The impact of the COVID-19 pandemic on childhood vaccination rates and the role of sociodemographic factors: A cohort study

OBJECTIVE

This study examines the impact of the COVID-19 pandemic on both routine and non-routine vaccinations in infants during their initial 18 months of life, concurrently exploring the complex influence of sociodemographic factors.

METHODS

A cohort study was conducted, involving 2007 children in two distinct periods: pre-pandemic (January-June 2018) and pandemic (March 2020-May 2021). Participants were classified into two cohorts: 962 children in the 2018 group and 1045 children in the 2020-21 group. Utilizing unconditional logistic regression, the association between vaccination (complete or non-routine) and socioeconomic factors was examined, with adjustments for potential confounding variables such as age, breastfeeding, gestational age, and twins.

RESULTS

The study's analysis reveals that in the post-pandemic period, mothers were three times more likely to opt for non-routine vaccines (95% CI 2.25-4.23). However, no significant alterations were observed in routine vaccination rates. Protective factors for complete vaccination included having an employed mother, higher education, and a medium-to-high income. Conversely, a higher income was associated with a reduced likelihood of complete vaccination (OR 0.34, 95% CI 0.20-0.59).

CONCLUSION

Contrary to initial expectations, this study concludes that the COVID-19 pandemic did not have a substantial impact on childhood complete vaccination rates. Nevertheless, a noticeable increase in the choice of non-routine vaccination was observed. Sociodemographic factors, such as maternal education, income, and employment status, emerged as key influencers, particularly in the context of deciding on non-routine vaccinations.

Combined use of QRISK3 and SCORE2 increases identification of ankylosing spondylitis patients at high cardiovascular risk: Results from the CARMA Project cohort after 7.5 years of follow-up

OBJECTIVE

To establish the predictive value of the QRESEARCH risk estimator version 3 (QRISK3) algorithm in identifying Spanish patients with ankylosing spondylitis (AS) at high risk of cardiovascular (CV) events and CV mortality. We also sought to determine whether to combine QRISK3 with another CV risk algorithm: the traditional SCORE, the modified SCORE (mSCORE) EULAR 2015/2016 or the SCORE2 may increase the identification of AS patients with high-risk CV disease.

METHODS

Information of 684 patients with AS from the Spanish prospective CARdiovascular in ReuMAtology (CARMA) project who at the time of the initial visit had no history of CV events and were followed in rheumatology outpatient clinics of tertiary centers for 7.5 years was reviewed. The risk chart algorithms were retrospectively tested using baseline data.

RESULTS

After 4,907 years of follow-up, 33 AS patients had experienced CV events. Linearized rate=6.73 per 1000 person-years (95 % CI: 4.63, 9.44). The four CV risk scales were strongly correlated. QRISK3 correctly discriminated between people with lower and higher CV risk, although the percentage of accumulated events over 7.5 years was clearly lower than expected according to the risk established by QRISK3. Also, mSCORE EULAR 2015/2016 showed the same discrimination ability as SCORE, although the percentage of predicted events was clearly higher than the percentage of actual events. SCORE2 also had a strong discrimination capacity according to CV risk. Combining QRISK3 with any other scale improved the model. This was especially true for the combination of QRISK3 and SCORE2 which achieved the lowest AIC (406.70) and BIC (415.66), so this combination would be the best predictive model.

CONCLUSIONS

In patients from the Spanish CARMA project, the four algorithms tested accurately discriminated those AS patients with higher CV risk and those with lower CV risk. Moreover, a model that includes QRISK3 and SCORE2 combined the best discrimination ability of QRISK3 with the best calibration of SCORE2.

Medical grade 3D printable bioabsorbable PLDL/Mg and PLDL/Zn composites for biomedical applications

Medical grade PLDL, PLDL/Mg and PLDL/Zn filaments were manufactured by a dual extrusion method and used to prepare coupons and scaffolds with controlled porosity by fused filament fabrication. The mechanical properties, degradation mechanisms and biological performance were carefully analyzed. It was found that the presence of 4 vol.% of Mg and Zn particles did not substantially modify the mechanical properties but accelerated the degradation rate of PLDL. Moreover, the acidification of the pH due to degradation of the PLDL was reduced in the presence of metallic particles. Finally, cell adhesion and proliferation were excellent in the medical grade PLDL as well as in the polymer/metal composites. These results demonstrate the potential of bioabsorbable metal/polymer composites to tailor the mechanical properties, degradation rate and biocompatibility for specific clinical applications.

Use of risk chart algorithms for the identification of psoriatic arthritis patients at high risk for cardiovascular disease: findings derived from the project CARMA cohort after a 7.5-year follow-up period

OBJECTIVE

To assess the predictive value of four cardiovascular (CV) risk algorithms for identifying high-risk psoriatic arthritis (PsA) patients.

METHODS

Evaluation of patients with PsA enrolled in the Spanish prospective project CARdiovascular in RheuMAtology. Baseline data of 669 PsA patients with no history of CV events at the baseline visit, who were followed in rheumatology outpatient clinics at tertiary centres for 7.5 years, were retrospectively analysed to test the performance of the Systematic Coronary Risk Assessment (SCORE), the modified version (mSCORE) European Alliance of Rheumatology Associations (EULAR) 2015/2016, the SCORE2 algorithm (the updated and improved version of SCORE) and the QRESEARCH risk estimator version 3 (QRISK3).

RESULTS

Over 4790 years of follow-up, there were 34 CV events, resulting in a linearised rate of 7.10 per 1000 person-years (95% CI 4.92 to 9.92). The four CV risk scales showed strong correlations and all showed significant associations with CV events (p<0.001). SCORE, mSCORE EULAR 2015/2016 and QRISK3 effectively differentiated between low and high CV risk patients, although the cumulative rate of CV events observed over 7.5 years was lower than expected based on the frequency predicted by these risk scales. Additionally, model improvement was observed when combining QRISK3 with any other scale, particularly the combination of QRISK3 and SCORE2, which yielded the lowest Akaike information criterion (411.15) and Bayesian information criterion (420.10), making it the best predictive model.

CONCLUSIONS

Risk chart algorithms are very useful for discriminating PsA at low and high CV risk. An integrated model featuring QRISK3 and SCORE2 yielded the optimal synergy of QRISK3's discrimination ability and SCORE2's calibration accuracy.

Association Between Assisted Reproductive Technology and Cerebral Palsy: A Meta-Analysis

BACKGROUND

Since 1978 many children are born thanks to assisted reproductive technology (ART). However, the long-term effects of these therapies are still not fully known. Our objective is to evaluate the risk of cerebral palsy (CP) after ART compared with that in those spontaneously conceived (SC) and to examine this risk in single, multiple, and preterm births and the evolution of the risk over the years.

METHODS

PubMed, Embase, and Web of Science databases were searched until December 2022. Studies were included if they studied CP cases in children born through ART. 16 studies were finally selected. Quality of studies was assessed using Newcastle Ottawa Scale. Pooled OR was estimated by weighting individual OR/RR by the inverse of their variance. A random-effect model was applied. To assess the causes of heterogeneity, we performed meta-regression analyses.

RESULTS

A significantly high risk of CP was found (OR = 1.27; 95% CI 1.12 to 1.43) in children born through ART compared with those SC. This risk increased in singletons (OR = 1.48; 95% CI 1.23 to 1.79) but disappeared in multiple (OR = 1.05; 95% CI 0.93 to 1.18) and preterm births (OR = 1.09; 95% CI 0.87 to 1.37). We found a higher risk of CP in children born before the year 2000 (OR = 3.40; 95% CI 2.49 to 4.63).

CONCLUSIONS

ARTs slightly increase the risk of CP once the effect of multiple gestation is controlled. Further studies are needed to clarify whether the techniques themselves, fertility problems, or associated maternal comorbidities are responsible for this risk.

Lifetime exposure to brominated trihalomethanes in drinking water and swimming pool attendance are associated with chronic lymphocytic leukemia: a Multicase-Control Study in Spain (MCC-Spain)

BACKGROUND

Chronic lymphocytic leukemia (CLL) etiology is poorly understood, and carcinogenic chemicals in drinking and recreational water are candidates.

OBJECTIVE

To evaluate the association between drinking-water exposure to trihalomethanes (THMs) and nitrate as well as lifetime swimming pool attendance and CLL.

METHODS

During 2010-2013, hospital-based CLL cases and population-based controls were recruited in Spain, providing information on residential histories, type of water consumed and swimming pool attendance. Average THMs and nitrate levels in drinking water were linked to lifetime water consumption. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using mixed models.

RESULTS

Final samples for residential tap water analyses and swimming pool attendance analyses were 144 cases/1230 controls and 157 cases/1240 controls, respectively. Mean (SD) values for average lifetime residential brominated THMs and chloroform in tap water (μg/L), and ingested nitrate (mg/day) were 48.1 (35.6), 18.5 (6.7) and 13.7 (9.6) respectively in controls; and 72.9 (40.7), 17.9 (5.4), and 14.1 (8.8) in CLL cases. For each 10 μg/L increase of brominated THMs and chloroform lifetime-average levels, the ORs (95% CI) were 1.22 (1.14, 1.31) and 0.54 (0.34, 0.87), respectively. For each 5 mg/day increase of ingested nitrate, the OR of CLL was 0.91 (0.80, 1.04). The OR of lifetime pool users (vs. non-users) was 2.38 (1.61, 3.52). Upon performing annual frequency of attending pools analysis through categorization, the second and third categories showed an ORs of 2.36 (1.49, 3.72) and 2.40 (1.51, 3.83), respectively, and P-trend of 0.001.

IMPACT STATEMENT

This study identifies an association of long-term exposure to THMs in drinking water, at concentrations below the regulatory thresholds and WHO guidelines, and swimming pool attendance, with chronic lymphocytic leukemia (CLL). These unprecedented findings are highly relevant since CLL is an incurable cancer with still unknown etiology and because the widespread exposure to chlorination by-products that remain in drinking and recreational water worldwide. Despite the demonstrated carcinogenicity in animals of several chlorination by-products, little is known about their potential risks on human health. This study makes a significant contribution to the search for environmental factors involved in the etiology of CLL and to the evidence of the health impact of these high prevalent water contaminants.

Influence of the drying mode of support on the properties of Pd/Al2O3-ZrO2 materials used for methane combustion

This work constitutes a new trial to enhance the properties of palladium supported on alumina modified with zirconium used as catalysts for methane combustion. The effect of the support drying mode is studied. For this aim, Al2O3-ZrO2 binary oxides with zirconium loading of 2 and 5% in weight were prepared using sol-gel process then dried under ordinary or supercritical conditions. Palladium with a loading of 0.5% was deposited on the support by wet impregnation. Several techniques have been used to investigate differences between the two types of the derived catalysts.

18F-Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography Findings of Polymyalgia Rheumatica in Patients with Giant Cell Arteritis

OBJECTIVE

Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are often overlapping conditions. We studied whether 18F-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) is useful in identifying PMR in the setting of large vessel (LV) GCA.

METHODS

LV-GCA patients diagnosed by PET-CT at a tertiary care center for a population of 450,000 people over a two-year period were reviewed. Scoring was performed based on potential significant FDG uptake at up to 16 sites in nine different extravascular areas (SCORE 16). Differences in extravascular sites of significant FDG uptake were evaluated between LV-GCA with a clinical diagnosis of PMR or not.

RESULTS

Fifty-four patients were diagnosed with LV-GCA by 18F-FDG-PET-CT. Of them, 21 (38.8%) were clinically diagnosed with PMR. Significant extravascular FDG uptake was more frequently observed in those with a clinical diagnosis of PMR. In this sense, the SCORE 16 was higher in those with clinical PMR (5.10 ± 4.05 versus 1.73 ± 2.31 in those without a clinical diagnosis of PMR; p < 0.001). A SCORE 16 involving more than four sites of significant FDG uptake yielded a sensitivity of 52% and a specificity of 91% for establishing a clinical diagnosis of PMR associated with LV-GCA. The best areas of significant FDG uptake to clinically identify PMR in patients with LV-GCA were the shoulder, the greater trochanter, and the lumbar interspinous regions, with an area under the ROC curve of 0.810 (0.691-0.930).

CONCLUSIONS

Significant extravascular 18F-FDG-PET-CT uptake may help establish a clinical diagnosis of PMR in patients with LV-GCA. These patients are more commonly diagnosed with PMR if they have significant FDG uptake in the shoulder, greater trochanter, and lumbar interspinous areas.

Circulating miRNAs signature on breast cancer: the MCC-Spain project

PURPOSE

To build models combining circulating microRNAs (miRNAs) able to identify women with breast cancer as well as different types of breast cancer, when comparing with controls without breast cancer.

METHOD

miRNAs analysis was performed in two phases: screening phase, with a total n = 40 (10 controls and 30 BC cases) analyzed by Next Generation Sequencing, and validation phase, which included 131 controls and 269 cases. For this second phase, the miRNAs were selected combining the screening phase results and a revision of the literature. They were quantified using RT-PCR. Models were built using logistic regression with LASSO penalization.

RESULTS

The model for all cases included seven miRNAs (miR-423-3p, miR-139-5p, miR-324-5p, miR-1299, miR-101-3p, miR-186-5p and miR-29a-3p); which had an area under the ROC curve of 0.73. The model for cases diagnosed via screening only took in one miRNA (miR-101-3p); the area under the ROC curve was 0.63. The model for disease-free cases in the follow-up had five miRNAs (miR-101-3p, miR-186-5p, miR-423-3p, miR-142-3p and miR-1299) and the area under the ROC curve was 0.73. Finally, the model for cases with active disease in the follow-up contained six miRNAs (miR-101-3p, miR-423-3p, miR-139-5p, miR-1307-3p, miR-331-3p and miR-21-3p) and its area under the ROC curve was 0.82.

CONCLUSION

We present four models involving eleven miRNAs to differentiate healthy controls from different types of BC cases. Our models scarcely overlap with those previously reported.

Instantaneous reproduction number and epidemic growth rate for predicting COVID-19 waves: the first 2 years of the pandemic in Spain

Introduction

Several indicators were employed to manage the COVID-19 pandemic. In this study, our objective was to compare the instantaneous reproductive number and the epidemic growth rate in the Spanish population.

Methods

Data on daily numbers of cases, admissions into hospitals, admissions into ICUs, and deaths due to COVID-19 in Spain from March 2020 to March 2022 were obtained. The four "pandemic state indicators", which are daily numbers of cases, admissions into hospitals, admissions into ICUs, and deaths due to COVID-19 in Spain from March 2020 to March 2022 were obtained from the Instituto de Salud Carlos III. The epidemic growth rate was estimated as the derivative of the natural logarithm of daily cases with respect to time. Both the reproductive number and the growth rate, as "pandemic trend indicators," were evaluated according to their capacity to anticipate waves as "pandemic state indicators."

Results

Using both the reproductive number and the epidemic growth rate, we were able to anticipate most COVID-19 waves. In most waves, the more severe the presentation of COVID-19, the more effective the pandemic trend indicators would be.

Conclusion

Besides daily number of cases or other measures of disease frequency, the epidemic growth rate and the reproductive number have different roles in measuring the trend of an epidemic. Naïve interpretations and the use of any indicator as a unique value to make decisions should be discouraged.

Changes in preterm birth and stillbirth during COVID-19 lockdowns in 26 countries

Preterm birth (PTB) is the leading cause of infant mortality worldwide. Changes in PTB rates, ranging from -90% to +30%, were reported in many countries following early COVID-19 pandemic response measures ('lockdowns'). It is unclear whether this variation reflects real differences in lockdown impacts, or perhaps differences in stillbirth rates and/or study designs. Here we present interrupted time series and meta-analyses using harmonized data from 52 million births in 26 countries, 18 of which had representative population-based data, with overall PTB rates ranging from 6% to 12% and stillbirth ranging from 2.5 to 10.5 per 1,000 births. We show small reductions in PTB in the first (odds ratio 0.96, 95% confidence interval 0.95-0.98, P value <0.0001), second (0.96, 0.92-0.99, 0.03) and third (0.97, 0.94-1.00, 0.09) months of lockdown, but not in the fourth month of lockdown (0.99, 0.96-1.01, 0.34), although there were some between-country differences after the first month. For high-income countries in this study, we did not observe an association between lockdown and stillbirths in the second (1.00, 0.88-1.14, 0.98), third (0.99, 0.88-1.12, 0.89) and fourth (1.01, 0.87-1.18, 0.86) months of lockdown, although we have imprecise estimates due to stillbirths being a relatively rare event. We did, however, find evidence of increased risk of stillbirth in the first month of lockdown in high-income countries (1.14, 1.02-1.29, 0.02) and, in Brazil, we found evidence for an association between lockdown and stillbirth in the second (1.09, 1.03-1.15, 0.002), third (1.10, 1.03-1.17, 0.003) and fourth (1.12, 1.05-1.19, <0.001) months of lockdown. With an estimated 14.8 million PTB annually worldwide, the modest reductions observed during early pandemic lockdowns translate into large numbers of PTB averted globally and warrant further research into causal pathways.

Time of leaving work pregnancy results during COVID-19 pandemic. The MOACC-19 cohort from Spain

BACKGROUND

COVID-19 pandemic has changed the way pregnancies have been controlled as well as working conditions. In countries with paid leave of work, leaving earlier has been a relevant measure for controlling the pandemic. No study has been published on factors associated with earlier leaving work in pregnancy and the consequences it could have on pregnancy outcomes.

OBJECTIVE

We aimed to identify woman and pregnancy characteristics associated with leaving work earlier and its consequences on pregnancy results.

METHOD

A cohort study was carried out in Cantabria, Northern Spain, including 760 women who were pregnant in 2020 and were working at the beginning of their pregnancy. Data on pregnancy characteristics and results were obtained from medical records and gestational age at leaving work was self-reported. In a logistic regression analysis, leaving work before 26th week of pregnancy was the main effect variable.

RESULTS

Several factors were associated with lower probability of leaving work before 26th week, including university studies (OR = 0.49, 95% CI: 0.36, 0.68), having presential work (OR = 0.57, 95% CI: 0.40, 0.81), women born in non-European countries (OR = 0.55, 95% CI: 0.30, 1.01) and non-smokers (OR for smokers = 1.79, 95% CI: 1.12, 2.87). Neither type of delivery, gestational age at delivery nor other pregnancy results were associated with the gestational age of leaving work.

CONCLUSION

Several pregnancy and women characteristics were associated with leaving work earlier in the COVID-19 pandemic, although it was not associated with any pregnancy outcome.

Long-Term Exposure to Nitrate and Trihalomethanes in Drinking Water and Prostate Cancer: A Multicase-Control Study in Spain (MCC-Spain)

BACKGROUND

Nitrate and trihalomethanes (THMs) in drinking water are widespread and are potential human carcinogens.

OBJECTIVE

We evaluated the association between drinking-water exposure to nitrate and THMs and prostate cancer.

METHODS

During the period 2008-2013, 697 hospital-based incident prostate cancer cases (97 aggressive tumors) and 927 population-based controls were recruited in Spain, providing information on residential histories and type of water consumed. Average nitrate and THMs levels in drinking water were linked with lifetime water consumption to calculate waterborne ingestion. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using mixed models with recruitment area as random effect. Effect modification by tumor grade (Gleason score), age, education, lifestyle, and dietary factors was explored.

RESULTS

Mean (±standard deviation) adult lifetime waterborne ingested nitrate (milligrams per day), brominated (Br)-THMs (micrograms per day), and chloroform (micrograms per day) were 11.5 (±9.0), 20.7 (±32.4), and 15.1 (±14.7) in controls. Waterborne ingested nitrate >13.8 vs. <5.5mg/d was associated with an OR of 1.74 (95% CI: 1.19, 2.54) overall, and 2.78 (95% CI: 1.23, 6.27) for tumors with Gleason scores ≥8. Associations were higher in the youngest and those with lower intakes of fiber, fruit/vegetables, and vitamin C. Waterborne ingested THMs were not associated with prostate cancer. Residential tap water levels of Br-THMs and chloroform showed, respectively, inverse and positive associations with prostate cancer.

CONCLUSIONS

Findings suggest long-term waterborne ingested nitrate could be a risk factor of prostate cancer, particularly for aggressive tumors. High intakes of fiber, fruit/vegetables and vitamin C may lower this risk. Association with residential levels but not ingested chloroform/Br-THM may suggest inhalation and dermal routes could be relevant for prostate cancer. https://doi.org/10.1289/EHP11391.

Ki67 and E-cadherin Are Independent Predictors of Long-term Survival in Endometrial Carcinoma

BACKGROUND/AIM

In previous studies, we identified estrogen receptor, progesterone receptor, Ki67, p53, c-erb-B2, and E-cadherin to be individually associated with the prognosis of endometrial carcinoma. In the present study, we aimed to identify which of the aforementioned are associated with survival after long-term follow-up.

PATIENTS AND METHODS

A total of 106 patients were followed until their demise, or for a median of 120 months in the case of survival (range=84-240 months). At the end of the study, 38 patients had died, and 68 were alive. The association of the studied variables with survival was analyzed by means of a Weibull regression model.

RESULTS

A final, restricted model adjusted for age, stage, and histological variety showed both Ki67 and E-cadherin to be independent predictors of a shorter and a longer survival, respectively.

CONCLUSION

Immunohistochemistry for Ki67 and E-cadherin is a cheap and relatively easy-to-interpret laboratory procedure for predicting survival of patients with endometrial carcinoma in clinical practice.

Development of SARS-CoV-2 specific IgG and IgA antibodies in serum and milk with different SARS-COV-2 vaccines in lactating women

BACKGROUND

Our main objective was to determine the evolution of IgG and IgA antibodies directed against SARS-CoV-2 protein S in the blood of lactating women and in breast milk.

METHODS

A cohort of 110 uninfected and vaccinated breastfeeding women was followed-up for 6 months at the Marqués de Valdecilla University Hospital, Spain, in 2020. An additional group of 23 breastfeeding mothers who had no previously documented infection and had not been vaccinated against SARS-CoV-2 were included as a control group. The antibodies in blood and breast milk and their evolution at 6 months post-vaccination were analysed.

RESULTS

One hundred ten breastfeeding mothers were included; 70 women (63.6%) were vaccinated with two doses of BNT162b2, 20 women (18.2%) received two doses of mRNA-1273, and 20 women (18.2%) received a single dose of ChAdOx1-S. No evidence of differences between concentrations of antibodies was found according to the type of vaccine, with the exception of serum IgA antibodies, which was higher in women vaccinated with mRNA-1273: mean [95%CI]: 0.05 AU/mL [0.03,0.06] with mRNA-1273, 0.02 AU/mL [0.01,0.03] with BNT162b2 and 0.01 AU/mL [0.00,0.03] with ChAdOx1-S, ANOVA p value = 0.03. The lack of difference between vaccines was also found when anti-S1 specific IgG in serum and breast milk were measured.

CONCLUSIONS

In lactating women vaccinated against COVID-19, anti-SARS-CoV-2 antibodies can be detected in both serum and breastmilk 6 months after receiving the second dose, although their concentrations decreased when compared with concentrations reached immediately after vaccination.

Cardiovascular and disease-related features associated with extra-articular manifestations in axial spondyloarthritis. A multicenter study of 888 patients

OBJECTIVES

To determine the potential impact of extra-articular manifestations (EAMs) on disease characteristics and cardiovascular (CV) risk in patients with axial spondylarthritis (axSpA).

METHODS

This is a cross-sectional study from the AtheSpAin cohort, a Spanish multicenter cohort to study atherosclerosis in axSpA. Data on the history of CV events, subclinical carotid atherosclerosis, and disease-related features, including EAMs, were collected.

RESULTS

888 axSpA patients were recruited. Concomitant acute anterior uveitis (AAU), psoriasis (PSO), and inflammatory bowel disease (IBD) were present in 177 (19.9%), 96 (10.8%), and 57 (6.4%) patients, respectively. When compared with axSpA patients without EAMs, a significant increase in past CV events was observed in patients with PSO (9% versus 4%, p = 0.048) and in those with at least one EAM (7% versus 4%, p = 0.032) or with more than one EAM (11% versus 4%, p = 0.022). The frequency of carotid plaques and the values of cIMT were higher in patients with EAMs than in those without EAMs, although only the univariable analysis for carotid plaques in patients with PSO (39% versus 30%, p = 0.038) and for cIMT in patients with AAU (665 ± 156 µm versus 637 ± 139 µm, p = 0.042) and those with at least one EAM (661 ± 155 µm versus 637 ± 139 µm, p = 0.024) showed significant results. In addition, patients with PSO or IBD were found to have specific disease-related features, such as higher ESR at diagnosis, and more frequent use of glucocorticoids and TNF inhibitors than those without EAMs. Also, PSO patients had more commonly peripheral involvement and those with AAU more severe radiographic damage than those without EAMs. The frequency of HLA B27 was higher in patients with AAU and lower in those with PSO or IBD compared to those without EAMs.

CONCLUSION

Patients with axSpA and EAMs, in addition to displaying their own disease-related features, are likely to have an increased CV risk that appears proportional to the number of EAMs and could be related to proatherogenic factors other than traditional CV risk factors, such as the inflammatory load and the use of glucocorticoids.

Evolution of Medical Students' Perception of the Patient's Right to Privacy

During clinical rotations, medical students experience situations in which the patients' right to privacy may be violated. The aim of this study is to analyze medical students' perception of clinical situations that affect patients' right to privacy, and to look for the influential factors that may contribute to the infringement on their rights, such as the students' age, sex, academic year or parents' educational level. A cross-sectional study was conducted with a survey via "Google Drive". It consisted of 16 questions about personal information, 24 questions about their experience when rotating and 21 questions about their opinion concerning several situations related to the right to privacy. A total of 129 medical students from various Spanish medical schools participated. Only 31% of 3rd-6th year students declared having signed a confidentiality agreement when starting their clinical practice, and most students (52%) reported that doctors "sometimes", "rarely" or "never" introduce themselves and the students when entering the patients' rooms. Additionally, about 50% of all students reported that they would take a picture of a patient's hospitalization report without his/her (consent), which would be useful for an assignment. Important mistakes during medical students' rotations have been observed, as well as a general lack of knowledge regarding patient's right to privacy among Spanish medical students. Men and older students showed better knowledge of current legislation, as well as those whose parents were both university-educated and those in higher academic years.

Sarcopenic osteoporosis, sarcopenic obesity, and sarcopenic osteoporotic obesity in the Camargo cohort (Cantabria, Spain)

The associations of sarcopenia with osteoporosis or obesity have a very low prevalence. No trend towards an association between osteoporosis and sarcopenia is observed. Sarcopenia and obesity tend not to coincide, as if they were antagonistic disorders.

PURPOSE

To know (a) the prevalence in our region of sarcopenic osteoporosis (association of sarcopenia and osteoporosis (T-score < - 2.5)), sarcopenic obesity, and the association of osteoporosis, sarcopenia, and obesity; (b) the tendency of osteoporosis, sarcopenia, and obesity to associate with each other; and (c) the bone mineral density (BMD), the components of sarcopenia, and the prevalence of fragility fractures in these associations.

METHODS

The study was performed in the Camargo cohort. Osteoporosis was diagnosed by DXA, sarcopenia by the EWGSOP-1 criteria, and obesity by body mass index (BMI) and fat percentage. Fractures were verified radiographically or by consulting the medical records.

RESULTS

The prevalence of sarcopenic osteoporosis was 2.8% and the OR for this association 1.03 (p = 0.89). The prevalence of sarcopenic obesity by BMI was 1.4% and by fat percentage 5.9% (corresponding ORs: 0.18 (p < 0.0001) and 0.58 (p < 0.003) respectively). The prevalence of the association of osteoporosis, sarcopenia, and obesity was 0.0% when assessed by BMI and 0.8% when assessed by fat percentage. Patients with sarcopenic osteoporosis have less muscle mass and more fragility fractures than sarcopenic patients overall. In patients with sarcopenic obesity by fat percentage, muscle mass and strength, as well as physical performance, were similar to those of sarcopenic patients overall. Neither BMD nor fracture prevalence showed differences between patients with sarcopenic obesity and patients with sarcopenia or obesity in general.

CONCLUSION

Our study supports the idea that the prevalence of the mixed disorders studied is low. No significant association between osteoporosis and sarcopenia was found. Sarcopenia and obesity seem to tend to occur in different people, as if suffering from one of them hinders suffering from the other.

Irisin as a Novel Biomarker of Subclinical Atherosclerosis, Cardiovascular Risk and Severe Disease in Axial Spondyloarthritis

Introduction

Patients with axial spondyloarthritis (axSpA) have a high disease burden mainly due to the rheumatic disease itself, and also exhibit accelerated atherosclerosis, that leads to a higher incidence of cardiovascular (CV) disease. Accordingly, the identification of biomarkers of CV risk and inflammation in axSpA patients is clinically relevant. In this sense, given the beneficial functions exerted by the adipomyokine irisin in processes related to CV disease and inflammation, our aim was to assess, for the first time, the role of irisin as a genetic and serological biomarker of subclinical atherosclerosis, CV risk and disease severity in axSpA patients.

Methods

A large cohort of 725 Spanish patients with axSpA was included. Subclinical atherosclerosis (presence of plaques and abnormal carotid intima-media thickness values) was evaluated by carotid ultrasound. Four irisin polymorphisms (rs16835198 G/T, rs3480 A/G, rs726344 G/A, and rs1570569 G/T) were genotyped by TaqMan probes. Additionally, serum irisin levels were determined by ELISA.

Results

Low irisin levels were linked to the presence of plaques (p=0.002) and atherogenic index values ≥4 (p=0.01). Serum irisin were positively correlated with C-peptide levels (p<0.001) and negatively correlated with visual analogue scale and Bath Ankylosing Spondylitis Metrology Index (p<0.05 in all the cases). Moreover, lower irisin levels were observed in patients with sacroiliitis and in those with a negative HLA-B27 status (p<0.001 and p=0.006, respectively), as well as in those treated with non-steroidal anti-inflammatory drugs and conventional disease-modifying antirheumatic drugs (p<0.001 and p=0.002, respectively). Interestingly, the TT genotype and the T allele of rs16835198 were less frequent in axSpA patients with ASDAS >2.1 (Odds Ratio (OR): 0.48 [0.28-0.83] and OR: 0.73 [0.57-0.92], respectively, p=0.01 in both cases). Additionally, the frequency of rs1570569 T allele was higher in these patients (OR: 1.46 [1.08-1.97], p=0.01). Furthermore, the GGGT haplotype was more frequent in patients with ASDAS values >2.1 (OR: 1.73 [1.13-2.66], p=0.01).

Conclusions

Our results indicate that low serum irisin levels could be indicators of the presence of subclinical atherosclerosis, high CV risk and more severe disease in axSpA patients. In addition, irisin may also constitute a genetic biomarker of disease activity in axSpA.

AB0146 BAFF, APRIL y BAFFR: DIFFERENTIAL BIOMARKERS BETWEEN IgA VASCULITIS AND IgA NEPHROPATHY?

Background

IgA vasculitis (IgAV) and IgA nephropathy (IgAN) are inflammatory conditions [1, 2], that share pathogenic mechanisms [1], in which B-lymphocytes are described as key cells implicated in these processes. BAFF, APRIL and BAFF-R are cytokines implicated in the development of B-lymphocytes [3, 4] and in autoimmune processes [5, 6]. In this regard, an influence of BAFF, APRIL and BAFFR polymorphisms was observed on several immune-mediated conditions, being BAFF GCTGT>A a shared insertion-deletion variant for inflammatory conditions [7, 8].

Objectives

To determine whether BAFF, APRIL and BAFFR could be used as differential biomarkers between IgAV and IgAN.

Methods

BAFF rs374039502 (which colocalizes with BAFF GCTGT>A), two tag variants within APRIL (rs11552708 and rs6608) and two tag variants within BAFFR (rs7290134 and rs77874543) were genotyped in 394 Caucasian IgAV patients, 95 patients with IgAN and 832 matched healthy controls.

Results

Similar genotype and allele frequencies were observed in the whole cohort of patients with IgAV when compared to those with IgAN when BAFF, APRIL and BAFFR variants were analyzed independently (Table 1). In accordance with that, no BAFF, APRIL and BAFFR genotype or allele differences were detected between IgAV patients who developed nephritis and patients with IgAN (Table 1). Additionally, no statistically significant differences were observed between the whole cohort of patients with IgAV and healthy controls as well as between patients with IgAN and healthy controls when each when BAFF, APRIL and BAFFR genetic variant was also analyzed independently (Table 1). Similar results were disclosed when haplotype frequencies of APRIL and BAFFR were compared between the different comparative groups above mentioned (data not shown).

Table 1.

Genotype and allele frequencies of BAFF, APRIL and BAFFR in the whole cohort of patients with IgAV, patients with IgAV who developed nephritis, patients with IgAN and healthy controls.

PolymorphismChangeData setGenotypes, % (n)Alleles, % (n)1/21/11/22/212BAFF rs374039502T/AIgAV92.1 (363)7.9 (31)0.096.1 (757)3.9 (31)IgAV with nephritis90.1 (128)9.9 (14)0.095.1 (270)4.9 (14)IgAN91.6 (87)8.4 (8)0.095.8 (182)4.2 (8)Controls91.8 (764)7.8 (65)0.4 (3)95.7 (1593)4.3 (71)APRIL rs11552708G/AIgAV78.7 (310)20.1 (79)1.3 (5)88.7 (699)11.3 (89)IgAV with nephritis81.1 (116)18.9 (27)0.090.6 (259)9.4 (27)IgAN75.8 (72)23.2 (22)1.1 (1)87.4 (166)12.6 (24)Controls78.7 (655)19.7 (164)1.6 (13)88.6 (1474)11.4 (190)APRIL rs6608C/TIgAV72.6 (286)25.4 (100)2.0 (8)85.3 (672)14.7 (116)IgAV with nephritis75.5 (108)23.1 (33)1.4 (2)87.1 (249)12.9 (37)IgAN65.3 (62)30.5 (29)4.2 (4)80.5 (153)19.5 (37)Controls71.0 (591)26.6 (221)2.4 (20)84.3 (1403)15.7 (261)BAFFR rs7290134A/GIgAV58.9 (232)35.5 (140)5.6 (22)76.6 (604)23.4 (184)IgAV with nephritis60.1 (86)32.2 (46)7.7 (11)76.2 (218)23.8 (68)IgAN57.9 (55)38.9 (37)3.2 (3)77.4 (147)22.6 (43)Controls58.7 (488)35.1 (292)6.3 (52)76.2 (1268)23.8 (396)BAFFR rs77874543G/CIgAV83.2 (328)15.5 (61)1.3 (5)91.0 (717)9.0 (71)IgAV with nephritis83.1 (118)16.9 (24)0.091.5 (260)8.5 (24)IgAN86.3 (82)13.7 (13)0.093.2 (167)6.8 (13)Controls83.7 (696)16.0 (133)0.4 (3)91.6 (1525)8.4 (139)

IgAV: IgA vasculitis; IgAN: IgA nephropathy.

Conclusion

Our results reveal a similar BAFF, APRIL and BAFFR genetic distribution in IgAV and IgAN, suggesting that these genes could not be used as differential biomarkers between these pathologies.

References

[1]N Engl J Med 2013;368:2402-14;

[2]Am J Kidney Dis 1988;12:373-7;

[3]J Exp Med 1999;189:1747-56;

[4]Nat Genet 2005;37:793-4;

[5]Arthritis Res Ther 2018;20:158;

[6]Arthritis Res Ther 2020;22:157;

[7]Engl J Med 2017;376:1615-26;

[8]Sci Rep 2018;8:8195.

Acknowledgements

This study was supported by the European Regional Development Fund (ERDF) and “Fondo de Investigaciones Sanitarias” (grant PI18/00042 and PI21/00042) from ‘Instituto de Salud Carlos III’ (ISCIII, Health Ministry, Spain). DP-P is a recipient of a Río Hortega programme fellowship from the ISCIII, co-funded by the European Social Fund (ESF, `Investing in your future´) [grant number CM20/00006]; SR-M is supported by funds of the RETICS Program co-funded by ERDF [grant number RD16/0012/0009]; VP-C is supported by a pre-doctoral grant from IDIVAL [grant number PREVAL 18/01]; RL-M is a recipient of a Miguel Servet type II programme fellowship from the ISCIII, co-funded by ESF `Investing in your future´ [grant number CPII21/00004].

Disclosure of Interests

Diana Prieto-Peña: None declared, Fernanda Genre: None declared, Sara Remuzgo Martinez: None declared, Verónica Pulito-Cueto: None declared, Belén Atienza-Mateo: None declared, Belén Sevilla: None declared, Javier Llorca: None declared, Norberto Ortego: None declared, Maite Leonardo: None declared, Ana Peñalba: None declared, Luis Martín-Penagos: None declared, Jose Alberto Miranda Fillloy: None declared, J. Narváez: None declared, LUIS CAMINAL MONTERO: None declared, PAZ COLLADO: None declared, Antonio Fernandez-Nebro: None declared, Gisela Díaz-Cordoves: None declared, Secundino Cigarrán: None declared, Jesús Calviño: None declared, Carmen Cobelo: None declared, Diego de Argila: None declared, Esther F. Vicente-Rabaneda: None declared, Esteban Rubio-Romero: None declared, MANUEL LEON LUQUE: None declared, Juan María Blanco-Madrigal: None declared, E. Galíndez-Agirregoikoa: None declared, Oreste Gualillo: None declared, Javier Martin Ibanez: None declared, Santos Castañeda: None declared, Ricardo Blanco Speakers bureau: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen and MSD, Consultant of: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen and MSD, Grant/research support from: Abbvie, MSD and Roche, Miguel A González-Gay Speakers bureau: Abbvie, MSD, Jansen, and Roche, Grant/research support from: Abbvie, Pfizer, Roche, Sanofi, Lilly, Celgene, MSD and GSK, Raquel López-Mejías: None declared

POS0327 IRISIN: A NEW MARKER OF SUBCLINICAL ATHEROSCLEROSIS, CARDIOVASCULAR RISK AND DISEASE ACTIVITY IN AXIAL SPONDYLOARTHRITIS?

Background

Axial spondyloarthritis (axSpA) is an inflammatory disease with detrimental effects on the health status of the individuals affected by this condition [1]. axSpA patients also exhibit high cardiovascular (CV) risk, mainly due to accelerated atherosclerosis [2]. Interestingly, the adipomyokine irisin was described to play a beneficial role in several physiological and pathophysiological processes such as inflammation, angiogenesis, oxidative stress, as well as lipid and bone metabolism [3]. However, studies on the role of irisin in CV risk in the setting of axSpA or in the pathogenesis of axSpA are limited [4].

Objectives

In this study we evaluated the role of irisin as a genetic and serological biomarker of subclinical atherosclerosis and CV risk in a large cohort of patients with axSpA. We also assessed its role as a marker of axSpA susceptibility and severity.

Methods

725 patients who fulfilled the Assessment of SpondyloArthritis international Society classification criteria for axSpA were included in this study [5]. In these patients, the presence of subclinical atherosclerosis (plaques and/or abnormal carotid intima-media thickness values) was assessed by carotid ultrasound. Four irisin polymorphisms (rs16835198 G/T, rs3480 A/G, rs726344 G/A and rs1570569 G/T) were genotyped by TaqMan probes in all the patients and in 656 age, sex and ethnically-matched healthy controls. Additionally, serum irisin levels were determined by ELISA in all the patients. All analyses were performed using STATA v.11.1 statistical software, adjusting for potential confounding factors. The strength of associations is indicated as odds ratios (OR) [95% confidence intervals].

Results

Low levels of serum irisin were linked to the presence of plaques (p=0.002) and with atherogenic index values indicative of an adverse lipid profile (p=0.01). Serum irisin levels also negatively correlated with visual analogue scale (VAS) patient, VAS physician and Bath Ankylosing Spondylitis Metrology Index (BASMI) values (p<0.05). Moreover, the presence of sacroiliitis was related to lower serum irisin levels (p<0.001). Furthermore, the minor alleles of rs3480 (G) and rs1570569 (T) were associated with higher values of Ankylosing Spondylitis Disease Activity Score (ASDAS) in axSpA patients (p≤0.01 in both cases). In this line, the frequency of the minor allele of rs1570569 (T) was higher in patients with ASDAS values >2.1 (indicative of high disease activity) (OR: 1.46 [1.08-1.97], p=0.01), while the minor allele of rs16835198 (T) was less frequent in this group of patients (OR: 0.73 [0.57-0.92], p=0.01).

Conclusion

Low serum irisin levels could be indicators of the presence of subclinical atherosclerosis, high CV risk and more severe disease in axSpA patients. In addition, irisin may also constitute a genetic biomarker of disease activity in axSpA.

References

[1]Packham J. Rheumatology (Oxford). 2018;57(6):vi29-vi34.

[2]Szabo SM, et al. Arthritis Rheum. 2011;63(11):3294–304.

[3]Korta P, et al. Medicina (Kaunas). 2019;55(8):485.

[4]Nam B, et al. Ann Rheum Dis. 2020;79:1358.

[5]Sieper J, et al. Ann Rheum Dis. 2009;68(2):ii1–44.

Acknowledgements

This work was partially supported by grants from Instituto de Investigación Sanitaria IDIVAL (NVAL17/10), from the `Asociación Cántabra de Reumatología’ awarded to FG. FG and JR-G are beneficiaries of a grant funded by `Instituto de Salud Carlos III´ (ISCIII) (PI20/00059). SR-M is supported by funds of the RETICS Program (RD16/0012/0009) from ISCIII, co-funded by the European Regional Development Fund. VP-C is supported by a pre-doctoral grant from IDIVAL (PREVAL18/01). RL-M is a recipient of a Miguel Servet type I programme fellowship from ISCIII, co-funded by the European Social Fund, `Investing in your future´ (grant CP16/00033).

Disclosure of Interests

Sara Remuzgo-Martínez: None declared, Javier Rueda-Gotor: None declared, Verónica Pulito-Cueto: None declared, Raquel López-Mejías: None declared, Alfonso Corrales: None declared, Leticia Lera-Gómez: None declared, Raquel Pérez-Fernández: None declared, Virginia Portilla: None declared, Iñigo Gonzalez-Mazon: None declared, Ricardo Blanco Speakers bureau: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen and MSD, Consultant of: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen and MSD, Grant/research support from: Abbvie, MSD and Roche, Rosa Expósito: None declared, Cristina Mata: None declared, Javier Llorca: None declared, Vanessa Hernández-Hernández: None declared, Carlos Rodríguez-Lozano: None declared, Nuria Barbarroja Puerto: None declared, Rafaela Ortega Castro: None declared, Esther F. Vicente-Rabaneda: None declared, Cristina Fernández-Carballido: None declared, Maria Paz Martínez-Vidal: None declared, David Castro-Corredor: None declared, Joaquín Anino-Fernández: None declared, Diana Peiteado: None declared, Chamaida Plasencia: None declared, E Galindez: None declared, María L. García Vivar: None declared, Nuria Vegas-Revenga: None declared, Irati Urionaguena: None declared, Oreste Gualillo: None declared, Juan Carlos Quevedo-Abeledo: None declared, Santos Castañeda: None declared, Iván Ferraz-Amaro: None declared, Miguel A González-Gay Speakers bureau: Abbvie, Pfizer, Roche, Sanofi, Lilly, Celgene, MSD, GSK, Grant/research support from: Abbvie, MSD, Janssen, Roche, Fernanda Genre: None declared

AB0145 IgA VASCULITIS AND IgA NEPHROPATHY SHARE A SIMILAR IL33-IL1RL1 ASSOCIATION PATTERN

Background

IgA vasculitis (IgAV) and IgA nephropathy (IgAN) are inflammatory conditions that share pathogenic and molecular mechanisms [1] and may represent different outcomes of a continuous spectrum of the disease [2]. Interleukin (IL)-33 is a cytokine that exerts its biological functions by binding to its receptor, IL-1 receptor like 1 (IL-1RL1) [3]. Several lines of evidence demonstrate that genetic variants located both in IL33 and IL1RL1 genes are implicated in the increased risk of numerous immune-mediated diseases [4].

Objectives

To determine whether IgAV and IgAN exhibit a different IL33-IL1RL1 association pattern.

Methods

Three tag genetic variants within IL33 (rs3939286, rs7025417 and rs7044343) and three tag polymorphisms within IL1RL1 (rs2310173, rs13015714 and rs2058660), which cover the major variability of these loci and that were previously associated with several inflammatory diseases were genotyped in 380 Caucasian patients with IgAV, 96 patients with IgAN and 845 sex and ethnically matched healthy controls.

Results

Similar genotype and allele frequencies were observed in the whole cohort of patients with IgAV when compared to those with IgAN when IL33-IL1RL1 genetic variants were analyzed independently (Table 1). In accordance with that, no IL33-IL1RL1 genotype or allele differences were detected between IgAV patients who developed nephritis and patients with IgAN (Table 1). Additionally, no statistically significant differences between the whole cohort of patients with IgAV and healthy controls as well as between patients with IgAN and healthy controls were observed when each IL33-IL1RL1 genetic variant was also analyzed independently (Table 1). Similar results were disclosed when haplotype frequencies were compared between the different comparative groups above mentioned (data not shown).

Table 1.

Genotype and allele frequencies of IL33 and IL1RL1 in the whole cohort of patients with IgAV, patients with IgAV who developed nephritis, patients with IgAN and healthy controls.

PolymorphismChangeData setGenotypes, % (n)Alleles, % (n)1/21/11/22/212IL33 rs3939286C/TIgAV49.1 (186)40.9 (155)10.0 (38)69.5 (527)30.5 (231)IgAV with nephritis48.5 (66)39.7 (54)11.8 (16)68.4 (186)31.6 (86)IgAN43.8 (42)49.0 (47)7.3 (7)68.2 (131)31.8 (61)Controls49.0 (414)41.4 (350)9.6 (81)69.7 (1178)30.3 (512)IL33 rs7025417T/CIgAV68.1 (254)29.5 (110)2.4 (9)82.8 (618)17.2 (128)IgAV with nephritis69.9 (93)27.1 (36)3.0 (4)83.5 (222)16.5 (44)IgAN61.5 (59)37.5 (36)1.0 (1)80.2 (154)19.8 (38)Controls70.8 (598)25.9 (219)3.3 (28)83.7 (1415)16.3 (275)IL33 rs7044343T/CIgAV42.3 (160)42.1 (159)15.6 (59)63.4 (479)36.6 (277)IgAV with nephritis44.5 (61)39.4 (54)16.1 (22)64.2 (176)35.8 (98)IgAN40.6 (39)49.0 (47)10.4 (10)65.1 (125)34.9 (67)Controls44.5 (376)43.9 (371)11.6 (98)66.4 (1123)33.6 (567)IL1RL1 rs2310173G/TIgAV29.2 (111)46.1 (175)24.7 (94)52.2 (397)47.8 (363)IgAV with nephritis32.1 (44)43.1 (59)24.8 (34)53.6 (147)46.4 (127)IgAN20.8 (20)46.9 (45)32.3 (31)44.3 (85)55.7 (107)Controls30.2 (255)46.7 (395)23.1 (195)53.6 (905)46.4 (785)IL1RL1 rs13015714T/GIgAV56.3 (211)39.5 (148)4.3 (16)76.0 (570)24.0 (180)IgAV with nephritis61.8 (84)33.8 (46)4.4 (6)78.7 (214)21.3 (58)IgAN54.2 (52)40.6 (39)5.2 (5)74.5 (143)25.5 (49)Controls57.2 (483)37.2 (314)5.7 (48)75.7 (1280)24.3 (410)IL1RL1 rs2058660A/GIgAV56.9 (215)38.6 (146)4.5 (17)76.2 (576)23.8 (180)IgAV with nephritis62.2 (84)31.9 (43)5.9 (8)78.1 (211)21.9 (59)IgAN53.1 (51)42.7 (41)4.2 (4)74.5 (143)25.5 (49)Controls56.7 (479)37.5 (317)5.8 (49)75.4 (1275)24.6 (415)

IgAV: IgA vasculitis; IgAN: IgA nephropathy.

Conclusion

Our results reveal that IgAV and IgAN share a similar IL33-IL1RL1 association pattern.

References

[1]N Engl J Med 2013;368:2402-14;

[2]Am J Kidney Dis 1988;12:373-7;

[3]J Immunol 2007;179:2551–5,

[4]Sci Rep 2021;11:16163

Acknowledgements

This study was supported by the European Regional Development Fund (ERDF) and “Fondo de Investigaciones Sanitarias” (grant PI18/00042 and PI21/00042) from ‘Instituto de Salud Carlos III’ (ISCIII, Health Ministry, Spain). DP-P is a recipient of a Río Hortega programme fellowship from the ISCIII, co-funded by the European Social Fund (ESF, `Investing in your future´) [grant number CM20/00006]; SR-M is supported by funds of the RETICS Program co-funded by ERDF [grant number RD16/0012/0009]; VP-C is supported by a pre-doctoral grant from IDIVAL [grant number PREVAL 18/01]; RL-M is a recipient of a Miguel Servet type II programme fellowship from the ISCIII, co-funded by ESF `Investing in your future´ [grant number CPII21/00004].

Disclosure of Interests

Diana Prieto-Peña: None declared, Sara Remuzgo Martinez: None declared, Fernanda Genre: None declared, Verónica Pulito-Cueto: None declared, Belén Atienza-Mateo: None declared, Belén Sevilla: None declared, Javier Llorca: None declared, Norberto Ortego: None declared, Maite Leonardo: None declared, Ana Peñalba: None declared, Luis Martín-Penagos: None declared, Jose Alberto Miranda Fillloy: None declared, J. Narváez: None declared, LUIS CAMINAL MONTERO: None declared, PAZ COLLADO: None declared, Antonio Fernandez-Nebro: None declared, Gisela Díaz-Cordoves: None declared, Secundino Cigarrán: None declared, Jesús Calviño: None declared, Carmen Cobelo: None declared, Patricia Quiroga Colino: None declared, Javier Sanchez Perez: None declared, Esteban Rubio-Romero: None declared, MANUEL LEON LUQUE: None declared, Juan María Blanco-Madrigal: None declared, E. Galíndez-Agirregoikoa: None declared, Oreste Gualillo: None declared, Javier Martin Ibanez: None declared, Santos Castañeda: None declared, Ricardo Blanco Speakers bureau: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen and MSD, Consultant of: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen and MSD, Grant/research support from: Abbvie, MSD and Roche, Miguel A González-Gay Speakers bureau: Abbvie, Pfizer, Roche, Sanofi, Lilly, Celgene, MSD and GSK, Grant/research support from: Abbvie, MSD, Jansen and Roche, Raquel López-Mejías: None declared

Intake Patterns of Specific Alcoholic Beverages by Prostate Cancer Status

Simple Summary

Previous studies have shown heavy intake of different alcoholic beverages affects prostate cancer (PCa) clinical outcomes differently. However, the intake patterns of specific alcoholic beverages for PCa status are understudied. The study’s objective is to evaluate intake patterns of total alcohol and three types of alcoholic beverage (beer, wine, and spirits) by PCa risk and aggressiveness status. This study included 10,029 men with European ancestry (4676 non-PCa men and 5353 PCa patients). We found PCa patients had a similar total heavy alcohol intake compared with non-PCa men. However, PCa patients were likely to drink more wine and spirits than non-PCa men. Patients with aggressive PCa drank more beer but not wine and spirits. Interestingly, heavy wine intake was inversely associated with PCa aggressiveness. These findings suggest that the intake patterns of specific alcoholic beverages differ by PCa status, and this information might help develop personalized alcohol intervention for PCa patients.

Abstract

Background: Previous studies have shown that different alcoholic beverage types impact prostate cancer (PCa) clinical outcomes differently. However, intake patterns of specific alcoholic beverages for PCa status are understudied. The study’s objective is to evaluate intake patterns of total alcohol and the three types of beverage (beer, wine, and spirits) by the PCa risk and aggressiveness status. Method: This is a cross-sectional study using 10,029 men (4676 non-PCa men and 5353 PCa patients) with European ancestry from the PCa consortium. Associations between PCa status and alcohol intake patterns (infrequent, light/moderate, and heavy) were tested using multinomial logistic regressions. Results: Intake frequency patterns of total alcohol were similar for non-PCa men and PCa patients after adjusting for demographic and other factors. However, PCa patients were more likely to drink wine (light/moderate, OR = 1.11, p = 0.018) and spirits (light/moderate, OR = 1.14, p = 0.003; and heavy, OR = 1.34, p = 0.04) than non-PCa men. Patients with aggressive PCa drank more beer than patients with non-aggressive PCa (heavy, OR = 1.48, p = 0.013). Interestingly, heavy wine intake was inversely associated with PCa aggressiveness (OR = 0.56, p = 0.009). Conclusions: The intake patterns of some alcoholic beverage types differed by PCa status. Our findings can provide valuable information for developing custom alcohol interventions for PCa patients.