1
|
Vasquez D, Palacio A, Chedraui P, Del Mar Sanchez M, Briones W, Tamariz L, Calle MA. Is Prior Zika Virus Infection Associated With Cardiovascular Disease? Cureus 2023; 15:e47141. [PMID: 38022258 PMCID: PMC10651160 DOI: 10.7759/cureus.47141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Zika virus (ZIKV) infection is associated with severe complications. Recently, reports have raised the possibility of cardiovascular complications. However, the complications that are reported are in case reports and occur immediately after infection. Our aim is to evaluate the cardiovascular complications of ZIKV infection in a younger patient population. METHODS We conducted a prospective cohort and included patients with a one-year history of prior confirmed ZIKV infection. We performed an echocardiogram, a 24-hour automated blood pressure, and a 24-hour Holter. Our primary outcome included a composite of having diastolic dysfunction, left ventricular hypertrophy, arrhythmias, valvular regurgitation, premature beats, or non-dipper status. RESULTS We included 47 patients with ZIKV and 16 patients without ZIKV. Patients with ZIKV had a similar age as controls (p>0.05). Having had a prior ZIKV infection was associated with diastolic dysfunction, left ventricular hypertrophy, valvular regurgitation, arrhythmias or premature beats, and non-dipper status (p<0.05). The adjusted OR of having the primary outcome was 2.3; 95% CI 1.3-2.7. After one year, IL-10 and C-reactive protein (CRP) were higher in ZIKV-infected patients compared to controls (p<0.05). CONCLUSIONS Our study found that young patients with a prior ZIKV infection have more echocardiographic, arrhythmic, and blood pressure changes when compared to similar-aged controls.
Collapse
Affiliation(s)
- Diego Vasquez
- Department of Epidemiology, Universidad Católica de Santiago de Guayaquil, Guayaquil, ECU
| | - Ana Palacio
- Population Health and Computational Medicine, University of Miami Miller School of Medicine, Miami, USA
| | - Peter Chedraui
- Escuela de Posgrado en Salud, Universidad Espíritu Santo, Samborondón, ECU
| | - Maria Del Mar Sanchez
- Department of Public Health and Epidemiology, Universidad Católica de Santiago de Guayaquil, Guayaquil, ECU
| | - Wladimir Briones
- Department of Epidemiology, Ministerio de Salud Publica, Quito, ECU
| | - Leonardo Tamariz
- Population Health and Computational Medicine, University of Miami Miller School of Medicine, Miami, USA
| | - Marco A Calle
- Department of Medicine, Universidad Católica de Santiago de Guayaquil, Guayaquil, ECU
| |
Collapse
|
2
|
Noyd DH, Liu Q, Yasui Y, Chow EJ, Bhatia S, Nathan PC, Landstrom AP, Tonorezos E, Casillas J, Berkman A, Ness KK, Mulrooney DA, Leisenring WM, Howell CR, Shoag J, Kirchhoff A, Howell RM, Gibson TM, Zullig LL, Armstrong GT, Oeffinger KC. Cardiovascular Risk Factor Disparities in Adult Survivors of Childhood Cancer Compared With the General Population. JACC CardioOncol 2023; 5:489-500. [PMID: 37614575 PMCID: PMC10443116 DOI: 10.1016/j.jaccao.2023.01.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 01/18/2023] [Accepted: 01/26/2023] [Indexed: 08/25/2023] Open
Abstract
Background It is unknown whether a history of childhood cancer modifies the established disparities in cardiovascular risk factors (CVRFs) observed in the general population. Objectives We sought to determine if disparities in CVRFs by race/ethnicity are similar among childhood cancer survivors compared with the general population. Methods The Childhood Cancer Survivor Study (CCSS) is a retrospective cohort with a longitudinal follow-up of 24,084 5-year survivors diagnosed between 1970 and 1999. Multivariable piecewise exponential regression estimated incidence rate ratios (IRRs) for hypertension, hyperlipidemia, diabetes, obesity, and ≥2 CVRFs by race/ethnicity. The CCSS sibling cohort and the National Health and Nutrition Examination Survey cohort were used to compare the sociodemographic-adjusted IRRs for same-race/same-ethnicity disparities. Results Non-Hispanic Black (NHB) (n = 1,092) and Hispanic (n = 1,405) survivors compared with non-Hispanic White (NHW) (n = 13,960) survivors reported a higher cumulative incidence of diabetes (8.4%, 9.7%, and 5.1%, respectively); obesity (47.2%, 48.9%, and 30.2%, respectively); multiple CVRFs (17.7%, 16.6%, and 12.3%, respectively); and, for NHB survivors, hypertension (19.5%, 13.6%, and 14.3%, respectively) by 40 years of age (P < 0.001). Controlling for sociodemographic and treatment factors compared with NHW survivors, IRRs for NHB were increased for hypertension (IRR: 1.4; 95% CI: 1.1-1.8), obesity (IRR: 1.7; 95% CI: 1.4-2.1), and multiple CVRFs (IRR: 1.6; 95% CI: 1.2-2.1). IRRs for Hispanic survivors were increased for diabetes (IRR: 1.8; 95% CI: 1.2-2.6) and obesity (IRR: 1.4; 95% CI: 1.2-1.7). The pattern of IRRs for CVRF differences was similar among CCSS sibling and National Health and Nutrition Examination Survey cohorts. Conclusions The higher burden of CVRFs among NHB and Hispanic survivors compared with NHW survivors was similar to the general population. The promotion of cardiovascular health equity is critical in this high-risk population.
Collapse
Affiliation(s)
- David H. Noyd
- Duke University Medical Center, Durham, North Carolina, USA
- The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Qi Liu
- University of Alberta, Edmonton, Canada
| | - Yutaka Yasui
- University of Alberta, Edmonton, Canada
- St. Jude Children’s Research Hospital, Memphis, Tennessee, USA
| | - Eric J. Chow
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Smita Bhatia
- University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Paul C. Nathan
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | | | - Jacqueline Casillas
- University of California Los Angeles Medical Center, Los Angeles, California, USA
| | - Amy Berkman
- Duke University Medical Center, Durham, North Carolina, USA
| | - Kirsten K. Ness
- St. Jude Children’s Research Hospital, Memphis, Tennessee, USA
| | | | | | | | | | | | - Rebecca M. Howell
- The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Leah L. Zullig
- Duke University Medical Center, Durham, North Carolina, USA
- Durham Veterans Administration Health Care System, Durham, North Carolina, USA
| | | | | |
Collapse
|
3
|
Lee AJ, Sanchez D, Reyes-Dumeyer D, Brickman AM, Lantigua RA, Vardarajan BN, Mayeux R. Reliability and Validity of self-reported Vascular Risk Factors in a Multi-Ethnic Community Based Study of Aging and Dementia. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.12.23288492. [PMID: 37131736 PMCID: PMC10153321 DOI: 10.1101/2023.04.12.23288492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
INTRODUCTION The reliability and validity of self-reported cardiovascular and cerebrovascular risk factors remains inconsistent in aging research. METHODS We assessed the reliability, validity, sensitivity, specificity, and percent agreement of self-reported hypertension, diabetes, and heart disease, in comparison with direct measures of blood pressure, hemoglobin A1c (HbA1c), and medication use in 1870 participants in a multiethic study of aging and dementia. RESULTS Reliability of self-reported for hypertension, diabetes, and heart disease was excellent. Agreement between self-reports and clinical measures was moderate for hypertension (kappa: 0.58), good for diabetes (kappa: 0.76-0.79), and moderate for heart disease (kappa: 0.45) differing slightly by age, sex, education, and race/ethnic group. Sensitivity and specificity for hypertension was 88.6%-78.1%, for diabetes was 87.7%-92.0% (HbA1c > 6.5%) or 92.7%-92.8% (HbA1c > 7%), and for heart disease was 85.8%-75.5%. DISCUSSION Self-reported history of hypertension, diabetes, and heart disease are reliable and valid compared to direct measurements or medication use.
Collapse
|
4
|
Salovaara PK, Li C, Nicholson A, Lipsitz SR, Natarajan S. Navigating COVID-19 and related challenges to completing clinical trials: Lessons from the PATRIOT and STEP-UP randomized prevention trials. Clin Trials 2023; 20:153-165. [PMID: 36562090 PMCID: PMC9790858 DOI: 10.1177/17407745221140041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND/AIMS High follow-up is critical in randomized clinical trials. We developed novel approaches to modify in-person visits and complete follow-up during COVID-19. Since these strategies are broadly applicable to circumstances wherein follow-up is difficult, they may help in contingency planning. The objective of this article is to develop and evaluate new approaches to replace detailed, in-person study visits for two trials focused on preventing diabetic foot complications. METHODS A quasi-experimental pre-post design compared approaches for follow-up during COVID-19 to approaches pre-COVID-19. Study subjects were outpatients at two Veterans Affairs Medical Centers. Following a research "hold," research resumed in February 2021 for Self-monitoring, Thermometry and Educating Patients for Ulcer Prevention (STEP UP) (n = 241), which focused on preventing recurrent foot ulcers, and in April 2021 for Preventing Amputation by Tailored Risk-based Intervention to Optimize Therapy (PATRIOT) (n = 406), which focused on preventing pre-ulcerative and ulcerative lesions. To complete data collection, we shortened visits, focused on primary and secondary outcomes, and conducted virtual visits when appropriate. For STEP UP, we created a 20-min assessment process that could be administered by phone. Since PATRIOT required plantar photographs to assess foot lesions, we conducted short face-to-face visits. We explored differences and assessed proportion completing visit, visit completion/100 person-months and compared COVID-19 to pre- COVID-19 using unadjusted risk ratios, incidence rate ratios, all with associated 95% confidence intervals (CIs). Finally, we report time-to-visit curves. RESULTS In both studies, participants whose follow-up concluded pre- COVID-19 seemed older than those whose follow-up concluded during COVID-19 (PATRIOT: 68.0 (67.2, 68.9) versus 65.2 years (61.9, 68.5); STEP UP: 67.5 (66.2, 68.9) versus 65.3 (63.3, 67.3)). For STEP UP, we completed 91 visits pre- COVID-19 (37.8% (31.6%, 44.2%)) and 63 visits during COVID-19 (78.8% (68.2%, 87.1%)). This was over 1309 person-months pre-COVID-19, and over 208.8 person-months during COVID-19; the visit completion rate/100 person-months were: pre-COVID-19 7.0 (5.6, 8.5), COVID-19 30.2 (23.2, 38.6); risk ratio: 2.1 (1.7, 2.5); and incidence rate ratio 4.3 (3.1, 5.9). Similarly, for PATRIOT, we completed 316 visits pre-COVID-19 (77.8% (73.5%, 81.8%)) and 27 assessments during COVID-19 (84.4% (67.2%, 94.7%)). This was over 1192.7 person-months pre-COVID-19 and 39.3 person-months during COVID-19. The visit completion rate/100 person-months in PATRIOT were: pre-COVID-19 2.7 (2.4, 3.0), COVID-19 6.9 (4.5, 10); risk ratio 1.1 (0.9, 1.3); incidence rate ratio 2.6 (1.8, 3.8). For both studies, the follow-up curves began separating at < 2 months. CONCLUSIONS We achieved higher completion rates during COVID-19 compared to pre-COVID-19 by modifying visits and focusing on primary and secondary outcomes. These strategies prevent excessive missing data, support more valid conclusions, and improve efficiency. They may provide important alternative strategies to achieving higher follow-up in randomized clinical trials.
Collapse
Affiliation(s)
- Priscilla K Salovaara
- Columbia University, New York, NY, USA.,VA New York Harbor Healthcare System, New York, NY, USA
| | - Christine Li
- VA New York Harbor Healthcare System, New York, NY, USA.,New York University, New York, NY, USA
| | - Andrew Nicholson
- VA New York Harbor Healthcare System, New York, NY, USA.,New York University Grossman School of Medicine, New York, NY, USA
| | - Stuart R Lipsitz
- Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Sundar Natarajan
- VA New York Harbor Healthcare System, New York, NY, USA.,New York University Grossman School of Medicine, New York, NY, USA
| |
Collapse
|
5
|
Piri N, Moradi Y, Gheshlagh RG, Abdullahi M, Fattahi E, Moradpour F. Validity of self-reported hypertension and related factors in the adult population: Preliminary results from the cohort in the west of Iran. J Clin Hypertens (Greenwich) 2023; 25:146-157. [PMID: 36625724 PMCID: PMC9903199 DOI: 10.1111/jch.14627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 12/13/2022] [Accepted: 12/13/2022] [Indexed: 01/11/2023]
Abstract
This study aimed to investigate the validity of self-reported hypertension and related factors in the Dehgolan Prospective Cohort Study (DehPCS). Data were obtained from 3996 participants aged 35-70 years in the enrolment phase of DehPCS. Self-reported hypertension and sociodemographic factors were collected by well-trained interviewers before hypertension diagnosis based on the reference criteria. The history of anti-hypertensive medication use and/or systolic blood pressure ≥140 (mmHg), or diastolic blood pressure ≥90 (mmHg) were considered as hypertension. Disagreement between self-reported and reference measures was assessed using sensitivity, specificity, positive, and negative predictive values (PPV and NPV), and kappa values. Binary and multinomial logistic regressions were used to investigate the correlates of validity of self-reported hypertension. The hypertension prevalence based on self-reports and the reference criteria was 19.49% and 21.60%, respectively. An acceptable percentage of kappa agreement value of 68.7% and relatively good overall agreement of 89.8% were found. Self-reported hypertension was guaranteed moderate sensitivity of 72.0% and high specificity of 94.5%, as well as the NPV and PPV of 92/7% and 77/9%, respectively. The chances of false-positive and false-negative reporting increased with older age, higher BMI, and a family history of hypertension. Being female, older age, higher BMI, concurrent diabetes, and stronger family ties to hypertension patients significantly increased the chance of reporting true positives relative to true negatives. Although, self-reported hypertension has an acceptable validity and can be used as a valid tool for screening epidemiological studies, it needs to be investigated because its validity is affected by age, gender, family history of hypertension, and other socio-demographic characteristics.
Collapse
Affiliation(s)
- Negar Piri
- Health Network of DehgolanKurdistan University of Medical SciencesSanandajIran
| | - Yousef Moradi
- Department of Epidemiology and BiostatisticsFaculty of MedicineKurdistan University of Medical SciencesSanandajIran
| | - Reza Ghanei Gheshlagh
- Spiritual Health Research CenterResearch Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
| | | | - Eghbal Fattahi
- Department of Internal MedicineTohid HospitalKurdistan University of Medical SciencesSanandajIran
| | - Farhad Moradpour
- Social Determinants of Health Research CenterResearch Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
| |
Collapse
|
6
|
Lee AJ, Sanchez D, Reyes-Dumeyer D, Brickman AM, Lantigua RA, Vardarajan BN, Mayeux R. Reliability and Validity of Self-Reported Vascular Risk Factors: Hypertension, Diabetes, and Heart Disease, in a Multi-Ethnic Community Based Study of Aging and Dementia. J Alzheimers Dis 2023; 95:275-285. [PMID: 37483004 PMCID: PMC10578288 DOI: 10.3233/jad-230374] [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] [Accepted: 06/21/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND Queries for the presence of cardiovascular and cerebrovascular risk factors are typically assessed through self-report. However, the reliability and validity of self-reported cardiovascular and cerebrovascular risk factors remain inconsistent in aging research. OBJECTIVE To determine the reliability and validity of the most frequently self-reported vascular risk factors: hypertension, diabetes, and heart disease. METHODS 1,870 individuals aged 65 years or older among African Americans, Caribbean Hispanics, and white non-Hispanic individuals were recruited as part of a community study of aging and dementia. We assessed the reliability, validity, sensitivity, specificity, and percent agreement of self-reported hypertension, diabetes, and heart disease, in comparison with direct measures of blood pressure, hemoglobin A1c (HbA1c), and medication use. The analyses were subsequently stratified by age, sex, education, and ethnic group. RESULTS Reliability of self-reported hypertension, diabetes, and heart disease was excellent. Agreement between self-reports and clinical measures was moderate for hypertension (kappa: 0.58), good for diabetes (kappa: 0.76-0.79), and moderate for heart disease (kappa: 0.45) differing slightly by age, sex, education, and ethnic group. Sensitivity and specificity for hypertension was 88.6% -78.1%, for diabetes was 87.7% -92.0% (HbA1c ≥6.5%) or 92.7% -92.8% (HbA1c ≥7%), and for heart disease was 85.8% -75.5%. Percent agreement of self-reported was 87.0% for hypertension, 91.6% -92.6% for diabetes, and 77.4% for heart disease. CONCLUSION Ascertainment of self-reported histories of hypertension, diabetes, and heart disease are reliable and valid compared to direct measurements or medication use.
Collapse
Affiliation(s)
- Annie J. Lee
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Neurology, College of Physicians and Surgeons, Columbia University and the New York Presbyterian Hospital, New York, NY, USA
| | - Didi Sanchez
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Neurology, College of Physicians and Surgeons, Columbia University and the New York Presbyterian Hospital, New York, NY, USA
| | - Dolly Reyes-Dumeyer
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Neurology, College of Physicians and Surgeons, Columbia University and the New York Presbyterian Hospital, New York, NY, USA
| | - Adam M. Brickman
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Neurology, College of Physicians and Surgeons, Columbia University and the New York Presbyterian Hospital, New York, NY, USA
| | - Rafael A. Lantigua
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Neurology, College of Physicians and Surgeons, Columbia University and the New York Presbyterian Hospital, New York, NY, USA
| | - Badri N. Vardarajan
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Neurology, College of Physicians and Surgeons, Columbia University and the New York Presbyterian Hospital, New York, NY, USA
| | - Richard Mayeux
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Neurology, College of Physicians and Surgeons, Columbia University and the New York Presbyterian Hospital, New York, NY, USA
- Department of Medicine, College of Physicians and Surgeons, Columbia University and the New York Presbyterian Hospital, New York, NY, USA
| |
Collapse
|
7
|
Kindratt TB, Dallo FJ, Zahodne LB. Cognitive Disability Among Arab Americans by Nativity Status and Arrival Year: Lack of Evidence for the Healthy Migrant Effect. J Racial Ethn Health Disparities 2022; 9:2056-2062. [PMID: 34505264 PMCID: PMC8904646 DOI: 10.1007/s40615-021-01144-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 10/20/2022]
Abstract
Limited research exists on cognitive disabilities among Arab Americans, especially as it relates to arrival year among the foreign-born. The objectives of this study were to estimate the age- and sex-adjusted prevalence and associations of cognitive disability by (1) nativity status and (2) arrival year (pre-1991, 1991-2000, 2001-2013, and 2014-2018). We analyzed 11 years (2008-2018) of data from the American Community Survey (ACS) Public Use Microdata Samples (weighted n = 264,086; ages ≥ 45 years). Weighted means, percentages, age- and sex-adjusted prevalence estimates, and logistic regression results (crude and adjusted) were calculated. Among all Arab Americans, the age- and sex-adjusted prevalence of cognitive disability was 6.5%. The prevalence was lower for US-born (4.0%) compared to foreign-born (6.0%) (p-value < 0.0001). In logistic regression results, foreign-born Arab Americans were more likely to have a cognitive disability compared to US-born Arab Americans after adjusting for age and sex (OR = 1.41; 95% CI = 1.24, 1.61). Among foreign-born, Arab Americans arriving in 2014 or later had a lower prevalence of cognitive disability (3.4%) compared to all other arrival years at approximately 4.7%. With those arriving prior to 1991 as the reference category, those arriving between 1991 and 2000 were more likely to report a cognitive disability (OR = 1.05; 95% CI = 1.00, 1.08). However, those arriving between 2014 and 2018 were less likely to report a cognitive disability (OR = 0.81; 95% CI = 0.73, 0.88). These findings challenge the universality of the "healthy migrant effect" and highlight the relevance of socioeconomic disparities for Arab American cognitive health.
Collapse
Affiliation(s)
- Tiffany B Kindratt
- Public Health Program, Department of Kinesiology, College of Nursing and Health Innovation, University of Texas At Arlington, Arlington, TX, 76013, USA
| | - Florence J Dallo
- Department of Public and Environmental Wellness, School of Health Sciences, Oakland University, Rochester, MI, 48309-4452, USA.
| | - Laura B Zahodne
- Department of Psychology, University of Michigan, Ann Arbor, MI, 48109, USA
| |
Collapse
|
8
|
Zang E, Shi Y, Wang X, Wu B, Fried TR. Trajectories of physical functioning among US adults with cognitive impairment. Age Ageing 2022; 51:6615423. [PMID: 35751871 PMCID: PMC9233517 DOI: 10.1093/ageing/afac139] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND physical functioning impairment is common among persons with cognitive impairment, but little is known about physical functioning trajectories across the US population or how trajectories may differ among persons with dementia and mild cognitive impairment (MCI). OBJECTIVE to examine trajectories of physical functioning among persons with MCI and dementia in the USA. DESIGN we used data from the National Health and Aging Trends study (NHATS) 2011-18. Physical functioning was assessed using the NHATS Expanded Short Physical Performance Battery. PARTICIPANTS the 661 individuals with MCI and 980 individuals with dementia were included in this study. METHODS we applied group-based trajectory models to identify latent groups and estimate their trajectories. Multinomial logistic regressions were applied to examine relationships between sociodemographic and health characteristics and trajectory group memberships. RESULTS both MCI- and dementia-specific trajectories differed at baseline levels and declined at varying rates across groups. Approximately, 78.43% of persons with MCI were in trajectories with a moderate rate of decline, with only 9.75% in a trajectory with good physical function and 11.82% with poor physical function without as much change over time. Among persons with dementia, approximately 81.4% experienced moderate or fast declines, and 18.52% with virtually no functional ability remained at this same low level. Worse physical functioning trajectories were found among persons who were females, Blacks, with at least four comorbidities, and among persons who had a low socioeconomic status. CONCLUSIONS persons with both dementia and MCI experienced steady declines in physical functioning. Socioeconomically disadvantaged groups have worse physical functioning trajectories.
Collapse
Affiliation(s)
- Emma Zang
- Address correspondence to: Emma Zang, Departments of Sociology and Biostatistics, Yale University, New Haven, CT 06511, USA. Tel: +1 (919) 536-9621.
| | - Yu Shi
- Department of Biostatistics, Yale University, New Haven, CT 06520, USA
| | - Xueqing Wang
- Office of Population Research, Princeton University, Princeton, NJ 08540, USA
- School of Public and International Affairs, Princeton University, Princeton, NJ 08540, USA
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, NY 10010, USA
| | - Terri R Fried
- Veterans Affairs Connecticut Healthcare System, West Haven, CT 06516, USA
- Department of Medicine, Yale School of Medicine, New Haven, CT 06520, USA
| |
Collapse
|
9
|
Leão TSS, Tomasi GH, Conzatti LP, Marrone LCP, Reynolds MA, Gomes MS. Oral inflammatory burden and carotid atherosclerosis among stroke patients. J Endod 2022; 48:597-605. [PMID: 35143813 DOI: 10.1016/j.joen.2022.01.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/28/2022] [Accepted: 01/30/2022] [Indexed: 12/26/2022]
Abstract
INTRODUCTION This study aimed to test the hypothesis that oral inflammatory burden (OIB) is independently associated with the carotid atherosclerotic burden (CAB) among individuals with ischemic stroke (IS) or transient ischemic attack (TIA). METHODS This cross-sectional observational study included 240 hospital patients with the diagnosis of IS or TIA. The main exposures were apical periodontitis (AP), root canal treatment (RCT), and crestal alveolar (periodontal) bone loss (BL), and the main outcome was the CAB. Exposure and outcome variables were measured through a head and neck multidetector computed tomography angiography and CAB was dichotomized in <50% and ≥50% vessel occlusion. OIB scored as a composite measure of the endodontic and periodontal disease exposure. Hospital health records provided information on socio-demographic and medical covariates. Prevalence ratios (PR) were calculated through Poisson regression models, estimating the relationship between the oral exposures and CAB, with =5%. RESULTS Mean age was 62.15 ± 13.1 years, with 56.7% males. Univariate analyses showed that AP≥2 (PR=1.83,95%CI=1.05-3.17) and endodontic burden (EB) (AP &/or RCT≥2) (PR=1.98,95%CI=1.13-3.47) were associated with CAB ≥50%. Multivariate models, adjusted for socio-demographic and medical covariates, revealed that pooled periodontal and endodontic parameters (OIB= BL ≥5mm & EB ≥2) was independently associated with CAB ≥50% (PR=2.47,95%CI= 1.04-5.87). CONCLUSION A higher OIB was independently associated with increased levels of CAB among IS or TIA hospital patients. The combination of endodontic and periodontal parameters strengthened the observed association and should be evaluated in future studies on the relationship between oral health and cardiovascular outcomes.
Collapse
Affiliation(s)
- T S S Leão
- Graduate Program in Dentistry, School of Health and Life Sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil;; Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA
| | - G H Tomasi
- Department of Neurology, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - L P Conzatti
- Department of Neurology, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - L C P Marrone
- Department of Neurology, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - M A Reynolds
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA
| | - M S Gomes
- Graduate Program in Dentistry, School of Health and Life Sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil;; Medical and Dental Center of the Military Police of Rio Grande do Sul, Brazil
| |
Collapse
|
10
|
Wang Z, Dong Y, Xu R, Wang X, Li Y, Zou Z. Early-Life Exposure to the Chinese Great Famine and Later Cardiovascular Diseases. Int J Public Health 2021; 66:603859. [PMID: 34744570 PMCID: PMC8565276 DOI: 10.3389/ijph.2021.603859] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 01/22/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: This study aimed to examine the association between early life famine exposure and adulthood cardiovascular diseases (CVDs) risk. Methods: A total of 5,504 subjects were selected using their birthdate from national baseline data of the China Health and Retirement Longitudinal Survey to analyze the association between famine exposure in early life and CVDs risk in adulthood. CVDs was defined based on the self-reported doctor's diagnosis. Results: The prevalence of CVDs in the unexposed group, fetal-exposed, infant-exposed, and preschool-exposed groups was 15.0%, 18.0%, 21.0%, and 18.3%, respectively. Compared with the unexposed group, fetal-exposed, infant-exposed and preschool-exposed groups had higher CVDs risk in adulthood (p < 0.05). Compared with the age-matched control group, infancy exposed to famine had a significantly higher adulthood CVDs risk (OR = 1.52, 95% CI: 1.15, 2.01; p = 0.006). The association seems to be stronger among population with higher education level (P interaction = 0.043). Sensitivity analysis revealed consistent association between early-life famine exposure and adult CVDs risk. Conclusion: Early life exposed to the China great famine may elevate the risk of CVDs in adulthood.
Collapse
Affiliation(s)
- Zhenghe Wang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Yanhui Dong
- School of Public Health and Institute of Child and Adolescent Health, Peking University, Beijing, China
| | - Rongbin Xu
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic, Australia
| | - Xijie Wang
- School of Public Health and Institute of Child and Adolescent Health, Peking University, Beijing, China
| | - Yanhui Li
- School of Public Health and Institute of Child and Adolescent Health, Peking University, Beijing, China
| | - Zhiyong Zou
- School of Public Health and Institute of Child and Adolescent Health, Peking University, Beijing, China
| |
Collapse
|
11
|
Chahine LM, Chin I, Caspell-Garcia C, Standaert DG, Brown E, Smolensky L, Arnedo V, Daeschler D, Riley L, Korell M, Dobkin R, Amondikar N, Gradinscak S, Shoulson I, Dean M, Kwok K, Cannon P, Marek K, Kopil C, Tanner CM, Marrason C. Comparison of an Online-Only Parkinson's Disease Research Cohort to Cohorts Assessed In Person. JOURNAL OF PARKINSONS DISEASE 2021; 10:677-691. [PMID: 31958097 PMCID: PMC7242834 DOI: 10.3233/jpd-191808] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Online tools for data collection could be of value in patient-oriented research. The Fox Insight (FI) study collects data online from individuals with self-reported Parkinson's disease (PD). Comparing the FI cohort to other cohorts assessed through more traditional (in-person) observational research studies would inform the representativeness and utility of FI data. OBJECTIVE To compare self-reported demographic characteristics, symptoms, medical history, and PD medication use of the FI PD cohort to other recent observational research study cohorts assessed with in-person visits. METHODS The FI PD cohort (n = 12,654) was compared to 3 other cohorts, selected based on data accessibility and breadth of assessments: Parkinson's Progression Markers Initiative (PPMI; PD n = 422), Parkinson's Disease Biomarker Program (PDBP; n = 700), and PD participants in the LRRK2 consortium without LRRK2 mutations (n = 508). Demographics, motor and non-motor assessments, and medications were compared across cohorts. Where available, identical items on surveys and assessments were compared; otherwise, expert opinion was used to determine comparable definitions for a given variable. RESULTS The proportion of females was significantly higher in FI (45.56%) compared to PPMI (34.36%) and PDBP (35.71%). The FI cohort had greater educational attainment as compared to all other cohorts. Overall, prevalence of difficulties with motor experiences of daily living and non-motor symptoms in the FI cohort was similar to other cohorts, with only a few significant differences that were generally small in magnitude. Missing data were rare for the FI cohort, except on a few variables. DISCUSSION Patterns of responses to patient-reported assessments obtained online on the PD cohort of the FI study were similar to PD cohorts assessed in-person.
Collapse
Affiliation(s)
| | | | | | | | - Ethan Brown
- University of California, and San Francisco Veterans Affairs Medical Care Plan, San Francisco, CA, USA
| | - Luba Smolensky
- The Michael J. Fox Foundation for Parkinson's Research, New York, NY, USA
| | - Vanessa Arnedo
- The Michael J. Fox Foundation for Parkinson's Research, New York, NY, USA
| | - Daisy Daeschler
- The Michael J. Fox Foundation for Parkinson's Research, New York, NY, USA
| | - Lindsey Riley
- The Michael J. Fox Foundation for Parkinson's Research, New York, NY, USA
| | - Monica Korell
- University of California, and San Francisco Veterans Affairs Medical Care Plan, San Francisco, CA, USA
| | - Roseanne Dobkin
- Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Ninad Amondikar
- The Michael J. Fox Foundation for Parkinson's Research, New York, NY, USA
| | - Stephen Gradinscak
- The Michael J. Fox Foundation for Parkinson's Research, New York, NY, USA
| | | | - Marissa Dean
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kevin Kwok
- Theravance Biopharma, San Francisco, CA, USA
| | | | - Kenneth Marek
- Institute for Neurodegenerative Disorders, New Haven, CT, USA
| | - Catherine Kopil
- The Michael J. Fox Foundation for Parkinson's Research, New York, NY, USA
| | - Caroline M Tanner
- University of California, and San Francisco Veterans Affairs Medical Care Plan, San Francisco, CA, USA
| | | | | |
Collapse
|
12
|
Golightly YM, Alvarez C, Arbeeva LS, Cleveland RJ, Schwartz TA, Renner JB, Murphy LB, Callahan LF, Jordan JM, Nelson AE. Associations of Comorbid Conditions and Transitions Across States of Knee Osteoarthritis in a Community-Based Cohort. ACR Open Rheumatol 2021; 3:512-521. [PMID: 34196495 PMCID: PMC8363852 DOI: 10.1002/acr2.11287] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 05/06/2021] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To examine relationships between knee osteoarthritis (KOA) and obesity, diabetes mellitus (DM), and cardiovascular disease (CVD). METHODS Associations of time-dependent obesity, DM, and CVD with KOA transition states over approximately 18 years were examined among 4093 participants from a community-based cohort. Transition states were 1) no knee symptoms and no radiographic KOA (rKOA; Kellgren-Lawrence grade ≥2 in at least one knee), 2) asymptomatic rKOA, 3) knee symptoms only, 4) symptomatic rKOA (sxKOA; rKOA and symptoms in same knee). Markov multistate models estimated adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for associations between comorbid conditions and transitions across states, adjusting for baseline age, sex, race, education, enrollment cohort, birth year, and time-dependent knee injury history. RESULTS At baseline, 40% of participants had obesity, 13% had DM, and 22% had CVD (mean age = 61 years; 34% Black; 37% male). Compared with those without obesity, those with obesity had a higher hazard of worsening from no rKOA/no symptoms to asymptomatic rKOA (aHR = 1.7; 95% CI = 1.3-2.2) and from knee symptoms to sxKOA (aHR = 1.7; 95% CI = 1.3-2.3), as well as a lower hazard of symptom resolution from sxKOA to asymptomatic rKOA (aHR = 0.5 [95% = CI 0.4-0.7]). Compared with those without CVD, those with CVD had a higher hazard of worsening from no rKOA/symptoms to knee symptoms (aHR = 1.5; 95% CI = 1.1-2.1). DM was not associated with transitions of rKOA. CONCLUSION Prevention of obesity and CVD may limit the development or worsening of rKOA and symptoms.
Collapse
|
13
|
Influence of coronary dominance on coronary artery calcification burden. Clin Imaging 2021; 77:283-286. [PMID: 34171741 DOI: 10.1016/j.clinimag.2021.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 05/29/2021] [Accepted: 06/06/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the influence of coronary artery dominance on observed coronary artery calcification burden in outpatients presenting for coronary computed tomography angiography (CCTA). METHODS A 12-month retrospective review was performed of all CCTAs at a single institution. Coronary arterial dominance, Agatston score and presence or absence of cardiovascular risk factors including hypertension (HTN), hyperlipidemia (HLD), diabetes and smoking were recorded. Dominance groups were compared in terms of calcium score adjusted for covariates using analysis of covariance based on ranks. Only covariates observed to be significant independent predictors of the relevant outcome were included in each analysis. All statistical tests were conducted at the two-sided 5% significance level. RESULTS 1223 individuals, 618 women and 605 men were included, mean age 60 years (24-93 years). Right coronary dominance was observed in 91.7% (n = 1109), left dominance in 8% (n = 98), and codominance in 1.3% (n = 16). The distribution of patients among Agatston score severity categories significantly differed between codominant and left (p = 0.008), and codominant and right (p = 0.022) groups, with higher prevalence of either zero or severe CAC in the codominant patients. There was no significant difference in Agatston score between dominance groups. In the subset of individuals with coronary artery calcification, Agatston score was significantly higher in codominant versus left dominant patients (mean Agatston score 595 ± 520 vs. mean 289 ± 607, respectively; p = 0.049), with a trend towards higher scores in comparison to the right-dominant group (p = 0.093). Significance was not maintained upon adjustment for covariates. CONCLUSIONS While the distribution of Agatston score severity categories differed in codominant versus right- or left-dominant patients, there was no significant difference in Agatston score based on coronary dominance pattern in our cohort. Reporting and inclusion of codominant subsets in larger investigations may elucidate whether codominant anatomy is associated with differing risk.
Collapse
|
14
|
Mohajer B, Kwee RM, Guermazi A, Berenbaum F, Wan M, Zhen G, Cao X, Haugen IK, Demehri S. Metabolic Syndrome and Osteoarthritis Distribution in the Hand Joints: A Propensity Score Matching Analysis From the Osteoarthritis Initiative. J Rheumatol 2021; 48:1608-1615. [PMID: 34329188 DOI: 10.3899/jrheum.210189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To investigate the metabolic syndrome (MetS) association with radiographic and symptomatic hand osteoarthritis (HOA). METHODS Using 1:2 propensity score matching for relevant confounders, we included 2509 participants (896 MetS positive and 1613 MetS negative) from the Osteoarthritis Initiative dataset. MetS and its components, according to the International Diabetes Federation criteria, were extracted from baseline data, and included hypertension, abdominal obesity, dyslipidemia, and diabetes. We scored distinct hand joints based on the modified Kellgren-Lawrence (mKL) grade of baseline radiographs, with HOA defined as mKL ≥ 2. In the cross-sectional analysis, we investigated the association between MetS and its components with radiographic HOA and the presence of nodal and erosive HOA phenotypes using regression models. In the longitudinal analysis, we performed Cox regression analysis for hand pain incidence in follow-up visits. RESULTS MetS was associated with higher odds of radiographic HOA, including the number of joints with OA (OR 1.32, 95% CI 1.08-1.62), the sum of joints mKLs (OR 2.42, 95% CI 1.24-4.71), mainly in distal interphalangeal joints (DIPs) and proximal interphalangeal joints (PIPs; OR 1.52, 95% CI 1.08-2.14 and OR 1.38, 95% CI 1.09-1.75, respectively), but not metacarpophalangeal (MCP) and first carpometacarpal (CMC1) joints. Hand pain incidence during follow-up was higher with MetS presence (HR 1.25, 95% CI 1.07-1.47). The erosive HOA phenotype and joints' nodal involvement were more frequent with MetS (OR 1.40, 95% CI 1.01-1.97 and OR 1.28, 95% CI 1.02-1.60, respectively). CONCLUSION MetS, a potentially modifiable risk factor, is associated with radiographic DIP and PIP OA and longitudinal hand pain incidence while sparing MCPs and CMC1s. Nodal and erosive HOA phenotypes are associated with MetS, suggestive of possible distinct pathophysiology.
Collapse
Affiliation(s)
- Bahram Mohajer
- This research was supported by the National Institutes of Health (NIH) National Institute on Aging under award number P01AG066603. The Osteoarthritis Initiative (OAI), a collaborative project between public and private sectors, includes 5 contracts: N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262. The OAI is conducted by the OAI project investigators and is financially supported by the National Institutes of Health (NIH). Private funding partners are Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer Inc. In preparing this manuscript, publicly available OAI project datasets were used. The results of this work do not necessarily reflect the opinions of the OAI project investigators, the NIH, or the private funding partners. B. Mohajer, MD, MPH, S. Demehri, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; R.M. Kwee, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, and Department of Radiology, Zuyderland Medical Center, Heerlen/Sittard/ Geleen, the Netherlands; A. Guermazi, MD, PhD, Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA; F. Berenbaum, MD, PhD, Department of Rheumatology, Sorbonne Université, INSERM CRSA, AP-HP Hospital Saint Antoine, Paris, France; M. Wan, PhD, G. Zhen, MD, X. Cao, PhD, Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. AG has received funding from MerckSerono, AstraZeneca, Galapagos, Pfizer, Roche, TissueGene ( for consultation), and Boston Imaging Core Lab (as the president and stockholder). SD has received funding from Toshiba Medical Systems ( for consultation) and grants from the GE Radiology Research Academic Fellowship and Carestream Health ( for a clinical trial study). IH has received funding from the Southeastern Norway Health Authority. None of the authors have any conflicting personal or financial relationships that could have influenced the results of this study. The other authors have no competing interests to declare. Address correspondence to Dr. B. Mohajer, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 5165, Baltimore, MD 21287, USA. . Accepted for publication June 2, 2021
| | - Robert M Kwee
- This research was supported by the National Institutes of Health (NIH) National Institute on Aging under award number P01AG066603. The Osteoarthritis Initiative (OAI), a collaborative project between public and private sectors, includes 5 contracts: N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262. The OAI is conducted by the OAI project investigators and is financially supported by the National Institutes of Health (NIH). Private funding partners are Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer Inc. In preparing this manuscript, publicly available OAI project datasets were used. The results of this work do not necessarily reflect the opinions of the OAI project investigators, the NIH, or the private funding partners. B. Mohajer, MD, MPH, S. Demehri, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; R.M. Kwee, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, and Department of Radiology, Zuyderland Medical Center, Heerlen/Sittard/ Geleen, the Netherlands; A. Guermazi, MD, PhD, Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA; F. Berenbaum, MD, PhD, Department of Rheumatology, Sorbonne Université, INSERM CRSA, AP-HP Hospital Saint Antoine, Paris, France; M. Wan, PhD, G. Zhen, MD, X. Cao, PhD, Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. AG has received funding from MerckSerono, AstraZeneca, Galapagos, Pfizer, Roche, TissueGene ( for consultation), and Boston Imaging Core Lab (as the president and stockholder). SD has received funding from Toshiba Medical Systems ( for consultation) and grants from the GE Radiology Research Academic Fellowship and Carestream Health ( for a clinical trial study). IH has received funding from the Southeastern Norway Health Authority. None of the authors have any conflicting personal or financial relationships that could have influenced the results of this study. The other authors have no competing interests to declare. Address correspondence to Dr. B. Mohajer, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 5165, Baltimore, MD 21287, USA. . Accepted for publication June 2, 2021
| | - Ali Guermazi
- This research was supported by the National Institutes of Health (NIH) National Institute on Aging under award number P01AG066603. The Osteoarthritis Initiative (OAI), a collaborative project between public and private sectors, includes 5 contracts: N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262. The OAI is conducted by the OAI project investigators and is financially supported by the National Institutes of Health (NIH). Private funding partners are Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer Inc. In preparing this manuscript, publicly available OAI project datasets were used. The results of this work do not necessarily reflect the opinions of the OAI project investigators, the NIH, or the private funding partners. B. Mohajer, MD, MPH, S. Demehri, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; R.M. Kwee, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, and Department of Radiology, Zuyderland Medical Center, Heerlen/Sittard/ Geleen, the Netherlands; A. Guermazi, MD, PhD, Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA; F. Berenbaum, MD, PhD, Department of Rheumatology, Sorbonne Université, INSERM CRSA, AP-HP Hospital Saint Antoine, Paris, France; M. Wan, PhD, G. Zhen, MD, X. Cao, PhD, Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. AG has received funding from MerckSerono, AstraZeneca, Galapagos, Pfizer, Roche, TissueGene ( for consultation), and Boston Imaging Core Lab (as the president and stockholder). SD has received funding from Toshiba Medical Systems ( for consultation) and grants from the GE Radiology Research Academic Fellowship and Carestream Health ( for a clinical trial study). IH has received funding from the Southeastern Norway Health Authority. None of the authors have any conflicting personal or financial relationships that could have influenced the results of this study. The other authors have no competing interests to declare. Address correspondence to Dr. B. Mohajer, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 5165, Baltimore, MD 21287, USA. . Accepted for publication June 2, 2021
| | - Francis Berenbaum
- This research was supported by the National Institutes of Health (NIH) National Institute on Aging under award number P01AG066603. The Osteoarthritis Initiative (OAI), a collaborative project between public and private sectors, includes 5 contracts: N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262. The OAI is conducted by the OAI project investigators and is financially supported by the National Institutes of Health (NIH). Private funding partners are Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer Inc. In preparing this manuscript, publicly available OAI project datasets were used. The results of this work do not necessarily reflect the opinions of the OAI project investigators, the NIH, or the private funding partners. B. Mohajer, MD, MPH, S. Demehri, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; R.M. Kwee, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, and Department of Radiology, Zuyderland Medical Center, Heerlen/Sittard/ Geleen, the Netherlands; A. Guermazi, MD, PhD, Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA; F. Berenbaum, MD, PhD, Department of Rheumatology, Sorbonne Université, INSERM CRSA, AP-HP Hospital Saint Antoine, Paris, France; M. Wan, PhD, G. Zhen, MD, X. Cao, PhD, Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. AG has received funding from MerckSerono, AstraZeneca, Galapagos, Pfizer, Roche, TissueGene ( for consultation), and Boston Imaging Core Lab (as the president and stockholder). SD has received funding from Toshiba Medical Systems ( for consultation) and grants from the GE Radiology Research Academic Fellowship and Carestream Health ( for a clinical trial study). IH has received funding from the Southeastern Norway Health Authority. None of the authors have any conflicting personal or financial relationships that could have influenced the results of this study. The other authors have no competing interests to declare. Address correspondence to Dr. B. Mohajer, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 5165, Baltimore, MD 21287, USA. . Accepted for publication June 2, 2021
| | - Mei Wan
- This research was supported by the National Institutes of Health (NIH) National Institute on Aging under award number P01AG066603. The Osteoarthritis Initiative (OAI), a collaborative project between public and private sectors, includes 5 contracts: N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262. The OAI is conducted by the OAI project investigators and is financially supported by the National Institutes of Health (NIH). Private funding partners are Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer Inc. In preparing this manuscript, publicly available OAI project datasets were used. The results of this work do not necessarily reflect the opinions of the OAI project investigators, the NIH, or the private funding partners. B. Mohajer, MD, MPH, S. Demehri, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; R.M. Kwee, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, and Department of Radiology, Zuyderland Medical Center, Heerlen/Sittard/ Geleen, the Netherlands; A. Guermazi, MD, PhD, Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA; F. Berenbaum, MD, PhD, Department of Rheumatology, Sorbonne Université, INSERM CRSA, AP-HP Hospital Saint Antoine, Paris, France; M. Wan, PhD, G. Zhen, MD, X. Cao, PhD, Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. AG has received funding from MerckSerono, AstraZeneca, Galapagos, Pfizer, Roche, TissueGene ( for consultation), and Boston Imaging Core Lab (as the president and stockholder). SD has received funding from Toshiba Medical Systems ( for consultation) and grants from the GE Radiology Research Academic Fellowship and Carestream Health ( for a clinical trial study). IH has received funding from the Southeastern Norway Health Authority. None of the authors have any conflicting personal or financial relationships that could have influenced the results of this study. The other authors have no competing interests to declare. Address correspondence to Dr. B. Mohajer, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 5165, Baltimore, MD 21287, USA. . Accepted for publication June 2, 2021
| | - Gehua Zhen
- This research was supported by the National Institutes of Health (NIH) National Institute on Aging under award number P01AG066603. The Osteoarthritis Initiative (OAI), a collaborative project between public and private sectors, includes 5 contracts: N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262. The OAI is conducted by the OAI project investigators and is financially supported by the National Institutes of Health (NIH). Private funding partners are Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer Inc. In preparing this manuscript, publicly available OAI project datasets were used. The results of this work do not necessarily reflect the opinions of the OAI project investigators, the NIH, or the private funding partners. B. Mohajer, MD, MPH, S. Demehri, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; R.M. Kwee, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, and Department of Radiology, Zuyderland Medical Center, Heerlen/Sittard/ Geleen, the Netherlands; A. Guermazi, MD, PhD, Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA; F. Berenbaum, MD, PhD, Department of Rheumatology, Sorbonne Université, INSERM CRSA, AP-HP Hospital Saint Antoine, Paris, France; M. Wan, PhD, G. Zhen, MD, X. Cao, PhD, Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. AG has received funding from MerckSerono, AstraZeneca, Galapagos, Pfizer, Roche, TissueGene ( for consultation), and Boston Imaging Core Lab (as the president and stockholder). SD has received funding from Toshiba Medical Systems ( for consultation) and grants from the GE Radiology Research Academic Fellowship and Carestream Health ( for a clinical trial study). IH has received funding from the Southeastern Norway Health Authority. None of the authors have any conflicting personal or financial relationships that could have influenced the results of this study. The other authors have no competing interests to declare. Address correspondence to Dr. B. Mohajer, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 5165, Baltimore, MD 21287, USA. . Accepted for publication June 2, 2021
| | - Xu Cao
- This research was supported by the National Institutes of Health (NIH) National Institute on Aging under award number P01AG066603. The Osteoarthritis Initiative (OAI), a collaborative project between public and private sectors, includes 5 contracts: N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262. The OAI is conducted by the OAI project investigators and is financially supported by the National Institutes of Health (NIH). Private funding partners are Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer Inc. In preparing this manuscript, publicly available OAI project datasets were used. The results of this work do not necessarily reflect the opinions of the OAI project investigators, the NIH, or the private funding partners. B. Mohajer, MD, MPH, S. Demehri, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; R.M. Kwee, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, and Department of Radiology, Zuyderland Medical Center, Heerlen/Sittard/ Geleen, the Netherlands; A. Guermazi, MD, PhD, Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA; F. Berenbaum, MD, PhD, Department of Rheumatology, Sorbonne Université, INSERM CRSA, AP-HP Hospital Saint Antoine, Paris, France; M. Wan, PhD, G. Zhen, MD, X. Cao, PhD, Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. AG has received funding from MerckSerono, AstraZeneca, Galapagos, Pfizer, Roche, TissueGene ( for consultation), and Boston Imaging Core Lab (as the president and stockholder). SD has received funding from Toshiba Medical Systems ( for consultation) and grants from the GE Radiology Research Academic Fellowship and Carestream Health ( for a clinical trial study). IH has received funding from the Southeastern Norway Health Authority. None of the authors have any conflicting personal or financial relationships that could have influenced the results of this study. The other authors have no competing interests to declare. Address correspondence to Dr. B. Mohajer, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 5165, Baltimore, MD 21287, USA. . Accepted for publication June 2, 2021
| | - Ida K Haugen
- This research was supported by the National Institutes of Health (NIH) National Institute on Aging under award number P01AG066603. The Osteoarthritis Initiative (OAI), a collaborative project between public and private sectors, includes 5 contracts: N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262. The OAI is conducted by the OAI project investigators and is financially supported by the National Institutes of Health (NIH). Private funding partners are Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer Inc. In preparing this manuscript, publicly available OAI project datasets were used. The results of this work do not necessarily reflect the opinions of the OAI project investigators, the NIH, or the private funding partners. B. Mohajer, MD, MPH, S. Demehri, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; R.M. Kwee, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, and Department of Radiology, Zuyderland Medical Center, Heerlen/Sittard/ Geleen, the Netherlands; A. Guermazi, MD, PhD, Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA; F. Berenbaum, MD, PhD, Department of Rheumatology, Sorbonne Université, INSERM CRSA, AP-HP Hospital Saint Antoine, Paris, France; M. Wan, PhD, G. Zhen, MD, X. Cao, PhD, Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. AG has received funding from MerckSerono, AstraZeneca, Galapagos, Pfizer, Roche, TissueGene ( for consultation), and Boston Imaging Core Lab (as the president and stockholder). SD has received funding from Toshiba Medical Systems ( for consultation) and grants from the GE Radiology Research Academic Fellowship and Carestream Health ( for a clinical trial study). IH has received funding from the Southeastern Norway Health Authority. None of the authors have any conflicting personal or financial relationships that could have influenced the results of this study. The other authors have no competing interests to declare. Address correspondence to Dr. B. Mohajer, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 5165, Baltimore, MD 21287, USA. . Accepted for publication June 2, 2021
| | - Shadpour Demehri
- This research was supported by the National Institutes of Health (NIH) National Institute on Aging under award number P01AG066603. The Osteoarthritis Initiative (OAI), a collaborative project between public and private sectors, includes 5 contracts: N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262. The OAI is conducted by the OAI project investigators and is financially supported by the National Institutes of Health (NIH). Private funding partners are Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer Inc. In preparing this manuscript, publicly available OAI project datasets were used. The results of this work do not necessarily reflect the opinions of the OAI project investigators, the NIH, or the private funding partners. B. Mohajer, MD, MPH, S. Demehri, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; R.M. Kwee, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, and Department of Radiology, Zuyderland Medical Center, Heerlen/Sittard/ Geleen, the Netherlands; A. Guermazi, MD, PhD, Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA; F. Berenbaum, MD, PhD, Department of Rheumatology, Sorbonne Université, INSERM CRSA, AP-HP Hospital Saint Antoine, Paris, France; M. Wan, PhD, G. Zhen, MD, X. Cao, PhD, Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. AG has received funding from MerckSerono, AstraZeneca, Galapagos, Pfizer, Roche, TissueGene ( for consultation), and Boston Imaging Core Lab (as the president and stockholder). SD has received funding from Toshiba Medical Systems ( for consultation) and grants from the GE Radiology Research Academic Fellowship and Carestream Health ( for a clinical trial study). IH has received funding from the Southeastern Norway Health Authority. None of the authors have any conflicting personal or financial relationships that could have influenced the results of this study. The other authors have no competing interests to declare. Address correspondence to Dr. B. Mohajer, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 5165, Baltimore, MD 21287, USA. . Accepted for publication June 2, 2021
| |
Collapse
|
15
|
Guo H, Yu Y, Ye Y, Zhou S. Accuracy of Self-Reported Hypertension, Diabetes, and Hyperlipidemia among Adults of Liwan, Guangzhou, China. IRANIAN JOURNAL OF PUBLIC HEALTH 2020; 49:1622-1630. [PMID: 33643935 PMCID: PMC7898086 DOI: 10.18502/ijph.v49i9.4076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: We aimed to determine the accuracy of self-reported diabetes, hypertension, and hyperlipidemia in Chinese adults and examine factors that affect the accuracy of self-reports. Methods: This representative cross-sectional survey was conducted in Liwan District, Guangzhou City, Southeast China. Self-reported data were collected using a structured questionnaire. Biometrical data were recorded, including blood lipid, blood glucose and arterial blood pressure levels. Sensitivity, specificity, and κ values of self-reports were used as measurements of accuracy or agreements. The Robust Poisson-GEE was applied to determine the association of participants’ characteristics with the accuracy of self-reports. Results: Self-reported and biometrical data of 1278 residents aged 18 yr and older (693 women and 585 men) were used to calculate three measures of agreement. The agreement between self-reports and biomedical measurements was substantial for both hypertension and diabetes (κ=0.77 and 0.76), but only slight for hyperlipidemia (κ=0.06). Similarly, the sensitivity was higher for hypertension and diabetes (72.3% and 71.2%) than for hyperlipidemia (6.8%), while the specificity was high overall (≥98%). The factors associated with an accurate self-reported diagnosis in respondents with disease included having undergone blood pressure measurement (for hypertension) or blood glucose measurement (for diabetes) in the past 6 month, having attended health knowledge lectures in the past year and having social health insurances (for hypertension), and having undergone physical discomfort in the past 2 weeks (for hypertension and diabetes). Conclusion: The accuracy of self-reported hypertension and diabetes was high, whereas that of self-reported hyperlipidemia was lower among the population.
Collapse
Affiliation(s)
- Huijie Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510006, China.,Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Yi Yu
- Guangzhou Liwan Center for Disease Control and Prevention, Guangzhou, 510176, China
| | - Yilu Ye
- Department of Psychiatry, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510700, China
| | - Shudong Zhou
- Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510006, China
| |
Collapse
|
16
|
Mereish EH, Goldstein CM. Minority Stress and Cardiovascular Disease Risk Among Sexual Minorities: Mediating Effects of Sense of Mastery. Int J Behav Med 2020; 27:726-736. [PMID: 32734472 DOI: 10.1007/s12529-020-09919-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Sexual minority adults are at greater risk for cardiovascular disease (CVD) risk factors than heterosexual adults. There is a dearth of research identifying factors that are associated with CVD risk among sexual minorities. This study examined the associations between distal and proximal minority stressors and CVD risk. We also tested a sense of mastery as one mechanism that might explain the link between minority stressors and CVD risk. METHODS Participants were 670 sexual minority adults (53.6% male; 76% White), ages 18 to 76 years (M = 41.19, SD = 14.73), obtained from a non-probability sample. Using an online survey, participants self-reported family history of CVD risk, physiological conditions (diabetes mellitus, high cholesterol, hypertension), and health behaviors (e.g., tobacco use, diet, exercise) that confer or protect against CVD risk. A weighted CVD risk index was computed. Linear and logistic regressions were conducted to test the effects of minority stressors on the CVD risk index and its specific indicators and to examine mediation. RESULTS Minority stressors were associated with a sense of mastery, and mastery was associated with lower CVD risk index scores. Proximal and distal minority stressors were not directly associated with the overall CVD risk index but were associated with some specific risk indicators. Mediation analyses revealed that both distal and proximal minority stressors were indirectly associated with the CVD risk index through mastery. CONCLUSIONS Research and interventions should aim to reduce CVD risk factors and target minority stressors and mastery to improve the cardiovascular health of sexual minorities.
Collapse
Affiliation(s)
- Ethan H Mereish
- Department of Health Studies, American University, Washington, DC, USA.
| | - Carly M Goldstein
- Weight Control and Diabetes Research Center, The Miriam Hospital, Alpert Medical School of Brown University, Providence, RI, USA
| |
Collapse
|
17
|
Scherzer ZA, Alvarez C, Renner JB, Murphy LB, Schwartz TA, Jordan JM, Golightly YM, Nelson AE. Effects of Comorbid Cardiovascular Disease and Diabetes on Hand Osteoarthritis, Pain, and Functional State Transitions: The Johnston County Osteoarthritis Project. J Rheumatol 2020; 47:1541-1549. [PMID: 32062598 DOI: 10.3899/jrheum.191075] [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] [Accepted: 01/29/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The purpose of this study is to examine the course of hand osteoarthritis (HOA) and its relationship with cardiovascular disease (CVD) and diabetes (DM). METHODS Data were collected at 3 timepoints from 845 Johnston County Osteoarthritis Project participants (two-thirds women, one-third African Americans, mean age 60 yrs) with and without HOA, CVD, or DM. A diagnosis of radiographic HOA (rHOA) required a Kellgren-Lawrence severity grade of ≥ 2 in at least 3 joints in each hand. A 4-state progressive model included transitions based on rHOA and pain or function as defined using the Australian/Canadian HOA Index (AUSCAN). Markov multistate models estimated HR (aHR) and 95% CI for associations between DM or CVD and specific state transitions, adjusting for baseline and time-varying covariates. RESULTS Participants with DM (vs those without DM) were more likely to experience worsening pain with rHOA. Individuals who had or developed CVD (vs those who did not) were significantly less likely to experience symptomatic improvement, regardless of rHOA status. Those with DM or CVD (vs those without these comorbidities) were less likely to experience improvement in function, although this was statistically significant only for those with DM and no rHOA. CONCLUSION Overall, having or developing DM and/or CVD reduced the likelihood of symptomatic and functional improvement over time, suggesting an effect of comorbid CVD and DM on the clinical and radiographic course of HOA. Additional studies are needed to confirm these findings.
Collapse
Affiliation(s)
- Zachary A Scherzer
- Z.A. Scherzer, BS, Medical Student, Oakland University William Beaumont School of Medicine, Rochester, Missouri, and Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Carolina Alvarez
- C. Alvarez, MS, Statistician, Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jordan B Renner
- J.B. Renner, MD, Professor of Radiology and Allied Health Sciences, Thurston Arthritis Research Center, and Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Louise B Murphy
- L.B. Murphy, PhD, Senior Service Fellow/Epidemiologist, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Todd A Schwartz
- T.A. Schwartz, DrPH, Associate Professor of Biostatistics, Thurston Arthritis Research Center, and Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Joanne M Jordan
- J.M. Jordan, MD, MPH, Joseph P. Archie, Jr. Eminent Professor of Medicine and Vice Dean for Faculty Affairs and Leadership Development, Thurston Arthritis Research Center, and Department of Medicine, and Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Yvonne M Golightly
- Y.M. Golightly, PT, PhD, Assistant Professor of Epidemiology, Thurston Arthritis Research Center, and Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, and Division of Physical Therapy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Amanda E Nelson
- A.E. Nelson, MD, MSCR, Associate Professor of Medicine, Thurston Arthritis Research Center, and Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| |
Collapse
|
18
|
Alvarez C, Cleveland RJ, Schwartz TA, Renner JB, Murphy LB, Jordan JM, Callahan LF, Golightly YM, Nelson AE. Comorbid conditions and the transition among states of hip osteoarthritis and symptoms in a community-based study: a multi-state time-to-event model approach. Arthritis Res Ther 2020; 22:12. [PMID: 31959228 PMCID: PMC6972032 DOI: 10.1186/s13075-020-2101-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 01/09/2020] [Indexed: 12/22/2022] Open
Abstract
Background We examined the association of three common chronic conditions (obesity, diabetes mellitus [DM], and cardiovascular disease [CVD]) with transitions among states of hip osteoarthritis (HOA). Methods This longitudinal analysis used data from the Johnston County Osteoarthritis Project (JoCo OA, n = 3857), a community-based study in North Carolina, USA, with 18.4 ± 1.5 years of follow-up. Transitions across the following states were modeled: development of radiographic HOA (rHOA; Kellgren-Lawrence grade [KLG] of< 2); development of hip symptoms (self-reported hip pain, aching, or stiffness on most days) or symptomatic HOA (sxHOA; rHOA and symptoms in the same hip), and resolution of symptoms. Obesity (body mass index ≥ 30 kg/m2) and self-reported DM and CVD were the time-dependent comorbid conditions of interest. Markov multi-state models were used to estimate adjusted hazard ratios and 95% confidence intervals to describe the associations between the conditions and HOA states. Results The sample included 33% African Americans, 39% men, with a mean (SD) age of 62.2 (9.8) years; the frequencies of the comorbidities increased substantially over time. When considered individually, obesity was associated with incident hip symptoms, while CVD and DM were associated with reduced symptom resolution. For those with > 1 comorbidity, the likelihood of incident sxHOA increased, while that of symptom resolution significantly decreased. When stratified by sex, the association between obesity and incident symptoms was only seen in women; among men with DM versus men without, there was a significant (~ 75%) reduction in symptom resolution in those with rHOA. When stratified by race, African Americans with DM, versus those without, were much more likely to develop sxHOA. Conclusions Comorbid chronic conditions are common in individuals with OA, and these conditions have a significant impact on the persistence and progression of HOA. OA management decisions, both pharmacologic and non-pharmacologic, should include considerations of the inter-relationships between OA and common comorbidities such as DM and CVD.
Collapse
Affiliation(s)
- Carolina Alvarez
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Doc J. Thurston Building, Campus Box #7280, Chapel Hill, NC, 27599-7280, USA
| | - Rebecca J Cleveland
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Doc J. Thurston Building, Campus Box #7280, Chapel Hill, NC, 27599-7280, USA
| | - Todd A Schwartz
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Doc J. Thurston Building, Campus Box #7280, Chapel Hill, NC, 27599-7280, USA.,Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 3106E McGavran-Greenberg Hall, Campus Box #7420, Chapel Hill, NC, 27599-7420, USA
| | - Jordan B Renner
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Doc J. Thurston Building, Campus Box #7280, Chapel Hill, NC, 27599-7280, USA.,Department of Radiology, University of North Carolina at Chapel Hill, 509 Old Infirmary Bldg, Campus Box #7510, Chapel Hill, NC, 27599-7510, USA
| | - Louise B Murphy
- Centers for Disease Control and Prevention, 4770 Buford Highway NE MS S106-7, Atlanta, GA, 30341, USA
| | - Joanne M Jordan
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Doc J. Thurston Building, Campus Box #7280, Chapel Hill, NC, 27599-7280, USA.,School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, USA.,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Leigh F Callahan
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Doc J. Thurston Building, Campus Box #7280, Chapel Hill, NC, 27599-7280, USA.,School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, USA.,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Yvonne M Golightly
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Doc J. Thurston Building, Campus Box #7280, Chapel Hill, NC, 27599-7280, USA.,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, USA.,Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, USA.,Division of Physical Therapy, Department of Allied Health, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Amanda E Nelson
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Doc J. Thurston Building, Campus Box #7280, Chapel Hill, NC, 27599-7280, USA. .,School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, USA.
| |
Collapse
|
19
|
Gonzalez-Chica DA, Bowden J, Miller C, Longo M, Nelson M, Reid C, Stocks N. Patient-reported GP health assessments rather than individual cardiovascular risk burden are associated with the engagement in lifestyle changes: population-based survey in South Australia. BMC FAMILY PRACTICE 2019; 20:173. [PMID: 31836016 PMCID: PMC6911269 DOI: 10.1186/s12875-019-1066-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 12/05/2019] [Indexed: 02/01/2023]
Abstract
Background Little is known about whether a more comprehensive health assessment, performed by a general practitioner (GP) during a clinical encounter, could influence patients’ lifestyle. We aimed to investigate whether health assessments, performed by GPs, are more important than the presence of cardiovascular disease (CVD) or cardiometabolic risk factors (obesity, diabetes, hypertension, dyslipidaemia) for engagement in lifestyle change. Methods Cross-sectional, population-based survey conducted in South Australia (September–December 2017) using face-to-face interviews and self-reported data of 2977 individuals aged 15+ years. The main outcome was engagement in four lifestyle changes: 1) increasing fruit/vegetable intake, 2) increasing physical activity level, 3) reducing alcohol consumption, and 4) attempts to stop smoking. Health assessments performed by a GP in the last 12 months included clinical/laboratory investigations (weight/waist circumference, blood pressure, glucose levels, lipid levels) and questions about lifestyle/wellbeing (current diet, physical activity, smoking status, alcohol intake, mental health, sleeping problems). Results were restricted to individuals aged 35+ years because of the low prevalence of CVD or their risk factors among younger participants. Logistic regression was used in all associations, adjusted for sociodemographic, lifestyle, mental health, and clinical variables. Results Of the 2384 investigated adults (mean age 57.3 ± 13.9 years; 51.9% females), 10.2% had CVD and 49.1% at least one cardiometabolic risk factor. Clinical/laboratory assessments performed by the GP were 2–3 times more frequent than assessments of lifestyle, mental health status, or sleeping problems, especially among those with CVD. Individuals with CVD or a cardiometabolic risk factor were no more likely to be increasing their fruit/vegetable consumption (33.6%), physical activity level (40.9%), reducing alcohol consumption (31.1%), or trying to quit smoking (34.0%) than ‘healthy’ participants. However, lifestyle changes were between 30 and 100% more likely when GPs performed three or more health assessments (either clinical/laboratory or questions about lifestyle/wellbeing) than when individuals did not visit the GP or when GPs performed no any assessment during these clinical encounters (p < 0.05 in all cases). Conclusion More frequent and comprehensive CVD-related assessments by GPs were more important in promoting a healthier lifestyle than the presence of CVD or cardiometabolic risk factors by themselves.
Collapse
Affiliation(s)
- David Alejandro Gonzalez-Chica
- Discipline of General Practice, Adelaide Medical School, The University of Adelaide, Helen Mayo North, Sturt Road, Level 1, Room 113. South Australia, Adelaide, 5005, Australia. .,Adelaide Rural Clinical School, The University of Adelaide, Adelaide, SA, Australia.
| | - Jacqueline Bowden
- Population Health Research Group, South Australian Health & Medical Research Institute, Adelaide, SA, Australia
| | - Caroline Miller
- Population Health and Clinical Monitoring, Drug Policy & Population Health, Drug & Alcohol Services South Australia, Adelaide, SA, Australia
| | - Marie Longo
- Population Health and Clinical Monitoring, Drug Policy & Population Health, Drug & Alcohol Services South Australia, Adelaide, SA, Australia
| | - Mark Nelson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Christopher Reid
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Nigel Stocks
- Discipline of General Practice, Adelaide Medical School, The University of Adelaide, Helen Mayo North, Sturt Road, Level 1, Room 113. South Australia, Adelaide, 5005, Australia
| |
Collapse
|
20
|
Spitzer S, Weber D. Reporting biases in self-assessed physical and cognitive health status of older Europeans. PLoS One 2019; 14:e0223526. [PMID: 31593576 PMCID: PMC6783110 DOI: 10.1371/journal.pone.0223526] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 09/23/2019] [Indexed: 11/18/2022] Open
Abstract
This paper explores which demographic characteristics substantially bias self-reported physical and cognitive health status of older Europeans. The analysis utilises micro-data for 19 European countries from the Survey of Health, Ageing and Retirement in Europe to compare performance-tested outcomes of mobility and memory with their self-reported equivalents. Relative importance analysis based on multinomial logistic regressions shows that the bias in self-reported health is mostly due to reporting heterogeneities between countries and age groups, whereas gender contributes little to the discrepancy. Concordance of mobility and cognition measures is highly related; however, differences in reporting behaviour due to education and cultural background have a larger impact on self-assessed memory than on self-assessed mobility. Southern as well as Central and Eastern Europeans are much more likely to misreport their physical and cognitive abilities than Northern and Western Europeans. Overall, our results suggest that comparisons of self-reported health between countries and age groups are prone to significant biases, whereas comparisons between genders are credible for most European countries. These findings are crucial given that self-assessed data are often the only information available to researchers and policymakers when asking health-related questions.
Collapse
Affiliation(s)
- Sonja Spitzer
- World Population Program at the International Institute for Applied Systems Analysis (IIASA), Wittgenstein Centre for Demography and Global Human Capital, Laxenburg, Austria
| | - Daniela Weber
- World Population Program at the International Institute for Applied Systems Analysis (IIASA), Wittgenstein Centre for Demography and Global Human Capital, Laxenburg, Austria.,Health Economics and Policy Division of the Vienna University of Economics and Business, Vienna, Austria
| |
Collapse
|
21
|
Dashti SG, Li WY, Buchanan DD, Clendenning M, Rosty C, Winship IM, Macrae FA, Giles GG, Hardikar S, Hua X, Thibodeau SN, Figueiredo JC, Casey G, Haile RW, Gallinger S, Le Marchand L, Newcomb PA, Potter JD, Lindor NM, Hopper JL, Jenkins MA, Win AK. Type 2 diabetes mellitus, blood cholesterol, triglyceride and colorectal cancer risk in Lynch syndrome. Br J Cancer 2019; 121:869-876. [PMID: 31551580 PMCID: PMC6888855 DOI: 10.1038/s41416-019-0580-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 08/26/2019] [Accepted: 08/30/2019] [Indexed: 12/26/2022] Open
Abstract
Background Type 2 diabetes mellitus and high total cholesterol and triglycerides are known to be associated with increased colorectal cancer risk for the general population. These associations are unknown for people with a germline DNA mismatch repair gene mutation (Lynch syndrome), who are at high risk of colorectal cancer. Methods This study included 2023 (56.4% female) carriers with a mismatch repair gene mutation (737 in MLH1, 928 in MSH2, 230 in MSH6, 106 in PMS2, 22 in EPCAM) recruited by the Colon Cancer Family Registry between 1998 and 2012. Weighted Cox regression was used to estimate the hazard ratios (HR) and 95% confidence intervals (CI) for the associations between self-reported type 2 diabetes, high cholesterol, triglyceride and colorectal cancer risk. Results Overall, 802 carriers were diagnosed with colorectal cancer at a median age of 42 years. A higher risk of colorectal cancer was observed in those with self-reported type-2 diabetes (HR 1.92; 95% CI, 1.03–3.58) and high cholesterol (HR 1.76; CI 1.23–2.52) compared with those without these conditions. There was no evidence of high triglyceride being associated with colorectal cancer risk. Conclusion For people with Lynch syndrome, self-reported type-2 diabetes mellitus and high cholesterol were associated with increased colorectal cancer risk.
Collapse
Affiliation(s)
- S Ghazaleh Dashti
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, 3010, Australia.,Victorian Comprehensive Cancer Centre, University of Melbourne Centre for Cancer Research, Melbourne, VIC, 3000, Australia.,Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, 3004, Australia
| | - Wing Yan Li
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, 3010, Australia.,Victorian Comprehensive Cancer Centre, University of Melbourne Centre for Cancer Research, Melbourne, VIC, 3000, Australia
| | - Daniel D Buchanan
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, 3010, Australia.,Victorian Comprehensive Cancer Centre, University of Melbourne Centre for Cancer Research, Melbourne, VIC, 3000, Australia.,Genetic Medicine, Royal Melbourne Hospital, Parkville, VIC, 3050, Australia.,Colorectal Oncogenomics Group, Department of Clinical Pathology, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Mark Clendenning
- Victorian Comprehensive Cancer Centre, University of Melbourne Centre for Cancer Research, Melbourne, VIC, 3000, Australia.,Colorectal Oncogenomics Group, Department of Clinical Pathology, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Christophe Rosty
- Victorian Comprehensive Cancer Centre, University of Melbourne Centre for Cancer Research, Melbourne, VIC, 3000, Australia.,Colorectal Oncogenomics Group, Department of Clinical Pathology, The University of Melbourne, Parkville, VIC, 3010, Australia.,Envoi Specialist Pathologists, Brisbane, QLD, 4059, Australia.,Faculty of Medicine, University of Queensland, Brisbane, QLD, 4006, Australia
| | - Ingrid M Winship
- Genetic Medicine, Royal Melbourne Hospital, Parkville, VIC, 3050, Australia.,Department of Medicine, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Finlay A Macrae
- Genetic Medicine, Royal Melbourne Hospital, Parkville, VIC, 3050, Australia.,Department of Medicine, The University of Melbourne, Parkville, VIC, 3010, Australia.,Colorectal Medicine and Genetics, Royal Melbourne Hospital, Parkville, VIC, 3050, Australia
| | - Graham G Giles
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, 3010, Australia.,Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, 3004, Australia
| | - Sheetal Hardikar
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, 84112, USA.,Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, 84112, USA.,Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, 98109, USA
| | - Xinwei Hua
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, 98109, USA.,School of Public Health, University of Washington, Seattle, WA, 98195, USA
| | - Stephen N Thibodeau
- Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55455, USA
| | - Jane C Figueiredo
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.,Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90032, USA
| | - Graham Casey
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, 22908, USA
| | - Robert W Haile
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
| | - Steven Gallinger
- Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, ON, M5G 1×5, Canada
| | - Loïc Le Marchand
- University of Hawaii Cancer Center, Honolulu, Hawaii, 96813, USA
| | - Polly A Newcomb
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, 98109, USA.,School of Public Health, University of Washington, Seattle, WA, 98195, USA
| | - John D Potter
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, 98109, USA.,School of Public Health, University of Washington, Seattle, WA, 98195, USA.,Centre for Public Health Research, Massey University, Wellington, 6140, New Zealand
| | - Noralane M Lindor
- Department of Health Science Research, Mayo Clinic Arizona, Scottsdale, AZ, 85259, USA
| | - John L Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, 3010, Australia.,Victorian Comprehensive Cancer Centre, University of Melbourne Centre for Cancer Research, Melbourne, VIC, 3000, Australia
| | - Mark A Jenkins
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, 3010, Australia.,Victorian Comprehensive Cancer Centre, University of Melbourne Centre for Cancer Research, Melbourne, VIC, 3000, Australia
| | - Aung Ko Win
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, 3010, Australia. .,Victorian Comprehensive Cancer Centre, University of Melbourne Centre for Cancer Research, Melbourne, VIC, 3000, Australia. .,Genetic Medicine, Royal Melbourne Hospital, Parkville, VIC, 3050, Australia.
| |
Collapse
|
22
|
Stocks NP, Gonzalez-Chica D, Hay P. Impact of gastrointestinal conditions, restrictive diets and mental health on health-related quality of life: cross-sectional population-based study in Australia. BMJ Open 2019; 9:e026035. [PMID: 31253614 PMCID: PMC6609067 DOI: 10.1136/bmjopen-2018-026035] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES To assess the relationship between gastrointestinal conditions, restrictive diets, mental health and health-related quality of life (HRQoL). DESIGN Cross-sectional population-based face-to-face survey. SETTING South Australia. PARTICIPANTS A representative sample of 2912 consenting adults (48.9±18.1 years; 50.9% females) investigated in 2015. PRIMARY AND SECONDARY OUTCOME MEASURES Participants self-reported diagnosis of gastrointestinal conditions, mental health and current use of restrictive diets. The physical component score (PCS) and mental component score (MCS) of HRQoL were investigated (Study Short Form 12 V.1 questionnaire). Linear regression models were used to test the associations, adjusting for (1) sociodemographic variables, (2) mental health status and (3) lifestyle and body mass index. RESULTS The prevalence of restrictive diets (36.1%; 95% CI 33.9 to 38.3) was higher among those with any self-reported gastrointestinal condition (60.7% vs 31.3% for those without these conditions; p<0.001). PCS was lower among those with a gastrointestinal condition (mean difference=-3.4; 95% CI -4.5 to -2.4) or on a restrictive diet (mean difference=-1.9; 95% CI -2.7 to -1.1), with a similar pattern, but with a smaller effect, observed for MCS. Being on a restrictive diet did not modify the relationship between having a gastrointestinal condition and reduced HRQoL. However, having a gastrointestinal condition was associated with a 2.4 points lower PCS (95% CI -3.5 to -1.3) among those without a mental health problem, while for those affected by a mental health condition this reduction was greater (mean difference=-5.9; 95% CI -8.7 to -3.1). For MCS, there was no evidence of interaction between mental health and gastrointestinal conditions. CONCLUSIONS One-third of Australian adults are restricting their diet, and this is associated with lower HRQoL. Being on a restrictive diet was not associated with a better HRQoL among individuals with a gastrointestinal condition. Mental health problems were associated with a stronger adverse relationship between gastrointestinal diseases and physical HRQoL. Health professionals should be alert to these associations when trying to improve health outcomes for patients.
Collapse
Affiliation(s)
- Nigel P Stocks
- General Practice, University of Adelaide, Adelaide, South Australia, Australia
| | - David Gonzalez-Chica
- Discipline of General Practice, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
| |
Collapse
|
23
|
Dey AK, Stamenova V, Bacopulos A, Jeyakumar N, Turner GR, Black SE, Levine B. Cognitive heterogeneity among community-dwelling older adults with cerebral small vessel disease. Neurobiol Aging 2019; 77:183-193. [DOI: 10.1016/j.neurobiolaging.2018.12.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 12/16/2018] [Accepted: 12/26/2018] [Indexed: 10/27/2022]
|
24
|
Paalanen L, Koponen P, Laatikainen T, Tolonen H. Public health monitoring of hypertension, diabetes and elevated cholesterol: comparison of different data sources. Eur J Public Health 2019; 28:754-765. [PMID: 29462296 DOI: 10.1093/eurpub/cky020] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Three data sources are generally used in monitoring health on the population level. Health interview surveys (HISs) are based on participants' self-report. Health examination surveys (HESs) yield more objective data, and also persons who are unaware of their elevated risks can be detected. Medical records (MRs) and other administrative registers also provide objective data, but their availability, coverage and quality vary between countries. We summarized studies comparing self-reported data with (i) measured data from HESs or (ii) MRs. We aimed to describe differences in feasibility and comparability of different data sources for monitoring (i) elevated blood pressure or hypertension (ii) elevated blood glucose or diabetes and (iii) elevated total cholesterol. Methods We conducted a literature search to identify studies, which validated self-reported measures against objective measures. We found 30 studies published since the year 2000 fulfilling our inclusion criteria (targeted to adults and comparing prevalence among the same persons). Results Hypertension and elevated total cholesterol were prone to be under-estimated in HISs. The under-estimate was more pronounced, when the HIS data were compared with HES data, and lower when compared with MRs. For diabetes, the HISs and the objective methods resulted in fairly similar prevalence rates. Conclusion The three data sources measure different manifestations of the risk factors and cannot be expected to yield similar prevalence rates. Using HIS data only may lead to under-estimation of elevated risk factor levels or disease prevalence. Whenever possible, information from the three data sources should be evaluated and combined.
Collapse
Affiliation(s)
- Laura Paalanen
- Department of Public Health Solutions, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Päivikki Koponen
- Department of Public Health Solutions, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Tiina Laatikainen
- Department of Public Health Solutions, National Institute for Health and Welfare (THL), Helsinki, Finland.,Institute of Public Health and Clinical Nutrition, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.,Siun Sote-Joint Municipal Authority for North Karelia Social and Health Services, Joensuu, Finland
| | - Hanna Tolonen
- Department of Public Health Solutions, National Institute for Health and Welfare (THL), Helsinki, Finland
| |
Collapse
|
25
|
Little MP, Fang M, Liu JJ, Weideman AM, Linet MS. Inflammatory disease and C-reactive protein in relation to therapeutic ionising radiation exposure in the US Radiologic Technologists. Sci Rep 2019; 9:4891. [PMID: 30894578 PMCID: PMC6426979 DOI: 10.1038/s41598-019-41129-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 02/21/2019] [Indexed: 12/12/2022] Open
Abstract
Chronic inflammation underlies many autoimmune diseases, including hypothyroidism, hyperthyroidism, and rheumatoid arthritis, also type-2 diabetes and osteoarthritis. Associations have been suggested of high-dose ionising radiation exposure with type-2 diabetes and elevated levels of C-reactive protein, a marker of chronic inflammation. In this analysis we used a proportional hazards model to assess effects of radiotherapy on risks of subsequent inflammatory disease morbidity in 110,368 US radiologic technologists followed from a baseline survey (1983–1989/1994–1998) through 2008. We used a linear model to assess log-transformed C-reactive protein concentration following radiotherapy in 1326 technologists. Relative risk of diabetes increased following radiotherapy (p < 0.001), and there was a borderline significant increasing trend per treatment (p = 0.092). For osteoarthritis there was increased relative risk associated with prior radiotherapy on all questionnaires (p = 0.005), and a significant increasing trend per previous treatment (p = 0.024). No consistent increases were observed for other types of inflammatory disease (hypothyroidism, hyperthyroidism, rheumatoid arthritis) associated with radiotherapy. There was a borderline significant (p = 0.059) increasing trend with dose for C-reactive protein with numbers of prior radiotherapy treatments. Our results suggest that radiotherapy is associated with subsequent increased risk of certain inflammatory conditions, which is reinforced by our finding of elevated levels of C-reactive protein.
Collapse
Affiliation(s)
- Mark P Little
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, 20892-9778, USA.
| | - Michelle Fang
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, 20892-9778, USA
| | - Jason J Liu
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, 20892-9778, USA
| | - Ann Marie Weideman
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, 20892-9778, USA
| | - Martha S Linet
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, 20892-9778, USA
| |
Collapse
|
26
|
Oksuzyan A, Dańko MJ, Caputo J, Jasilionis D, Shkolnikov VM. Is the story about sensitive women and stoical men true? Gender differences in health after adjustment for reporting behavior. Soc Sci Med 2019; 228:41-50. [PMID: 30875543 DOI: 10.1016/j.socscimed.2019.03.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 01/28/2019] [Accepted: 03/03/2019] [Indexed: 10/27/2022]
Abstract
Research indicates that women have higher levels of physical disability and depression and lower scores on physical performance tests compared to men, while the evidence for gender differences in self-rated health is equivocal. Scholars note that these patterns may be related to women over-reporting and men under-reporting health problems, but gender differences in reporting behaviors have not been rigorously tested. Using Wave 1 of the Survey of Health, Ageing and Retirement in Europe (SHARE), the present study investigates the extent to which adjusting for differences in reporting behavior modifies gender differences in general health. We also examine whether men and women's reporting behaviors are consistent across different levels of education. After adjusting for reporting heterogeneity, gender differences in both poor and good health widened. However, we found no clear gender-specific patterns in reporting either poor or good health. Our findings also do not provide convincing evidence that education is an important determinant of general health reporting, although the female disadvantage in poor health and the male advantage in good health were more apparent in lower than higher education groups at all ages. The results challenge prevailing stereotypes that women over-report and men under-report health problems and highlight the importance of attending to health problems reported by women and men with equal care.
Collapse
Affiliation(s)
- Anna Oksuzyan
- Max Planck Institute for Demographic Research, Konrad-Zuse Str.1, 18057, Rostock, Germany.
| | - Maciej J Dańko
- Max Planck Institute for Demographic Research, Konrad-Zuse Str.1, 18057, Rostock, Germany
| | - Jennifer Caputo
- Max Planck Institute for Demographic Research, Konrad-Zuse Str.1, 18057, Rostock, Germany
| | - Domantas Jasilionis
- Max Planck Institute for Demographic Research, Konrad-Zuse Str.1, 18057, Rostock, Germany; Demographic Research Centre, Vytautas Magnus University, Jonavos Str. 66, 44138, Kaunas, Lithuania
| | - Vladimir M Shkolnikov
- Max Planck Institute for Demographic Research, Konrad-Zuse Str.1, 18057, Rostock, Germany; National Research University Higher School of Economics, Bolshoy Tryokhsvyatitelsky Pereulok 3, 109028, Moscow, Russian Federation
| |
Collapse
|
27
|
Merzenich H, Blettner M, Niehoff D, Schwentner L, Schmidt M, Schmitt M, Wollschläger D. Cardiac late events in German breast cancer patients: a validation study on the agreement between patient self-reports and information from physicians. BMC Cardiovasc Disord 2018; 18:218. [PMID: 30497402 PMCID: PMC6267788 DOI: 10.1186/s12872-018-0961-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 11/20/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Self-administered health-status questionnaires are important tools in epidemiology. The objective of the presented validation study is to measure the agreement between breast cancer patients' self-reports and their physicians' information on late cardiac events, and to investigate determinants of agreement. To estimate possible misclassification is an important requirement for observational studies on cardiovascular endpoints. METHODS A retrospective, multi-center cohort study included 11,982 women diagnosed with breast cancer in Germany in 1998-2008. In 2014, a questionnaire survey assessed cardiovascular risk factors and incident cardiac events after therapy. A validation study was conducted, based on a sample of 3091 breast cancer patients from two university hospitals. Among them, 2261 women (73%) sent back the questionnaire on cardiovascular events, and 1316 women gave consent to request medical records from their general practitioners. A total of 1212/1316 (92.1%) medical records could be obtained for validation. Cohen's kappa coefficient was calculated, and multivariate regression was applied to study the influence of patient characteristics on agreement between both data sources. RESULTS Overall agreement for the composite endpoint of any cardiac event was 84.5% (kappa 0.35). Of 1055 breast cancer patients reporting no cardiac event, 950 (90%) had no such diagnosis in physicians' medical records. A total of 157 breast cancer survivors indicated a cardiac event, and the same diagnosis was confirmed by GPs for 74 (47%) women. For specific diagnoses, moderate to substantial agreement of self-reports was found for myocardial infarction (kappa 0.54) and stroke (kappa 0.61). Poor to fair agreement was present for angina pectoris, valvular heart disease, arrhythmia, and congestive heart failure. Younger age, higher education and a more recent cancer diagnosis were found to be associated with greater total agreement. CONCLUSIONS For the composite endpoint, survivors of breast cancer report the absence of cardiac disease accurately. However, for specific diagnoses, self-reported morbidity data from breast cancer patients may not fully agree with information from physicians. The agreement is moderate for acute events like myocardial infarction and stroke, but poor to fair for chronic diseases.
Collapse
Affiliation(s)
- Hiltrud Merzenich
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center Mainz, Obere Zahlbacher Str. 69, 55131 Mainz, Germany
| | - Maria Blettner
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center Mainz, Obere Zahlbacher Str. 69, 55131 Mainz, Germany
| | - Dorothea Niehoff
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center Mainz, Obere Zahlbacher Str. 69, 55131 Mainz, Germany
| | - Lukas Schwentner
- Department of Gynecology and Obstetrics, University Hospital Ulm, Prittwitzstr. 43, 89075 Ulm, Germany
| | - Marcus Schmidt
- Department of Obstetrics and Gynecology, University Medical Center Mainz, 55101 Mainz, Germany
| | - Margit Schmitt
- Department of Gynecology and Obstetrics, University Hospital Ulm, Prittwitzstr. 43, 89075 Ulm, Germany
| | - Daniel Wollschläger
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center Mainz, Obere Zahlbacher Str. 69, 55131 Mainz, Germany
| |
Collapse
|
28
|
George C, Ducatman AM, Conway BN. Increased risk of respiratory diseases in adults with Type 1 and Type 2 diabetes. Diabetes Res Clin Pract 2018; 142:46-55. [PMID: 29802957 DOI: 10.1016/j.diabres.2018.05.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 05/09/2018] [Accepted: 05/17/2018] [Indexed: 01/09/2023]
Abstract
AIMS Diabetes is linked with decreases in lung elasticity and in capacity to transfer carbon monoxide. Systemic inflammation, a common concern with diabetes, may contribute to airflow obstruction. We examined the association of self-reported diabetes with self-reported respiratory diseases (RDs) among 53,146 adults from the C8 Health Project. METHODS Participants were categorized into three groups: Type 1 (T1D, n = 781), Type 2 (T2D, n = 4277), or no diabetes (n = 48,088). ORs (95% CIs) for the association of diabetes with four RDs were computed: emphysema, chronic obstructive pulmonary disease (COPD), chronic bronchitis (CB), and asthma. Covariates controlled for were age, sex, estimated glomerular filtration rate, C-reactive protein, smoking history, BMI, and perfluorooctonaoic acid (C8). RESULTS RDs were present in 26%, 21% and 13% of persons with T1D, T2D, and no diabetes, respectively. In multivariable analyses, persons with T1D were 62% more likely to have any RD (OR: 1.62, CI: (1.36-1.93)), while those with T2D were 1.3 times as likely (OR: 1.26, CI: 1.15-1.37)). Compared to those without diabetes, in those with T1D and T2D diabetes respectively, ORs (CIs) for COPD were 1.89 (1.38-2.57), 1.45 (1.23-1.71), asthma: 1.51 (1.21-1.87), 1.38 (1.24-1.53), CB: 1.96 (1.57-2.45), 1.35 (1.20-1.52) and emphysema: 1.25 (0.85-1.82), 1.31 (1.10-1.56). Population attributable risks for any RDs associated with a history of smoking were 19%, 30%, and 26% for those with Type 1, Type 2, and no diabetes respectively. CONCLUSIONS Diabetes, more so in T1D, appears to increase RD risk. Smoking is an important risk factor, but not as informative in Type 1 diabetes.
Collapse
Affiliation(s)
- Chelsey George
- Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, United States
| | - Alan M Ducatman
- Department of Occupational and Environmental Health, School of Public Health, West Virginia University, Morgantown, WV, United States
| | - Baqiyyah N Conway
- Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, United States; Department of Epidemiology and Biostatistics, School of Rural and Community Health, University of Texas Health Science Center at Tyler, Tyler, TX, United States.
| |
Collapse
|
29
|
Caceres VDM, Stocks N, Adams R, Haag DG, Peres KG, Peres MA, González-Chica DA. Physical activity moderates the deleterious relationship between cardiovascular disease, or its risk factors, and quality of life: Findings from two population-based cohort studies in Southern Brazil and South Australia. PLoS One 2018; 13:e0198769. [PMID: 29879229 PMCID: PMC5991645 DOI: 10.1371/journal.pone.0198769] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 05/24/2018] [Indexed: 11/22/2022] Open
Abstract
Background Few studies have investigated the relationship between physical activity (PA) of low intensity and duration with quality of life (QoL) among individuals at risk or with cardiovascular disease (CVD). Objectives To investigate whether PA of different intensity and duration moderates the relationship between CVD and its risk factors (obesity, hypertension, diabetes, dyslipidaemia) and QoL in adults. Methods Population-based cross-sectional studies using data from the EpiFloripa Cohort Study (Southern Brazil; n = 1,220, 38.8±12.0 years, 48.2% males) and the North West Adelaide Health Study (NWAHS, South Australia; n = 1,661, 43.7±11.1 years, 49.7% males). The physical and psychological domains of QoL were assessed using the WHOQOL-Bref (EpiFloripa) or the SF-36 (NWAHS) questionnaires. The diagnosis of CVD and its risk factors were self-reported. PA was self-reported and quantified by its intensity [“walking” or moderate/vigorous (MVPA)] and duration (none, 1–150, ≥150 min/week). Both studies were analysed separately, and results were adjusted for sociodemographic variables. Results Participants at risk or with CVD from both studies showed a lower QoL than ‘healthy’ individuals with a stronger relationship for the physical domain. PA duration showed a direct-trend relationship with QoL, but the associations were stronger for MVPA in both studies. However, when stratified by health status, the magnitude of the association between “walking” duration and a higher physical QoL was greater among those at risk or with CVD compared to ‘healthy’ individuals. Conversely, among Australians with CVD, MVPA was associated with a better physical QoL only when its duration was ≥150 min/week. All associations were stronger in the NWAHS than in the Brazilian study. Conclusions “Walking” was more prevalent than MVPA and was consistently associated with a better physical QoL among those at risk or with CVD. These findings should be considered in the design of public health interventions designed to increase PA and improve QoL.
Collapse
Affiliation(s)
- Viviane de Menezes Caceres
- Discipline of General Practice, Adelaide Medical School, NHMRC Centre of Research Excellence to Reduce Inequality in Heart Disease, The University of Adelaide, Adelaide, South Australia, Australia
- Postgraduate Program in Rehabilitation Sciences, Department of Health Sciences, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil
| | - Nigel Stocks
- Discipline of General Practice, Adelaide Medical School, NHMRC Centre of Research Excellence to Reduce Inequality in Heart Disease, The University of Adelaide, Adelaide, South Australia, Australia
| | - Robert Adams
- The Health Observatory, Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Dandara Gabriela Haag
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Karen Glazer Peres
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Marco Aurélio Peres
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - David Alejandro González-Chica
- Discipline of General Practice, Adelaide Medical School, NHMRC Centre of Research Excellence to Reduce Inequality in Heart Disease, The University of Adelaide, Adelaide, South Australia, Australia
- * E-mail:
| |
Collapse
|
30
|
Ilangkovan N, Mogensen CB, Mickley H, Lassen AT, Lambrechtsen J, Sand NPR, Albiniussen R, Byg J, Hald F, Grønhøj MH, Diederichsen A. Prevalence of coronary artery calcification in a non-specific chest pain population in emergency and cardiology departments compared with the background population: a prospective cohort study in Southern Denmark with 12-month follow-up of cardiac endpoints. BMJ Open 2018; 8:e018391. [PMID: 29502085 PMCID: PMC5855253 DOI: 10.1136/bmjopen-2017-018391] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To examine and compare the prevalence of coronary artery calcification (CAC) and the frequency of cardiac events in a background population and a cohort of patients with non-specific chest pain (NSCP) who present to an emergency or cardiology department and are discharged without an obvious reason for their symptom. DESIGN A double-blinded, prospective, observational cohort study that measures both CT-determined CAC scores and cardiac events after 1 year of follow-up. SETTING Emergency and cardiology departments in the Region of Southern Denmark. SUBJECTS In total, 229 patients with NSCP were compared with 722 patients from a background comparator population. MAIN OUTCOMES MEASURES Prevalence of CAC and incidence of unstable angina (UAP), acute myocardial infarction (MI), ventricular tachycardia (VT), coronary revascularisation and cardiac-related mortality 1 year after index contact. RESULTS There was no significant difference in the prevalence of CAC (OR 0.9 (95% CI 0.6 to 1.3), P=0.546) or the frequency of cardiac endpoints (P=0.64) between the studied groups. When compared with the background population, the OR for patients with NSCP for a CAC >100 Agatston units (AU) was 1.0 (95% CI 0.6 to 1.5), P=0.826. During 1 year of follow-up, two (0.9%) patients with NSCP underwent cardiac revascularisation, while none experienced UAP, MI, VT or death. In the background population, four (0.6%) participants experienced a clinical cardiac endpoint; two had an MI, one had VT and one had a cardiac-related death. CONCLUSION The prevalence of CAC (CAC >0 AU) among patients with NSCP is comparable to a background population and there is a low risk of a cardiac event in the first year after discharge. A CAC study does not provide notable clinical utility for risk-stratifying patients with NSCP. TRIAL REGISTRATION NUMBER NCT02422316; Pre-results.
Collapse
Affiliation(s)
| | | | - Hans Mickley
- Cardiology Department, Odense University Hospital, Odense, Denmark
| | | | | | | | | | - Jørgen Byg
- Cardiology Department, Hospital of Southern Denmark, Aabenraa, Denmark
| | - Flemming Hald
- Cardiology Department, Vejle Hospital, Vejle, Denmark
| | | | | |
Collapse
|
31
|
González-Chica DA, Hill CL, Gill TK, Hay P, Haag D, Stocks N. Individual diseases or clustering of health conditions? Association between multiple chronic diseases and health-related quality of life in adults. Health Qual Life Outcomes 2017; 15:244. [PMID: 29268792 PMCID: PMC5740772 DOI: 10.1186/s12955-017-0806-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 11/22/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Chronic diseases are highly prevalent and cluster in individuals (multimorbidity). This study investigated the association between multimorbidity and Health-Related Quality of Life (HRQoL), assessing the combination of chronic diseases highly correlated with this outcome. METHODS We conducted a household survey in 2015 in a random sample of 2912 South Australian adults (48.9 ± 18.1 years; 50.9% females), obtaining information on sociodemographics, lifestyle, and 17 chronic conditions clustered in four different groups (metabolic, cardiovascular, gastrointestinal, and musculoskeletal). Information on physical (PCS) and mental components scores (MCS) of HRQoL were assessed using the SF-12 questionnaire. Multivariable linear regression models considering individual diseases (mutually adjusted) and clusters within- and between-groups were used to test the associations. RESULTS Only 41% of the sample was negative for all the investigated diseases. The most prevalent conditions were osteoarthritis, obesity and hypertension, which affected one in every four individuals. PCS was markedly lower among those reporting stroke, heart failure, and osteoarthritis, but they were not associated with MCS. Direct-trend relationships were observed between the number of chronic conditions (clusters within- and between-groups) and PCS, but not with MCS. The strongest association with PCS was for musculoskeletal conditions (difference between those affected by 2+ conditions and those free of these conditions -6.7 95%CI -8.5;-5.4), and lower PCS were observed in any combination of clusters between-group including musculoskeletal diseases. CONCLUSION In the context of multimorbidity, musculoskeletal diseases are a key determinant group of PCS, amplifying the association of other chronic conditions on physical but not on mental health.
Collapse
Affiliation(s)
- David Alejandro González-Chica
- Discipline of General Practice, Adelaide Medical School, NHMRC Centre of Research Excellence to Reduce Inequality in Heart Disease, The University of Adelaide, Hughes Building, Level 8, Room 813, Adelaide, SA, 5005, Australia.
| | - Catherine L Hill
- Department of Rheumatology, The Queen Elizabeth Hospital, Adelaide, SA, Australia
| | - Tiffany K Gill
- Discipline of Medicine, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - Phillipa Hay
- Centre for Health Research, School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - Dandara Haag
- Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, SA, Australia
| | - Nigel Stocks
- Discipline of General Practice, Adelaide Medical School, NHMRC Centre of Research Excellence to Reduce Inequality in Heart Disease, The University of Adelaide, Hughes Building, Level 8, Room 813, Adelaide, SA, 5005, Australia
| |
Collapse
|
32
|
Yu OHY, Richards B, Berger C, Josse RG, Leslie WD, Goltzman D, Kaiser SM, Kovacs CS, Davison KS. The association between sclerostin and incident type 2 diabetes risk: a cohort study. Clin Endocrinol (Oxf) 2017; 86:520-525. [PMID: 28090669 DOI: 10.1111/cen.13300] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 12/19/2016] [Accepted: 12/28/2016] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To determine whether sclerostin is associated with fasting glucose, insulin levels, insulin resistance or increased risk of incident type 2 diabetes. BACKGROUND Type 2 diabetic patients have a higher risk of fractures. Recent studies suggest sclerostin, a regulator of osteoblast activity, is associated with diabetes. MATERIALS AND METHODS Sclerostin levels were obtained from 1778 individuals with no history of type 2 diabetes participating in the population-based Canadian Multicentre Osteoporosis Study (CaMos) cohort. Participants were followed until diagnosis of type 2 diabetes, death or end of the study period (31 December 2013). The relationship of sclerostin with fasting glucose, insulin levels and homoeostatic model assessment-insulin resistance (HOMA-IR) was studied in linear regression models. Cox proportional hazards models were used to determine the association of sclerostin levels and the risk of incident type 2 diabetes during a mean 7·5 years of follow-up. RESULTS Fasting glucose, fasting insulin levels and HOMA-IR were weakly correlated with sclerostin levels (Spearman's correlation coefficient: 0·11, P < 0·05; -0·09, P < 0·05; and -0·07, P = 0·02, respectively). Multiple linear regression analyses confirmed a significant association between sclerostin and fasting insulin and HOMA-IR but no significant association with fasting glucose levels. Sclerostin levels were not found to be significantly associated with the risk of incident type 2 diabetes (HR: 1·30; 95% CI: 0·37-4·57). CONCLUSIONS We observed an association between sclerostin levels with fasting insulin levels and HOMA-IR, but there was no clear association with type 2 diabetes risk. Further studies are needed to understand the role of sclerostin in type 2 diabetes.
Collapse
Affiliation(s)
- O H Y Yu
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
- Division of Endocrinology, Jewish General Hospital, Montreal, QC, Canada
| | - B Richards
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
- Division of Endocrinology, Jewish General Hospital, Montreal, QC, Canada
| | - C Berger
- CaMos Coordinating Centre, McGill University, Montreal, QC, Canada
| | - R G Josse
- Division of Endocrinology & Metabolism, St Michael's University of Toronto, Toronto, ON, Canada
| | - W D Leslie
- Department of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - D Goltzman
- Department of Medicine, McGill University and McGill University Health Centre, Montreal, QC, Canada
| | - S M Kaiser
- Division of Endocrinology & Metabolism, Dalhousie University, Halifax, NS, Canada
| | - C S Kovacs
- Discipline of Medicine-Endocrinology, Memorial University of Newfoundland, St. John's, NL, Canada
| | - K S Davison
- A Priori Medical Sciences Inc., Victoria, BC, Canada
| |
Collapse
|
33
|
Resende EDPF, Costa-Silva L, Carmona KC, Machado TH, Machado JCB, Guimarães HC, Barbosa MT, Teixeira AL, de Souza LC, Caramelli P. Ischemic cerebrovascular burden evaluated by magnetic resonance imaging in an elderly Brazilian community: The Pietà study. eNeurologicalSci 2016; 5:30-34. [PMID: 29430555 PMCID: PMC5803083 DOI: 10.1016/j.ensci.2016.11.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 08/08/2016] [Accepted: 11/28/2016] [Indexed: 01/18/2023] Open
Abstract
In developing countries, cardiovascular risk factors are poorly controlled, leading to high prevalence of cerebrovascular diseases. The aim of the study was to evaluate the burden of white matter lesions in magnetic resonance through the Fazekas scale in a population aged 75 + years living in the community, and to investigate possible associations between vascular lesions, cardiovascular risk factors and cognitive status. Subjects were selected from a community-based study on brain aging conducted in Caeté (Minas Gerais state), Brazil. Overall, 177 participants (112 cognitively healthy, 36 with cognitive impairment-no dementia and 29 with dementia), being 108 women, aged 79.3 ± 3.8 years, with 3.1 ± 2.9 years of educational level, underwent a 3 Tesla magnetic resonance scanner with fluid attenuated image recovery acquisition. Severity of white matter lesions was assessed through the Fazekas scale. Severe white matter lesions were present in 31.1% of the whole sample and in 25.0% of the cognitively healthy individuals. A significant association was found between severe white matter lesions and cognitive impairment (OR = 2.20, 95% CI 1.17–6.53; p = 0.021), as well as with hypertension (OR = 1.92, 95% CI 1.03–7.39; p = 0.043). In conclusion, a high prevalence of severe white matter lesions was observed in this elderly Brazilian population sample, and white matter lesions were associated with hypertension and cognitive status. Importantly, the prevalence of white matter lesions was also high in cognitively healthy subjects. The ischemic cerebrovascular burden assessed by MRI in an elderly Brazilian community is very high. MRI white matter lesions were associated with cognitive impairment and hypertension. Even in cognitively healthy individuals the prevalence of ischemic cerebrovascular lesions was high.
Collapse
Affiliation(s)
- Elisa de Paula França Resende
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Av. Prof Alfredo Balena, 190, room 246, Belo Horizonte, MG 30130-100, Brazil
| | - Luciana Costa-Silva
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Av. Prof Alfredo Balena, 190, room 246, Belo Horizonte, MG 30130-100, Brazil
| | - Karoline Carvalho Carmona
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Av. Prof Alfredo Balena, 190, room 246, Belo Horizonte, MG 30130-100, Brazil
| | - Thais Helena Machado
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Av. Prof Alfredo Balena, 190, room 246, Belo Horizonte, MG 30130-100, Brazil
| | - João Carlos Barbosa Machado
- Faculdade de Ciências Médicas de Minas Gerais, Alameda Ezequiel Dias, 275, Belo Horizonte, MG 30130-110, Brazil
| | - Henrique Cerqueira Guimarães
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Av. Prof Alfredo Balena, 190, room 246, Belo Horizonte, MG 30130-100, Brazil
| | - Maira Tonidandel Barbosa
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Av. Prof Alfredo Balena, 190, room 246, Belo Horizonte, MG 30130-100, Brazil
| | - Antônio Lúcio Teixeira
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Av. Prof Alfredo Balena, 190, room 246, Belo Horizonte, MG 30130-100, Brazil
| | - Leonardo Cruz de Souza
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Av. Prof Alfredo Balena, 190, room 246, Belo Horizonte, MG 30130-100, Brazil
| | - Paulo Caramelli
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Av. Prof Alfredo Balena, 190, room 246, Belo Horizonte, MG 30130-100, Brazil
| |
Collapse
|
34
|
Little CE, Emery C, Scott SH, Meeuwisse W, Palacios-Derflingher L, Dukelow SP. Do children and adolescent ice hockey players with and without a history of concussion differ in robotic testing of sensory, motor and cognitive function? J Neuroeng Rehabil 2016; 13:89. [PMID: 27729040 PMCID: PMC5059996 DOI: 10.1186/s12984-016-0195-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 09/22/2016] [Indexed: 11/30/2022] Open
Abstract
Background KINARM end point robotic testing on a range of tasks evaluating sensory, motor and cognitive function in children/adolescents with no neurologic impairment has been shown to be reliable. The objective of this study was to determine whether differences in baseline performance on multiple robotic tasks could be identified between pediatric/adolescent ice hockey players (age range 10–14) with and without a history of concussion. Methods Three hundred and eighty-five pediatric/adolescent ice hockey players (ages 10–14) completed robotic testing (94 with and 292 without a history of concussion). Five robotic tasks characterized sensorimotor and/or cognitive performance with assessment of reaching, position sense, bimanual motor function, visuospatial skills, attention and decision-making. Seventy-six performance parameters are reported across all tasks. Results There were no significant differences in performance demonstrated between children with a history of concussion [median number of days since last concussion: 480 (range 8–3330)] and those without across all five tasks. Performance by the children with no history of concussion was used to identify parameter reference ranges that spanned 95 % of the group. All 76 parameter means from the concussion group fell within the normative reference ranges. Conclusions There are no differences in sensorimotor and/or cognitive performance across multiple parameters using KINARM end point robotic testing in children/adolescents with or without a history of concussion.
Collapse
Affiliation(s)
- C Elaine Little
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.
| | - Carolyn Emery
- Faculty of Kinesiology and Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Stephen H Scott
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
| | - Willem Meeuwisse
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Luz Palacios-Derflingher
- Faculty of Kinesiology, Cumming School of Medicine, and Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Sean P Dukelow
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| |
Collapse
|