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Cullati S, Sieber S, Gabriel R, Studer M, Chiolero A, van der Linden BWA. Lifetime employment trajectories and cancer. Sci Rep 2024; 14:20224. [PMID: 39215024 PMCID: PMC11364773 DOI: 10.1038/s41598-024-70909-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 08/22/2024] [Indexed: 09/04/2024] Open
Abstract
Working life is associated with lifestyle, screening uptake, and occupational health risks that may explain differences in cancer onset. To better understand the association between working life and cancer risk, we need to account for the entire employment history. We investigated whether lifetime employment trajectories are associated with cancer risk. We used data from 6809 women and 5716 men, average age 70 years, from the Survey of Health, Ageing, and Retirement in Europe. Employment history from age 16 to 65 was collected retrospectively using a life calendar and trajectories were constructed using sequence analysis. Associations between employment trajectories and self-reported cancer were assessed using logistic regression. We identified eight employment trajectories for women and two for men. Among women, the risk of cancer was higher in the trajectories "Mainly full-time to home/family", "Full-time or home/family to part-time", "Mainly full-time", and "Other" compared with the "Mainly home/family" trajectory. Among men, the risk of cancer was lower in the "Mainly self-employment" trajectory compared with "Mainly full-time". We could show how employment trajectories were associated with cancer risk, underlining the potential of sequence analysis for life course epidemiology. More research is needed to understand these associations and determine if causal relationships exist.
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Affiliation(s)
- Stéphane Cullati
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Route Des Arsenaux 41, CH-1700, Fribourg, Switzerland.
- Quality of Care Service, University Hospitals of Geneva, Geneva, Switzerland.
| | - Stefan Sieber
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
| | - Rainer Gabriel
- Institute of Diversity and Social Integration, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Matthias Studer
- Institute of Demographics and Socioeconomics, University of Geneva, Geneva, Switzerland
| | - Arnaud Chiolero
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Route Des Arsenaux 41, CH-1700, Fribourg, Switzerland
- School of Population and Global Health, McGill University, Montreal, Canada
- Swiss School of Public Health (SSPH+), Zurich, Switzerland
| | - Bernadette W A van der Linden
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Route Des Arsenaux 41, CH-1700, Fribourg, Switzerland.
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Whitley E, Benzeval M, Kelly-Irving M, Kumari M. When in the lifecourse? Socioeconomic position across the lifecourse and biological health score. Ann Epidemiol 2024; 96:73-79. [PMID: 38945315 DOI: 10.1016/j.annepidem.2024.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 06/14/2024] [Accepted: 06/25/2024] [Indexed: 07/02/2024]
Abstract
PURPOSE Educational attainment is associated with multiphysiological wear and tear. However, associations with measures of socioeconomic position (SEP) across different life-stages are not established. METHODS Using regression models and data from 8105 participants from the UK Household Longitudinal Study (Understanding Society), we examined associations of lifecourse SEP with an overall biological health score (BHS). BHS is broader than usual measures of biological 'wear and tear' and is based on six physiological subsystems (endocrine, metabolic, cardiovascular, inflammatory/immune, liver, and kidney), with higher scores indicating worse health. Lifecourse SEP was based on respondents' parental, first, and most recent occupations. RESULTS Associations with SEP at all life-stages demonstrated higher BHS with increasing disadvantage (e.g. slope index of inequality (SII) (95 % CI) for most recent SEP: 0.04 (0.02, 0.06)). There was little difference in the magnitude of associations for SEP measured at each life-stage. Cumulative disadvantage across the lifecourse showed a stepped association with increasing BHS (SII (95 % CI): 0.05 (0.04, 0.07)). Associations were largely driven by metabolic, cardiovascular, and inflammatory systems. CONCLUSION Our results suggest that disadvantaged SEP across the lifecourse contributes cumulatively to poorer biological health, highlighting that every life-stage should be a target for public health policies and intervention.
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Affiliation(s)
- Elise Whitley
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, G3 7HR Glasgow, UK.
| | - Michaela Benzeval
- Institute for Social and Economic Research, University of Essex, Colchester CO4 3SQ, UK; School of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
| | | | - Meena Kumari
- Institute for Social and Economic Research, University of Essex, Colchester CO4 3SQ, UK
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3
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Cullati S, Sieber S, Gabriel R, Studer M, Chiolero A, van der Linden BWA. Lifetime Employment Trajectories and Cancer: A Population-Based Cohort Study. RESEARCH SQUARE 2024:rs.3.rs-4207039. [PMID: 38699299 PMCID: PMC11065066 DOI: 10.21203/rs.3.rs-4207039/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
Working life is associated with lifestyle, screening uptake, and occupational health risks that may explain differences in cancer onset. To better understand the association between working life and cancer risk, we need to account for the entire employment history. We investigated whether lifetime employment trajectories are associated with cancer risk. We used data from 6,809 women and 5,716 men, average age 70 years, from the Survey of Health, Ageing, and Retirement in Europe. Employment history from age 16 to 65 was collected retrospectively using a life calendar and trajectories were constructed using sequence analysis. Associations between employment trajectories and self-reported cancer were assessed using logistic regression. We identified eight employment trajectories for women and two for men. Among women, the risk of cancer was higher in the trajectories "Mainly full-time to home/family", "Full-time or home/family to part-time", "Mainly full-time", and "Other" compared with the "Mainly home/family" trajectory. Among men, the risk of cancer was lower in the "Mainly self-employment" trajectory compared with "Mainly full-time". We could show how employment trajectories were associated with cancer risk, underlining the potential of sequence analysis for life course epidemiology. More research is needed to understand these associations and determine if causal relationships exist.
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4
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Nazarko L. Type 2 diabetes post pandemic: enabling your patients to regain control. Br J Community Nurs 2024; 29:124-130. [PMID: 38421888 DOI: 10.12968/bjcn.2024.29.3.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
There are now an estimated five million people living with diabetes in the UK, most have type 2 diabetes. The COVID-19 pandemic affected access to care, led to delays in diagnoses of diabetes and many people with diabetes experienced a deterioration in their diabetes control. This article provides guidance on how nurses can work with people at risk of diabetes to prevent diabetes, to induce remission and how to use medication to treat diabetes.
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Choi JW, Kim TH, Park JS, Lee CH. Association between Relative Thrombocytosis and Microalbuminuria in Adults with Mild Fasting Hyperglycemia. J Pers Med 2024; 14:89. [PMID: 38248790 PMCID: PMC10817638 DOI: 10.3390/jpm14010089] [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: 12/01/2023] [Revised: 01/05/2024] [Accepted: 01/11/2024] [Indexed: 01/23/2024] Open
Abstract
An elevated platelet count may contribute to significant thrombotic events and pose a risk for diabetic microvascular complications. Albuminuria, one of the hallmarks of diabetes, is thought to be a risk factor for endothelial dysfunction. In this study, we investigated the association between relative thrombocytosis and an increased urine albumin-to-creatinine ratio in healthy adult participants. Using multivariate analyses on data from the Korea National Health and Nutrition Examination Survey V-VI, 12,525 eligible native Koreans aged ≥ 20 were categorized into platelet count quintiles by sex. The highest platelet count quintile included younger, more obese participants with elevated white blood cell counts, poor lipid profiles, and a better estimated glomerular filtration rate. Restricted cubic spline regression analysis revealed significant associations between platelet count and fasting blood glucose, glycated hemoglobin, and urine albumin-to-creatinine ratio. Adjusted logistic regression models indicated that heightened fasting blood glucose and platelet count were linked to risk of microalbuminuria (fasting blood glucose, odds ratio = 1.026, 95%CI = 1.011-1.042; platelet count, odds ratio = 1.004, 95%CI = 1.002-1.006). Particularly, an increased platelet count was notably associated with microalbuminuria progression in subjects with impaired fasting glucose. These findings suggest that an elevated platelet count, even below diagnostic thrombocytosis levels, independently correlates with an increased risk of vascular endothelial dysfunction in patients with impaired fasting glucose.
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Affiliation(s)
- Jong Wook Choi
- Research Institute of Medical Science, Konkuk University School of Medicine, Chungju 27478, Republic of Korea;
| | - Tae Hoon Kim
- Department of Internal Medicine, CHA Bundang Medical Center, Seongnam 13495, Republic of Korea;
| | - Joon-Sung Park
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul 04763, Republic of Korea;
| | - Chang Hwa Lee
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul 04763, Republic of Korea;
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Soares Andrade CA, Shahin B, Dede O, Akpeji AO, Ajene CL, Albano Israel FE, Varga O. The burden of type 2 diabetes mellitus in states of the European Union and United Kingdom at the national and subnational levels: A systematic review. Obes Rev 2023; 24:e13593. [PMID: 37401729 DOI: 10.1111/obr.13593] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 03/31/2023] [Accepted: 05/21/2023] [Indexed: 07/05/2023]
Abstract
Type 2 diabetes mellitus (T2D) is a highly prevalent disease worldwide, with an equally increased expenditure associated with it. We aimed to longitudinally evaluate the epidemiologic and economic burden of T2D in the current member states of the European Union and the United Kingdom (EU-28). The present systematic review is registered on PROSPERO (CRD42020219894), and it followed the PRISMA guidelines. Eligibility criteria comprised original observational studies in English reporting economic and epidemiological data for T2D in member states of the EU-28. Methodological assessment was performed with the Joanna Briggs Institute (JBI) Critical Appraisal Tools. The search retrieved 2253 titles and abstracts. After study selection, 41 studies were included in the epidemiologic analysis and 25 in the economic analysis. Economic and epidemiologic studies covered only 15 member states with reported data between 1970 and 2017, resulting in an incomplete picture. For children in particular, limited information is available. The prevalence, incidence, mortality, and expenditure of the T2D population have increased across the decades in member states. Therefore, policies should aim to prevent or reduce the burden of T2D in the EU and consequently mitigate the expenditure on T2D.
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Affiliation(s)
| | - Balqees Shahin
- Faculty of Medicine, Department of Public Health and Epidemiology, University of Debrecen, Debrecen, Hungary
| | - Onisoyonivosekume Dede
- Faculty of Medicine, Department of Public Health and Epidemiology, University of Debrecen, Debrecen, Hungary
| | - Anne Omagu Akpeji
- Faculty of Medicine, Department of Public Health and Epidemiology, University of Debrecen, Debrecen, Hungary
| | - Comfort-Lucia Ajene
- Faculty of Medicine, Department of Public Health and Epidemiology, University of Debrecen, Debrecen, Hungary
| | | | - Orsolya Varga
- Faculty of Medicine, Department of Public Health and Epidemiology, University of Debrecen, Debrecen, Hungary
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Seixas BV, Macinko J. Distinct domains of childhood disadvantage and cognitive performance among older Brazilians: Evidence from ELSI-Brazil. SSM Popul Health 2023; 22:101416. [PMID: 37215155 PMCID: PMC10193012 DOI: 10.1016/j.ssmph.2023.101416] [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: 10/19/2022] [Revised: 04/20/2023] [Accepted: 04/23/2023] [Indexed: 05/24/2023] Open
Abstract
Objective To investigate the relationship between of distinct domains of childhood disadvantage and cognitive performance among older adults within the context of a middle-income country. Methods This study used baseline data (2015/2016) from the Brazilian Longitudinal Study of Aging (ELSI), a nationally representative cohort of 9412 adults aged 50 and over. Nine childhood exposure variables were grouped into three domains (family SES, childhood health, and cultural capital), for which scores were created. Survey-weighted Ordinary Least Squares (OLS) regressions estimated the association childhood disadvantage with cognitive performance as measured by immediate memory, late memory and semantic verbal fluency. Mediation analysis assessed whether adulthood socioeconomic status (SES) mediated this relationship of interest. Results Important disparities in cognitive performance were observed, particularly in terms of age, education, income, occupational status. Before controlling for adulthood SES in the multivariable analysis, all domains of childhood disadvantage were found to be associated with lower cognitive performance across all three measures. After inclusion of adulthood SES variables, the observed associations only remained for semantic verbal fluency. Formal mediation analysis indicated that adulthood SES mediates 47.9% (95% CI: 34.3%-78.6%) of the association between later-life verbal fluency and poor childhood health, and 49.9% (95% CI: 43.6%-57.8%) of the association between later-life verbal fluency and low childhood cultural capital. Conclusions We found that childhood disadvantage is associated with low performance in memory tests and semantic verbal fluency tests among older Brazilians. Adulthood SES fully mediated the association between all domains of childhood disadvantage and memory performance and only partially mediated its association with verbal fluency. Our findings support policy efforts to enhance early childhood development and improve adulthood SES, and guide additional research to better the mechanisms driving these relationships.
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Affiliation(s)
- Brayan V. Seixas
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles (UCLA), 650 Charles E Young Dr S, Los Angeles, CA, 90095, USA
| | - James Macinko
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles (UCLA), 650 Charles E Young Dr S, Los Angeles, CA, 90095, USA
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles (UCLA), 650 Charles E Young Dr S, Los Angeles, CA, 90095, USA
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Nübel J, Du Y, Baumert J, Hapke U, Färber F, Heidemann C, Scheidt-Nave C. Perceived Chronic Stress Is Associated With the German Diabetes Risk Score Among Adults Without Known Diabetes in Germany. Psychosom Med 2023; 85:332-340. [PMID: 36917488 DOI: 10.1097/psy.0000000000001183] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
OBJECTIVE There is evidence that psychological distress increases the risk of type 2 diabetes (T2D), but implications for prevention remain elusive. We examined the association between chronic stress and the German Diabetes Risk Score (GDRS) among adults without diabetes in Germany. METHODS The study population consisted of 4654 persons aged 18 to 64 years without known diabetes drawn from the German Health Interview and Examination Survey for Adults (2008-2011). The predicted 5-year T2D risk (in percent) was estimated using the GDRS. Perceived chronic stress was assessed by the Screening Scale of the Trier Inventory for the Assessment of Chronic Stress and categorized into "up to average," "above average," and "high." The cross-sectional association of chronic stress with log-transformed GDRS (expressed as geometric mean ratio [GMR]) was analyzed in multivariable linear regression models. Covariables included age, sex, community size, region, educational level, living alone, social support, depression, and alcohol use. RESULTS The mean predicted 5-year T2D risk rates were 2.7%, 2.9%, and 3.0% for chronic stress up to average, above average, and high chronic stress, respectively. Adjusted mean predicted 5-year risk was significantly higher among persons with chronic stress above average (GMR = 1.10, 95% confidence interval = 1.02-1.19) and high stress (GMR = 1.21, 95% CI = 1.06-1.39) compared with persons with chronic stress up to average. No interactions with sex or other covariables were found. CONCLUSIONS Perceived chronic stress is independently associated with an increased predicted T2D risk in cross-sectional analysis and should be considered as T2D risk factor in longitudinal studies.
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Affiliation(s)
- Julia Nübel
- From the Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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9
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Association of urinary prostaglandin E2 metabolite and mortality among adults. Sci Rep 2022; 12:18905. [PMID: 36344823 PMCID: PMC9640635 DOI: 10.1038/s41598-022-23773-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 11/04/2022] [Indexed: 11/09/2022] Open
Abstract
Prostaglandins play a critical role in inflammatory response. To investigate the association of urinary PGE-M, a stable end-product of prostaglandin E2 (PGE2) with overall and cause-specific mortality and examine potential effect modifiers, we obtained urinary PGE-M levels of 2927 non-cancerous adults from our previous case-control studies nested in the Shanghai Women's Health Study and Shanghai Men's Health Study, two cohort studies conducted in Shanghai, China. Mortality data and modifiable factors associated with urinary PGE-M were obtained from the parent cohort studies. Using linear regression models, we found that high urinary PGE-M levels were significantly associated with low education, heaving smoking, old age at urine collection, and abdominal obesity. Using Cox proportional hazards models, we found that increase (per standard deviation) of urinary PGE-M levels were significantly associated with overall mortality (adjusted hazard ratio = 1.19, 95% confidence interval: 1.07, 1.33) and particularly deaths from cardiometabolic diseases (adjusted hazard ratio = 1.27, 95% confidence interval: 1.11, 1.44). The increased death risks persisted across different time intervals during the follow-up and were stronger among participants who were younger than 60 (P = 0.0014 for all- cause mortality and P = 0.007 for deaths from cardiometabolic diseases) at urine collection or perhaps among those who had higher education.
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Habib S, Sangaraju SL, Yepez D, Grandes XA, Talanki Manjunatha R. The Nexus Between Diabetes and Depression: A Narrative Review. Cureus 2022; 14:e25611. [PMID: 35784974 PMCID: PMC9249007 DOI: 10.7759/cureus.25611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2022] [Indexed: 12/30/2022] Open
Abstract
Comorbid diabetes and depression are a significant public health burden as the consequences of both diseases are worsened by each other. In this study, we have compiled and analyzed findings from various studies to demonstrate that diabetes has a strong association with depression. Both have a significant impact on the quality of life, although the exact mechanisms through which these two chronic diseases affect each other remain unknown. This article discussed the shared etiological factors of comorbidity between diabetes and depression, including physiological (e.g., deregulation of the hypothalamic-pituitary-adrenal (HPA) axis, sympathetic nervous system (SNS) overactivity, microvascular dysfunction, arterial stiffening, inflammation, and cytokines), behavioral (e.g., diet and lifestyle modifications), and environmental (e.g., childhood adversity, poverty, and neighborhood environment). Included data from a range of settings have suggested that the prognosis of both diabetes and depression, in terms of complications, treatment efficacy, morbidity, and mortality, is worse for either disease when they occur concurrently than individually. The implication for the physical, mental, and social well-being of depression in diabetes causes poor self-care and adherence to medical treatment. This article also highlights the importance of regular screening and prompts the treatment of comorbid diabetes and depression with pharmacotherapy, face-to-face psychotherapy, and non-face-to-face models of alternative psychological interventions, including information and communication technologies (ICTs), computer-based diabetes self-management interventions, and digital mental health intervention, to improve the outcomes of both diseases.
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Affiliation(s)
- Salma Habib
- Internal Medicine, Institute of Applied Health Sciences (IAHS), Chittagong, BGD
| | - Sai Lahari Sangaraju
- Research, People's Education Society (PES) Institute of Medical Sciences and Research, Kuppam, IND
| | - Daniela Yepez
- General Medicine, Universidad Catolica de Santiago de Guayaquil, Guayaquil, ECU
| | - Xavier A Grandes
- General Medicine, Universidad Catolica de Santiago de Guayaquil, Guayaquil, ECU
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Laframboise NA, Seabrook JA, Matthews JI, Dworatzek PDN. Sixty Percent of Foods Advertised in Grocery Store Flyers are Not In-line with Canada's Food Guide. CAN J DIET PRACT RES 2022; 83:1-7. [PMID: 35014540 DOI: 10.3148/cjdpr-2021-035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Purpose: To evaluate foods advertised in discount and premium grocery flyers for their alignment with Canada's 2007 Food Guide (CFG) and assess if alignment differed by food category, season, page location, and price.Methods: Weekly flyers (n = 192) were collected from discount and premium grocery chains from each of 4 seasons. Health Canada's Surveillance Tool was used to assess food items as in-line or not in-line with CFG.Results: Of 35 576 food items, 39.7% were in-line with CFG. There were no differences in proportions of foods not in-line in discount versus premium flyers (60.9% and 60.0%, respectively). Other Foods and Meat & Alternatives were advertised most (28.0% and 26.3%, respectively; P < 0.001). Milk & Alternatives were the least advertised food group (10.3%). Vegetables & Fruit (19.6%), Grains (21.6%), Milk & Alternatives (20.6%), and Meat & Alternatives (20.2%) were promoted least in Fall (P < 0.001). A higher proportion of foods advertised on middle pages were not in-line (61.0%) compared with front (56.6%) and back (58.8%) pages (P < 0.001). Not in-line foods were more expensive ($3.49, IQR = $2.82) than in-line foods ($3.28, IQR = $2.81; P < 0.001).Conclusions: While there was no difference in healthfulness of foods advertised in discount versus premium flyers, grocers advertised more foods not in-line with CFG. Government policies to improve the food environment should consider grocery flyers.
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Affiliation(s)
- Natalie A Laframboise
- School of Food and Nutritional Sciences, Brescia University College, Western University, London, ON
| | - Jamie A Seabrook
- School of Food and Nutritional Sciences, Brescia University College, Western University, London, ON
- Department of Paediatrics, Western University, London, ON
- Department of Epidemiology and Biostatistics, Western University, London, ON
- Children's Health Research Institute, London, ON
- Lawson Health Research Institute, London, ON
- Human Environments Analysis Laboratory, London, ON
| | - June I Matthews
- School of Food and Nutritional Sciences, Brescia University College, Western University, London, ON
| | - Paula D N Dworatzek
- School of Food and Nutritional Sciences, Brescia University College, Western University, London, ON
- Schulich Interfaculty Program in Public Health, Schulich School of Medicine & Dentistry, Western University 1285 Western Road, London, ON N6G 1H2
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Diabetes Mellitus and Associated Factors in Slovakia: Results from the European Health Interview Survey 2009, 2014, and 2019. Nutrients 2021; 13:nu13072156. [PMID: 34201793 PMCID: PMC8308286 DOI: 10.3390/nu13072156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 06/17/2021] [Accepted: 06/21/2021] [Indexed: 01/04/2023] Open
Abstract
Diabetes mellitus (DM) is a high-risk non-communicable disease with an emerging burden for the European Union (EU) member states in the past decades. The unfavorable trend of the burden is striking compared to the declining disease burden due to cardiovascular diseases or stagnation of neoplasms. The goal of this study is to describe the temporal changes of diabetes in the adult population of Slovakia through the three European Health Interview Survey (EHIS) waves and to assess the association between DM and socioeconomic and/or lifestyle characteristics. These cross-sectional studies were carried out using microdata derived from Slovakia’s EHISs conducted in the years 2009 (n = 4972), 2014 (n = 5490), and 2019 (n = 5527). The DM variable was compared to the independent variables such as sociodemographic and lifestyle characteristics including dietary patterns and physical activity. DM prevalence for the EHIS in 2009, 2014, and 2019 were 6.1%, 8.2%, and 9.8%, respectively. In bivariate analysis, the relationship between DM and age, education level, job status, BMI, walking for at least 10 min, and physical activity was significant in the three EHISs. In 2014 and 2019, there was an inverse association between the risk of DM and walking regularly. There was no association between the frequency of eating fruits or vegetables and DM, with the exception of 2009, where a negative association between eating vegetables one to six times a week and DM was observed. Present health policies and activities in Slovakia were unable to reverse the increasing DM burden, indicating that a more systematic approach is needed. Complex policy strategies and legislative measures must be developed and implemented at both the national and EU levels.
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Mendivil CO, Gutiérrez Romero SA, Peláez-Jaramillo MJ, Nieves-Barreto LD, Montaño-Rodríguez A, Betancourt-Villamizar E. Diabetes and associated dietary intake among urban adults: COPEN (Colombian Nutritional Profiles)-a cross-sectional study. BMJ Open 2021; 11:e042050. [PMID: 34140339 PMCID: PMC8212409 DOI: 10.1136/bmjopen-2020-042050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES Diabetes is increasing rapidly in low-income and middle-income countries. We aimed to estimate the prevalence of diabetes, describe its correlates and its associated dietary intake in urban adults from Colombia. SETTING The Colombian Study of Nutritional Profiles was a population-based, cross-sectional, multi-stage probabilistic sampling survey designed to represent the five main Colombian cities. PARTICIPANTS Between June and November 2018, we studied 736 non-pregnant participants aged 18 or older. Diabetes was defined as a random plasma glucose ≥200 mg/dL, self-reported prior diagnosis of diabetes or use of any oral or injectable antidiabetic medication(s). Participants also fulfilled a detailed 157-item food-frequency questionnaire. PRIMARY AND SECONDARY OUTCOME MEASURES Prevalence of diabetes, dietary intake of key nutrients, achievement of dietary goals among individuals with diabetes. RESULTS The overall estimated prevalence of diabetes was 10.1%, with no difference by sex (9.6% in women, 10.8% in men, p=0.43). The association between diabetes and education level depended on sex, diabetes was more prevalent among more educated men and less educated women. Abdominal obesity was associated with a 65% increase in diabetes prevalence among men, and a 163% increase in women. Individuals with diabetes reported lower mean consumption of all nutrients, but after adjustment by sex, age, socioeconomic level (SEL) and body mass index, only their lower sodium consumption remained significant (p=0.013). The proportion of non-achievement of dietary intake goals among participants with diabetes was 94.4% for saturated fats, 86.7% for sodium, 84.4% for fibre and 80% for trans fats. In multivariate logistic regression models, age was the strongest independent correlate of diabetes. CONCLUSIONS Diabetes by self-report, random plasma glucose or medication use was highly prevalent among Colombian adults. There were large differences by abdominal obesity status, region of residence, SEL and educational level. The proportion of individuals with diabetes meeting dietary recommendations was alarmingly low.
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Affiliation(s)
- Carlos O Mendivil
- School of Medicine, Universidad de los Andes, Bogota, Colombia
- Endocrinology Section, Department of Internal Medicine, Fundacion Santa Fe de Bogota, Bogota, Colombia
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Mediterranean Diet and White Blood Cell Count-A Randomized Controlled Trial. Foods 2021; 10:foods10061268. [PMID: 34199545 PMCID: PMC8227102 DOI: 10.3390/foods10061268] [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: 05/20/2021] [Accepted: 05/31/2021] [Indexed: 12/26/2022] Open
Abstract
We aimed to assess the effects of the antioxidant-rich Mediterranean diet (MedDiet) on white blood cell count. Our study population included participants in the PREvención con DIeta MEDiterránea study (average age 67 years old, 58% women, high cardiovascular risk). We assessed whether a MedDiet intervention enriched in extra-virgin olive oil or nuts, versus a low-fat control diet, modified the incidence of leukocytosis (>11 × 109 leukocytes/L), mild leukopenia (<4.5 × 109 leukocytes/L), or severe leukopenia (<3.5 × 109 leukocytes/L) in individuals without the condition at baseline (n = 3190, n = 2925, and n = 3190, respectively). We also examined whether MedDiet modified the association between leukocyte count alterations and all-cause mortality. Both MedDiet interventions were associated with a lower risk of developing leukopenia (incidence rates: 5.06% in control diet, 3.29% in MedDiet groups combined; hazard ratio [95% confidence interval]: 0.54 [0.36-0.80]) and severe leukopenia (incidence rates: 1.26% in control diet, 0.46% in MedDiet groups combined; hazard ratio: 0.25 [0.10-0.60]). High cumulative adherence to a MedDiet was linked to lower risk of leukocytosis (incidence rates: 2.08% in quartile 1, 0.65% in quartile 4; HRQ4-Q1: 0.29 [0.085-0.99]) and attenuated the association between leukopenia and all-cause mortality (P-interaction = 0.032). In brief, MedDiet decreased the incidence of white blood cell count-related alterations in high cardiovascular risk individuals.
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Ribó-Coll M, Lassale C, Sacanella E, Ros E, Toledo E, Sorlí JV, Babio N, Lapetra J, Gómez-Gracia E, Alonso-Gómez ÁM, Fiol M, Serra-Majem L, Pinto X, Castañer O, Díez-Espino J, González JI, Becerra-Tomás N, Cofán M, Díaz-López A, Estruch R, Hernáez Á. Mediterranean diet and antihypertensive drug use: a randomized controlled trial. J Hypertens 2021; 39:1230-1237. [PMID: 33496530 DOI: 10.1097/hjh.0000000000002765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine in older individuals at high cardiovascular risk whether following a Mediterranean diet decreased the necessity of antihypertensive drugs and modulated their associated cardiovascular risk. METHODS In the PREvención con DIeta MEDiterránea study, we assessed whether volunteers randomly allocated to an intervention with a Mediterranean diet enriched with extra-virgin olive oil or nuts (relative to a low-fat control diet) disclosed differences in the risk of: initiating antihypertensive medication in nonusers at baseline (n = 2188); and escalating therapy in participants using one, two, or three drugs at baseline (n = 2361, n = 1579, and n = 554, respectively). We also assessed whether allocation to Mediterranean diet modified the association between antihypertensive drug use and incident cardiovascular events. RESULTS Participants allocated to Mediterranean diet interventions were associated with lower risk of initiating antihypertensive therapy [5-year incidence rates: 47.1% in the control diet, 43.0% in MedDiets; hazard ratio = 0.84, 95% CI (0.74--0.97), in a model adjusted for age, sex, and recruitment site]. Volunteers using two drugs at baseline in the Mediterranean diet intervention enriched with extra-virgin olive oil decreased their risk of therapy escalation [5-year incidence rates: 22.9% in the control diet, 20.1% in the MedDiet; hazard ratio = 0.77, 95% CI (0.60--0.99)]. Allocation to Mediterranean diet interventions attenuated the association between antihypertensive therapy at baseline and incidence of major adverse cardiovascular events (P interaction = 0.003). CONCLUSION In an older population at high cardiovascular risk, following a Mediterranean diet reduced the risk of initiating or escalating antihypertensive medication and attenuated cardiovascular risk in antihypertensive drug users.
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Affiliation(s)
- Margarita Ribó-Coll
- Cardiovascular Risk, Nutrition, and Aging Research Group, August Pi i Sunyer Biomedical Research Institute (IDIBAPS)
- PhD program in Food Science and Nutrition, Faculty of Pharmacy and Food Science, Universitat de Barcelona, Barcelona
| | - Camille Lassale
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM)
| | - Emilio Sacanella
- Cardiovascular Risk, Nutrition, and Aging Research Group, August Pi i Sunyer Biomedical Research Institute (IDIBAPS)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Internal Medicine Service, Hospital Clínic
| | - Emilio Ros
- Cardiovascular Risk, Nutrition, and Aging Research Group, August Pi i Sunyer Biomedical Research Institute (IDIBAPS)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clínic, Barcelona
| | - Estefanía Toledo
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona
| | - José V Sorlí
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Department of Preventive Medicine and Public Health, Universidad de Valencia, Valencia
| | - Nancy Babio
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Unitat de Nutrició Humana, Departament de Bioquimica i Biotecnologia, Universitat Rovira i Virgili
- Institut d'Investigació Pere Virgili (IISPV), Hospital Universitari Sant Joan de Reus, Reus
| | - José Lapetra
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla
| | - Enrique Gómez-Gracia
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Department of Preventive Medicine and Public Health, Universidad de Málaga, Málaga
| | - Ángel M Alonso-Gómez
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, Vitoria-Gasteiz
| | - Miquel Fiol
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Health Research Institute of the Balearic Islands (IdISBa). Hospital Son Espases. Palma de Mallorca
| | - Lluis Serra-Majem
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Instituto de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria
- Centro Hospitalario Universitario Insular Materno Infantil, Servicio Canario de Salud, Las Palmas
| | - Xavier Pinto
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat
| | - Olga Castañer
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM)
| | - Javier Díez-Espino
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona
- Centro de Salud de Tafalla, Gerencia de Atención Primaria, Servicio Navarro de Salud-Osasunbidea, Tafalla
- Instituto de Investigación Sanitaria de Navarra (IDISNA), Pamplona
| | - José I González
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Department of Preventive Medicine and Public Health, Universidad de Valencia, Valencia
| | - Nerea Becerra-Tomás
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Department of Preventive Medicine and Public Health, Universidad de Valencia, Valencia
- Unitat de Nutrició Humana, Departament de Bioquimica i Biotecnologia, Universitat Rovira i Virgili
- Institut d'Investigació Pere Virgili (IISPV), Hospital Universitari Sant Joan de Reus, Reus
| | - Montserrat Cofán
- Cardiovascular Risk, Nutrition, and Aging Research Group, August Pi i Sunyer Biomedical Research Institute (IDIBAPS)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clínic, Barcelona
| | - Andrés Díaz-López
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Unitat de Nutrició Humana, Departament de Bioquimica i Biotecnologia, Universitat Rovira i Virgili
- Institut d'Investigació Pere Virgili (IISPV), Hospital Universitari Sant Joan de Reus, Reus
| | - Ramón Estruch
- Cardiovascular Risk, Nutrition, and Aging Research Group, August Pi i Sunyer Biomedical Research Institute (IDIBAPS)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Internal Medicine Service, Hospital Clínic
| | - Álvaro Hernáez
- Cardiovascular Risk, Nutrition, and Aging Research Group, August Pi i Sunyer Biomedical Research Institute (IDIBAPS)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Blanquerna School of Health Sciences, Universitat Ramon Llull, Barcelona, Spain
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Hernáez Á, Lassale C, Castro-Barquero S, Ros E, Tresserra-Rimbau A, Castañer O, Pintó X, Vázquez-Ruiz Z, Sorlí JV, Salas-Salvadó J, Lapetra J, Gómez-Gracia E, Alonso-Gómez ÁM, Fiol M, Serra-Majem L, Sacanella E, Razquin C, Corella D, Guasch-Ferré M, Cofán M, Estruch R. Mediterranean Diet Maintained Platelet Count within a Healthy Range and Decreased Thrombocytopenia-Related Mortality Risk: A Randomized Controlled Trial. Nutrients 2021; 13:559. [PMID: 33567733 PMCID: PMC7915168 DOI: 10.3390/nu13020559] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/03/2021] [Accepted: 02/03/2021] [Indexed: 12/18/2022] Open
Abstract
There is little information on the dietary modulation of thrombosis-related risk factors such as platelet count. We aimed to assess the effects of Mediterranean diet (MedDiet) on platelet count and related outcomes in an older population at high cardiovascular risk. In participants of the PREDIMED (PREvención con DIeta MEDiterránea) study, we assessed whether an intervention with a MedDiet enriched with extra-virgin olive oil or nuts, relative to a low-fat control diet, modulated platelet count (n = 4189), the risk of developing thrombocytosis and thrombocytopenia (n = 3086), and the association between these alterations and all-cause mortality (median follow-up time: 3.0 years). Although platelet count increased over time (+0.98·109 units/L·year [95% confidence interval: 0.12; 1.84]), MedDiet interventions moderated this increase, particularly in individuals with near-high baseline count (both MedDiets combined: -3.20·109 units/L·year [-5.81; -0.59]). Thrombocytopenia incidence was lower in the MedDiet interventions (incidence rates: 2.23% in control diet, 0.91% in MedDiets combined; hazard ratio: 0.44 [0.23; 0.83]). Finally, thrombocytopenia was associated with a higher risk of all-cause mortality (hazard ratio: 4.71 [2.69; 8.24]), but this relationship was attenuated in those allocated to MedDiet (p-interaction = 0.018). In brief, MedDiet maintained platelet counts within a healthy range and attenuated platelet-related mortality in older adults at high cardiovascular risk.
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Affiliation(s)
- Álvaro Hernáez
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (S.C.-B.); (E.R.); (E.S.); (M.C.); (R.E.)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Blanquerna School of Health Sciences, Universitat Ramon Llull, 08025 Barcelona, Spain
- Centre for Fertility and Health (CeFH), Norwegian Institute of Public Health, 0473 Oslo, Norway
| | - Camille Lassale
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
| | - Sara Castro-Barquero
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (S.C.-B.); (E.R.); (E.S.); (M.C.); (R.E.)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain
| | - Emilio Ros
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (S.C.-B.); (E.R.); (E.S.); (M.C.); (R.E.)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clínic, 08036 Barcelona, Spain
| | - Anna Tresserra-Rimbau
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Department of Nutrition, Food Science and Gastronomy, XaRTA, INSA, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain
- Unitat de Nutrició Humana, Departament de Bioquimica i Biotecnologia, Universitat Rovira i Virgili, Hospital Universitari Sant Joan de Reus, 43201 Reus, Spain
- Institut d’Investigació Pere Virgili (IISPV), 43204 Reus, Spain
| | - Olga Castañer
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
| | - Xavier Pintó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Lipids and Vascular Risk Unit, Internal Medicine Service, Hospital Universitario de Bellvitge, 08907 L’Hospitalet de Llobregat, Spain
| | - Zenaida Vázquez-Ruiz
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Department of Preventive Medicine and Public Health, Universidad de Navarra, 31008 Pamplona, Spain
| | - José V. Sorlí
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Department of Preventive Medicine, Universidad de Valencia, 46010 Valencia, Spain
| | - Jordi Salas-Salvadó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Unitat de Nutrició Humana, Departament de Bioquimica i Biotecnologia, Universitat Rovira i Virgili, Hospital Universitari Sant Joan de Reus, 43201 Reus, Spain
- Institut d’Investigació Pere Virgili (IISPV), 43204 Reus, Spain
| | - José Lapetra
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Research Unit, Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, 41013 Sevilla, Spain
| | - Enrique Gómez-Gracia
- Department of Preventive Medicine and Public Health, Universidad de Málaga, 29071 Málaga, Spain;
| | - Ángel M. Alonso-Gómez
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, 01009 Vitoria-Gasteiz, Spain
| | - Miquel Fiol
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Health Research Institute of the Balearic Islands (IdISBa), Hospital Son Espases, 07120 Palma de Mallorca, Spain
| | - Lluis Serra-Majem
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Instituto de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, 35016 Las Palmas, Spain
- Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Servicio Canario de Salud, 35016 Las Palmas, Spain
| | - Emilio Sacanella
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (S.C.-B.); (E.R.); (E.S.); (M.C.); (R.E.)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain
- Internal Medicine Service, Hospital Clínic, 08036 Barcelona, Spain
| | - Cristina Razquin
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Department of Preventive Medicine and Public Health, Universidad de Navarra, 31008 Pamplona, Spain
- Department of Endocrinology and Nutrition, Complejo Hospitalario de Navarra, 31008 Pamplona, Spain
| | - Dolores Corella
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Department of Preventive Medicine, Universidad de Valencia, 46010 Valencia, Spain
| | - Marta Guasch-Ferré
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Institut d’Investigació Pere Virgili (IISPV), 43204 Reus, Spain
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
| | - Montserrat Cofán
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (S.C.-B.); (E.R.); (E.S.); (M.C.); (R.E.)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clínic, 08036 Barcelona, Spain
| | - Ramón Estruch
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (S.C.-B.); (E.R.); (E.S.); (M.C.); (R.E.)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain
- Internal Medicine Service, Hospital Clínic, 08036 Barcelona, Spain
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Castro-Barquero S, Ribó-Coll M, Lassale C, Tresserra-Rimbau A, Castañer O, Pintó X, Martínez-González MÁ, Sorlí JV, Salas-Salvadó J, Lapetra J, Gómez-Gracia E, Alonso-Gómez ÁM, Fiol M, Serra-Majem L, Sacanella E, Basterra-Gortari FJ, Portolés O, Babio N, Cofán M, Ros E, Estruch R, Hernáez Á. Mediterranean Diet Decreases the Initiation of Use of Vitamin K Epoxide Reductase Inhibitors and Their Associated Cardiovascular Risk: A Randomized Controlled Trial. Nutrients 2020; 12:E3895. [PMID: 33352771 PMCID: PMC7766197 DOI: 10.3390/nu12123895] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/12/2020] [Accepted: 12/16/2020] [Indexed: 12/29/2022] Open
Abstract
Our aim is to assess whether following a Mediterranean Diet (MedDiet) decreases the risk of initiating antithrombotic therapies and the cardiovascular risk associated with its use in older individuals at high cardiovascular risk. We evaluate whether participants of the PREvención con DIeta MEDiterránea (PREDIMED) study allocated to a MedDiet enriched in extra-virgin olive oil or nuts (versus a low-fat control intervention) disclose differences in the risk of initiation of: (1) vitamin K epoxide reductase inhibitors (acenocumarol/warfarin; n = 6772); (2) acetylsalicylic acid as antiplatelet agent (n = 5662); and (3) other antiplatelet drugs (cilostazol/clopidogrel/dipyridamole/ditazol/ticlopidine/triflusal; n = 6768). We also assess whether MedDiet modifies the association between the antithrombotic drug baseline use and incident cardiovascular events. The MedDiet intervention enriched with extra-virgin olive oil decreased the risk of initiating the use of vitamin K epoxide reductase inhibitors relative to control diet (HR: 0.68 [0.46-0.998]). Their use was also more strongly associated with an increased risk of cardiovascular disease in participants not allocated to MedDiet interventions (HRcontrol diet: 4.22 [1.92-9.30], HRMedDiets: 1.71 [0.83-3.52], p-interaction = 0.052). In conclusion, in an older population at high cardiovascular risk, following a MedDiet decreases the initiation of antithrombotic therapies and the risk of suffering major cardiovascular events among users of vitamin K epoxide reductase inhibitors.
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Affiliation(s)
- Sara Castro-Barquero
- Cardiovascular Risk, Nutrition and Aging Research Group, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (S.C.-B.); (M.R.-C.); (E.S.); (R.E.)
- Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (M.Á.M.-G.); (J.V.S.); (J.S.-S.); (J.L.); (E.G.-G.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (F.J.B.-G.); (O.P.); (N.B.); (M.C.); (E.R.)
| | - Margarita Ribó-Coll
- Cardiovascular Risk, Nutrition and Aging Research Group, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (S.C.-B.); (M.R.-C.); (E.S.); (R.E.)
- Faculty of Pharmacy and Food Science, Universitat de Barcelona, 08028 Barcelona, Spain
| | - Camille Lassale
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (M.Á.M.-G.); (J.V.S.); (J.S.-S.); (J.L.); (E.G.-G.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (F.J.B.-G.); (O.P.); (N.B.); (M.C.); (E.R.)
- Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
| | - Anna Tresserra-Rimbau
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (M.Á.M.-G.); (J.V.S.); (J.S.-S.); (J.L.); (E.G.-G.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (F.J.B.-G.); (O.P.); (N.B.); (M.C.); (E.R.)
- Unitat de Nutrició Humana, Departament de Bioquimica i Biotecnologia, Hospital Universitari Sant Joan de Reus, Universitat Rovira i Virgili, 43201 Reus, Spain
- Institut d′Investigació Pere Virgili (IISPV), 43204 Reus, Spain
- Department of Nutrition, Food Science and Gastronomy, XaRTA, INSA, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain
| | - Olga Castañer
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (M.Á.M.-G.); (J.V.S.); (J.S.-S.); (J.L.); (E.G.-G.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (F.J.B.-G.); (O.P.); (N.B.); (M.C.); (E.R.)
- Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
| | - Xavier Pintó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (M.Á.M.-G.); (J.V.S.); (J.S.-S.); (J.L.); (E.G.-G.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (F.J.B.-G.); (O.P.); (N.B.); (M.C.); (E.R.)
- Lipids and Vascular Risk Unit, Internal Medicine Service, Hospital Universitario de Bellvitge, 08907 L’Hospitalet de Llobregat, Spain
| | - Miguel Ángel Martínez-González
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (M.Á.M.-G.); (J.V.S.); (J.S.-S.); (J.L.); (E.G.-G.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (F.J.B.-G.); (O.P.); (N.B.); (M.C.); (E.R.)
- Department of Preventive Medicine and Public Health, Universidad de Navarra, 31008 Pamplona, Spain
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
| | - José V. Sorlí
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (M.Á.M.-G.); (J.V.S.); (J.S.-S.); (J.L.); (E.G.-G.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (F.J.B.-G.); (O.P.); (N.B.); (M.C.); (E.R.)
- Department of Preventive Medicine, Universidad de Valencia, 46100 Valencia, Spain
| | - Jordi Salas-Salvadó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (M.Á.M.-G.); (J.V.S.); (J.S.-S.); (J.L.); (E.G.-G.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (F.J.B.-G.); (O.P.); (N.B.); (M.C.); (E.R.)
- Unitat de Nutrició Humana, Departament de Bioquimica i Biotecnologia, Hospital Universitari Sant Joan de Reus, Universitat Rovira i Virgili, 43201 Reus, Spain
- Institut d′Investigació Pere Virgili (IISPV), 43204 Reus, Spain
| | - José Lapetra
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (M.Á.M.-G.); (J.V.S.); (J.S.-S.); (J.L.); (E.G.-G.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (F.J.B.-G.); (O.P.); (N.B.); (M.C.); (E.R.)
- Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, 41013 Sevilla, Spain
| | - Enrique Gómez-Gracia
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (M.Á.M.-G.); (J.V.S.); (J.S.-S.); (J.L.); (E.G.-G.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (F.J.B.-G.); (O.P.); (N.B.); (M.C.); (E.R.)
- Department of Preventive Medicine and Public Health, Universidad de Málaga, 29071 Málaga, Spain
| | - Ángel M. Alonso-Gómez
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (M.Á.M.-G.); (J.V.S.); (J.S.-S.); (J.L.); (E.G.-G.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (F.J.B.-G.); (O.P.); (N.B.); (M.C.); (E.R.)
- Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, 01009 Vitoria-Gasteiz, Spain
| | - Miquel Fiol
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (M.Á.M.-G.); (J.V.S.); (J.S.-S.); (J.L.); (E.G.-G.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (F.J.B.-G.); (O.P.); (N.B.); (M.C.); (E.R.)
- Health Research Institute of the Balearic Islands (IdISBa), Hospital Son Espases, 07120 Palma de Mallorca, Spain
| | - Lluis Serra-Majem
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (M.Á.M.-G.); (J.V.S.); (J.S.-S.); (J.L.); (E.G.-G.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (F.J.B.-G.); (O.P.); (N.B.); (M.C.); (E.R.)
- Instituto de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, 35016 Las Palmas, Spain
- Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Servicio Canario de Salud, 35016 Las Palmas, Spain
| | - Emilio Sacanella
- Cardiovascular Risk, Nutrition and Aging Research Group, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (S.C.-B.); (M.R.-C.); (E.S.); (R.E.)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (M.Á.M.-G.); (J.V.S.); (J.S.-S.); (J.L.); (E.G.-G.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (F.J.B.-G.); (O.P.); (N.B.); (M.C.); (E.R.)
- Internal Medicine Service, Hospital Clínic, 08036 Barcelona, Spain
| | - Francisco Javier Basterra-Gortari
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (M.Á.M.-G.); (J.V.S.); (J.S.-S.); (J.L.); (E.G.-G.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (F.J.B.-G.); (O.P.); (N.B.); (M.C.); (E.R.)
- Department of Preventive Medicine and Public Health, Universidad de Navarra, 31008 Pamplona, Spain
- Department of Endocrinology and Nutrition, Complejo Hospitalario de Navarra, 31008 Pamplona, Spain
| | - Olga Portolés
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (M.Á.M.-G.); (J.V.S.); (J.S.-S.); (J.L.); (E.G.-G.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (F.J.B.-G.); (O.P.); (N.B.); (M.C.); (E.R.)
- Department of Preventive Medicine, Universidad de Valencia, 46100 Valencia, Spain
| | - Nancy Babio
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (M.Á.M.-G.); (J.V.S.); (J.S.-S.); (J.L.); (E.G.-G.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (F.J.B.-G.); (O.P.); (N.B.); (M.C.); (E.R.)
- Unitat de Nutrició Humana, Departament de Bioquimica i Biotecnologia, Hospital Universitari Sant Joan de Reus, Universitat Rovira i Virgili, 43201 Reus, Spain
- Institut d′Investigació Pere Virgili (IISPV), 43204 Reus, Spain
| | - Montserrat Cofán
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (M.Á.M.-G.); (J.V.S.); (J.S.-S.); (J.L.); (E.G.-G.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (F.J.B.-G.); (O.P.); (N.B.); (M.C.); (E.R.)
- Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clínic, 08036 Barcelona, Spain
| | - Emilio Ros
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (M.Á.M.-G.); (J.V.S.); (J.S.-S.); (J.L.); (E.G.-G.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (F.J.B.-G.); (O.P.); (N.B.); (M.C.); (E.R.)
- Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clínic, 08036 Barcelona, Spain
| | - Ramón Estruch
- Cardiovascular Risk, Nutrition and Aging Research Group, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (S.C.-B.); (M.R.-C.); (E.S.); (R.E.)
- Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (M.Á.M.-G.); (J.V.S.); (J.S.-S.); (J.L.); (E.G.-G.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (F.J.B.-G.); (O.P.); (N.B.); (M.C.); (E.R.)
- Internal Medicine Service, Hospital Clínic, 08036 Barcelona, Spain
| | - Álvaro Hernáez
- Cardiovascular Risk, Nutrition and Aging Research Group, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (S.C.-B.); (M.R.-C.); (E.S.); (R.E.)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (M.Á.M.-G.); (J.V.S.); (J.S.-S.); (J.L.); (E.G.-G.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (F.J.B.-G.); (O.P.); (N.B.); (M.C.); (E.R.)
- Blanquerna School of Health Sciences, Universitat Ramon Llull, 08025 Barcelona, Spain
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Spatiotemporal trends and influence factors of global diabetes prevalence in recent years. Soc Sci Med 2020; 256:113062. [PMID: 32464417 DOI: 10.1016/j.socscimed.2020.113062] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/17/2020] [Accepted: 05/12/2020] [Indexed: 11/21/2022]
Abstract
Diabetes is one of the most widespread global epidemics and has become the main component of the global disease burden. Based on data regarding the prevalence of diabetes in 203 countries and territories from 2013 to 2017, we employed the Bayesian space-time model to investigate the spatiotemporal trends in the global diabetes prevalence. The factors influencing the diabetes prevalence were assessed by the Bayesian LASSO regression model. We identified 77 (37.9%) hotspots with a higher diabetes prevalence than the global average, 10 (0.4%) warm spots with global average level and 116 (57.1%) cold spots with lower level than global average. Of the 203 countries and territories, 68 (33.5%), including 31 hotspots, 5 warm spots and 32 cold spots, exhibited an increasing trend. Of these, 60 experienced an annual increase of more than 0.25%, and 8 showed an increasing trend. Three populous countries, namely China, the USA and Mexico, exhibited a high prevalence and an increasing trend simultaneously. Three socioeconomic factors, body mass index (BMI), urbanization rate (UR) and gross domestic product per capita (GDP-PC), and PM2.5 pollution were found to significantly influence the prevalence of diabetes. BMI was the strongest factor; for every 1% increase in BMI, the prevalence of diabetes increased by 2.371% (95% confidence interval (95% CI): 0.957%, 3.890%) in 2013 and by 3.045% (95% CI: 1.803%, 4.397%) in 2015 and 2017. PM2.5 pollution could be a risk factor, and its influencing magnitude gradually increased as well. With an annual PM2.5 concentrations increase of 1.0% in a country, the prevalence of diabetes increased by 0.196% (95% CI: 0.020%, 0.356%). The UR, on the other hand, was found to be inversely associated with the prevalence of diabetes; with each UR increase of 1%, the prevalence of diabetes decreased by 0.006% (95% CI: 0.001%, 0.011%).
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Jacobs E, Tönnies T, Rathmann W, Brinks R, Hoyer A. Association between regional deprivation and type 2 diabetes incidence in Germany. BMJ Open Diabetes Res Care 2019; 7:e000857. [PMID: 31908802 PMCID: PMC6936410 DOI: 10.1136/bmjdrc-2019-000857] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 11/12/2019] [Accepted: 11/22/2019] [Indexed: 11/04/2022] Open
Abstract
Objective The aim of this analysis was to estimate the association between regional deprivation and type 2 diabetes incidence and to investigate differences by age and sex for Germany. Research design and methods Type 2 diabetes incidence rate ratios comparing the most deprived fifth of the population to the remainder of the population (divided into quintiles) were estimated using the illness-death model, which describes the relationship between prevalence, mortality, and incidence. For the analysis, we used the type 2 diabetes prevalence and the general mortality rate according to deprivation quintiles, which we calculated based on valid estimates for Germany. Because mortality rate ratios for people with type 2 diabetes compared with people without type 2 diabetes are lacking for Germany, we used estimates from Scotland. Estimates were standardized to the German population in 2012 and stratified by sex. Results Incidence of type 2 diabetes was estimated to be over twice as high among people living in the most deprived regions of Germany compared with people living in the least deprived regions (men: 2.41, 95% CI 1.27 to 4.28; women: 2.40, 95% CI 1.25 to 4.29). The strength of the association increased with increasing age until the age of 75 years. No sex differences were present. Conclusions The study adds new evidence regarding the association between type 2 diabetes incidence and regional deprivation for Germany. The results underpin the importance to intensify public health actions to reduce social inequalities in Germany and whole Europe in the future.
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Affiliation(s)
- Esther Jacobs
- Institute for Biometrics and Epidemiology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Thaddäus Tönnies
- Institute for Biometrics and Epidemiology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Wolfgang Rathmann
- Institute for Biometrics and Epidemiology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Ralph Brinks
- Institute for Biometrics and Epidemiology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Hiller Research Unit for Rheumatology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Annika Hoyer
- Institute for Biometrics and Epidemiology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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A multilevel life course perspective on type 2 diabetes. JAAPA 2019; 32:34-38. [PMID: 31770303 DOI: 10.1097/01.jaa.0000604868.56572.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The prevalence of type 2 diabetes has increased over the past 3 decades, particularly among adolescents as obesity also increases in this age group. Given the long-term effects associated with type 2 diabetes, public health intervention is needed. However, simply advising a patient to lose weight and increase physical exercise ignores the complex interplay of many levels of influences throughout a patient's life. This article describes type 2 diabetes from a multilevel life course perspective that can help clinicians find areas of possible intervention and understand the challenges patients face.
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Zarnani K, Nichols TE, Alfaro-Almagro F, Fagerlund B, Lauritzen M, Rostrup E, Smith SM. Discovering markers of healthy aging: a prospective study in a Danish male birth cohort. Aging (Albany NY) 2019; 11:5943-5974. [PMID: 31480020 PMCID: PMC6738442 DOI: 10.18632/aging.102151] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 07/31/2019] [Indexed: 01/23/2023]
Abstract
There is a pressing need to identify markers of cognitive and neural decline in healthy late-midlife participants. We explored the relationship between cross-sectional structural brain-imaging derived phenotypes (IDPs) and cognitive ability, demographic, health and lifestyle factors (non-IDPs). Participants were recruited from the 1953 Danish Male Birth Cohort (N=193). Applying an extreme group design, members were selected in 2 groups based on cognitive change between IQ at age ~20y (IQ-20) and age ~57y (IQ-57). Subjects showing the highest (n=95) and lowest (n=98) change were selected (at age ~57) for assessments on multiple IDPs and non-IDPs. We investigated the relationship between 453 IDPs and 70 non-IDPs through pairwise correlation and multivariate canonical correlation analysis (CCA) models. Significant pairwise associations included positive associations between IQ-20 and gray-matter volume of the temporal pole. CCA identified a richer pattern - a single "positive-negative" mode of population co-variation coupling individual cross-subject variations in IDPs to an extensive range of non-IDP measures (r = 0.75, Pcorrected < 0.01). Specifically, this mode linked higher cognitive performance, positive early-life social factors, and mental health to a larger brain volume of several brain structures, overall volume, and microstructural properties of some white matter tracts. Interestingly, both statistical models identified IQ-20 and gray-matter volume of the temporal pole as important contributors to the inter-individual variation observed. The converging patterns provide novel insight into the importance of early adulthood intelligence as a significant marker of late-midlife neural decline and motivates additional study.
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Affiliation(s)
- Kiyana Zarnani
- Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark.,Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark.,Department of Neuroscience, University of Copenhagen, Copenhagen, Denmark.,Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB), Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Thomas E Nichols
- Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB), Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.,Oxford Big Data Institute, Li Ka Shing, Centre For Health Information and Discovery, Nuffield Department of Population Health University of Oxford, Oxford, UK.,Department of Statistics, University of Warwick, Coventry, UK
| | - Fidel Alfaro-Almagro
- Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB), Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Birgitte Fagerlund
- Center for Neuropsychiatric Schizophrenia Research, Mental Health Center, Glostrup, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Martin Lauritzen
- Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark.,Department of Neuroscience, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Medicine, Glostrup, Denmark
| | - Egill Rostrup
- Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark.,Center for Neuropsychiatric Schizophrenia Research, Mental Health Center, Glostrup, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Stephen M Smith
- Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB), Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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Santos HP, Bhattacharya A, Martin EM, Addo K, Psioda M, Smeester L, Joseph RM, Hooper SR, Frazier JA, Kuban KC, O’Shea T, Fry RC. Epigenome-wide DNA methylation in placentas from preterm infants: association with maternal socioeconomic status. Epigenetics 2019; 14:751-765. [PMID: 31062658 PMCID: PMC6615526 DOI: 10.1080/15592294.2019.1614743] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 04/19/2019] [Accepted: 04/26/2019] [Indexed: 02/07/2023] Open
Abstract
This study evaluated the hypothesis that prenatal maternal socioeconomic status (SES) adversity is associated with DNA methylation in the placenta. SES adversity was defined by the presence of, as well as a summative count of, four factors: less than college education, single marital status, food and nutritional service assistance, and public health insurance. Epigenome-wide DNA methylation was assessed using the Illumina EPIC array in 426 placentas from a sample of infants born < 28 weeks of gestation from the Extremely Low Gestational Age Newborn cohort. Associations between SES adversity and DNA methylation were assessed with robust linear regressions adjusted for covariates and controlled the false discovery rate at < 10%. We also examined whether such associations were sex specific. Indicators of SES adversity were associated with differential methylation at 33 CpG sites. Of the 33 identified CpG sites, 19 (57.6%) displayed increased methylation, and 14 (42.4%) displayed decreased methylation in association with at least one of the SES adversity factors. Sex differences were observed in DNA methylation associated with summative SES score; in which placentas derived from female pregnancies showed more robust differential CpG methylation than placentas from male pregnancies. Maternal SES adversity was associated with differential methylation of genes with key role in gene transcription and placental function, potentially altering immunity and stress response. Further investigation is needed to evaluate the role of epigenetic differences in mediating the association between maternal socioeconomic status during pregnancy and later life health outcomes in children.
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Affiliation(s)
- Hudson P. Santos
- School of Nursing, University of North Carolina, Chapel Hill, NC, USA
- Institute for Environmental Health Solutions, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Arjun Bhattacharya
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Elizabeth M. Martin
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Kezia Addo
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina, Chapel Hill, NC, USA
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Matt Psioda
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Lisa Smeester
- Institute for Environmental Health Solutions, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina, Chapel Hill, NC, USA
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Robert M. Joseph
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA
| | - Stephen R. Hooper
- Department of Allied Health Sciences, School of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Jean A. Frazier
- Eunice Kennedy Shriver Center, University of Massachusetts Medical School, Worcester, MA, USA
- Department of Psychiatry, University of Massachusetts Medical School/University of Massachusetts Memorial Health Care, Worcester, MA, USA
| | - Karl C. Kuban
- Department of Pediatrics, Division of Pediatric Neurology, Boston University Medical Center, Boston, MA, USA
| | - T.Michael O’Shea
- Department of Pediatrics, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Rebecca C. Fry
- Institute for Environmental Health Solutions, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina, Chapel Hill, NC, USA
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
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Yang Z, Lei G, Li X, Wang Y, Xie Z, Zhang X, He Y, Xiong Y, Yang T. Does symptomatic knee osteoarthritis increase the risk of all-cause mortality? Data from four international population-based longitudinal surveys of aging. Clin Rheumatol 2019; 38:3253-3259. [PMID: 31327086 DOI: 10.1007/s10067-019-04672-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 06/09/2019] [Accepted: 07/01/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed at examining the association between symptomatic knee osteoarthritis and all-cause mortality based on four population-based longitudinal surveys. METHOD Data were retrieved from the English Longitudinal Study of Aging (ELSA), the Survey of Health, Aging and Retirement in Europe (SHARE), the Korean Longitudinal Study of Aging (KLoSA), and the Indonesian Family Life Survey (IFLS). The association between symptomatic knee osteoarthritis and all-cause mortality over the 8- to 12-year follow-up period was assessed using Cox-proportional hazard models. RESULTS In the entire sample of 59,522 participants (4823 with symptomatic knee osteoarthritis; 54,699 without symptomatic knee osteoarthritis [control group]; mean age: 61.8 years; female percentage: 55.3%), 8375 died (937 in the symptomatic knee osteoarthritis group, 7438 in the control group) during the follow-up period. Patients with symptomatic knee osteoarthritis had a higher risk of all-cause mortality than control group without adjusting for potential confounders in each survey, and the unadjusted hazard ratios (HRs) of all-cause mortality were 1.32 (95% confidence interval [CI] 1.18 to 1.47) in ELSA, 1.40 (95%CI 1.24 to 1.56) in SHARE, 1.25 (95%CI 1.06 to 1.47) in KLoSA, and 1.65 (95%CI 1.31 to 2.07) in IFLS. However, with adjustment of potential confounders, the corresponding HRs dropped to 1.07 (95%CI 0.94 to 1.20) in ELSA, 1.08 (95%CI 0.97 to 1.22) in SHARE, 0.91 (95%CI 0.77 to 1.08) in KLoSA, and 0.89 (95%CI 0.66 to 1.21) in IFLS, respectively. CONCLUSIONS In these four population-based longitudinal studies, no association between symptomatic knee osteoarthritis and increased risk of all-cause mortality was observed after adjusting for potential confounders. Key Points • This study evaluated the association between symptomatic knee OA and the risk of all-cause mortality among the participants retrieved from four large population-based longitudinal studies across the world. • No association between symptomatic knee osteoarthritis and increased risk of all-cause mortality was observed after considering potential confounders, and our findings were consistent with the results derived from four independent longitudinal studies. • The present study included four international population-based longitudinal studies, comprising both developed and developing areas, which allowed the findings to be interpreted under larger circumstance.
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Affiliation(s)
- Zidan Yang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Guanghua Lei
- Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, Hunan, China
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiaoxiao Li
- Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, Hunan, China
| | - Yilun Wang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zikun Xie
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiurui Zhang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yuchen He
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yilin Xiong
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Tubao Yang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
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Early Life Socioeconomic Disadvantage and Epigenetic Programming of a Pro-inflammatory Phenotype: a Review of Recent Evidence. CURR EPIDEMIOL REP 2018. [DOI: 10.1007/s40471-018-0169-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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25
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The contribution of health behaviors to socioeconomic inequalities in health: A systematic review. Prev Med 2018; 113:15-31. [PMID: 29752959 DOI: 10.1016/j.ypmed.2018.05.003] [Citation(s) in RCA: 215] [Impact Index Per Article: 35.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 05/02/2018] [Accepted: 05/05/2018] [Indexed: 12/22/2022]
Abstract
Unhealthy behaviors and their social patterning have been frequently proposed as factors mediating socioeconomic differences in health. However, a clear quantification of the contribution of health behaviors to the socioeconomic gradient in health is lacking. This study systematically reviews the role of health behaviors in explaining socioeconomic inequalities in health. Published studies were identified by a systematic review of PubMed, Embase and Web-of-Science. Four health behaviors were considered: smoking, alcohol consumption, physical activity and diet. We restricted health outcomes to cardiometabolic disorders and mortality. To allow comparison between studies, the contribution of health behaviors, or the part of the socioeconomic gradient in health that is explained by health behaviors, was recalculated in all studies according to the absolute scale difference method. We identified 114 articles on socioeconomic position, health behaviors and cardiometabolic disorders or mortality from electronic databases and articles reference lists. Lower socioeconomic position was associated with an increased risk of all-cause mortality and cardiometabolic disorders, this gradient was explained by health behaviors to varying degrees (minimum contribution -43%; maximum contribution 261%). Health behaviors explained a larger proportion of the SEP-health gradient in studies conducted in North America and Northern Europe, in studies examining all-cause mortality and cardiovascular disease, among men, in younger individuals, and in longitudinal studies, when compared to other settings. Of the four behaviors examined, smoking contributed the most to social inequalities in health, with a median contribution of 19%. Health behaviors contribute to the socioeconomic gradient in cardiometabolic disease and mortality, but this contribution varies according to population and study characteristics. Nevertheless, our results should encourage the implementation of interventions targeting health behaviors, as they may reduce socioeconomic inequalities in health and increase population health.
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Kim I, Song YM, Ko H, Sung J, Lee K, Shin J, Shin S. Educational Disparities in Risk for Metabolic Syndrome. Metab Syndr Relat Disord 2018; 16:416-424. [PMID: 29975597 DOI: 10.1089/met.2017.0170] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The objective of this study was to evaluate the relationship between educational level as a surrogate marker of socioeconomic status and the risk of developing metabolic syndrome (MetS). METHODS Study subjects were 1915 Korean adults (1193 women and 722 men) who participated in a cohort study. Educational level was categorized into two groups: (1) high education (more than 12 years of education), and (2) low education (less than 12 years of education). MetS was defined according to diagnostic criteria of the National Cholesterol Education Program (NCEP-III) and the International Diabetes Federation (IDF). Multiple logistic regression analysis and Cox proportional hazard analysis were performed to evaluate cross-sectional and prospective association between MetS or MetS components and educational level after adjusting for covariates. RESULTS The overall prevalence of MetS at baseline was 15.0% in women and 20.4% in men. Incidence of MetS over 4.52 years was 16.6 per 1000 person-year in women and 27.6 per 1000 person-year in men. The prevalence and incidence of MetS were higher in the low educational group than those in the high educational group in both sexes. At baseline, the risk of MetS (odds ratio [OR]: 1.63, 95% confidence interval [CI]: 1.05-2.53 for NCEP criteria; OR: 2.30, 95% CI: 1.41-3.76 for IDF criteria) and abdominal obesity (OR: 2.62, 95% CI: 1.75-3.93) were higher in less educated women compared with those in more educated women. In men, there was no association between Mets or MetS components and educational level. Over 4.6 years of follow-up, the risk of developing MetS in women in the low education group (hazard ratio [HR]: 1.95, 95% CI: 1.12-3.50 for NCEP criteria; HR: 2.36, 95% CI: 1.14-4.86 for IDF criteria) was significantly higher than that in the high education group. In men, low education significantly increased the risk of developing impaired fasting glucose (HR: 1.95, 95% CI: 1.12-3.40). CONCLUSION An inverse association between educational level and MetS was found in Korean women, suggesting that socioeconomic disparities might increase the risk of MetS development, especially in women.
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Affiliation(s)
- Insub Kim
- 1 Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, South Korea
| | - Yun-Mi Song
- 1 Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, South Korea
| | - Hyeonyoung Ko
- 2 Health Promotion Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine , Seoul, South Korea
| | - Joohon Sung
- 3 Department of Epidemiology, School of Public Health and Institute of Health Environment, Seoul National University , Seoul, South Korea
| | - Kayoung Lee
- 4 Department of Family Medicine, Busan Paik Hospital, Inje University , College of Medicine, Busan, South Korea
| | - Jinyoung Shin
- 5 Department of Family Medicine, Konkuk University Medical Center , Seoul, South Korea
| | - Sujeong Shin
- 1 Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, South Korea
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Batty GD, Zaninotto P, Watt RG, Bell S. Associations of pet ownership with biomarkers of ageing: population based cohort study. BMJ 2017; 359:j5558. [PMID: 29237607 PMCID: PMC5728306 DOI: 10.1136/bmj.j5558] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/24/2017] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To examine the prospective relation between animal companionship and biomarkers of ageing in older people. DESIGN Analyses of data from the English Longitudinal Study of Ageing, an ongoing, open, prospective cohort study initiated in 2002-03. SETTING Nationally representative study from England. PARTICIPANTS 8785 adults (55% women) with a mean age of 67 years (SD 9) at pet ownership assessment in 2010-11 (wave 5). MAIN OUTCOME MEASURE Established biomarkers of ageing in the domains of physical, immunological, and psychological function, as assessed in 2012-13 (wave 6). RESULTS One third of study members reported pet ownership: 1619 (18%) owned a dog, 1077 (12%) a cat, and 274 (3%) another animal. After adjustment for a range of covariates, there was no evidence of a clear association of any type of pet ownership with walking speed, lung function, chair rise time, grip strength, leg raises, balance, three markers of systemic inflammation, memory, or depressive symptoms. CONCLUSION In this population of older adults, the companionship of creatures great and small seems to essentially confer no relation with standard ageing phenotypes.
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Affiliation(s)
- G David Batty
- Department of Epidemiology and Public Health, University College, London, UK
| | - Paola Zaninotto
- Department of Epidemiology and Public Health, University College, London, UK
| | - Richard G Watt
- Department of Epidemiology and Public Health, University College, London, UK
| | - Steven Bell
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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Gaye A, Gibbons GH, Barry C, Quarells R, Davis SK. Influence of socioeconomic status on the whole blood transcriptome in African Americans. PLoS One 2017; 12:e0187290. [PMID: 29206834 PMCID: PMC5716587 DOI: 10.1371/journal.pone.0187290] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 10/17/2017] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The correlation between low socioeconomic status (SES) and poor health outcome or higher risk of disease has been consistently reported by many epidemiological studies across various race/ancestry groups. However, the biological mechanisms linking low SES to disease and/or disease risk factors are not well understood and remain relatively under-studied. The analysis of the blood transcriptome is a promising window for elucidating how social and environmental factors influence the molecular networks governing health and disease. To further define the mechanistic pathways between social determinants and health, this study examined the impact of SES on the blood transcriptome in a sample of African-Americans. METHODS An integrative approach leveraging three complementary methods (Weighted Gene Co-expression Network Analysis, Random Forest and Differential Expression) was adopted to identify the most predictive and robust transcriptome pathways associated with SES. We analyzed the expression of 15079 genes (RNA-seq) from whole blood across 36 samples. RESULTS The results revealed a cluster of 141 co-expressed genes over-expressed in the low SES group. Three pro-inflammatory pathways (IL-8 Signaling, NF-κB Signaling and Dendritic Cell Maturation) are activated in this module and over-expressed in low SES. Random Forest analysis revealed 55 of the 141 genes that, collectively, predict SES with an area under the curve of 0.85. One third of the 141 genes are significantly over-expressed in the low SES group. CONCLUSION Lower SES has consistently been linked to many social and environmental conditions acting as stressors and known to be correlated with vulnerability to chronic illnesses (e.g. asthma, diabetes) associated with a chronic inflammatory state. Our unbiased analysis of the blood transcriptome in African-Americans revealed evidence of a robust molecular signature of increased inflammation associated with low SES. The results provide a plausible link between the social factors and chronic inflammation.
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Affiliation(s)
- Amadou Gaye
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States of America
- * E-mail:
| | - Gary H. Gibbons
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States of America
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States of America
| | - Charles Barry
- Brown University, Providence, RI, United States of America
| | - Rakale Quarells
- Community Health and Preventive Medicine, Cardiovascular Research Institute Morehouse School of Medicine, Atlanta, GA, United States of America
| | - Sharon K. Davis
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States of America
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Prescott SL, Logan AC. Each meal matters in the exposome: Biological and community considerations in fast-food-socioeconomic associations. ECONOMICS AND HUMAN BIOLOGY 2017; 27:328-335. [PMID: 29107462 DOI: 10.1016/j.ehb.2017.09.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 09/23/2017] [Accepted: 09/25/2017] [Indexed: 06/07/2023]
Abstract
Advances in omics and microbiome technology have transformed the ways in which the biological consequences of life in the 'ecological theatre' can be visualized. Exposome science examines the total accumulated environmental exposures (both detrimental and beneficial) as a means to understand the response of the 'total organism to the total environment' over time. The repetitive stimulation of compensatory physiological responses (immune, cardiovascular, neuroendocrine) in response to stress - including sources of stress highly relevant to socioeconomic disadvantage - may lead to metabolic dysregulation and cellular damage, ultimately influencing behavior and disease. The collective toll of physiological wear and tear, known as allostatic load, is not paid equally throughout developed societies. It is paid in excess by the disadvantaged. In the context of fast-food, human and experimental research demonstrates that the biological response to a single fast-food-style meal - especially as mediated by the microbiome- is a product of the person's total lived experience, including the ability to buffer the fast-food meal-induced promotion of inflammation and oxidative stress. Emerging research indicates that each meal and its nutritional context matters. As we discuss, equal weekly visits to major fast-food outlets by the affluent and deprived do not translate into biological equivalency. Hence, debate concerning reducing fast-food outlets through policy - especially in disadvantaged neighborhoods where they are prevalent - requires a biological context. The fast-food establishment and fast-food meal - as they represent matters of food justice and press upon non-communicable disease risk - are far more than physical structures and collections of carbohydrate, fat, sugar and sodium.
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Affiliation(s)
- Susan L Prescott
- School of Medicine, University of Western Australia, PO Box D184, Princess Margaret Hospital, Perth, WA, 6001, Australia; International Inflammation (in-FLAME) Network, Research Group of the Worldwide Universities Network (WUN), 6010 Park Ave, Suite #4081, West New York, NJ, 07093, United States.
| | - Alan C Logan
- International Inflammation (in-FLAME) Network, Research Group of the Worldwide Universities Network (WUN), 6010 Park Ave, Suite #4081, West New York, NJ, 07093, United States
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Abstract
BACKGROUND Environmental and lifestyle changes, in addition to the ageing of populations, are generally believed to account for the rapid global increase in type 2 diabetes prevalence and incidence in recent decades. DISCUSSION In this review, we present a comprehensive overview of factors contributing to diabetes risk, including aspects of diet quality and quantity, little physical activity, increased monitor viewing time or sitting in general, exposure to noise or fine dust, short or disturbed sleep, smoking, stress and depression, and a low socioeconomic status. In general, these factors promote an increase in body mass index. Since loss of β-cell function is the ultimate cause of developing overt type 2 diabetes, environmental and lifestyle changes must have resulted in a higher risk of β-cell damage in those at genetic risk. Multiple mechanistic pathways may come into play. CONCLUSIONS Strategies of diabetes prevention should aim at promoting a 'diabetes-protective lifestyle' whilst simultaneously enhancing the resistance of the human organism to pro-diabetic environmental and lifestyle factors. More research on diabetes-protective mechanisms seems warranted.
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Kolb H, Martin S. Environmental/lifestyle factors in the pathogenesis and prevention of type 2 diabetes. BMC Med 2017; 15:131. [PMID: 28720102 PMCID: PMC5516328 DOI: 10.1186/s12916-017-0901-x] [Citation(s) in RCA: 363] [Impact Index Per Article: 51.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 06/23/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Environmental and lifestyle changes, in addition to the ageing of populations, are generally believed to account for the rapid global increase in type 2 diabetes prevalence and incidence in recent decades. DISCUSSION In this review, we present a comprehensive overview of factors contributing to diabetes risk, including aspects of diet quality and quantity, little physical activity, increased monitor viewing time or sitting in general, exposure to noise or fine dust, short or disturbed sleep, smoking, stress and depression, and a low socioeconomic status. In general, these factors promote an increase in body mass index. Since loss of β-cell function is the ultimate cause of developing overt type 2 diabetes, environmental and lifestyle changes must have resulted in a higher risk of β-cell damage in those at genetic risk. Multiple mechanistic pathways may come into play. CONCLUSIONS Strategies of diabetes prevention should aim at promoting a 'diabetes-protective lifestyle' whilst simultaneously enhancing the resistance of the human organism to pro-diabetic environmental and lifestyle factors. More research on diabetes-protective mechanisms seems warranted.
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Affiliation(s)
- Hubert Kolb
- Faculty of Medicine, University of Duesseldorf, Duesseldorf, Germany. .,West-German Centre of Diabetes and Health, Duesseldorf Catholic Hospital Group, Hohensandweg 37, 40591, Duesseldorf, Germany.
| | - Stephan Martin
- Faculty of Medicine, University of Duesseldorf, Duesseldorf, Germany.,West-German Centre of Diabetes and Health, Duesseldorf Catholic Hospital Group, Hohensandweg 37, 40591, Duesseldorf, Germany
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Davillas A, Benzeval M, Kumari M. Socio-economic inequalities in C-reactive protein and fibrinogen across the adult age span: Findings from Understanding Society. Sci Rep 2017; 7:2641. [PMID: 28572594 PMCID: PMC5454021 DOI: 10.1038/s41598-017-02888-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 04/19/2017] [Indexed: 12/16/2022] Open
Abstract
Systemic inflammation has been proposed as a physiological process linking socio-economic position (SEP) to health. We examined how SEP inequalities in inflammation -assessed using C-reactive protein (CRP) and fibrinogen- varied across the adult age span. Current (household income) and distal (education) markers of SEP were used. Data from 7,943 participants (aged 25+) of Understanding Society (wave 2, 1/2010-3/2012) were employed. We found that SEP inequalities in inflammation followed heterogeneous patterns by age, which differed by the inflammatory marker examined rather than by SEP measures. SEP inequalities in CRP emerged in 30s, increased up to mid-50s or early 60 s when they peaked and then decreased with age. SEP inequalities in fibrinogen decreased with age. Body mass index (BMI), smoking, physical activity and healthy diet explained part, but not all, of the SEP inequalities in inflammation; in general, BMI exerted the largest attenuation. Cumulative advantage theories and those considering age as a leveler for the accumulation of health and economic advantages across the life-span should be dynamically integrated to better understand the observed heterogeneity in SEP differences in health across the lifespan. The attenuating roles of health-related lifestyle indicators suggest that targeting health promotion policies may help reduce SEP inequalities in health.
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Affiliation(s)
- Apostolos Davillas
- Institute for Social and Economic Research (ISER), University of Essex, Colchester, UK.
| | - Michaela Benzeval
- Institute for Social and Economic Research (ISER), University of Essex, Colchester, UK
| | - Meena Kumari
- Institute for Social and Economic Research (ISER), University of Essex, Colchester, UK
- Department of Epidemiology and Public Health, University College London, London, UK
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Korkmaz FT, Kerr DE. Genome-wide methylation analysis reveals differentially methylated loci that are associated with an age-dependent increase in bovine fibroblast response to LPS. BMC Genomics 2017; 18:405. [PMID: 28545453 PMCID: PMC5445414 DOI: 10.1186/s12864-017-3796-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 05/16/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Differences in DNA methylation are known to contribute to the development of immune-related disorders in humans but relatively little is known about how methylation regulates immune function in cattle. Utilizing whole-transcriptome analyses of bovine dermal fibroblasts, we have previously identified an age and breed-dependent up-regulation of genes within the toll-like receptor 4 (TLR4) pathway that correlates with enhanced fibroblast production of IL-8 in response to lipopolysaccharide (LPS). Age-dependent differences in IL-8 production are abolished by treatment with 5-aza-2-deoxycytidine and Trichostatin A (AZA-TSA), suggesting epigenetic regulation of the innate response to LPS. In the current study, we performed reduced representation bisulfite sequencing (RRBS) on fibroblast cultures isolated from the same animals at 5- and 16-months of age to identify genes that exhibit variable methylation with age. To validate the role of methylation in gene expression, six innate response genes that were hyper-methylated in young animals were assessed by RT-qPCR in fibroblasts from animals at different ages and from different breeds. RESULTS We identified 14,094 differentially methylated CpGs (DMCs) that differed between fibroblast cultures at 5- versus 16-months of age. Of the 5065 DMCs that fell within gene regions, 1117 were located within promoters, 1057 were within gene exons and 2891 were within gene introns and 67% were more methylated in young cultures. Transcription factor enrichment of the promoter regions hyper-methylated in young cultures revealed significant regulation by the key pro-inflammatory regulator, NF-κB. Additionally, five out of six chosen genes (PIK3R1, FES, NFATC1, TNFSF13 and RORA) that were more methylated in young cultures showed a significant reduction in expression post-LPS treatment in comparison with older cultures. Two of these genes, FES and NFATC1, were similarly down-regulated in Angus cultures that also exhibit a low LPS response phenotype. CONCLUSIONS Our study has identified immune-related loci regulated by DNA methylation in cattle that may contribute to differential cellular response to LPS, two of which exhibit an identical expression profile in both low-responding age and breed phenotypes. Methylation biomarkers of differential immunity may prove useful in developing selection strategies for replacement cows that are less susceptible to severe infections, such as coliform mastitis.
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Affiliation(s)
- Filiz T Korkmaz
- Cellular, Molecular and Biomedical Sciences Program, University of Vermont, 89 Beaumont Avenue, C141C Given, Burlington, VT, 05405, USA. .,Department of Animal and Veterinary Sciences, University of Vermont, 570 Main Street, 213 Terrill Hall, Burlington, VT, 05405, USA.
| | - David E Kerr
- Cellular, Molecular and Biomedical Sciences Program, University of Vermont, 89 Beaumont Avenue, C141C Given, Burlington, VT, 05405, USA.,Department of Animal and Veterinary Sciences, University of Vermont, 570 Main Street, 213 Terrill Hall, Burlington, VT, 05405, USA
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Derks IPM, Koster A, Schram MT, Stehouwer CDA, Dagnelie PC, Groffen DAI, Bosma H. The association of early life socioeconomic conditions with prediabetes and type 2 diabetes: results from the Maastricht study. Int J Equity Health 2017; 16:61. [PMID: 28381297 PMCID: PMC5382485 DOI: 10.1186/s12939-017-0553-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 03/20/2017] [Indexed: 02/06/2023] Open
Abstract
Background Using cross-sectional data from The Maastricht Study, we examined the association of socioeconomic conditions in early life with prediabetes and T2DM in adulthood. We also examined potential mediating pathways via both adulthood socioeconomic conditions and adult BMI and health behaviours. Methods Of the 3263 participants (aged 40–75 years), 493 had prediabetes and 906 were diagnosed with T2DM. By using logistic regression analyses, the associations and possible mediating pathways were examined. Results Participants with low early life socioeconomic conditions had a 1.56 times higher odds of prediabetes (95% confidence interval (CI) = 1.21-2.02) and a 1.61 times higher odds of T2DM (95% CI = 1.31-1.99). The relation between low early life socioeconomic conditions and prediabetes was independent of current socioeconomic conditions (OR = 1.38, 95% CI = 1.05-1.80), whereas the relation with T2DM was not independent of current socioeconomic conditions (OR = 1.10, 95% CI = 0.87-1.37). BMI party mediated the association between early life socioeconomic conditions and prediabetes. Conclusions Socioeconomic inequalities starting in early life were associated with diabetes-related outcomes in adulthood and suggest the usefulness of early life interventions aimed at tackling these inequalities. Electronic supplementary material The online version of this article (doi:10.1186/s12939-017-0553-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ivonne P M Derks
- Department of Social Medicine, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.,CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.,The Generation R Study Group, Erasmus Medical Centre, Rotterdam, The Netherlands.,Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands
| | - Annemarie Koster
- Department of Social Medicine, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.,CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Miranda T Schram
- Department of Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands.,Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Coen D A Stehouwer
- Department of Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands.,Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Pieter C Dagnelie
- CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.,Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands.,Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
| | - Danielle A I Groffen
- Department of Social Medicine, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.,CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Hans Bosma
- Department of Social Medicine, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands. .,CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
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