1
|
Lendt C, Hettiarachchi P, Johansson PJ, Duncan S, Lund Rasmussen C, Narayanan A, Stewart T. Assessing the Accuracy of Activity Classification Using Thigh-Worn Accelerometry: A Validation Study of ActiPASS in School-Aged Children. J Phys Act Health 2024:1-8. [PMID: 39159934 DOI: 10.1123/jpah.2024-0259] [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: 04/10/2024] [Revised: 06/14/2024] [Accepted: 06/29/2024] [Indexed: 08/21/2024]
Abstract
BACKGROUND The ActiPASS software was developed from the open-source Acti4 activity classification algorithm for thigh-worn accelerometry. However, the original algorithm has not been validated in children or compared with a child-specific set of algorithm thresholds. This study aims to evaluate the accuracy of ActiPASS in classifying activity types in children using 2 published sets of Acti4 thresholds. METHODS Laboratory and free-living data from 2 previous studies were used. The laboratory condition included 41 school-aged children (11.0 [4.8] y; 46.5% male), and the free-living condition included 15 children (10.0 [2.6] y; 66.6% male). Participants wore a single accelerometer on the dominant thigh, and annotated video recordings were used as a reference. Postures and activity types were classified with ActiPASS using the original adult thresholds and a child-specific set of thresholds. RESULTS Using the original adult thresholds, the mean balanced accuracy (95% CI) for the laboratory condition ranged from 0.62 (0.56-0.67) for lying to 0.97 (0.94-0.99) for running. For the free-living condition, accuracy ranged from 0.61 (0.48-0.75) for lying to 0.96 (0.92-0.99) for cycling. Mean balanced accuracy for overall sedentary behavior (sitting and lying) was ≥0.97 (0.95-0.99) across all thresholds and conditions. No meaningful differences were found between the 2 sets of thresholds, except for superior balanced accuracy of the adult thresholds for walking under laboratory conditions. CONCLUSIONS The results indicate that ActiPASS can accurately classify different basic types of physical activity and sedentary behavior in children using thigh-worn accelerometer data.
Collapse
Affiliation(s)
- Claas Lendt
- Human Potential Centre, School of Sport and Recreation, Auckland University of Technology, Auckland, New Zealand
- Institute for Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
| | - Pasan Hettiarachchi
- Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Peter J Johansson
- Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden
| | - Scott Duncan
- Human Potential Centre, School of Sport and Recreation, Auckland University of Technology, Auckland, New Zealand
| | | | - Anantha Narayanan
- Human Potential Centre, School of Sport and Recreation, Auckland University of Technology, Auckland, New Zealand
| | - Tom Stewart
- Human Potential Centre, School of Sport and Recreation, Auckland University of Technology, Auckland, New Zealand
| |
Collapse
|
2
|
Vinueza Veloz MF, Bhatta L, Jones PR, Tesli M, Smith GD, Davies NM, Brumpton BM, Næss ØE. Educational attainment and mental health conditions: a within-sibship Mendelian randomization study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.08.10.24311789. [PMID: 39148847 PMCID: PMC11326327 DOI: 10.1101/2024.08.10.24311789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
Importance Observational studies have demonstrated consistent protective effects of higher educational attainment (EA) on the risk of suffering mental health conditions (MHC). Determining whether these beneficial effects are causal is challenging given the potential role of dynastic effects and demographic factors (assortative mating and population structure) in this association. Objective To evaluate to what extent the relationship between EA and various MHC is independent from dynastic effects and demographic factors. Design Within-sibship Mendelian randomization (MR) study. Setting One-sample MR analyses included participants' data from the Trøndelag Health Study (HUNT, Norway) and UK Biobank (United Kingdom). For two-sample MR analyses we used summary statistics from publicly available genome-wide-association-studies. Participants 61 880 siblings (27 507 sibships). Exposure Years of education. Main outcomes Scores for symptoms of anxiety, depression and neuroticism using the Hospital Anxiety Depression Scale (HADS), the 7-item Generalized Anxiety Disorder Scale (GAD-7), the 9-item Patient Health Questionnaire (PHQ-9), and the Eysenck Personality Questionnaire, as well as self-reported consumption of psychotropic medication. Results One standard deviation (SD) unit increase in years of education was associated with a lower symptom score of anxiety (-0.20 SD [95%CI: -0.26, -0.14]), depression (-0.11 SD [-0.43, 0.22]), neuroticism (-0.30 SD [-0.53, -0.06]), and lower odds of psychotropic medication consumption (OR: 0.60 [0.52, 0.69]). Estimates from the within-sibship MR analyses showed some attenuation, which however were suggestive of a causal association (anxiety: -0.17 SD [-0.33, -0.00]; depression: -0.18 SD [-1.26, 0.89]; neuroticism: -0.29 SD [-0.43, -0.15]); psychotropic medication consumption: OR, 0.52 [0.34, 0.82]). Conclusions and Relevance Associations between EA and MHC in adulthood, although to some extend explained by dynastic effects and demographic factors, overall remain robust, indicative of a causal effect. However, larger studies are warranted to improve statistical power and further validate our conclusions. Key points Question: Are the protective effects of higher educational attainment on the risk of suffering mental health conditions independent from familial (i.e.,dynastic effects) and demographic factors (i.e., assortative mating and population structure)?Findings: Although to some extend explained by familial and demographic factors, overall the protective effects of higher educational attainment remain robust.Meaning: Our findings are consistent with those of previous observational studies, which suggests that higher educational attainment may causally reduce the risk of suffering a mental health condition.
Collapse
|
3
|
Livingston G, Huntley J, Liu KY, Costafreda SG, Selbæk G, Alladi S, Ames D, Banerjee S, Burns A, Brayne C, Fox NC, Ferri CP, Gitlin LN, Howard R, Kales HC, Kivimäki M, Larson EB, Nakasujja N, Rockwood K, Samus Q, Shirai K, Singh-Manoux A, Schneider LS, Walsh S, Yao Y, Sommerlad A, Mukadam N. Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. Lancet 2024; 404:572-628. [PMID: 39096926 DOI: 10.1016/s0140-6736(24)01296-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 04/08/2024] [Accepted: 06/16/2024] [Indexed: 08/05/2024]
Affiliation(s)
- Gill Livingston
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK.
| | - Jonathan Huntley
- Department of Clinical and Biomedical Sciences, University of Exeter, Exeter, UK
| | - Kathy Y Liu
- Division of Psychiatry, University College London, London, UK
| | - Sergi G Costafreda
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Geriatric Department, Oslo University Hospital, Oslo, Norway
| | - Suvarna Alladi
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - David Ames
- National Ageing Research Institute, Melbourne, VIC, Australia; University of Melbourne Academic Unit for Psychiatry of Old Age, Melbourne, VIC, Australia
| | - Sube Banerjee
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | | | - Carol Brayne
- Cambridge Public Health, University of Cambridge, Cambridge, UK
| | - Nick C Fox
- The Dementia Research Centre, Department of Neurodegenerative Disease, University College London, London, UK
| | - Cleusa P Ferri
- Health Technology Assessment Unit, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil; Department of Psychiatry, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Laura N Gitlin
- College of Nursing and Health Professions, AgeWell Collaboratory, Drexel University, Philadelphia, PA, USA
| | - Robert Howard
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Helen C Kales
- Department of Psychiatry and Behavioral Sciences, UC Davis School of Medicine, University of California, Sacramento, CA, USA
| | - Mika Kivimäki
- Division of Psychiatry, University College London, London, UK; Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Eric B Larson
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Noeline Nakasujja
- Department of Psychiatry College of Health Sciences, Makerere University College of Health Sciences, Makerere University, Kampala City, Uganda
| | - Kenneth Rockwood
- Centre for the Health Care of Elderly People, Geriatric Medicine, Dalhousie University, Halifax, NS, Canada
| | - Quincy Samus
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Bayview, Johns Hopkins University, Baltimore, MD, USA
| | - Kokoro Shirai
- Graduate School of Social and Environmental Medicine, Osaka University, Osaka, Japan
| | - Archana Singh-Manoux
- Division of Psychiatry, University College London, London, UK; Université Paris Cité, Inserm U1153, Paris, France
| | - Lon S Schneider
- Department of Psychiatry and the Behavioural Sciences and Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Sebastian Walsh
- Cambridge Public Health, University of Cambridge, Cambridge, UK
| | - Yao Yao
- China Center for Health Development Studies, School of Public Health, Peking University, Beijing, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China
| | - Andrew Sommerlad
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Naaheed Mukadam
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| |
Collapse
|
4
|
Austin TR, Nethander M, Fink HA, Törnqvist AE, Jalal DI, Buzkova P, Barzilay JI, Carbone L, Gabrielsen ME, Grahnemo L, Lu T, Hveem K, Jonasson C, Kizer JR, Langhammer A, Mukamal KJ, Gerszten RE, Psaty BM, Robbins JA, Sun YV, Skogholt AH, Kanis JA, Johansson H, Åsvold BO, Valderrabano RJ, Zheng J, Richards JB, Coward E, Ohlsson C. A plasma protein-based risk score to predict hip fractures. NATURE AGING 2024; 4:1064-1075. [PMID: 38802582 PMCID: PMC11333168 DOI: 10.1038/s43587-024-00639-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 05/01/2024] [Indexed: 05/29/2024]
Abstract
As there are effective treatments to reduce hip fractures, identification of patients at high risk of hip fracture is important to inform efficient intervention strategies. To obtain a new tool for hip fracture prediction, we developed a protein-based risk score in the Cardiovascular Health Study using an aptamer-based proteomic platform. The proteomic risk score predicted incident hip fractures and improved hip fracture discrimination in two Trøndelag Health Study validation cohorts using the same aptamer-based platform. When transferred to an antibody-based proteomic platform in a UK Biobank validation cohort, the proteomic risk score was strongly associated with hip fractures (hazard ratio per s.d. increase, 1.64; 95% confidence interval 1.53-1.77). The proteomic risk score, but not available polygenic risk scores for fractures or bone mineral density, improved the C-index beyond the fracture risk assessment tool (FRAX), which integrates information from clinical risk factors (C-index, FRAX 0.735 versus FRAX + proteomic risk score 0.776). The developed proteomic risk score constitutes a new tool for stratifying patients according to hip fracture risk; however, its improvement in hip fracture discrimination is modest and its clinical utility beyond FRAX with information on femoral neck bone mineral density remains to be determined.
Collapse
Grants
- U01HL130114 U.S. Department of Health & Human Services | NIH | National Heart, Lung, and Blood Institute (NHLBI)
- U01 HL080295 NHLBI NIH HHS
- U01 HL130114 NHLBI NIH HHS
- HHSN268200800007C NHLBI NIH HHS
- R01HL144483 U.S. Department of Health & Human Services | NIH | National Heart, Lung, and Blood Institute (NHLBI)
- U01HL080295 U.S. Department of Health & Human Services | NIH | National Heart, Lung, and Blood Institute (NHLBI)
- N01HC85086 NHLBI NIH HHS
- KAW 2015.0317 Knut och Alice Wallenbergs Stiftelse (Knut and Alice Wallenberg Foundation)
- LU2021-0096 IngaBritt och Arne Lundbergs Forskningsstiftelse (Ingabritt and Arne Lundberg Research Foundation)
- N01HC85083 NHLBI NIH HHS
- 2020-01392 Vetenskapsrådet (Swedish Research Council)
- N01HC85080 NHLBI NIH HHS
- N01HC85081 NHLBI NIH HHS
- HHSN268201200036C NHLBI NIH HHS
- R01 HL144483 NHLBI NIH HHS
- HHSN268201800001C NHLBI NIH HHS
- 75N92021D00006 NHLBI NIH HHS
- N01HC85082 NHLBI NIH HHS
- N01HC85079 NHLBI NIH HHS
- R01 AG023629 NIA NIH HHS
- the Swedish state under the agreement between the Swedish government and the county councils, the ALF-agreement (ALFGBG-720331 and ALFGBG-965235)
- U.S. Department of Health & Human Services | NIH | National Heart, Lung, and Blood Institute (NHLBI)
- U.S. Department of Health & Human Services | U.S. Department of Health and Human Services, Administration for Community Living | National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR)
Collapse
Affiliation(s)
- Thomas R Austin
- Cardiovascular Health Research Unit, University of Washington, Seattle, WA, US
| | - Maria Nethander
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Osteoporosis Centre, Centre for Bone and Arthritis Research at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Bioinformatics and Data Center, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Howard A Fink
- Geriatric Research Education and Clinical Center, VA Health Care System, Minneapolis, MN, US
- Department of Medicine, University of Minnesota, Minneapolis, MN, US
| | - Anna E Törnqvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Osteoporosis Centre, Centre for Bone and Arthritis Research at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Diana I Jalal
- Division of Nephrology, Department of Internal Medicine, Carver College of Medicine, Iowa City, IA, US
- Iowa City VA Medical Center, Iowa City, IA, US
| | - Petra Buzkova
- Department of Biostatistics, University of Washington, Seattle, WA, US
| | - Joshua I Barzilay
- Division of Endocrinology, Kaiser Permanente of Georgia, Atlanta, GA, US
| | - Laura Carbone
- Charlie Norwood VAMC, Augusta, GA, US
- Division of Rheumatology, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA, US
| | - Maiken E Gabrielsen
- HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Louise Grahnemo
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Osteoporosis Centre, Centre for Bone and Arthritis Research at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Tianyuan Lu
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
- Quantitative Life Sciences Program, McGill University, Montreal, Quebec, Canada
- 5 Prime Sciences Inc, Montreal, Quebec, Canada
| | - Kristian Hveem
- HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- HUNT Research Centre, NTNU, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Christian Jonasson
- HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jorge R Kizer
- Cardiology Section, San Francisco VA Health Care System, San Francisco, CA, US
- Department of Medicine, Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, US
| | - Arnulf Langhammer
- HUNT Research Centre, NTNU, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Kenneth J Mukamal
- Department of Medicine, Beth Israel Deaconess Medical Center, Brookline, MA, US
| | - Robert E Gerszten
- Department of Medicine, Beth Israel Deaconess Medical Center, Brookline, MA, US
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, University of Washington, Seattle, WA, US
- Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle, WA, US
| | - John A Robbins
- Department of Medicine, University of California, Davis, CA, US
| | - Yan V Sun
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, US
| | - Anne Heidi Skogholt
- HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - John A Kanis
- Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, UK
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Helena Johansson
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Osteoporosis Centre, Centre for Bone and Arthritis Research at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Bjørn Olav Åsvold
- HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Endocrinology, Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Rodrigo J Valderrabano
- Research Program in Men's Health, Aging and Metabolism, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, US
| | - Jie Zheng
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Shanghai Digital Medicine Innovation Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- MRC Integrative Epidemiology Unit (IEU), Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, UK
| | - J Brent Richards
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
- Quantitative Life Sciences Program, McGill University, Montreal, Quebec, Canada
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Department of Twin Research, King's College London, London, UK
| | - Eivind Coward
- HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Claes Ohlsson
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Osteoporosis Centre, Centre for Bone and Arthritis Research at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Region Västra Götaland, Sahlgrenska University Hospital, Department of Drug Treatment, Gothenburg, Sweden.
| |
Collapse
|
5
|
Hopkins J, McVeigh JA, Hill KD, Burton E. Physical Activity Levels and Sedentary Behavior of People Living With Mild Cognitive Impairment: A Cross-Sectional Study Using Thigh-Worn Accelerometers. J Aging Phys Act 2024; 32:520-530. [PMID: 38684211 DOI: 10.1123/japa.2023-0176] [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: 05/15/2023] [Revised: 11/29/2023] [Accepted: 02/17/2024] [Indexed: 05/02/2024]
Abstract
Community-dwelling people with Mild Cognitive Impairment self-reporting not to be meeting recommended physical activity levels participated in this study to (a) determine compliance of wearing (thigh-worn) accelerometers, (b) describe physical activity levels and sedentary behavior, and (c) determine the validity of the Physical Activity Scale for the Elderly (PASE) compared with activPAL accelerometers. A total of 79 people had valid accelerometer data (median [interquartile range]: age, 71 [54-75] years). Compliance was 86.81%. Participants were sedentary for 10.6 hr per day and engaged in a median of 9 min per day of moderate-intensity physical activity. Fair correlations were found between the PASE and total stepping time per day (r = .35, p < .01), total number of steps per day (r = .36, p < .01), and number of steps in stepping activities completed for ≤1 min (r = .42, p < .01). The PASE and Standing time (r = .04, p = .724) and PASE and Sitting time (r = .04, p = .699) had little to no relationship. The use of thigh-worn accelerometers for this population is achievable. People with Mild Cognitive Impairment have high levels of sedentary behavior and minimal engagement in moderate-intensity physical activity. The PASE has fair, positive criterion validity with activity-based outcomes measured by activPAL accelerometers but not with sedentary behavior, which is high for this population.
Collapse
Affiliation(s)
- Jane Hopkins
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia
| | - Joanne A McVeigh
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia
- Movement Physiology Laboratory, School of Physiology, University of Witwatersrand, Johannesburg, South Africa
- enAble Institute, Curtin University, Perth, WA, Australia
| | - Keith D Hill
- Rehabilitation, Ageing and Independent Living (RAIL) Research Center, Monash University, Frankston, VIC, Australia
- National Center for Healthy Ageing, Monash University and Peninsula Health, Frankston, VIC, Australia
| | - Elissa Burton
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia
- enAble Institute, Curtin University, Perth, WA, Australia
| |
Collapse
|
6
|
Lerfald M, Allore H, Nilsen TIL, Eldholm RS, Martinez-Velilla N, Selbæk G, Ernstsen L. Longitudinal Patterns of Systolic Blood Pressure, Diastolic Blood Pressure, Cardiorespiratory Fitness, and Their Association With Dementia Risk: The HUNT Study. J Gerontol A Biol Sci Med Sci 2024; 79:glae161. [PMID: 38894618 PMCID: PMC11266981 DOI: 10.1093/gerona/glae161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND High blood pressure and poor cardiorespiratory fitness are independent risk factors for dementia. However, few studies have examined if combined longitudinal patterns of these modifiable risk factors are associated with dementia risk. METHODS In this prospective cohort study, we used data from the population-based Trøndelag Health (HUNT) Study, Norway. We applied group-based multidimensional trajectory modeling to identify age-specific multidimensional trajectories of SBP, DBP, and estimated cardiorespiratory fitness across 3 surveys (HUNT1, 1984-1986 to HUNT3, 2006-2008). Dementia was diagnosed in the HUNT4 70+ substudy in 2017-2019. We used multivariate logistic regression to estimate odds ratios (ORs) and risk differences (RDs) of dementia. RESULTS In total, 7 594 participants (54.9% women) were included, with a mean age of 44.7 (SD 6.3) years at HUNT1. Dementia was diagnosed in 1 062 (14.0%) participants. We identified 2 multidimensional trajectories throughout adulthood within 3 age groups: one with higher systolic blood pressure (SBP) and diastolic blood pressure (DBP), and lower estimated cardiorespiratory fitness (the poorer group), and one with lower SBP and DBP, and higher cardiorespiratory fitness (the better group). After adjustment for sex, apolipoprotein E ε4 status, education, marital status, and diabetes, the better group had consistently lower risk of dementia in all age groups with the lowest OR in the middle-aged group of 0.63 (95% confidence intervals [95% CI]: 0.51, 0.78) with corresponding RD of -0.07 (95% CI: -0.10, -0.04). CONCLUSIONS Having a beneficial multidimensional trajectory of SBP, DBP, and cardiorespiratory fitness in adulthood was associated with reduced dementia risk. Aiming for optimal SBP, DBP, and estimated cardiorespiratory fitness throughout adulthood may reduce dementia risk.
Collapse
Affiliation(s)
- Maren Lerfald
- Faculty of Medicine and Health Science, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Heather Allore
- Department of Internal Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut, USA
- Department of Biostatistics, Yale School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Tom I L Nilsen
- Faculty of Medicine and Health Science, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Anaesthesia and Intensive Care, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Rannveig S Eldholm
- Department of Geriatrics, Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Faculty of Medicine and Health Science, Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Geir Selbæk
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Oslo, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Linda Ernstsen
- Faculty of Medicine and Health Science, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| |
Collapse
|
7
|
Lendt C, Braun T, Biallas B, Froböse I, Johansson PJ. Thigh-worn accelerometry: a comparative study of two no-code classification methods for identifying physical activity types. Int J Behav Nutr Phys Act 2024; 21:77. [PMID: 39020353 PMCID: PMC11253440 DOI: 10.1186/s12966-024-01627-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 07/05/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND The more accurate we can assess human physical behaviour in free-living conditions the better we can understand its relationship with health and wellbeing. Thigh-worn accelerometry can be used to identify basic activity types as well as different postures with high accuracy. User-friendly software without the need for specialized programming may support the adoption of this method. This study aims to evaluate the classification accuracy of two novel no-code classification methods, namely SENS motion and ActiPASS. METHODS A sample of 38 healthy adults (30.8 ± 9.6 years; 53% female) wore the SENS motion accelerometer (12.5 Hz; ±4 g) on their thigh during various physical activities. Participants completed standardized activities with varying intensities in the laboratory. Activities included walking, running, cycling, sitting, standing, and lying down. Subsequently, participants performed unrestricted free-living activities outside of the laboratory while being video-recorded with a chest-mounted camera. Videos were annotated using a predefined labelling scheme and annotations served as a reference for the free-living condition. Classification output from the SENS motion software and ActiPASS software was compared to reference labels. RESULTS A total of 63.6 h of activity data were analysed. We observed a high level of agreement between the two classification algorithms and their respective references in both conditions. In the free-living condition, Cohen's kappa coefficients were 0.86 for SENS and 0.92 for ActiPASS. The mean balanced accuracy ranged from 0.81 (cycling) to 0.99 (running) for SENS and from 0.92 (walking) to 0.99 (sedentary) for ActiPASS across all activity types. CONCLUSIONS The study shows that two available no-code classification methods can be used to accurately identify basic physical activity types and postures. Our results highlight the accuracy of both methods based on relatively low sampling frequency data. The classification methods showed differences in performance, with lower sensitivity observed in free-living cycling (SENS) and slow treadmill walking (ActiPASS). Both methods use different sets of activity classes with varying definitions, which may explain the observed differences. Our results support the use of the SENS motion system and both no-code classification methods.
Collapse
Affiliation(s)
- Claas Lendt
- Institute for Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany.
| | - Theresa Braun
- Institute for Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
| | - Bianca Biallas
- Institute for Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
| | - Ingo Froböse
- Institute for Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
| | - Peter J Johansson
- Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
| |
Collapse
|
8
|
Ustad A, Sverdrup K, Tangen GG, Døhl Ø, Vereijken B, Thingstad P, Skjæret-Maroni N. Daily physical activity in older adults across levels of care: the HUNT Trondheim 70 + study. Eur Rev Aging Phys Act 2024; 21:20. [PMID: 39014310 PMCID: PMC11253329 DOI: 10.1186/s11556-024-00355-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 07/06/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND Physical activity (PA) is imperative for healthy ageing and is a modifiable lifestyle factor. Accurate, clinically meaningful estimates of daily PA among older adults can inform targeted interventions to maintain function and independence. This study describes daily PA in older adults across levels of care as a first step contributing to the limited evidence on potential associations between PA and the use of care services. METHODS This study used data from the Trondheim 70 + cohort in the population-based Norwegian HUNT Study. In total, 1042 participants aged 70 years or older with valid activity data were included. PA was assessed using two accelerometers over 7 consecutive days and was classified into PA (walking, standing, running, and cycling) and sedentary behavior (sitting and lying). Data on received care services were retrieved from municipal registers and participants were classified into four levels of care: 1) independently living (81.9%), 2) independently living with low-level home care services (6.5%), 3) recipients of home care services (6.0%), and 4) nursing home residents (5.7%). Time spent in the activity types and duration of bouts are presented across levels of care. RESULTS Participants mean age was 77.5 years (range: 70.1-105.4, 55% female) and PA was lower with higher age. Across levels of care, significant group differences were found in the total time spent in PA, particularly in walking and standing. Daily PA, duration of active bouts, and number of daily walking bouts were lower for participants receiving higher levels of care. Standing was the dominant type of PA and walking appeared predominantly in short bouts at all care levels. CONCLUSIONS This is the first population-based study using device-measured PA to describe daily PA across levels of care. The results showed that low-intensity activities constitute the primary component of everyday PA, advocating for placing greater emphasis on the significant role these activities play in maintaining daily PA at older age. Furthermore, the study demonstrated that activity types and bout durations are related to the ability to live independently among older adults. Overall, these findings can contribute to better target interventions to maintain function and independence in older adults.
Collapse
Affiliation(s)
- Astrid Ustad
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Edvard Griegs Gate 8, 7030, Trondheim, Norway.
| | - Karen Sverdrup
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Oslo, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Gro Gujord Tangen
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Oslo, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
- Oslo Metropolitan University, Oslo, Norway
| | - Øystein Døhl
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Edvard Griegs Gate 8, 7030, Trondheim, Norway
- Department of Finance, Trondheim Municipality, Trondheim, Norway
| | - Beatrix Vereijken
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Edvard Griegs Gate 8, 7030, Trondheim, Norway
| | - Pernille Thingstad
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Edvard Griegs Gate 8, 7030, Trondheim, Norway
- Department of Health and Welfare, Trondheim Municipality, Trondheim, Norway
| | - Nina Skjæret-Maroni
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Edvard Griegs Gate 8, 7030, Trondheim, Norway
| |
Collapse
|
9
|
Kuś A, Sterenborg RBTM, Haug EB, Galesloot TE, Visser WE, Smit JWA, Bednarczuk T, Peeters RP, Åsvold BO, Teumer A, Medici M. Towards Personalized TSH Reference Ranges: A Genetic and Population-Based Approach in Three Independent Cohorts. Thyroid 2024. [PMID: 38919119 DOI: 10.1089/thy.2024.0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
Background: Serum thyroid-stimulating hormone (TSH) measurement is the diagnostic cornerstone for primary thyroid dysfunction. There is high inter-individual but limited intra-individual variation in TSH concentrations, largely due to genetic factors. The currently used wide population-based reference intervals may lead to inappropriate management decisions. Methods: A polygenic score (PGS) including 59 genetic variants was used to calculate genetically determined TSH reference ranges in a thyroid disease-free cohort (n = 6,834). Its effect on reclassification of diagnoses was investigated when compared to using population-based reference ranges. Next, results were validated in a second independent population-based thyroid disease-free cohort (n = 3,800). Potential clinical implications were assessed in a third independent population-based cohort including individuals without thyroid disease (n = 26,321) as well as individuals on levothyroxine (LT4) treatment (n = 1,132). Results: PGS was a much stronger predictor of individual TSH concentrations than FT4 (total variance in TSH concentrations explained 9.2-11.1% vs. 2.4-2.7%, respectively) or any other nongenetic factor (total variance in TSH concentrations explained 0.2-1.8%). Genetically determined TSH reference ranges differed significantly between PGS quartiles in all cohorts, while the differences in FT4 concentrations were absent or only minor. Up to 24.7-30.1% of individuals, previously classified as having subclinical hypo- and hyperthyroidism when using population-based TSH reference ranges, were reclassified as euthyroid when genetically determined TSH reference ranges were applied. Individuals in the higher PGS quartiles had a higher probability of being prescribed LT4 treatment compared to individuals from the lower PGS quartiles (3.3% in Q1 vs. 5.2% in Q4, Pfor trend =1.7 × 10-8). Conclusions: Individual genetic profiles have the potential to personalize TSH reference ranges, with large effects on reclassification of diagnosis and LT4 prescriptions. As the currently used PGS can only predict approximately 10% of inter-individual variation in TSH concentrations, it should be further improved when more genetic variants determining TSH concentrations are identified in future studies.
Collapse
Affiliation(s)
- Aleksander Kuś
- Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Warsaw, Poland
| | - Rosalie B T M Sterenborg
- Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Eirin B Haug
- Department of Public Health and Nursing, HUNT Center for Molecular and Clinical Epidemiology, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Tessel E Galesloot
- Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - W Edward Visser
- Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Johannes W A Smit
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Tomasz Bednarczuk
- Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Warsaw, Poland
| | - Robin P Peeters
- Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Bjørn O Åsvold
- Department of Public Health and Nursing, HUNT Center for Molecular and Clinical Epidemiology, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Endocrinology, Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Public Health and Nursing, HUNT Research Centre, NTNU, Norwegian University of Science and Technology, Levanger, Norway
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Bialystok, Poland
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Marco Medici
- Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| |
Collapse
|
10
|
Monti R, Eick L, Hudjashov G, Läll K, Kanoni S, Wolford BN, Wingfield B, Pain O, Wharrie S, Jermy B, McMahon A, Hartonen T, Heyne H, Mars N, Lambert S, Hveem K, Inouye M, van Heel DA, Mägi R, Marttinen P, Ripatti S, Ganna A, Lippert C. Evaluation of polygenic scoring methods in five biobanks shows larger variation between biobanks than methods and finds benefits of ensemble learning. Am J Hum Genet 2024; 111:1431-1447. [PMID: 38908374 PMCID: PMC11267524 DOI: 10.1016/j.ajhg.2024.06.003] [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: 11/20/2023] [Revised: 05/31/2024] [Accepted: 06/05/2024] [Indexed: 06/24/2024] Open
Abstract
Methods of estimating polygenic scores (PGSs) from genome-wide association studies are increasingly utilized. However, independent method evaluation is lacking, and method comparisons are often limited. Here, we evaluate polygenic scores derived via seven methods in five biobank studies (totaling about 1.2 million participants) across 16 diseases and quantitative traits, building on a reference-standardized framework. We conducted meta-analyses to quantify the effects of method choice, hyperparameter tuning, method ensembling, and the target biobank on PGS performance. We found that no single method consistently outperformed all others. PGS effect sizes were more variable between biobanks than between methods within biobanks when methods were well tuned. Differences between methods were largest for the two investigated autoimmune diseases, seropositive rheumatoid arthritis and type 1 diabetes. For most methods, cross-validation was more reliable for tuning hyperparameters than automatic tuning (without the use of target data). For a given target phenotype, elastic net models combining PGS across methods (ensemble PGS) tuned in the UK Biobank provided consistent, high, and cross-biobank transferable performance, increasing PGS effect sizes (β coefficients) by a median of 5.0% relative to LDpred2 and MegaPRS (the two best-performing single methods when tuned with cross-validation). Our interactively browsable online-results and open-source workflow prspipe provide a rich resource and reference for the analysis of polygenic scoring methods across biobanks.
Collapse
Affiliation(s)
- Remo Monti
- Hasso Plattner Institute, University of Potsdam, Digital Engineering Faculty, Potsdam, Germany; Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Berlin Institute for Medical Systems Biology, Berlin, Germany
| | - Lisa Eick
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Georgi Hudjashov
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Kristi Läll
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Stavroula Kanoni
- William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Brooke N Wolford
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Benjamin Wingfield
- European Molecular Biology Laboratory, European Bioinformatics Institute, Wellcome Genome Campus, Hinxton, Cambridge, UK
| | - Oliver Pain
- Maurice Wohl Clinical Neuroscience Institute, Department of Basic and Clinical Neuroscience; Institute of Psychiatry, Psychology and Neuroscience; King's College London, London, UK
| | - Sophie Wharrie
- Aalto University, Department of Computer Science, Espoo, Finland
| | - Bradley Jermy
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Aoife McMahon
- European Molecular Biology Laboratory, European Bioinformatics Institute, Wellcome Genome Campus, Hinxton, Cambridge, UK
| | - Tuomo Hartonen
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Henrike Heyne
- Hasso Plattner Institute, University of Potsdam, Digital Engineering Faculty, Potsdam, Germany
| | - Nina Mars
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland; Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA; Stanley Center for Psychiatric Research and Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Samuel Lambert
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway; Cambridge Baker Systems Genomics Initiative, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia; British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK; British Heart Foundation Cambridge Centre of Research Excellence, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Kristian Hveem
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health, Norwegian University of Science and Technology, Trondheim, Norway; Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Michael Inouye
- Cambridge Baker Systems Genomics Initiative, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK; Cambridge Baker Systems Genomics Initiative, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia; British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK; Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK; British Heart Foundation Cambridge Centre of Research Excellence, School of Clinical Medicine, University of Cambridge, Cambridge, UK; Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK
| | | | - Reedik Mägi
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Pekka Marttinen
- Aalto University, Department of Computer Science, Espoo, Finland
| | - Samuli Ripatti
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland; Department of Public Health, University of Helsinki, Helsinki, Finland; Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Andrea Ganna
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland; Massachusetts General Hospital and Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Christoph Lippert
- Hasso Plattner Institute, University of Potsdam, Digital Engineering Faculty, Potsdam, Germany; Windreich Department of Artificial Intelligence and Human Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| |
Collapse
|
11
|
Lukina P, Andersen IL, Klaasen RA, Warren DJ, Bolstad N, Mjønes P, Rønne E, Iversen R, Sollid LM, Lundin KEA, Ness-Jensen E. The Prevalence and Rate of Undiagnosed Celiac Disease in an Adult General Population, the Trøndelag Health Study, Norway. Clin Gastroenterol Hepatol 2024:S1542-3565(24)00602-5. [PMID: 38987013 DOI: 10.1016/j.cgh.2024.06.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 06/06/2024] [Accepted: 06/10/2024] [Indexed: 07/12/2024]
Abstract
BACKGROUND & AIMS This study aimed to determine the total prevalence of celiac disease (CeD), including undiagnosed cases, in a population-based study of adults screened for CeD. METHODS The study used the fourth Trøndelag Health Study (HUNT4), conducted in 2017-2019, where 56,042 adult (aged >20 years) residents of Nord-Trøndelag County, Norway, participated. Serum samples from 54,505 participants were analyzed for anti-transglutaminase 2 IgA and IgG. Seropositive individuals were invited for a clinical assessment, including upper endoscopy with duodenal biopsies. Previously diagnosed and seronegative CeD cases were identified through linkage to hospital records and the Norwegian Patient Registry. RESULTS The rate of CeD seropositivity was 2.0% (1107/54,505). Out of these, 724 individuals attended the clinical assessment. Additionally, the hospital records and registry identified individuals with a known CeD diagnosis, that were seronegative or without serology in HUNT4 or seropositive in HUNT4 but did not participate in the clinical assessment. In total, the study confirmed a new CeD diagnosis after participation in HUNT4 in 470 individuals and a known CeD diagnosis before participation in HUNT4 in 383 individuals. The total biopsy-confirmed prevalence of CeD was 1.5% (853/56,042), and the ratio of new, previously undiagnosed CeD cases (after HUNT4) to known, previously diagnosed CeD cases (before HUNT4) was 1.2:1 (470/383). CONCLUSIONS The total prevalence of CeD in this population-based study of adults in Norway was high and many individuals were previously undiagnosed. Detection of CeD should be improved, because early diagnosis is crucial for effective management and prevention of complications.
Collapse
Affiliation(s)
- Polina Lukina
- HUNT Research Centre, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Levanger, Norway; Department of Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway.
| | - Ina L Andersen
- HUNT Research Centre, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Levanger, Norway; Department of Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Rolf A Klaasen
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - David J Warren
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Nils Bolstad
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Patricia Mjønes
- Department of Clinical and Molecular Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway; Department of Pathology, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Elin Rønne
- Department of Pathology, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Rasmus Iversen
- Norwegian Coeliac Disease Research Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ludvig M Sollid
- Norwegian Coeliac Disease Research Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Immunology, Oslo University Hospital, Oslo, Norway
| | - Knut E A Lundin
- Norwegian Coeliac Disease Research Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Section for Gastroenterology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Eivind Ness-Jensen
- HUNT Research Centre, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Levanger, Norway; Department of Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway; Department of Molecular Medicine and Surgery, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
12
|
Chen Q, Berg B, Grotle M, Maher CG, Storheim K, Machado GC. Primary care seeking among adults with chronic neck and low back pain in Norway: A prospective study from the HUNT study linked to Norwegian primary healthcare registry. Eur J Pain 2024. [PMID: 38970150 DOI: 10.1002/ejp.2310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 06/15/2024] [Accepted: 06/19/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND To describe the frequency of primary care seeking for neck or back-related conditions among people with chronic neck and low back pain and to develop prediction models of primary care seeking and frequent visits. METHODS We included participants of the Trøndelag Health Study (HUNT4, 2017-19) in Norway who self-reported chronic neck and/or low back pain in the preceding year, and extracted data of primary care visits from the Norwegian primary healthcare registry. We investigated a total of 23 potential predictors and used multivariable logistic regression models to predict primary care seeking for neck or back-related conditions and frequent visits by healthcare provider (i.e., the highest quartile of number of visits). RESULTS Among the 15,352 HUNT4 participants with chronic neck and/or low back pain, 6231 participants (40.6%) sought primary care for neck or back-related conditions (median = 5 visits, IQR 2-15) within 2 years after the study. Participants who consulted physical therapists sought care the most frequently (median = 10 visits, IQR 3-26). Discrimination of the best-fit prediction model of primary care seeking and frequent visits by healthcare provider, assessed by C-statistic, ranged from 0.66-0.76. Participants who made frequent primary care visits in the preceding year were highly likely to continue frequent care seeking in the following 2 years. CONCLUSIONS Around 40% of people seek primary care for chronic neck and low back pain, and frequent care seeking may continue for years. Future studies should investigate strategies to reduce recurrent primary care visits, especially seeking physical therapist care, and promote self-management of chronic pain. SIGNIFICANCE People with chronic neck and low back pain who seek physical therapist care had the highest frequency of care seeking, underscoring the significant burden on healthcare systems. The high frequency of visits and associated healthcare expenditures highlight the critical need for effective and valuable primary care for chronic pain management. To mitigate recurrent visits and reduce costs, it is essential to provide patients with evidence-based treatments and self-management interventions.
Collapse
Affiliation(s)
- Qiuzhe Chen
- Sydney Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Bjørnar Berg
- Centre for Intelligent Musculoskeletal Health, Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
| | - Margreth Grotle
- Centre for Intelligent Musculoskeletal Health, Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
- Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
| | - Chris G Maher
- Sydney Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Kjersti Storheim
- Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Gustavo C Machado
- Sydney Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| |
Collapse
|
13
|
Morooka H, Haug EB, Malmo V, Loennechen JP, Mukamal KJ, Rich-Edwards J, Sen A, Janszky I, Horn J. Association of age at menarche, reproductive lifespan and age at menopause with the risk of atrial fibrillation: The HUNT study. Maturitas 2024; 185:107979. [PMID: 38552530 DOI: 10.1016/j.maturitas.2024.107979] [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: 12/14/2023] [Revised: 02/22/2024] [Accepted: 03/22/2024] [Indexed: 06/03/2024]
Abstract
BACKGROUND Age at menarche, reproductive lifespan, and age at menopause are associated with several cardiovascular diseases, but their relationship with atrial fibrillation (AF) is uncertain. METHODS We linked information on all women who participated in the third survey of the population-based, longitudinal HUNT study in Norway with medical records from all local hospitals. A total of 14,632 women aged 60 or more were followed for validated incident AF. We retrieved age at menarche and age at menopause from the HUNT questionnaires. Reproductive lifespan was defined as the difference between age at menarche and age at menopause. We used Cox proportional hazards regression models to assess associations between AF and age at menarche, reproductive lifespan, and age at menopause. RESULTS During a median follow-up of 8.17 years (136,494 person-years), 1217 (8.3 %) participants developed AF. In multivariable-adjusted analyses, we observed no associations between early or late age at menarche and AF (hazard ratios (HRs): <12 years: 0.85 [95 % confidence interval (CI), 0.65-1.12]; ≥16 years: 0.99 [95 % CI, 0.80-1.24] compared to those who attained menarche at 13-14 years). The HR for a reproductive lifespan shorter than 30 years was 0.91 [95 % CI, 0.72-1.15] compared to 34-37 years. Likewise, there was no clear association between premature or early age at menopause and AF (HRs: <40 years: 1.21 [95 % CI, 0.83-1.75]; 40-44 years: 0.97 [95 % CI, 0.77-1.22] compared to 50-54 years). CONCLUSIONS In this population of women aged 60 years and over, the risk of AF was not associated with age at menarche, reproductive lifespan, or age at menopause.
Collapse
Affiliation(s)
- Hikaru Morooka
- Department of Public Health and Nursing, Faculty of Medicine, Norwegian University of Science and Technology, Mauritz Hansens gate 2, 7030 Trondheim, Norway; Department of Obstetrics and Gynecology, Levanger Hospital, Nord-Trøndelag Hospital Trust, Kirkegata 2, 7600 Levanger, Norway.
| | - Eirin B Haug
- Department of Public Health and Nursing, Faculty of Medicine, Norwegian University of Science and Technology, Mauritz Hansens gate 2, 7030 Trondheim, Norway
| | - Vegard Malmo
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health, Norwegian University of Science and Technology, 7491 Trondheim, Norway; Clinic of Cardiology, St. Olavs University Hospital, Prinsesse Kristinas gate 3, 7030 Trondheim, Norway
| | - Jan Pål Loennechen
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health, Norwegian University of Science and Technology, 7491 Trondheim, Norway; Clinic of Cardiology, St. Olavs University Hospital, Prinsesse Kristinas gate 3, 7030 Trondheim, Norway
| | - Kenneth J Mukamal
- Department of Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA
| | - Janet Rich-Edwards
- Connors Center for Women's Health and Gender Biology, Division of Women's Health, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Abhijit Sen
- Department of Public Health and Nursing, Faculty of Medicine, Norwegian University of Science and Technology, Mauritz Hansens gate 2, 7030 Trondheim, Norway; Center for Oral Health Services and Research (TkMidt), Professor Brochs gt. 2, 7030 Trondheim, Norway
| | - Imre Janszky
- Department of Public Health and Nursing, Faculty of Medicine, Norwegian University of Science and Technology, Mauritz Hansens gate 2, 7030 Trondheim, Norway; Regional Center for Health Care Improvement, St. Olav's University Hospital, Prinsesse Kristinas gate 3, 7030 Trondheim, Norway; Department of Global Public Health, Karolinska Institutet, Norrbackagatan 4, 171 76 Stockholm, Sweden
| | - Julie Horn
- Department of Public Health and Nursing, Faculty of Medicine, Norwegian University of Science and Technology, Mauritz Hansens gate 2, 7030 Trondheim, Norway; Department of Obstetrics and Gynecology, Levanger Hospital, Nord-Trøndelag Hospital Trust, Kirkegata 2, 7600 Levanger, Norway
| |
Collapse
|
14
|
Morooka H, Haug EB, Malmo V, Loennechen JP, Mukamal KJ, Sen A, Janszky I, Horn J. Parity, infertility, age at first birth and risk of atrial fibrillation: data from the HUNT study. Eur J Prev Cardiol 2024:zwae215. [PMID: 38946335 DOI: 10.1093/eurjpc/zwae215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 05/30/2024] [Accepted: 06/22/2024] [Indexed: 07/02/2024]
Abstract
AIMS Although parity, infertility, and age at first birth are important for later development of cardiovascular disease, research on their association with atrial fibrillation (AF) is limited. METHODS We linked data from the population-based HUNT study, the Medical Birth Registry of Norway (MBRN) and validated medical records from local hospitals. A total of 24,015 women aged 45 years or older were followed for verified incident AF. Parity and age at first birth were retrieved from the MBRN or from self-reported questionnaires in the HUNT. History of infertility was self-reported on the HUNT questionnaire. Cox-proportional hazard models were used to calculate hazard ratios (HR) for the multivariable-adjusted associations of parity, infertility, and age at first birth with risk of AF. RESULTS During a median follow-up of 12.8 years, 1,448 (6.0%) participants developed AF. Women with higher parity (four or more births vs. two births) were at 21% higher risk of AF (HR 1.21, 95% confidence interval (CI), 1.05-1.39). History of infertility was also associated with risk of AF (HR 1.20, 95% CI, 1.02-1.42). Among parous women, younger age at first birth (<20 years vs. 20-29 years) was associated with a 20% higher risk of AF (HR 1.20, 95% CI, 1.03-1.40). CONCLUSION Women with four or more births, or a history of infertility, or younger age at first birth have approximately a 20% higher risk of AF among women over 45 years old.
Collapse
Affiliation(s)
- Hikaru Morooka
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Obstetrics and Gynecology, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Eirin B Haug
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Vegard Malmo
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Cardiology, St. Olavs University Hospital, Trondheim, Norway
| | - Jan Pål Loennechen
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Cardiology, St. Olavs University Hospital, Trondheim, Norway
| | - Kenneth J Mukamal
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, USA
| | - Abhijit Sen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Center for Oral Health Services and Research (TkMidt), Trondheim, Norway
| | - Imre Janszky
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Regional Center for Health Care Improvement, St. Olavs University Hospital, Trondheim, Norway
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Julie Horn
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Obstetrics and Gynecology, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| |
Collapse
|
15
|
Visnes ES, Hallan A, Bomme M, Holmberg D, Møller-Hansen J, Lagergren J, Ness-Jensen E. Prevalence and risk factors of gastro-oesophageal reflux symptoms among adolescents, the HUNT study. Scand J Gastroenterol 2024; 59:816-820. [PMID: 38756009 DOI: 10.1080/00365521.2024.2349646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 04/23/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Gastro-oesophageal reflux disease (GORD) is recognized by symptoms of heartburn and acid regurgitation. These gastro-oesophageal reflux symptoms (GORS) are common in adults, but data from adolescents are sparse. This study aimed to assess the prevalence and risk factors of GORS among adolescents in a large and unselected population. METHODS This study was based on the Trøndelag Health Study (HUNT), a longitudinal series of population-based health surveys conducted in Nord-Trøndelag County, Norway. This study included data from Young-HUNT4 performed in 2017-2019, where all inhabitants aged 13-19 years were invited and 8066 (76.0%) participated. The presence of GORS (any or frequent) during the past 12 months and tobacco smoking status were reported through self-administrated questionnaires, whereas body mass index (BMI) was objectively measured. RESULTS Among 7620 participating adolescents reporting on the presence of GORS, the prevalence of any GORS and frequent GORS was 33.2% (95% confidence interval [CI] 32.2 - 34.3%) and 3.6% (95% CI 3.2 - 4.0%), respectively. The risk of frequent GORS was lower among boys compared to girls (OR 0.61; 95% CI 0.46 - 0.79), higher in current smokers compared to never smokers (OR 1.80; 95% CI 1.10 - 2.93) and higher among obese compared to underweight/normal weight adolescents (OR 2.50; 95% CI 1.70 - 3.66). CONCLUSION A considerable proportion of adolescents had GORS in this population-based study, particularly girls, tobacco smokers, and individuals with obesity, but frequent GORS was relatively uncommon. Measures to avoid tobacco smoking and obesity in adolescents may prevent GORS.
Collapse
Affiliation(s)
- Ellen Sylvia Visnes
- Department of Public Health and Nursing, HUNT Research Centre, NTNU, Norwegian University of Science and Technology, Levanger, Norway
| | | | - Maria Bomme
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Medical Gastroenterology S, Odense University Hospital, Odense, Denmark
| | - Dag Holmberg
- Department of Molecular Medicine and Surgery, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Jane Møller-Hansen
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Medical Gastroenterology S, Odense University Hospital, Odense, Denmark
| | - Jesper Lagergren
- Department of Molecular Medicine and Surgery, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
- School of Cancer and Pharmaceutical Sciences, King's College London, UK
| | - Eivind Ness-Jensen
- Department of Public Health and Nursing, HUNT Research Centre, NTNU, Norwegian University of Science and Technology, Levanger, Norway
- Department of Molecular Medicine and Surgery, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
- Medical Department, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| |
Collapse
|
16
|
Glette M, Stiles TC, Woodhouse A, Nilsen TIL, Landmark T. Chronic fatigue in the general population: Prevalence, natural course and associations with chronic pain (the HUNT pain study). Eur J Pain 2024. [PMID: 38940382 DOI: 10.1002/ejp.2307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 06/10/2024] [Accepted: 06/12/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND Fatigue and pain are both prevalent and frequently co-occur. No standard measure of fatigue exists, but most definitions include a continuum between high levels of energy and fatigue. There is limited knowledge about the course of fatigue in the general population and its association with functioning and other health outcomes. Our main aim was to identify trajectories of energy and fatigue in the general population and to investigate whether chronic pain is related to a negative prognosis of chronic fatigue. METHODS Longitudinal latent class analysis was performed to classify 4771 individuals into trajectory groups based on five quarterly repeated measures. RESULTS A five-cluster solution was identified: 'much energy' (n = 1471, [31%]), 'varying energy' (n = 1445, [30%]), 'some energy' (n = 921, [19%]), 'low energy' [chronic moderate fatigue] (n = 852, [18%]) and 'no energy' [chronic severe fatigue] (n = 82, [2%]). Individuals with chronic moderate fatigue who reported chronic pain had reduced probability of improvement over the following 3 years (OR = 0.67, 95% CI [0.52, 0.88]). CONCLUSIONS Chronic fatigue is highly prevalent in the general population and a small proportion have chronic severe fatigue. When chronic pain co-occurs with chronic fatigue, improvement of chronic fatigue is less likely, indicating that these symptoms may perpetuate each other. SIGNIFICANCE STATEMENT Understanding the close relationship between chronic pain and chronic fatigue is important as they both contribute to suffering and loss of functioning, may be related to the same underlying diseases, or in the absence of disease, may share common mechanisms. This study highlights the important role of chronic pain in relation to chronic fatigue, both by showing a strong association between the prevalence of the two conditions, and by showing that chronic pain is associated with a negative prognosis of chronic fatigue.
Collapse
Affiliation(s)
- Mari Glette
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Anesthesiology and Intensive Care Medicine, St. Olav's University Hospital, Trondheim, Norway
| | - Tore Charles Stiles
- Department of Psychology, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Astrid Woodhouse
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Anesthesiology and Intensive Care Medicine, St. Olav's University Hospital, Trondheim, Norway
| | - Tom Ivar Lund Nilsen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Tormod Landmark
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Anesthesiology and Intensive Care Medicine, St. Olav's University Hospital, Trondheim, Norway
| |
Collapse
|
17
|
Jiang L, Sun YQ, Denos M, Brumpton BM, Chen Y, Malmo V, Sanderson E, Mai XM. Serum vitamin D, blood pressure and hypertension risk in the HUNT study using observational and Mendelian randomization approaches. Sci Rep 2024; 14:14312. [PMID: 38906907 PMCID: PMC11192928 DOI: 10.1038/s41598-024-64649-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 06/11/2024] [Indexed: 06/23/2024] Open
Abstract
Limited studies have triangulated the relationship between serum 25-hydroxyvitamin D [25(OH)D] levels and systolic blood pressure (SBP), diastolic blood pressure (DBP) or hypertension risk utilizing both observational and Mendelian randomization (MR) approaches. We employed data from the Norwegian Trøndelag Health Study (HUNT) to conduct cross-sectional (n = 5854) and prospective (n = 3592) analyses, as well as one-sample MR (n = 86,324). We also used largest publicly available data for two-sample MR. Our cross-sectional analyses showed a 25 nmol/L increase in 25(OH)D was associated with a 1.73 mmHg decrease in SBP (95% CI - 2.46 to - 1.01), a 0.91 mmHg decrease in DBP (95% CI - 1.35 to - 0.47) and 19% lower prevalence of hypertension (OR 0.81, 95% CI 0.74 to 0.90) after adjusting for important confounders. However, these associations disappeared in prospective analyses. One-sample and two-sample MR results further suggested no causal relationship between serum vitamin D levels and blood pressure or hypertension risk in the general population.
Collapse
Affiliation(s)
- Lin Jiang
- Department of Public Health and Nursing, Faculty of Medicine and Health Science, Norwegian University of Science and Technology(NTNU), Postbox 8905, MTFS, N-7491, Trondheim, Norway.
- Clinic of Cardiology, St. Olavs Hospital, Trondheim, Norway.
| | - Yi-Qian Sun
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Pathology, Clinic of Laboratory Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- TkMidt-Center for Oral Health Services and Research, Mid-Norway, Trondheim, Norway
| | - Marion Denos
- Department of Public Health and Nursing, Faculty of Medicine and Health Science, Norwegian University of Science and Technology(NTNU), Postbox 8905, MTFS, N-7491, Trondheim, Norway
| | - Ben Michael Brumpton
- Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- K.G. Jebsen Centre for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- HUNT Research Centre, Department of Public Health and Nursing, Norwegian University of Science and Technology, Levanger, Norway
| | - Yue Chen
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Vegard Malmo
- Clinic of Cardiology, St. Olavs Hospital, Trondheim, Norway
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Eleanor Sanderson
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Xiao-Mei Mai
- Department of Public Health and Nursing, Faculty of Medicine and Health Science, Norwegian University of Science and Technology(NTNU), Postbox 8905, MTFS, N-7491, Trondheim, Norway
| |
Collapse
|
18
|
Vonen HD, Sund ER, Ariansen I, Krokstad S. Trends in socioeconomic inequalities in self-rated health and mental distress during four decades in a Norwegian population: a HUNT Study. Eur J Public Health 2024; 34:435-440. [PMID: 38848711 PMCID: PMC11161161 DOI: 10.1093/eurpub/ckae019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Socioeconomic inequalities constitute an important focus area for public health, and it has long been established that higher educational level and longer lifespan are correlated. Little is known about decennial time trends in poor self-rated health and mental distress. METHODS This study linked decennial cross-sectional survey data on self-rated health and mental distress from the Trøndelag Health Study (HUNT) from 1984 to 2019 with educational registry data using personal identification numbers. Survey participation ranged from 50 807 to 77 212. Slope index of inequality (SII) and relative index of inequality (RII) were calculated using generalized linear models in Stata. Analyses were stratified by sex and age, using the age categories of 30-59 years and 60-80 years. RESULTS Absolute inequalities in self-rated health and mental distress between educational groups have stayed relatively stable throughout all rounds of HUNT. Relative inequalities in self-rated health and mental distress have generally increased, and both men and women with the lowest education level were more likely to experience poor self-rated health and mental distress relative to those with the highest education level. RII in self-rated health increased over time for both sexes and both age groups. RII for mental distress increased in both sexes and both age groups, except for men and women aged 60-80. DISCUSSION This study shows that relative inequalities in self-rated and mental health in the Norwegian population are still persistent and have increased. Further knowledge about groups with a disadvantageous health situation should have implications for health care resource allocation.
Collapse
Affiliation(s)
- Hanne Dahl Vonen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Erik R Sund
- Department of Public Health and Nursing, HUNT Research Centre, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
- Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway
| | - Inger Ariansen
- Department of Chronic Diseases, The Norwegian Institute of Public Health, Oslo, Norway
| | - Steinar Krokstad
- Department of Public Health and Nursing, HUNT Research Centre, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| |
Collapse
|
19
|
Asante EO, Chen Y, Eldholm RS, Høvik H, Kolberg M, Skjellegrind HK, Torabi-Gaarden R, Mai XM, Sun YQ. Associations of Serum Vitamin D With Dental Caries and Periodontitis: The HUNT Study. Int Dent J 2024; 74:500-509. [PMID: 38565436 PMCID: PMC11123562 DOI: 10.1016/j.identj.2024.03.005] [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: 07/03/2023] [Revised: 03/04/2024] [Accepted: 03/09/2024] [Indexed: 04/04/2024] Open
Abstract
OBJECTIVE To study the relationships of serum 25-hydroxyvitamin D [25(OH)D] with dental caries and periodontitis in a general Norwegian adult population. METHODS We analysed a subsample of 1605 participants from the Trøndelag Health Study (HUNT) in Norway that had serum 25(OH)D levels measured in HUNT3 (2006-08) and oral health assessed in the HUNT4 Oral Health Study (2017-19). Negative binomial and Poisson regression models were used to estimate the ratios of means (RMs; for count oral outcomes) and prevalence ratios (PRs; for dichotomous oral outcomes). RESULTS Serum 25(OH)D was inversely associated with the number of decayed teeth in a dose-response gradient (<30.0 nmol/L: RM 1.41, 95% CI 1.07-1.85; 30.0-49.9 nmol/L: 1.14, 0.98-1.32 and ≥75.0 nmol/L: 0.84, 0.67-1.04, as compared to the 50.0-74.9 nmol/L group, P for trend <.001). Each 25 nmol/L decrease in 25(OH)D level was associated with a 15% (RM 1.15, 95% CI 1.05-1.26) increase in the mean number of decayed teeth. Serum 25(OH)D <30.0 nmol/L was associated with a 35% higher prevalence of severe periodontitis (PR 1.35, 95% CI 1.00-1.83). No association was observed between 25(OH)D and the number of natural teeth. CONCLUSION The present study suggested that serum 25(OH)D level had an inverse and dose-response association with the number of decayed teeth, and serum 25(OH)D <30 nmol/L was associated with a higher prevalence of severe periodontitis in this Norwegian adult population.
Collapse
Affiliation(s)
- Ernest Obeng Asante
- Center for Oral Health Services and Research Mid-Norway (TkMidt), Trondheim, Norway; Department of Clinical and Molecular Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Yue Chen
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Rannveig Sakshaug Eldholm
- Department of Neuromedicine and Movement Science, NTNU, Norwegian University of Science and Technology, Trondheim, Norway; Department of Geriatrics, Clinic of Medicine, St. Olavs Hospital, Trondheim, Norway
| | - Hedda Høvik
- Center for Oral Health Services and Research Mid-Norway (TkMidt), Trondheim, Norway
| | - Marit Kolberg
- Center for Oral Health Services and Research Mid-Norway (TkMidt), Trondheim, Norway
| | - Håvard Kjesbu Skjellegrind
- HUNT Research Centre, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Levanger, Norway; Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Roya Torabi-Gaarden
- Center for Oral Health Services and Research Mid-Norway (TkMidt), Trondheim, Norway
| | - Xiao-Mei Mai
- Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Yi-Qian Sun
- Center for Oral Health Services and Research Mid-Norway (TkMidt), Trondheim, Norway; Department of Clinical and Molecular Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway; Department of Pathology, Clinic of Laboratory Medicine, St. Olavs Hospital, Trondheim, Norway
| |
Collapse
|
20
|
Breidablik HJ, Hufthammer KO, Rangul V, Andersen JR, Meland E, Hetlevik Ø, Vie TL. Lower levels of physical activity volume are beneficial, and it's never too late to start: Results from the HUNT Study, Norway. Scand J Public Health 2024; 52:476-485. [PMID: 36960923 DOI: 10.1177/14034948231162729] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
AIMS We aimed to explore (a) how different patterns of physical activity (PA) over time (36 years) were associated with all-cause and cause-specific mortality, (b) if the association was similar for males and females and for different body mass levels and (c) how change in PA was associated with mortality for subjects who started out as physically inactive. METHODS The study is based on the prospective population-based cohort Trøndelag Health Study (HUNT) from 1984 to 2020, across four study waves. Data were linked to the Norwegian Cause of Death Registry. There were 123,005 participants, divided into three groups: persistently active, persistently inactive and mixed, with two cut-offs for PA: 60 and 150 minutes per week. The results are reported as cumulative incidence and hazard ratios (HRs). RESULTS At 60 minutes of PA per week, 8% of participants were persistently inactive, 15% were persistently active and 77% had a mixed pattern. At 150 minutes, the corresponding numbers were 32%, 2% and 65%. Compared to the persistently inactive group, for the 60-minute cut-off, the mixed group had an all-cause mortality HR of 0.83 (95% confidence interval (CI) 0.70-0.98), and the persistently active group had an HR of 0.51 (95% CI 0.40-0.65). For the 150-minute cut-off, the corresponding HRs were 0.84 (95% CI 0.75-0.94) and 0.48 (95% CI 0.26-0.88). The patterns were similar for males and females and across body mass index levels. Initially inactive participants had lower mortality if they ended up physically active, regardless of their activity level at an intermediate time point. CONCLUSIONS At least 60 minutes of PA per week was associated with a marked reduction in mortality when this was a lasting habit over three decades. Given that six times as many people reach this less ambitious goal, it is vital to encourage all levels of PA in public health promotion. Any increase in PA during the lifespan is beneficial.
Collapse
Affiliation(s)
| | | | - Vegar Rangul
- HUNT Research Centre, Department of Public Health and Nursing, Norwegian University of Science and Technology, Norway
| | | | - Eivind Meland
- Department of Global Public Health and Primary Care, University of Bergen, Norway
| | - Øystein Hetlevik
- Department of Global Public Health and Primary Care, University of Bergen, Norway
| | - Tina Løkke Vie
- Department of development and health research, Helse Førde HF, Norway
| |
Collapse
|
21
|
Nordstrand AE, Bøe HJ, Hjemdal O, Huffman AH, Noll LK, Reichelt JG, Bakker LP, Anyan F. Differences in resilience profiles between military veterans and the general population: An exploratory latent profile analysis using the HUNT-4 survey. Stress Health 2024; 40:e3343. [PMID: 37929999 DOI: 10.1002/smi.3343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 09/20/2023] [Accepted: 10/25/2023] [Indexed: 11/07/2023]
Abstract
Using latent profile analyses, the current work investigated levels of adverse childhood experiences, symptoms of anxiety and depression and 3 dimensions of relational promotive factors) to identify resilience profiles in a large general population sample (N = 161,622, mean age = 53.02; SD = 17.80; 56.1% females). We then used the same method to identify the resilience profiles of military veterans (N = 386, mean age = 43.47; SD = 10.08; 9.8% females), all of whom had served in Afghanistan. A four-profile-solution was the best fitting for the general population (High resilient 30%, Moderate resilient 13%, Low resilient 53%, Work/social-based resilience 4%), while a three-profile-solution had the best fit in the veteran cohort (Family-based resilience 28%, Work/social-based resilience 62%, Hardy loners 10%). To ground the identified profiles in occupational function, we also checked how they predicted reports of sleep difficulties, job demand and job control. Despite both samples inhabiting a geographic region known for high socioeconomic similarity among residents, we found marked differences in profile-solutions between the military veterans and the general population. Our findings suggests that resilience profiles are highly influenced by cohort characteristics and the specific resources needed to manage a given stressor load. Accordingly, the generalisability of specific protective factors may be low across distinct cohorts, and reliable findings need to be obtained in specific populations as defined by stressor context, sample characteristics, and relevant outcomes.
Collapse
Affiliation(s)
- Andreas Espetvedt Nordstrand
- Norwegian Armed Forces, Joint Medical Services, Oslo, Norway
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Psychological Sciences, Northern Arizona University (NAU), Flagstaff, Arizona, USA
| | - Hans Jakob Bøe
- Norwegian Armed Forces, Joint Medical Services, Oslo, Norway
- Department of Psychology, University of Oslo (UiO), Oslo, Norway
| | - Odin Hjemdal
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Ann Hergatt Huffman
- Department of Psychological Sciences, Northern Arizona University (NAU), Flagstaff, Arizona, USA
| | - Laura Katherine Noll
- Department of Psychological Sciences, Northern Arizona University (NAU), Flagstaff, Arizona, USA
| | | | | | - Frederick Anyan
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| |
Collapse
|
22
|
Zerouga I, Valeur J, Sommer C, Cvancarova Småstuen M, Medhus AW, Lund C, Johansen I, Cetinkaya RB, Bengtson MB, Torp R, Hovde Ø, Huppertz-Hauss G, Detlie TE, Aabrekk TB, Ricanek P, Frigstad SO, Hopstock LA, Opheim R, Kristensen VA, Høivik ML, Hauger Carlsen M, Aas AM. Dietary intake and nutritional status in patients with newly diagnosed inflammatory bowel disease: insights from the IBSEN III study. Scand J Gastroenterol 2024; 59:652-660. [PMID: 38356408 DOI: 10.1080/00365521.2024.2313056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 01/25/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND Dietary recommendations in inflammatory bowel disease (IBD) are inconclusive, and patients may follow restrictive diets with increased risk of malnutrition. The aim of this study was to compare dietary intakes and nutritional status in men and women with newly diagnosed IBD with a general population sample, and to investigate whether intakes were in line with the Nordic Nutrition Recommendations. METHODS This was a cross-sectional study including adults≥ 40 years with IBD from the Inflammatory Bowel Disease in South-Eastern Norway (IBSEN) III cohort study. A validated food frequency questionnaire (FFQ) was used in dietary data collection, and a sample from the seventh survey of the Tromsø Study was included as a comparison group. RESULTS A total of 227 men and women with IBD were included. IBD patients had higher intake of grain products, sweetened beverages, energy, fat and polyunsaturated fat (PUFA), but lower intake of dairy products, alcohol and iodine compared to adults from the comparison sample (p < 0.01). Intakes of saturated fat and carbohydrates in both genders, and vitamin D in women were not within recommended levels. Anemia and hypoalbuminemia were more prevalent in IBD patients than in the comparison sample. CONCLUSIONS Dietary intakes in newly diagnosed IBD patients were mostly in line with Nordic Nutrition Recommendations. Higher proportion of IBD patients exceeded recommended allowances of fat and added sugar than the comparison sample. Insufficient micronutrient intake, anemia and hypoalbuminemia are present challenges in IBD patients that require monitoring.
Collapse
Affiliation(s)
- Insaf Zerouga
- Department of Clinical Service, Section of Nutrition and Dietetics, Division of Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Jørgen Valeur
- Unger-Vetlesens Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Christine Sommer
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Milada Cvancarova Småstuen
- Department of Gastroenterology, Oslo University Hospital, Oslo, Norway
- Department of Public Health, Oslo Metropolitan University, Oslo, Norway
| | - Asle Wilhelm Medhus
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Gastroenterology, Oslo University Hospital, Oslo, Norway
| | - Charlotte Lund
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Gastroenterology, Oslo University Hospital, Oslo, Norway
| | - Ingunn Johansen
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Health Sciences, Østfold University College, Fredrikstad, Norway
| | | | | | - Roald Torp
- Medical department, Innlandet Hospital Trust, Hamar, Norway
| | - Øistein Hovde
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Medicine, Innlandet Hospital Trust, Gjøvik, Norway
| | | | - Trond Espen Detlie
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Medicine, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Tone Bergene Aabrekk
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Medical department, Vestfold Hospital Trust, Tønsberg, Norway
| | - Petr Ricanek
- Department of Medicine, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Svein Oskar Frigstad
- Department of Medicine, Bærum Hospital, Vestre Viken Hospital Trust, Gjettum, Norway
| | - Laila Arnesdatter Hopstock
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromso, Norway
- Department of Nutrition, Faculty of Medicine, UiT The Arctic University of Norway, Tromso, Norway
| | - Randi Opheim
- Department of Gastroenterology, Oslo University Hospital, Oslo, Norway
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Marte Lie Høivik
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Gastroenterology, Oslo University Hospital, Oslo, Norway
| | | | - Anne-Marie Aas
- Department of Clinical Service, Section of Nutrition and Dietetics, Division of Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
23
|
Tevik K, Skråstad RB, Benth JŠ, Selbæk G, Bergh S, Eldholm RS, Krokstad S, Helvik AS. Prevalence and change in alcohol consumption in older adults over time, assessed with self-report and Phosphatidylethanol 16:0/18:1 -The HUNT Study. PLoS One 2024; 19:e0304714. [PMID: 38820445 PMCID: PMC11142565 DOI: 10.1371/journal.pone.0304714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 05/16/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Changes in alcohol consumption may affect older adults' health. We examined prevalence and changes in the alcohol consumption of older women and men (≥65 years) in Norway over a 24-year period. METHODS Data from three population-based health surveys (The Trøndelag Health Study-HUNT2 1995-97, HUNT3 2006-08, HUNT4 2017-19) were used. Alcohol consumption was measured using self-reported measures and an objective measure of alcohol consumption (Phosphatidylethanol 16:0/18:1, PEth). Self-reported lifetime abstinence, former drinking, current drinking, frequent drinking (≥4 times/week), and risk drinking (≥8 units/week) were measured. The PEth concentrations were stratified: <0.03 μmol/l (abstinence/very low level of alcohol consumption); >0.06 μmol/l (indicating >1 unit/day); >0.10 μmol/l (indicating >3 units/day), and >0.30 μmol/l (heavy alcohol consumption). RESULTS In HUNT4, the prevalence of self-reported lifetime abstinence, frequent drinking, and risk drinking was 5.2%, 4.4%, and 5.6%, respectively, while prevalence of PEth <0.03 μmol/l was 68.1% and PEth >0.06 μmol/l was 21.2%. Over the course of the three surveys, the prevalence of self-reported lifetime abstinence decreased, while the prevalence of frequent drinking and risk drinking increased. Men were less often abstainers and more often frequent and risky drinkers than women in all three surveys. Gender differences for abstinence and current drinking reduced with time. From HUNT3 to HUNT4, the prevalence of PEth <0.03 μmol/l decreased, while the prevalence of PEth >0.06 μmol/l increased. Men compared to women, had less often PEth <0.03 μmol/l and more often PEth >0.06 and >0.10 μmol/l in HUNT3 and HUNT4. Women and men ≥75 years were just as likely to have PEth >0.30 μmol/l in HUNT4. The gender differences in PEth concentrations were reduced in HUNT4 among those aged 70-74 years or ≥75 years. CONCLUSION Alcohol consumption has increased among Norwegian older adults over a 24-year period, but at a slower pace during the last decade.
Collapse
Affiliation(s)
- Kjerstin Tevik
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Ragnhild Bergene Skråstad
- Department of Clinical Pharmacology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Jūratė Šaltytė Benth
- Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway
- Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - Geir Selbæk
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Sverre Bergh
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Research Centre for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
| | - Rannveig Sakshaug Eldholm
- Department of Geriatrics, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Steinar Krokstad
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Anne-Sofie Helvik
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| |
Collapse
|
24
|
Skåra KH, Hernáez Á, Næss Ø, Fraser A, Lawlor DA, Burgess S, Brumpton BM, Magnus MC. Cardiovascular disease risk factors and infertility: multivariable analyses and one-sample Mendelian randomization analyses in the Trøndelag Health Study. Hum Reprod Open 2024; 2024:hoae033. [PMID: 38911051 PMCID: PMC11190059 DOI: 10.1093/hropen/hoae033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 05/03/2024] [Indexed: 06/25/2024] Open
Abstract
STUDY QUESTION Are cardiovascular disease (CVD) risk factors causally associated with higher risk of infertility among women and men? SUMMARY ANSWER We found evidence to support a causal relationship between smoking initiation and history of infertility in women. WHAT IS KNOWN ALREADY Several CVD risk factors are associated with history of infertility. Previous studies using Mendelian randomization (MR) further support a causal relationship between BMI and infertility in women. STUDY DESIGN SIZE DURATION We used data from the Trøndelag Health Study (HUNT) in Norway, a prospective population-based cohort study, including 26 811 women and 15 598 men participating in three survey collections in 1995-1997 (HUNT2), 2006-2008 (HUNT3), and 2017-2019 (HUNT4). PARTICIPANTS/MATERIALS SETTING METHODS Our outcome was women's self-reported history of infertility, defined as ever having tried to conceive for 12 months or more or having used ART. We assigned the history of infertility reported by women to their male partners; therefore, the measure of infertility was on the couple level. We used both conventional multivariable analyses and one-sample MR analyses to evaluate the association between female and male CVD risk factors (including BMI, blood pressure, lipid profile measurements, and smoking behaviours) and history of infertility in women and men, separately. MAIN RESULTS AND THE ROLE OF CHANCE A total of 4702 women (18%) and 2508 men (16%) were classified with a history of infertility. We found a higher risk of infertility among female smokers compared to non-smokers in both multivariable and MR analyses (odds ratio (OR) in multivariable analysis, 1.20; 95% CI, 1.12-1.28; OR in MR analysis, 1.13; CI, 1.02-1.26), and potentially for higher BMI (OR in multivariable analysis, 1.13; CI, 1.09-1.18; OR in MR analysis, 1.11, CI, 0.92-1.34). In multivariable analysis in women, we also found evidence of associations between triglyceride levels, high-density lipoprotein cholesterol, lifetime smoking index, and smoking intensity with higher risk of infertility. However, these results were not consistent in MR analyses. We found no robust or consistent associations between male CVD risk factors and infertility. LIMITATIONS REASONS FOR CAUTION Our main limitation was that the CVD risk factors measured might not adequately capture the relevant time periods for when couples were trying to conceive. Additionally, we did not have information on causes of infertility in either women or men. WIDER IMPLICATIONS OF THE FINDINGS Women with infertility could have a worse CVD risk factor profile and thus public health interventions aimed at reducing the impact of some CVD risk factors, such as smoking and BMI, could reduce the burden of infertility. However, additional MR studies of the relationship between CVD risk factors and infertility with a larger sample size would be of value. STUDY FUNDING/COMPETING INTERESTS The study was supported by a grant from the European Research Council under the European Union's Horizon 2020 research and innovation program (grant agreements no. 947684). This research was also supported by the Research Council of Norway through its Centres of Excellence funding scheme (project no. 262700) and partly funded by the Research Council of Norway, project: Women's fertility-an essential component of health and well-being (project no. 320656). D.A.L. and A.F. work in a unit that is supported by the University of Bristol and the UK Medical Research Council (MC_UU_00011/6). D.A.L.'s contribution to the article is supported by the European Research Council (101021566), the British Heart Foundation (CH/F/20/90003 and AA/18/7/34219). S.B.'s contribution to the article is supported by the Wellcome Trust (225790/Z/22/Z). B.M.B. is funded by The Liaison Committee for education, research and innovation in Central Norway; and the Joint Research Committee between St. Olavs Hospital and the Faculty of Medicine and Health Sciences, NTNU. The genotyping in HUNT was financed by the National Institute of Health (NIH); University of Michigan; The Research Council of Norway; The Liaison Committee for education, research and innovation in Central Norway; and the Joint Research Committee between St. Olavs Hospital and the Faculty of Medicine and Health Sciences, NTNU. None of the funding organizations influenced the study design, reporting, or interpretation of results. The views expressed in the present article are those of the authors and not necessarily any acknowledged funding organization. D.A.L. reports grants from Medtronic Ltd and Roche Diagnostics outside the submitted work. The other authors have no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.
Collapse
Affiliation(s)
- Karoline H Skåra
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Álvaro Hernáez
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Consorcio CIBER, M.P. Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
- Blanquerna School of Health Sciences, Universitat Ramon Llull, Barcelona, Spain
| | - Øyvind Næss
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Abigail Fraser
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Stephen Burgess
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Ben M Brumpton
- HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing, NTNU Norwegian University of Science and Technology, Levanger, Norway
- HUNT Research Centre, Department of Public Health and Nursing, NTNU Norwegian University of Science and Technology, Levanger, Norway
- Clinic of Medicine, St Olavs Hospital, Trondheim University, Trondheim, Norway
| | - Maria C Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| |
Collapse
|
25
|
Edwin TH, Håberg AK, Zotcheva E, Bratsberg B, Jugessur A, Engdahl B, Bowen C, Selbæk G, Kohler HP, Harris JR, Tom SE, Krokstad S, Mekonnen T, Stern Y, Skirbekk VF, Strand BH. Trajectories of Occupational Cognitive Demands and Risk of Mild Cognitive Impairment and Dementia in Later Life: The HUNT4 70+ Study. Neurology 2024; 102:e209353. [PMID: 38630959 PMCID: PMC11175637 DOI: 10.1212/wnl.0000000000209353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 02/13/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND AND OBJECTIVES The cognitive reserve hypothesis posits that cognitively stimulating work delays the onset of mild cognitive impairment (MCI) and dementia. However, the effect of occupational cognitive demands across midlife on the risk of these conditions is unclear. METHODS Using a cohort study design, we evaluated the association between registry-based trajectories of occupational cognitive demands from ages 30-65 years and clinically diagnosed MCI and dementia in participants in the HUNT4 70+ Study (2017-19). Group-based trajectory modeling identified trajectories of occupational cognitive demands, measured by the routine task intensity (RTI) index (lower RTI indicates more cognitively demanding occupation) from the Occupational Information Network. Multinomial regression was implemented to estimate the relative risk ratios (RRRs) of MCI and dementia, after adjusting for age, sex, education, income, baseline hypertension, obesity, diabetes, psychiatric impairment, hearing impairment, loneliness, smoking status, and physical inactivity assessed at HUNT1-2 in 1984-1986 and 1995-1997. To handle missing data, we used inverse probability weighting to account for nonparticipation in cognitive testing and multiple imputation. RESULTS Based on longitudinal RTI scores for 305 unique occupations, 4 RTI trajectory groups were identified (n = 7,003, 49.8% women, age range 69-104 years): low RTI (n = 1,431, 20.4%), intermediate-low RTI (n = 1,578, 22.5%), intermediate-high RTI (n = 2,601, 37.1%), and high RTI (n = 1,393, 19.9%). Participants in the high RTI group had a higher risk of MCI (RRR 1.74, 95% CI 1.41-2.14) and dementia (RRR 1.37, 95% CI 1.01-1.86), after adjusting for age, sex, and education compared with participants in the low RTI group. In a sensitivity analysis, controlling for income and baseline health-related factors, the point estimates were not appreciably changed (RRR 1.66, 95% CI 1.35-2.06 for MCI, and RRR 1.31, 95% CI 0.96-1.78 for dementia). DISCUSSION People with a history of cognitively stimulating occupations during their 30s, 40s, 50s, and 60s had a lower risk of MCI and dementia older than 70 years, highlighting the importance of occupational cognitive stimulation during midlife for maintaining cognitive function in old age. Further research is required to pinpoint the specific occupational cognitive demands that are most advantageous for maintaining later-life cognitive function.
Collapse
Affiliation(s)
- Trine H Edwin
- From the Department of Geriatric Medicine (T.H.E., G.S., B.H.S.), Oslo University Hospital; Department for Physical Health and Aging (A.K.H., E.Z., B.E., T.M., V.F.S., B.H.S.), Norwegian Institute of Public Health, Oslo; Department of Neuromedicine and Movement Science (A.K.H.), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim; Norwegian National Centre for Ageing and Health (E.Z., G.S., V.F.S., B.H.S.), Vestfold Hospital Trust, Tønsberg; Centre for Fertility and Health (B.B., A.J., J.R.H., V.F.S.), Norwegian Institute of Public Health; Ragnar Frisch Center for Economic Research (B.B.), Oslo; Department of Global Public Health and Primary Care (A.J.), University of Bergen, Norway; Independent Researcher (C.B.), Vienna, Austria; Faculty of Medicine (G.S.), University of Oslo, Norway; Population Aging Research Center and Department of Sociology (H.-P.K.), University of Pennsylvania, Philadelphia; Cognitive Neuroscience Division (S.E.T., Y.S.), Department of Neurology, Columbia University, New York; Department of Epidemiology (S.E.T.), Columbia University, Mailman School of Public Health; HUNT Research Centre (S.K.), Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim; and Levanger Hospital (S.K.), Nord-Trøndelag Hospital Trust, Norway
| | - Asta K Håberg
- From the Department of Geriatric Medicine (T.H.E., G.S., B.H.S.), Oslo University Hospital; Department for Physical Health and Aging (A.K.H., E.Z., B.E., T.M., V.F.S., B.H.S.), Norwegian Institute of Public Health, Oslo; Department of Neuromedicine and Movement Science (A.K.H.), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim; Norwegian National Centre for Ageing and Health (E.Z., G.S., V.F.S., B.H.S.), Vestfold Hospital Trust, Tønsberg; Centre for Fertility and Health (B.B., A.J., J.R.H., V.F.S.), Norwegian Institute of Public Health; Ragnar Frisch Center for Economic Research (B.B.), Oslo; Department of Global Public Health and Primary Care (A.J.), University of Bergen, Norway; Independent Researcher (C.B.), Vienna, Austria; Faculty of Medicine (G.S.), University of Oslo, Norway; Population Aging Research Center and Department of Sociology (H.-P.K.), University of Pennsylvania, Philadelphia; Cognitive Neuroscience Division (S.E.T., Y.S.), Department of Neurology, Columbia University, New York; Department of Epidemiology (S.E.T.), Columbia University, Mailman School of Public Health; HUNT Research Centre (S.K.), Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim; and Levanger Hospital (S.K.), Nord-Trøndelag Hospital Trust, Norway
| | - Ekaterina Zotcheva
- From the Department of Geriatric Medicine (T.H.E., G.S., B.H.S.), Oslo University Hospital; Department for Physical Health and Aging (A.K.H., E.Z., B.E., T.M., V.F.S., B.H.S.), Norwegian Institute of Public Health, Oslo; Department of Neuromedicine and Movement Science (A.K.H.), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim; Norwegian National Centre for Ageing and Health (E.Z., G.S., V.F.S., B.H.S.), Vestfold Hospital Trust, Tønsberg; Centre for Fertility and Health (B.B., A.J., J.R.H., V.F.S.), Norwegian Institute of Public Health; Ragnar Frisch Center for Economic Research (B.B.), Oslo; Department of Global Public Health and Primary Care (A.J.), University of Bergen, Norway; Independent Researcher (C.B.), Vienna, Austria; Faculty of Medicine (G.S.), University of Oslo, Norway; Population Aging Research Center and Department of Sociology (H.-P.K.), University of Pennsylvania, Philadelphia; Cognitive Neuroscience Division (S.E.T., Y.S.), Department of Neurology, Columbia University, New York; Department of Epidemiology (S.E.T.), Columbia University, Mailman School of Public Health; HUNT Research Centre (S.K.), Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim; and Levanger Hospital (S.K.), Nord-Trøndelag Hospital Trust, Norway
| | - Bernt Bratsberg
- From the Department of Geriatric Medicine (T.H.E., G.S., B.H.S.), Oslo University Hospital; Department for Physical Health and Aging (A.K.H., E.Z., B.E., T.M., V.F.S., B.H.S.), Norwegian Institute of Public Health, Oslo; Department of Neuromedicine and Movement Science (A.K.H.), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim; Norwegian National Centre for Ageing and Health (E.Z., G.S., V.F.S., B.H.S.), Vestfold Hospital Trust, Tønsberg; Centre for Fertility and Health (B.B., A.J., J.R.H., V.F.S.), Norwegian Institute of Public Health; Ragnar Frisch Center for Economic Research (B.B.), Oslo; Department of Global Public Health and Primary Care (A.J.), University of Bergen, Norway; Independent Researcher (C.B.), Vienna, Austria; Faculty of Medicine (G.S.), University of Oslo, Norway; Population Aging Research Center and Department of Sociology (H.-P.K.), University of Pennsylvania, Philadelphia; Cognitive Neuroscience Division (S.E.T., Y.S.), Department of Neurology, Columbia University, New York; Department of Epidemiology (S.E.T.), Columbia University, Mailman School of Public Health; HUNT Research Centre (S.K.), Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim; and Levanger Hospital (S.K.), Nord-Trøndelag Hospital Trust, Norway
| | - Astanand Jugessur
- From the Department of Geriatric Medicine (T.H.E., G.S., B.H.S.), Oslo University Hospital; Department for Physical Health and Aging (A.K.H., E.Z., B.E., T.M., V.F.S., B.H.S.), Norwegian Institute of Public Health, Oslo; Department of Neuromedicine and Movement Science (A.K.H.), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim; Norwegian National Centre for Ageing and Health (E.Z., G.S., V.F.S., B.H.S.), Vestfold Hospital Trust, Tønsberg; Centre for Fertility and Health (B.B., A.J., J.R.H., V.F.S.), Norwegian Institute of Public Health; Ragnar Frisch Center for Economic Research (B.B.), Oslo; Department of Global Public Health and Primary Care (A.J.), University of Bergen, Norway; Independent Researcher (C.B.), Vienna, Austria; Faculty of Medicine (G.S.), University of Oslo, Norway; Population Aging Research Center and Department of Sociology (H.-P.K.), University of Pennsylvania, Philadelphia; Cognitive Neuroscience Division (S.E.T., Y.S.), Department of Neurology, Columbia University, New York; Department of Epidemiology (S.E.T.), Columbia University, Mailman School of Public Health; HUNT Research Centre (S.K.), Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim; and Levanger Hospital (S.K.), Nord-Trøndelag Hospital Trust, Norway
| | - Bo Engdahl
- From the Department of Geriatric Medicine (T.H.E., G.S., B.H.S.), Oslo University Hospital; Department for Physical Health and Aging (A.K.H., E.Z., B.E., T.M., V.F.S., B.H.S.), Norwegian Institute of Public Health, Oslo; Department of Neuromedicine and Movement Science (A.K.H.), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim; Norwegian National Centre for Ageing and Health (E.Z., G.S., V.F.S., B.H.S.), Vestfold Hospital Trust, Tønsberg; Centre for Fertility and Health (B.B., A.J., J.R.H., V.F.S.), Norwegian Institute of Public Health; Ragnar Frisch Center for Economic Research (B.B.), Oslo; Department of Global Public Health and Primary Care (A.J.), University of Bergen, Norway; Independent Researcher (C.B.), Vienna, Austria; Faculty of Medicine (G.S.), University of Oslo, Norway; Population Aging Research Center and Department of Sociology (H.-P.K.), University of Pennsylvania, Philadelphia; Cognitive Neuroscience Division (S.E.T., Y.S.), Department of Neurology, Columbia University, New York; Department of Epidemiology (S.E.T.), Columbia University, Mailman School of Public Health; HUNT Research Centre (S.K.), Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim; and Levanger Hospital (S.K.), Nord-Trøndelag Hospital Trust, Norway
| | - Catherine Bowen
- From the Department of Geriatric Medicine (T.H.E., G.S., B.H.S.), Oslo University Hospital; Department for Physical Health and Aging (A.K.H., E.Z., B.E., T.M., V.F.S., B.H.S.), Norwegian Institute of Public Health, Oslo; Department of Neuromedicine and Movement Science (A.K.H.), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim; Norwegian National Centre for Ageing and Health (E.Z., G.S., V.F.S., B.H.S.), Vestfold Hospital Trust, Tønsberg; Centre for Fertility and Health (B.B., A.J., J.R.H., V.F.S.), Norwegian Institute of Public Health; Ragnar Frisch Center for Economic Research (B.B.), Oslo; Department of Global Public Health and Primary Care (A.J.), University of Bergen, Norway; Independent Researcher (C.B.), Vienna, Austria; Faculty of Medicine (G.S.), University of Oslo, Norway; Population Aging Research Center and Department of Sociology (H.-P.K.), University of Pennsylvania, Philadelphia; Cognitive Neuroscience Division (S.E.T., Y.S.), Department of Neurology, Columbia University, New York; Department of Epidemiology (S.E.T.), Columbia University, Mailman School of Public Health; HUNT Research Centre (S.K.), Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim; and Levanger Hospital (S.K.), Nord-Trøndelag Hospital Trust, Norway
| | - Geir Selbæk
- From the Department of Geriatric Medicine (T.H.E., G.S., B.H.S.), Oslo University Hospital; Department for Physical Health and Aging (A.K.H., E.Z., B.E., T.M., V.F.S., B.H.S.), Norwegian Institute of Public Health, Oslo; Department of Neuromedicine and Movement Science (A.K.H.), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim; Norwegian National Centre for Ageing and Health (E.Z., G.S., V.F.S., B.H.S.), Vestfold Hospital Trust, Tønsberg; Centre for Fertility and Health (B.B., A.J., J.R.H., V.F.S.), Norwegian Institute of Public Health; Ragnar Frisch Center for Economic Research (B.B.), Oslo; Department of Global Public Health and Primary Care (A.J.), University of Bergen, Norway; Independent Researcher (C.B.), Vienna, Austria; Faculty of Medicine (G.S.), University of Oslo, Norway; Population Aging Research Center and Department of Sociology (H.-P.K.), University of Pennsylvania, Philadelphia; Cognitive Neuroscience Division (S.E.T., Y.S.), Department of Neurology, Columbia University, New York; Department of Epidemiology (S.E.T.), Columbia University, Mailman School of Public Health; HUNT Research Centre (S.K.), Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim; and Levanger Hospital (S.K.), Nord-Trøndelag Hospital Trust, Norway
| | - Hans-Peter Kohler
- From the Department of Geriatric Medicine (T.H.E., G.S., B.H.S.), Oslo University Hospital; Department for Physical Health and Aging (A.K.H., E.Z., B.E., T.M., V.F.S., B.H.S.), Norwegian Institute of Public Health, Oslo; Department of Neuromedicine and Movement Science (A.K.H.), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim; Norwegian National Centre for Ageing and Health (E.Z., G.S., V.F.S., B.H.S.), Vestfold Hospital Trust, Tønsberg; Centre for Fertility and Health (B.B., A.J., J.R.H., V.F.S.), Norwegian Institute of Public Health; Ragnar Frisch Center for Economic Research (B.B.), Oslo; Department of Global Public Health and Primary Care (A.J.), University of Bergen, Norway; Independent Researcher (C.B.), Vienna, Austria; Faculty of Medicine (G.S.), University of Oslo, Norway; Population Aging Research Center and Department of Sociology (H.-P.K.), University of Pennsylvania, Philadelphia; Cognitive Neuroscience Division (S.E.T., Y.S.), Department of Neurology, Columbia University, New York; Department of Epidemiology (S.E.T.), Columbia University, Mailman School of Public Health; HUNT Research Centre (S.K.), Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim; and Levanger Hospital (S.K.), Nord-Trøndelag Hospital Trust, Norway
| | - Jennifer R Harris
- From the Department of Geriatric Medicine (T.H.E., G.S., B.H.S.), Oslo University Hospital; Department for Physical Health and Aging (A.K.H., E.Z., B.E., T.M., V.F.S., B.H.S.), Norwegian Institute of Public Health, Oslo; Department of Neuromedicine and Movement Science (A.K.H.), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim; Norwegian National Centre for Ageing and Health (E.Z., G.S., V.F.S., B.H.S.), Vestfold Hospital Trust, Tønsberg; Centre for Fertility and Health (B.B., A.J., J.R.H., V.F.S.), Norwegian Institute of Public Health; Ragnar Frisch Center for Economic Research (B.B.), Oslo; Department of Global Public Health and Primary Care (A.J.), University of Bergen, Norway; Independent Researcher (C.B.), Vienna, Austria; Faculty of Medicine (G.S.), University of Oslo, Norway; Population Aging Research Center and Department of Sociology (H.-P.K.), University of Pennsylvania, Philadelphia; Cognitive Neuroscience Division (S.E.T., Y.S.), Department of Neurology, Columbia University, New York; Department of Epidemiology (S.E.T.), Columbia University, Mailman School of Public Health; HUNT Research Centre (S.K.), Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim; and Levanger Hospital (S.K.), Nord-Trøndelag Hospital Trust, Norway
| | - Sarah E Tom
- From the Department of Geriatric Medicine (T.H.E., G.S., B.H.S.), Oslo University Hospital; Department for Physical Health and Aging (A.K.H., E.Z., B.E., T.M., V.F.S., B.H.S.), Norwegian Institute of Public Health, Oslo; Department of Neuromedicine and Movement Science (A.K.H.), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim; Norwegian National Centre for Ageing and Health (E.Z., G.S., V.F.S., B.H.S.), Vestfold Hospital Trust, Tønsberg; Centre for Fertility and Health (B.B., A.J., J.R.H., V.F.S.), Norwegian Institute of Public Health; Ragnar Frisch Center for Economic Research (B.B.), Oslo; Department of Global Public Health and Primary Care (A.J.), University of Bergen, Norway; Independent Researcher (C.B.), Vienna, Austria; Faculty of Medicine (G.S.), University of Oslo, Norway; Population Aging Research Center and Department of Sociology (H.-P.K.), University of Pennsylvania, Philadelphia; Cognitive Neuroscience Division (S.E.T., Y.S.), Department of Neurology, Columbia University, New York; Department of Epidemiology (S.E.T.), Columbia University, Mailman School of Public Health; HUNT Research Centre (S.K.), Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim; and Levanger Hospital (S.K.), Nord-Trøndelag Hospital Trust, Norway
| | - Steinar Krokstad
- From the Department of Geriatric Medicine (T.H.E., G.S., B.H.S.), Oslo University Hospital; Department for Physical Health and Aging (A.K.H., E.Z., B.E., T.M., V.F.S., B.H.S.), Norwegian Institute of Public Health, Oslo; Department of Neuromedicine and Movement Science (A.K.H.), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim; Norwegian National Centre for Ageing and Health (E.Z., G.S., V.F.S., B.H.S.), Vestfold Hospital Trust, Tønsberg; Centre for Fertility and Health (B.B., A.J., J.R.H., V.F.S.), Norwegian Institute of Public Health; Ragnar Frisch Center for Economic Research (B.B.), Oslo; Department of Global Public Health and Primary Care (A.J.), University of Bergen, Norway; Independent Researcher (C.B.), Vienna, Austria; Faculty of Medicine (G.S.), University of Oslo, Norway; Population Aging Research Center and Department of Sociology (H.-P.K.), University of Pennsylvania, Philadelphia; Cognitive Neuroscience Division (S.E.T., Y.S.), Department of Neurology, Columbia University, New York; Department of Epidemiology (S.E.T.), Columbia University, Mailman School of Public Health; HUNT Research Centre (S.K.), Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim; and Levanger Hospital (S.K.), Nord-Trøndelag Hospital Trust, Norway
| | - Teferi Mekonnen
- From the Department of Geriatric Medicine (T.H.E., G.S., B.H.S.), Oslo University Hospital; Department for Physical Health and Aging (A.K.H., E.Z., B.E., T.M., V.F.S., B.H.S.), Norwegian Institute of Public Health, Oslo; Department of Neuromedicine and Movement Science (A.K.H.), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim; Norwegian National Centre for Ageing and Health (E.Z., G.S., V.F.S., B.H.S.), Vestfold Hospital Trust, Tønsberg; Centre for Fertility and Health (B.B., A.J., J.R.H., V.F.S.), Norwegian Institute of Public Health; Ragnar Frisch Center for Economic Research (B.B.), Oslo; Department of Global Public Health and Primary Care (A.J.), University of Bergen, Norway; Independent Researcher (C.B.), Vienna, Austria; Faculty of Medicine (G.S.), University of Oslo, Norway; Population Aging Research Center and Department of Sociology (H.-P.K.), University of Pennsylvania, Philadelphia; Cognitive Neuroscience Division (S.E.T., Y.S.), Department of Neurology, Columbia University, New York; Department of Epidemiology (S.E.T.), Columbia University, Mailman School of Public Health; HUNT Research Centre (S.K.), Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim; and Levanger Hospital (S.K.), Nord-Trøndelag Hospital Trust, Norway
| | - Yaakov Stern
- From the Department of Geriatric Medicine (T.H.E., G.S., B.H.S.), Oslo University Hospital; Department for Physical Health and Aging (A.K.H., E.Z., B.E., T.M., V.F.S., B.H.S.), Norwegian Institute of Public Health, Oslo; Department of Neuromedicine and Movement Science (A.K.H.), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim; Norwegian National Centre for Ageing and Health (E.Z., G.S., V.F.S., B.H.S.), Vestfold Hospital Trust, Tønsberg; Centre for Fertility and Health (B.B., A.J., J.R.H., V.F.S.), Norwegian Institute of Public Health; Ragnar Frisch Center for Economic Research (B.B.), Oslo; Department of Global Public Health and Primary Care (A.J.), University of Bergen, Norway; Independent Researcher (C.B.), Vienna, Austria; Faculty of Medicine (G.S.), University of Oslo, Norway; Population Aging Research Center and Department of Sociology (H.-P.K.), University of Pennsylvania, Philadelphia; Cognitive Neuroscience Division (S.E.T., Y.S.), Department of Neurology, Columbia University, New York; Department of Epidemiology (S.E.T.), Columbia University, Mailman School of Public Health; HUNT Research Centre (S.K.), Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim; and Levanger Hospital (S.K.), Nord-Trøndelag Hospital Trust, Norway
| | - Vegard F Skirbekk
- From the Department of Geriatric Medicine (T.H.E., G.S., B.H.S.), Oslo University Hospital; Department for Physical Health and Aging (A.K.H., E.Z., B.E., T.M., V.F.S., B.H.S.), Norwegian Institute of Public Health, Oslo; Department of Neuromedicine and Movement Science (A.K.H.), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim; Norwegian National Centre for Ageing and Health (E.Z., G.S., V.F.S., B.H.S.), Vestfold Hospital Trust, Tønsberg; Centre for Fertility and Health (B.B., A.J., J.R.H., V.F.S.), Norwegian Institute of Public Health; Ragnar Frisch Center for Economic Research (B.B.), Oslo; Department of Global Public Health and Primary Care (A.J.), University of Bergen, Norway; Independent Researcher (C.B.), Vienna, Austria; Faculty of Medicine (G.S.), University of Oslo, Norway; Population Aging Research Center and Department of Sociology (H.-P.K.), University of Pennsylvania, Philadelphia; Cognitive Neuroscience Division (S.E.T., Y.S.), Department of Neurology, Columbia University, New York; Department of Epidemiology (S.E.T.), Columbia University, Mailman School of Public Health; HUNT Research Centre (S.K.), Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim; and Levanger Hospital (S.K.), Nord-Trøndelag Hospital Trust, Norway
| | - Bjørn H Strand
- From the Department of Geriatric Medicine (T.H.E., G.S., B.H.S.), Oslo University Hospital; Department for Physical Health and Aging (A.K.H., E.Z., B.E., T.M., V.F.S., B.H.S.), Norwegian Institute of Public Health, Oslo; Department of Neuromedicine and Movement Science (A.K.H.), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim; Norwegian National Centre for Ageing and Health (E.Z., G.S., V.F.S., B.H.S.), Vestfold Hospital Trust, Tønsberg; Centre for Fertility and Health (B.B., A.J., J.R.H., V.F.S.), Norwegian Institute of Public Health; Ragnar Frisch Center for Economic Research (B.B.), Oslo; Department of Global Public Health and Primary Care (A.J.), University of Bergen, Norway; Independent Researcher (C.B.), Vienna, Austria; Faculty of Medicine (G.S.), University of Oslo, Norway; Population Aging Research Center and Department of Sociology (H.-P.K.), University of Pennsylvania, Philadelphia; Cognitive Neuroscience Division (S.E.T., Y.S.), Department of Neurology, Columbia University, New York; Department of Epidemiology (S.E.T.), Columbia University, Mailman School of Public Health; HUNT Research Centre (S.K.), Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim; and Levanger Hospital (S.K.), Nord-Trøndelag Hospital Trust, Norway
| |
Collapse
|
26
|
Young J, Lyngbakken MN, Hveem K, Røsjø H, Omland T. Systolic Blood Pressure, Diastolic Blood Pressure and Pulse Pressure and the Risk of Subclinical Myocardial Injury: The HUNT Study. J Am Heart Assoc 2024; 13:e031107. [PMID: 38639374 PMCID: PMC11179940 DOI: 10.1161/jaha.123.031107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 03/07/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Subclinical myocardial injury expressed as higher cardiac troponin concentrations may represent an important intermediary between hypertension and the risk of cardiovascular disease. The study aimed to assess the relative strength of associations between systolic blood pressure (BP), diastolic BP, and pulse pressure, and subclinical myocardial injury, and how change in BP variables over time associates with subclinical myocardial injury. METHODS AND RESULTS cTnl (cardiac troponin I) was measured in 32 968 participants of the fourth wave of the population-based cohort HUNT4 (Trøndelag Health Study) without a history of cardiovascular disease. An additional longitudinal analysis included participants from HUNT4 with BP measurements from HUNT3 (n=18 681). Associations between BP variables and cTnI concentrations were assessed by linear and logistic regression analyses. The median cTnI concentration was 1.6 ng/L (25th-75th percentiles, 0.6-3.1 ng/L), median age was 52 years (39.1-65.6 years), and 57% were female subjects. Cross-sectionally, only systolic BP categories ≥130 mm Hg associated with higher cTnI concentrations, compared with a reference systolic BP of <110 mm Hg. All categories of diastolic BP and pulse pressure were positively associated with higher cTnI concentrations when diastolic BP 70 to 79 mm Hg and pulse pressure <40 mm Hg were used as references, respectively. When comparing systolic BP, diastolic BP, and pulse pressure as continuous variables, cross-sectionally, pulse pressure most strongly associated with cTnI concentrations (P for all comparisons <0.001), whereas longitudinally, change in diastolic BP was most strongly associated with cTnI concentrations (P for all comparisons <0.05). CONCLUSIONS Subjects with high pulse pressure and longitudinal increase in diastolic BP are at higher risk for subclinical myocardial injury.
Collapse
Affiliation(s)
- Juliet Young
- K. G. Jebsen Center for Cardiac BiomarkersInstitute of Clinical Medicine, University of OsloOsloNorway
| | - Magnus Nakrem Lyngbakken
- K. G. Jebsen Center for Cardiac BiomarkersInstitute of Clinical Medicine, University of OsloOsloNorway
- Department of CardiologyAkershus University HospitalLørenskogNorway
| | - Kristian Hveem
- HUNT Research Centre, Department of Public Health and General PracticeNorwegian University of Science and TechnologyLevangerNorway
- Levanger Hospital, Nord‐Trøndelag Hospital TrustLevangerNorway
| | - Helge Røsjø
- K. G. Jebsen Center for Cardiac BiomarkersInstitute of Clinical Medicine, University of OsloOsloNorway
- Division of Research and InnovationAkershus University HospitalLørenskogNorway
| | - Torbjørn Omland
- K. G. Jebsen Center for Cardiac BiomarkersInstitute of Clinical Medicine, University of OsloOsloNorway
- Department of CardiologyAkershus University HospitalLørenskogNorway
| |
Collapse
|
27
|
Giri S, Tronvik E, Dalen H, Ellekjær H, Loennechen JP, Olsen A, Hagen K. Migraine and risk of atrial fibrillation: A 9-year follow-up based on the Trøndelag Health Study. Cephalalgia 2024; 44:3331024241254517. [PMID: 38808530 DOI: 10.1177/03331024241254517] [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: 05/30/2024]
Abstract
BACKGROUND Data from some population-based studies have indicated an increased risk of atrial fibrillation (AF) among patients with migraine, particularly among individuals with migraine with aura. The present study aimed to assess the association between primary headache disorders and AF. METHODS In a population-based 9-year follow-up design, we evaluated the questionnaire-based headache diagnosis, migraine and tension-type headache (TTH) included, collected in the Trøndelag Health Study (HUNT3) conducted in 2006-2008, and the subsequent risk of AF in the period until December 2015. The population at risk consisted of 39,340 individuals ≥20 years without AF at HUNT3 baseline who answered headache questionnaire during HUNT3. The prospective association was evaluated by multivariable Cox proportional hazard models with 95% confidence intervals (CIs). RESULTS Among the 39,340 participants, 1524 (3.8%) developed AF during the 9-year follow up, whereof 91% of these were ≥55 years. In the multivariable analyses, adjusting for known confounders, we did not find any association between migraine or TTH and risk of AF. The adjusted hazard ratios (HRs) were respectively 0.84 (95% CI = 0.64-1.11) for migraine, 1.16 (95% CI = 0.86-1.27) for TTH and 1.04 (95% CI = 0.86-1.27) for unclassified headache. However, in sensitivity analyses of individuals aged ≥55 years, a lower risk of AF was found for migraine (HR = 0.53; 95% CI = 0.39-0.73). CONCLUSIONS In this large population-based study, no increased risk of AF was found among individuals with migraine or TTH at baseline. Indeed, among individuals aged ≥55 years, migraine was associated with a lower risk for AF.
Collapse
Affiliation(s)
- Samita Giri
- Department of Neuromedicine and Movement Science, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- NorHEAD - Norwegian Centre for Headache Research, NTNU, Trondheim, Norway
| | - Erling Tronvik
- Department of Neuromedicine and Movement Science, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- NorHEAD - Norwegian Centre for Headache Research, NTNU, Trondheim, Norway
- Department of Neurology and Clinical Neurophysiology, St Olavs University Hospital, Trondheim, Norway
| | - Håvard Dalen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Cardiology, St Olavs University Hospital, Trondheim, Norway
- Department of Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Hanne Ellekjær
- Department of Neuromedicine and Movement Science, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- Stroke Unit, Department of Internal Medicine, St Olavs University Hospital, Trondheim, Norway
| | - Jan P Loennechen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Cardiology, St Olavs University Hospital, Trondheim, Norway
| | - Alexander Olsen
- NorHEAD - Norwegian Centre for Headache Research, NTNU, Trondheim, Norway
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Rehabilitation, St Olavs University Hospital, Trondheim, Norway
| | - Knut Hagen
- Department of Neuromedicine and Movement Science, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- NorHEAD - Norwegian Centre for Headache Research, NTNU, Trondheim, Norway
- Clinical Research Unit, St Olavs University Hospital, Trondheim, Norway
| |
Collapse
|
28
|
Mundal I, Schei J, Lydersen S, Thomsen PH, Nøvik TS, Kvitland LR. Prevalence of chronic and multisite pain in adolescents and young adults with ADHD: a comparative study between clinical and general population samples (the HUNT study). Eur Child Adolesc Psychiatry 2024; 33:1433-1442. [PMID: 37386203 PMCID: PMC11098922 DOI: 10.1007/s00787-023-02249-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 06/19/2023] [Indexed: 07/01/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) and chronic pain are prevalent and associated. We examined the prevalence and distribution of chronic pain in adolescents and young adults with ADHD using 9-years longitudinal data (from T1:2009-2011 to T3:2018-2019) with three time points from a clinical health survey compared to two age-matched reference population-based samples. Mixed-effect logistic regression and binary linear regression were used to estimate the probability for chronic and multisite pain at each time point and to compare the prevalence of chronic pain with the reference populations. The prevalence of chronic and multisite pain was high in those with ADHD, especially in female young adults, with highly prevalent chronic pain at 9 years of follow-up (75.9%) compared to 45.7% in females in the reference population. The probability of having pain was only statistically significant for chronic pain in males at 3 years of follow-up (41.9%, p = 0.021). Those with ADHD were at higher risk of reporting single-site and multisite pain compared to the general population at all measurement points. Longitudinal studies should be tailored to further understand the complex sex differences of comorbid chronic pain and ADHD in adolescents, exploring predictive factors of pain assessing long-term associations with bodyweight, psychiatric comorbidities, and possible mechanisms of stimulant use effects on pain.
Collapse
Affiliation(s)
- Ingunn Mundal
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
- Department of Health and Social Sciences, Molde University College, Molde, Norway.
- Kristiansund Community Mental Health Centre, Division of Psychiatry, Møre and Romsdal Hospital Trust, Kristiansund, Norway.
| | - Jorun Schei
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Stian Lydersen
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Per Hove Thomsen
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Psychiatry, Aarhus N, Denmark
| | - Torunn Stene Nøvik
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Levi R Kvitland
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- St. Olavs University Hospital, Trondheim, Norway
| |
Collapse
|
29
|
Hall M, Skogholt AH, Surakka I, Dalen H, Almaas E. Genome-wide association studies reveal differences in genetic susceptibility between single events vs. recurrent events of atrial fibrillation and myocardial infarction: the HUNT study. Front Cardiovasc Med 2024; 11:1372107. [PMID: 38725839 PMCID: PMC11079265 DOI: 10.3389/fcvm.2024.1372107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 04/04/2024] [Indexed: 05/12/2024] Open
Abstract
Genetic research into atrial fibrillation (AF) and myocardial infarction (MI) has predominantly focused on comparing afflicted individuals with their healthy counterparts. However, this approach lacks granularity, thus overlooking subtleties within patient populations. In this study, we explore the distinction between AF and MI patients who experience only a single disease event and those experiencing recurrent events. Integrating hospital records, questionnaire data, clinical measurements, and genetic data from more than 500,000 HUNT and United Kingdom Biobank participants, we compare both clinical and genetic characteristics between the two groups using genome-wide association studies (GWAS) meta-analyses, phenome-wide association studies (PheWAS) analyses, and gene co-expression networks. We found that the two groups of patients differ in both clinical characteristics and genetic risks. More specifically, recurrent AF patients are significantly younger and have better baseline health, in terms of reduced cholesterol and blood pressure, than single AF patients. Also, the results of the GWAS meta-analysis indicate that recurrent AF patients seem to be at greater genetic risk for recurrent events. The PheWAS and gene co-expression network analyses highlight differences in the functions associated with the sets of single nucleotide polymorphisms (SNPs) and genes for the two groups. However, for MI patients, we found that those experiencing single events are significantly younger and have better baseline health than those with recurrent MI, yet they exhibit higher genetic risk. The GWAS meta-analysis mostly identifies genetic regions uniquely associated with single MI, and the PheWAS analysis and gene co-expression networks support the genetic differences between the single MI and recurrent MI groups. In conclusion, this work has identified novel genetic regions uniquely associated with single MI and related PheWAS analyses, as well as gene co-expression networks that support the genetic differences between the patient subgroups of single and recurrent occurrence for both MI and AF.
Collapse
Affiliation(s)
- Martina Hall
- Department of Biotechnology and Food Science, Norwegian University of Science and Technology, Trondheim, Norway
- K.G. Jebsen Center for Genetic Epidemiology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Anne Heidi Skogholt
- K.G. Jebsen Center for Genetic Epidemiology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ida Surakka
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Haavard Dalen
- Clinic of Cardiology, St. Olavs University Hospital, Trondheim, Norway
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Eivind Almaas
- Department of Biotechnology and Food Science, Norwegian University of Science and Technology, Trondheim, Norway
- K.G. Jebsen Center for Genetic Epidemiology, Norwegian University of Science and Technology, Trondheim, Norway
| |
Collapse
|
30
|
Ibsen TL, Strand BH, Bergh S, Livingston G, Lurås H, Mamelund SE, Voshaar RO, Rokstad AMM, Thingstad P, Gerritsen D, Selbæk G. A longitudinal cohort study on the use of health and care services by older adults living at home with/without dementia before and during the COVID-19 pandemic: the HUNT study. BMC Health Serv Res 2024; 24:485. [PMID: 38641570 PMCID: PMC11027287 DOI: 10.1186/s12913-024-10846-y] [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: 07/07/2023] [Accepted: 03/11/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Older adults and people with dementia were anticipated to be particularly unable to use health and care services during the lockdown period following the COVID-19 pandemic. To better prepare for future pandemics, we aimed to investigate whether the use of health and care services changed during the pandemic and whether those at older ages and/or dementia experienced a higher degree of change than that observed by their counterparts. METHODS Data from the Norwegian Trøndelag Health Study (HUNT4 70 + , 2017-2019) were linked to two national health registries that have individual-level data on the use of primary and specialist health and care services. A multilevel mixed-effects linear regression model was used to calculate changes in the use of services from 18 months before the lockdown, (12 March 2020) to 18 months after the lockdown. RESULTS The study sample included 10,607 participants, 54% were women and 11% had dementia. The mean age was 76 years (SD: 5.7, range: 68-102 years). A decrease in primary health and care service use, except for contact with general practitioners (GPs), was observed during the lockdown period for people with dementia (p < 0.001) and those aged ≥ 80 years without dementia (p = 0.006), compared to the 6-month period before the lockdown. The use of specialist health services decreased during the lockdown period for all groups (p ≤ 0.011), except for those aged < 80 years with dementia. Service use reached levels comparable to pre-pandemic data within one year after the lockdown. CONCLUSION Older adults experienced an immediate reduction in the use of health and care services, other than GP contacts, during the first wave of the COVID-19 pandemic. Within primary care services, people with dementia demonstrated a more pronounced reduction than that observed in people without dementia; otherwise, the variations related to age and dementia status were small. Both groups returned to services levels similar to those during the pre-pandemic period within one year after the lockdown. The increase in GP contacts may indicate a need to reallocate resources to primary health services during future pandemics. TRIAL REGISTRATION The study is registered at ClinicalTrials.gov, with the identification number NCT04792086.
Collapse
Affiliation(s)
- Tanja Louise Ibsen
- The Norwegian National Centre for Ageing and Health (Ageing and Health), Vestfold Hospital Trust, Tønsberg, Norway.
| | - Bjørn Heine Strand
- The Norwegian National Centre for Ageing and Health (Ageing and Health), Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Sverre Bergh
- The Norwegian National Centre for Ageing and Health (Ageing and Health), Vestfold Hospital Trust, Tønsberg, Norway
- Research Centre for Age-Related Functional Decline and Disease (AFS), Innlandet Hospital Trust, Ottestad, Norway
| | - Gill Livingston
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Hilde Lurås
- Health Services Research Unit, Akershus University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Svenn-Erik Mamelund
- Centre for Research On Pandemics & Society (PANSOC), at Oslo Metropolitan University, Oslo, Norway
| | - Richard Oude Voshaar
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Anne Marie Mork Rokstad
- The Norwegian National Centre for Ageing and Health (Ageing and Health), Vestfold Hospital Trust, Tønsberg, Norway
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
| | - Pernille Thingstad
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Health and Social Services, Trondheim Municipality, Trondheim, Norway
| | - Debby Gerritsen
- Department of Primary and Community Care, Research Institute for Medical Innovation, Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, Netherlands
| | - Geir Selbæk
- The Norwegian National Centre for Ageing and Health (Ageing and Health), Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
31
|
Øvretveit K, Ingeström EML, Spitieris M, Tragante V, Wade KH, Thomas LF, Wolford BN, Wisløff U, Gudbjartsson DF, Holm H, Stefansson K, Brumpton BM, Hveem K. Polygenic risk scores associate with blood pressure traits across the lifespan. Eur J Prev Cardiol 2024; 31:644-654. [PMID: 38007706 PMCID: PMC11025038 DOI: 10.1093/eurjpc/zwad365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 10/18/2023] [Accepted: 11/02/2023] [Indexed: 11/28/2023]
Abstract
AIMS Hypertension is a major modifiable cause of morbidity and mortality that affects over 1 billion people worldwide. Blood pressure (BP) traits have a strong genetic component that can be quantified with polygenic risk scores (PRSs). To date, the performance of BP PRSs has mainly been assessed in adults, and less is known about polygenic hypertension risk in childhood. METHODS AND RESULTS Multiple PRSs for systolic BP (SBP), diastolic BP (DBP), and pulse pressure were developed using either genome-wide significant weights, pruning and thresholding, or Bayesian regression. Among 87 total PRSs, the top performer for each trait was applied in independent cohorts of children and adult to assess genotype-phenotype associations and disease risk across the lifespan. Differences between those with low (1st decile), average (2nd-9th decile), and high (10th decile) PRS emerge in the first years of life and are maintained throughout adulthood. These diverging BP trajectories also seem to affect cardiovascular and renal disease risk, with increased risk observed among those in the top decile and reduced risk among those in the bottom decile of the polygenic risk distribution compared with the rest of the population. CONCLUSION Genetic risk factors are associated with BP traits across the lifespan, beginning in the first years of life. Given the importance of exposure time in disease pathogenesis and the early rise in BP levels among those genetically susceptible, PRSs may help identify high-risk individuals prior to hypertension onset, facilitate primordial prevention, and reduce the burden of this public health challenge.
Collapse
Affiliation(s)
- Karsten Øvretveit
- K.G. Jebsen Centre for Genetic Epidemiology, Faculty of Medicine and Health Sciences, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Postboks 8905, N-7491 Trondheim, Norway
| | - Emma M L Ingeström
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Michail Spitieris
- K.G. Jebsen Centre for Genetic Epidemiology, Faculty of Medicine and Health Sciences, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Postboks 8905, N-7491 Trondheim, Norway
- Department of Mathematical Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | | | - Kaitlin H Wade
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol BS8 1TH, UK
- Population Health Science, Bristol Medical School, Bristol BS8 1TH, UK
- Avon Longitudinal Study of Parents and Children, Bristol BS8 1TH, UK
| | - Laurent F Thomas
- K.G. Jebsen Centre for Genetic Epidemiology, Faculty of Medicine and Health Sciences, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Postboks 8905, N-7491 Trondheim, Norway
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Brooke N Wolford
- K.G. Jebsen Centre for Genetic Epidemiology, Faculty of Medicine and Health Sciences, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Postboks 8905, N-7491 Trondheim, Norway
| | - Ulrik Wisløff
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Daniel F Gudbjartsson
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
- School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | - Hilma Holm
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
| | - Kari Stefansson
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Ben M Brumpton
- K.G. Jebsen Centre for Genetic Epidemiology, Faculty of Medicine and Health Sciences, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Postboks 8905, N-7491 Trondheim, Norway
- HUNT Research Centre, Department of Public Health and Nursing, Norwegian University of Science and Technology, Levanger, Norway
| | - Kristian Hveem
- K.G. Jebsen Centre for Genetic Epidemiology, Faculty of Medicine and Health Sciences, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Postboks 8905, N-7491 Trondheim, Norway
- Department of Innovation and Research, St. Olavs Hospital, Trondheim, Norway
| |
Collapse
|
32
|
Riise HKR, Igland J, Graue M, Haugstvedt A, Østbye T, Søfteland E, Hermann M, Carlsson S, Åsvold BO, Iversen MM. Decreasing lifetime prevalence of diabetes-related foot ulcers in Norway: repeated cross-sectional population-based surveys from the HUNT study (1995-2019). Front Endocrinol (Lausanne) 2024; 15:1354385. [PMID: 38694943 PMCID: PMC11061349 DOI: 10.3389/fendo.2024.1354385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/26/2024] [Indexed: 05/04/2024] Open
Abstract
Background and aims Diabetes-related foot ulcers (DFU) are a persistent healthcare challenge, impacting both patients and healthcare systems, with adverse effects on quality of life and productivity. Our primary aim was to examine the trends in lifetime prevalence of DFU, as well as other micro- and macrovascular complications in the Trøndelag Health Study (HUNT) in Norway. Methods This study consists of individuals ≥20 years with diabetes participating in the population-based cross-sectional HUNT surveys (1995-2019). Prevalence ratios, comparing the lifetime prevalence of DFU and other relevant micro- and macrovascular complications between the HUNT surveys, were calculated using Poisson regression. Results The lifetime prevalence (95% confidence interval (CI)) of a DFU requiring three or more weeks to heal was 11.0% (9.5-12.7) in HUNT2, 7.5% (6.3-8.8) in HUNT3 and 5.3% (4.4-6.3) in HUNT4. The decrease in DFU prevalence from 1995 to 2019 was observed in both men and women, for all age groups, and for both type 1 and type 2 diabetes. The highest lifetime prevalence of DFU was found among those with type 1 diabetes. The decrease in HbA1c from HUNT2 to HUNT4 did not differ between those with and without a DFU. The prevalence of chronic kidney disease (eGFR <60 mL/min/1.73 m2 (eGFR categories G3-G5)) increased in both individuals with and without a DFU. Conclusion Results from the HUNT surveys show a substantial decline in the lifetime prevalence of DFU from 1995 to 2019.
Collapse
Affiliation(s)
- Hilde K. R. Riise
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Jannicke Igland
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Marit Graue
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Anne Haugstvedt
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Truls Østbye
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC, United States
| | - Eirik Søfteland
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Monica Hermann
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Sofia Carlsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Bjørn Olav Åsvold
- HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing, NTNU – Norwegian University of Science and Technology, Trondheim, Norway
- Department of Endocrinology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- HUNT Research Center, Department of Public Health and Nursing, NTNU – Norwegian University of Science and Technology, Levanger, Norway
| | - Marjolein M. Iversen
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| |
Collapse
|
33
|
Holvik K, Abel MH, Holmen J, Krokstad S, Totland TH, Meyer HE. No change in 24-h sodium intake estimated from spot urine in Norwegian adults from 2006 to 2019: the population-based Trøndelag Health Study (HUNT). Public Health Nutr 2024; 27:e117. [PMID: 38602104 PMCID: PMC11036440 DOI: 10.1017/s136898002400082x] [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: 08/14/2023] [Revised: 03/06/2024] [Accepted: 04/03/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVE Monitoring time trends in salt consumption is important for evaluating the impact of salt reduction initiatives on public health outcomes. There has so far not been available data to indicate if salt consumption in Norway has changed during the previous decade. We aimed to assess whether average 24-h salt intake estimated from spot urine samples in the adult population of mid-Norway changed from 2006-2008 to 2017-2019 and to describe variations by sex, age and educational level. DESIGN Repeated cross-sectional studies. SETTING The population-based Trøndelag Health Study (HUNT). PARTICIPANTS In each of two consecutive waves (HUNT3: 2006-2008 and HUNT4: 2017-2019), spot urine samples were collected from 500 men and women aged 25-64 years, in addition to 250 men and women aged 70-79 years in HUNT4. Based on spot urine concentrations of Na, K and creatinine and age, sex and BMI, we estimated 24-h Na intake using the International Cooperative Study on Salt and Blood Pressure (INTERSALT) equation for the Northern European region. RESULTS Mean (95 % CI) estimated 24-h salt intakes in men were 11·1 (95 % CI 10·8, 11·3) g in HUNT3 and 10·9 (95 % CI 10·6, 11·1) g in HUNT4, P = 0·25. Corresponding values in women were 7·7 (95 % CI 7·5, 7·9) g and 7·7 (95 % CI 7·5, 7·9) g, P = 0·88. Mean estimated salt intake in HUNT4 decreased with increasing age in women, but not in men, and it did not differ significantly across educational level in either sex. CONCLUSIONS Estimated 24-h salt intake in adult men and women in mid-Norway did not change from 2006-2008 to 2017-2019.
Collapse
Affiliation(s)
- Kristin Holvik
- Department of Physical Health and Ageing, Norwegian Institute
of Public Health, 0213Oslo, Norway
| | - Marianne Hope Abel
- Department of Physical Health and Ageing, Norwegian Institute
of Public Health, 0213Oslo, Norway
| | - Jostein Holmen
- HUNT Research Center, Department of Public Health and Nursing,
Norwegian University of Science and Technology (NTNU),
Trondheim, Norway
| | - Steinar Krokstad
- HUNT Research Center, Department of Public Health and Nursing,
Norwegian University of Science and Technology (NTNU),
Trondheim, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust,
Levanger, Norway
| | - Torunn Holm Totland
- Department of Physical Health and Ageing, Norwegian Institute
of Public Health, 0213Oslo, Norway
| | - Haakon E Meyer
- Department of Physical Health and Ageing, Norwegian Institute
of Public Health, 0213Oslo, Norway
- Department of Community Medicine and Global Health, Institute of Health
and Society, University of Oslo, Oslo,
Norway
| |
Collapse
|
34
|
Næss M, Kvaløy K, Sørgjerd EP, Sætermo KS, Norøy L, Røstad AH, Hammer N, Altø TG, Vikdal AJ, Hveem K. Data Resource Profile: The HUNT Biobank. Int J Epidemiol 2024; 53:dyae073. [PMID: 38836303 PMCID: PMC11150882 DOI: 10.1093/ije/dyae073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 05/23/2024] [Indexed: 06/06/2024] Open
Affiliation(s)
- Marit Næss
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Kirsti Kvaløy
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
- Department of Community Medicine, Center for Sami Health Research, Arctic University of Norway, Tromso, Norway
| | - Elin P Sørgjerd
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Kristin S Sætermo
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Lise Norøy
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Ann Helen Røstad
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Nina Hammer
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Trine Govasli Altø
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Anne Jorunn Vikdal
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Kristian Hveem
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology), Trondheim, Norway
- Department of Research, St Olav’s Hospital, Trondheim, Norway
| |
Collapse
|
35
|
Moksnes MR, Hansen AF, Wolford BN, Thomas LF, Rasheed H, Simić A, Bhatta L, Brantsæter AL, Surakka I, Zhou W, Magnus P, Njølstad PR, Andreassen OA, Syversen T, Zheng J, Fritsche LG, Evans DM, Warrington NM, Nøst TH, Åsvold BO, Flaten TP, Willer CJ, Hveem K, Brumpton BM. A genome-wide association study provides insights into the genetic etiology of 57 essential and non-essential trace elements in humans. Commun Biol 2024; 7:432. [PMID: 38594418 PMCID: PMC11004147 DOI: 10.1038/s42003-024-06101-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 03/22/2024] [Indexed: 04/11/2024] Open
Abstract
Trace elements are important for human health but may exert toxic or adverse effects. Mechanisms of uptake, distribution, metabolism, and excretion are partly under genetic control but have not yet been extensively mapped. Here we report a comprehensive multi-element genome-wide association study of 57 essential and non-essential trace elements. We perform genome-wide association meta-analyses of 14 trace elements in up to 6564 Scandinavian whole blood samples, and genome-wide association studies of 43 trace elements in up to 2819 samples measured only in the Trøndelag Health Study (HUNT). We identify 11 novel genetic loci associated with blood concentrations of arsenic, cadmium, manganese, selenium, and zinc in genome-wide association meta-analyses. In HUNT, several genome-wide significant loci are also indicated for other trace elements. Using two-sample Mendelian randomization, we find several indications of weak to moderate effects on health outcomes, the most precise being a weak harmful effect of increased zinc on prostate cancer. However, independent validation is needed. Our current understanding of trace element-associated genetic variants may help establish consequences of trace elements on human health.
Collapse
Affiliation(s)
- Marta R Moksnes
- HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing, NTNU-Norwegian University of Science and Technology, Trondheim, Norway.
| | - Ailin F Hansen
- HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| | - Brooke N Wolford
- HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| | - Laurent F Thomas
- HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
- Department of Clinical and Molecular Medicine, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
- BioCore-Bioinformatics Core Facility, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Laboratory Medicine, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Humaira Rasheed
- HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Division of Medicine and Laboratory Sciences, University of Oslo, Oslo, Norway
| | - Anica Simić
- Department of Chemistry, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| | - Laxmi Bhatta
- HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| | - Anne Lise Brantsæter
- Department of Food Safety, Division of Climate and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Ida Surakka
- Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, MI, USA
| | - Wei Zhou
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Per Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Pål R Njølstad
- Mohn Center for Diabetes Precision Medicine, Department of Clinical Science, University of Bergen, Bergen, Norway
- Children and Youth Clinic, Haukeland University Hospital, Bergen, Norway
| | - Ole A Andreassen
- NORMENT Centre, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Tore Syversen
- Department of Neuroscience, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| | - Jie Zheng
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Shanghai Digital Medicine Innovation Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- MRC Integrative Epidemiology Unit (IEU), Bristol Medical School, University of Bristol, Bristol, UK
| | - Lars G Fritsche
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Center for Statistical Genetics, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - David M Evans
- Institute for Molecular Biosciences, The University of Queensland, Brisbane, QLD, Australia
- Frazer Institute, The University of Queensland, Woolloongabba, QLD, Australia
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
| | - Nicole M Warrington
- HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
- Institute for Molecular Biosciences, The University of Queensland, Brisbane, QLD, Australia
- Frazer Institute, The University of Queensland, Woolloongabba, QLD, Australia
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
| | - Therese H Nøst
- HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Bjørn Olav Åsvold
- HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
- HUNT Research Centre, Department of Public Health and Nursing, NTNU-Norwegian University of Science and Technology, Levanger, Norway
- Department of Endocrinology, Clinic of Medicine, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Trond Peder Flaten
- Department of Chemistry, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| | - Cristen J Willer
- HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
- Department of Human Genetics, University of Michigan, Ann Arbor, MI, USA
| | - Kristian Hveem
- HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
- HUNT Research Centre, Department of Public Health and Nursing, NTNU-Norwegian University of Science and Technology, Levanger, Norway
| | - Ben M Brumpton
- HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing, NTNU-Norwegian University of Science and Technology, Trondheim, Norway.
- HUNT Research Centre, Department of Public Health and Nursing, NTNU-Norwegian University of Science and Technology, Levanger, Norway.
- Clinic of Medicine, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway.
| |
Collapse
|
36
|
Marcuzzi A, Mork PJ, Aasdahl L, Skarpsno E, Moe K, Nilsen TIL. Incidence of sick leave and disability pension in adults with musculoskeletal pain and co-occurring long-term conditions: data from the Norwegian HUNT study and national registries. BMC Musculoskelet Disord 2024; 25:273. [PMID: 38589843 PMCID: PMC11003184 DOI: 10.1186/s12891-024-07405-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 04/01/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Musculoskeletal pain is one of the leading causes of work productivity loss. Long-term conditions (LTCs) commonly occur alongside musculoskeletal pain. However, the incidence of sick leave and disability pension according to LTC status in people with musculoskeletal pain has not been previously described. METHODS Working-age participants (20-65 years) with persistent musculoskeletal pain who participated in the HUNT3 Study (1995-97) were included. Twenty-five LTCs were classified into 8 LTC groups according to the International Classification of Diseases version 11. Data on sickness and disability benefits were obtained from the National Insurance Database and linked to the HUNT3 data using participants' personal identification number. Age-adjusted incidence rates (IRs) (per 10,000 person-years) and hazard ratios (HRs) of sick leave during 5-year follow-up and disability pension during ~ 25-year follow-up were estimated with 95% confidence intervals (CIs) and presented according to LTC status. RESULTS Overall, 11,080 participants with musculoskeletal pain were included. Of those, 32% reported one LTC and 45% reported ≥ 2 LTCs. During the follow up period, 1,312 participants (12%) received disability pension due to musculoskeletal conditions. The IR of sick leave and disability pension due to musculoskeletal conditions increased with number of LTCs. Specifically, the IR of sick leave was 720 (95% CI 672 to 768) in participants without any LTCs and 968 (95% CI 927 to 1,009) if they had ≥ 2 LTCs. The IRs of disability pension were 87 (95% CI 75 to 98) and 167 (95% CI 154 to 179) among those with no LTCs and ≥ 2 LTCs, respectively. The incidence of sick leave and disability pension due to musculoskeletal conditions was largely similar across LTCs, although the incidence of disability pension was somewhat higher among people with sleep disorders (IR: 223, 95% CI 194 to 252). CONCLUSIONS Among people with persistent musculoskeletal pain, the incidence of prematurely leaving the work force due to musculoskeletal conditions was twice as high for those with multiple LTCs compared to those without any LTCs. This was largely irrespective of the type of LTC, indicating that the number of LTCs are an important feature when evaluating work participation among people with musculoskeletal pain.
Collapse
Affiliation(s)
- Anna Marcuzzi
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
- Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim, Norway.
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
| | - Paul Jarle Mork
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Lene Aasdahl
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Unicare Helsefort Rehabilitation Center, Rissa, Norway
| | - Eivind Skarpsno
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Karoline Moe
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Tom Ivar Lund Nilsen
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| |
Collapse
|
37
|
Mrowiec K, Debik J, Jelonek K, Kurczyk A, Ponge L, Wilk A, Krzempek M, Giskeødegård GF, Bathen TF, Widłak P. Profiling of serum metabolome of breast cancer: multi-cancer features discriminate between healthy women and patients with breast cancer. Front Oncol 2024; 14:1377373. [PMID: 38646441 PMCID: PMC11027565 DOI: 10.3389/fonc.2024.1377373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 03/25/2024] [Indexed: 04/23/2024] Open
Abstract
Introduction The progression of solid cancers is manifested at the systemic level as molecular changes in the metabolome of body fluids, an emerging source of cancer biomarkers. Methods We analyzed quantitatively the serum metabolite profile using high-resolution mass spectrometry. Metabolic profiles were compared between breast cancer patients (n=112) and two groups of healthy women (from Poland and Norway; n=95 and n=112, respectively) with similar age distributions. Results Despite differences between both cohorts of controls, a set of 43 metabolites and lipids uniformly discriminated against breast cancer patients and healthy women. Moreover, smaller groups of female patients with other types of solid cancers (colorectal, head and neck, and lung cancers) were analyzed, which revealed a set of 42 metabolites and lipids that uniformly differentiated all three cancer types from both cohorts of healthy women. A common part of both sets, which could be called a multi-cancer signature, contained 23 compounds, which included reduced levels of a few amino acids (alanine, aspartate, glutamine, histidine, phenylalanine, and leucine/isoleucine), lysophosphatidylcholines (exemplified by LPC(18:0)), and diglycerides. Interestingly, a reduced concentration of the most abundant cholesteryl ester (CE(18:2)) typical for other cancers was the least significant in the serum of breast cancer patients. Components present in a multi-cancer signature enabled the establishment of a well-performing breast cancer classifier, which predicted cancer with a very high precision in independent groups of women (AUC>0.95). Discussion In conclusion, metabolites critical for discriminating breast cancer patients from controls included components of hypothetical multi-cancer signature, which indicated wider potential applicability of a general serum metabolome cancer biomarker.
Collapse
Affiliation(s)
- Katarzyna Mrowiec
- Center for Translational Research and Molecular Biology of Cancer, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Julia Debik
- Department of Circulation and Medical Imaging, The Norwegian University of Science and Technology, Trondheim, Norway
- Department of Public Health and Nursing, The Norwegian University of Science and Technology, Trondheim, Norway
| | - Karol Jelonek
- Center for Translational Research and Molecular Biology of Cancer, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Agata Kurczyk
- Department of Biostatistics and Bioinformatics, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Lucyna Ponge
- Center for Translational Research and Molecular Biology of Cancer, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Agata Wilk
- Department of Biostatistics and Bioinformatics, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland
- Department of Systems Biology and Engineering, Silesian University of Technology, Gliwice, Poland
| | - Marcela Krzempek
- Department of Biostatistics and Bioinformatics, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Guro F. Giskeødegård
- Department of Circulation and Medical Imaging, The Norwegian University of Science and Technology, Trondheim, Norway
| | - Tone F. Bathen
- Department of Circulation and Medical Imaging, The Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Radiology and Nuclear Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Piotr Widłak
- 2nd Department of Radiology, Medical University of Gdansk, Gdansk, Poland
| |
Collapse
|
38
|
Aakre KM, Lyngbakken MN, Faaren AL, Røsjø H, Dalen H, Omland T. Reference intervals of circulating secretoneurin concentrations determined in a large cohort of community dwellers: the HUNT study. Clin Chem Lab Med 2024; 0:cclm-2024-0154. [PMID: 38564801 DOI: 10.1515/cclm-2024-0154] [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: 01/31/2024] [Accepted: 03/07/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVES Secretoneurin (SN) is a novel cardiac biomarker that associates with the risk of mortality and dysfunctional cardiomyocyte Ca2+ handling in heart failure patients. Reference intervals for SN are unknown. METHODS SN was measured with a CE-marked ELISA in healthy community dwellers from the fourth wave of the Trøndelag Health Study (HUNT4) conducted in 2017-2019. The common, sex and age specific 90th, 95th, 97.5th and 99th percentiles were calculated using the non-parametric method and outlier exclusion according to the Reed test. The applicability of sex and age specific reference intervals were investigated using Harris and Boyd test. We also estimated the percentiles in a subset with normal findings on echocardiographic screening. RESULTS The total cohort included 887 persons (56.4 % women). After echocardiographic screening 122 persons were excluded, leaving a total of 765 persons (57.8 % women). The 97.5th percentile (95 % CI in brackets) of SN was 59.7 (57.5-62.1) pmol/L in the total population and 58.6 (57.1-62.1) pmol/L after echocardiography screening. In general, slightly higher percentiles were found in women and elderly participants, but less than 4 % in these subgroups had concentrations deviating from the common 97.5th percentile. Low BMI or eGFR was also associated with higher concentrations of SN. CONCLUSIONS Upper reference limits for SN were similar amongst healthy adult community dwellers regardless of prescreening including cardiac echocardiography or not. Women and elderly showed higher concentrations of SN, but the differences were not sufficiently large to justify age and sex stratified upper reference limits.
Collapse
Affiliation(s)
- Kristin M Aakre
- Department of Medical Biochemistry and Pharmacology, 60498 Haukeland University Hospital , Bergen, Norway
- Department of Heart Disease, 60498 Haukeland University Hospital , Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Magnus N Lyngbakken
- Department of Cardiology, Division of Medicine, 60483 Akershus University Hospital , Lørenskog, Norway
- K.G. Jebsen Centre for Cardiac Biomarkers, 60504 Institute of Clinical Medicine, University of Oslo , Oslo, Norway
| | | | - Helge Røsjø
- K.G. Jebsen Centre for Cardiac Biomarkers, 60504 Institute of Clinical Medicine, University of Oslo , Oslo, Norway
- Akershus Clinical Research Center (ACR), Division of Research and Innovation, 60483 Akershus University Hospital , Lørenskog, Norway
| | - Håvard Dalen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Cardiology, St Olav's University Hospital, Trondheim, Norway
- Department of Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Torbjørn Omland
- Department of Cardiology, Division of Medicine, 60483 Akershus University Hospital , Lørenskog, Norway
- K.G. Jebsen Centre for Cardiac Biomarkers, 60504 Institute of Clinical Medicine, University of Oslo , Oslo, Norway
| |
Collapse
|
39
|
Abel MH, Totland TH, Holvik K, Brantsæter AL, Krokstad S, Åsvold BO, Meyer HE. Iodine status and determinants in adults in Norway - results from a population-based health examination survey (The HUNT Study). Food Nutr Res 2024; 68:9761. [PMID: 38571917 PMCID: PMC10989228 DOI: 10.29219/fnr.v68.9761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 01/23/2024] [Accepted: 02/16/2024] [Indexed: 04/05/2024] Open
Abstract
Background In Norway, there is a lack of knowledge about the iodine status in the general and older adult population, and there is no established national monitoring programme for iodine. Several studies have indicated that iodine deficiency is prevalent in subgroups of the population. Salt iodisation is currently being considered as a measure to increase the population iodine status. In this cross-sectional study, the aim was to evaluate iodine status and determinants in the adult and older adult population in Mid-Norway, before salt iodisation is likely to be initiated. Methods The study sample was a subsample of participants in the fourth wave of the population-based Trøndelag Health Study (HUNT4, 2017-2019) with available spot-urine samples. This subsample included participants with 25-64 years (n = 500) and 70-79 years (n = 250). The urine samples were analysed for iodine and creatinine. Information on the habitual intake of milk/yoghurt, fish, supplement use, use of thyroid medication and relevant background factors was collected through a general questionnaire. Multivariable quantile regression was used to model differences in the median urinary iodine concentration (UIC) by determinants. Estimates were weighted to match the age and sex distribution of the Norwegian population aged 25-79 years in 2019. Results Median UIC was 97 µg/L (95% confidence interval [CI]: 92, 103) indicating borderline iodine deficiency at a group level. The median UIC increased with age, and iodine status was insufficient in participants below age 55 years (median 92 µg/L [95% CI: 85, 99]). Important determinants of UIC were habitual milk/yoghurt intake, daily supplement use and current use of thyroid medication, but not intake of lean or fatty fish. Risk of mild-to-moderate iodine deficiency was seen in those with a low intake of milk/yoghurt, no supplement use and who did not use thyroid medication. No group was identified as being at risk of iodine excess. Conclusion Iodine status was adequate in older adults but mildly deficient in adults under 55 years. Milk intake, supplement use and use of thyroid medication are important determinants of iodine intake in Norway.
Collapse
Affiliation(s)
- Marianne Hope Abel
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Torunn Holm Totland
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Kristin Holvik
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Steinar Krokstad
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, NTNU, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Bjørn Olav Åsvold
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, NTNU, Levanger, Norway
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Endocrinology, Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Haakon E. Meyer
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| |
Collapse
|
40
|
Torske MO, Steen N, Ursin JT, Krokstad S, Nørstebø H, Muri K. Cohort profile: The FarmMERGE project-Merging human and animal databases to investigate the relationship between farmer and livestock health and welfare. The HUNT Study. PLoS One 2024; 19:e0301045. [PMID: 38547183 PMCID: PMC10977672 DOI: 10.1371/journal.pone.0301045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 02/14/2024] [Indexed: 04/02/2024] Open
Abstract
Stockmanship is an important determinant for good animal welfare and health. The goal of the FarmMERGE project is to investigate the associations between farmer health and work environment, and the health, productivity and welfare of their livestock. We merged several livestock industry databases with a major total population-based health study in Norway (The Trøndelag Health Study 2017-2019 (HUNT4)). This paper describes the project's collection and merging of data, and the cohort of farmers and farms that were identified as a result of our registry merge. There were 56,042 participants of HUNT4 (Nord-Trøndelag County participants only, participation rate: 54.0%). We merged a list of HUNT4 participants whose self-reported main occupation was "farmer" (n = 2,407) with agricultural databases containing production and health data from sheep, swine, dairy and beef cattle from 2017-2020. The Central Coordinating Register for Legal Entities was used as an intermediary step to achieve a link between the farmer and farming enterprise data. We identified 816 farmers (89.5% male, mean age 51.3 years) who had roles in 771 farming enterprises with documented animal production. The cohort included 675 unique farmer-farm combinations in cattle production, 139 in sheep, and 125 in swine. We linked at least one HUNT4 participant to approximately 63% of the dairy farms, 53% of the beef cattle farms, 30% of the sheep farms, and 38% of the swine farms in Nord-Trøndelag County in the 2017-2019 period. Using existing databases may be an efficient way of collecting large amounts of data for research, and using total population-based human health surveys may decrease response bias. However, the quality of the resulting research data will depend on the quality of the databases used, and thorough knowledge of the databases is required.
Collapse
Affiliation(s)
| | - Natalie Steen
- Faculty of Biosciences and Aquaculture, Nord University, Steinkjer, Norway
| | - Jonil Tau Ursin
- Faculty of Biosciences and Aquaculture, Nord University, Steinkjer, Norway
- Faculty of Biosciences and Aquaculture, Nord University, Bodø, Norway
| | - Steinar Krokstad
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Håvard Nørstebø
- TINE SA, Farm Advisory Services, Research and & Development Department, Ås, Norway
| | - Karianne Muri
- Department of Production Animal Clinical Sciences, Faculty of Veterinary Medicine, Norwegian University of Life Sciences (NMBU), Ås, Norway
| |
Collapse
|
41
|
Austin TR, Fink HA, Jalal DI, Törnqvist AE, Buzkova P, Barzilay JI, Lu T, Carbone L, Gabrielsen ME, Grahnemo L, Hveem K, Jonasson C, Kizer JR, Langhammer A, Mukamal KJ, Gerszten RE, Nethander M, Psaty BM, Robbins JA, Sun YV, Skogholt AH, Åsvold BO, Valderrabano RJ, Zheng J, Richards JB, Coward E, Ohlsson C. Large-scale circulating proteome association study (CPAS) meta-analysis identifies circulating proteins and pathways predicting incident hip fractures. J Bone Miner Res 2024; 39:139-149. [PMID: 38477735 PMCID: PMC11070286 DOI: 10.1093/jbmr/zjad011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/09/2023] [Accepted: 11/23/2023] [Indexed: 03/14/2024]
Abstract
Hip fractures are associated with significant disability, high cost, and mortality. However, the exact biological mechanisms underlying susceptibility to hip fractures remain incompletely understood. In an exploratory search of the underlying biology as reflected through the circulating proteome, we performed a comprehensive Circulating Proteome Association Study (CPAS) meta-analysis for incident hip fractures. Analyses included 6430 subjects from two prospective cohort studies (Cardiovascular Health Study and Trøndelag Health Study) with circulating proteomics data (aptamer-based 5 K SomaScan version 4.0 assay; 4979 aptamers). Associations between circulating protein levels and incident hip fractures were estimated for each cohort using age and sex-adjusted Cox regression models. Participants experienced 643 incident hip fractures. Compared with the individual studies, inverse-variance weighted meta-analyses yielded more statistically significant associations, identifying 23 aptamers associated with incident hip fractures (conservative Bonferroni correction 0.05/4979, P < 1.0 × 10-5). The aptamers most strongly associated with hip fracture risk corresponded to two proteins of the growth hormone/insulin growth factor system (GHR and IGFBP2), as well as GDF15 and EGFR. High levels of several inflammation-related proteins (CD14, CXCL12, MMP12, ITIH3) were also associated with increased hip fracture risk. Ingenuity pathway analysis identified reduced LXR/RXR activation and increased acute phase response signaling to be overrepresented among those proteins associated with increased hip fracture risk. These analyses identified several circulating proteins and pathways consistently associated with incident hip fractures. These findings underscore the usefulness of the meta-analytic approach for comprehensive CPAS in a similar manner as has previously been observed for large-scale human genetic studies. Future studies should investigate the underlying biology of these potential novel drug targets.
Collapse
Affiliation(s)
- Thomas R Austin
- Cardiovascular Health Research Unit, University of Washington, Seattle, WA, 98195, United States
| | - Howard A Fink
- Geriatric Research Education and Clinical Center, VA Health Care System, Minneapolis, MN, 56401, United States
| | - Diana I Jalal
- Division of Nephrology, Department of Internal Medicine, Carver College of Medicine, Iowa City, IA, 52242, United States
- Iowa City VA Medical Center, Iowa City, IA, 52246, United States
| | - Anna E Törnqvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Osteoporosis Centre, Centre for Bone and Arthritis Research at the Sahlgrenska Academy, University of Gothenburg, 413 45, Gothenburg, Sweden
| | - Petra Buzkova
- Department of Biostatistics, University of Washington, Seattle, WA, 98115, United States
| | - Joshua I Barzilay
- Division of Endocrinology, Kaiser Permanente of Georgia, Atlanta, GA, 30339, United States
| | - Tianyuan Lu
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, H3T 1E2, Canada
- Quantitative Life Sciences Program, McGill University, Montreal, Quebec, H3G 0B1, Canada
- 5 Prime Sciences Inc, Montreal, Quebec, H3Y 2W4, Canada
| | - Laura Carbone
- Charlie Norwood VAMC, Augusta, GA, 30901, United States
- Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA, 30912, United States
| | - Maiken E Gabrielsen
- Department of Public Health and Nursing, K.G. Jebsen Center for Genetic Epidemiology, Norwegian University of Science and Technology, 7491, Trondheim, Norway
| | - Louise Grahnemo
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Osteoporosis Centre, Centre for Bone and Arthritis Research at the Sahlgrenska Academy, University of Gothenburg, 413 45, Gothenburg, Sweden
| | - Kristian Hveem
- Department of Public Health and Nursing, K.G. Jebsen Center for Genetic Epidemiology, Norwegian University of Science and Technology, 7491, Trondheim, Norway
- HUNT Research Centre, NTNU, 7600, Levanger, Norway
| | - Christian Jonasson
- Department of Public Health and Nursing, K.G. Jebsen Center for Genetic Epidemiology, Norwegian University of Science and Technology, 7491, Trondheim, Norway
| | - Jorge R Kizer
- Cardiology Section, San Francisco VA Health Care System, San Francisco, CA, 94121, United States
- Department of Medicine, Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, 94158, United States
| | - Arnulf Langhammer
- HUNT Research Centre, NTNU, 7600, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, 7600, Levanger, Norway
| | - Kenneth J Mukamal
- Department of Medicine, Beth Israel Deaconess Medical Center, Brookline, MA, 2446, United States
| | - Robert E Gerszten
- Department of Medicine, Beth Israel Deaconess Medical Center, Brookline, MA, 2446, United States
| | - Maria Nethander
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Osteoporosis Centre, Centre for Bone and Arthritis Research at the Sahlgrenska Academy, University of Gothenburg, 413 45, Gothenburg, Sweden
- Bioinformatics and Data Center, Sahlgrenska Academy, University of Gothenburg, 413 90, Gothenburg, Sweden
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, University of Washington, Seattle, WA, 98195, United States
- Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle, WA, 98195, United States
| | - John A Robbins
- Department of Medicine, University of California, Davis, CA, 95817, United States
| | - Yan V Sun
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, United States
| | - Anne Heidi Skogholt
- Department of Public Health and Nursing, K.G. Jebsen Center for Genetic Epidemiology, Norwegian University of Science and Technology, 7491, Trondheim, Norway
| | - Bjørn Olav Åsvold
- Department of Public Health and Nursing, K.G. Jebsen Center for Genetic Epidemiology, Norwegian University of Science and Technology, 7491, Trondheim, Norway
- Department of Endocrinology, Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, 7491, Trondheim, Norway
| | - Rodrigo J Valderrabano
- Research Program in Men’s Health, Aging and Metabolism, Harvard Medical School, Brigham and Women’s Hospital, Boston, MA, 2130, United States
| | - Jie Zheng
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai Jiao Tong University School of Medicine, Ruijin Hospital, Shanghai, 200025, China
- Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Shanghai National Clinical Research Center for Metabolic Diseases, Shanghai Digital Medicine Innovation Center, Shanghai Jiao Tong University School of Medicine, Ruijin Hospital, Shanghai, 200025, China
- MRC Integrative Epidemiology Unit (IEU), Bristol Medical School, University of Bristol, Oakfield House, Bristol, BS8 2BN, United Kingdom
| | - J Brent Richards
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, H3T 1E2, Canada
- 5 Prime Sciences Inc, Montreal, Quebec, H3Y 2W4, Canada
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
- Department of Medicine, McGill University, Montreal, Quebec, H4A 3J1, Canada
- Department of Twin Research, King’s College London, London, SE1 7EH, United Kingdom
| | - Eivind Coward
- Department of Public Health and Nursing, K.G. Jebsen Center for Genetic Epidemiology, Norwegian University of Science and Technology, 7491, Trondheim, Norway
| | - Claes Ohlsson
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Osteoporosis Centre, Centre for Bone and Arthritis Research at the Sahlgrenska Academy, University of Gothenburg, 413 45, Gothenburg, Sweden
- Department of Drug Treatment, Region Västra Götaland, Sahlgrenska University Hospital, 413 45, Gothenburg, Sweden
| |
Collapse
|
42
|
Schjerven FE, Ingeström EML, Steinsland I, Lindseth F. Development of risk models of incident hypertension using machine learning on the HUNT study data. Sci Rep 2024; 14:5609. [PMID: 38454041 PMCID: PMC10920790 DOI: 10.1038/s41598-024-56170-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/03/2024] [Indexed: 03/09/2024] Open
Abstract
In this study, we aimed to create an 11-year hypertension risk prediction model using data from the Trøndelag Health (HUNT) Study in Norway, involving 17 852 individuals (20-85 years; 38% male; 24% incidence rate) with blood pressure (BP) below the hypertension threshold at baseline (1995-1997). We assessed 18 clinical, behavioral, and socioeconomic features, employing machine learning models such as eXtreme Gradient Boosting (XGBoost), Elastic regression, K-Nearest Neighbor, Support Vector Machines (SVM) and Random Forest. For comparison, we used logistic regression and a decision rule as reference models and validated six external models, with focus on the Framingham risk model. The top-performing models consistently included XGBoost, Elastic regression and SVM. These models efficiently identified hypertension risk, even among individuals with optimal baseline BP (< 120/80 mmHg), although improvement over reference models was modest. The recalibrated Framingham risk model outperformed the reference models, approaching the best-performing ML models. Important features included age, systolic and diastolic BP, body mass index, height, and family history of hypertension. In conclusion, our study demonstrated that linear effects sufficed for a well-performing model. The best models efficiently predicted hypertension risk, even among those with optimal or normal baseline BP, using few features. The recalibrated Framingham risk model proved effective in our cohort.
Collapse
Affiliation(s)
- Filip Emil Schjerven
- Department of Computer Science, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Emma Maria Lovisa Ingeström
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ingelin Steinsland
- Department of Mathematical Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Frank Lindseth
- Department of Computer Science, Norwegian University of Science and Technology, Trondheim, Norway
| |
Collapse
|
43
|
Jacobsen KK, Børte S, Laborie LB, Kristiansen H, Schäfer A, Gundersen T, Zayats T, Slagsvold Winsvold BK, Rosendahl K. COL11A1 is associated with developmental dysplasia of the hip and secondary osteoarthritis in the HUNT study. OSTEOARTHRITIS AND CARTILAGE OPEN 2024; 6:100424. [PMID: 38283578 PMCID: PMC10820335 DOI: 10.1016/j.ocarto.2023.100424] [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: 09/05/2023] [Revised: 10/19/2023] [Accepted: 12/01/2023] [Indexed: 01/30/2024] Open
Abstract
Objective Developmental dysplasia of the hip (DDH) is a congenital condition affecting 2-3% of all infants. DDH increases the risk of osteoarthritis, is the cause of 30 % of all total hip arthroplasties (THAs) in adults <40 years of age and can result in loss of life quality. Our aim was to explore the genetic background of DDH in order to improve diagnosis, management and longterm outcome. Design We used the large, ongoing, longitudinal Trøndelag Health Study (HUNT) database. Case definition was based on ICD-9/-10 diagnoses of DDH, or osteoarthritis secondary to DDH. Analyses were performed using SAIGE software, with covariates including sex, batch, birth year and principal components. We included only single nucleotide polymorphisms (SNPs) with minor allele frequency (MAF) ≥ 0.01, R2≥ 0.8 and Hardy-Weinberg equilibrium (HWE) P-value ≥ 0.0001. Significance level was set at p < 5 × 10-8. Meta-analysis using data from DDH and primary osteoarthritis genome-wide association studies (GWASs) was done using METAL software. The study was approved by the regional ethical committee. Results Analysis included 69,500 individuals, of which 408 cases, and 8,531,386 SNPs. Two SNPs near COL11A1 were significantly associated with DDH; rs713162 (β = -0.43, SE = 0.07, p = 8.4 × 10-9) and rs6577334 (β = -0.43, SE = 0.08, p = 8.9 × 10-9). COL11A1 has previously been associated with acetabular dysplasia and osteoarthritis. Meta-analysis supported previous GWAS findings of both DDH and primary osteoarthritis. Conclusions This large, genome-wide case-control study indicates an association between COL11A1 and DDH and is an important contribution to investigating the etiology of DDH, with further research needed.
Collapse
Affiliation(s)
- Kaya Kvarme Jacobsen
- Department of Orthopedic Surgery, District General Hospital of Førde, Førde, Norway
| | - Sigrid Børte
- Research and Communication Unit for Musculoskeletal Health, Division of Clinical Neuroscience, Oslo University Hospital, Ullevaal, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Lene Bjerke Laborie
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Section for Pediatric Radiology, Department of Radiology, Haukeland University Hospital, Bergen, Norway
| | - Hege Kristiansen
- Department of Paediatrics, District General Hospital of Førde, Førde, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Annette Schäfer
- Department of Paediatrics, District General Hospital of Førde, Førde, Norway
| | - Trude Gundersen
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Department of Orthopaedic Surgery, Haukeland University Hospital, Bergen, Norway
| | - Tetyana Zayats
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- PROMENTA, Department of Psychology, University of Oslo, Oslo, Norway
| | - Bendik Kristoffer Slagsvold Winsvold
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
- Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - Karen Rosendahl
- Department of Radiology, University Hospital of North-Norway, Tromsø, Norway
- Department of Clinical Medicine, UiT, The Arctic University of Norway, Tromsø, Norway
| |
Collapse
|
44
|
Zhu AH, Nir TM, Javid S, Villalon-Reina JE, Rodrigue AL, Strike LT, de Zubicaray GI, McMahon KL, Wright MJ, Medland SE, Blangero J, Glahn DC, Kochunov P, Håberg AK, Thompson PM, Jahanshad N. Lifespan reference curves for harmonizing multi-site regional brain white matter metrics from diffusion MRI. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.02.22.581646. [PMID: 38463962 PMCID: PMC10925090 DOI: 10.1101/2024.02.22.581646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Age-related white matter (WM) microstructure maturation and decline occur throughout the human lifespan, complementing the process of gray matter development and degeneration. Here, we create normative lifespan reference curves for global and regional WM microstructure by harmonizing diffusion MRI (dMRI)-derived data from ten public datasets (N = 40,898 subjects; age: 3-95 years; 47.6% male). We tested three harmonization methods on regional diffusion tensor imaging (DTI) based fractional anisotropy (FA), a metric of WM microstructure, extracted using the ENIGMA-DTI pipeline. ComBat-GAM harmonization provided multi-study trajectories most consistent with known WM maturation peaks. Lifespan FA reference curves were validated with test-retest data and used to assess the effect of the ApoE4 risk factor for dementia in WM across the lifespan. We found significant associations between ApoE4 and FA in WM regions associated with neurodegenerative disease even in healthy individuals across the lifespan, with regional age-by-genotype interactions. Our lifespan reference curves and tools to harmonize new dMRI data to the curves are publicly available as eHarmonize (https://github.com/ahzhu/eharmonize).
Collapse
Affiliation(s)
- Alyssa H Zhu
- Imaging Genetics Center, USC Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
- Department of Biomedical Engineering, USC Viterbi School of Engineering, Los Angeles, CA, USA
| | - Talia M Nir
- Imaging Genetics Center, USC Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - Shayan Javid
- Imaging Genetics Center, USC Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
- Department of Biomedical Engineering, USC Viterbi School of Engineering, Los Angeles, CA, USA
| | - Julio E Villalon-Reina
- Imaging Genetics Center, USC Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - Amanda L Rodrigue
- Department of Psychiatry and Behavioral Science, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Lachlan T Strike
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Queensland University of Technology, Brisbane, QLD, Australia
| | | | - Katie L McMahon
- Queensland University of Technology, Brisbane, QLD, Australia
| | - Margaret J Wright
- Queensland Brain Institute, University of Queensland, Brisbane, QLD, Australia
- Centre for Advanced Imaging, University of Queensland, Brisbane, QLD, Australia
| | - Sarah E Medland
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Queensland University of Technology, Brisbane, QLD, Australia
- School of Psychology, `, Brisbane, QLD, Australia
| | - John Blangero
- Department of Human Genetics, University of Texas Rio Grande Valley, Brownsville, TX, USA
- South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Brownsville, TX, USA
| | - David C Glahn
- Department of Psychiatry and Behavioral Science, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
- Olin Neuropsychiatry Research Center, Institute of Living, Hartford, CT, USA
| | - Peter Kochunov
- Faillace Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Asta K Håberg
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of MiDtT National Research Center, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Paul M Thompson
- Imaging Genetics Center, USC Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
- Department of Biomedical Engineering, USC Viterbi School of Engineering, Los Angeles, CA, USA
| | - Neda Jahanshad
- Imaging Genetics Center, USC Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
- Department of Biomedical Engineering, USC Viterbi School of Engineering, Los Angeles, CA, USA
| |
Collapse
|
45
|
Tronstad I, Hoff M, Horn J, Vikjord SAA, Videm V, Johansson J, Nilsen TIL, Langhammer A. Rheumatoid arthritis, disease-modifying antirheumatic drugs and risk of major osteoporotic fracture: prospective data from the HUNT Study, Norway. RMD Open 2024; 10:e003919. [PMID: 38382944 PMCID: PMC10882308 DOI: 10.1136/rmdopen-2023-003919] [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: 11/17/2023] [Accepted: 01/31/2024] [Indexed: 02/23/2024] Open
Abstract
OBJECTIVES Rheumatoid arthritis has been associated with increased fracture risk. New treatments have improved the course of the disease substantially, but it is not clear if this influences fracture risk. We examined if rheumatoid arthritis, overall and according to disease-modifying antirheumatic drugs (DMARDs), is associated with a risk of major osteoporotic fractures. METHODS Overall, 92 285 participants in the population-based Nord-Trndelag Health Study (HUNT), Norway were included and linked with hospital records for a validated rheumatoid arthritis diagnosis (n=605), type of DMARD treatment and fracture diagnosis. Participants were followed up until the first major osteoporotic fracture, death, emigration or end of follow-up. Cox regression was used to estimate HRs for fractures among individuals with rheumatoid arthritis, overall and by DMARD treatment, compared with participants without rheumatoid arthritis. RESULTS A total of 9670 fractures were observed during follow-up, of which 88 were among those with rheumatoid arthritis. Compared with the reference group of participants without rheumatoid arthritis, those with the disease had an HR of fracture of 1.41 (95% CI 1.13 to 1.74). The association was largely similar for users of csDMARDs (HR 1.44; 95% CI 1.15 to 1.81), whereas the association for bDMARD users was weaker and less precise (HR 1.19; 95% CI 0.64 to 2.21). CONCLUSION Participants with rheumatoid arthritis had a 40% higher risk of fracture than participants without the disease. A similar fracture risk was observed for conventional synthetic DMARD use, whereas there was weak evidence that the use of biological DMARDs may be associated with a somewhat lower fracture risk.
Collapse
Affiliation(s)
- Ingebjørg Tronstad
- HUNT Research Centre, Department of Public Health and Nursing, Norwegian University of Science and Technology, Faculty of Medicine and Health Sciences, Levanger, Trøndelag, Norway
- Department of Medicine and Rehabilitation, Nord-Trøndelag Hospital Trust, Levanger Hospital, Levanger, Trøndelag, Norway
| | - Mari Hoff
- Department of Rheumatology, St Olavs Hospital Trondheim University Hospital, Trondheim, Trøndelag, Norway
- Neuromedicine and Movement Science, Norwegian University of Science and Technology, Faculty of Medicine and Health Sciences, Trondheim, Trøndelag, Norway
| | - Julie Horn
- HUNT Research Centre, Department of Public Health and Nursing, Norwegian University of Science and Technology, Faculty of Medicine and Health Sciences, Levanger, Trøndelag, Norway
- Department of Obstetrics and Gynecology, Nord-Trøndelag Hospital Trust, Levanger Hospital, Levanger, Trøndelag, Norway
| | - Sigrid Anna Aalberg Vikjord
- HUNT Research Centre, Department of Public Health and Nursing, Norwegian University of Science and Technology, Faculty of Medicine and Health Sciences, Levanger, Trøndelag, Norway
- Clinic of Thoracic and Occupational Medicine, St Olavs Hospital Trondheim University Hospital, Trondheim, Trøndelag, Norway
| | - Vibeke Videm
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Faculty of Medicine and Health Sciences, Trondheim, Trøndelag, Norway
- Department of Immunology and Transfusion Medicine, St Olavs Hospital Trondheim University Hospital, Trondheim, Trøndelag, Norway
| | - Jonas Johansson
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Troms, Norway
| | - Tom Ivar Lund Nilsen
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Faculty of Medicine and Health Sciences, Trondheim, Trøndelag, Norway
| | - Arnulf Langhammer
- HUNT Research Centre, Department of Public Health and Nursing, Norwegian University of Science and Technology, Faculty of Medicine and Health Sciences, Levanger, Trøndelag, Norway
- Nord-Trøndelag Hospital Trust, Levanger, Norway, Levanger Hospital, Levanger, Trøndelag, Norway
| |
Collapse
|
46
|
Xu Z, Rao X, Xing Y, Zhu Z, Yan L, Huang J, Zhang J, Zheng R. Connecting atrial fibrillation to digestive neoplasms: exploring mediation via ischemic stroke and heart failure in Mendelian randomization studies. Front Oncol 2024; 14:1301327. [PMID: 38444673 PMCID: PMC10912520 DOI: 10.3389/fonc.2024.1301327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 01/22/2024] [Indexed: 03/07/2024] Open
Abstract
Background Notwithstanding the acknowledged interplay between atrial fibrillation (AF) and the emergence of digestive system neoplasms, the intricacies of this relationship remain ambiguous. By capitalizing univariable Mendelian Randomization (MR) complemented by a mediated MR tactic, our pursuit was to elucidate the causative roles of AF in precipitating digestive system malignancies and potential intermediary pathways. Method This research endeavor seeks to scrutinize the causal clinical implications of whether genetic predispositions to AF correlate with an increased risk of digestive system malignancies, employing MR analytical techniques. Utilizing a dataset amalgamated from six studies related to AF, encompassing over 1,000,000 subjects, we performed univariable MR assessments, employing the random-effects inverse-variance weighted (IVW) methodology as our principal analytical paradigm. Subsequently, a mediated MR framework was employed to probe the potential mediating influence of AF on the nexus between hypertension (HT), heart failure (HF), ischemic stroke (IS), coronary artery disease (CAD), and digestive system neoplasms. Result The univariable MR evaluation unveiled a notable causal nexus between the genetic inclination toward AF and the genetic susceptibility to colon, esophageal, and small intestine malignancies. The mediated MR scrutiny ascertained that the genetic inclination for AF amplifies the risk profile for colon cancer via IS pathways and partially explains the susceptibility to esophageal and small intestine tumors through the HF pathway. Conclusion Our investigative endeavor has highlighted a definitive causative association between genetic inclination to AF and specific digestive system neoplasms, spotlighting IS and HF as instrumental mediators. Such revelations furnish pivotal perspectives on the complex genetic interconnections between cardiovascular anomalies and certain digestive tract tumors, emphasizing prospective therapeutic and diagnostic worthy of pursuit.
Collapse
Affiliation(s)
- Zhijie Xu
- Beijing University of Chinese Medicine, Beijing, China
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Xuezhi Rao
- Beijing University of Chinese Medicine, Beijing, China
- The Second School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yaxuan Xing
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhiwei Zhu
- Beijing University of Chinese Medicine, Beijing, China
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Longmei Yan
- Beijing University of Chinese Medicine, Beijing, China
| | - Jian Huang
- Department of Acupuncture and Moxibustion, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jingchun Zhang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ruwen Zheng
- Department of Acupuncture and Moxibustion, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| |
Collapse
|
47
|
Engdahl B, Aarhus L. Prevalence and predictors of self-reported hearing aid use and benefit in Norway: the HUNT study. BMC Public Health 2024; 24:474. [PMID: 38355451 PMCID: PMC10867996 DOI: 10.1186/s12889-024-17852-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 01/23/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Knowledge on hearing aid use and benefit is important to ensure appropriate and effective treatment. We aimed to assess prevalence and predictors of hearing aid use and benefit in Norway, as well as possible birth cohort changes. METHODS We analyzed two large cross-sectional, population-based hearing surveys of 63,182 adults in 1996-1998 and 2017-2019 (the HUNT study). We used multivariable regression models to examine independent predictors of hearing aid use and benefit, including demography, hearing-related variables, known risk factors for hearing loss and birth cohort. RESULTS The nationally weighted hearing aid use in the adult population increased from 4.2% in 1997 to 5.8% in 2018. The use among individuals with disabling hearing loss (≥ 35 dB HL) increased from 46.3% to 64.4%. Most users reported some (47%) or great (48%) help from their hearing aids. In addition to the level of hearing loss and birth cohort, factors associated with hearing aid use included lower age, tinnitus, childhood-onset hearing loss, higher education, marriage, having children, being exposed to occupational noise or impulse noise, recurrent ear infections, and head injury. In addition to the level of hearing loss, factors related to hearing aid benefit included younger age, female gender, and higher income. Being bothered by tinnitus reduced the benefit. CONCLUSION Our study shows an increase in self-reported hearing aid usage over time in Norway, with lower adoption rates and perceived benefits observed among the elderly. The results suggest that having a spouse and children positively influences the adoption of hearing aids. These findings emphasize the necessity of customized strategies to address demographic disparities and the need for innovative enhancements in hearing rehabilitation programs.
Collapse
Affiliation(s)
- Bo Engdahl
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, Postbox 4404 Nydalen, N-0403, Oslo, Norway.
| | - Lisa Aarhus
- Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway
- Department of Internal Medicine, Diakonhjemmet Hospital, Oslo, Norway
| |
Collapse
|
48
|
Rangul V, Holmen TL, Langhammer A, Ingul JM, Pape K, Fenstad JS, Kvaløy K. Cohort Profile Update: The Young-HUNT Study, Norway. Int J Epidemiol 2024; 53:dyae013. [PMID: 38302751 PMCID: PMC10834360 DOI: 10.1093/ije/dyae013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 01/17/2024] [Indexed: 02/03/2024] Open
Affiliation(s)
- Vegar Rangul
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Turid Lingaas Holmen
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Arnulf Langhammer
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Jo Magne Ingul
- Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kristine Pape
- Department of Public Health and Nursing, Faculty and Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Trondheim, Norway
| | - Jørn Søberg Fenstad
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Kirsti Kvaløy
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| |
Collapse
|
49
|
Vikan KK, Landmark T, Gjeilo KH. Prevalence of chronic pain and chronic widespread pain among subjects with heart failure in the general population: The HUNT study. Eur J Pain 2024; 28:273-284. [PMID: 37680005 DOI: 10.1002/ejp.2176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 08/15/2023] [Accepted: 08/21/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Pain in chronic heart failure (HF) is a significant but often unrecognized symptom. Characteristics of pain in subjects with HF are largely undescribed. The study aimed to address a knowledge gap in the relationship between HF and pain by investigating the prevalence of chronic pain and chronic widespread pain (CWP) among subjects with HF. METHODS Population data from the HUNT3 study in Norway (2006-2008, n = 50,802) was used. HF was measured by self-report. CWP was defined as having pain in both sides of the body, pain in the upper and lower limbs, and axial pain for at least 3 months in the last year. Associations between HF and CWP and HF and moderate to high pain intensity were analysed with logistic regression. RESULTS Among subjects with HF in the general population, the prevalence of chronic pain was 67.8%, 20.7% had CWP, and 58.8% had moderate to high intensity pain. Compared to participants with cardiovascular disease but not HF, the odds of both CWP (OR = 1.6; 95% CI: 1.3-2.0) and moderate to high intensity pain (OR = 1.3; 95% CI: 1.3-1.8) were higher among participants with HF-controlled for age, sex, body mass index, and comorbidity. CONCLUSIONS Our study confirmed the high prevalence of pain among HF subjects. This pain could not be explained by comorbidity or sociodemographic factors, which are relevant for clinical and research purposes. Pain management should not be restricted to cardiac-related pain but to chronic pain in general. SIGNIFICANCE This epidemiological study corroborates previous studies reporting a high prevalence of pain in the HF-population. We found that the relationship between HF, CWP, and pain intensity could not be explained by comorbidity or sociodemographic factors, illustrating the burden of chronic pain related to HF. Our results expand the understanding of pain in HF and highlight the need to identify and manage chronic pain among individuals with HF, as widespread pain adds to the symptom burden in individuals with HF.
Collapse
Affiliation(s)
- K K Vikan
- Department of Circulation and Medical Imaging, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
- The Norwegian Registry for Vascular Surgery (NORKAR), Department of Medical Quality Registries, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - T Landmark
- Department of Circulation and Medical Imaging, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
- National Competence Centre for Complex Symptom Disorders, Clinic of Anesthesia and Intensive Care, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - K H Gjeilo
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Cardiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Cardiothoracic Surgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| |
Collapse
|
50
|
Nordstoga AL, Adhikari S, Skarpsno ES. The joint association of insomnia disorder and lifestyle on the risk of activity-limiting spinal pain: the HUNT Study. Sleep Med 2024; 114:244-249. [PMID: 38241943 DOI: 10.1016/j.sleep.2024.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/11/2024] [Accepted: 01/11/2024] [Indexed: 01/21/2024]
Abstract
OBJECTIVES To investigate whether the combination of multiple healthy lifestyle factors modify the well-established association between insomnia disorder and risk of activity-limiting spinal pain. METHODS We conducted a prospective study of 10,228 individuals who participated in two surveys over ∼11 years and were free of chronic pain in the neck, upper back, and lower back at baseline. Adjusted risk ratios (RRs) were calculated for the risk of activity-limiting chronic spinal pain (i.e., pain that impairs daily activities at work or leisure time) at follow-up associated with the joint association of insomnia disorder and the combination of five lifestyle factors (body mass index, leisure time physical activity, alcohol consumption, diet, and smoking) at baseline. RESULTS Our data indicate an additive interaction between insomnia disorder and lifestyle on risk of activity-limiting spinal pain, i.e., compared with participants without insomnia disorder and the best lifestyle score, participants with insomnia disorder and the worst lifestyle score had a RR of activity-limiting spinal pain of 3.57 (95 % CI: 2.65-4.80); participants with insomnia disorder and the best lifestyle score had a RR of 1.56 (95 % CI: 0.97-2.50); and those without insomnia disorder and the worst lifestyle score had a RR of 1.32 (95 % CI: 1.12-1.55). CONCLUSIONS Poor lifestyle behaviour amplifies the adverse effect of insomnia disorder on the risk of activity-limiting chronic spinal pain.
Collapse
Affiliation(s)
- Anne Lovise Nordstoga
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
| | - Shreesti Adhikari
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Eivind Schjelderup Skarpsno
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway
| |
Collapse
|