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Sørensen DSD, Krogh J, Rasmussen ÅK, Andreassen M. Variation in serum adrenal hormones in female 21-hydroxylase deficient patients. Endocr Connect 2022; 11:EC-22-0143. [PMID: 35904224 PMCID: PMC9254284 DOI: 10.1530/ec-22-0143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 05/27/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND There is no consensus regarding markers of optimal treatment or timing between glucocorticoid intake and assessment of hormone levels in the follow-up of female 21-hydroxylase deficient patients. OBJECTIVE To examine visit-to-visit repeatability in levels of adrenal hormones in adult female patients, to identify predictors of repeatability in hormone levels and to examine concordance between levels of different adrenal hormones. METHOD All patients with confirmed 21-hydroxylase deficiency treated with glucocorticoids, were included. The two most recent blood samples collected on a stable dose of glucocorticoid replacement were compared. Complete concordance was defined as all measured adrenal hormones either within, below or above normal range evaluated in a single-day measurement. RESULTS Sixty-two patients, median age of 35 (range 18-74) years were included. All hormone levels showed moderate to excellent repeatability with an intraclass correlation coefficient between 0.80 and 0.99. Repeatability of hormone levels was not affected by the use of long-acting glucocorticoids or time of day for blood sample collection. The median difference in time between the two sample collections was 1.5 (range 0-7.5) h. Complete concordance between 17-hydroxyprogesterone, androstenedione, and testosterone was found in 21% of cases. CONCLUSION During everyday, clinical practice hormone levels in adult female patients with 21-hydroxylase deficiency showed a moderate to excellent repeatability, despite considerable variation in time of day for blood sample collection. We found no major predictors of hormone level variation. Future studies are needed to address the relationship between the timing of glucocorticoid intake vs adrenal hormone levels and clinical outcome in both adults and children.
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Affiliation(s)
- Ditte Sofie Dahl Sørensen
- Department of Endocrinology and Metabolism, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jesper Krogh
- Department of Endocrinology and Metabolism, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Åse Krogh Rasmussen
- Department of Endocrinology and Metabolism, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Mikkel Andreassen
- Department of Endocrinology and Metabolism, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Correspondence should be addressed to M Andreassen:
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2
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Bender AM, Sørensen J, Diderichsen F, Brønnum-Hansen H. A health inequality impact assessment from reduction in overweight and obesity. BMC Public Health 2020; 20:1823. [PMID: 33256647 PMCID: PMC7706236 DOI: 10.1186/s12889-020-09831-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 11/04/2020] [Indexed: 11/12/2022] Open
Abstract
Background In recent years, social differences in overweight and obesity (OWOB) have become more pronounced. Health impact assessments provide population-level scenario evaluations of changes in disease prevalence and risk factors. The objective of this study was to simulate the health effects of reducing the prevalence of overweight and obesity in populations with short and medium education. Methods The DYNAMO-HIA tool was used to conduct a health inequality impact assessment of the future reduced disease prevalence (ischemic heart disease (IHD), diabetes, stroke, and multi-morbidity) and changes in life expectancy for the 2040-population of Copenhagen, Denmark (n = 742,130). We simulated an equalized weight scenario where the prevalence of OWOB in the population with short and medium education was reduced to the levels of the population with long education. Results A higher proportion of the population with short and medium education were OWOB relative to the population with long education. They also had a higher prevalence of cardiometabolic diseases. In the equalized weight scenario, the prevalence of diabetes in the population with short education was reduced by 8–10% for men and 12–13% for women. Life expectancy increased by one year among women with short education. Only small changes in prevalence and life expectancy related to stroke and IHD were observed. Conclusion Reducing the prevalence of OWOB in populations with short and medium education will reduce the future prevalence of cardiometabolic diseases, increase life expectancy, and reduce the social inequality in health. These simulations serve as reference points for public health debates. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-020-09831-x.
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Affiliation(s)
- Anne Mette Bender
- Department of Public Health, University of Copenhagen, Faculty of Health Sciences, Section of Social Medicine, CSS, Øster Farimagsgade 5, Postbox 2099, DK-1014, Copenhagen K, Denmark.
| | - Jan Sørensen
- Danish Centre for Health Economics (DaCHE), University of Southern Denmark, Odense, Denmark.,Healthcare Outcome Research Centre (HORC), Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Finn Diderichsen
- Department of Public Health, University of Copenhagen, Faculty of Health Sciences, Section of Social Medicine, CSS, Øster Farimagsgade 5, Postbox 2099, DK-1014, Copenhagen K, Denmark
| | - Henrik Brønnum-Hansen
- Department of Public Health, University of Copenhagen, Faculty of Health Sciences, Section of Social Medicine, CSS, Øster Farimagsgade 5, Postbox 2099, DK-1014, Copenhagen K, Denmark
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3
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Mayne DJ, Morgan GG, Jalaludin BB, Bauman AE. Area-Level Walkability and the Geographic Distribution of High Body Mass in Sydney, Australia: A Spatial Analysis Using the 45 and Up Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16040664. [PMID: 30813499 PMCID: PMC6406292 DOI: 10.3390/ijerph16040664] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 02/07/2019] [Accepted: 02/19/2019] [Indexed: 12/12/2022]
Abstract
Improving the walkability of built environments to promote healthy lifestyles and reduce high body mass is increasingly considered in regional development plans. Walkability indexes have the potential to inform, benchmark and monitor these plans if they are associated with variation in body mass outcomes at spatial scales used for health and urban planning. We assessed relationships between area-level walkability and prevalence and geographic variation in overweight and obesity using an Australian population-based cohort comprising 92,157 Sydney respondents to the 45 and Up Study baseline survey between January 2006 and April 2009. Individual-level data on overweight and obesity were aggregated to 2006 Australian postal areas and analysed as a function of area-level Sydney Walkability Index quartiles using conditional auto regression spatial models adjusted for demographic, social, economic, health and socioeconomic factors. Both overweight and obesity were highly clustered with higher-than-expected prevalence concentrated in the urban sprawl region of western Sydney, and lower-than-expected prevalence in central and eastern Sydney. In fully adjusted spatial models, prevalence of overweight and obesity was 6% and 11% lower in medium-high versus low, and 10% and 15% lower in high versus low walkability postcodes, respectively. Postal area walkability explained approximately 20% and 9% of the excess spatial variation in overweight and obesity that remained after accounting for other individual- and area-level factors. These findings provide support for the potential of area-level walkability indexes to inform, benchmark and monitor regional plans aimed at targeted approaches to reducing population-levels of high body mass through environmental interventions. Future research should consider potential confounding due to neighbourhood self-selection on area-level walkability relations.
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Affiliation(s)
- Darren J Mayne
- The University of Sydney, School of Public Health, Sydney, NSW 2006, Australia.
- Illawarra Shoalhaven Local Health District, Public Health Unit, Warrawong, NSW 2502, Australia.
- University of Wollongong, School of Medicine, Wollongong, NSW 2522, Australia.
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW 2522, Australia.
| | - Geoffrey G Morgan
- The University of Sydney, School of Public Health, Sydney, NSW 2006, Australia.
- The University of Sydney, University Centre for Rural Health, Rural Clinical School-Northern Rivers, Sydney, NSW 2006, Australia.
| | - Bin B Jalaludin
- Ingham Institute, University of New South Wales, Sydney, NSW 2052, Australia.
- Epidemiology, Healthy People and Places Unit, Population Health, South Western Sydney Local Health District, Liverpool, NSW 1871, Australia.
| | - Adrian E Bauman
- The University of Sydney, School of Public Health, Sydney, NSW 2006, Australia.
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4
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Eliasen M, Jørgensen T, Schröder A, Dantoft TM, Fink P, Poulsen CH, Johansen NB, Eplov LF, Skovbjerg S, Kreiner S. Somatic symptom profiles in the general population: a latent class analysis in a Danish population-based health survey. Clin Epidemiol 2017; 9:421-433. [PMID: 28883742 PMCID: PMC5574686 DOI: 10.2147/clep.s137167] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Purpose The aim of this study was to identify and describe somatic symptom profiles in the general adult population in order to enable further epidemiological research within multiple somatic symptoms. Methods Information on 19 self-reported common somatic symptoms was achieved from a population-based questionnaire survey of 36,163 randomly selected adults in the Capital Region of Denmark (55.4% women). The participants stated whether they had been considerably bothered by each symptom within 14 days prior to answering the questionnaire. We used latent class analysis to identify the somatic symptom profiles. The profiles were further described by their association with age, sex, chronic disease, and self-perceived health. Results We identified 10 different somatic symptom profiles defined by number, type, and site of the symptoms. The majority of the population (74.0%) had a profile characterized by no considerable bothering symptoms, while a minor group of 3.9% had profiles defined by a high risk of multiple somatic symptoms. The remaining profiles were more likely to be characterized by a few specific symptoms. The profiles could further be described by their associations with age, sex, chronic disease, and self-perceived health. Conclusion The identified somatic symptom profiles could be distinguished by number, type, and site of the symptoms. The profiles have the potential to be used in further epidemiological studies on risk factors and prognosis of somatic symptoms but should be confirmed in other population-based studies with specific focus on symptom burden.
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Affiliation(s)
- Marie Eliasen
- Research Centre for Prevention and Health, Centre for Health, The Capital Region of Denmark, Glostrup
| | - Torben Jørgensen
- Research Centre for Prevention and Health, Centre for Health, The Capital Region of Denmark, Glostrup.,Department of Public Health, University of Copenhagen, Copenhagen.,Department of Clinical Medicine, Aalborg University, Aalborg
| | - Andreas Schröder
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus C
| | - Thomas Meinertz Dantoft
- Research Centre for Prevention and Health, Centre for Health, The Capital Region of Denmark, Glostrup
| | - Per Fink
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus C
| | - Chalotte Heinsvig Poulsen
- Research Centre for Prevention and Health, Centre for Health, The Capital Region of Denmark, Glostrup.,Mental Health Centre Copenhagen, The Capital Region of Denmark, Hellerup, Denmark
| | - Nanna Borup Johansen
- Research Centre for Prevention and Health, Centre for Health, The Capital Region of Denmark, Glostrup
| | - Lene Falgaard Eplov
- Mental Health Centre Copenhagen, The Capital Region of Denmark, Hellerup, Denmark
| | - Sine Skovbjerg
- Research Centre for Prevention and Health, Centre for Health, The Capital Region of Denmark, Glostrup
| | - Svend Kreiner
- Department of Public Health, University of Copenhagen, Copenhagen
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5
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Svensson S, Eek F, Christiansen L, Wisén A. The effect of different exercise intensities on health related quality of life in people classified as obese. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2017. [DOI: 10.1080/21679169.2017.1296021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Frida Eek
- Physiotherapy Research Group, Department of Health Sciences, Lund University, Lund, Sweden
| | | | - Anita Wisén
- Physiotherapy Research Group, Department of Health Sciences, Lund University, Lund, Sweden
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Spangmose AL, Malchau SS, Schmidt L, Vassard D, Rasmussen S, Loft A, Forman J, Pinborg A. Academic performance in adolescents born after ART-a nationwide registry-based cohort study. Hum Reprod 2017; 32:447-456. [PMID: 28057876 DOI: 10.1093/humrep/dew334] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 11/21/2016] [Accepted: 12/07/2016] [Indexed: 01/19/2023] Open
Abstract
STUDY QUESTION Is academic performance in adolescents aged 15-16 years and conceived after ART, measured as test scores in ninth grade, comparable to that for spontaneously conceived (SC) adolescents? SUMMARY ANSWER ART singletons had a significantly lower mean test score in the adjusted analysis when compared with SC singletons, yet the differences were small and probably not of clinical relevance. WHAT IS KNOWN ALREADY Previous studies have shown similar intelligence quotient (IQ) levels in ART and SC children, but only a few have been on adolescents. Academic performance measured with standardized national tests has not previously been explored in a complete national cohort of adolescents conceived after ART. STUDY DESIGN, SIZE, DURATION A Danish national registry-based cohort including all 4766 ART adolescents (n = 2836 singletons and n = 1930 twins) born in 1995-1998 were compared with two SC control cohorts: a randomly selected singleton population (n = 5660) and all twins (n = 7064) born from 1995 to 1998 in Denmark. Nine children who died during the follow-up period were excluded from the study. PARTICIPANTS/MATERIALS, SETTING, METHODS Mean test scores on a 7-point-marking scale from -3 to 12 were compared, and adjustments were made for relevant reproductive and socio-demographic covariates including occupational and educational level of the parents. MAIN RESULTS AND THE ROLE OF CHANCE The crude mean test score was higher in both ART singletons and ART twins compared with SC adolescents. The crude mean differences were +0.41 (95% CI 0.30-0.53) and +0.45 (95% CI 0.28-0.62) between ART and SC singletons and between ART and SC twins, respectively. However, the adjusted mean overall test score was significantly lower for ART singletons compared with SC singletons (adjusted mean difference -0.15 (95% CI -0.29-(-0.02))). For comparison, the adjusted mean difference was +2.05 (95% CI 1.82-2.28) between the highest and the lowest parental educational level, suggesting that the effect of ART is weak compared with the conventional predictors. The adjusted analyses showed significantly lower mean test scores in mathematics and physics/chemistry for ART singletons compared with SC singletons. Comparing ART twins with SC twins yielded no difference in academic performance in the adjusted analyses. Similar crude and adjusted overall mean test scores were found when comparing ART singletons and ART twins. LIMITATIONS, REASONS FOR CAUTION Missing data on educational test scores occurred in 6.6% of adolescents aged 15-16 years for the birth cohorts 1995-1997, where all of the children according to their age should have passed the ninth grade exam at the time of data retrieval. As sensitivity analyses yielded no significant difference in the adjusted risk of having missing test scores between any of the groups, it is unlikely that this should bias our results. Adjustment for body mass index and smoking during pregnancy was not possible. WIDER IMPLICATIONS OF THE FINDINGS As our results are based on national data, our findings can be applied to other populations. The findings of this paper suggest that a possible small negative effect of parental subfertility or ART treatment is counterbalanced by the higher educational level in the ART parents. STUDY FUNDING/COMPETING INTERESTS The Danish Medical Association in Copenhagen (KMS) funded this study with a scholarship grant. None of the authors had any competing interests. TRIAL REGISTRATION NO STATISTICS DENMARK 704676.
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Affiliation(s)
- A L Spangmose
- Department of Obstetrics and Gynaecology, Fertility Clinic, Copenhagen University Hospital, Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Copenhagen, Denmark
| | - S S Malchau
- Department of Obstetrics and Gynaecology, Fertility Clinic, Copenhagen University Hospital, Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Copenhagen, Denmark
| | - L Schmidt
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - D Vassard
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - S Rasmussen
- Department of Obstetrics and Gynaecology, Fertility Clinic, Copenhagen University Hospital, Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Copenhagen, Denmark
| | - A Loft
- Fertility Clinic Section 4071, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - J Forman
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - A Pinborg
- Department of Obstetrics and Gynaecology, Fertility Clinic, Copenhagen University Hospital, Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Copenhagen, Denmark
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Parlesak A, Tetens I, Dejgård Jensen J, Smed S, Gabrijelčič Blenkuš M, Rayner M, Darmon N, Robertson A. Use of Linear Programming to Develop Cost-Minimized Nutritionally Adequate Health Promoting Food Baskets. PLoS One 2016; 11:e0163411. [PMID: 27760131 PMCID: PMC5070943 DOI: 10.1371/journal.pone.0163411] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 09/08/2016] [Indexed: 11/19/2022] Open
Abstract
Background Food-Based Dietary Guidelines (FBDGs) are developed to promote healthier eating patterns, but increasing food prices may make healthy eating less affordable. The aim of this study was to design a range of cost-minimized nutritionally adequate health-promoting food baskets (FBs) that help prevent both micronutrient inadequacy and diet-related non-communicable diseases at lowest cost. Methods Average prices for 312 foods were collected within the Greater Copenhagen area. The cost and nutrient content of five different cost-minimized FBs for a family of four were calculated per day using linear programming. The FBs were defined using five different constraints: cultural acceptability (CA), or dietary guidelines (DG), or nutrient recommendations (N), or cultural acceptability and nutrient recommendations (CAN), or dietary guidelines and nutrient recommendations (DGN). The variety and number of foods in each of the resulting five baskets was increased through limiting the relative share of individual foods. Results The one-day version of N contained only 12 foods at the minimum cost of DKK 27 (€ 3.6). The CA, DG, and DGN were about twice of this and the CAN cost ~DKK 81 (€ 10.8). The baskets with the greater variety of foods contained from 70 (CAN) to 134 (DGN) foods and cost between DKK 60 (€ 8.1, N) and DKK 125 (€ 16.8, DGN). Ensuring that the food baskets cover both dietary guidelines and nutrient recommendations doubled the cost while cultural acceptability (CAN) tripled it. Conclusion Use of linear programming facilitates the generation of low-cost food baskets that are nutritionally adequate, health promoting, and culturally acceptable.
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Affiliation(s)
- Alexandr Parlesak
- WHO Collaborating Centre for Global Nutrition and Health, Metropolitan University College, Copenhagen, Denmark
- * E-mail:
| | - Inge Tetens
- National Food Institute, Technical University of Denmark, Research Group for Risk-Benefit, Søborg, Denmark
| | - Jørgen Dejgård Jensen
- Department of Food and Resource Economics, Section for Consumption, Bioethics and Governance, Copenhagen University, Copenhagen, Denmark
| | - Sinne Smed
- Department of Food and Resource Economics, Section for Consumption, Bioethics and Governance, Copenhagen University, Copenhagen, Denmark
| | - Mojca Gabrijelčič Blenkuš
- Nacionalni inštitut za javno zdravje—NIJZ (National Institute of Public Health), Ljubljana, Slovenia
| | - Mike Rayner
- Nuffield Department of Population Health, British Heart Foundation Centre on Population Approaches for Non-Communicable Disease Prevention, Oxford University, Oxford, United Kingdom
| | - Nicole Darmon
- The Institut National de la Recherche Agronomique 1260 INRA, the Institut National de la Santé et de la Recherche Médicale 1062 INSERM, Aix-Marseille University, Unité Mixte de Recherche (UMR) “Nutrition, Obesity and Risk of Thrombosis”, Marseille, France
| | - Aileen Robertson
- WHO Collaborating Centre for Global Nutrition and Health, Metropolitan University College, Copenhagen, Denmark
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Eliasen M, Kreiner S, Ebstrup JF, Poulsen CH, Lau CJ, Skovbjerg S, Fink PK, Jørgensen T. Somatic Symptoms: Prevalence, Co-Occurrence and Associations with Self-Perceived Health and Limitations Due To Physical Health - A Danish Population-Based Study. PLoS One 2016; 11:e0150664. [PMID: 26930630 PMCID: PMC4773248 DOI: 10.1371/journal.pone.0150664] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 02/16/2016] [Indexed: 01/17/2023] Open
Abstract
A high number of somatic symptoms have been associated with poor health status and increased health care use. Previous studies focused on number of symptoms without considering the specific symptoms. The aim of the study was to investigate 1) the prevalence of 19 somatic symptoms, 2) the associations between the symptoms, and 3) the associations between the somatic symptoms, self-perceived health and limitations due to physical health accounting for the co-occurrence of symptoms. Information on 19 somatic symptoms, self-perceived health and limitations due to physical health was achieved from a population-based questionnaire survey of 36,163 randomly selected adults in the Capital Region of Denmark in 2006/07. Chain graph models were used to transparently identify and describe the associations between symptoms, self-perceived health and limitations due to physical health. In total, 94.9% of the respondents were bothered by one or more of the 19 somatic symptoms. The symptoms were associated in a complex structure. Still, recognisable patterns were identified within organ systems/body parts. When accounting for symptom co-occurrence; dizziness, pain in legs, respiratory distress and tiredness were all strongly directly associated with both of the outcomes (γ>0.30). Chest pain was strongly associated with self-perceived health, and other musculoskeletal symptoms and urinary retention were strongly associated with limitations due to physical health. Other symptoms were either moderate or not statistically associated with the health status outcomes. Opposite, almost all the symptoms were strongly associated with the two outcomes when not accounting for symptom co-occurrence. In conclusion, we found that somatic symptoms were frequent and associated in a complex structure. The associations between symptoms and health status measures differed between the symptoms and depended on the co-occurrence of symptoms. This indicates an importance of considering both the specific symptoms and symptom co-occurrence in further symptom research instead of merely counting symptoms.
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Affiliation(s)
- Marie Eliasen
- Research Centre for Prevention and Health, The Capital Region of Denmark, Glostrup, Denmark
- * E-mail:
| | - Svend Kreiner
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jeanette F. Ebstrup
- Research Centre for Prevention and Health, The Capital Region of Denmark, Glostrup, Denmark
| | - Chalotte H. Poulsen
- Research Centre for Prevention and Health, The Capital Region of Denmark, Glostrup, Denmark
- Mental Health Centre Copenhagen, The Capital Region of Denmark, Gentofte, Denmark
| | - Cathrine J. Lau
- Research Centre for Prevention and Health, The Capital Region of Denmark, Glostrup, Denmark
| | - Sine Skovbjerg
- Research Centre for Prevention and Health, The Capital Region of Denmark, Glostrup, Denmark
| | - Per K. Fink
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
| | - Torben Jørgensen
- Research Centre for Prevention and Health, The Capital Region of Denmark, Glostrup, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Pottegård A, Clark P, Friis S, Hallas J, Lund L. Long-term Use of Statins and Risk of Renal Cell Carcinoma: A Population-based Case-Control Study. Eur Urol 2015; 69:877-82. [PMID: 26603781 DOI: 10.1016/j.eururo.2015.10.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 10/06/2015] [Indexed: 01/18/2023]
Abstract
BACKGROUND Use of statins has been suggested to protect against renal cell carcinoma (RCC); however, studies have typically been underpowered, and the results are conflicting. OBJECTIVE To determine whether the use of statins is associated with a reduced risk of RCC using high-quality registry data. DESIGN, SETTING, AND PARTICIPANTS We conducted a nationwide case-control study based on all histologically verified cases of RCC in Denmark between 2002 and 2012 (n=4606) matched 1:10 to cancer-free controls. Data on drug use, comorbidity, and educational level were obtained from Danish nationwide prescription, patient, and demographic registries. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Odds ratios (ORs) and 95% confidence intervals (CIs) for RCC associated with long-term use (≥5 yr) of statins were estimated using conditional logistic regression, adjusting for potential confounders. RESULTS AND LIMITATIONS The adjusted OR for RCC associated with long-term use of statins was 1.06 (95% CI, 0.91-1.23). Analyses stratified by duration of statin use, type of statin, and patient characteristics all yielded ORs close to unity, except for a slightly increased OR for RCC associated with long-term statin use among women (OR: 1.25; 95% CI, 0.96-1.62). The main limitation of our study was lack of information on lifestyle factors, notably obesity, which may have biased the risk estimates upward. CONCLUSIONS Our study does not support an important chemopreventive effect of long-term statin use against RCC. The marginally increased and statistically insignificant risk estimates can readily be interpreted as a null finding, considering the lack of control for obesity and other lifestyle risk factors. PATIENT SUMMARY Previous studies have shown that the use of cholesterol-lowering drugs (statins) may protect against renal cancer. In a large study including all Danish renal cancers during an 11-yr period, we found no evidence of such an effect.
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Affiliation(s)
- Anton Pottegård
- Clinical Pharmacology, Department of Public Health, University of Southern Denmark, Odense C, Denmark.
| | - Peter Clark
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA; Clinical Institute, University of Southern Denmark, Odense C, Denmark
| | - Søren Friis
- Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen Ø, Denmark
| | - Jesper Hallas
- Clinical Pharmacology, Department of Public Health, University of Southern Denmark, Odense C, Denmark
| | - Lars Lund
- Clinical Institute, University of Southern Denmark, Odense C, Denmark; Department of Urology, Odense University Hospital, Odense C, Denmark
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