scholarly journals Incident gout and weight change patterns: a retrospective cohort study of US adults

2020 ◽  
Author(s):  
Lu Bai ◽  
JIANBO ZHOU ◽  
Yujia Wang ◽  
Marly Augusto Cardoso
Keyword(s):  
Weight Change ◽  
Retrospective Cohort ◽  
Population Attributable Fraction ◽  
Adult Life ◽  
Elevated Risk ◽  
Attributable Fraction ◽  
Health And Nutrition ◽  
Hazard Ratios ◽  
Using Data

Abstract OBJECTIVE To investigated the association between weight change patterns across adulthood and incident gout. METHODS Using data from the National Health and Nutrition Examination Survey (NHANES), we categorized individuals into four weight-change groups based on their recalled weight during young adulthood and midlife. Hazard ratios (HR) and 95% CI relating weight change patterns to incident gout over 10-year follow-up were calculated. The hypothetical population attributable fraction (PAF) for the weight change patterns was calculated. RESULTS Among our sample of adults who were 40–74 years old at their midlife weight measure (n = 11079), 320 developed to gout. Compared with participants who remained stable non-obese during adulthood, the highest risks were found for gaining weight (HR 1.65; 1.19–2.29) participants. And stable obese pattern had a marginal significance of the elevated risk of incident gout conditions (HR 1.84; 0.98–2.78). No significant associations were found between losing weight change patterns and the risk of gout during the study period. If participants who gained weight had become non-obese during the 10-year follow-up, an estimated 3.2%(95% CI: 0-6.3) of observed gout cases could have been averted. Also, if the population had maintained a normal BMI, 32.9%(95% CI: 18.2–44.9) of cases could have been prevented during the ten years. CONCLUSIONS Gaining weight over adulthood was associated with increased risks of gout. These findings highlight that maintaining non-obese weight and weight loss across adulthood is essential for the prevention and treatment of gout in adult life.

scholarly journals Incident gout and weight change patterns: a retrospective cohort study of US adults

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Lu Bai ◽  
Jian-Bo Zhou ◽  
Tao Zhou ◽  
Roger B. Newson ◽  
Marly Augusto Cardoso
Keyword(s):  
Weight Change ◽  
Population Attributable Fraction ◽  
Adult Life ◽  
Significant Risk ◽  
Later Life ◽  
Significant Risk Factor ◽  
Weight Changes ◽  
Cox Models ◽  
Increased Risk

Abstract Background Although the relationship between obesity and incident gout has been clarified, the influence of weight changes during the transition from early adulthood to midlife and the different weight change patterns in specific age ranges on the incidence of gout in later life remain unknown. Therefore, we aimed to investigate the association between weight change patterns across adulthood and incident gout. Methods Using data from the National Health and Nutrition Examination Survey (NHANES), we categorized individuals into four weight change patterns: those who remained obese (stable obese), those who moved from a non-obese body mass index (BMI) to an obese BMI (gaining), those who moved from an obese BMI to a non-obese BMI (losing), and those who remained non-obese (stable non-obese). Incident gout reflected its occurrence over the 10-year follow-up from the recalled midlife weight measure to the time of this survey. Hazard ratios (HRs) and 95% confidence intervals relating weight change patterns to incident gout over the 10-year follow-up period were calculated using Cox models adjusted for covariates. The hypothetical population attributable fraction (PAF) for the weight change patterns was calculated. Results Among our sample of adults aged 40–74 years at their midlife weight measure (n = 11,079), 320 developed gout. The highest risk of incident gout was found for participants with the stable obese pattern (HR 1.84; 1.08–3.14) and not for participants who remained stable non-obese during adulthood. Moreover, gaining weight was a significant risk factor for incident gout (HR 1.65; 1.19–2.29). No significant associations were found between losing weight change patterns and the risk of gout during the study period. If participants who gained weight had become non-obese during the 10-year follow-up, an estimated 3.2% (95% CI 0–6.3) of observed gout cases could have been averted. In addition, if the population had maintained a normal BMI, 32.9% (95% CI 18.2–44.9) cases could have been prevented during the 10 years. Conclusions Gaining weight over adulthood was associated with an increased risk of gout. These findings have highlighted that maintaining non-obese weight and weight loss across adulthood is essential for the prevention and treatment of gout in adult life.

scholarly journals P0779THE POPULATION ATTRIBUTABLE FRACTION OF HYPERURICEMIA FOR ALL-CAUSE AND CARDIOVASCULAR MORTALITY: A NATIONWIDE COMMUNITY-BASED STUDY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Tomomi Tanaka ◽  
Tomomi Tanaka ◽  
Masahiro Miyata ◽  
Kazunobu Ichikawa ◽  
Tsuneo Konta ◽  
...  
Keyword(s):  
Cardiovascular Mortality ◽  
Large Scale ◽  
Hazard Analysis ◽  
Population Attributable Fraction ◽  
Attributable Fraction ◽  
Proportional Hazard ◽  
Community Based ◽  
Cox Proportional Hazard ◽  
Hazard Ratios

Abstract Background and Aims Hyperuricemia is often observed in subjects with chronic kidney disease and is associated with all-cause and cardiovascular mortality. In this study, we evaluated the effect size of hyperuricemia for all-cause and cardiovascular mortality in a community-based population, using the index of population attributable fraction (PAF). Method This large-scale cohort study used the nationwide database of 500,511 health check-up participants (215,728 men, 284,783 women, average age 62 years) and calculated the PAF of hyperuricemia (serum uric acid >7 mg/dL) for all-cause and cardiovascular deaths during the 7-year follow-up period. Results The frequency of hyperuricemia at baseline was 9.7% in total subjects (men: 22.0%; women: 2.6%). During the follow-up period, 5,578 deaths (1.1%) were noted (men: 3,749 [1.7%], women: 1,829 [0.6%]), including 1,104 cardiovascular deaths (0.2%) (men: 762 [0.4%], women: 342 [0.1%]). In the Cox proportional hazard analysis adjusted for confounding factors including age, gender, body mass index, smoking, alcohol consumption, hypertension, diabetes, dyslipidemia and eGFR, hyperuricemia was an independent risk factor for all-cause and cardiovascular mortality, (adjusted hazard ratios [95% confidence interval]; 1.39 [1.27-1.53] for all-cause mortality, and 1.76 [1.47-2.11] for cardiovascular mortality). The adjusted PAF of hyperuricemia for all-cause and cardiovascular deaths were 3.1% and 4.7% (approximately 1 in 32 all-cause deaths, and 1 in 21 cardiovascular deaths), respectively. In subgroup analyses, the association between hyperuricemia and death was stronger in men and smokers. The adjusted PAF for all-cause and cardiovascular deaths was 5.5% and 8.6% (approximately 1 in 18 all-cause deaths, 1 in 12 cardiovascular deaths) in men, and 6.2% and 8.2% (approximately 1 in 16 all-cause deaths, 1 in 12 cardiovascular deaths) in smokers, respectively. Conclusion This study showed that a substantial number of all-cause and cardiovascular deaths, was statistically attributed to hyperuricemia in the community-based population, especially men and smokers.

scholarly journals Incident gout and weight change patterns: a retrospective cohort study of US adults

2021 ◽  
Author(s):  
Lu Bai ◽  
JIANBO ZHOU ◽  
Tao Zhou ◽  
Roger B Newson ◽  
Marly Augusto Cardoso
Keyword(s):  
Weight Change ◽  
Population Attributable Fraction ◽  
Adult Life ◽  
Significant Risk ◽  
Later Life ◽  
Significant Risk Factor ◽  
Weight Changes ◽  
Cox Models ◽  
Increased Risk

Abstract BackgroundAlthough the relationship between obesity and incident gout has been clarified, the influence of weight changes during the transition from early adulthood to midlife and the different weight change patterns in specific age ranges on the incidence of gout in later life remain unknown. Therefore, we aimed to investigate the association between weight change patterns across adulthood and incident gout. MethodsUsing data from the National Health and Nutrition Examination Survey (NHANES), we categorized individuals into four weight change patterns: those who remained obese (stable obese), those who moved from a non-obese body mass index (BMI) to an obese BMI (gaining), those who moved from an obese BMI to a non-obese BMI (losing), and those who remained non-obese (stable non-obese). Incident gout reflected its occurrence over the 10-year follow-up from the recalled midlife weight measure to the time of this survey. Hazard ratios (HRs) and 95% confidence intervals relating weight change patterns to incident gout over the 10-year follow-up period were calculated using Cox models adjusted for covariates. The hypothetical population attributable fraction (PAF) for the weight change patterns was calculated.ResultsAmong our sample of adults aged 40–74 years at their midlife weight measure (n=11079), 320 developed gout. The highest risk of incident gout was found for participants with the stable obese pattern (HR 1.84; 1.08–3.14) and not for participants who remained stable non-obese during adulthood. Moreover, gaining weight was a significant risk factor for incident gout (HR 1.65; 1.19–2.29). No significant associations were found between losing weight change patterns and the risk of gout during the study period. If participants who gained weight had become non-obese during the 10-year follow-up, an estimated 3.2% (95% CI: 0–6.3) of observed gout cases could have been averted. In addition, if the population had maintained a normal BMI, 32.9% (95% CI: 18.2–44.9) cases could have been prevented during the 10 years.ConclusionsGaining weight over adulthood was associated with an increased risk of gout. These findings have highlighted that maintaining non-obese weight and weight loss across adulthood is essential for the prevention and treatment of gout in adult life.

Association between selenium intake, diabetes, and mortality in adults: findings from National Health and Nutrition Examination Survey (NHANES) 2003-2014

2021 ◽  
pp. 1-24
Author(s):  
Bushra Hoque ◽  
Zumin Shi
Keyword(s):  
National Health ◽  
Cox Regression ◽  
Inverse Association ◽  
Nutrition Examination Survey ◽  
Health And Nutrition ◽  
Hazard Ratios ◽  
The Us ◽  
All Cause Mortality ◽  
Cvd Mortality

Abstract Selenium (Se) is a trace mineral that has antioxidant and anti-inflammatory properties. This study aimed to investigate the association between Se intake, diabetes, all-cause and cause-specific mortality in a representative sample of US adults. Data from 18,932 adults who attended the 2003-2014 National Health and Nutrition Examination Survey (NHANES) were analysed. Information on mortality was obtained from the US mortality registry updated to 2015. Multivariable logistic regression and Cox regression were used. Cross-sectionally, Se intake was positively associated with diabetes. Comparing extreme quartiles of Se intake, the odds ratio (OR) for diabetes was 1.44 (95% CI: 1.09–1.89). During a mean of 6.6 years follow-up, there were 1627 death (312 CVD, 386 cancer). High intake of Se was associated with a lower risk of all-cause mortality. When comparing the highest with the lowest quartiles of Se intake, the hazard ratios (HRs) for all-cause, CVD mortality, cancer mortality and other mortality were: 0.77 (95% CI 0.59-1.01), 0.62 (95% CI, 0.35-1.13), 1.42 (95% CI, 0.78-2.58) and 0.60 (95% CI,0.40-0.80), respectively. The inverse association between Se intake and all-cause mortality was only found among white participants. In conclusion, Se intake was positively associated with diabetes but inversely associated with all-cause mortality. There was no interaction between Se intake and diabetes in relation to all-cause mortality.

Abstract P668: Clinically Meaningful Weight Gain Before Menopause and Risk of Stroke

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Maria D Zambrano Espinoza ◽  
Emma Kersey ◽  
Amelia K Boehme ◽  
Joshua Willey ◽  
Eliza C Miller
Keyword(s):  
Weight Gain ◽  
Weight Change ◽  
Stroke Risk ◽  
Cox Regression ◽  
Reference Group ◽  
Weight Changes ◽  
Younger Women ◽  
Hazard Ratios ◽  
History Of ◽  
Using Data

Background: Obesity is an independent risk factor for stroke. Weight gain has been associated with a higher risk of cardiovascular diseases in postmenopausal women. It is unclear, however, if weight changes before menopause have similar effects. We hypothesized that clinically meaningful premenopausal weight gain, defined as Body Mass Index (BMI) change >5%, would be associated with a higher stroke risk later in life. Methods: Using data from the California Teachers Study, we identified women aged < 55 with no history of stroke. We used weight changes between 1995-2006 as proxy for premenopausal weight gain. We defined weight change as modest or moderate using BMI changes of 5-10% and >10% respectively. Stroke outcomes were obtained from linkage to California hospitalization records. We used Cox regression models to calculate hazard ratios with 95% confidence intervals for the association of weight change and future stroke, adjusting for vascular risk factors. Results: Of 17,295 women included in the study, 113 had a stroke. In comparison to women who maintained a stable weight, women with moderate weight gain during premenopausal years had 2.0 times the risk of stroke. In the adjusted analysis, women with moderate weight gain had 89.6% higher risk of stroke, compared to the reference group. We found no significant association with stroke in women who had modest weight changes. Conclusion: Moderate premenopausal weight gain significantly increased stroke risk in women. Younger women should be educated about the effects of weight gain on future brain health. Count: 1836/1950

scholarly journals Cardiovascular Health and Stroke in Older British Men

Stroke ◽  
2020 ◽  
Vol 51 (11) ◽  
pp. 3286-3294
Author(s):  
Ayesha Ahmed ◽  
Snehal M. Pinto Pereira ◽  
Lucy Lennon ◽  
Olia Papacosta ◽  
Peter Whincup ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Cardiovascular Health ◽  
Population Attributable Fraction ◽  
Cox Models ◽  
Population Attributable Fractions ◽  
Hazard Ratios ◽  
Attributable Fractions ◽  
Time Point

Background and Purpose: Research exploring the utility of cardiovascular health (CVH) and its Life’s Simple 7 (LS7) components (body mass index, blood pressure [BP], glucose, cholesterol, physical activity, smoking, and diet) for prevention of stroke in older adults is limited. In the British Regional Heart Study, we explored (1) prospective associations of LS7 metrics and composite CVH scores with, and their impact on, stroke in middle and older age; and (2) if change in CVH was associated with subsequent stroke. Methods: Men without cardiovascular disease were followed from baseline recruitment (1978–1980), and again from re-examination 20 years later, for stroke over a median period of 20 years and 16 years, respectively. LS7 were measured at each time point except baseline diet. Cox models estimated hazard ratios (95% CI) of stroke for (1) ideal and intermediate versus poor levels of LS7; (2) composite CVH scores; and (3) 4 CVH trajectory groups (low-low, low-high, high-low, high-high) derived by dichotomising CVH scores from each time point across the median value. Population attributable fractions measured impact of LS7. Results: At baseline (n=7274, mean age 50 years), healthier levels of BP, physical activity, and smoking were associated with reduced stroke risk. At 20-year follow-up (n=3798, mean age 69 years) only BP displayed an association. Hazard ratios for intermediate and ideal (versus poor) levels of BP 0.65 (0.52–0.81) and 0.40 (0.24–0.65) at baseline; and 0.84 (0.67–1.05) and 0.57 (0.36–0.90) at 20-year follow-up. With reference to low-low trajectory, the low-high trajectory was associated with 40% reduced risk, hazard ratio 0.60 (0.44–0.83). Associations of CVH scores weakened, and population attributable fractions of LS7 reduced, from middle to old age; population attributable fraction of nonideal BP from 53% to 39%. Conclusions: Except for BP, CVH is weakly associated with stroke at older ages. Prevention strategies for older adults should prioritize BP control but also enhance focus beyond traditional risk factors.

scholarly journals Differential mortality rates in major and subthreshold depression: meta-analysis of studies that measured both

2013 ◽  
Vol 202 (1) ◽  
pp. 22-27 ◽  
Author(s):  
Pirn Cuijpers ◽  
Nicole Vogelzangs ◽  
Jos Twisk ◽  
Annet Kleiboer ◽  
Juan Li ◽  
...  
Keyword(s):  
Major Depression ◽  
Excess Mortality ◽  
Meta Analysis ◽  
Population Attributable Fraction ◽  
Attributable Fraction ◽  
Differential Mortality ◽  
Bibliographic Databases ◽  
Subthreshold Depression ◽  
The Difference

BackgroundAlthough the association between depression and excess mortality has been well established, it is not clear whether this is greater in major depression than in subthreshold depression.AimsTo compare excess mortality in major depression with that in subthreshold depression.MethodWe searched bibliographic databases and included prospective studies in which both major and subthreshold depression were examined at baseline and mortality was measured at follow-up.ResultsA total of 22 studies were included. People with major depression had a somewhat increased chance of dying earlier than people with subthreshold depression but this difference was not significant, although there was a trend (relative risk 1.13, 95% CI 0.98-1.30, P=0.1). The population attributable fraction was 7% for major depression and an additional 7% for subthreshold depression.ConclusionsAlthough excess mortality may be somewhat higher in major than in subthreshold depression, the difference is small and the overall impact on excess mortality is comparable.

scholarly journals Effect of Bariatric Surgery on Survival and Hospitalizations in Patients with Severe Obesity. A Retrospective Cohort Study

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3150
Author(s):  
Enrica Migliore ◽  
Amelia Brunani ◽  
Giovannino Ciccone ◽  
Eva Pagano ◽  
Simone Arolfo ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Proportional Hazards ◽  
Severe Obesity ◽  
Hospital Admissions ◽  
Cox Proportional Hazards ◽  
Hazard Ratios

Bariatric surgery (BS) confers a survival benefit in specific subsets of patients with severe obesity; otherwise, effects on hospital admissions are still uncertain. We assessed the long-term effect on mortality and on hospitalization of BS in patients with severe obesity. This was a retrospective cohort study, including all patients residing in Piedmont (age 18–60 years, BMI ≥ 40 kg/m2) admitted during 2002–2018 to the Istituto Auxologico Italiano. Adjusted hazard ratios (HR) for BS were estimated for mortality and hospitalization, considering surgery as a time-varying variable. Out of 2285 patients, 331 (14.5%) underwent BS; 64.4% received sleeve gastrectomy (SG), 18.7% Roux-en-Y gastric bypass (RYGB), and 16.9% adjustable gastric banding (AGB). After 10-year follow-up, 10 (3%) and 233 (12%) patients from BS and non-BS groups died, respectively (HR = 0.52; 95% CI 0.27–0.98, by a multivariable Cox proportional-hazards regression model). In patients undergoing SG or RYGB, the hospitalization probability decreased significantly in the after-BS group (HR = 0.77; 0.68–0.88 and HR = 0.78; 0.63–0.98, respectively) compared to non-BS group. When comparing hospitalization risk in the BS group only, a marked reduction after surgery was found for all BS types. In conclusion, BS significantly reduced the risk of all-cause mortality and hospitalization after 10-year follow-up.

scholarly journals The Population-Attributable Fraction for Premature Mortality Due to Cardiovascular Disease Associated With Stage 1 and 2 Hypertension Among Japanese

2020 ◽  
Author(s):  
Yu Hatano ◽  
Yuichiro Yano ◽  
Shouichi Fujimoto ◽  
Yuji Sato ◽  
Kunitoshi Iseki ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Population Attributable Fraction ◽  
Heart Association ◽  
Premature Mortality ◽  
Attributable Fraction ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Stage 1 ◽  
Cvd Mortality

Abstract BACKGROUND Our aim was to assess how the population-attributable fraction (PAF) for premature mortality due to cardiovascular disease (CVD) associated with hypertension changes if blood pressure (BP) thresholds for hypertension were lowered from systolic/diastolic BP ≥140/90 mm Hg to ≥130/80 mm Hg, as defined using the 2017 American College of Cardiology/American Heart Association blood pressure guideline. METHODS Analyses were conducted using a database of participants who underwent a national health checkup examination started in 2008 in Japan (n = 510,238; mean age, 59.6 ± 8.1 years; 42% men). Each participant was categorized as having normal or elevated BP, or stage 1 or 2 hypertension according to the guideline. Data on premature mortality due to CVD occurring before age 70 years were available through March 2015. RESULTS Over a median follow-up of 3.4 years, 739 deaths from CVD occurred. After multivariable adjustment, hazard ratios for premature CVD mortality for elevated BP, stage 1 hypertension, and stage 2 hypertension vs. normal BP were 1.02 (95% confidence interval, 0.72, 1.44), 1.33 (1.02, 1.75), and 2.41 (1.90, 3.05), respectively. The PAF associated with stage 1 and 2 hypertension was 4.4% and 39.4%, respectively. CONCLUSIONS In the current nationwide study of Japanese adults, stage 1 and 2 hypertension were associated with an increased risk for premature CVD mortality. The PAF for premature CVD mortality associated with hypertension increased by 4.4% if BP thresholds for hypertension were lowered from systolic/diastolic BP ≥140/90 to ≥130/80 mm Hg.

Weight Change from Early to Middle Adulthood and Incident Asthma Later in Life: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Tao Wang ◽  
Yunping Zhou ◽  
Nan Kong ◽  
Jianzhong Zhang ◽  
Guo Cheng ◽  
...  
Keyword(s):  
Cohort Study ◽  
Weight Gain ◽  
Weight Change ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Early Adulthood ◽  
Adult Onset ◽  
Middle Adulthood ◽  
Hazard Ratios ◽  
Incident Asthma

Abstract Background: Data describing the effects of weight change across adulthood on asthma are important for the prevention of asthma. This study aimed to investigate the association between weight change from early to middle adulthood and risk of incident asthma.Methods: Using data from the National Health and Nutrition Examination Survey (NHANES), we performed a nationally retrospective cohort study of the U.S. general population. A total of 20 771 people aged 40-74 years with recalled weight at young and middle adulthood were included in the cohort. Hazard ratios relating weight change to incident asthma over 10 years of follow-up were calculated using Cox models adjusting for covariates.Results: Compared with participants with stable non-obesity between young and middle adulthood, the hazard ratios of incident asthma were 1.63 (95% confidence interval 1.29 to 2.07) for weight gain (non-obesity to obesity), 1.41 (0.97 to 2.05) for stable obesity, and 1.21 (0.41 to 3.62) for weight loss (obesity to non-obesity). In addition, participants who gained more than 20 kg had a hazard ratio of 1.53 (1.15 to 2.03), compared with those whose weight had remained stable. When stratified by sex, the association between weight gain and incident asthma was seen only in females. Population attributable fraction calculations estimated that 10.2% of adult-onset asthma could be averted, if all those who were non-obesity at early adulthood could prevent weight gain by midlife. Conclusion: The findings implied that maintaining normal weight across adulthood, especially preventing weight gain in early adulthood, was important for preventing adult-onset asthma.

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