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Becerra-Tomás N, Markozannes G, Cariolou M, Balducci K, Vieira R, Kiss S, Aune D, Greenwood DC, Dossus L, Copson E, Renehan AG, Bours M, Demark-Wahnefried W, Hudson MM, May AM, Odedina FT, Skinner R, Steindorf K, Tjønneland A, Velikova G, Baskin ML, Chowdhury R, Hill L, Lewis SJ, Seidell J, Weijenberg MP, Krebs J, Cross AJ, Tsilidis KK, Chan DSM. Post-diagnosis adiposity and colorectal cancer prognosis: A Global Cancer Update Programme (CUP Global) systematic literature review and meta-analysis. Int J Cancer 2024; 155:400-425. [PMID: 38692659 DOI: 10.1002/ijc.34905] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 12/15/2023] [Accepted: 01/17/2024] [Indexed: 05/03/2024]
Abstract
The adiposity influence on colorectal cancer prognosis remains poorly characterised. We performed a systematic review and meta-analysis on post-diagnosis adiposity measures (body mass index [BMI], waist circumference, waist-to-hip ratio, weight) or their changes and colorectal cancer outcomes. PubMed and Embase were searched through 28 February 2022. Random-effects meta-analyses were conducted when at least three studies had sufficient information. The quality of evidence was interpreted and graded by the Global Cancer Update Programme (CUP Global) independent Expert Committee on Cancer Survivorship and Expert Panel. We reviewed 124 observational studies (85 publications). Meta-analyses were possible for BMI and all-cause mortality, colorectal cancer-specific mortality, and cancer recurrence/disease-free survival. Non-linear meta-analysis indicated a reverse J-shaped association between BMI and colorectal cancer outcomes (nadir at BMI 28 kg/m2). The highest risk, relative to the nadir, was observed at both ends of the BMI distribution (18 and 38 kg/m2), namely 60% and 23% higher risk for all-cause mortality; 95% and 26% for colorectal cancer-specific mortality; and 37% and 24% for cancer recurrence/disease-free survival, respectively. The higher risk with low BMI was attenuated in secondary analyses of RCTs (compared to cohort studies), among studies with longer follow-up, and in women suggesting potential methodological limitations and/or altered physiological state. Descriptively synthesised studies on other adiposity-outcome associations of interest were limited in number and methodological quality. All the associations were graded as limited (likelihood of causality: no conclusion) due to potential methodological limitations (reverse causation, confounding, selection bias). Additional well-designed observational studies and interventional trials are needed to provide further clarification.
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Affiliation(s)
- Nerea Becerra-Tomás
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Georgios Markozannes
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
| | - Margarita Cariolou
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Katia Balducci
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Rita Vieira
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Sonia Kiss
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Nutrition, Oslo New University College, Oslo, Norway
- Department of Research, The Cancer Registry of Norway, Oslo, Norway
| | - Darren C Greenwood
- Leeds Institute for Data Analytics, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Laure Dossus
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Ellen Copson
- Cancer Sciences Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Andrew G Renehan
- The Christie NHS Foundation Trust, Manchester Cancer Research Centre, NIHR Manchester Biomedical Research Centre, Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Martijn Bours
- Department of Epidemiology, GROW School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
| | - Wendy Demark-Wahnefried
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Melissa M Hudson
- Department of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Anne M May
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | | | - Roderick Skinner
- Department of Paediatric and Adolescent Haematology/Oncology, Great North Children's Hospital and Translational and Clinical Research Institute, and Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Diet, Cancer and Health, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Galina Velikova
- School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | | | - Rajiv Chowdhury
- Department of Global Health, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Lynette Hill
- World Cancer Research Fund International, London, UK
| | - Sarah J Lewis
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jaap Seidell
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Matty P Weijenberg
- Department of Epidemiology, GROW School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
| | - John Krebs
- Department of Biology, University of Oxford, Oxford, UK
| | - Amanda J Cross
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Konstantinos K Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
| | - Doris S M Chan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
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van de Weijer MP, Verweij KJH, Treur JL. Commentary on Carrasquilla et al.: Smoking and obesity; uncovering causal mechanisms through triangulation of different methods. Addiction 2024; 119:1035-1036. [PMID: 38622751 DOI: 10.1111/add.16506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 03/15/2024] [Indexed: 04/17/2024]
Affiliation(s)
- Margot P van de Weijer
- Genetic Epidemiology, Department of Psychiatry, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Karin J H Verweij
- Genetic Epidemiology, Department of Psychiatry, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Jorien L Treur
- Genetic Epidemiology, Department of Psychiatry, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
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3
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Carrasquilla GD, García-Ureña M, Romero-Lado MJ, Kilpeläinen TO. Estimating causality between smoking and abdominal obesity by Mendelian randomization. Addiction 2024; 119:1024-1034. [PMID: 38509034 DOI: 10.1111/add.16454] [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: 06/09/2023] [Accepted: 01/12/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND AND AIMS Smokers tend to have a lower body weight than non-smokers, but also more abdominal fat. It remains unclear whether or not the relationship between smoking and abdominal obesity is causal. Previous Mendelian randomization (MR) studies have investigated this relationship by relying upon a single genetic variant for smoking heaviness. This approach is sensitive to pleiotropic effects and may produce imprecise causal estimates. We aimed to estimate causality between smoking and abdominal obesity using multiple genetic instruments. DESIGN MR study using causal analysis using summary effect estimates (CAUSE) and latent heritable confounder MR (LHC-MR) methods that instrument smoking using genome-wide data, and also two-sample MR (2SMR) methods. SETTING Genome-wide association studies (GWAS) summary statistics from participants of European ancestry, obtained from the GWAS and Sequencing Consortium of Alcohol and Nicotine use (GSCAN), Genetic Investigation of Anthropometric Traits (GIANT) Consortium and the UK Biobank. PARTICIPANTS We used GWAS results for smoking initiation (n = 1 232 091), life-time smoking (n = 462 690) and smoking heaviness (n = 337 334) as exposure traits, and waist-hip ratio (WHR) and waist and hip circumferences (WC and HC) (n up to 697 734), with and without adjustment for body mass index (adjBMI), as outcome traits. MEASUREMENTS Smoking initiation, life-time smoking, smoking heaviness, WHR, WC, HC, WHRadjBMI, WCadjBMI and HCadjBMI. FINDINGS Both CAUSE and LHC-MR indicated a positive causal effect of smoking initiation on WHR (0.13 [95% confidence interval (CI) = 0.10, 0.16 and 0.49 (0.41, 0.57), respectively] and WHRadjBMI (0.07 (0.03, 0.10) and 0.31 (0.26, 0.37). Similarly, they indicated a positive causal effect of life-time smoking on WHR [0.35 (0.29, 0.41) and 0.44 (0.38, 0.51)] and WHRadjBMI [0.18 (0.13, 0.24) and 0.26 (0.20, 0.31)]. In follow-up analyses, smoking particularly increased visceral fat. There was no evidence of a mediating role by cortisol or sex hormones. CONCLUSIONS Smoking initiation and higher life-time smoking may lead to increased abdominal fat distribution. The increase in abdominal fat due to smoking is characterized by an increase in visceral fat. Thus, efforts to prevent and cease smoking can have the added benefit of reducing abdominal fat.
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Affiliation(s)
- Germán D Carrasquilla
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Genomic Mechanisms of Disease, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Mario García-Ureña
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - María J Romero-Lado
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Tuomas O Kilpeläinen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Genomic Mechanisms of Disease, Broad Institute of MIT and Harvard, Cambridge, MA, USA
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Ferrari G, de Maio Nascimento M, Petermann-Rocha F, Rezende LFM, O'Donovan G, Gouveia ÉR, Cristi-Montero C, Marques A. Lifestyle risk factors and all-cause and cause-specific mortality in the Mexico City prospective study: Assessing the influence of reverse causation. J Affect Disord 2024; 352:517-524. [PMID: 38408614 DOI: 10.1016/j.jad.2024.02.072] [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: 12/12/2023] [Revised: 02/15/2024] [Accepted: 02/19/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND We examined the association between individual lifestyle risk factors with all-cause and cause-specific mortality. METHODS Prospective cohort study including 155,002 participants from the Mexico City Prospective Study. Cox regression models were used to estimate the association between individual lifestyle risk factors and all-cause and cause-specific mortality. Participants with prevalent diseases at baseline and participants who died during the first 2, 5, 10, and 15 years of follow-up were excluded to account for reverse causation. RESULTS 27,469 people died during 18.3 years of follow-up years. Overweight and moderate alcohol consumption were inversely associated with all-cause mortality, while low physical activity and smoking were positively associated when all participants were included, regardless of prevalent disease or duration of follow-up. The direction of the association of overweight with all-cause mortality changed from inverse to positive after excluding the first 10 years of follow-up. Compared with normal weight, the hazard ratio (95 % confidence interval) was 1.17 (1.13,1.22) for obesity after excluding those who died in the first 5 years of follow-up and 1.71 (1.59,1.84) after excluding the first 15 years of follow-up. The magnitude of the association of alcohol intake, low physical activity, and smoking with mortality attenuated, whereas for fruits and vegetables increased, after excluding longer periods of follow-up. LIMITATIONS The data were collected exclusively in Mexico City; lifestyle risk factors were self-reported and thus prone to misclassification bias. CONCLUSIONS Reverse causation may influence both the magnitude and the direction of the associations between lifestyle risk factors and mortality.
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Affiliation(s)
- Gerson Ferrari
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Providencia, Chile; Universidad de Santiago de Chile (USACH), Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Santiago, Chile.
| | | | - Fanny Petermann-Rocha
- Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago, Chile
| | - Leandro F M Rezende
- Departamento de Medicina Preventiva, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Gary O'Donovan
- Instituto Masira, Universidad de Santander, Bucaramanga, Colombia; Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Facultad de Medicina, Universidad de los Andes, Bogotá, Colombia
| | - Élvio R Gouveia
- Department of Physical Education and Sport, University of Madeira, Funchal, Portugal; Laboratory of Robotics and Engineering Systems (LARSYS), Interactive Technologies Institute, Funchal, Portugal
| | - Carlos Cristi-Montero
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Adilson Marques
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal; Faculdade de Medicina, ISAMB, Universidade de Lisboa, Lisbon, Portugal
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Ma K, Liu H, Guo L, Li J, Lei Y, Li X, Sun L, Yang L, Yuan T, Wang C, Zhang D, Li J, Liu M, Hua Y, Zhang L. Comparison of metabolic syndrome prevalence and characteristics using five different definitions in China: a population-based retrospective study. Front Public Health 2024; 12:1333910. [PMID: 38439751 PMCID: PMC10909998 DOI: 10.3389/fpubh.2024.1333910] [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: 12/01/2023] [Accepted: 02/05/2024] [Indexed: 03/06/2024] Open
Abstract
Background Metabolic syndrome (MetS) is on the rise in developing countries and is characterized by a series of indications of metabolic disturbance. However, the prevalence of MetS varies under different definitions. The study aimed to compare five definitions of MetS in the China adult population, to explore their prevalence, characteristics and agreement. Methods The data for the retrospective study came from the China Health and Retirement Longitudinal Study (CHARLS), consisting of 9,588 participants (≥45). MetS definitions from International Diabetes Federation (IDF) (2006), National Cholesterol Education Program Adult Treatment Panel III (ATPIII) (2005), National Cholesterol Education Program Adult Treatment Panel III (ATPIII) (2001), Chinese Diabetes society (CDS) (2004) and the World Health Organization (WHO) (1999). We used binary and multivariable logistic analysis to explore factors connected with MetS. Results The five definitions of MetS led to different prevalence of MetS:34.52% by IDF (2006), 38.63% by ATP (2005), 25.94% by ATP (2001), 26.31% by CDS (2004), 21.57% by WHO (1999). According to the definition of IDF (2006) (22.32% vs. 45.06%), ATPIII (2005) definition (27.99% vs. 47.82%), ATPIII (2001) definition (15.37% vs. 35.07%), CDS (2004) definition (19.96% vs. 31.80%), and WHO (1999) definition (17.44% vs. 25.14%), the prevalence of MetS in men was low but in women was high. The agreement between the five definitions for men was good except for the IDF (2006) definition and ATPIII (2001) definition (kappa = 0.51), with kappa values from 0.64 to 0.85. For women, the agreement between the five definitions was good ranging from 0.67 to 0.95, however, except for the definition of CDS (2004) and the definition of IDF (2006) (kappa = 0.44), the definition of WHO (1999) and the definition of IDF (2006) (kappa = 0.55), and the definition of WHO (1999) and the definition of ATPIII (2005) (kappa = 0.54). Binary logistic analysis indicated that although the impact and relevance varied by sex and definition, age, education, marital status, current residence, current smoking, alcohol using, taking activities and number of chronic diseases were factors connected to MetS. Conclusion the prevalence and characteristics of the five definitions of MetS are different in the Chinese population. Therefore, it is vital to use the same definition for a country to diagnose MetS. On the other side, a lower prevalence in men than in women and the consistency of five MetS definitions are good in men but relatively poor in women.
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Affiliation(s)
- Keli Ma
- Department of Graduate School, Wannan Medical College, Wuhu, Anhui, China
| | - Haiyang Liu
- Student Health Center, Wannan Medical College, Wuhu, Anhui, China
| | - Leilei Guo
- Department of Surgical Nursing, School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Jinlong Li
- Key Laboratory of Occupational Health and Safety for Coal Industry in Hebei Province, Department of Occupational and Environmental Health, School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Yunxiao Lei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Xiaoping Li
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Lu Sun
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Liu Yang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Ting Yuan
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Congzhi Wang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Dongmei Zhang
- Department of Pediatric Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Jing Li
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Mingming Liu
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Ying Hua
- Rehabilitation Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
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Zhang Y, Chen GC, Sotres-Alvarez D, Perreira KM, Daviglus ML, Pirzada A, Gallo LC, Llabre MM, Cai J, Xue X, Isasi CR, Kaplan R, Qi Q. General or Central Obesity and Mortality Among US Hispanic and Latino Adults. JAMA Netw Open 2024; 7:e2351070. [PMID: 38227314 PMCID: PMC10792478 DOI: 10.1001/jamanetworkopen.2023.51070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/01/2023] [Indexed: 01/17/2024] Open
Abstract
Importance The Hispanic and Latino population is the second largest ethnic group in the US, but associations of obesity parameters with mortality in this population remain unclear. Objective To investigate the associations of general and central obesity with mortality among US Hispanic and Latino adults. Design, Setting, and Participants The Hispanic Community Health Study/Study of Latinos is an ongoing, multicenter, population-based cohort study with a multistage probability sampling method performed in Hispanic and Latino adults aged 18 to 74 years with a baseline between January 1, 2008, and December 31, 2011. Active follow-up for this analyses extended from baseline through February 17, 2022. All analyses accounted for complex survey design (ie, stratification and clustering) and sampling weights to generate estimates representing the noninstitutionalized, 18- to 74-year-old Hispanic or Latino populations from selected communities. Exposures Body mass index (BMI; calculated as weight in kilograms divided by height in meters squared), body fat percentage, waist circumference (WC), and waist to hip ratio (WHR). Main Outcome and Measure Deaths were ascertained via death certificates, the National Death Index, and active follow-up. Results Of 15 773 adults (mean [SE] age, 40.9 [0.3] years; 52.8% female), 686 deaths occurred during a median (IQR) follow-up of 10.0 (9.9-10.2) years. When adjusting for sociodemographic, lifestyle, and family history covariates, hazard ratios (HRs) for mortality were 1.55 (95% CI, 1.08-2.22) for a BMI of 35.0 or greater vs 18.5 to 24.9, 1.22 (95% CI, 0.92-1.64) for the highest vs lowest body fat percentage groups (defined according to sex-, age-, and Hispanic or Latino background-specific BMI distribution), 1.35 (95% CI, 0.98-1.85) for WC greater than 102 cm (men) or 88 cm (women) vs 94 cm (men) or 80 cm (women) or less, and 1.91 (95% CI, 1.28-2.86) for WHR of 0.90 (men) or 0.85 (women) or greater vs less than 0.90 (men) or 0.85 (women). Only WHR was associated with mortality with additional adjustment for major comorbidities (HR, 1.75; 95% CI, 1.17-2.62). The association of WHR with mortality was stronger among women compared with men (P = .03 for interaction), and the association between BMI and mortality was stronger among men (P = .02 for interaction). The positive association between severe obesity (BMI ≥ 35.0) and mortality was observed only among adults with WHR of 0.90 (men) or 0.85 (women) or greater but not among those with WHR below 0.90 (men) or 0.85 (women) (P = .005 for interaction) who had greater hip circumference. Conclusions and Relevance In this cohort of US Hispanic and Latino adults, WHR was independently associated with higher all-cause mortality regardless of BMI and prevalent comorbidities. These findings suggest that prioritizing clinical screening and intervention for WHR in this population may be an important public health strategy, with sex-specific strategies potentially being needed.
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Affiliation(s)
- Yanbo Zhang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Guo-Chong Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Daniela Sotres-Alvarez
- Department of Biostatistics, Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Krista M. Perreira
- Department of Social Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill
| | | | - Amber Pirzada
- Institute for Minority Health Research, University of Illinois, Chicago
| | - Linda C. Gallo
- Department of Psychology, San Diego State University, San Diego, California
| | - Maria M. Llabre
- Department of Psychology, University of Miami, Miami, Florida
| | - Jianwen Cai
- Department of Biostatistics, Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Xiaonan Xue
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Carmen R. Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Robert Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Qibin Qi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
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Shaheen N, Shaheen A, Diab RA, Saad AM, Abdelwahab OA, Soliman S, Hefnawy MT, Ramadan A, Meshref M, Nashwan AJ. Association of serum leptin and ghrelin levels with smoking status on body weight: a systematic review and meta-analysis. Front Psychiatry 2023; 14:1296764. [PMID: 38111614 PMCID: PMC10725976 DOI: 10.3389/fpsyt.2023.1296764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 11/20/2023] [Indexed: 12/20/2023] Open
Abstract
Background and aims Smoking cigarettes is a major global health problem that affects appetite and weight. The aim of this systematic review was to determine how smoking affected plasma leptin and ghrelin levels. Methods A comprehensive search of PubMed, Scopus, Web of Science, and Ovid was conducted using a well-established methodology to gather all related publications. Results A total of 40 studies were included in the analysis of 11,336 patients. The overall effect showed a with a mean difference (MD) of -1.92[95%CI; -2.63: -1.20] and p = 0.00001. Subgroup analysis by study design revealed significant differences as well, but with high heterogeneity within the subgroups (I2 of 82.3%). Subgroup by sex showed that there was a significant difference in mean difference between the smoking and non-smoking groups for males (MD = -5.75[95% CI; -8.73: -2.77], p = 0.0002) but not for females (MD = -3.04[95% CI; -6.6:0.54], p = 0.10). Healthy, pregnant, diabetic and CVD subgroups found significant differences in the healthy (MD = -1.74[95% CI; -03.13: -0.35], p = 0.01) and diabetic (MD = -7.69[95% CI, -1.64: -0.73], p = 0.03). subgroups, but not in the pregnant or cardiovascular disease subgroups. On the other hand, the meta-analysis found no statistically significant difference in Ghrelin serum concentration between smokers and non-smokers (MD = 0.52[95% CI, -0.60:1.63], p = 0.36) and observed heterogeneity in the studies (I2 = 68%). Conclusion This study demonstrates a correlation between smoking and serum leptin/ghrelin levels, which explains smoking's effect on body weight. Systematic review registration https://www.crd.york.ac.uk/ prospero/display_record.php, identifier (Record ID=326680).
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Affiliation(s)
- Nour Shaheen
- Alexandria Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Ahmed Shaheen
- Alexandria Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Rehab Adel Diab
- Faculty of Medicine, Al-Azhar University, Medical Research Group of Egypt, Cairo, Egypt
| | | | - Omar Ahmed Abdelwahab
- Faculty of Medicine, Al-Azhar University, Medical Research Group of Egypt, Cairo, Egypt
| | - Sama Soliman
- Faculty of Medicine, The Pavlov First State Medical University of St. Petersburg, St. Petersburg, Russia
| | - Mahmoud Tarek Hefnawy
- Faculty of Medicine, Zagazig University, Medical Research Group of Egypt, Cairo, Egypt
| | - Alaa Ramadan
- Faculty of Medicine, South Valley University, Qena, Egypt
| | - Mostafa Meshref
- Neurology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
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Park S, Kim SG, Lee S, Kim Y, Cho S, Kim K, Kim YC, Han SS, Lee H, Lee JP, Joo KW, Lim CS, Kim YS, Kim DK. Causal effects from tobacco smoking initiation on obesity-related traits: a Mendelian randomization study. Int J Obes (Lond) 2023; 47:1232-1238. [PMID: 37634025 DOI: 10.1038/s41366-023-01371-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 08/08/2023] [Accepted: 08/17/2023] [Indexed: 08/28/2023]
Abstract
BACKGROUND There is a widespread notion that tobacco smoking controls weight based on the appetite suppressive effect of nicotine. However, the causal relationship between smoking initiation and obesity-related traits in the general population are unclear. METHODS This Mendelian randomization analysis utilized 378 genetic variants associated with tobacco smoking initiation (usually in adolescence or young adulthood) identified in a genome-wide association study (meta-analysis) of 1.2 million individuals. Outcome data for body mass index, waist circumference, hip circumference, and waist-to-hip ratio were extracted from the 337,138 white British-ancestry UK Biobank participants aged 40-69 years. Replication analyses were performed for genome-wide association study meta-analysis for body mass index, including the GERA/GIANT data including 364,487 samples from mostly European individuals. In addition, summary-level Mendelian randomization by inverse variance weighted method and pleiotropy-robust Mendelian randomization methods, including median-based and MR-Egger regression, was performed. RESULTS Summary-level Mendelian randomization analysis indicated that genetically predicted smoking initiation is causally linked to higher body mass index [+0.28 (0.18-0.38) kg/m2], waist circumference [+0.88 (0.66-1.10) cm], hip circumference [+0.40 (0.23-0.57) cm], and waist-to-hip ratio [+0.006 (0.005-0.007)]. These results were consistent with those of the pleiotropy-robust Mendelian randomization analysis. Additionally, in replication analysis, genetically predicted smoking initiation was significantly associated with a higher body mass index [+0.03 (0.01, 0.05] kg/m2). CONCLUSION Tobacco initiation may lead to worse obesity-related traits in the general 40- to 69-year-old individuals. Therefore, tobacco-use initiation as a long-term weight-control measure should be discouraged.
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Affiliation(s)
- Sehoon Park
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Seong Geun Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Soojin Lee
- Department of Internal Medicine, Uijeongbu Eulji University Medical Center, Seoul, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Yaerim Kim
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Semin Cho
- Department of Internal Medicine, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Gyeonggi-do, Korea
| | - Kwangsoo Kim
- Transdisciplinary Department of Medicine & Advanced Technology, Seoul National University Hospital, Seoul, Korea
| | - Yong Chul Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Seung Seok Han
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Kidney Research Institute, Seoul National University, Seoul, Korea
| | - Hajeong Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jung Pyo Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Kidney Research Institute, Seoul National University, Seoul, Korea
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Kwon Wook Joo
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Kidney Research Institute, Seoul National University, Seoul, Korea
| | - Chun Soo Lim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Kidney Research Institute, Seoul National University, Seoul, Korea
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Yon Su Kim
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Kidney Research Institute, Seoul National University, Seoul, Korea
| | - Dong Ki Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
- Kidney Research Institute, Seoul National University, Seoul, Korea.
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9
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Iskander MMZ, Lamont GJ, Tan J, Pisano M, Uriarte SM, Scott DA. Tobacco smoke exacerbates Filifactor alocis pathogenicity. J Clin Periodontol 2023; 50:121-130. [PMID: 36122937 PMCID: PMC9976951 DOI: 10.1111/jcpe.13729] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 08/11/2022] [Accepted: 09/14/2022] [Indexed: 11/30/2022]
Abstract
AIM Filifactor alocis has recently emerged as a periodontal pathobiont that appears to thrive in the oral cavity of smokers. We hypothesized that identification of smoke-responsive F. alocis genes would provide insight into adaptive strategies and that cigarette smoke would enhance F. alocis pathogenesis in vivo. MATERIALS AND METHODS F. alocis was grown in vitro and cigarette smoke extract-responsive genes determined by RNAseq. Mice were exposed, or not, to mainstream 1R6F research cigarette smoke and infected with F. alocis, or not, in an acute ligature model of periodontitis. Key clinical, infectious, and immune data were collected. RESULTS In culture, F. alocis growth was unaffected by smoke conditioning and only a small number of genes were specifically regulated by smoke exposure. Reduced murine mass, differences in F. alocis-cognizant antibody production, and altered immune profiles as well as altered alveolar bone loss were all attributable to smoke exposure and/or F. alocis infection in vivo. CONCLUSIONS F. alocis is well-adapted to tobacco-rich conditions and its pathogenesis is enhanced by tobacco smoke exposure. A smoke-exposed ligature model of periodontitis shows promise as a tool with which to further unravel mechanisms underlying tobacco-enhanced, bacteria-induced disease.
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Affiliation(s)
- Mina M Z Iskander
- Department of Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - Gwyneth J Lamont
- Department of Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - Jinlian Tan
- Department of Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - Michele Pisano
- Department of Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - Silvia M Uriarte
- Department of Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - David A Scott
- Department of Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, Kentucky, USA
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10
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Soares AG, Howe LD, Heron J, Hammerton G, Rich-Edwards J, Magnus MC, Halligan SL, Fraser A. How does childhood maltreatment influence cardiovascular disease? A sequential causal mediation analysis. Int J Epidemiol 2022; 51:555-566. [PMID: 34041541 PMCID: PMC9082818 DOI: 10.1093/ije/dyab085] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Childhood maltreatment has been consistently associated with cardiovascular disease (CVD). However, the mechanisms of this relationship are not yet fully understood. We explored the relative contribution of anxiety/depression, smoking, body mass index (BMI) and inflammation (C-reactive protein, CRP) to the association between childhood maltreatment and CVD in men and women aged 40-69 years in the UK. METHODS We used data from 40 596 men and 59 511 women from UK Biobank. To estimate the indirect effects of childhood maltreatment (physical, sexual and emotional abuse, and emotional and physical neglect) on incident CVD via each of the mediators, we applied a sequential mediation approach. RESULTS All forms of maltreatment were associated with increased CVD risk [hazard ratios (HRs) ranging from 1.09 to 1.27]. Together, anxiety/depression, smoking, BMI and inflammation (indexed by CRP) mediated 26-90% of the association between childhood maltreatment and CVD, and the contribution of these mediators differed by type of maltreatment and sex. Anxiety/depression mediated the largest proportion of the association of sexual abuse, emotional abuse and emotional neglect with CVD (accounting for 16-43% of the total effect), especially in women. In men, BMI contributed the most to the indirect effect of associations of physical abuse and physical neglect with CVD; in women, anxiety/depression and BMI had similar contributions. CONCLUSIONS These findings add to the understanding of how childhood maltreatment affects CVD risk and identify modifiable mediating factors that could potentially reduce the burden of CVD in people exposed to maltreatment in early life.
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Affiliation(s)
- Ana G Soares
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Laura D Howe
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Jon Heron
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Gemma Hammerton
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Janet Rich-Edwards
- Department of Medicine, Harvard Medical School and Brigham and Women’s Hospital and Department of Epidemiology, Harvard Chan School of Public Health, Boston, MA, USA
| | - Maria C Magnus
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Sarah L Halligan
- Department of Psychology, University of Bath, Bath, UK
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Abigail Fraser
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
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11
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Yuan Z, Liu L, Guo P, Yan R, Xue F, Zhou X. Likelihood-based Mendelian randomization analysis with automated instrument selection and horizontal pleiotropic modeling. SCIENCE ADVANCES 2022; 8:eabl5744. [PMID: 35235357 PMCID: PMC8890724 DOI: 10.1126/sciadv.abl5744] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 01/05/2022] [Indexed: 05/03/2023]
Abstract
Mendelian randomization (MR) is a common tool for identifying causal risk factors underlying diseases. Here, we present a method, MR with automated instrument determination (MRAID), for effective MR analysis. MRAID borrows ideas from fine-mapping analysis to model an initial set of candidate single-nucleotide polymorphisms that are in potentially high linkage disequilibrium with each other and automatically selects among them the suitable instruments for causal inference. MRAID also explicitly models both uncorrelated and correlated horizontal pleiotropic effects that are widespread for complex trait analysis. MRAID achieves both tasks through a joint likelihood framework and relies on a scalable sampling-based algorithm to compute calibrated P values. Comprehensive and realistic simulations show that MRAID can provide calibrated type I error control and reduce false positives while being more powerful than existing approaches. We illustrate the benefits of MRAID for an MR screening analysis across 645 trait pairs in U.K. Biobank, identifying multiple lifestyle causal risk factors of cardiovascular disease-related traits.
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Affiliation(s)
- Zhongshang Yuan
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Lu Liu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Ping Guo
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Ran Yan
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Fuzhong Xue
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Xiang Zhou
- Department of Biostatistics, University of Michigan, Ann Arbor, MI 48109, USA
- Center for Statistical Genetics, University of Michigan, Ann Arbor, MI 48109, USA
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12
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Jin YJ, Kwon MJ, Kim JH, Kim JH, Choi HG. Association between Thyroid Cancer and Breast Cancer: Two Longitudinal Follow-Up Studies Using a National Health Screening Cohort. J Pers Med 2022; 12:jpm12020133. [PMID: 35207622 PMCID: PMC8880453 DOI: 10.3390/jpm12020133] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/07/2022] [Accepted: 01/09/2022] [Indexed: 12/15/2022] Open
Abstract
Background: The purpose of this study was to evaluate the association between thyroid cancer and breast cancer. Methods: Data from the Korean National Health Insurance Service-Health Screening Cohort were collected from 2002 to 2013. In study I, 3949 thyroid cancer participants were 1:4 matched with 15,796 control I participants, and hazard ratios (HRs) with 95% confidence intervals (CIs) for breast cancer were evaluated using a stratified Cox proportional hazard model. In study II, 3308 breast cancer participants were 1:4 matched with 13,232 control II participants, and HRs with 95% CIs for thyroid cancer were assessed in the same way as in study I. In the subgroup analyses, associations were analyzed according to radioactive iodine (RAI) treatment and age (<60 years old and ≥60 years old). Results: The adjusted HR for breast cancer in the thyroid cancer group was 1.64 (95% CI = 1.13–2.39, p = 0.010). The adjusted HR for thyroid cancer in the breast cancer group was 1.91 (95% CI = 1.47–2.49, p < 0.001). In the subgroup analyses, the groups that were older and not treated with RAI treatment showed consistent results in study I, and the younger and older groups showed consistent results in study II. Conclusions: Based on this cohort study, breast and thyroid cancer have a reciprocal positive association.
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Affiliation(s)
- Young Ju Jin
- Department of Otorhinolaryngology-Head & Neck Surgery, Wonkwang University Hospital, College of Medicine, Wonkwang University, Iksan 54538, Korea;
| | - Mi Jung Kwon
- Department of Pathology, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang 14068, Korea;
| | - Ji Hee Kim
- Department of Neurosurgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang 14068, Korea;
| | - Joo-Hee Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang 14068, Korea;
| | - Hyo Geun Choi
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang 14068, Korea
- Correspondence: ; Tel.: +82-31-380-3849; Fax: +82-31-386-3860
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13
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Cannabis use and obesity-traits: A Mendelian randomization study. Drug Alcohol Depend 2021; 226:108863. [PMID: 34304124 DOI: 10.1016/j.drugalcdep.2021.108863] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 05/12/2021] [Accepted: 05/16/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Observational studies suggested that cannabis use is associated with decreased body fatness; however, observational studies are subject to confounding, making causal inference and determining the direction of these associations difficult. We performed Mendelian randomization (MR) using summary statistics from genome-wide association studies (GWAS) to investigate the potential causal association of cannabis use and obesity-related traits. METHODS We used 51 single nucleotide polymorphisms (SNPs) associated with lifetime cannabis use at P 1<× 10-5 from a GWAS of 184,765 individuals of European descent and 27 SNPs genome-wide associated with cannabis use disorder as instrumental variables. The GWAS for body mass index (BMI) was derived from a meta-analysis of up to 322,154 individuals, and the GWAS for waist circumference (WC) and waist-hip ratio (WHR) included 210,088 participants. RESULTS MR showed that lifetime cannabis use (beta = - 0.018, 95 % confidence interval (CI): - 0.05-0.015; P-value = 0.279, Q-value = 0.279) and cannabis use disorder (beta = 0.023, 95 % CI: 0.023-0.045; P-value = 0.034, Q-value = 0.092) were not associated with BMI. Considering WC and WHR as indicators of obesity, our findings did not support a causal association. Leave-one out analyses and pleiotropy-robust methods did not indicate bias in any of the estimates. CONCLUSIONS Overall, the MR study provides little evidence that cannabis influences obesity related traits.
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14
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Pedersen KM, Çolak Y, Vedel-Krogh S, Kobylecki CJ, Bojesen SE, Nordestgaard BG. Risk of ulcerative colitis and Crohn's disease in smokers lacks causal evidence. Eur J Epidemiol 2021; 37:735-745. [PMID: 34091767 DOI: 10.1007/s10654-021-00763-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/13/2021] [Indexed: 11/24/2022]
Abstract
Smoking has been associated with opposing risks of ulcerative colitis and Crohn's disease. Whether these observational associations reflect actual causal associations, confounding, or reverse causation is unclear. Using a Mendelian randomization approach, we tested the hypothesis that smoking protects against ulcerative colitis and is a cause of Crohn's disease. We included 118,683 white Danes aged ≥ 20 from the Copenhagen General Population Study (2003-2015) and the Copenhagen City Heart Study (1991-94 and 2001-03). During follow-up until 2018, we investigated the association of smoking and CHRNA3 rs1051730, where the T-allele is strongly associated with nicotine dependence, with risk of ulcerative colitis and Crohn's disease. We identified 1312 cases of ulcerative colitis and 671 cases of Crohn's disease. Compared to never-smokers, multivariable adjusted hazard ratios (HRs) for ulcerative colitis were 1.69(95% confidence interval [CI] 1.32-2.15) in former smokers and 2.27(1.74-2.96) in current smokers. Corresponding HRs for Crohn's disease were 1.31(0.93-1.84) and 1.93(1.34-2.78), respectively. Among ever-smokers when compared to non-carriers of the CHRNA3 rs1051730 T-allele, age and sex adjusted HRs for risk of ulcerative colitis were 1.03(95%CI 0.89-1.18) in heterozygotes and 0.91(0.72-1.16) in homozygotes. Corresponding HRs for Crohn's disease were 1.05(0.87-1.28) and 1.02(0.74-1.41), respectively. In a meta-analysis combined with UK Biobank, there was no evidence that CHRNA3 rs1051730 was associated with risk of ulcerative colitis or Crohn's disease. In conclusion, current versus never-smoking was associated with unexpected 2.3-fold risk of ulcerative colitis and expected 1.9-fold risk of Crohn's disease in prospective analyses; however, genetic evidence of lifelong increased smoking intensity did not support causal relationships.
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Affiliation(s)
- Kasper Mønsted Pedersen
- Department of Clinical Biochemistry, Copenhagen University Hospital, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark.,The Copenhagen General Population Study, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Yunus Çolak
- Department of Clinical Biochemistry, Copenhagen University Hospital, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark.,The Copenhagen General Population Study, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Signe Vedel-Krogh
- Department of Clinical Biochemistry, Copenhagen University Hospital, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark.,The Copenhagen General Population Study, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Camilla Jannie Kobylecki
- Department of Clinical Biochemistry, Copenhagen University Hospital, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark.,The Copenhagen General Population Study, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark
| | - Stig Egil Bojesen
- Department of Clinical Biochemistry, Copenhagen University Hospital, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark.,The Copenhagen General Population Study, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,The Copenhagen City Heart Study, Copenhagen University Hospital, Frederiksberg Hospital, Frederiksberg, Denmark
| | - Børge Grønne Nordestgaard
- Department of Clinical Biochemistry, Copenhagen University Hospital, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark. .,The Copenhagen General Population Study, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark. .,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. .,The Copenhagen City Heart Study, Copenhagen University Hospital, Frederiksberg Hospital, Frederiksberg, Denmark.
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15
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Ren B, Wan S, Liu L, Qu M, Wu H, Shen H. Distributions of serum thyroid-stimulating hormone in 2020 thyroid disease-free adults from areas with different iodine levels: a cross-sectional survey in China. J Endocrinol Invest 2021; 44:1001-1010. [PMID: 32816248 DOI: 10.1007/s40618-020-01395-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 08/13/2020] [Indexed: 01/09/2023]
Abstract
PURPOSE The aim of the present study was to describe the distributions of serum thyroid- stimulating hormone (TSH) levels in thyroid disease-free adults from areas with different iodine levels in China. Meanwhile, we aimed to evaluate the influence of age and gender on the distribution of TSH, assess the relationship between concentrations of TSH and free thyroxine (FT4), and analyze the factors that may affect TSH levels. METHODS 2020 adults were included from April 2016 to June 2019. Urinary iodine concentration, serum iodine concentration, serum TSH, FT4, free triiodothyronine, thyroid peroxidase antibodies and thyroglobulin antibodies were measured, and thyroid ultrasonography was performed. RESULTS The median of TSH in iodine-fortification areas (IFA), iodine-adequate areas (IAA), iodine-excessive areas (IEA) were 2.32, 2.11 and 2.34 mIU/L, respectively. Serum TSH concentrations were significantly higher in IFA and IEA than that in IAA (p = 0.005 and < 0.0001). The TSH values of most adults were distributed within the range of 1.01-3.00 mIU/L with the same trend in three groups. In our study, TSH levels did not change with age, and the TSH level of females was higher than that of males (p < 0.0001). There was a negative correlation between FT4 and TSH in IAA (r = - 0.160, p < 0.0001) and IEA (r = - 0.177, p < 0.0001), but there was no correlation between FT4 and TSH in IFA (r = - 0.046, p = 0.370). BMI, smoking status, education levels, and marital status were associated with TSH. CONCLUSION Our study provides a basis for establishing the reference intervals of TSH in different iodine level areas.
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Affiliation(s)
- B Ren
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - S Wan
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
- Department of Preventive Medicine, Qiqihar Medical University, Qiqihar, Heilongjiang, China
| | - L Liu
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - M Qu
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - H Wu
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - H Shen
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China.
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16
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Zhou W, Liu G, Hung RJ, Haycock PC, Aldrich MC, Andrew AS, Arnold SM, Bickeböller H, Bojesen SE, Brennan P, Brunnström H, Melander O, Caporaso NE, Landi MT, Chen C, Goodman GE, Christiani DC, Cox A, Field JK, Johansson M, Kiemeney LA, Lam S, Lazarus P, Marchand LL, Rennert G, Risch A, Schabath MB, Shete SS, Tardón A, Zienolddiny S, Shen H, Amos CI. Causal relationships between body mass index, smoking and lung cancer: Univariable and multivariable Mendelian randomization. Int J Cancer 2021; 148:1077-1086. [PMID: 32914876 PMCID: PMC7845289 DOI: 10.1002/ijc.33292] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 07/24/2020] [Accepted: 07/29/2020] [Indexed: 12/19/2022]
Abstract
At the time of cancer diagnosis, body mass index (BMI) is inversely correlated with lung cancer risk, which may reflect reverse causality and confounding due to smoking behavior. We used two-sample univariable and multivariable Mendelian randomization (MR) to estimate causal relationships of BMI and smoking behaviors on lung cancer and histological subtypes based on an aggregated genome-wide association studies (GWASs) analysis of lung cancer in 29 266 cases and 56 450 controls. We observed a positive causal effect for high BMI on occurrence of small-cell lung cancer (odds ratio (OR) = 1.60, 95% confidence interval (CI) = 1.24-2.06, P = 2.70 × 10-4 ). After adjustment of smoking behaviors using multivariable Mendelian randomization (MVMR), a direct causal effect on small cell lung cancer (ORMVMR = 1.28, 95% CI = 1.06-1.55, PMVMR = .011), and an inverse effect on lung adenocarcinoma (ORMVMR = 0.86, 95% CI = 0.77-0.96, PMVMR = .008) were observed. A weak increased risk of lung squamous cell carcinoma was observed for higher BMI in univariable Mendelian randomization (UVMR) analysis (ORUVMR = 1.19, 95% CI = 1.01-1.40, PUVMR = .036), but this effect disappeared after adjustment of smoking (ORMVMR = 1.02, 95% CI = 0.90-1.16, PMVMR = .746). These results highlight the histology-specific impact of BMI on lung carcinogenesis and imply mediator role of smoking behaviors in the association between BMI and lung cancer.
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Affiliation(s)
- Wen Zhou
- Department of Epidemiology, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China
- Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, Texas
| | - Geoffrey Liu
- Princess Margaret Cancer Center, University Health Network, Toronto, Ontario, Canada
| | - Rayjean J. Hung
- Prosserman Centre for Population Health Research, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Philip C. Haycock
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | - Melinda C. Aldrich
- Department of Thoracic Surgery and Division of Epidemiology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Angeline S. Andrew
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire
| | | | - Heike Bickeböller
- Department of Genetic Epidemiology, University Medical Center, Georg-August-Universität Göttingen, Göttingen, Germany
| | - Stig E. Bojesen
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Paul Brennan
- Genetic Epidemology Group, International Agency for Research on Cancer, Lyon, France
| | | | | | - Neil E. Caporaso
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Maria Teresa Landi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Chu Chen
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center and Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA
| | - Gary E. Goodman
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center and Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA
| | - David C. Christiani
- Departments of Environmental Health and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Angela Cox
- Academic Unit of Clinical Oncology, University of Sheffield, Sheffield, UK
| | - John K. Field
- Department of Molecular and Clinical Cancer Medicine, Roy Castle Lung Cancer Research Programme, The University of Liverpool Cancer Research Centre, Liverpool, UK
| | | | - Lambertus A. Kiemeney
- Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Stephen Lam
- Department of Integrative Oncology, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Philip Lazarus
- Department of Pharmaceutical Sciences, College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, Washington
| | - Loïc Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii
| | - Gad Rennert
- Department of Community Medicine and Epidemiology, Carmel Medical Center and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology and Clalit National Cancer Control Center, Haifa, Israel
| | - Angela Risch
- Department of Biosciences, Allergy-Cancer-BioNano Research Centre, University of Salzburg, Salzburg, Austria
- Cancer Cluster Salzburg, University of Salzburg, Salzburg, Austria
- Division of Cancer Epigenomics, DKFZ – German Cancer Research Center, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), Member of the German Center for Lung Research (DZL), Heidelberg, Germany
| | - Matthew B. Schabath
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Sanjay S. Shete
- Department of Biostatistics, Division of Basic Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Adonina Tardón
- Faculty of Medicine, University of Oviedo and ISPA and CIBERESP, Oviedo, Spain
| | | | - Hongbing Shen
- Department of Epidemiology, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China
| | - Christopher I. Amos
- Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, Texas
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17
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Inference of a causal relation between low-density lipoprotein cholesterol and hypertension using mendelian randomization analysis. Clin Hypertens 2021; 27:7. [PMID: 33637130 PMCID: PMC7913402 DOI: 10.1186/s40885-021-00162-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 01/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is known in some studies that higher the LDL-C, the greater the risk of developing cardiovascular disease. However, studies of the causal effects between LDL-C and hypertension are limited by their observational study design, and genetic epidemiology studies of associations between LDL-C and hypertension are lacking, as are studies using data for Koreans. In this study, we confirmed the causal effect of LDL-C on hypertension using Korean chip data. METHOD The epidemiology and genotype data were collected from the Korean Genome and Epidemiology Study conducted by the Korea National Institute of Health and covered 20,701 subjects. Single-nucleotide polymorphisms associated with LDL-C were selected (p-value < 5 × 10- 8) from the Global Lipids Genetics Consortium database, and Mendelian randomization analysis (MRA) was performed with counted genetic risk scores and weighted genetic risk scores (WGRSs) for 24 single-nucleotide polymorphisms. RESULT The assumptions for MRA were statistically confirmed, and WGRSs showed a strong association with LDL-C. Interestingly, while the relationship between LDL-C and hypertension was not statistically significant in the observational study, MRA study demonstrated that the risk of hypertension increased as LDL-C increased in both men and women. CONCLUSIONS The results of this study confirmed that the relationship between LDL-C and hypertension is greatly influenced by genetic information.
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Cigarette smoking exposure breaks the homeostasis of cholesterol and bile acid metabolism and induces gut microbiota dysbiosis in mice with different diets. Toxicology 2021; 450:152678. [PMID: 33440193 DOI: 10.1016/j.tox.2021.152678] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/18/2020] [Accepted: 01/01/2021] [Indexed: 12/12/2022]
Abstract
Exposure of humans to second-hand smoking (SHS) increases glucose and lipid metabolic disorders. The link of hepatic metabolic dysfunction to environmental cigarette smoking has been noticed, but the related mechanism is still unclear. C57BL/6 mice with normal food diet (NFD) or high fat diet (HFD) were exposed to 15 min cigarette smoking twice a day in a 0.038 m3 box for 4 weeks, and the concentration of nicotine in the air of the box was 21.05 mg/m3 during the smoke exposure. Liver tissues and serum were collected for gene expression and biochemistry test. The fecal microbiota was also checked through 16S rDNA sequences. Cigarette smoking exposure increased the accumulation of total cholesterol (TC) in liver, and the expression of cholesterol synthesis-related genes was upregulated. The expression of CYP8B1 protein was significantly down-regulated, and the ratio of cholic acid (CA) to chenodeoxycholic acid (CDCA) was significantly reduced in the liver of mice exposed to cigarette smoking especially for HFD group. Cigarette smoking exposure caused insulin resistance in the liver of mice with HFD. The composition of the gut microbiota was altered with the exposure of cigarette smoking, and the change of the distribution of primary bile acids might be one of the reasons. It was concluded that cigarette smoking would break the homeostasis of cholesterol and bile acids metabolism and changed the composition of gut microbiota. Our discoveries confirmed that smoking bans are important for the public health.
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19
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Levin MG, Klarin D, Assimes TL, Freiberg MS, Ingelsson E, Lynch J, Natarajan P, O’Donnell C, Rader DJ, Tsao PS, Chang KM, Voight BF, Damrauer SM. Genetics of Smoking and Risk of Atherosclerotic Cardiovascular Diseases: A Mendelian Randomization Study. JAMA Netw Open 2021; 4:e2034461. [PMID: 33464320 PMCID: PMC7816104 DOI: 10.1001/jamanetworkopen.2020.34461] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
IMPORTANCE Smoking is associated with atherosclerotic cardiovascular disease, but the relative contribution to each subtype (coronary artery disease [CAD], peripheral artery disease [PAD], and large-artery stroke) remains less well understood. OBJECTIVE To determine the association between genetic liability to smoking and risk of CAD, PAD, and large-artery stroke. DESIGN, SETTING, AND PARTICIPANTS Mendelian randomization study using summary statistics from genome-wide associations of smoking (UK Biobank; up to 462 690 individuals), CAD (Coronary Artery Disease Genome Wide Replication and Meta-analysis plus the Coronary Artery Disease Genetics Consortium; up to 60 801 cases, 123 504 controls), PAD (VA Million Veteran Program; up to 24 009 cases, 150 983 controls), and large-artery stroke (MEGASTROKE; up to 4373 cases, 406 111 controls). This study was conducted using summary statistic data from large, previously described cohorts. Review of those publications does not reveal the total recruitment dates for those cohorts. Data analyses were conducted from August 2019 to June 2020. EXPOSURES Genetic liability to smoking (as proxied by genetic variants associated with lifetime smoking index). MAIN OUTCOMES AND MEASURES Risk (odds ratios [ORs]) of CAD, PAD, and large-artery stroke. RESULTS Genetic liability to smoking was associated with increased risk of PAD (OR, 2.13; 95% CI, 1.78-2.56; P = 3.6 × 10-16), CAD (OR, 1.48; 95% CI, 1.25-1.75; P = 4.4 × 10-6), and stroke (OR, 1.40; 95% CI, 1.02-1.92; P = .04). Genetic liability to smoking was associated with greater risk of PAD than risk of large-artery stroke (ratio of ORs, 1.52; 95% CI, 1.05-2.19; P = .02) or CAD (ratio of ORs, 1.44; 95% CI, 1.12-1.84; P = .004). The association between genetic liability to smoking and atherosclerotic cardiovascular diseases remained independent from the effects of smoking on traditional cardiovascular risk factors. CONCLUSIONS AND RELEVANCE In this mendelian randomization analysis of data from large studies of atherosclerotic cardiovascular diseases, genetic liability to smoking was a strong risk factor for CAD, PAD, and stroke, although the estimated association was strongest between smoking and PAD. The association between smoking and atherosclerotic cardiovascular disease was independent of traditional cardiovascular risk factors.
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Affiliation(s)
- Michael G. Levin
- Division of Cardiovascular Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
- Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania
| | - Derek Klarin
- Malcolm Randall VA Medical Center, Gainesville, Florida
- Department of Surgery, University of Florida, Gainesville
| | - Themistocles L. Assimes
- Palo Alto VA Healthcare System, Palo Alto, California
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California
- Stanford Cardiovascular Institute, Stanford University, Stanford, California
| | - Matthew S. Freiberg
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
- Geriatric Research Education and Clinical Centers, Veterans Affairs Tennessee Valley Healthcare System, Nashville
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Erik Ingelsson
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California
- Stanford Cardiovascular Institute, Stanford University, Stanford, California
- Stanford Diabetes Research Center, Stanford University, Stanford, California
- Now with GlaxoSmithKline, San Francisco, California
| | - Julie Lynch
- Edith Nourse VA Medical Center, Bedford, Massachusetts
- VA Informatics and Computing Infrastructure, Salt Lake City, Utah
| | - Pradeep Natarajan
- Cardiovascular Research Center, Massachusetts General Hospital, Boston
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
- VA Boston Healthcare System, Boston, Massachusetts
| | | | - Daniel J. Rader
- Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
- Department of Genetics, University of Pennsylvania Perelman School of Medicine, Philadelphia
- Institute for Translational Medicine and Therapeutics, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Philip S. Tsao
- Palo Alto VA Healthcare System, Palo Alto, California
- Stanford Cardiovascular Institute, Division of Cardiovascular Medicine, Department of Medicine, Stanford University, Palo Alto, California
| | - Kyong-Mi Chang
- Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania
| | - Benjamin F. Voight
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania
- Department of Genetics, University of Pennsylvania Perelman School of Medicine, Philadelphia
- Institute for Translational Medicine and Therapeutics, University of Pennsylvania Perelman School of Medicine, Philadelphia
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Scott M. Damrauer
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania
- Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia
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20
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Zou X, Wang L, Xiao L, Xu Z, Yao T, Shen M, Zeng Y, Zhang L. Deciphering the Irregular Risk of Stroke Increased by Obesity Classes: A Stratified Mendelian Randomization Study. Front Endocrinol (Lausanne) 2021; 12:750999. [PMID: 34925231 PMCID: PMC8671740 DOI: 10.3389/fendo.2021.750999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 11/08/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND To investigate the relationship between different classes of obesity and stroke, we conducted a stratified Mendelian randomization (MR) study. METHODS The body mass index (BMI) data of 263,407 Europeans with three classes of obesity (obesity class I, 30 kg/m2 ≤ BMI < 35 kg/m2; obesity class II, 35 kg/m2 ≤ BMI < 40 kg/m2; obesity class III, 40 kg/m2 ≤ BMI) were extracted from the Genetic Investigation of ANthropometric Traits (GIANT) consortium. Summary-level data of stroke and its subtypes [ischemic stroke (IS) and intracerebral hemorrhage (ICH)] were obtained from the genome-wide association study (GWAS) meta-analysis, which was performed by the MEGASTROKE consortium. MR methods were used to identify the causal relationships. RESULTS The MR analysis revealed that both obesity class I [odds ratio (OR) = 1.08, 95% CI: 1.05-1.12, p = 1.0 × 10-5] and obesity class II (OR = 1.06, 95% CI: 1.03-1.09, p = 1 × 10-4) were significantly positively related to IS, while obesity class III was not (OR = 1.01, 95% CI: 0.96-1.06, p = 0.65). In contrast to IS, there was no class of obesity associated with ICH risk. Further examination of the relationship between obesity classification and IS subtypes revealed that certain degrees of obesity were related to large artery stroke (LAS) (OR = 1.14, 95% CI: 1.04-1.24, p = 2.8 × 10-3 for class I; OR = 1.08, 95% CI: 1.01-1.16, p = 0.002 for class II) and cardioembolic stroke (CES) (OR = 1.11, 95% CI: 1.02-1.20, p = 0.02 for class I; OR = 1.08, 95% CI: 1.02-1.15, p = 0.007 for class II). CONCLUSIONS A higher risk of IS, but not ICH, could be linked to obesity classes I and II. A strong association between LAS and CES and obesity was observed among all IS subtypes in the obese population.
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Affiliation(s)
- Xuelun Zou
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Leiyun Wang
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, Changsha, China
| | - Linxiao Xiao
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Zihao Xu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Tianxing Yao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Minxue Shen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yi Zeng
- Department of Geriatrics, Second Xiangya Hospital, Central South University, Changsha, China
| | - Le Zhang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
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21
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Dobbie F, Uny I, Jackson SE, Brown J, Aveyard P, Bauld L. Vaping for weight control: Findings from a qualitative study. Addict Behav Rep 2020; 12:100275. [PMID: 32637557 PMCID: PMC7330875 DOI: 10.1016/j.abrep.2020.100275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 04/11/2020] [Accepted: 04/15/2020] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Smokers have expressed concern about weight gain once they stop smoking and weight gain is a risk factor associated with smoking relapse. Nicotine in e-cigarettes, as well as vaping behaviour, may support smoking cessation by reducing weight gain. This study explored the factors that influence attitudes towards, and awareness of, e-cigarettes and weight control post smoking cessation. METHODS Qualitative study involving focus groups with adults in the UK (n = 58) who were either exclusive vapers or dual users. RESULTS There was limited awareness and/or inclination to vape to prevent weight gain after stopping smoking. Reasons for this centred on: the health gains of stopping smoking outweighing any potential weight gain; a lack of understanding of the appetite supressing effects of nicotine; a belief that vaping could not suppress appetite like a cigarette and could result in craving for certain flavours; concerns about the longer-term effects of e-cigarettes on health and the ethics of promoting vaping as way to support smoking cessation by limiting weight gain, especially for young women. CONCLUSION Participants in this study do not appear inclined to use e-cigarettes to prevent weight gain after smoking cessation. There is a lack of understanding about why nicotine might help prevent weight gain and a concern that e-cigarette flavours could provoke cravings and that vaping may be unsafe in the long-term.
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Affiliation(s)
- Fiona Dobbie
- Usher Institute and SPECTRUM Consortium, College of Medicine and Veterinary Medicine, University of Edinburgh, UK
| | - Isabelle Uny
- Institute for Social Marketing, University of Stirling, UK
| | - Sarah E. Jackson
- Department of Behavioural Science and Health and SPECTRUM Consortium, University College London, UK
| | - Jamie Brown
- Department of Behavioural Science and Health and SPECTRUM Consortium, University College London, UK
| | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
| | - Linda Bauld
- Usher Institute and SPECTRUM Consortium, College of Medicine and Veterinary Medicine, University of Edinburgh, UK
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22
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Kodal JB, Çolak Y, Kobylecki CJ, Vedel-Krogh S, Nordestgaard BG, Afzal S. Smoking Reduces Plasma Bilirubin: Observational and Genetic Analyses in the Copenhagen General Population Study. Nicotine Tob Res 2020; 22:104-110. [PMID: 30202916 DOI: 10.1093/ntr/nty188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 09/05/2018] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Observational studies have found lower concentrations of plasma bilirubin in current smokers compared with former and never smokers. However, whether there is a causal relationship between smoking and bilirubin is unknown. In a Mendelian randomization analysis, we tested the hypothesis that higher tobacco consumption is causally associated with lower concentrations of plasma bilirubin. METHODS We genotyped 103 557 individuals aged 20-100 years from the Copenhagen General Population Study for the CHRNA3 rs1051730 genotype, known to be associated with higher tobacco consumption. Tobacco consumption was defined as daily and cumulative tobacco consumption. RESULTS In observational multivariable-adjusted analyses, a 10 g/day higher daily tobacco consumption was associated with a 0.28 µmol/L (95% confidence interval = 0.20 to 0.35) lower concentration of plasma bilirubin in current smokers, and a 10 pack-year higher cumulative tobacco consumption was associated with a 0.19 µmol/L (0.17 to 0.21) lower concentration of plasma bilirubin in former and current smokers. Using the CHRNA3 rs1051730 genotype as a proxy for daily and cumulative tobacco consumption, the difference in plasma bilirubin per T-allele was -0.12 µmol/L (-0.23 to -0.002) in current smokers and -0.09 µmol/L (-0.15 to -0.01) in current and former smokers combined. Furthermore, observationally bilirubin concentrations increased with time from smoking cessation in former smokers. CONCLUSION Higher daily and cumulative tobacco consumption were associated with lower concentrations of plasma bilirubin in observational and genetic analyses, suggesting that the association is causal. IMPLICATIONS Our results are compatible with two possible interpretations of previous observational studies, either that bilirubin is a mediator of smoking-induced respiratory disease or that the association between plasma bilirubin and respiratory disease stems from residual confounding because of smoking. Future studies should examine whether bilirubin is a causal risk factor for respiratory disease, or merely a marker of smoking status.
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Affiliation(s)
- Jakob B Kodal
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,Department of clinical biochemistry, The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,Department of clinical medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Yunus Çolak
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,Department of clinical biochemistry, The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Camilla J Kobylecki
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,Department of clinical biochemistry, The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Signe Vedel-Krogh
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,Department of clinical biochemistry, The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,Department of clinical biochemistry, The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,Department of clinical medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Shoaib Afzal
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,Department of clinical biochemistry, The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
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23
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Çolak Y, Afzal S, Lange P, Nordestgaard BG. Smoking, Systemic Inflammation, and Airflow Limitation: A Mendelian Randomization Analysis of 98 085 Individuals From the General Population. Nicotine Tob Res 2020; 21:1036-1044. [PMID: 29688528 DOI: 10.1093/ntr/nty077] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 04/20/2018] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Smoking is associated with systemic and local inflammation in the lungs. Furthermore, in chronic obstructive pulmonary disease, which is often caused by smoking, there is often systemic inflammation that is linked to lung function impairment. However, the causal pathways linking smoking, systemic inflammation, and airflow limitation are still unknown. We tested whether higher tobacco consumption is associated with higher systemic inflammation, observationally and genetically and whether genetically higher systemic inflammation is associated with airflow limitation. METHODS We included 98 085 individuals aged 20-100 years from the Copenhagen General Population Study; 36589 were former smokers and 16172 were current smokers. CHRNA3 rs1051730 genotype was used as a proxy for higher tobacco consumption and the IL6R rs2228145 genotype was used for higher systemic inflammation. Airflow limitation was defined as forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) <70%. RESULTS Difference in plasma level of C-reactive protein was 4.8% (95% CI = 4.4% to 5.2%) per 10 pack-year increase and 1.6% (95% CI = 0.4% to 2.8%) per T allele. Corresponding differences were 1.2% (95% CI = 1.1% to 1.3%) and 0.5% (95% CI = 0.3% to 0.8%) for fibrinogen, 1.2% (95% CI = 1.2% to 1.3%) and 0.7% (95% CI = 0.5% to 1.0%) for α1-antitrypsin, 2.0% (95% CI = 1.8% to 2.1%) and 0.7% (95% CI = 0.4% to 1.1%) for leukocytes, 1.9% (95% CI = 1.8% to 2.1%) and 0.8% (95% CI = 0.4% to 1.2%) for neutrophils, and 0.8% (95% CI = 0.7% to 1.0%) and 0.4% (95% CI = 0.1% to 0.7%) for thrombocytes. The differences in these levels were lower for former smokers compared with current smokers. The IL6R rs2228145 genotype was associated with higher plasma acute-phase reactants but not with airflow limitation. Compared with the C/C genotype, the odds ratio for airflow limitation was 0.95 (95% CI = 0.89 to 1.02) for A/C genotype and 0.94 (95% CI = 0.87 to 1.01) for A/A genotype. CONCLUSIONS Higher tobacco consumption is associated with higher systemic inflammation both genetically and observationally, whereas systemic inflammation was not associated with airflow limitation genetically. IMPLICATIONS The association between higher tobacco consumption and higher systemic inflammation may be causal, and the association is stronger among current smokers compared to former smokers, indicating that smoking cessation may reduce the effects of smoking on systemic inflammation. Systemic inflammation does not seem to be a causal driver in development of airflow limitation. These findings can help to understand the pathogenic effects of smoking and the interplay between smoking, systemic inflammation, and airflow limitation and hence development and progression of chronic obstructive pulmonary disease.
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Affiliation(s)
- Yunus Çolak
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Shoaib Afzal
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Peter Lange
- The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Internal Medicine, Section of Respiratory Medicine, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Kaltoft M, Langsted A, Nordestgaard BG. Obesity as a Causal Risk Factor for Aortic Valve Stenosis. J Am Coll Cardiol 2020; 75:163-176. [DOI: 10.1016/j.jacc.2019.10.050] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 10/22/2019] [Accepted: 10/23/2019] [Indexed: 11/26/2022]
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25
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Izumida T, Nakamura Y, Ishikawa S. Impact of body mass index and metabolically unhealthy status on mortality in the Japanese general population: The JMS cohort study. PLoS One 2019; 14:e0224802. [PMID: 31697720 PMCID: PMC6837339 DOI: 10.1371/journal.pone.0224802] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 10/22/2019] [Indexed: 12/13/2022] Open
Abstract
This study aimed to investigate the associations of body mass index (BMI) and metabolically unhealthy weight with all-cause mortality, cardiovascular disease (CVD) mortality, and cancer mortality as well as the effect of age on the associations. This prospective study enrolled Japanese individuals in the general population. Participants were divided into eight phenotypes according to the BMI classification and metabolic status. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using a Cox regression hazard model. In total, 10,824 individuals with a mean age of 55.3 years were evaluated. During a mean follow-up of 18.4 years (198,776 person-years), 2,274 participants died. Among the metabolically unhealthy, the association between BMI and mortality was J-shaped after adjustment for various confounders (multivariable HR [95% CI] for all-cause mortality: underweight, 2.0 [1.5-2.7]; obesity 2.8 [2.1-3.6]). The association remained the same in metabolically unhealthy participants aged <65 years and ≥65 years. The results were compatible in the analyses restricted to subjects who never smoked. Regardless of age, metabolically unhealthy underweight (MUHU) have approximately a 3-fold higher risk of CVD mortality, compared with metabolically healthy normal weight. Not only metabolically unhealthy obesity, but also MUHU was strongly associated with an increased risk of mortality. More attention should be given to the health issues of metabolically unhealthy participants without obesity, particularly those with MUHU.
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Affiliation(s)
| | - Yosikazu Nakamura
- Division of Public Health, Center for Community Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Shizukiyo Ishikawa
- Division of Public Health, Center for Community Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
- * E-mail:
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26
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Millard LAC, Munafò MR, Tilling K, Wootton RE, Davey Smith G. MR-pheWAS with stratification and interaction: Searching for the causal effects of smoking heaviness identified an effect on facial aging. PLoS Genet 2019; 15:e1008353. [PMID: 31671092 PMCID: PMC6822717 DOI: 10.1371/journal.pgen.1008353] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 08/07/2019] [Indexed: 01/07/2023] Open
Abstract
Mendelian randomization (MR) is an established approach to evaluate the effect of an exposure on an outcome. The gene-by-environment (GxE) study design can be used to determine whether the genetic instrument affects the outcome through pathways other than via the exposure of interest (horizontal pleiotropy). MR phenome-wide association studies (MR-pheWAS) search for the effects of an exposure, and can be conducted in UK Biobank using the PHESANT package. In this proof-of-principle study, we introduce the novel GxE MR-pheWAS approach, that combines MR-pheWAS with the use of GxE interactions. This method aims to identify the presence of effects of an exposure while simultaneously investigating horizontal pleiotropy. We systematically test for the presence of causal effects of smoking heaviness-stratifying on smoking status (ever versus never)-as an exemplar. If a genetic variant is associated with smoking heaviness (but not smoking initiation), and this variant affects an outcome (at least partially) via tobacco intake, we would expect the effect of the variant on the outcome to differ in ever versus never smokers. We used PHESANT to test for the presence of effects of smoking heaviness, instrumented by genetic variant rs16969968, among never and ever smokers respectively, in UK Biobank. We ranked results by the strength of interaction between ever and never smokers. We replicated previously established effects of smoking heaviness, including detrimental effects on lung function. Novel results included a detrimental effect of heavier smoking on facial aging. We have demonstrated how GxE MR-pheWAS can be used to identify potential effects of an exposure, while simultaneously assessing whether results may be biased by horizontal pleiotropy.
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Affiliation(s)
- Louise A. C. Millard
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Intelligent Systems Laboratory, Department of Computer Science, University of Bristol, Bristol, United Kingdom
| | - Marcus R. Munafò
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, Bristol, United Kingdom
| | - Kate Tilling
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Robyn E. Wootton
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, Bristol, United Kingdom
| | - George Davey Smith
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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Jackson SE, Brown J, Aveyard P, Dobbie F, Uny I, West R, Bauld L. Vaping for weight control: A cross-sectional population study in England. Addict Behav 2019; 95:211-219. [PMID: 30981033 PMCID: PMC6555398 DOI: 10.1016/j.addbeh.2019.04.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 03/19/2019] [Accepted: 04/05/2019] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Concern about weight gain is a barrier to smoking cessation. E-cigarettes may help quitters to control their weight through continued exposure to the appetite-suppressant effects of nicotine and behavioural aspects of vaping. This study explored the views and practices of smokers, ex-smokers and current e-cigarette users relating to vaping and weight control. METHODS Cross-sectional survey of past-year smokers (n = 1320), current smokers (n = 1240) and current e-cigarette users (n = 394) in England, conducted April-July 2018. Data were weighted to match the English population on key sociodemographic characteristics. RESULTS Of e-cigarette users, 4.6% (95%CI 2.6-6.6) reported vaping for weight control, and 1.9% (95%CI 0.6-3.2) reported vaping to replace meals/snacks. It was rare for individuals who had smoked in the past year to have heard (8.8%, 95%CI 7.3-10.3) or believe (6.4%, 95%CI 5.1-7.7) that vaping could help control weight. Women (OR = 0.62, 95%CI 0.42-0.93) and older people (OR = 0.30, 95%CI 0.13-0.72) were less likely to have heard the claim and women were less likely to believe it (OR = 0.44, 95%CI 0.27-0.72). However, 13.4% (95%CI 11.3-15.5) and 13.1% (95%CI 11.0-15.2) of current smokers who did not use e-cigarettes said they would be more likely to try e-cigarettes or quit smoking, respectively, if vaping could help control their weight. CONCLUSION One in 16 English people who have smoked in the last year believe that vaping would prevent weight gain after stopping. One in 22 people who vape are using e-cigarettes for this purpose. However, should evidence emerge that e-cigarettes prevent weight gain, one in eight people who smoke would be tempted to quit smoking and use e-cigarettes.
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Affiliation(s)
- Sarah E Jackson
- Department of Behavioural Science and Health, University College London, UK.
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, UK; Department of Clinical, Educational and Health Psychology, University College London, UK
| | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
| | - Fiona Dobbie
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, UK
| | - Isabelle Uny
- Institute for Social Marketing, University of Stirling, UK
| | - Robert West
- Department of Behavioural Science and Health, University College London, UK
| | - Linda Bauld
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, UK
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Pedersen KM, Çolak Y, Ellervik C, Hasselbalch HC, Bojesen SE, Nordestgaard BG. Smoking and Increased White and Red Blood Cells. Arterioscler Thromb Vasc Biol 2019; 39:965-977. [DOI: 10.1161/atvbaha.118.312338] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objective—
Whether tobacco smoking causally affects white and red blood cells and thrombocyte counts is unknown. Using a Mendelian randomization approach, we tested the hypothesis that smoking causes increases in these blood cell indices.
Approach and Results—
We included 104 607 white Danes aged 20 to 100 years from the Copenhagen General Population Study with information on blood cell indices, smoking habits, and
CHRNA3
(alpha 3 nicotinic cholinergic receptor) rs1051730 genotype, where the T allele causes higher tobacco consumption; 41 759 were former smokers and 17 852 current smokers. In multivariable adjusted observational analyses and compared with never smokers, white blood cells were associated with up to 19% increases, thrombocytes with up to 4.7% increases, and red blood cell indices with up to 2.3% increases in former and current smokers. All associations were dose dependent, with tobacco consumption but for white blood cells and thrombocytes also dependent on smoking cessation time in former smokers; highest increases were for <1-year smoking cessation and lowest increases for >10-year smoking cessation. In age- and sex-adjusted genetic analyses, percent differences per T allele increase in current smokers were 1.15% (95% CI, 0.61%–1.68%) for leukocytes, 1.07% (0.38%–1.76%) for neutrophils, 1.34% (0.66%–2.02%) for lymphocytes, 1.50% (0.83%–2.18%) for monocytes, −0.60% (−1.91% to 0.74%) for eosinophils, 0.17% (−0.94% to 1.29%) for basophils, 0.38% (−0.17% to 0.93%) for thrombocytes, 0.04% (−0.14% to 0.23%) for erythrocytes, 0.34% (0.17% to 0.50%) for hematocrit, 0.26% (0.09% to 0.43%) for hemoglobin, and 0.29% (0.18% to 0.41%) for mean corpuscular volume.
Conclusions—
Smoking causes increased blood leukocytes, neutrophils, lymphocytes, and monocytes, as well as increased hematocrit, hemoglobin, and mean corpuscular volume. The observational smoking relationships were long term for white blood cells and short term for red blood cell indices.
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Affiliation(s)
- Kasper Mønsted Pedersen
- From the Department of Clinical Biochemistry and the Copenhagen General Population Study, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark (K.M.P., Y.Ç., S.E.B., B.G.N.)
- Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (K.M.P., Y.Ç., C.E., H.C.H., S.E.B., B.G.N.)
| | - Yunus Çolak
- From the Department of Clinical Biochemistry and the Copenhagen General Population Study, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark (K.M.P., Y.Ç., S.E.B., B.G.N.)
- Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (K.M.P., Y.Ç., C.E., H.C.H., S.E.B., B.G.N.)
| | - Christina Ellervik
- Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (K.M.P., Y.Ç., C.E., H.C.H., S.E.B., B.G.N.)
- Department of Laboratory Medicine, Boston Children’s Hospital, MA (C.E.)
- The Danish General Suburban Population Study, Copenhagen University Hospital, Næstved, Slagelse, and Ringsted Hospital, Næstved, Denmark (C.E.)
| | - Hans Carl Hasselbalch
- Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (K.M.P., Y.Ç., C.E., H.C.H., S.E.B., B.G.N.)
- Department of Hematology, Zealand University Hospital, Roskilde and Køge Hospital, Denmark (H.C.H.)
| | - Stig Egil Bojesen
- From the Department of Clinical Biochemistry and the Copenhagen General Population Study, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark (K.M.P., Y.Ç., S.E.B., B.G.N.)
- Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (K.M.P., Y.Ç., C.E., H.C.H., S.E.B., B.G.N.)
| | - Børge Grønne Nordestgaard
- From the Department of Clinical Biochemistry and the Copenhagen General Population Study, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark (K.M.P., Y.Ç., S.E.B., B.G.N.)
- Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (K.M.P., Y.Ç., C.E., H.C.H., S.E.B., B.G.N.)
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Sun YQ, Burgess S, Staley JR, Wood AM, Bell S, Kaptoge SK, Guo Q, Bolton TR, Mason AM, Butterworth AS, Di Angelantonio E, Vie GÅ, Bjørngaard JH, Kinge JM, Chen Y, Mai XM. Body mass index and all cause mortality in HUNT and UK Biobank studies: linear and non-linear mendelian randomisation analyses. BMJ 2019; 364:l1042. [PMID: 30957776 PMCID: PMC6434515 DOI: 10.1136/bmj.l1042] [Citation(s) in RCA: 112] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/12/2019] [Indexed: 02/02/2023]
Abstract
EDITOR'S NOTE Please see the Editor's Note (doi: https://doi.org/10.1136/bmj.l1042) on Methodological Criticism and an Updated Analysis OBJECTIVE To investigate the shape of the causal relation between body mass index (BMI) and mortality. DESIGN Linear and non-linear mendelian randomisation analyses. SETTING Nord-Trøndelag Health (HUNT) Study (Norway) and UK Biobank (United Kingdom). PARTICIPANTS Middle to early late aged participants of European descent: 56 150 from the HUNT Study and 366 385 from UK Biobank. MAIN OUTCOME MEASURES All cause and cause specific (cardiovascular, cancer, and non-cardiovascular non-cancer) mortality. RESULTS 12 015 and 10 344 participants died during a median of 18.5 and 7.0 years of follow-up in the HUNT Study and UK Biobank, respectively. Linear mendelian randomisation analyses indicated an overall positive association between genetically predicted BMI and the risk of all cause mortality. An increase of 1 unit in genetically predicted BMI led to a 5% (95% confidence interval 1% to 8%) higher risk of mortality in overweight participants (BMI 25.0-29.9) and a 9% (4% to 14%) higher risk of mortality in obese participants (BMI ≥30.0) but a 34% (16% to 48%) lower risk in underweight (BMI <18.5) and a 14% (-1% to 27%) lower risk in low normal weight participants (BMI 18.5-19.9). Non-linear mendelian randomisation indicated a J shaped relation between genetically predicted BMI and the risk of all cause mortality, with the lowest risk at a BMI of around 22-25 for the overall sample. Subgroup analyses by smoking status, however, suggested an always-increasing relation of BMI with mortality in never smokers and a J shaped relation in ever smokers. CONCLUSIONS The previously observed J shaped relation between BMI and risk of all cause mortality appears to have a causal basis, but subgroup analyses by smoking status revealed that the BMI-mortality relation is likely comprised of at least two distinct curves, rather than one J shaped relation. An increased risk of mortality for being underweight was only evident in ever smokers.
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Affiliation(s)
- Yi-Qian Sun
- Department of Clinical and Molecular Medicine (IKOM), NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Stephen Burgess
- MRC Biostatistics Unit, Cambridge Institute of Public Health, Cambridge CB2 0SR, UK
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - James R Staley
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Angela M Wood
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Steven Bell
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Stephen K Kaptoge
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Qi Guo
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Thomas R Bolton
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Amy M Mason
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Adam S Butterworth
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Emanuele Di Angelantonio
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Gunnhild Å Vie
- Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Johan H Bjørngaard
- Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jonas Minet Kinge
- Norwegian Institute of Public Health, Oslo, Norway
- University of Oslo, Oslo, Norway
| | - Yue Chen
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Xiao-Mei Mai
- Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
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Sun M, Jiang Y, Sun C, Li J, Guo X, Lv Y, Yu Y, Yao Y, Jin L. The associations between smoking and obesity in northeast China: a quantile regression analysis. Sci Rep 2019; 9:3732. [PMID: 30872597 PMCID: PMC6418137 DOI: 10.1038/s41598-019-39425-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 01/22/2019] [Indexed: 11/25/2022] Open
Abstract
Obesity is a risk factors of chronic diseases, and smoking is associated with both chronic diseases and obesity. There were some controversies about the associations between smoking and obesity. Thus, our study aimed to explore the associations of smoking with obesity, using body mass index (BMI) and waist circumference (WC) as obesity indices in northeast China. We enrolled a sample of 16,412 participants in Jilin province aged 18-79 in this study, which were derived from a cross-sectional survey in 2012. We used quantile regression (QR) models to identify the associations of smoking with obesity in different quantiles of BMI (or WC) by genders. The differences of BMI and WC by genders were statistically significant (p < 0.05). In conclusion, compared with current non-smokers, current smokers had lower BMI but higher WC. As increasing of WC, the association of WC with smoking was getting stronger, especially in females.
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Affiliation(s)
- Mengzi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Yan Jiang
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Chong Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Jiagen Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xin Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Yaogai Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Yaqin Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Yan Yao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China.
| | - Lina Jin
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China.
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Bell JA, Carslake D, O'Keeffe LM, Frysz M, Howe LD, Hamer M, Wade KH, Timpson NJ, Davey Smith G. Associations of Body Mass and Fat Indexes With Cardiometabolic Traits. J Am Coll Cardiol 2018; 72:3142-3154. [PMID: 30545453 PMCID: PMC6290112 DOI: 10.1016/j.jacc.2018.09.066] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 08/15/2018] [Accepted: 09/16/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Body mass index (BMI) is criticized for not distinguishing fat from lean mass and ignoring fat distribution, leaving its ability to detect health effects unclear. OBJECTIVES The aim of this study was to compare BMI with total and regional fat indexes from dual-energy x-ray absorptiometry in their associations with cardiometabolic traits. Duration of exposure to and change in each index across adolescence were examined in relation to detailed traits in young adulthood. METHODS BMI was examined alongside total, trunk, arm, and leg fat indexes (each in kilograms per square meter) from dual-energy x-ray absorptiometry at ages 10 and 18 years in relation to 230 traits from targeted metabolomics at age 18 years in 2,840 offspring from the Avon Longitudinal Study of Parents and Children. RESULTS Higher total fat mass index and BMI at age 10 years were similarly associated with cardiometabolic traits at age 18 years, including higher systolic and diastolic blood pressure, higher very low-density lipoprotein and low-density lipoprotein cholesterol, lower high-density lipoprotein cholesterol, higher triglycerides, and higher insulin and glycoprotein acetyls. Associations were stronger for both indexes measured at age 18 years and for gains in each index from age 10 to 18 years (e.g., 0.45 SDs [95% confidence interval: 0.38 to 0.53] in glycoprotein acetyls per SD unit gain in fat mass index vs. 0.38 SDs [95% confidence interval: 0.27 to 0.48] per SD unit gain in BMI). Associations resembled those for trunk fat index. Higher lean mass index was weakly associated with traits and was not protective against higher fat mass index. CONCLUSIONS The results of this study support abdominal fatness as a primary driver of cardiometabolic dysfunction and BMI as a useful tool for detecting its effects.
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Affiliation(s)
- Joshua A Bell
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.
| | - David Carslake
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Linda M O'Keeffe
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Monika Frysz
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Laura D Howe
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Mark Hamer
- School of Sport, Exercise & Health Sciences, Loughborough University, Leicestershire, United Kingdom
| | - Kaitlin H Wade
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Nicholas J Timpson
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - George Davey Smith
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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Liu X, Zhang D, Liu Y, Sun X, Hou Y, Wang B, Ren Y, Zhao Y, Han C, Cheng C, Liu F, Shi Y, Chen X, Liu L, Chen G, Hong S, Zhang M, Hu D. A J-shaped relation of BMI and stroke: Systematic review and dose-response meta-analysis of 4.43 million participants. Nutr Metab Cardiovasc Dis 2018; 28:1092-1099. [PMID: 30287124 DOI: 10.1016/j.numecd.2018.07.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 07/13/2018] [Accepted: 07/13/2018] [Indexed: 01/14/2023]
Abstract
BACKGROUND AND AIM Many studies have shown increased risk of stroke with greater adiposity as measured by body mass index (BMI), but questions remain about the shape of the dose-response relation. We conducted a systematic review and meta-analysis of prospective studies to clarify the strength and shape of the dose-response relation between BMI and risk of stroke. METHODS AND RESULTS PubMed and Embase databases were searched for articles published up to May 11, 2018. Random-effects generalized least-squares regression models were used to estimate study-specific dose-response association, and restricted cubic splines were used to model the association. We included reports of 44 prospective cohort studies describing 102 466 incident cases among 4 432 475 participants. With a 5-unit increment in BMI, the summary relative risk for stroke incidence was 1.10 (95% confidence interval, 1.06 to 1.13; I2 = 88.0%). The dose-response relation was J-shaped (Pnon-linearity <0.001). The risk was not increased at the low BMI range (<24 kg/m2), but was increased within the high BMI range (>25 kg/m2). CONCLUSION Both overweight and obesity increase the risk of stroke with a J-shaped dose-response relation, and the nadir of the curve was observed at BMI 23-24 kg/m2.
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Affiliation(s)
- X Liu
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - D Zhang
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Y Liu
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - X Sun
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Y Hou
- College of Physical Education, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - B Wang
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Y Ren
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Y Zhao
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - C Han
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - C Cheng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - F Liu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Y Shi
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - X Chen
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - L Liu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - G Chen
- Department of Clinical Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - S Hong
- Department of Clinical Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - M Zhang
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - D Hu
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.
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33
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Roos ET, Lallukka T, Lahelma E, Rahkonen O. Joint associations between smoking and obesity as determinants of premature mortality among midlife employees. Eur J Public Health 2018; 27:135-139. [PMID: 28177439 DOI: 10.1093/eurpub/ckw111] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Affiliation(s)
- Eira T Roos
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | | | - Eero Lahelma
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
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Cigarette smoking and thyroid cancer risk: a cohort study. Br J Cancer 2018; 119:638-645. [PMID: 30111870 PMCID: PMC6162293 DOI: 10.1038/s41416-018-0224-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 07/16/2018] [Accepted: 07/17/2018] [Indexed: 12/29/2022] Open
Abstract
Background We evaluated the association between smoking status and thyroid cancer risk and whether this association is mediated by body mass index (BMI) and thyroid-stimulating hormone (TSH). Methods We performed a cohort study of 96,855 Korean adults who were followed annually or biennially for a median of 5.9 years. Results During 511,052.9 person-years of follow-up, 1,250 participants developed thyroid cancer. In men, we observed a dose-dependent inverse association between current smoking, pack-years, and thyroid cancer. After adjustment for confounders, adjusted hazard ratios (95% confidence intervals) for thyroid cancer comparing current and former smokers to never smokers were 0.58 (0.45–0.75) and 0.93 (0.73–1.18), respectively. After further adjustment for BMI and TSH as potential mediators, this association was slightly attenuated, but remained significant. For women, current smokers tended to have a lower risk of thyroid cancer, but this association did not reach statistical significance. Conclusions In this cohort study, current smoking was associated with a decreased risk of incident thyroid cancer in men but not in women and this association was observed even after adjusting for TSH and BMI levels as potential mediators. Further mechanistic studies are needed to elucidate the possible effect of smoking on the pathogenesis of thyroid cancer development.
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Aune D, Schlesinger S, Norat T, Riboli E. Body mass index, abdominal fatness, and the risk of sudden cardiac death: a systematic review and dose-response meta-analysis of prospective studies. Eur J Epidemiol 2018; 33:711-722. [PMID: 29417316 PMCID: PMC6061127 DOI: 10.1007/s10654-017-0353-9] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 12/26/2017] [Indexed: 12/11/2022]
Abstract
Although overweight and obesity are established risk factors for some types of heart disease including ischemic heart disease, heart failure and atrial fibrillation, less is known about the association between adiposity and sudden cardiac death. We conducted a systematic review and meta-analysis of prospective studies to clarify the association between adiposity and risk of sudden cardiac death. PubMed and Embase databases were searched up to July 20th 2017. Summary relative risks (RRs) and 95% confidence intervals (CIs) were calculated using random effects models. The summary RR was 1.16 (95% CI 1.05-1.28, I2 = 68%, n = 14) per 5 unit increment in BMI, and 1.82 (95% CI 1.61-2.07, I2 = 0%, n = 3) per 0.1 unit increase in waist-to-hip ratio, and 1.03 (95% CI 0.93-1.15, I2 = 0%, n = 2) per 10 cm increase in waist circumference. The heterogeneity in the analysis of BMI and sudden cardiac death persisted across most subgroup analyses. The association was stronger among studies with longer follow-up compared to short follow-up and was observed in the European and American studies, but not in the Asian studies. There was a J-shaped association between BMI and sudden cardiac death and the lowest risk was observed in the normal weight range, however, the increased risk with a low BMI was attenuated among studies with a longer duration of follow-up. This meta-analysis suggest an increased risk of sudden cardiac death with increasing BMI and waist-to-hip ratio, however, further studies with stratification for smoking status are needed of waist circumference, weight changes and adiposity at younger ages.
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Affiliation(s)
- Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, Paddington, London, W2 1PG, UK.
- Bjørknes University College, Oslo, Norway.
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.
| | - Sabrina Schlesinger
- Institute for Biometrics and Epidemiology, German Diabetes Center (DDZ), Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Teresa Norat
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, Paddington, London, W2 1PG, UK
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, Paddington, London, W2 1PG, UK
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Carreras-Torres R, Johansson M, Haycock PC, Relton CL, Davey Smith G, Brennan P, Martin RM. Role of obesity in smoking behaviour: Mendelian randomisation study in UK Biobank. BMJ 2018; 361:k1767. [PMID: 29769355 PMCID: PMC5953237 DOI: 10.1136/bmj.k1767] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/05/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To determine whether body mass index, body fat percentage, and waist circumference influence smoking status and intensity. DESIGN Mendelian randomisation study. SETTING UK Biobank, with replication of results from the Tobacco and Genetics (TAG) consortium. PARTICIPANTS European descent participants from the UK Biobank cohort (n=372 791) and the TAG consortium (n=74 035). MAIN OUTCOME MEASURES Risk of current and past smoking, number of cigarettes smoked per day, age of smoking initiation. RESULTS The Mendelian randomisation analysis indicated that each standard deviation increment in body mass index (4.6) increased the risk of being a smoker (odds ratio 1.18 (95% confidence interval 1.13 to 1.23), P<0.001). This association was replicated in the TAG consortium data (1.19 (1.06 to 1.33), P=0.003). Furthermore, each standard deviation increment in body mass index was estimated to increase smoking intensity by 0.88 cigarettes per day (95% confidence interval 0.50 to 1.26, P<0.001) in UK Biobank and 1.27 cigarettes per day in the TAG consortium (0.46 to 2.07, P=0.002). Similar results were also seen for body fat percentage and waist circumference in both UK Biobank and the TAG consortium data. CONCLUSIONS These results strongly suggest that higher adiposity influences smoking behaviour and could have implications for the implementation of public health interventions aiming to reduce the prevalence of these important risk factors.
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Affiliation(s)
| | - Mattias Johansson
- Section of Genetics, International Agency for Research on Cancer, Lyon, France
| | - Philip C Haycock
- Medical Research Council Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Caroline L Relton
- Medical Research Council Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - George Davey Smith
- Medical Research Council Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Paul Brennan
- Section of Genetics, International Agency for Research on Cancer, Lyon, France
| | - Richard M Martin
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
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Bermudez V, Olivar LC, Torres W, Navarro C, Gonzalez R, Espinoza C, Morocho A, Mindiola A, Chacin M, Arias V, Añez R, Salazar J, Riaño-Garzon M, Diaz-Camargo E, Bautista MJ, Rojas J. Cigarette smoking and metabolic syndrome components: a cross-sectional study from Maracaibo City, Venezuela. F1000Res 2018; 7:565. [PMID: 30705749 PMCID: PMC6343224 DOI: 10.12688/f1000research.14571.2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/18/2018] [Indexed: 10/06/2023] Open
Abstract
Background: A growing body of evidence suggests that cigarette smoking can cause the onset of metabolic syndrome prior to cardiovascular diseases. Therefore, the objective of this study was to evaluate the relationship between smoking habit and metabolic syndrome components in an adult population from Maracaibo city, Venezuela. Methods: The Maracaibo City Metabolic Syndrome Prevalence Study is a descriptive, cross-sectional study with random and multi-stage sampling. In this sub-study, 2212 adults from both genders were selected. On the basis of their medical background, they were classified as smokers, non-smokers and former smokers. Metabolic syndrome was defined according to Harmonizing 2009 criteria, using population-specific abdominal circumference cut-off points. The association between risk factors was evaluated using a logistic regression model. Results: In the studied population, 14.8% were smokers, 15.4% were former smokers. In the multivariate analysis, the presence of metabolic syndrome (smokers: OR, 1.54; 95% CI, 1.11-2.14; p=0.010) and its components were related to cigarette smoking, with the exception of hyperglycemia. High blood pressure was inversely associated with current smoking status (smokers: OR, 0.70 (0.51-0.95); p=0.025). Conclusion: Cigarette smoking represents a related factor with metabolic syndrome, being associated with low high-density lipoprotein-cholesterol, increased abdominal circumference and elevated triacylglyceride levels. Former smokers did not present a greater risk for developing this metabolic disease when compared to non-smokers. The effect of avoiding this habit should be evaluated in future studies in our population.
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Affiliation(s)
- Valmore Bermudez
- Grupo de Investigación Altos Estudios de Frontera, Universidad Simón Bolívar, Cúcuta, Colombia
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Luis Carlos Olivar
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Wheeler Torres
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Carla Navarro
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Robys Gonzalez
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Cristobal Espinoza
- Latacunga Province General Hospital, Ministry of Public Health, Cotopaxi, Ecuador
| | - Alicia Morocho
- Latacunga Province General Hospital, Ministry of Public Health, Cotopaxi, Ecuador
| | - Andres Mindiola
- Geriatric Research Education and Clinical Center, United States Department of Veterans Affairs, Miami, Florida, USA
| | - Maricarmen Chacin
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Victor Arias
- Grupo de Investigación Altos Estudios de Frontera, Universidad Simón Bolívar, Cúcuta, Colombia
| | - Roberto Añez
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Juan Salazar
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Manuel Riaño-Garzon
- Grupo de Investigación Altos Estudios de Frontera, Universidad Simón Bolívar, Cúcuta, Colombia
| | - Edgar Diaz-Camargo
- Grupo de Investigación Altos Estudios de Frontera, Universidad Simón Bolívar, Cúcuta, Colombia
| | - Maria Judith Bautista
- Grupo de Investigación Altos Estudios de Frontera, Universidad Simón Bolívar, Cúcuta, Colombia
| | - Joselyn Rojas
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
- Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, 02115, USA
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38
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Bermudez V, Olivar LC, Torres W, Navarro C, Gonzalez R, Espinoza C, Morocho A, Mindiola A, Chacin M, Arias V, Añez R, Salazar J, Riaño-Garzon M, Diaz-Camargo E, Bautista MJ, Rojas J. Cigarette smoking and metabolic syndrome components: a cross-sectional study from Maracaibo City, Venezuela. F1000Res 2018; 7:565. [PMID: 30705749 PMCID: PMC6343224 DOI: 10.12688/f1000research.14571.3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/09/2019] [Indexed: 12/24/2022] Open
Abstract
Background: A growing body of evidence suggests that cigarette smoking can cause the onset of metabolic syndrome prior to cardiovascular diseases. Therefore, the objective of this study was to evaluate the relationship between smoking habit and metabolic syndrome components in an adult population from Maracaibo city, Venezuela. Methods: The Maracaibo City Metabolic Syndrome Prevalence Study is a descriptive, cross-sectional study with random and multi-stage sampling. In this sub-study, 2212 adults from both genders were selected. On the basis of their medical background, they were classified as smokers, non-smokers and former smokers. Metabolic syndrome was defined according to Harmonizing 2009 criteria, using population-specific abdominal circumference cut-off points. The association between risk factors was evaluated using a logistic regression model. Results: In the studied population, 14.8% were smokers, 15.4% were former smokers. In the multivariate analysis, the presence of metabolic syndrome (smokers: OR, 1.54; 95% CI, 1.11-2.14; p=0.010) and its components were related to cigarette smoking, with the exception of hyperglycemia. High blood pressure was inversely associated with current smoking status (smokers: OR, 0.70 (0.51-0.95); p=0.025). Conclusion: Cigarette smoking represents a related factor with metabolic syndrome, being associated with low high-density lipoprotein-cholesterol, increased abdominal circumference and elevated triacylglyceride levels. Former smokers did not present a greater risk for developing this metabolic disease when compared to non-smokers. The effect of avoiding this habit should be evaluated in future studies in our population.
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Affiliation(s)
- Valmore Bermudez
- Grupo de Investigación Altos Estudios de Frontera, Universidad Simón Bolívar, Cúcuta, Colombia
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Luis Carlos Olivar
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Wheeler Torres
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Carla Navarro
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Robys Gonzalez
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Cristobal Espinoza
- Latacunga Province General Hospital, Ministry of Public Health, Cotopaxi, Ecuador
| | - Alicia Morocho
- Latacunga Province General Hospital, Ministry of Public Health, Cotopaxi, Ecuador
| | - Andres Mindiola
- Geriatric Research Education and Clinical Center, United States Department of Veterans Affairs, Miami, Florida, USA
| | - Maricarmen Chacin
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Victor Arias
- Grupo de Investigación Altos Estudios de Frontera, Universidad Simón Bolívar, Cúcuta, Colombia
| | - Roberto Añez
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Juan Salazar
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Manuel Riaño-Garzon
- Grupo de Investigación Altos Estudios de Frontera, Universidad Simón Bolívar, Cúcuta, Colombia
| | - Edgar Diaz-Camargo
- Grupo de Investigación Altos Estudios de Frontera, Universidad Simón Bolívar, Cúcuta, Colombia
| | - Maria Judith Bautista
- Grupo de Investigación Altos Estudios de Frontera, Universidad Simón Bolívar, Cúcuta, Colombia
| | - Joselyn Rojas
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
- Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, 02115, USA
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39
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Bermudez V, Olivar LC, Torres W, Navarro C, Gonzalez R, Espinoza C, Morocho A, Mindiola A, Chacin M, Arias V, Añez R, Salazar J, Riaño-Garzon M, Diaz-Camargo E, Bautista MJ, Rojas J. Cigarette smoking and metabolic syndrome components: a cross-sectional study from Maracaibo City, Venezuela. F1000Res 2018; 7:565. [PMID: 30705749 PMCID: PMC6343224 DOI: 10.12688/f1000research.14571.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/24/2018] [Indexed: 10/06/2023] Open
Abstract
Background: A growing body of evidence suggests that cigarette smoking can cause the onset of metabolic syndrome prior to cardiovascular diseases. Therefore, the objective of this study was to evaluate the relationship between smoking habit and metabolic syndrome components in an adult population from Maracaibo city, Venezuela. Methods: The Maracaibo City Metabolic Syndrome Prevalence Study is a descriptive, cross-sectional study with random and multi-stage sampling. In this sub-study, 2212 adults from both genders were selected. On the basis of their medical background, they were classified as smokers, non-smokers and former smokers. Metabolic syndrome was defined according to Harmonizing 2009 criteria, using population-specific abdominal circumference cut-off points. The association between risk factors was evaluated using a logistic regression model. Results: In the studied population, 14.8% were smokers, 15.4% were former smokers. In the multivariate analysis, the presence of metabolic syndrome (smokers: OR, 1.54; 95% CI, 1.11-2.14; p=0.010) and its components were related to cigarette smoking, with the exception of hyperglycemia. High blood pressure was inversely associated with current smoking status (smokers: OR, 0.70 (0.51-0.95); p=0.025). Conclusion: Cigarette smoking represents an independent risk factor for the development of metabolic syndrome, being associated with low high-density lipoprotein-cholesterol, increased abdominal circumference and elevated triacylglyceride levels. Former smokers did not present a greater risk for developing this metabolic disease when compared to non-smokers. The effect of avoiding this habit should be evaluated in future studies in our population.
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Affiliation(s)
- Valmore Bermudez
- Grupo de Investigación Altos Estudios de Frontera, Universidad Simón Bolívar, Cúcuta, Colombia
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Luis Carlos Olivar
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Wheeler Torres
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Carla Navarro
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Robys Gonzalez
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Cristobal Espinoza
- Latacunga Province General Hospital, Ministry of Public Health, Cotopaxi, Ecuador
| | - Alicia Morocho
- Latacunga Province General Hospital, Ministry of Public Health, Cotopaxi, Ecuador
| | - Andres Mindiola
- Geriatric Research Education and Clinical Center, United States Department of Veterans Affairs, Miami, Florida, USA
| | - Maricarmen Chacin
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Victor Arias
- Grupo de Investigación Altos Estudios de Frontera, Universidad Simón Bolívar, Cúcuta, Colombia
| | - Roberto Añez
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Juan Salazar
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Manuel Riaño-Garzon
- Grupo de Investigación Altos Estudios de Frontera, Universidad Simón Bolívar, Cúcuta, Colombia
| | - Edgar Diaz-Camargo
- Grupo de Investigación Altos Estudios de Frontera, Universidad Simón Bolívar, Cúcuta, Colombia
| | - Maria Judith Bautista
- Grupo de Investigación Altos Estudios de Frontera, Universidad Simón Bolívar, Cúcuta, Colombia
| | - Joselyn Rojas
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
- Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, 02115, USA
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40
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Dudbridge F. Commentary: Tobacco consumption and body weight: Mendelian randomization across a range of exposure. Int J Epidemiol 2018; 45:e1-e3. [PMID: 25817168 PMCID: PMC5841830 DOI: 10.1093/ije/dyv033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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41
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Nordestgaard AT, Nordestgaard BG. Coffee intake, cardiovascular disease and all-cause mortality: observational and Mendelian randomization analyses in 95 000-223 000 individuals. Int J Epidemiol 2018; 45:1938-1952. [PMID: 28031317 DOI: 10.1093/ije/dyw325] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2016] [Indexed: 01/09/2023] Open
Abstract
Background Coffee has been associated with modestly lower risk of cardiovascular disease and all-cause mortality in meta-analyses; however, it is unclear whether these are causal associations. We tested first whether coffee intake is associated with cardiovascular disease and all-cause mortality observationally; second, whether genetic variations previously associated with caffeine intake are associated with coffee intake; and third, whether the genetic variations are associated with cardiovascular disease and all-cause mortality. Methods First, we used multivariable adjusted Cox proportional hazard regression models evaluated with restricted cubic splines to examine observational associations in 95 366 White Danes. Second, we estimated mean coffee intake according to five genetic variations near the AHR (rs4410790; rs6968865) and CYP1A1/2 genes (rs2470893; rs2472297; rs2472299). Third, we used sex- and age adjusted Cox proportional hazard regression models to examine genetic associations with cardiovascular disease and all-cause mortality in 112 509 Danes. Finally, we used sex and age-adjusted logistic regression models to examine genetic associations with ischaemic heart disease including the Cardiogram and C4D consortia in a total of up to 223 414 individuals. We applied similar analyses to ApoE genotypes associated with plasma cholesterol levels, as a positive control. Results In observational analyses, we observed U-shaped associations between coffee intake and cardiovascular disease and all-cause mortality; lowest risks were observed in individuals with medium coffee intake. Caffeine intake allele score (rs4410790 + rs2470893) was associated with a 42% higher coffee intake. Hazard ratios per caffeine intake allele were 1.02 (95% confidence interval: 1.00-1.03) for ischaemic heart disease, 1.02 (0.99-1.02) for ischaemic stroke, 1.02 (1.00-1.03) for ischaemic vascular disease, 1.02 (0.99-1.06) for cardiovascular mortality and 1.01 (0.99-1.03) for all-cause mortality. Including international consortia, odds ratios per caffeine intake allele for ischaemic heart disease were 1.00 (0.98-1.02) for rs4410790, 1.01 (0.99-1.03) for rs6968865, 1.02 (1.00-1.04) for rs2470893, 1.02 (1.00-1.04) for rs2472297 and 1.03 (0.99-1.06) for rs2472299. Conversely, 5% lower cholesterol level caused by ApoE genotype had a corresponding odds ratio for ischaemic heart disease of 0.93 (0.89-0.97). Conclusions Observationally, coffee intake was associated with U-shaped lower risk of cardiovascular disease and all-cause mortality; however, genetically caffeine intake was not associated with risk of cardiovascular disease or all-cause mortality.
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Affiliation(s)
- Ask Tybjærg Nordestgaard
- Department of Clinical Biochemistry and the Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Børge Grønne Nordestgaard
- Department of Clinical Biochemistry and the Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen University Hospital, Frederiksberg, Denmark
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42
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Lang BM, Biedermann L, van Haaften WT, de Vallière C, Schuurmans M, Begré S, Zeitz J, Scharl M, Turina M, Greuter T, Schreiner P, Heinrich H, Kuntzen T, Vavricka SR, Rogler G, Beerenwinkel N, Misselwitz B. Genetic polymorphisms associated with smoking behaviour predict the risk of surgery in patients with Crohn's disease. Aliment Pharmacol Ther 2018; 47:55-66. [PMID: 29052254 DOI: 10.1111/apt.14378] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 08/04/2017] [Accepted: 09/22/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Smoking is a strong environmental factor leading to adverse outcomes in Crohn's disease, but a more benign course in ulcerative colitis. Several single nucleotide polymorphisms (SNPs) are associated with smoking quantity and behaviour. AIM To assess whether smoking-associated SNPs interact with smoking to influence the clinical course of inflammatory bowel diseases. METHODS Genetic and prospectively obtained clinical data from 1434 Swiss inflammatory bowel disease cohort patients (821 Crohn's disease and 613 ulcerative colitis) were analysed. Six SNPs associated with smoking quantity and behaviour (rs588765, rs1051730, rs1329650, rs4105144, rs6474412 and rs3733829) were combined to form a risk score (range: 0-12) by adding the number of risk alleles. We calculated multivariate models for smoking, risk of surgery, fistula, Crohn's disease location and ulcerative colitis disease extent. RESULTS In Crohn's disease patients who smoke, the number of surgeries was associated with the genetic risk score. This translates to a predicted 3.5-fold (95% confidence interval: 2.4- to 5.7-fold, P<.0001) higher number of surgical procedures in smokers with 12 risk alleles than individuals with the lowest risk. Patients with a risk score >7 had a significantly shorter time to first intestinal surgery. The genetic risk score did not predict surgery in ulcerative colitis or occurrence of fistulae in Crohn's disease. SNP rs6265 was associated with ileal disease in Crohn's disease (P<.05) and proctitis in ulcerative colitis (P<.05). CONCLUSIONS SNPs associated with smoking quantity is associated with an increased risk for surgery in Crohn's disease patients who smoke. Our data provide an example of genetics interacting with the environment to influence the disease course of inflammatory bowel disease.
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Affiliation(s)
- B M Lang
- Department of Biosystems Science and Engineering, ETH Zurich, Basel, Switzerland.,Swiss Institute of Bioinformatics (SIB), Lausanne, Switzerland
| | - L Biedermann
- Division of Gastroenterology, University Hospital Zurich (USZ) and Zurich University, Zurich, Switzerland
| | - W T van Haaften
- Division of Gastroenterology, University Hospital Zurich (USZ) and Zurich University, Zurich, Switzerland.,Department of Gastroenterology and Hepatology, University Medical Center Groningen, Groningen, The Netherlands
| | - C de Vallière
- Division of Gastroenterology, University Hospital Zurich (USZ) and Zurich University, Zurich, Switzerland
| | - M Schuurmans
- Division of Pneumology, University Hospital Zurich (USZ) and Zurich University, Zurich, Switzerland
| | - S Begré
- Hohenegg Hospital, Meilen, Switzerland
| | - J Zeitz
- Division of Gastroenterology, University Hospital Zurich (USZ) and Zurich University, Zurich, Switzerland
| | - M Scharl
- Division of Gastroenterology, University Hospital Zurich (USZ) and Zurich University, Zurich, Switzerland
| | - M Turina
- Division of Visceral Surgery, University Hospital Zurich (USZ), Zurich, Switzerland
| | - T Greuter
- Division of Gastroenterology, University Hospital Zurich (USZ) and Zurich University, Zurich, Switzerland
| | - P Schreiner
- Division of Gastroenterology, University Hospital Zurich (USZ) and Zurich University, Zurich, Switzerland
| | - H Heinrich
- Division of Gastroenterology, University Hospital Zurich (USZ) and Zurich University, Zurich, Switzerland
| | - T Kuntzen
- Division of Gastroenterology, University Hospital Zurich (USZ) and Zurich University, Zurich, Switzerland
| | - S R Vavricka
- Division of Gastroenterology, Triemli Hospital Zurich, Zürich, Switzerland
| | - G Rogler
- Division of Gastroenterology, University Hospital Zurich (USZ) and Zurich University, Zurich, Switzerland
| | - N Beerenwinkel
- Department of Biosystems Science and Engineering, ETH Zurich, Basel, Switzerland.,Swiss Institute of Bioinformatics (SIB), Lausanne, Switzerland
| | - B Misselwitz
- Division of Gastroenterology, University Hospital Zurich (USZ) and Zurich University, Zurich, Switzerland
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Lohse T, Rohrmann S, Faeh D, Hothorn T. Continuous outcome logistic regression for analyzing body mass index distributions. F1000Res 2017; 6:1933. [PMID: 29259768 PMCID: PMC5721934 DOI: 10.12688/f1000research.12934.1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/26/2017] [Indexed: 01/14/2023] Open
Abstract
Body mass indices (BMIs) are applied to monitor weight status and associated health risks in populations. Binary or multinomial logistic regression models are commonly applied in this context, but are only applicable to BMI values categorized within a small set of defined ad hoc BMI categories. This approach precludes comparisons with studies and models based on different categories. In addition, ad hoc categorization of BMI values prevents the estimation and analysis of the underlying continuous BMI distribution and leads to information loss. As an alternative to multinomial regression following ad hoc categorization, we propose a continuous outcome logistic regression model for the estimation of a continuous BMI distribution. Parameters of interest, such as odds ratios for specific categories, can be extracted from this model post hoc in a general way. A continuous BMI logistic regression that describes BMI distributions avoids the necessity of ad hoc and post hoc category choice and simplifies between-study comparisons and pooling of studies for joint analyses. The method was evaluated empirically using data from the Swiss Health Survey.
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Affiliation(s)
- Tina Lohse
- Institut für Epidemiologie, Biostatistik und Prävention, Universität Zürich, Zürich, 8001, Switzerland
| | - Sabine Rohrmann
- Institut für Epidemiologie, Biostatistik und Prävention, Universität Zürich, Zürich, 8001, Switzerland
| | - David Faeh
- Institut für Epidemiologie, Biostatistik und Prävention, Universität Zürich, Zürich, 8001, Switzerland
| | - Torsten Hothorn
- Institut für Epidemiologie, Biostatistik und Prävention, Universität Zürich, Zürich, 8001, Switzerland
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Rønn PF, Lucas M, Laouan Sidi EA, Tvermosegaard M, Andersen GS, Lauritzen T, Toft U, Carstensen B, Christensen DL, Jørgensen ME. The obesity-associated risk of cardiovascular disease and all-cause mortality is not lower in Inuit compared to Europeans: A cohort study of Greenlandic Inuit, Nunavik Inuit and Danes. Atherosclerosis 2017; 265:207-214. [DOI: 10.1016/j.atherosclerosis.2017.08.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 07/14/2017] [Accepted: 08/17/2017] [Indexed: 01/28/2023]
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Carreras-Torres R, Johansson M, Haycock PC, Wade KH, Relton CL, Martin RM, Davey Smith G, Albanes D, Aldrich MC, Andrew A, Arnold SM, Bickeböller H, Bojesen SE, Brunnström H, Manjer J, Brüske I, Caporaso NE, Chen C, Christiani DC, Christian WJ, Doherty JA, Duell EJ, Field JK, Davies MPA, Marcus MW, Goodman GE, Grankvist K, Haugen A, Hong YC, Kiemeney LA, van der Heijden EHFM, Kraft P, Johansson MB, Lam S, Landi MT, Lazarus P, Le Marchand L, Liu G, Melander O, Park SL, Rennert G, Risch A, Haura EB, Scelo G, Zaridze D, Mukeriya A, Savić M, Lissowska J, Swiatkowska B, Janout V, Holcatova I, Mates D, Schabath MB, Shen H, Tardon A, Teare MD, Woll P, Tsao MS, Wu X, Yuan JM, Hung RJ, Amos CI, McKay J, Brennan P. Obesity, metabolic factors and risk of different histological types of lung cancer: A Mendelian randomization study. PLoS One 2017; 12:e0177875. [PMID: 28594918 PMCID: PMC5464539 DOI: 10.1371/journal.pone.0177875] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 05/04/2017] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Assessing the relationship between lung cancer and metabolic conditions is challenging because of the confounding effect of tobacco. Mendelian randomization (MR), or the use of genetic instrumental variables to assess causality, may help to identify the metabolic drivers of lung cancer. METHODS AND FINDINGS We identified genetic instruments for potential metabolic risk factors and evaluated these in relation to risk using 29,266 lung cancer cases (including 11,273 adenocarcinomas, 7,426 squamous cell and 2,664 small cell cases) and 56,450 controls. The MR risk analysis suggested a causal effect of body mass index (BMI) on lung cancer risk for two of the three major histological subtypes, with evidence of a risk increase for squamous cell carcinoma (odds ratio (OR) [95% confidence interval (CI)] = 1.20 [1.01-1.43] and for small cell lung cancer (OR [95%CI] = 1.52 [1.15-2.00]) for each standard deviation (SD) increase in BMI [4.6 kg/m2]), but not for adenocarcinoma (OR [95%CI] = 0.93 [0.79-1.08]) (Pheterogeneity = 4.3x10-3). Additional analysis using a genetic instrument for BMI showed that each SD increase in BMI increased cigarette consumption by 1.27 cigarettes per day (P = 2.1x10-3), providing novel evidence that a genetic susceptibility to obesity influences smoking patterns. There was also evidence that low-density lipoprotein cholesterol was inversely associated with lung cancer overall risk (OR [95%CI] = 0.90 [0.84-0.97] per SD of 38 mg/dl), while fasting insulin was positively associated (OR [95%CI] = 1.63 [1.25-2.13] per SD of 44.4 pmol/l). Sensitivity analyses including a weighted-median approach and MR-Egger test did not detect other pleiotropic effects biasing the main results. CONCLUSIONS Our results are consistent with a causal role of fasting insulin and low-density lipoprotein cholesterol in lung cancer etiology, as well as for BMI in squamous cell and small cell carcinoma. The latter relation may be mediated by a previously unrecognized effect of obesity on smoking behavior.
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Affiliation(s)
| | - Mattias Johansson
- Section of Genetics, International Agency for Research on Cancer (IARC), Lyon, France
| | - Philip C. Haycock
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Kaitlin H. Wade
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Caroline L. Relton
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Richard M. Martin
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
- National Institute for Health Research Biomedical Research Unit in Nutrition, Diet and Lifestyle at University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, United Kingdom
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Demetrius Albanes
- Metabolic Epidemiology Branch, DCEG, National Cancer Institute, NIH, Rockville, Maryland, United States of America
| | - Melinda C. Aldrich
- Department of Thoracic Surgery, Division of Epidemiology, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Angeline Andrew
- Norris Cotton Cancer Center, Lebanon, New Hampshire, United States of America
| | - Susanne M. Arnold
- University of Kentucky Markey Cancer Center, Lexington, Kentucky, United States of America
| | | | - Stig E. Bojesen
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Hans Brunnström
- Laboratory Medicine Region Skåne, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Jonas Manjer
- Laboratory Medicine Region Skåne, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | | | - Neil E. Caporaso
- Genetic Epidemiology Branch, DCEG, National Cancer Institute, NIH, Rockville, Maryland, United States of America
| | - Chu Chen
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - David C. Christiani
- Departments of Environmental Health and Epidemiology, Harvard T. H. Chan School of Public Health and Department of Medicine, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, United States of America
| | - W. Jay Christian
- Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, Kentucky, United States of America
| | - Jennifer A. Doherty
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Lebanon, New Hampshire, United States of America
| | - Eric J. Duell
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - John K. Field
- Roy Castle Lung Cancer Research Programme, Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, The University of Liverpool, Liverpool, United Kingdom
| | - Michael P. A. Davies
- Roy Castle Lung Cancer Research Programme, Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, The University of Liverpool, Liverpool, United Kingdom
| | - Michael W. Marcus
- Roy Castle Lung Cancer Research Programme, Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, The University of Liverpool, Liverpool, United Kingdom
| | - Gary E. Goodman
- Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Kjell Grankvist
- Department of Medical Biosciences, Umeå University, Umeå, Sweden
| | - Aage Haugen
- National Institute of Occupational Health, Oslo, Norway
| | - Yun-Chul Hong
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | | | | | - Peter Kraft
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | | | - Stephen Lam
- British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Maria Teresa Landi
- Genetic Epidemiology Branch, DCEG, National Cancer Institute, NIH, Rockville, Maryland, United States of America
| | - Philip Lazarus
- Washington State University College of Pharmacy, Spokane, Washington, United States of America
| | - Loïc Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii, United States of America
| | - Geoffrey Liu
- Ontario Cancer Institute, Princess Margaret Cancer Center, Toronto, Ontario, Canada
| | - Olle Melander
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden
| | - Sungshim L. Park
- Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Gad Rennert
- Clalit National Cancer Control Center and Department of Community Medicine and Epidemiology, Carmel Medical Center and B. Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Angela Risch
- University of Salzburg and Cancer Cluster Salzburg, Salzburg, Austria
| | - Eric B. Haura
- Department of Thoracic Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, United States of America
| | - Ghislaine Scelo
- Section of Genetics, International Agency for Research on Cancer (IARC), Lyon, France
| | - David Zaridze
- Russian N.N. Blokhin Cancer Research Centre, Moscow, The Russian Federation
| | - Anush Mukeriya
- Russian N.N. Blokhin Cancer Research Centre, Moscow, The Russian Federation
| | - Milan Savić
- Department of Thoracic Surgery, Clinical Center of Serbia, Belgrade, Serbia
| | - Jolanta Lissowska
- Department of Cancer Epidemiology and Prevention, Maria Sklodowska-Curie Institute – Oncology Center, Warsaw, Poland
| | - Beata Swiatkowska
- Nofer Institute of Occupational Medicine, Department of Environmental Epidemiology, Lodz, Poland
| | - Vladimir Janout
- Department of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Ivana Holcatova
- Institute of Public Health and Preventive Medicine, Charles University, 2nd Faculty of Medicine, Prague, Czech Republic
| | - Dana Mates
- National Institute of Public Health, Bucharest, Romania
| | - Matthew B. Schabath
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, United States of America
| | - Hongbing Shen
- Department of Epidemiology and Biostatistics, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Adonina Tardon
- Instituto Universitario de Oncología del Principado de Asturias (IUOPA), University of Oviedo and CIBERESP, Oviedo, Spain
| | - M Dawn Teare
- University of Sheffield, Sheffield, United Kingdom
| | - Penella Woll
- University of Sheffield, Sheffield, United Kingdom
| | | | - Xifeng Wu
- The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Jian-Min Yuan
- Division of Cancer Control and Population Science, University of Pittsburgh Cancer Institute; and Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, United States of America
| | - Rayjean J. Hung
- Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, Canada
| | - Christopher I. Amos
- Department of Biomedical Data Science, Geisel School of medicine, Dartmouth College, Lebanon, New Hampshire, United States of America
| | - James McKay
- Section of Genetics, International Agency for Research on Cancer (IARC), Lyon, France
| | - Paul Brennan
- Section of Genetics, International Agency for Research on Cancer (IARC), Lyon, France
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Hughes A, Kumari M. Unemployment, underweight, and obesity: Findings from Understanding Society (UKHLS). Prev Med 2017; 97:19-25. [PMID: 28034731 DOI: 10.1016/j.ypmed.2016.12.045] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 12/20/2016] [Accepted: 12/23/2016] [Indexed: 01/09/2023]
Abstract
Elevated morbidity and mortality among jobseekers may be partly explained by adiposity, but previous studies of unemployment and body mass index (BMI), which have usually modelled associations as linear, have produced inconsistent results. However, both underweight and obesity are associated with mortality, and both weight loss and weight gain associated with a stressful environment. If unemployment is associated with both underweight and obesity for different subgroups, these associations may previously have masked each other, whilst affecting health through divergent pathways. We investigated whether there is a previously overlooked U-shaped association of unemployment and BMI, which could help explain jobseekers' elevated morbidity and mortality, and identify groups vulnerable to underweight and obesity during unemployment. We used multinomial models to simultaneously investigate associations of unemployment with BMI-defined underweight, overweight, and obesity in 10,737 working-age UK adults from Understanding Society (UKHLS) in 2010-12. Moderating impacts of unemployment duration, demographic factors and smoking were explored. Current jobseekers were more likely to be underweight (Odds ratio (OR): 4.05, 95% confidence interval (CI): 2.12-7.73) and less likely to be overweight (OR: 0.71, CI: 0.55, 0.92) adjusted for gender, age, education, health, smoking and physical activity, while unemployed non-smokers had increased odds of obesity (OR: 1.52, CI: 1.06-2.18). Underweight and overweight associations were more apparent for longer-term jobseekers, men, and jobseekers from lower-income households. We conclude that unemployment is associated with underweight and, in nonsmokers, obesity. Results show the unemployment-adiposity relationship cannot be properly studied assuming unidirectionality of effects, and suggest unemployment may affect health of different groups via divergent adiposity-mediated pathways.
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Affiliation(s)
- Amanda Hughes
- Institute for Social and Economic Research, University of Essex, Wivenhoe Park, Colchester, Essex CO4 3SQ, UK.
| | - Meena Kumari
- Institute for Social and Economic Research, University of Essex, Wivenhoe Park, Colchester, Essex CO4 3SQ, UK.
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Body mass index as a predictor of healthy and disease-free life expectancy between ages 50 and 75: a multicohort study. Int J Obes (Lond) 2017; 41:769-775. [PMID: 28138135 PMCID: PMC5418561 DOI: 10.1038/ijo.2017.29] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Revised: 01/02/2017] [Accepted: 01/20/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND While many studies have shown associations between obesity and increased risk of morbidity and mortality, little comparable information is available on how body mass index (BMI) impacts health expectancy. We examined associations of BMI with healthy and chronic disease-free life expectancy in four European cohort studies. METHODS Data were drawn from repeated waves of cohort studies in England, Finland, France and Sweden. BMI was categorized into four groups from normal weight (18.5-24.9 kg m-2) to obesity class II (⩾35 kg m-2). Health expectancy was estimated with two health indicators: sub-optimal self-rated health and having a chronic disease (cardiovascular disease, cancer, respiratory disease and diabetes). Multistate life table models were used to estimate sex-specific healthy life expectancy and chronic disease-free life expectancy from ages 50 to 75 years for each BMI category. RESULTS The proportion of life spent in good perceived health between ages 50 and 75 progressively decreased with increasing BMI from 81% in normal weight men and women to 53% in men and women with class II obesity which corresponds to an average 7-year difference in absolute terms. The proportion of life between ages 50 and 75 years without chronic diseases decreased from 62 and 65% in normal weight men and women and to 29 and 36% in men and women with class II obesity, respectively. This corresponds to an average 9 more years without chronic diseases in normal weight men and 7 more years in normal weight women between ages 50 and 75 years compared to class II obese men and women. No consistent differences were observed between cohorts. CONCLUSIONS Excess BMI is associated with substantially shorter healthy and chronic disease-free life expectancy, suggesting that tackling obesity would increase years lived in good health in populations.
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Lassi G, Taylor AE, Timpson NJ, Kenny PJ, Mather RJ, Eisen T, Munafò MR. The CHRNA5-A3-B4 Gene Cluster and Smoking: From Discovery to Therapeutics. Trends Neurosci 2016; 39:851-861. [PMID: 27871728 PMCID: PMC5152594 DOI: 10.1016/j.tins.2016.10.005] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 10/14/2016] [Accepted: 10/20/2016] [Indexed: 01/11/2023]
Abstract
Genome-wide association studies (GWASs) have identified associations between the CHRNA5-CHRNA3-CHRNB4 gene cluster and smoking heaviness and nicotine dependence. Studies in rodents have described the anatomical localisation and function of the nicotinic acetylcholine receptors (nAChRs) formed by the subunits encoded by this gene cluster. Further investigations that complemented these studies highlighted the variability of individuals' smoking behaviours and their ability to adjust nicotine intake. GWASs of smoking-related health outcomes have also identified this signal in the CHRNA5-CHRNA3-CHRNB4 gene cluster. This insight underpins approaches to strengthen causal inference in observational data. Combining genetic and mechanistic studies of nicotine dependence and smoking heaviness may reveal novel targets for medication development. Validated targets can inform genetic therapeutic interventions for smoking cessation and tobacco-related diseases.
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Affiliation(s)
- Glenda Lassi
- UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, Bristol, UK; Oncology Translational Medicine Unit, Early Clinical Development, AstraZeneca, Cambridge, UK.
| | - Amy E Taylor
- UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, Bristol, UK; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | | | - Paul J Kenny
- Department of Neuroscience and Experimental Therapeutics Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Tim Eisen
- Oncology Translational Medicine Unit, Early Clinical Development, AstraZeneca, Cambridge, UK; Department of Oncology, University of Cambridge, Cambridge, UK
| | - Marcus R Munafò
- UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, Bristol, UK; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
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Tuovinen EL, Saarni SE, Männistö S, Borodulin K, Patja K, Kinnunen TH, Kaprio J, Korhonen T. Smoking status and abdominal obesity among normal- and overweight/obese adults: Population-based FINRISK study. Prev Med Rep 2016; 4:324-30. [PMID: 27486563 PMCID: PMC4959936 DOI: 10.1016/j.pmedr.2016.07.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 07/01/2016] [Accepted: 07/08/2016] [Indexed: 12/18/2022] Open
Abstract
Several studies have reported direct associations of smoking with body mass index (BMI) and abdominal obesity. However, the interplay between them is poorly understood. Our first aim was to investigate the interaction between smoking status and BMI on abdominal obesity (waist circumference, WC). Our second aim was to examine how the association of smoking status with WC varies among normal and overweight/obese men and women. We examined 5833 participants from the National FINRISK 2007 Study. The interactions between smoking and BMI on WC were analyzed. Participants were categorized into eight groups according to BMI (normal weight vs. overweight/obese) and smoking status (never smoker, ex-smoker, occasional/light/moderate daily smoker, heavy daily smoker). The associations between each BMI/smoking status -group and WC were analyzed by multiple regressions, the normal-weight never smokers as the reference group. The smoking status by BMI-interaction on WC was significant for women, but not for men. Among the overweight/obese women, ex-smokers (β = 2.73; 1.99, 3.46) and heavy daily smokers (β = 4.90; 3.35, 6.44) had the highest estimates for WC when adjusted for age, BMI, alcohol consumption and physical activity. In comparison to never smoking overweight/obese women, the β-coefficients of ex-smokers and heavy daily smokers were significantly higher. Among men and normal weight women the β -coefficients did not significantly differ by smoking status. An interaction between smoking status and BMI on abdominal obesity was observed in women: overweight/obese heavy daily smokers were particularly vulnerable for abdominal obesity. This risk group should be targeted for cardiovascular disease prevention.
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Affiliation(s)
- Eeva-Liisa Tuovinen
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Institute for Molecular Medicine FIMM, University of Helsinki, Helsinki, Finland
| | - Suoma E. Saarni
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Hospital District of Southwest Finland and Turku University Hospital, Turku, Finland
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Satu Männistö
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Katja Borodulin
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | | | | | - Jaakko Kaprio
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Institute for Molecular Medicine FIMM, University of Helsinki, Helsinki, Finland
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Tellervo Korhonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
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Xu L, Lam TH, Jiang CQ, Zhang WS, Jin YL, Zhu T, Lam HKB, Schooling CM, Adab P, Thomas GN, Cheng KK. Changes in adiposity in an older Chinese population in rapid economic transition. Obesity (Silver Spring) 2016; 24:2217-23. [PMID: 27670402 DOI: 10.1002/oby.21599] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 06/08/2016] [Accepted: 06/09/2016] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To examine the changes in body mass index (BMI) and waist circumference (WC) in Guangzhou, South China, which is probably experiencing the most rapid economic transition in history. METHODS In this study, 17,786 Chinese aged 50+ years were recruited from 2003 to 2008 and followed up until 2012. BMI and WC were measured at two time points. RESULTS During the mean follow-up of 3.6 years (median = 3, interquartile = 1), age-adjusted mean BMI increased only slightly. By contrast, mean WC increased sharply by 0.94 cm (95% confidence interval 0.93-0.94) annually in men and 1.29 cm (1.28-1.29) annually in women. In 77% of women and 69% of men, WC increased, and among them, the mean annual increase was 2.01 cm and 1.70 cm, respectively. Among healthy, never-smoking participants, the incidence of central obesity was 29.0% (36.4% in women and 14.2% in men). The incidence of general obesity was 1.9% and was similarly low in both men and women (2.1% vs. 1.8%). Conversely, 20.3% of individuals with general obesity became nonobese, and 12.8% of individuals with central obesity returned to normal. CONCLUSIONS Central obesity has risen sharply in this cohort. Such increases may have been greatly underestimated previously and should form the basis of an even stronger warning for regions undergoing economic transitions in China and elsewhere.
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Affiliation(s)
- Lin Xu
- School of Public Health, The University of Hong Kong, Hong Kong
| | - Tai Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong.
| | | | | | - Ya Li Jin
- Guangzhou No.12 Hospital, Guangzhou, China
| | - Tong Zhu
- Guangzhou No.12 Hospital, Guangzhou, China
| | - Hubert K B Lam
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Catherine Mary Schooling
- School of Public Health, The University of Hong Kong, Hong Kong
- CUNY School of Public Health at Hunter College, New York, New York, USA
| | - Peymane Adab
- Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK
| | - G Neil Thomas
- Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK
| | - Kar Keung Cheng
- Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK
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