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Vardell VA, Ose J, Rets AV, Tantravahi SK, Patel AB. Chronic Myelomonocytic Leukemia and Atypical Chronic Myeloid Leukemia: A National Analysis. CLINICAL LYMPHOMA, MYELOMA & LEUKEMIA 2024:S2152-2650(24)00283-0. [PMID: 39179449 DOI: 10.1016/j.clml.2024.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Revised: 07/22/2024] [Accepted: 07/23/2024] [Indexed: 08/26/2024]
Abstract
BACKGROUND Myelodysplastic/myeloproliferative overlap syndromes (MDS/MPN) are rare blood cancers characterized by concomitant myeloid hyperplasia and dysplasia. These heterogenous disorders include chronic myelomonocytic leukemia (CMML) and atypical chronic myeloid leukemia (aCML). METHODS Using two large national cancer databases to examine a total of 15,704 CMML and 702 aCML patients, we report the largest study to date on the incidence, survival and demographic characteristics of CMML and aCML in the United States. RESULTS Overall age-adjusted incidence of CMML and aCML was 0.63 per 100,000 Americans per year and 0.03 per 100,000 per year, respectively. CMML incidence in the U.S. was noted to rise steadily in the years between 2001 and 2019. Median patient age was 75 and 72 years for CMML and aCML, and the majority of CMML and aCML patients were male (62.9% and 62.0%) and White (90.1% and 86.3%). Median OS was 17.4 months for CMML, and 15.2 months for aCML. Multivariate Cox regression demonstrated features associated with reduced survival, including increasing age, comorbidities, Medicaid insurance status, and low-income residential zip code, highlighting survival disparities in underinsured and socioeconomically disadvantaged patients. In CMML, Black race was associated with inferior survival, while female sex, management at an academic center, and later calendar-year of diagnosis were associated with improved OS. CONCLUSION These findings underscore the need to better understand the biological basis for such differences in survival and reflect the importance of access to specialized care for patients with these rare disorders.
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Affiliation(s)
- Victoria A Vardell
- Department of Internal Medicine, University of Utah, Salt Lake City, UT; Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Jennifer Ose
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT; Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Anton V Rets
- Department of Pathology, University of Utah, Salt Lake City, UT; ARUP Laboratories, University of Utah, Salt Lake City, UT
| | - Srinivas K Tantravahi
- Department of Internal Medicine, University of Utah, Salt Lake City, UT; Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Division of Hematology and Hematologic Malignancies, University of Utah, Salt Lake City, UT
| | - Ami B Patel
- Department of Internal Medicine, University of Utah, Salt Lake City, UT; Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Division of Hematology and Hematologic Malignancies, University of Utah, Salt Lake City, UT.
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Hassanin FF, Naser AY, Aalam WA, Hanbazazh M. Eye and adnexa hospitalization in Australia: An ecological study. Medicine (Baltimore) 2024; 103:e38829. [PMID: 38968452 PMCID: PMC11224824 DOI: 10.1097/md.0000000000038829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 06/14/2024] [Indexed: 07/07/2024] Open
Abstract
To investigate the trends of hospital admissions concerning diseases of the eye and adnexa in Australia in the past 2 decades. This is a descriptive ecological study on the population level that examined hospitalization data for the duration between 1998 and 2021 in Australia. Hospitalization data were extracted from the National Hospital Morbidity Database. The chi-squared test was utilized to assess the difference in admission rates between the years 1998 and 2021. Hospital admission rate for diseases of the eye and adnexa increased by 1.20-fold (from 852.32 [95% confidence interval [CI] 848.16-856.47] in 1998 to 1873.72 [95% CI 1868.48-1878.96] in 2021 per 100,000 persons, P < .01). The most common cause of hospitalization for diseases of the eye and adnexa was disorders of the lens (65.7%), followed by disorders of the choroid and retina (15.6%), followed by disorders of the eyelid, lacrimal system, and orbit (7.7%). Hospital admission rate among males increased by 1.25-fold (from 737.67 [95% CI 732.18-743.16] in 1998 to 1657.19 [95% CI 1650.19-1664.20] in 2021 per 100,000 persons). Hospital admission rate among females increased less sharply by 1.03-fold (from 965.37 [95% CI 959.14-971.59] in 1998 to 1964.35 [95% CI 1956.80-1971.90] in 2021 per 100,000 persons). There are clear gender and age roles in the epidemiology of hospital admissions related to eye and adnexa disorders. Lens disorders were the most common cause of hospital admission. The admission rate increase during the past decades could be due to increases in life expectancy, lifestyle changes, and improvements in screening protocols.
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Affiliation(s)
- Fadi Fouad Hassanin
- Department of Ophthalmology, College of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Abdallah Y. Naser
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan
| | - Waseem A. Aalam
- Department of Ophthalmology, College of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Mehenaz Hanbazazh
- Department of Pathology, College of Medicine, University of Jeddah, Jeddah, Saudi Arabia
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Ma D, Sun Y, Chen G, Hao S, Jiang Z, Wang R, Hao S. The association between physical activity intensity and frailty risk among older adults across different age groups and genders: Evidence from four waves of the China Health and Retirement Longitudinal Survey. PLoS One 2024; 19:e0305346. [PMID: 38861565 PMCID: PMC11166314 DOI: 10.1371/journal.pone.0305346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 05/29/2024] [Indexed: 06/13/2024] Open
Abstract
"Exercise is the best medicine" is well known, but the optimal dose of physical activity (PA) for males and females across different age groups is still unknown. This study, using data from the four waves of CHARLS, aimed to determine the optimal PA dose that reduces frailty risks among older adults across various age groups and both sexes. We created a frailty index score using 63 health-related variables and used 0.21 as the frailty cut point. Binary logistic regression was used to compare the effect of vigorous, moderate, and light intensity PA under IPAQ criteria on frailty risk. The study found that regardless of whether males or females, the optimal effect of vigorous-intensity PA in reducing the risk of frailty is consistently observed throughout the entire old age career. Moreover, the age groups at which moderate-intensity PA reduces the risk of frailty were from age 70 for males and from age 80 for females. And light-intensity PA had no effect on reducing the risk of frailty. Moderate and vigorous intensity of PA in older adults should be promoted, but guidelines and recommendations must account for optimal associations with PA dose across genders and age groups.
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Affiliation(s)
- Di Ma
- Department of Sports Science, College of Sports & Arts, Hanyang University ERICA Campus, Ansan, South Korea
| | - Yulin Sun
- Department of Sports Science, College of Sports & Arts, Hanyang University ERICA Campus, Ansan, South Korea
| | - Guoyang Chen
- Department of Sports Science, College of Sports & Arts, Hanyang University ERICA Campus, Ansan, South Korea
| | - Siwei Hao
- Department of Sports Science, College of Sports & Arts, Hanyang University ERICA Campus, Ansan, South Korea
| | - Zhenping Jiang
- Department of Sports Science, College of Sports & Arts, Hanyang University ERICA Campus, Ansan, South Korea
| | - Rui Wang
- Department of Sports Science, College of Sports & Arts, Hanyang University ERICA Campus, Ansan, South Korea
| | - Shuaipeng Hao
- Department of Sports Science, College of Sports & Arts, Hanyang University ERICA Campus, Ansan, South Korea
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Yang C, Mao Z, Wu S, Yin S, Sun Y, Cui D. Influencing factors, gender differences and the decomposition of inequalities in cognitive function in Chinese older adults: a population-based cohort study. BMC Geriatr 2024; 24:371. [PMID: 38664618 PMCID: PMC11045435 DOI: 10.1186/s12877-024-04857-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 10/04/2023] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Evidence remains limited and inconsistent for assessing cognitive function in Chinese older adults (CFCOA) and inequalities in cognitive function in Chinese older adults (ICFCOA) and exploring their influencing factors and gender differences. This study aimed to identify influencing factors and inequality in CFCOA to empirically explore the existence and sources of gender differences in such inequality and analyse their heterogeneous effects. METHODS Based on data from the China Health and Retirement Longitudinal Study (CHARLS) for three periods from 2011 to 2015, recentered influence function unconditional quantile regression (RIF-UQR) and recentered influence function ordinary least squares (RIF-OLS) regression were applied to assess influencing factors of CFCOA, while grouped treatment effect estimation, Oaxaca-Blinder decomposition, and propensity score matching (PSM) methods were conducted to identify gender differences in ICFCOA and influencing factors, respectively. RESULTS The results showed heterogeneous effects of gender, age, low BMI, subjective health, smoking, education, social interactions, physical activity, and household registration on CFCOA. Additionally, on average, ICFCOA was about 19.2-36.0% higher among elderly females than among elderly males, mainly due to differences in characteristic effects and coefficient effects of factors such as marital status and education. CONCLUSIONS Different factors have heterogeneous and gender-differenced effects on CFCOA and ICFCOA, while the formation and exacerbation of ICFCOA were allied to marital status and education. Considering the severe ageing and the increasing incidence of cognitive decline, there is an urgent need for the government and society to adopt a comprehensive approach to practically work for promoting CFCOA and reducing ICFCOA.
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Affiliation(s)
- Ciran Yang
- School of Public Health, Wuhan University, 115# Donghu Road, 430071, Wuhan, China
- Global Health Institute, Wuhan University, Wuhan, China
| | - Zongfu Mao
- School of Public Health, Wuhan University, 115# Donghu Road, 430071, Wuhan, China
- Global Health Institute, Wuhan University, Wuhan, China
| | - Shaotang Wu
- School of Public Health, Wuhan University, 115# Donghu Road, 430071, Wuhan, China
- Global Health Institute, Wuhan University, Wuhan, China
| | - Shicheng Yin
- School of Public Health, Wuhan University, 115# Donghu Road, 430071, Wuhan, China
- Global Health Institute, Wuhan University, Wuhan, China
| | - Yu Sun
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, China
| | - Dan Cui
- School of Public Health, Wuhan University, 115# Donghu Road, 430071, Wuhan, China.
- Global Health Institute, Wuhan University, Wuhan, China.
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Thai NQN, LaCroix AZ, Haring B, Wactawski-Wende J, Manson JE, Posis AIB, Shadyab AH. The association of leukocyte telomere length with exceptional longevity among older women. GeroScience 2024; 46:2083-2092. [PMID: 37843740 PMCID: PMC10828273 DOI: 10.1007/s11357-023-00964-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/25/2023] [Indexed: 10/17/2023] Open
Abstract
The association of leukocyte telomere length (LTL) with survival to late life with intact mobility has not been adequately studied. This prospective cohort study consisted of 1451 postmenopausal women from a Women's Health Initiative ancillary study, who were eligible, because of birth year, to survive to age 90 as of March 6, 2021. LTL was measured by Southern blot at baseline (1993-1998). Associations between LTL and survival to age 90 were evaluated using logistic regression models adjusted for socio-demographic characteristics, health factors, and lifestyle factors. Multinominal logistic regression was utilized to examine associations of LTL with survival to age 90 with or without intact mobility. Mediation analysis examined the extent to which incident coronary heart disease and stroke-mediated the association between LTL and longevity. Overall, 76.7% of women were White, and 23.3% were Black; average age at baseline was 70.4±3.5 years. Relative to death before age 90, the odds of survival to age 90 were 60% higher (OR, 1.60; 95% CI, 1.28-2.01), the odds of survival to age 90 with mobility limitation were 72% higher (OR, 1.72; 95% CI, 1.33-2.21), and the odds of survival to age 90 with intact mobility were 44% higher (OR, 1.44; 95% CI, 1.06-1.95) for every one kilobase longer LTL. Absence of CHD, stroke, or CHD/stroke mediated the association of LTL with survival to age 90 by 11.1%, 37.4%, and 31.3%, respectively; however, these findings were not significant. Longer LTL was associated with higher odds of survival to age 90 among older women.
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Affiliation(s)
- Nhat Quang N Thai
- UCSD-SDSU Joint-Doctoral Program in Public Health (Epidemiology), University of California, San Diego, La Jolla, CA, USA.
| | - Andrea Z LaCroix
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA
| | - Bernhard Haring
- Division of Cardiology, University Heart Center, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University of Buffalo - SUNY, Buffalo, NY, USA
| | - JoAnn E Manson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, BA, Boston, MA, USA
| | - Alexander Ivan B Posis
- UCSD-SDSU Joint-Doctoral Program in Public Health (Epidemiology), University of California, San Diego, La Jolla, CA, USA
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA
| | - Aladdin H Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA
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Wang L, Ye C, Zhao F, Wu H, Wang R, Zhang Z, Li J. Association Between the Dietary Inflammatory Index and the Risk of Fracture in Chinese Adults: Longitudinal Study. JMIR Public Health Surveill 2023; 9:e43501. [PMID: 37590048 PMCID: PMC10472179 DOI: 10.2196/43501] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 06/06/2023] [Accepted: 06/21/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Chronic inflammation plays a crucial role in tissue injury, osteoporosis, and fracture. The dietary inflammatory index (DII) is a tool for assessing the potential for inflammation in the diet. However, the association between the DII and fractures remains controversial from previous studies. OBJECTIVE We aimed to explore the correlation between the DII and fracture risk in Chinese adults. METHODS We included 11,999 adults (5519 men and 6480 women) who were a part of the China Health and Nutrition Survey (1997-2015) prospective cohort. A 3-day, 24-hour meal review method was used to calculate the DII score. The fractures were identified using a questionnaire. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% CIs for fractures. Subgroup, sensitivity, and restricted cubic spline analyses were performed. RESULTS During the 18 years of follow-up (median follow-up 9.0 years), 463 men and 439 women developed fractures. The median DII score was 0.64 (IQR -1.74 to 1.46) for the total sample, 0.75 (IQR -1.68 to 1.50) for men, and 0.53 (IQR -1.79 to 1.42) for women. The DII score had a positive correlation with the risk of fracture among women but not among men. For men, after adjusting for covariates, the HRs for quintiles of DII were 1, 0.96 (95% CI 0.66-1.41), 1.05 (95% CI 0.74-1.49), 0.89 (95% CI 0.62-1.26), and 0.94 (95% CI 0.67-1.34; trend: P=.62). The HRs for women were 1, 1.13 (95% CI 0.72-1.79), 1.24 (95% CI 0.83-1.86), 1.51 (95% CI 1.02-2.22), and 1.62 (95% CI 1.10-2.39; trend: P=.004). The restricted cubic spline analysis showed a significant association between fracture risk and DII score in women (overall association: P=.01); as the DII scores were >0.53, HRs showed a significant upward trend. Women aged <50 years or who are nonsmokers, who are nondrinkers, or with nonabdominal obesity had a positive association between fracture risk and the DII score. In sensitivity analyses, after excluding people with diabetes or hypertension, there was still a positive association between fracture risk and the DII score in women. Among the DII components, the DII scores of protein (trend: P=.03), niacin (trend: P=.002), and iron (trend: P=.02) showed significant associations with the risk of fracture in women. CONCLUSIONS Proinflammatory diet consumption increased the fracture risk in Chinese women aged <50 years. The high consumption of anti-inflammatory foods and low consumption of proinflammatory foods may be an important strategy to prevent fractures in women.
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Affiliation(s)
- Lu Wang
- Department of Epidemiology and Health Statistics, Hebei Medical University, Shijiazhuang, China
| | - Chen Ye
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Fanghong Zhao
- Beijing Center for Disease Control and Prevention, Beijing, China
| | - Hongjing Wu
- Department of Epidemiology and Health Statistics, Hebei Medical University, Shijiazhuang, China
| | - Ruoyu Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Zhaofeng Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing, China
- Beijing's Key Laboratory of Food Safety Toxicology Research and Evaluation, Beijing, China
| | - Jie Li
- Department of Epidemiology and Health Statistics, Hebei Medical University, Shijiazhuang, China
- Beijing Fengtai District Center for Disease Control and Prevention, Beijing, China
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de Oliveira DC, Máximo RDO, Ramírez PC, de Souza AF, Luiz MM, Delinocente MLB, Steptoe A, de Oliveira C, Alexandre TDS. Does the incidence of frailty differ between men and women over time? Arch Gerontol Geriatr 2023; 106:104880. [PMID: 36493577 PMCID: PMC9868103 DOI: 10.1016/j.archger.2022.104880] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 11/24/2022] [Accepted: 11/27/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND/OBJECTIVE The mechanisms, risk factors and influence of sex on the incidence of frailty components are not fully understood. The aim of this study was to analyse sex differences in factors associated with the increase in the number of frailty components. METHODS A 12-year follow-up analysis was conducted with 1,747 participants aged ≥ 60 of the ELSA Study with no frailty at baseline. Generalised linear mixed models were used to analyse the increase in the number of frailty components stratified by sex, considering socioeconomic, behavioural, clinical and biochemical characteristics as exposure variables. RESULTS The increase in the number of frailty components in both sexes was associated with an advanced age (70 to 79 years and 80 years or older), low educational level, sedentary lifestyle, elevated depressive symptoms, joint disease, high C-reactive protein levels, perception of poor vision and uncontrolled diabetes (p < 0.05). Osteoporosis, low weight, heart disease, living with one or more people and perception of poor hearing were associated with an increase in the number of frailty components in men. High fibrinogen concentration, controlled diabetes, stroke and perception of fair vision were associated with the outcome in women (p < 0.05). Obese women and men and overweight women had a lower increase in the number of frailty components compared to those in the ideal weight range. CONCLUSIONS Socioeconomic factors, musculoskeletal disorders, heart disease and low weight seem to sustain the frailty process in men, whereas cardiovascular and neuroendocrine disorders seem to sustain the frailty process in women.
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Affiliation(s)
- Dayane Capra de Oliveira
- Postgraduate Programme in Physical Therapy, Federal University of Sao Carlos. Rodovia, Washington Luís, km 235, SP-310 Sao Carlos, Sao Paulo 13565-905, Brazil
| | - Roberta de Oliveira Máximo
- Postgraduate Programme in Physical Therapy, Federal University of Sao Carlos. Rodovia, Washington Luís, km 235, SP-310 Sao Carlos, Sao Paulo 13565-905, Brazil
| | - Paula Camila Ramírez
- Postgraduate Programme in Physical Therapy, Federal University of Sao Carlos. Rodovia, Washington Luís, km 235, SP-310 Sao Carlos, Sao Paulo 13565-905, Brazil; Escuela de Fisioterapia, Universidad Industrial de Santander. Carrera 32 Nº 29-31, Bucaramanga 680006, Colômbia
| | - Aline Fernanda de Souza
- Postgraduate Programme in Physical Therapy, Federal University of Sao Carlos. Rodovia, Washington Luís, km 235, SP-310 Sao Carlos, Sao Paulo 13565-905, Brazil
| | - Mariane Marques Luiz
- Postgraduate Programme in Physical Therapy, Federal University of Sao Carlos. Rodovia, Washington Luís, km 235, SP-310 Sao Carlos, Sao Paulo 13565-905, Brazil
| | - Maicon Luis Bicigo Delinocente
- Postgraduate Programme in Gerontology, Federal University of Sao Carlos. Rodovia, Washington Luís, km 235, SP-310, Sao Carlos, Sao Paulo 13565-905, Brazil
| | - Andrew Steptoe
- Department of Epidemiology and Public Health, University College of London (UCL). Gower Street, London WC1E 6BT, United Kingdom
| | - Cesar de Oliveira
- Department of Epidemiology and Public Health, University College of London (UCL). Gower Street, London WC1E 6BT, United Kingdom
| | - Tiago da Silva Alexandre
- Postgraduate Programme in Physical Therapy, Federal University of Sao Carlos. Rodovia, Washington Luís, km 235, SP-310 Sao Carlos, Sao Paulo 13565-905, Brazil; Postgraduate Programme in Gerontology, Federal University of Sao Carlos. Rodovia, Washington Luís, km 235, SP-310, Sao Carlos, Sao Paulo 13565-905, Brazil; Department of Epidemiology and Public Health, University College of London (UCL). Gower Street, London WC1E 6BT, United Kingdom; Gerontology Department, Federal University of Sao Carlos, Rodovia Washington Luís, km 235, SP-310, Sao Carlos, Sao Paulo 13565-905, Brazil.
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Metin A, Erbiçer ES, Şen S, Çetinkaya A. Gender and COVID-19 related fear and anxiety: A meta-analysis. J Affect Disord 2022; 310:384-395. [PMID: 35561885 PMCID: PMC9090872 DOI: 10.1016/j.jad.2022.05.036] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 03/24/2022] [Accepted: 05/05/2022] [Indexed: 01/11/2023]
Abstract
Studies conducted during the pandemic revealed strong associations between gender and COVID-19 related fear and anxiety. Females perceive coronavirus as a greater threat to personal health and population than males. The aim of the current meta-analysis is to estimate gender difference in COVID-19 related fear and anxiety. The second purpose of this study is to clarify the role of potential moderators in COVID-19 fear and anxiety. For these reasons, studies published between March 2020 and October 2021 were searched in various databases (Web of Science, SCOPUS, PubMed, and Google Scholar). In total, 315 studies met the inclusion criteria, and 60 studies for COVID-19 related fear and 23 studies for COVID-19 related anxiety were included in the current study. Cohen's d effect size values were calculated based on these individual studies showing the difference between males and females in terms of COVID-19 related fear and anxiety. Results revealed that gender has a moderate and statistically significant effect on COVID-19 related fear (ES = 0.307) and anxiety (ES = 0.316) in favor of females. Moderator analyses showed that continent variable was a statistically significant moderator of gender difference in COVID-19 related fear and anxiety. The highest effect size of gender differences in COVID-related fear and anxiety were obtained from the studies conducted in Europe. However, other moderators (the average age of sample, culture, timing, and population) were not statistically significant. Although this meta-analysis has a few limitations, the findings showed that COVID-19 outbreak negatively affected females more.
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Affiliation(s)
- Ahmet Metin
- Faculty of Education, Department of Guidance and Psychological Counseling, Erciyes University, Talas, Kayseri, Turkey.
| | - Eyüp Sabır Erbiçer
- Faculty of Education, Department of Guidance and Psychological Counseling, Hacettepe University, Beytepe, Ankara, Turkey
| | - Sedat Şen
- Harran University, Şanlıurfa, Turkey
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Gottfried S. Women: Diet, Cardiometabolic Health, and Functional Medicine. Phys Med Rehabil Clin N Am 2022; 33:621-645. [DOI: 10.1016/j.pmr.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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McCombe PA. The role of sex and pregnancy in multiple sclerosis: what do we know and what should we do? Expert Rev Neurother 2022; 22:377-392. [PMID: 35354378 DOI: 10.1080/14737175.2022.2060079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Multiple sclerosis (MS) is more prevalent in women than in men. The sex of the patient, and pregnancy, are reported to be associated with the clinical features of MS. The mechanism of this is unclear. AREAS COVERED This review summarizes data about sex differences in MS and the role of pregnancy. Possible mechanisms for the effects of sex and pregnancy are summarized, and practical suggestions for addressing these issues are provided. EXPERT OPINION There is considerable interdependence of the variables that are associated with MS. Men have a worse outcome of MS, and this could be due to the same factors that lead to greater incidence of neurodegenerative disease in men. The possible role of parity on the long-term outcome of MS is of interest. Future studies that look at the mechanisms of the effects of the sex of the patient on the outcome of MS are required. However, there are some actions that can be taken without further research. We can concentrate on public health measures that address the modifiable risk factors for MS and ensure that disease is controlled in women who intend to become pregnant and use appropriate disease modifying agents during pregnancy.
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Affiliation(s)
- Pamela A McCombe
- The University of Queensland, Centre for Clinical Research, Royal Brisbane and Women's Hospital, Herston, Australia
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Predictors of renal infarction in patients presenting to the emergency department with flank pain: A retrospective observational study. PLoS One 2021; 16:e0261054. [PMID: 34874969 PMCID: PMC8651137 DOI: 10.1371/journal.pone.0261054] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 11/24/2021] [Indexed: 11/24/2022] Open
Abstract
Objectives Flank pain is a common symptom in the emergency department and can be caused by a variety of diseases. Renal infarction (RI) is a very rare disease, and many RI patients complain of flank pain. However, there is no definitive predictor of RI when patients complain of flank pain. This study aimed to identify the clinical factors for predicting RI in patients with flank pain. Methods This retrospective single-center study was conducted on patients complaining of flank pain from January 2016 to March 2020 at a South Korean tertiary care hospital. Exclusion criteria included patients who did not undergo contrast-enhanced computed tomography, age < 18 years, and trauma. Demographic and laboratory data were obtained from medical records. Logistic regression analysis was conducted to identify predictors of RI occurrence. Results In all, 2,131 patients were enrolled, and 39 (1.8%) had RI. From a multivariable logistic regression analysis, an age ≥ 65 years (odds ratio [OR], 3.249; 95% confidence interval [CI], 1.366–7.725; p = 0.008), male sex (OR, 2.846; 95% CI, 1.190–6.808; p = 0.019), atrial fibrillation (OR, 10.386; 95% CI, 3.724–28.961; p < 0.001), current smoker (OR, 10.022; 95% CI, 4.565–22.001; p < 0.001), and no hematuria (OR, 0.267; 95% CI, 0.114–0.628; p = 0.002) were significantly associated with the occurrence of RI. Conclusions Five clinical factors, i.e., age ≥ 65 years, male sex, atrial fibrillation, current smoker, and no hematuria, were significantly associated with the occurrence of RI in patients with flank pain.
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Reid N, Weerasekera S, Hubbard RE, Gordon EH. Frailty in ethnic minority women. Maturitas 2021; 152:26-31. [PMID: 34674805 DOI: 10.1016/j.maturitas.2021.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 07/05/2021] [Accepted: 07/08/2021] [Indexed: 11/25/2022]
Abstract
In majority populations in high- and middle-income countries, women live longer yet experience higher levels of frailty than men of the same age. It is unclear whether this 'sex-frailty paradox' is present in ethnic minority populations. In this narrative review, we explore biological, behavioural and social factors associated with mortality, morbidity and frailty in women, particularly ethnic minority women. We ascertain that natural menopause occurs earlier in women of particular ethnicities. Ethnic minority women (living in high-income countries) have more children and higher rates of chronic disease and disability, all of which are associated with frailty. In some ethnic minorities, women are less likely to engage in deleterious health behaviours such as smoking and alcohol consumption. However, in others the reverse is true. Women from migrant ethnic minorities tend to have lower levels of physical activity. With time, they can also adopt adverse behavioural patterns of the majority population. Although the evidence is sparse, sex differences in health reporting and social assets, as well as gender roles, are likely to contribute to sex differences in frailty in ethnic minorities. Overall, ethnic minority women are a particularly vulnerable group, but the majority of risk factors for frailty appear to be mutable rather than fixed. Future research may examine interventions that target frailty in different races and ethnicities at individual, population and global levels.
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Affiliation(s)
- Natasha Reid
- Faculty of Medicine, The University of Queensland, Queensland, Australia.
| | - Shavini Weerasekera
- Faculty of Medicine, The University of Queensland, Queensland, Australia; Princess Alexandra Hospital, Metro South Health Hospital and Health Service, Queensland, Australia; School of Medicine, Griffith University, Queensland, Australia
| | - Ruth E Hubbard
- Faculty of Medicine, The University of Queensland, Queensland, Australia; Princess Alexandra Hospital, Metro South Health Hospital and Health Service, Queensland, Australia
| | - Emily H Gordon
- Faculty of Medicine, The University of Queensland, Queensland, Australia; Princess Alexandra Hospital, Metro South Health Hospital and Health Service, Queensland, Australia
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13
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Sun Y, Fan LY, Huang CT, Liu CC, Chen TF, Lu CJ, Guo WY, Chang YC, Chiu MJ. Prognostic Features of Sporadic Creutzfeldt-Jakob Disease: An Analysis of Taiwan's Nationwide Surveillance. J Am Med Dir Assoc 2021; 23:845-851. [PMID: 34492219 DOI: 10.1016/j.jamda.2021.08.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 08/08/2021] [Accepted: 08/09/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To study the prognostic features of Creutzfeldt-Jakob disease (CJD) and shed light on its future therapy. DESIGN Retrospective cohort study of a longitudinal national cohort of the Taiwan Centers for Disease Control. SETTING AND PARTICIPANTS All patients with suspected CJD are reported to the CJD surveillance unit of the Taiwan Centers for Disease Control. An expert committee discussed the reported cases and designated a consensus-based diagnosis. From 1996 to 2020, a total of 809 cases were referred to the CJD surveillance unit for confirmation; of these, 441 cases (women, n = 230) were determined to be sporadic CJD. METHODS We investigated the clinical manifestations and laboratory findings for 400 patients diagnosed with definite or probable sporadic CJD. We used Kaplan-Meier analyses and Cox proportional hazards model to identify prognostic factors. RESULTS The mean age of onset was 67 ± 9.9 years. The mean survival duration was 13.3 ± 14.2 (median 10) months. The leading clinical symptoms were myoclonus (73%) and akinetic mutism (54%). For PRNP polymorphism, 99% of patients (195/197) showed a methionine homozygous genotype at codon 129 (M129M). The sensitivity of periodic sharp wave complexes (PSWCs) on electroencephalograms (EEGs) was 59.7%. The sensitivity of cerebrospinal fluid 14-3-3 protein and total tau protein (>1200 pg/mL) were 69.7% and 75.6%, respectively. Younger patients lived longer than those aged ≥65 years [hazard ratio (HR) 0.466, P < .001]. Women had a better survival probability in the first 3 years than their male counterparts (HR 0.712, P = .005). PSWCs had a persistent negative effect on survival (HR 0.788, P < .05). Although uncommon, epileptic seizures were the only clinical prognostic factor for survival time (HR 0.768, P < .05). PSWCs can be used as an EEG biomarker for prognosis. Epileptic seizures, though not common, are the only clinical prognostic factor for a short survival. CONCLUSIONS AND IMPLICATIONS We found that a lower age of onset and female gender favor the survival of patients with sCJD. PSWCs are EEG biomarkers unfavorable for survival, and so are epileptic seizures.
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Affiliation(s)
- Yu Sun
- Department of Neurology, En Chu Kong Hospital, New Taipei City, Taiwan; Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ling-Yun Fan
- Queensland Brain Institute, University of Queensland, St Lucia, Queensland, Australia
| | - Chung-Te Huang
- Center for Research, Diagnostics and Vaccine Development, Taiwan Centers for Disease Control, Taipei, Taiwan
| | - Chih-Ching Liu
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Ta-Fu Chen
- Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chien-Jung Lu
- Department of Neurology, En Chu Kong Hospital, New Taipei City, Taiwan; Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Wan-Yuo Guo
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yang-Chyuan Chang
- Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Neurology, Min-Sheng General Hospital, Taoyuan, Taiwan.
| | - Ming-Jang Chiu
- Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Psychology, College of Science, National Taiwan University, Taipei, Taiwan; Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan.
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14
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Elective paraesophageal hernia repair in elderly patients: an analysis of ACS-NSQIP database for contemporary morbidity and mortality. Surg Endosc 2021; 36:1407-1413. [PMID: 33712938 DOI: 10.1007/s00464-021-08425-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 02/27/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Elective paraesophageal hernia (PEH) repair in asymptomatic or minimally symptomatic patients ≥ 65 years of age remains controversial. The widely cited Markov Monte Carlo decision analytic model recommends watchful waiting in this group, unless the mortality rate for elective repair was to reach ≤ 0.5%; at which point, surgery would become the optimal treatment. We hypothesized that with advances in minimally invasive surgery, perioperative care, and practice specialization, that mortality threshold has been reached in the contemporary era. However, the safety net would decrease as age increases, particularly in octogenarians. METHODS We identified 12,422 patients from the 2015-2017 ACS-NSQIP database, who underwent elective minimally invasive PEH repair, of whom 5476 (44.1%) were with age ≥ 65. Primary outcome was 30-day mortality. Secondary outcomes were length of stay (LOS), operative time, pneumonia, pulmonary embolism, unplanned intubation, sepsis, bleeding requiring transfusion, readmission, and return to OR. RESULTS Patients age ≥ 65 had a higher 30-day mortality (0.5% vs 0.2%; p < 0.001). Subset analysis of patients age 65-80 and > 80 showed a 30-day mortality of 0.4% vs. 1.8%, respectively (p < 0.001). Independent predictors of mortality in patients ≥ 65 years were age > 80 (OR 5.23, p < 0.001) and COPD (OR 2.59, p = 0.04). Patients ≥ 65 had a slightly higher incidence of pneumonia (2% vs 1.2%; p < 0.001), unplanned intubation (0.8% vs 0.5%; p < 0.05), pulmonary embolism (0.7% vs 0.3%; p = 0.001), bleeding requiring transfusion (1% vs 0.5%; p < 0.05), and LOS (2.38 vs 1.86 days, p < 0.001) with no difference in sepsis, return to OR or readmission. CONCLUSION This is the largest series evaluating elective PEH repair in the recent era. While morbidity and mortality do increase with age, the mortality remains below 0.5% until age 80. Our results support consideration for a paradigm shift in the management of patients < 80 years toward elective repair of PEH.
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15
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Seghieri G, De Bellis A, Seghieri M, Gualdani E, Policardo L, Franconi F, Francesconi P. Gender Difference in the Risk of Adverse Outcomes After Diabetic Foot Disease: A Mini-Review. Curr Diabetes Rev 2021; 17:207-213. [PMID: 32674734 DOI: 10.2174/1573399816666200716195600] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/28/2020] [Accepted: 06/30/2020] [Indexed: 11/22/2022]
Abstract
Diabetic foot disease (DFD) is a complication of diabetes mellitus, characterized by multiple pathogenetic factors, bearing a very high burden of disability as well as of direct and indirect costs for individuals or healthcare systems. A further characteristic of DFD is that it is associated with a marked risk of subsequent hospitalizations for incident cardiovascular events, chronic renal failure or of allcause mortality. Additionally, DFD is strongly linked to the male sex, being much more prevalent among men. However, even if DFD mainly affects males, several past reports suggest that females are disadvantaged as regards the risk of subsequent adverse outcomes. This review aims to clarify this point, attempting to provide an explanation for this apparent oddity: being DFD a typically male complication of diabetes but, seemingly, with a greater load of subsequent consequences for females.
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Affiliation(s)
| | - Alessandra De Bellis
- Diabetes and Metabolic Diseases Unit, "San Giovanni di Dio" Hospital, Florence, Italy
| | - Marta Seghieri
- Diabetes and Metabolic Diseases Unit, "San Giovanni di Dio" Hospital, Florence, Italy
| | | | | | - Flavia Franconi
- National Laboratory of Gender Medicine and Gender Pharmacology of National Institute of Biostructures and Biosystems, University of Sassari, Italy
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16
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Eckhardt F, Pauliny A, Rollings N, Mutschmann F, Olsson M, Kraus C, Kappeler PM. Stress-related changes in leukocyte profiles and telomere shortening in the shortest-lived tetrapod, Furcifer labordi. BMC Evol Biol 2020; 20:160. [PMID: 33261558 PMCID: PMC7709289 DOI: 10.1186/s12862-020-01724-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 11/18/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Life history theory predicts that during the lifespan of an organism, resources are allocated to either growth, somatic maintenance or reproduction. Resource allocation trade-offs determine the evolution and ecology of different life history strategies and define an organisms' position along a fast-slow continuum in interspecific comparisons. Labord's chameleon (Furcifer labordi) from the seasonal dry forests of Madagascar is the tetrapod species with the shortest reported lifespan (4-9 months). Previous investigations revealed that their lifespan is to some degree dependent on environmental factors, such as the amount of rainfall and the length of the vegetation period. However, the intrinsic mechanisms shaping such a fast life history remain unknown. Environmental stressors are known to increase the secretion of glucocorticoids in other vertebrates, which, in turn, can shorten telomeres via oxidative stress. To investigate to what extent age-related changes in these molecular and cellular mechanisms contribute to the relatively short lifetime of F. labordi, we assessed the effects of stressors indirectly via leukocyte profiles (H/L ratio) and quantified relative telomere length from blood samples in a wild population in Kirindy Forest. We compared our findings with the sympatric, but longer-lived sister species F. cf. nicosiai, which exhibit the same annual timing of reproductive events, and with wild-caught F. labordi that were singly housed under ambient conditions. RESULTS We found that H/L ratios were consistently higher in wild F. labordi compared to F. cf. nicosiai. Moreover, F. labordi already exhibited relatively short telomeres during the mating season when they were 3-4 months old, and telomeres further shortened during their post-reproductive lives. At the beginning of their active season, telomere length was relatively longer in F. cf. nicosiai, but undergoing rapid shortening towards the southern winter, when both species gradually die off. Captive F. labordi showed comparatively longer lifespans and lower H/L ratios than their wild counterparts. CONCLUSION We suggest that environmental stress and the corresponding accelerated telomere attrition have profound effects on the lifespan of F. labordi in the wild, and identify physiological mechanisms potentially driving their relatively early senescence and mortality.
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Affiliation(s)
- Falk Eckhardt
- Department Sociobiology/Anthropology, Institute of Zoology and Anthropology, University of Göttingen, Kellnerweg 6, 37077, Göttingen, Germany
| | - Angela Pauliny
- Department of Biological and Environmental Science, University of Gothenburg, Medicinaregatan 18A, 41390, Göteborg, Sweden
| | - Nicky Rollings
- School of Life and Environmental Sciences, University of Sydney, Sydney, NSW, Australia
| | | | - Mats Olsson
- Department of Biological and Environmental Science, University of Gothenburg, Medicinaregatan 18A, 41390, Göteborg, Sweden
| | - Cornelia Kraus
- Department Sociobiology/Anthropology, Institute of Zoology and Anthropology, University of Göttingen, Kellnerweg 6, 37077, Göttingen, Germany.,Behavioral Ecology and Sociobiology Unit, German Primate Center, Leibniz Institute of Primatology, Kellnerweg 4, 37077, Göttingen, Germany
| | - Peter M Kappeler
- Department Sociobiology/Anthropology, Institute of Zoology and Anthropology, University of Göttingen, Kellnerweg 6, 37077, Göttingen, Germany. .,Behavioral Ecology and Sociobiology Unit, German Primate Center, Leibniz Institute of Primatology, Kellnerweg 4, 37077, Göttingen, Germany.
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17
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Chrzastek Z, Guligowska A, Piglowska M, Soltysik B, Kostka T. Association between sucrose and fiber intake and symptoms of depression in older people. Nutr Neurosci 2020; 25:886-897. [PMID: 32945734 DOI: 10.1080/1028415x.2020.1819106] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Objectives: This study aimed to analyze the relationship between sucrose and fiber intake and symptoms of depression in older people.Material and Methods: The research group consisted of 813 community-dwelling subjects (221 males and 592 females, median age 75). The symptoms of depression were assessed using the Geriatric Depression Scale (GDS). Participants were divided into two subgroups according to the GDS scale. Group A: 0-5 points - no symptoms of depression (612, M:167, W:445), and group B: 6-15 points - with symptoms of depression (201, M:54, W:147). The level of nutrient consumption was assessed with a 24 h Recall Questionnaire and the software 'Dieta 5.0'.Results: In males, consumption of sucrose (A: 30 g (18.1-53.3), B: 62.8 g (43.2-92.6)) (median (25%-75% quartile) and % of energy from sucrose (A: 7.3% (4.8-11.9), B: 13.5% (7.8-18.6)) were significantly higher in the group with symptoms of depression. Kilocalories per 1 g of fiber intake ratios were higher in depressive groups of both males (A: 89.1 kcal/g (68.1-109), B: 103.9 kcal/g (86.1-134.1)) and females (A: 78.6 kcal/g (62.1-99.9), B: 93 kcal/g (67.1-118.3)). Females without symptoms of depression consumed significantly more fiber (17.2 g (12.9-23.1)) than females with symptoms of depression (16.1 g (11.3-20)).Conclusions: This analysis shows increased kilocalories per 1 g of fiber intake in patients with symptoms of depression. In males, symptoms of depression were connected with higher consumption of sucrose and higher % of energy intake from sucrose. In females, greater fiber consumption was related to less frequent symptoms of depression.
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Affiliation(s)
- Zuzanna Chrzastek
- Department of Geriatrics Healthy Ageing Research Centre, Medical University of Lodz, Lodz, Poland
| | - Agnieszka Guligowska
- Department of Geriatrics Healthy Ageing Research Centre, Medical University of Lodz, Lodz, Poland
| | - Malgorzata Piglowska
- Department of Geriatrics Healthy Ageing Research Centre, Medical University of Lodz, Lodz, Poland
| | - Bartlomiej Soltysik
- Department of Geriatrics Healthy Ageing Research Centre, Medical University of Lodz, Lodz, Poland
| | - Tomasz Kostka
- Department of Geriatrics Healthy Ageing Research Centre, Medical University of Lodz, Lodz, Poland
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18
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Öngel ME, Yıldız C, Akpınaroğlu C, Yilmaz B, Özilgen M. Why women may live longer than men do? A telomere-length regulated and diet-based entropic assessment. Clin Nutr 2020; 40:1186-1191. [PMID: 32807581 DOI: 10.1016/j.clnu.2020.07.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/23/2020] [Accepted: 07/25/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND & AIMS Empirical analyses of the data available around the word concluded that women have longer life span now, when compared to the men. Available literature unfortunately could not offer full answers to this observation. The "entropic age" concept suggests that ageing related changes in the body, such as loss of molecular functions and overwhelming of the maintenance systems, may be explained in terms of entropy generation. METHODS Telomere-length regulated entropic assessment based on metabolic activity with four different diets carried out. RESULTS Estimates of the life expectancy of the women on all of these diets is longer than those of the men. Faster shortening of the telomere lengths in men was the major reason of the shorter life expectancy. The highest and the lowest life expectancy for women were estimated with Mediterranean and the vegetarian diets, respectively; men were estimated to have the longest life span with the vegetarian diet and the shortest life span with the ketogenic diet. CONCLUSIONS A higher rate of metabolism causes higher entropy generation and hints correlations that can be helpful in future ageing research. Faster shortening of the telomere lengths in men was the major reason of the estimation of the shorter life span for men.
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Affiliation(s)
- Melek Ece Öngel
- Department and Nutrition and Dietetics, Yeditepe University, 34755, Kayısdagi, Atasehir, Istanbul, Turkey
| | - Cennet Yıldız
- Department of Food Engineering, Yeditepe University, 34755, Kayısdagi, Atasehir, Istanbul, Turkey
| | - Can Akpınaroğlu
- Department of Genetics and Bioengineering, Yeditepe University, 34755, Kayısdagi, Atasehir, Istanbul, Turkey
| | - Bayram Yilmaz
- Yeditepe University, Faculty of Medicine, Yeditepe University Hospital, Istanbul, Turkey
| | - Mustafa Özilgen
- Department of Food Engineering, Yeditepe University, 34755, Kayısdagi, Atasehir, Istanbul, Turkey.
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19
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Kuo PL, Schrack JA, Shardell MD, Levine M, Moore AZ, An Y, Elango P, Karikkineth A, Tanaka T, de Cabo R, Zukley LM, AlGhatrif M, Chia CW, Simonsick EM, Egan JM, Resnick SM, Ferrucci L. A roadmap to build a phenotypic metric of ageing: insights from the Baltimore Longitudinal Study of Aging. J Intern Med 2020; 287:373-394. [PMID: 32107805 PMCID: PMC7670826 DOI: 10.1111/joim.13024] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Over the past three decades, considerable effort has been dedicated to quantifying the pace of ageing yet identifying the most essential metrics of ageing remains challenging due to lack of comprehensive measurements and heterogeneity of the ageing processes. Most of the previously proposed metrics of ageing have been emerged from cross-sectional associations with chronological age and predictive accuracy of mortality, thus lacking a conceptual model of functional or phenotypic domains. Further, such models may be biased by selective attrition and are unable to address underlying biological constructs contributing to functional markers of age-related decline. Using longitudinal data from the Baltimore Longitudinal Study of Aging (BLSA), we propose a conceptual framework to identify metrics of ageing that may capture the hierarchical and temporal relationships between functional ageing, phenotypic ageing and biological ageing based on four hypothesized domains: body composition, energy regulation, homeostatic mechanisms and neurodegeneration/neuroplasticity. We explored the longitudinal trajectories of key variables within these phenotypes using linear mixed-effects models and more than 10 years of data. Understanding the longitudinal trajectories across these domains in the BLSA provides a reference for researchers, informs future refinement of the phenotypic ageing framework and establishes a solid foundation for future models of biological ageing.
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Affiliation(s)
- P-L Kuo
- From the, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - J A Schrack
- From the, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - M D Shardell
- From the, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - M Levine
- Department of Pathology, Yale School of Medicine, New Haven, CT, USA
| | - A Z Moore
- From the, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Y An
- Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - P Elango
- From the, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - A Karikkineth
- Clinical Research Unit, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - T Tanaka
- From the, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - R de Cabo
- From the, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - L M Zukley
- Clinical Research Unit, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - M AlGhatrif
- From the, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA.,Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - C W Chia
- Laboratory of Clinical Investigation, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - E M Simonsick
- From the, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - J M Egan
- Laboratory of Clinical Investigation, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - S M Resnick
- Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - L Ferrucci
- From the, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
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20
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Abstract
Frailty describes an individual's vulnerability to adverse health outcomes and is a useful construct that assists health professionals to understand the heterogeneity of the ageing population. While the pathophysiological pathways that lead to frailty are not well defined, an individual's sex appears to be a key factor influencing the ageing trajectory. Compared with age-matched men, women tend to have poorer health status (ie, they are more frail) but longer life expectancy (ie, they are more resilient). It seems likely that a combination of biological, behavioural and social factors underpin this male-female health-survival paradox. Randomised controlled trial data for frailty interventions in older adults are emerging, with multicomponent programs incorporating exercise and nutrition-based strategies showing promise. Pharmaceutical and other innovative therapeutic strategies for frailty are highly anticipated. Sex differences in the effectiveness of frailty interventions have not been addressed in the research literature to date. In the future, successful interventions may target many (if not all) biopsychosocial domains, with careful consideration of issues relevant to each sex.
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Affiliation(s)
- Emily H Gordon
- Centre for Health Services Research, University of Queensland, Brisbane, QLD
| | - Ruth E Hubbard
- Centre for Health Services Research, University of Queensland, Brisbane, QLD
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21
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Kim HS, Kwon M, Lee HY, Shivappa N, Hébert JR, Sohn C, Na W, Kim MK. Higher Pro-Inflammatory Dietary Score is Associated with Higher Hyperuricemia Risk: Results from the Case-Controlled Korean Genome and Epidemiology Study_Cardiovascular Disease Association Study. Nutrients 2019; 11:E1803. [PMID: 31387233 PMCID: PMC6722783 DOI: 10.3390/nu11081803] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 07/26/2019] [Accepted: 08/02/2019] [Indexed: 12/12/2022] Open
Abstract
In previous studies, the elevated dietary inflammatory index (DII®) scores have been consistently associated with several chronic diseases. However, the relationship with hyperuricemia remains unknown. The aim of this study was to determine if the DII is associated with hyperuricemia risk. The study included 13,701 participants (men 5102; women 8599) in a large-scale cross-sectional study in South Korea. A validated semi-quantitative food frequency questionnaire (SQFFQ) was used to measure dietary intake, and blood samples were obtained to determine hyperuricemia. As the DII score increased, the hyperuricemia risk increased among women (OR 1.35, 95% CI 1.03-1.77, p trend = 0.02). However, no significant results were found for men. Women with lower BMI scores had higher risks of hyperuricemia with higher DII scores (OR 1.62, 95% CI 1.05-2.52, p trend = 0.03). As the DII increased, however, only women who consumed alcohol ("past or current drinkers") had higher risks of hyperuricemia (OR 1.92, 1.22-3.02, p trend = 0.004). Among the DII components, intake of flavonoids showed a significant association with the hyperuricemia risk in women (OR 0.75, 0.59-0.96, p trend = 0.03). Our results suggest that higher intake of pro-inflammatory diet is significantly associated with higher risk of hyperuricemia among women. These results reinforce the importance of less pro-inflammatory habitual dietary patterns in lowering the risk of hyperuricemia and secondary afflictions such as cardiovascular diseases.
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Affiliation(s)
- Hye Sun Kim
- Division of Cancer Epidemiology and Prevention, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 10408, Korea
| | - Minji Kwon
- Division of Cancer Epidemiology and Prevention, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 10408, Korea
| | - Hyun Yi Lee
- Division of Cancer Epidemiology and Prevention, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 10408, Korea
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
- Connecting Health Innovations LLC, Columbia, SC 29201, USA
| | - James R Hébert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
- Connecting Health Innovations LLC, Columbia, SC 29201, USA
| | - Cheongmin Sohn
- Department of Food and Nutrition, Wonkwang University, 460 Iksandaero, Iksan, Jeonbuk 54538, Korea
| | - Woori Na
- Department of Food and Nutrition, Wonkwang University, 460 Iksandaero, Iksan, Jeonbuk 54538, Korea
| | - Mi Kyung Kim
- Division of Cancer Epidemiology and Prevention, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 10408, Korea.
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Türkarslan KK, Okay D, Çevrim M, Bozo Ö. Life is short, stay awake: Death anxiety and bedtime procrastination. The Journal of General Psychology 2019; 147:43-61. [PMID: 31291166 DOI: 10.1080/00221309.2019.1633994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
In the present study, the relation between bedtime procrastination and death anxiety, and also the moderator roles of gender and purpose in life were investigated. Data were collected from 245 participants through an online survey. The results revealed that gender, but not purpose in life, moderated the relation between death anxiety and bedtime procrastination. The effect of death anxiety on bedtime procrastination was significant only for males. Further, this effect was still significant even after controlling circadian energy and self-control. The findings can be explained based on the Terror Management Theory. Bedtime procrastination can be considered risk-taking behavior, and it functions as a world view for males. Moreover, males might have regarded sleep as a waste of time, and therefore, delayed bedtime to increase their non-sleeping lifetime.
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Affiliation(s)
| | - Deniz Okay
- Middle East Technical University.,TED University
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Gordon EH, Hubbard RE. Do sex differences in chronic disease underpin the sex-frailty paradox? Mech Ageing Dev 2019; 179:44-50. [PMID: 30825457 DOI: 10.1016/j.mad.2019.02.004] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 02/17/2019] [Accepted: 02/26/2019] [Indexed: 12/21/2022]
Abstract
The 'male-female health-survival paradox' is a well-described clinical phenomenon. More recently, it has been conceptualized as a 'sex-frailty paradox': females may be considered to be more frail (because they have poorer health status) but also less frail (because they are less vulnerable to death) than males of the same age. Here, we review potential biological, behavioral and social mechanisms underpinning sex differences in morbidity, mortality and frailty before considering the question at the center of the sex paradox - why is it that females are able to tolerate poor health better than males? We explore, in detail, a frequently cited explanation for the sex paradox that centers on sex differences in chronic disease and conclude by presenting a new approach to this old hypothesis.
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Affiliation(s)
- E H Gordon
- Centre for Health Services Research, Level 2, Building 33, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD, 4102, Australia.
| | - R E Hubbard
- Centre for Health Services Research, Level 2, Building 33, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD, 4102, Australia
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Olsson M, Wapstra E, Friesen C. Ectothermic telomeres: it's time they came in from the cold. Philos Trans R Soc Lond B Biol Sci 2019; 373:rstb.2016.0449. [PMID: 29335373 PMCID: PMC5784069 DOI: 10.1098/rstb.2016.0449] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2017] [Indexed: 12/17/2022] Open
Abstract
We review the evolutionary ecology and genetics of telomeres in taxa that cannot elevate their body temperature to a preferred level through metabolism but do so by basking or seeking out a warm environment. This group of organisms contains all living things on earth, apart from birds and mammals. One reason for our interest in this synthetic group is the argument that high, stable body temperature increases the risk of malignant tumours if long, telomerase-restored telomeres make cells 'live forever'. If this holds true, ectotherms should have significantly lower cancer frequencies. We discuss to what degree there is support for this 'anti-cancer' hypothesis in the current literature. Importantly, we suggest that ectothermic taxa, with variation in somatic telomerase expression across tissue and taxa, may hold the key to understanding ongoing selection and evolution of telomerase dynamics in the wild. We further review endotherm-specific effects of growth on telomeres, effects of autotomy ('tail dropping') on telomere attrition, and costs of maintaining sexual displays measured in telomere attrition. Finally, we cover plant ectotherm telomeres and life histories in a separate 'mini review'.This article is part of the theme issue 'Understanding diversity in telomere dynamics'.
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Affiliation(s)
- Mats Olsson
- Department of Biological and Environmental Sciences, University of Gothenburg, Medicinaregatan 18, Box 463, 405 30 Gothenburg, Sweden .,School of Biological Sciences, The University of Wollongong, 2522 Wollongong, New South Wales, Australia
| | - Erik Wapstra
- School of Biological Sciences, University of Tasmania, Private Bag 55, Hobart 7001, Tasmania, Australia
| | - Christopher Friesen
- School of Life and Environmental Sciences, University of Sydney, Heydon-Laurence Bldg A08, Science Road, Sydney, NSW 2006, Australia
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25
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Warraich HJ, Califf RM. Differences in Health Outcomes between Men and Women: Biological, Behavioral, and Societal Factors. Clin Chem 2019; 65:19-23. [DOI: 10.1373/clinchem.2018.287334] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 06/26/2018] [Indexed: 11/06/2022]
Affiliation(s)
- Haider J Warraich
- Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Robert M Califf
- Duke Forge, Duke University School of Medicine, Durham, NC
- Department of Medicine, Stanford University, Stanford, CA
- Verily Life Sciences (Alphabet), South San Francisco, CA
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26
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Cunningham-Myrie CA, Mabile E, Govia I, Younger NO, Tulloch-Reid MK, McFarlane S, Francis D, Gordon-Strachan G, Wilks R, Greene LG, Lyew-Ayee P, Theall KP. Neighbourhood characteristics and cumulative biological risk: evidence from the Jamaica Health and Lifestyle Survey 2008: a cross-sectional study. BMJ Open 2018; 8:e021952. [PMID: 30552247 PMCID: PMC6303643 DOI: 10.1136/bmjopen-2018-021952] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 08/11/2018] [Accepted: 10/04/2018] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To examine whether neighbourhood characteristics are associated with cumulative biological risk (CBR) and sex differences in CBR in a nationally representative sample in Jamaica, a small island developing country with increasing prevalence of non-communicable diseases (NCDs). DESIGN Cross-sectional study SETTING: A population-based cross-sectional survey, the Jamaica Health and Lifestyle Survey 2008 (JHLS II) recruited persons at their homes over a 4 month period from all 14 parishes and 113 neighbourhoods defined as enumeration districts (EDs). PARTICIPANTS 2544 persons aged 15-74 years old from the 2008 Jamaica Health and Lifestyle Survey (JHLS II), who completed interviewer-administered questionnaires and had biomarkers assessed, and whose home addresses could be reliably geocoded. PRIMARY OUTCOME A summary measure CBR was created using seven markers-systolic and diastolic blood pressure readings, waist circumference, body mass index, total cholesterol, fasting blood glucose levels and self-reported asthma. Weighted multilevel models examined clustering, using the intraclass correlation coefficient (ICC), of CBR across neighbourhoods and the impact of neighbourhood characteristics (recreational space availability and neighbourhood disorder) on CBR. RESULTS Women had significantly higher mean CBR scores than men across all age groups. There was significant clustering of CBR by ED, and among women versus men (ICC: F=6.9%, M=0.7%). Women living in more disordered neighbourhoods were 26% more likely to have high CBR as those in less disordered ones (aOR=1.26, 95% CI=1.08 to 1.47; p<0.05). Individuals living in EDs with greater recreational space availability were 25% less likely to have a high CBR (aOR=0.75, 95% CI=0.64 to 0.90; p<0.05). CONCLUSIONS Policy-makers in Jamaica should pay greater attention to neighbourhood factors such as recreational space availability and neighbourhood disorder that may contribute to CBR in any effort to curtail the epidemic of NCDs.
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Affiliation(s)
| | - Emily Mabile
- Louisiana Department of Health, Office of Public Health, Bureau of Family Health, Baton Rouge, Louisiana, USA
| | - Ishtar Govia
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - Novie O Younger
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | | | - Shelly McFarlane
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - Damian Francis
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | | | - Rainford Wilks
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - Lisa-Gaye Greene
- Mona GeoInformatics Institute, University of the West Indies, Mona, Jamaica
| | - Parris Lyew-Ayee
- Mona GeoInformatics Institute, University of the West Indies, Mona, Jamaica
| | - Katherine P Theall
- Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA
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Piotrowska Ż, Niezgoda M, Łebkowski W, Filipek A, Domian N, Kasacka I. Sex differences in distribution of cannabinoid receptors (CB1 and CB2), S100A6 and CacyBP/SIP in human ageing hearts. Biol Sex Differ 2018; 9:50. [PMID: 30482253 PMCID: PMC6258148 DOI: 10.1186/s13293-018-0209-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 11/09/2018] [Indexed: 02/04/2023] Open
Abstract
Background Women live about 4 years longer due to lower prevalence of cardiovascular complication with ageing. However, the mechanisms involved in the preservation of heart functionality in women have not been fully elucidated. The endocannabinoid system fulfils a significant role in the regulation of cardiovascular system functioning. Cannabinoids, acting through specific receptors (CB1 and CB2), influence on blood pressure, heart rate and myocardial contractility. The function of cardiac muscle cells is strictly dependent on calcium ions. Calcium homeostasis in cardiomyocytes is subjected to complex regulation via calcium-binding proteins. Among them, increasing attention has been paid to the recently discovered S100A6 and CacyBP/SIP. In order to better understand sex differences in the regulation of cardiomyocyte function during ageing, we undertook the present research aimed at immunohistochemical identification and comparative evaluation of cannabinoid receptors, S100A6 and CacyBP/SIP, in the myocardium of ageing men and women. Methods The study was conducted on the hearts of 12 men and 10 women (organ donors) without a history of cardiovascular disease. The subjects were divided into two age groups: subjects older than 50 years and subjects under 50 years old. Paraffin heart sections were processed by immunohistochemistry for detection of cannabinoids receptors, S100A6 and CacyBP/SIP. In the heart samples from each study, participant’s expression of genes coding for CB1, CB2, S100A6 and CacyBP/SIP using real-time PCR method was measured. Results CB1 and CB2 immunoreactivity in the cytoplasm of cardiomyocytes in the heart of subjects over 50 was weaker than in younger individuals. In the heart of younger men, CB1-immunoreactivity was weaker and CB2-immunoreaction was stronger compared to women. In the hearts of older men, the CB1-immunostaining was more intense and CB2-immunoreactivity was weaker than in women. Immunodetection of CB1 shoved the presence of receptor in the intercalated discs, but only in the hearts of individuals over the 50 years old. In the hearts of older individuals, stronger immunolabelling was observed for S100A6 and CacyBP/SIP. Male hearts had greater S100A6-immunoreactivity (both age groups) but less CacyBP/SIP immunostaining (individuals over 50 years) compared to the age-matched women. The expression of genes coding CB1, CB2, S100A6 and CacyBP/SIP in the human heart was sex and age-dependent. Observed changes between men and women as well as between subject under and over 50 years were consistent with immunohistochemically stated changes in peptide content. Conclusion Together, the data presented here indicate a close interaction between ageing and sex on the distribution and levels of cannabinoid receptors (CB1, CB2), S100A6 and CacyBP/SIP in the human heart.
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Affiliation(s)
- Żaneta Piotrowska
- Department of Histology and Cytophysiology, Medical University of Białystok, Białystok, Poland
| | - Michał Niezgoda
- Department of Histology and Cytophysiology, Medical University of Białystok, Białystok, Poland
| | - Wojciech Łebkowski
- Department of Neurosurgery, Medical University of Białystok, Białystok, Poland
| | - Anna Filipek
- Nencki Institute of Experimental Biology, Polish Academy of Sciences, Warsaw, Poland
| | - Natalia Domian
- Department of Histology and Cytophysiology, Medical University of Białystok, Białystok, Poland
| | - Irena Kasacka
- Department of Histology and Cytophysiology, Medical University of Białystok, Białystok, Poland.
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29
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Forth G. Elderly People Growing Tails: The Constitution of a Nonempirical Idea. CURRENT ANTHROPOLOGY 2018. [DOI: 10.1086/698936] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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30
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Höhn A, Larsen LA, Schneider DC, Lindahl-Jacobsen R, Rau R, Christensen K, Oksuzyan A. Sex differences in the 1-year risk of dying following all-cause and cause-specific hospital admission after age 50 in comparison with a general and non-hospitalised population: a register-based cohort study of the Danish population. BMJ Open 2018; 8:e021813. [PMID: 30018099 PMCID: PMC6059308 DOI: 10.1136/bmjopen-2018-021813] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 05/03/2018] [Accepted: 06/07/2018] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES We examine the mortality of men and women within the first year after all-cause and cause-specific hospital admission to investigate whether the sex differences in mortality after hospitalisation are higher than in the corresponding general and non-hospitalised population. DESIGN This is a population-based, longitudinal study with nationwide coverage. The study population was identified by linking the National Patient Register with the Central Population Register using a 5% random sample of the Danish population. SETTING The population born between 1898 and 1961, who was alive and residing in Denmark after 1977, was followed up between 1977 and 2011 with respect to hospital admissions and mortality while aged 50-79. PRIMARY OUTCOME MEASURES The absolute sex differences in the 1-year risk of dying after all-cause and cause-specific hospital admission. The hospitalised population sex differentials were then compared with the sex differences in a general and a non-hospitalised population, randomly matched by age, sex and hospitalisation status. RESULTS The risk of dying was consistently higher for hospitalised men and women. At all ages, the absolute sex differences in mortality were largest in the hospitalised population, were smaller in the general population and were smallest in the non-hospitalised population. This pattern was consistent across all-cause admissions, and with respect to admissions for neoplasms, circulatory diseases and respiratory diseases. For all-cause hospital admissions, absolute sex differences in the 1-year risk of dying resulted in 43.8 excess male deaths per 1,000 individuals within the age range 50-79, while the levels were lower in the general and the non-hospitalised population, at levels of 13.5 and 6.6, respectively. CONCLUSIONS This study indicates a larger male disadvantage in mortality following hospitalisation, pointing towards an association between the health status of a population and the magnitude of the female advantage in mortality.
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Affiliation(s)
- Andreas Höhn
- Max Planck Institute for Demographic Research, Rostock, Germany
- Department of Epidemiology, Biostatistics, and Biodemography, University of Southern Denmark, Odense, Denmark
| | - Lisbeth Aagaard Larsen
- Department of Epidemiology, Biostatistics, and Biodemography, University of Southern Denmark, Odense, Denmark
| | | | - Rune Lindahl-Jacobsen
- Department of Epidemiology, Biostatistics, and Biodemography, University of Southern Denmark, Odense, Denmark
| | - Roland Rau
- Max Planck Institute for Demographic Research, Rostock, Germany
- Department of Sociology and Demography, University of Rostock, Rostock, Germany
| | - Kaare Christensen
- Department of Epidemiology, Biostatistics, and Biodemography, University of Southern Denmark, Odense, Denmark
- Danish Aging Research Center, Odense, Denmark
| | - Anna Oksuzyan
- Max Planck Institute for Demographic Research, Rostock, Germany
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Hotzi B, Kosztelnik M, Hargitai B, Takács‐Vellai K, Barna J, Bördén K, Málnási‐Csizmadia A, Lippai M, Ortutay C, Bacquet C, Pasparaki A, Arányi T, Tavernarakis N, Vellai T. Sex-specific regulation of aging in Caenorhabditis elegans. Aging Cell 2018; 17:e12724. [PMID: 29493066 PMCID: PMC5946081 DOI: 10.1111/acel.12724] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2017] [Indexed: 02/03/2023] Open
Abstract
A fascinating aspect of sexual dimorphism in various animal species is that the two sexes differ substantially in lifespan. In humans, for example, women's life expectancy exceeds that of men by 3-7 years. Whether this trait can be attributed to dissimilar lifestyles or genetic (regulatory) factors remains to be elucidated. Herein, we demonstrate that in the nematode Caenorhabditis elegans, the significantly longer lifespan of hermaphrodites-which are essentially females capable of sperm production-over males is established by TRA-1, the terminal effector of the sex-determination pathway. This transcription factor directly controls the expression of daf-16/FOXO, which functions as a major target of insulin/IGF-1 signaling (IIS) and key modulator of aging across diverse animal phyla. TRA-1 extends hermaphrodite lifespan through promoting daf-16 activity. Furthermore, TRA-1 also influences reproductive growth in a DAF-16-dependent manner. Thus, the sex-determination machinery is an important regulator of IIS in this organism. These findings provide a mechanistic insight into how longevity and development are specified unequally in the two genders. As TRA-1 is orthologous to mammalian GLI (glioma-associated) proteins, a similar sex-specific mechanism may also operate in humans to determine lifespan.
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Affiliation(s)
| | | | - Balázs Hargitai
- Department of GeneticsEötvös Loránd UniversityBudapestHungary
| | | | - János Barna
- Department of GeneticsEötvös Loránd UniversityBudapestHungary
| | - Kincső Bördén
- Department of GeneticsEötvös Loránd UniversityBudapestHungary
| | | | - Mónika Lippai
- Department of Anatomy, Cell‐ and Developmental BiologyEötvös Loránd UniversityBudapestHungary
| | | | - Caroline Bacquet
- Institute of EnzymologyResearch Centre for Natural SciencesHungarian Academy of SciencesBudapestHungary
| | - Angela Pasparaki
- Institute of Molecular Biology and BiotechnologyFoundation for Research and Technology‐HellasHeraklionGreece
| | - Tamás Arányi
- Institute of EnzymologyResearch Centre for Natural SciencesHungarian Academy of SciencesBudapestHungary
- BNMI (INSERM 1083/CNRS 6214)Université d'AngersAngersFrance
| | - Nektarios Tavernarakis
- Institute of Molecular Biology and BiotechnologyFoundation for Research and Technology‐HellasHeraklionGreece
| | - Tibor Vellai
- Department of GeneticsEötvös Loránd UniversityBudapestHungary
- MTA‐ELTE Genetics Research GroupEötvös Loránd UniversityBudapestHungary
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Gordon EH, Hubbard RE. The Pathophysiology of Frailty: Why Sex Is So Important. J Am Med Dir Assoc 2018; 19:4-5. [DOI: 10.1016/j.jamda.2017.10.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 10/06/2017] [Indexed: 12/31/2022]
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Reniers G, Blom S, Lieber J, Herbst AJ, Calvert C, Bor J, Barnighausen T, Zaba B, Li ZR, Clark SJ, Grant AD, Lessells R, Eaton JW, Hosegood V. Tuberculosis mortality and the male survival deficit in rural South Africa: An observational community cohort study. PLoS One 2017; 12:e0185692. [PMID: 29016619 PMCID: PMC5634548 DOI: 10.1371/journal.pone.0185692] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 09/18/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Women live on average five years longer than men, and the sex difference in longevity is typically lower in populations with high mortality. South Africa-a high mortality population with a large sex disparity-is an exception, but the causes of death that contribute to this difference are not well understood. METHODS Using data from a demographic surveillance system in rural KwaZulu-Natal (2000-2014), we estimate differences between male and female adult life expectancy by HIV status. The contribution of causes of death to these life expectancy differences are computed with demographic decomposition techniques. Cause of death information comes from verbal autopsy interviews that are interpreted with the InSilicoVA tool. RESULTS Adult women lived an average of 10.4 years (95% confidence Interval 9.0-11.6) longer than men. Sex differences in adult life expectancy were even larger when disaggregated by HIV status: 13.1 (95% confidence interval 10.7-15.3) and 11.2 (95% confidence interval 7.5-14.8) years among known HIV negatives and positives, respectively. Elevated male mortality from pulmonary tuberculosis (TB) and external injuries were responsible for 43% and 31% of the sex difference in life expectancy among the HIV negative population, and 81% and 16% of the difference among people living with HIV. CONCLUSIONS The sex differences in adult life expectancy in rural KwaZulu-Natal are exceptionally large, atypical for an African population, and largely driven by high male mortality from pulmonary TB and injuries. This is the case for both HIV positive and HIV negative men and women, signalling a need to improve the engagement of men with health services, irrespective of their HIV status.
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Affiliation(s)
- Georges Reniers
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Sylvia Blom
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Charles H. Dyson School of Applied Economics and Management, Cornell University, Ithaca, New York, United States of America
| | - Judith Lieber
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Abraham J. Herbst
- Africa Health Research Institute, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Clara Calvert
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Jacob Bor
- Department of Global Health, Boston University, Boston, Massachusetts, United States of America
| | - Till Barnighausen
- Africa Health Research Institute, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- Department of Global Health and Population, T. H. Chan School of Public Health, Harvard University, Cambridge, Massachusetts, United States of America
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany
| | - Basia Zaba
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Zehang R. Li
- Department of Statistics, University of Washington, Seattle, United States of America
| | - Samuel J. Clark
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Department of Sociology, The Ohio State University, Columbus, Ohio
| | - Alison D. Grant
- Africa Health Research Institute, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Richard Lessells
- Africa Health Research Institute, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jeffrey W. Eaton
- Department of Infectious Disease Epidemiology, School of Public Health, Imperial College, London, United Kingdom
| | - Victoria Hosegood
- Africa Health Research Institute, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- Social Statistics and Demography, University of Southampton, Southampton, United Kingdom
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Olsson M, Wapstra E, Friesen CR. Evolutionary ecology of telomeres: a review. Ann N Y Acad Sci 2017; 1422:5-28. [DOI: 10.1111/nyas.13443] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 06/30/2017] [Accepted: 07/06/2017] [Indexed: 12/26/2022]
Affiliation(s)
- Mats Olsson
- Department of Biological and Environmental Sciences University of Gothenburg Gothenburg Sweden
- School of Biological Sciences The University of Wollongong Wollongong New South Wales Australia
| | - Erik Wapstra
- School of Biological Sciences University of Tasmania Hobart Tasmania Australia
| | - Christopher R. Friesen
- School of Life and Environmental Sciences University of Sydney Sydney New South Wales Australia
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Adjei NK, Brand T, Zeeb H. Gender inequality in self-reported health among the elderly in contemporary welfare countries: A cross-country analysis of time use activities, socioeconomic positions and family characteristics. PLoS One 2017; 12:e0184676. [PMID: 28949984 PMCID: PMC5614435 DOI: 10.1371/journal.pone.0184676] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 08/29/2017] [Indexed: 11/19/2022] Open
Abstract
Background Paradoxically, despite their longer life expectancy, women report poorer health than men. Time devoted to differing social roles could be an explanation for the observed gender differences in health among the elderly. The objective of this study was to explain gender differences in self-reported health among the elderly by taking time use activities, socio-economic positions, family characteristics and cross-national differences into account. Methods Data from the Multinational Time Use Study (MTUS) on 13,223 men and 18,192 women from Germany, Italy, Spain, UK and the US were analyzed. Multiple binary logistic regression models were used to examine the association between social factors and health for men and women separately. We further identified the relative contribution of different factors to total gender inequality in health using the Blinder-Oaxaca decomposition method. Results Whereas time allocated to paid work, housework and active leisure activities were positively associated with health, time devoted to passive leisure and personal activities were negatively associated with health among both men and women, but the magnitude of the association varied by gender and country. We found significant gender differences in health in Germany, Italy and Spain, but not in the other countries. The decomposition showed that differences in the time allocated to active leisure and level of educational attainment accounted for the largest health gap. Conclusions Our study represents a first step in understanding cross-national differences in the association between health status and time devoted to role-related activities among elderly men and women. The results, therefore, demonstrate the need of using an integrated framework of social factors in analyzing and explaining the gender and cross-national differences in the health of the elderly population.
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Affiliation(s)
- Nicholas Kofi Adjei
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
- * E-mail:
| | - Tilman Brand
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Hajo Zeeb
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
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Does gender inequity increase men's mortality risk in the United States? A multilevel analysis of data from the National Longitudinal Mortality Study. SSM Popul Health 2017; 3:358-365. [PMID: 29349229 PMCID: PMC5769061 DOI: 10.1016/j.ssmph.2017.03.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 11/08/2016] [Accepted: 03/10/2017] [Indexed: 11/23/2022] Open
Abstract
A number of theoretical approaches suggest that gender inequity may give rise to health risks for men. This study undertook a multilevel analysis to ascertain if state-level measures of gender inequity are predictors of men's mortality in the United States. Data for the analysis were taken primarily from the National Longitudinal Mortality Study, which is based on a random sample of the non-institutionalised population. The full data set included 174,703 individuals nested within 50 states and had a six-year follow-up for mortality. Gender inequity was measured by nine variables: higher education, reproductive rights, abortion provider access, elected office, management, business ownership, labour force participation, earnings and relative poverty. Covariates at the individual level were age, income, education, race/ethnicity, marital status and employment status. Covariates at the state level were income inequality and per capita gross domestic product. The results of logistic multilevel modelling showed a number of measures of state-level gender inequity were significantly associated with men's mortality. In all of these cases greater gender inequity was associated with an increased mortality risk. In fully adjusted models for all-age adult men the elected office (OR 1.05 95% CI 1.01–1.09), business ownership (OR 1.04 95% CI 1.01–1.08), earnings (OR 1.04 95% CI 1.01–1.08) and relative poverty (OR 1.07 95% CI 1.03–1.10) measures all showed statistically significant effects for each 1 standard deviation increase in the gender inequity z-score. Similar effects were seen for working-age men. In older men (65+ years) only the earnings and relative poverty measures were statistically significant. This study provides evidence that gender inequity may increase men's health risks. The effect sizes while small are large enough across the range of gender inequity identified to have important population health implications. Theoretical approaches link gender inequity to increased health risks for men. Multilevel analysis allows investigation of a contextual effect of gender inequity. The study modelled the effect of state-level gender inequity on men's mortality. Aspects of gender inequity predicted an increased mortality risk for men.
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Liu E, Ng SK, Kahawita S, Andrew NH, Henderson T, Craig JE, Landers J. Ten-year all-cause mortality and its association with vision among Indigenous Australians within Central Australia: the Central Australian Ocular Health Study. Clin Exp Ophthalmol 2017; 45:348-356. [DOI: 10.1111/ceo.12880] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 11/07/2016] [Accepted: 11/13/2016] [Indexed: 12/14/2022]
Affiliation(s)
- Ebony Liu
- Department of Ophthalmology; Flinders University, Flinders Medical Centre; Adelaide South Australia Australia
| | - Soo K Ng
- Department of Ophthalmology; Flinders University, Flinders Medical Centre; Adelaide South Australia Australia
| | - Shyalle Kahawita
- Department of Ophthalmology; Flinders University, Flinders Medical Centre; Adelaide South Australia Australia
| | - Nicholas H Andrew
- Department of Ophthalmology; Flinders University, Flinders Medical Centre; Adelaide South Australia Australia
| | - Tim Henderson
- Department of Ophthalmology; Alice Springs Hospital; Alice Springs Northern Territory Australia
| | - Jamie E Craig
- Department of Ophthalmology; Flinders University, Flinders Medical Centre; Adelaide South Australia Australia
| | - John Landers
- Department of Ophthalmology; Flinders University, Flinders Medical Centre; Adelaide South Australia Australia
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Das A. "Inflammaging" and Estradiol among Older U.S. Women: A Nationally Representative Longitudinal Study. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2017; 63:295-308. [PMID: 29199869 DOI: 10.1080/19485565.2017.1403304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Despite accumulating small-sample and clinical evidence on "inflammaging," no population-representative longitudinal studies have specifically examined women's late-life inflammation trends. While a range of studies indicates estradiol's immunomodulation role, evidence is contradictory on whether its effects are pro- or antiinflammatory among older women. Using longitudinal data from the first two waves of the National Social Life, Health and Aging Project-a national probability sample of older U.S. adults aged 57 to 85 years at baseline-this study began to fill these gaps. Findings suggested rather than being a lifelong process, older women's inflammaging may have a biological window that closes with senescence. Moreover, their endogenous estradiol plays a proinflammatory rather than immunoprotective role. Nor does this sex steroid modulate age effects on women's inflammation. More sex-specific basic research is needed on causal mechanisms underlying women's late-life inflammaging patterns.
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Affiliation(s)
- Aniruddha Das
- a Department of Sociology and Centre on Population Dynamics , McGill University , Montreal , Quebec , Canada
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Chmielewski P. The relationship between adult stature and longevity: tall men are unlikely to outlive their short peers – evidence from a study of all adult deaths in Poland in the years 2004–2008. ANTHROPOLOGICAL REVIEW 2016. [DOI: 10.1515/anre-2016-0032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Abstract
Early epidemiological studies demonstrated that short stature is associated with cardiovascular disease (CVD), diabetes, lower energy intake or food deprivation during growth, poor health, and increased all-cause mortality. Nevertheless, the links between adult height and longevity become tenuous if certain confounders (e.g. BMI, SES, educational attainment, etc.) are allowed for. Furthermore, numerous studies have found that like excess weight, tallness is costly in terms of longevity in late ontogeny, and shorter people tend to outlive their taller peers, especially if they are slim and maintain a healthy diet and lifestyle. Therefore, there is currently a lack of agreement in the literature as to whether and how body height and lifespan are linked. The objective of this study was to explore the relationship between adult stature and longevity on the basis of a large sample from a population-based cohort study. Data on declared height and exact dates of birth and death were available from 480,493 men and 364,666 women who died in the years 2004-2008 in Poland. To control for secular changes, the sample was divided into fifteen birth cohorts and each group was subsequently split into five height categories using pentiles, separately for both sexes. The analysis has revealed an inverse relationship between height and lifespan in men and women. However, after controlling for secular changes in height, the relationship turned out to be very weak and linear in men, and inverted U-shaped in women. In general, taller individuals had lower age at death compared to shorter ones, and this relationship was more pronounced and consistent in men. To sum up, these findings do not comport with the traditional belief that taller individuals live longer. The role of several possible biological mechanisms pertinent to enhanced longevity in smaller individuals was emphasized, and these biological factors were discussed.
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Affiliation(s)
- Piotr Chmielewski
- Department of Anatomy, Faculty of Medicine, Wrocław Medical University, Poland
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Chmielewski P, Borysławski K, Strzelec B. Contemporary views on human aging and longevity. ANTHROPOLOGICAL REVIEW 2016. [DOI: 10.1515/anre-2016-0010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Aging is currently stimulating intense interest of both researchers and the general public. In developed countries, the average life expectancy has increased by roughly 30 years within the last century, and human senescence has been delayed by around a decade. Although aging is arguably the most familiar aspect of human biology, its proximate and ultimate causes have not been elucidated fully and understood yet. Nowadays there are two main approaches to the ultimate causes of aging. These are deterministic and stochastic models. The proximate theories constitute a distinct group of explanations. They focus on mechanistic causes of aging. In this view, there is no reason to believe that there is only one biological mechanism responsible for aging. The aging process is highly complex and results from an accumulation of random molecular damage. Currently, the disposable soma theory (DST), proposed by Thomas Kirkwood, is the most influential and coherent line of reasoning in biogerontology. This model does not postulate any particular mechanism underpinning somatic defense. Therefore, it is compatible with various models, including mechanistic and evolutionary explanations. Recently, however, an interesting theory of hyper-function of mTOR as a more direct cause of aging has been formulated by Mikhail Blagosklonny, offering an entirely different approach to numerous problems and paradoxes in current biogerontology. In this view, aging is quasi-programmed, which means that it is an aimless continuation of developmental growth. This mTOR-centric model allows the prediction of completely new relationships. The aim of this article is to present and compare the views of both parties in the dispute, based on the results of some recent experimental studies, and the contemporary knowledge of selected major aspects of human aging and longevity
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Affiliation(s)
- Piotr Chmielewski
- Department of Anatomy, Faculty of Medicine, Wroclaw Medical University, ul. Chałubińskiego 6a, 50-368 Wrocław, Poland
| | - Krzysztof Borysławski
- Department of Anthropology, Institute of Biology, Wroclaw University of Environmental and Life Sciences
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Abstract
Using historical data from 1,763 birth cohorts from 1800 to 1935 in 13 developed countries, we show that what is now seen as normal-a large excess of female life expectancy in adulthood-is a demographic phenomenon that emerged among people born in the late 1800s. We show that excess adult male mortality is clearly rooted in specific age groups, 50-70, and that the sex asymmetry emerged in cohorts born after 1880 when male:female mortality ratios increased by as much as 50% from a baseline of about 1.1. Heart disease is the main condition associated with increased excess male mortality for those born after 1900. We further show that smoking-attributable deaths account for about 30% of excess male mortality at ages 50-70 for cohorts born in 1900-1935. However, after accounting for smoking, substantial excess male mortality at ages 50-70 remained, particularly from cardiovascular disease. The greater male vulnerability to cardiovascular conditions emerged with the reduction in infectious mortality and changes in health-related behaviors.
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Shigematsu K, Watanabe Y, Nakano H. Lower hazard ratio for death in women with cerebral hemorrhage. Acta Neurol Scand 2015; 132:59-64. [PMID: 25643895 DOI: 10.1111/ane.12359] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of the study was to clarify the hazard ratio for death within 30 days after stroke comparing women to men. MATERIAL AND METHODS We reviewed all stroke patients registered in the Kyoto Stroke Registry (from January 1999 to December 2009) in Japan. Hazard ratio (HR) for death and 95% confidence interval were calculated by the Cox regression in stroke and in each stroke subtype: cerebral infarction (CI), cerebral hemorrhage, (CH) and subarachnoid hemorrhage (SAH). We also evaluated HR for death in women in each consciousness level at the onset of stroke: the Japan Coma Scale (JCS) 0 (alert), JCS 1-digit code (disoriented but awake), JCS 2-digit code (arousable with stimulation), and JCS 3-digit code (unarousable). RESULTS A total of 13,788 patients were analyzed. HR for death comparing women to men were 1.04 (0.88-1.23, P = 0.66 in stroke as a whole), 0.91 (0.69-1.21, P = 0.51 in CI), 0.53 (0.41-0.71, P < 0.01 in CH), and 0.89 (0.60-1.30, P = 0.535 in SAH) after adjustment for age and histories of hypertension, arrhythmia, diabetes mellitus and hyperlipemia and uses of tobacco and alcohol. Stratified by JCS, HR for death in women with CH were 0.32 (0.11-0.94 in JCS0), 0.48 (0.28-0.82 in JCS1), 0.49 (0.28-0.83 in JCS2), and 0.79 (0.65-0.97 in JCS3), respectively. HR for death in women with CI in JCS3 was significantly lower than in men (0.71; 0.52-0.98). CONCLUSION We evaluated HR for death comparing men to women in stroke and in each stroke subtype. Women with CH had lower HR for death within 30 days after stroke than men.
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Affiliation(s)
- K. Shigematsu
- Department of Neurology; National Hospital Organization; Minami Kyoto Hospital; Kyoto Japan
| | - Y. Watanabe
- Department of Epidemiology for Community Health and Medicine; Graduate School of Medical Science; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - H. Nakano
- Department of Neurosurgery; Kyoto Kidugawa Hospital; Kyoto Japan
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TenNapel MJ, Lynch CF, Burns TL, Wallace R, Smith BJ, Button A, Domann FE. SIRT6 minor allele genotype is associated with >5-year decrease in lifespan in an aged cohort. PLoS One 2014; 9:e115616. [PMID: 25541994 PMCID: PMC4277407 DOI: 10.1371/journal.pone.0115616] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 11/27/2014] [Indexed: 01/17/2023] Open
Abstract
Aging is a natural process involving complex interplay between environment, metabolism, and genes. Sirtuin genes and their downstream targets have been associated with lifespan in numerous organisms from nematodes to humans. Several target proteins of the sirtuin genes are key sensors and/or effectors of oxidative stress pathways including FOXO3, SOD3, and AKT1. To examine the relationship between single nucleotide polymorphisms (SNP) at candidate genes in these pathways and human lifespan, we performed a molecular epidemiologic study of an elderly cohort (≥65 years old.). Using age at death as a continuous outcome variable and assuming a co-dominant genetic model within the framework of multi-variable linear regression analysis, the genotype-specific adjusted mean age at death was estimated for individual SNP genotypes while controlling for age-related risk factors including smoking, body mass index, alcohol consumption and co-morbidity. Significant associations were detected between human lifespan and SNPs in genes SIRT3, SIRT5, SIRT6, FOXO3 and SOD3. Individuals with either the CC or CT genotype at rs107251 within SIRT6 displayed >5-year mean survival advantages compared to the TT genotype (5.5 and 5.9 years, respectively; q-value = 0.012). Other SNPs revealed genotype-specific mean survival advantages ranging from 0.5 to 1.6 years. Gender also modified the effect of SNPs in SIRT3, SIRT5 and AKT1 on lifespan. Our novel findings highlight the impact of sirtuins and sirtuin-related genotypes on lifespan, the importance of evaluating gender and the advantage of using age as a continuous variable in analyses to report mean age at death.
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Affiliation(s)
- Mindi J TenNapel
- Department of Epidemiology, College of Public Health, The University of Iowa, 01620 PFPW, 200 Hawkins Drive, Iowa City, Iowa, United States of America
| | - Charles F Lynch
- Department of Epidemiology, College of Public Health, The University of Iowa, 01620 PFPW, 200 Hawkins Drive, Iowa City, Iowa, United States of America
| | - Trudy L Burns
- Department of Epidemiology, College of Public Health, The University of Iowa, 01620 PFPW, 200 Hawkins Drive, Iowa City, Iowa, United States of America
| | - Robert Wallace
- Department of Epidemiology, College of Public Health, The University of Iowa, 01620 PFPW, 200 Hawkins Drive, Iowa City, Iowa, United States of America
| | - Brian J Smith
- Department of Epidemiology, College of Public Health, The University of Iowa, 01620 PFPW, 200 Hawkins Drive, Iowa City, Iowa, United States of America
| | - Anna Button
- Department of Epidemiology, College of Public Health, The University of Iowa, 01620 PFPW, 200 Hawkins Drive, Iowa City, Iowa, United States of America
| | - Frederick E Domann
- Free Radical & Radiation Biology Program, Department of Radiation Oncology, The University of Iowa, Iowa City, Iowa, United States of America
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Gender-dimorphic regulation of muscular proteins in response to high fat diet and sex steroid hormones. BIOTECHNOL BIOPROC E 2014. [DOI: 10.1007/s12257-014-0378-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Abstract
Why do humans live longer than other higher primates? Why do women live longer than men? What is the significance of the menopause? Answers to these questions may be sought by reference to the mechanisms by which human aging might have evolved. Here, an evolutionary hypothesis is presented that could answer all three questions, based on the following suppositions. First, that the evolution of increased human longevity was driven by increased late-life reproduction by men in polygynous primordial societies. Second, that the lack of a corresponding increase in female reproductive lifespan reflects evolutionary constraint on late-life oocyte production. Third, that antagonistic pleiotropy acting on androgen-generated secondary sexual characteristics in men increased reproductive success earlier in life, but shortened lifespan. That the gender gap in aging is attributable to androgens appears more likely given a recent report of exceptional longevity in eunuchs. Yet androgen depletion therapy, now used to treat prostatic hyperplasia, appears to accelerate other aspects of aging (e.g. cardiovascular disease). One possibility is that low levels of androgens throughout life reduces aging rate, but late-life androgen depletion does not.
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Affiliation(s)
- David Gems
- Institute of Healthy Ageing, and Department of Genetics, Evolution and Environment, University College London, London WC1E 6BT, UK
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Yazdani N, Mojbafan M, Taleba M, Amiri P, Nejadian F, Ashtiani MK, Amoli MM. Sex-specific association of RANTES gene -403 variant in Meniere's disease. Eur Arch Otorhinolaryngol 2014; 272:2221-5. [PMID: 24961438 DOI: 10.1007/s00405-014-3151-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 06/11/2014] [Indexed: 11/28/2022]
Abstract
Several studies have shown the correlation between RANTES gene and inflammatory disorders; the aim of the present study was to investigate the association between RANTES promoter gene polymorphism and Meniere's disease (MD) in an Iranian population. In this study patients with MD comprising definite MD (N = 56) and probable MD (N = 15) were selected according to diagnostic criteria of AAO-HNS. The control group (N = 101) were healthy normal subjects who did not have a history of ear disease and vertigo. PCR-RFLP for RANTES -403G>A has been performed. We found a protective role for RANTES -403A allele in male group in our population. None of the male patients with MD were carrier of allele A which was significantly different from the presence of allele A in the male control group (AA+GA vs. GG: p = 0.0004, OR 0.05, 95 % CI 0.001-0.39). This difference was not significant in female group. There was no significant association between RANTES gene polymorphism and the level of hearing loss. our results showed a sex-specific association between RANTES gene polymorphism and MD but more studies are necessary to further assess this association.
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Affiliation(s)
- Nasrin Yazdani
- Otorhinolaryngology Research Center, Amir-Alam Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran
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Shanahan L, Bauldry S, Freeman J, Bondy CL. Self-rated health and C-reactive protein in young adults. Brain Behav Immun 2014; 36:139-46. [PMID: 24513874 PMCID: PMC4313081 DOI: 10.1016/j.bbi.2013.10.020] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 10/17/2013] [Accepted: 10/20/2013] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Poor self-rated health (SRH) and elevated inflammation and morbidity and mortality are robustly associated in middle- and older-aged adults. Less is known about SRH-elevated inflammation associations during young adulthood and whether these linkages differ by sex. METHODS Data came from the National Longitudinal Study of Adolescent Health. At Wave IV, young adults aged 24–34 reported their SRH, acute and chronic illnesses, and sociodemographic and psychological characteristics relevant to health. Trained fieldworkers assessed medication use, BMI, waist circumference, and also collected bloodspots from which high-sensitivity CRP (hs-CRP) was assayed. The sample size for the present analyses was N = 13,236. RESULTS Descriptive and bivariate analyses revealed a graded association between SRH and hs-CRP: Lower ratings of SRH were associated with a higher proportion of participants with hs-CRP >3 mg/L and higher mean levels of hs-CRP. Associations between SRH and hs-CRP remained significant when acute and chronic illnesses, medication use, and health behaviors were taken into account. When BMI was taken into account, the association between SRH and hs-CRP association fully attenuated in females; a small, but significant association between SRH and hs-CRP remained in males. CONCLUSION Poor SRH and elevated hs-CRP are associated in young adults, adjusting for other health status measures, medication use, and health behavior. In males, SRH provided information about elevated hs-CRP that was independent of BMI. In females, BMI may be a better surrogate indicator of global health and pro-inflammatory influences compared to SRH.
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Sex-differentiated changes in C-reactive protein from ages 9 to 21: the contributions of BMI and physical/sexual maturation. Psychoneuroendocrinology 2013; 38:2209-17. [PMID: 23711900 PMCID: PMC3777291 DOI: 10.1016/j.psyneuen.2013.04.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Revised: 04/10/2013] [Accepted: 04/10/2013] [Indexed: 11/23/2022]
Abstract
BACKGROUND Sex differences in levels of C-reactive protein (CRP) are well established in adulthood, but little is known about when and why they emerge. Here, we tested longitudinal models of CRP levels from ages 9 to 21, when marked physical and behavioral changes could contribute to growing sex disparities in CRP. METHODS Data from the community-based prospective-longitudinal Great Smoky Mountains Study (N=1420) were used. Participants were 9-13 years old at intake and were followed through age 21. High-sensitivity C-reactive protein (CRP) was assayed from up to nine bloodspot collections per person. BMI, physical/sexual maturation, substance use, and control variables were assessed during yearly interviews to age 16, and at ages 19 and 21. RESULTS Multilevel models revealed that the development of CRP in females was best described by a quadratic trend: after slow increases in CRP until age 15, the rate of increase accelerated thereafter. Changes in CRP in males were best described by a smaller, linear increase. After sex-differentiated associations with BMI, physical/sexual maturation, and substance use variables had been accounted for, increases in CRP after age 15 no longer differed by sex. CONCLUSION Physical/sexual maturation and behavioral changes during adolescence could initiate life-long sex disparities in CRP.
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Young RC, Kitaysky AS, Haussmann MF, Descamps S, Orben RA, Elliott KH, Gaston AJ. Age, sex, and telomere dynamics in a long-lived seabird with male-biased parental care. PLoS One 2013; 8:e74931. [PMID: 24023967 PMCID: PMC3762738 DOI: 10.1371/journal.pone.0074931] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Accepted: 08/07/2013] [Indexed: 11/24/2022] Open
Abstract
The examination of telomere dynamics is a recent technique in ecology for assessing physiological state and age-related traits from individuals of unknown age. Telomeres shorten with age in most species and are expected to reflect physiological state, reproductive investment, and chronological age. Loss of telomere length is used as an indicator of biological aging, as this detrimental deterioration is associated with lowered survival. Lifespan dimorphism and more rapid senescence in the larger, shorter-lived sex are predicted in species with sexual size dimorphism, however, little is known about the effects of behavioral dimorphism on senescence and life history traits in species with sexual monomorphism. Here we compare telomere dynamics of thick-billed murres (Urialomvia), a species with male-biased parental care, in two ways: 1) cross-sectionally in birds of known-age (0-28 years) from one colony and 2) longitudinally in birds from four colonies. Telomere dynamics are compared using three measures: the telomere restriction fragment (TRF), a lower window of TRF (TOE), and qPCR. All showed age-related shortening of telomeres, but the TRF measure also indicated that adult female murres have shorter telomere length than adult males, consistent with sex-specific patterns of ageing. Adult males had longer telomeres than adult females on all colonies examined, but chick telomere length did not differ by sex. Additionally, inter-annual telomere changes may be related to environmental conditions; birds from a potentially low quality colony lost telomeres, while those at more hospitable colonies maintained telomere length. We conclude that sex-specific patterns of telomere loss exist in the sexually monomorphic thick-billed murre but are likely to occur between fledging and recruitment. Longer telomeres in males may be related to their homogamous sex chromosomes (ZZ) or to selection for longer life in the care-giving sex. Environmental conditions appeared to be the primary drivers of annual changes in adult birds.
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Affiliation(s)
- Rebecca C. Young
- Department of Biology and Wildlife, Institute of Arctic Biology, University of Alaska Fairbanks, Fairbanks, Alaska, United States of America
| | - Alexander S. Kitaysky
- Department of Biology and Wildlife, Institute of Arctic Biology, University of Alaska Fairbanks, Fairbanks, Alaska, United States of America
| | - Mark F. Haussmann
- Biology Department, Bucknell University; Lewisburg, Pennyslvania, United States of America
| | | | - Rachael A. Orben
- Department of Ocean Sciences, Long Marine Laboratory, University of California Santa Cruz, Santa Cruz, California, United States of America
| | - Kyle H. Elliott
- Department of Biological Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Anthony J. Gaston
- Department of Biological Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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50
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Abstract
This article addresses 2 questions. First, to what extent are sex and gender incorporated into research on genetics and health? Second, how might social science understandings of sex and gender, and gender differences in health, become more integrated into scholarship in this area? We review articles on genetics and health published in selected peer-reviewed journals. Although sex is included frequently as a control or stratifying variable, few articles articulate a conceptual frame or methodological justification for conducting research in this way, and most are not motivated by sex or gender differences in health. Gender differences in health are persistent, unexplained, and shaped by multilevel social factors. Future scholarship on genetics and health needs to incorporate more systematic attention to sex and gender, gender as an environment, and the intertwining of social and biological variation over the life course. Such integration will advance understandings of gender differences in health, and may yield insight regarding the processes and circumstances that make genomic variation relevant for health and well-being.
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Affiliation(s)
- Susan E Short
- Susan E. Short is with the Department of Sociology and the Population Studies Training Center, Brown University, Providence, RI. Yang Claire Yang is with the Department of Sociology, Lineberger Comprehensive Cancer Center, and Carolina Population Center at the University of North Carolina-Chapel Hill. Tania M. Jenkins is with the Department of Sociology, Brown University
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