those with the lowest gluten intake (≥20 v <7 g/day) had double the risk of type 1 diabetes development in their offspring (adjusted hazard ratio 2.00 (95% confidence interval 1.02 to 4.00)). Conclusions High gluten intake by mothers during pregnancy could increase the risk of their children developing type 1 diabetes. However, confirmation of these findings are warranted, preferably in an intervention setting.

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Abstract WP167: Effects of Selective Serotonin Reuptake Inhibitors versus Tricyclic Antidepressants on Cerebrovascular Events

Stroke ◽

10.1161/str.44.suppl_1.awp167 ◽

2013 ◽

Vol 44 (suppl_1) ◽

Author(s):

Jou Wei Lin ◽

Chia-Hsuin Chang ◽

Chin-Hsien Lin

Keyword(s):

Confidence Interval ◽

Serotonin Reuptake ◽

Selective Serotonin Reuptake Inhibitors ◽

Tricyclic Antidepressants ◽

Hazard Ratio ◽

Serotonin Reuptake Inhibitors ◽

Adjusted Hazard Ratio ◽

Selective Serotonin ◽

Cerebrovascular Events ◽

Reduced Risk

Background: The objective of this study was to examine the effects of selective serotonin reuptake inhibitors (SSRIs) versus tricyclic antidepressants (TCAs) on cerebrovascular events in patients with depression or anxiety. Methods: We performed a retrospective cohort study in a nationwide population. The patients who started to take SSRIs and TCAs with a diagnosis of depression or anxiety between January 1, 2001 and December 31, 2009 were identified from the Taiwan National Health Insurance claims database. We examined the association between the two types of antidepressants and incidence of stroke using a proportional hazard model adjusted for risk factors for stroke. Results: Among of the 24,662 SSRI and 14,736 TCA initiators, the crude incidence rate for stroke was 10.03 and 13.77 per 100 person-years respectively. SSRI use was associated with a significantly reduced risk as compared with TCAs with the adjusted hazard ratio of 0.67 (95% confidence interval 0.47 to 0.96) in a dose-dependent manner. No significant effect modification was found among subgroups, such as hypertension, diabetes, previous cardiovascular and cerebrovascular diseases. The adjusted hazard ratio was 1.09 (95% confidence interval 0.65 to 1.85) for those aged more than 65 years, suggesting only a potential trend for a higher risk of stroke with SSRIs in the geriatric group. Conclusions: As compared with TCAs, the use of SSRIs was associated with a reduced risk for cerebrovascular events in a clear dose-response manner. Further researches are needed to examine the potential risk and benefit of SSRI use for patients with high risk of stroke.

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Determinants of hospitalizations for pneumonia among Finnish drug users

SAGE Open Medicine ◽

10.1177/2050312118784311 ◽

2018 ◽

Vol 6 ◽

pp. 205031211878431 ◽

Cited By ~ 3

Author(s):

Olubunmi O Olubamwo ◽

Ifeoma N Onyeka ◽

Alex Aregbesola ◽

Kimmo Ronkainen ◽

Jari Tiihonen ◽

...

Keyword(s):

Drug Use ◽

Confidence Interval ◽

Drug Users ◽

Cox Regression ◽

Hazard Ratio ◽

Adjusted Hazard Ratio ◽

Intravenous Drug ◽

Intravenous Drug Use ◽

Cox Models ◽

Clinical Consultation

Objective: The study examined the determinants of being hospitalized for pneumonia in a large cohort of drug users. Methods: Information of 4817 clients seeking treatment for illicit drug use was linked with the Finnish hospital discharge register to identify those who were hospitalized with main/primary diagnoses of pneumonia during 1997–2013. Cox regression models were used to examine the association between age, gender, homelessness, and route of drug administration of the primary drug at initial clinical consultation and pneumonia hospitalization. Findings were presented as adjusted hazard ratios and 95% confidence intervals. Results: There were 354 persons diagnosed with pneumonia, with a total of 522 hospitalizations at the end of 2013. The univariate Cox models revealed that being over 44 years of age, male gender, homelessness, and intravenous drug use at initial clinical consultation increased the risk of being hospitalized for pneumonia. In the fully adjusted multivariate model, being over 44 years was the strongest factor independently associated with pneumonia hospitalization (adjusted hazard ratio: 2.67, 95% confidence interval: 1.56–4.57, p < 0.001), followed by homelessness (adjusted hazard ratio: 1.75, 95% confidence interval: 1.38–2.22, p < 0.001) and intravenous drug use (adjusted hazard ratio: 1.27, 95% confidence interval: 1.01–1.59, p = 0.041). Of the 354 clients hospitalized for pneumonia, 31.9% ( n = 113) were rehospitalized within 30 days of being discharged. One-third of the reasons for the 30-day rehospitalization were pneumonia-related. Conclusion: Vaccination, measures addressing housing instability, safe injecting and good hygienic practices, and treating underlying drug use problems could help to reduce morbidity for pneumonia in this cohort.

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Clinical Predictors of Preeclampsia in Pregnant Women with Chronic Kidney Disease

Medicina ◽

10.3390/medicina56050213 ◽

2020 ◽

Vol 56 (5) ◽

pp. 213

Author(s):

Bogdan Marian Sorohan ◽

Andreea Andronesi ◽

Gener Ismail ◽

Roxana Jurubita ◽

Bogdan Obrisca ◽

...

Keyword(s):

Chronic Kidney Disease ◽

High Risk ◽

Kidney Disease ◽

Confidence Interval ◽

Pregnant Women ◽

Cumulative Risk ◽

Hazard Ratio ◽

Adjusted Hazard Ratio ◽

Clinical Predictors ◽

Mean Time

Background and Objectives: Pregnant women with chronic kidney disease (CKD) are at high risk of adverse maternal and fetal outcomes. Preeclampsia (PE) superimposed on CKD is estimated to occur in 21%–79% of pregnancies. Both conditions share common features such as proteinuria and hypertension, making differential diagnosis difficult. Objective: The aim of this study was to evaluate the incidence and the clinical-biological predictors of preeclampsia in pregnant women with CKD. Material and Methods: We retrospectively analyzed 34 pregnant women with pre-existing CKD admitted to our department between 2008 and 2017. Results: Among the 34 patients, 19 (55.8%) developed PE and the mean time of occurrence was 31.26 ± 2.68 weeks of gestation. The median value of 24-h proteinuria at referral was 0.87 g/day (interquartile range 0.42–1.50) and 47.1% of patients had proteinuria of ≥1 g/day. Patients with PE tended to be more hypertensive, with a more decreased renal function at referral and had significantly higher proteinuria (1.30 vs. 0.63 g/day, p = 0.02). Cox multivariate analysis revealed that proteinuria ≥1 g/day at referral and pre-existing hypertension were independently associated with PE (adjusted hazard ratio = 4.10, 95% confidence interval: 1.52–11.02, p = 0.005, adjusted hazard ratio = 2.62, 95% confidence interval: 1.01–6.77, p = 0.04, respectively). The cumulative risk of PE was significantly higher in pregnant women with proteinuria ≥1 g/day at referral (log-rank, p = 0.003). Proteinuria ≥ 1 g/day at referral and pre-exiting hypertension predicted PE development with accuracies of 73.5% and 64.7%, respectively. Conclusions: Pregnant patients with pre-existing CKD are at high risk of developing preeclampsia, while proteinuria ≥ 1 g/day at referral and pre-existing hypertension were independent predictors of superimposed preeclampsia.

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P1731High-sensitivity troponin with sex-specific thresholds in suspected acute coronary syndrome

European Heart Journal ◽

10.1093/eurheartj/ehz748.0486 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

K K Lee ◽

A V Ferry ◽

A Anand ◽

F E Strachan ◽

A R Chapman ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Coronary Syndrome ◽

Confidence Interval ◽

Myocardial Injury ◽

Primary Outcome ◽

Hazard Ratio ◽

Adjusted Hazard Ratio ◽

Coronary Syndrome ◽

Diagnostic Thresholds ◽

The Impact

Abstract Background/Introduction Major disparities between women and men in the diagnosis, management and outcome of acute coronary syndrome are well recognised. Whether sex-specific diagnostic thresholds for myocardial infarction will address these differences is uncertain. Purpose To evaluate the impact of implementing a high-sensitivity cardiac troponin I (hs-cTnI) assay with sex-specific diagnostic thresholds for myocardial infarction in women and men with suspected acute coronary syndrome. Methods In a stepped-wedge, cluster-randomized controlled trial across ten hospitals we evaluated the implementation of a hs-cTnI assay in 48,282 (47% women) consecutive patients with suspected acute coronary syndrome. During a validation phase the hs-cTnI assay results were suppressed and a contemporary cTnI assay with a single threshold was used to guide care. Myocardial injury was defined as any hs-cTnI concentration >99th centile of 16 ng/L in women and 34 ng/L in men. The primary outcome was myocardial infarction after the initial presentation or cardiovascular death at 1 year. In this prespecified analysis, we evaluated outcomes in men and women before and after implementation of the hs-cTnI assay. Results Use of the hs-cTnI assay with sex-specific thresholds increased myocardial injury in women by 42% (from 3,521 (16%) to 4,991 (22%)) and by 6% in men (from 5,068 (20%) to 5,369 (21%)). Whilst treatment increased in both sexes, women with myocardial injury remained less likely than men to undergo coronary revascularisation (15% versus34%), or to receive dual anti-platelet (26% versus43%), statin (16% versus26%) or other preventative therapies (P<0.001 for all). The primary outcome occurred in 18% (369/2,072) and 17% (488/2,919) of women with myocardial injury during the validation and implementation phase respectively (adjusted hazard ratio 1.11, 95% confidence interval 0.92 to 1.33), compared to 18% (370/2,044) and 15% (513/3,325) of men (adjusted hazard ratio 0.85, 95% confidence interval 0.71 to 1.01). Patient management Conclusion Use of sex-specific thresholds identified five-times more additional women than men with myocardial injury, such that the proportion of women and men with myocardial injury is now similar. Despite this increase, women received approximately half the number of treatments for coronary artery disease as men and their outcomes were not improved. Acknowledgement/Funding The British Heart Foundation

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Antenatal Steroid Therapy for Fetal Lung Maturation and the Subsequent Risk of Childhood Asthma: A Longitudinal Analysis

Journal of Pregnancy ◽

10.1155/2010/789748 ◽

2010 ◽

Vol 2010 ◽

pp. 1-9 ◽

Cited By ~ 6

Author(s):

Jason D. Pole ◽

Cameron A. Mustard ◽

Teresa To ◽

Joseph Beyene ◽

Alexander C. Allen

Keyword(s):

Risk Factor ◽

Confidence Interval ◽

Steroid Therapy ◽

Independent Risk Factor ◽

Cox Proportional Hazards ◽

Hazard Ratio ◽

Adjusted Hazard Ratio ◽

Care Utilization ◽

Lung Maturation ◽

Antenatal Steroid

This study was designed to test the hypothesis that fetal exposure to corticosteroids in the antenatal period is an independent risk factor for the development of asthma in early childhood with little or no effect in later childhood. A population-based cohort study of all pregnant women who resided in Nova Scotia, Canada, and gave birth to a singleton fetus between 1989 and 1998 was undertaken. After a priori specified exclusions, 80,448 infants were available for analysis. Using linked health care utilization records, incident asthma cases developed after 36 months of age were identified. Extended Cox proportional hazards models were used to estimate hazard ratios while controlling for confounders. Exposure to corticosteroids during pregnancy was associated with a risk of asthma in childhood between 3–5 years of age: adjusted hazard ratio of 1.19 (95% confidence interval: 1.03, 1.39), with no association noted after 5 years of age: adjusted hazard ratio for 5–7 years was 1.06 (95% confidence interval: 0.86, 1.30) and for 8 or greater years was 0.74 (95% confidence interval: 0.54, 1.03). Antenatal steroid therapy appears to be an independent risk factor for the development of asthma between 3 and 5 years of age.

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Dietary Polyunsaturated Fat Intake in Relation to Head and Neck, Esophageal, and Gastric Cancer Incidence in the National Institutes of Health–AARP Diet and Health Study

American Journal of Epidemiology ◽

10.1093/aje/kwaa024 ◽

2020 ◽

Vol 189 (10) ◽

pp. 1096-1113 ◽

Cited By ~ 2

Author(s):

Shawn A Zamani ◽

Kathleen M McClain ◽

Barry I Graubard ◽

Linda M Liao ◽

Christian C Abnet ◽

...

Keyword(s):

Gastric Cancer ◽

Confidence Interval ◽

Head And Neck ◽

Proportional Hazards ◽

Epidemiologic Studies ◽

Cox Proportional Hazards ◽

Hazard Ratio ◽

National Institutes Of Health ◽

Health Study ◽

Long Chain

Abstract Recent epidemiologic studies have examined the association of fish consumption with upper gastrointestinal cancer risk, but the associations with n-3 and n-6 polyunsaturated fatty acid (PUFA) subtypes remain unclear. Using the National Institutes of Health–AARP Diet and Health Study (United States, 1995–2011), we prospectively investigated the associations of PUFA subtypes, ratios, and fish with the incidence of head and neck cancer (HNC; n = 2,453), esophageal adenocarcinoma (EA; n = 855), esophageal squamous cell carcinoma (n = 267), and gastric cancer (cardia: n = 603; noncardia: n = 631) among 468,952 participants (median follow-up, 15.5 years). A food frequency questionnaire assessed diet. Multivariable-adjusted hazard ratios were estimated using Cox proportional hazards regression. A Benjamini-Hochberg (BH) procedure was used for false-discovery control. Long-chain n-3 PUFAs were associated with a 20% decreased HNC and EA risk (for HNC, quintile5 vs. 1 hazard ratio = 0.81, 95% confidence interval: 0.71, 0.92, and BH-adjusted Ptrend = 0.001; and for EA, quintile5 vs. 1 hazard ratio = 0.79, 95% confidence interval: 0.64, 0.98, and BH-adjusted Ptrend = 0.1). Similar associations were observed for nonfried fish but only for high intake. Further, the ratio of long-chain n-3:n-6 was associated with a decreased HNC and EA risk. No consistent associations were observed for gastric cancer. Our results indicate that dietary long-chain n-3 PUFA and nonfried fish intake are associated with lower HNC and EA risk.

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