1
|
Desnavailles P, Praud D, Le Provost B, Kobayashi H, Deygas F, Amadou A, Coudon T, Grassot L, Faure E, Couvidat F, Severi G, Mancini FR, Fervers B, Proust-Lima C, Leffondré K. Trajectories of long-term exposure to PCB153 and Benzo[a]pyrene (BaP) air pollution and risk of breast cancer. Environ Health 2024; 23:72. [PMID: 39244555 PMCID: PMC11380782 DOI: 10.1186/s12940-024-01106-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 07/24/2024] [Indexed: 09/09/2024]
Abstract
BACKGROUND While genetic, hormonal, and lifestyle factors partially elucidate the incidence of breast cancer, emerging research has underscored the potential contribution of air pollution. Polychlorinated biphenyls (PCBs) and benzo[a]pyrene (BaP) are of particular concern due to endocrine-disrupting properties and their carcinogenetic effect. OBJECTIVE To identify distinct long term trajectories of exposure to PCB153 and BaP, and estimate their associations with breast cancer risk. METHODS We used data from the XENAIR case-control study, nested within the ongoing prospective French E3N cohort which enrolled 98,995 women aged 40-65 years in 1990-1991. Cases were incident cases of primary invasive breast cancer diagnosed from cohort entry to 2011. Controls were randomly selected by incidence density sampling, and individually matched to cases on delay since cohort entry, and date, age, department of residence, and menopausal status at cohort entry. Annual mean outdoor PCB153 and BaP concentrations at residential addresses from 1990 to 2011 were estimated using the CHIMERE chemistry-transport model. Latent class mixed models were used to identify profiles of exposure trajectories from cohort entry to the index date, and conditional logistic regression to estimate their association with the odds of breast cancer. RESULTS 5058 cases and 5059 controls contributed to the analysis. Five profiles of trajectories of PCB153 exposure were identified. The class with the highest PCB153 concentrations had a 69% increased odds of breast cancer compared to the class with the lowest concentrations (95% CI 1.08, 2.64), after adjustment for education and matching factors. The association between identified BaP trajectories and breast cancer was weaker and suffered from large CI. CONCLUSIONS Our results support an association between long term exposure to PCB153 and the risk of breast cancer, and encourage further studies to account for lifetime exposure to persistent organic pollutants.
Collapse
Affiliation(s)
- Pauline Desnavailles
- Bordeaux Population Health Center (BPH Inserm U1219), Université de Bordeaux, 146 Rue Leo Saignat, Bordeaux, 33000, France
| | - Delphine Praud
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France
- Inserm U1296 Radiations : Défense, Santé, Environnement, Lyon, France
| | - Blandine Le Provost
- Bordeaux Population Health Center (BPH Inserm U1219), Université de Bordeaux, 146 Rue Leo Saignat, Bordeaux, 33000, France
| | - Hidetaka Kobayashi
- Bordeaux Population Health Center (BPH Inserm U1219), Université de Bordeaux, 146 Rue Leo Saignat, Bordeaux, 33000, France
| | - Floriane Deygas
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France
- Inserm U1296 Radiations : Défense, Santé, Environnement, Lyon, France
| | - Amina Amadou
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France
- Inserm U1296 Radiations : Défense, Santé, Environnement, Lyon, France
| | - Thomas Coudon
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France
- Inserm U1296 Radiations : Défense, Santé, Environnement, Lyon, France
| | - Lény Grassot
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France
- Inserm U1296 Radiations : Défense, Santé, Environnement, Lyon, France
| | - Elodie Faure
- Department of Statistics, Computer Science and Applications (DISIA), University of Florence, Florence, Italy
| | - Florian Couvidat
- National Institute for Industrial Environment and Risks (INERIS), Verneuil-en-Halatte, France
| | - Gianluca Severi
- Centre de Recherche en Epidémiologie Et Santé Des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, UPS UVSQ, Gustave Roussy, Villejuif, France
- Department of Statistics, Computer Science and Applications (DISIA), University of Florence, Florence, Italy
| | - Francesca Romana Mancini
- Department of Statistics, Computer Science and Applications (DISIA), University of Florence, Florence, Italy
| | - Béatrice Fervers
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France
- Inserm U1296 Radiations : Défense, Santé, Environnement, Lyon, France
| | - Cécile Proust-Lima
- Bordeaux Population Health Center (BPH Inserm U1219), Université de Bordeaux, 146 Rue Leo Saignat, Bordeaux, 33000, France
| | - Karen Leffondré
- Bordeaux Population Health Center (BPH Inserm U1219), Université de Bordeaux, 146 Rue Leo Saignat, Bordeaux, 33000, France.
| |
Collapse
|
2
|
Kuiper JR, Liu SH, Lanphear BP, Calafat AM, Cecil KM, Xu Y, Yolton K, Kalkwarf HJ, Chen A, Braun JM, Buckley JP. Estimating effects of longitudinal and cumulative exposure to PFAS mixtures on early adolescent body composition. Am J Epidemiol 2024; 193:917-925. [PMID: 38400650 DOI: 10.1093/aje/kwae014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 02/07/2024] [Accepted: 02/20/2024] [Indexed: 02/25/2024] Open
Abstract
Few methods have been used to characterize repeatedly measured biomarkers of chemical mixtures. We applied latent profile analysis (LPA) to serum concentrations of 4 perfluoroalkyl and polyfluoroalkyl substances (PFAS) measured at 4 time points from gestation to age 12 years. We evaluated the relationships between profiles and z scores of height, body mass index, fat mass index, and lean body mass index at age 12 years (n = 218). We compared LPA findings with an alternative approach for cumulative PFAS mixtures using g-computation to estimate the effect of simultaneously increasing the area under the receiver operating characteristic curve (AUC) for all PFAS. We identified 2 profiles: a higher PFAS profile (35% of sample) and a lower PFAS profile (relative to each other), based on their average PFAS concentrations at all time points. The higher PFAS profile had generally lower z scores for all outcomes, with somewhat larger effects for males, though all 95% CIs crossed the null. For example, the higher PFAS profile was associated with a 0.50-unit lower (β = -0.50; 95% CI, -1.07 to 0.08) BMI z score among males but not among females (β = 0.04; 95% CI, -0.45 to 0.54). We observed similar patterns with AUCs. We found that a higher childhood PFAS profile and higher cumulative PFAS mixtures may be associated with altered growth in early adolescence. This article is part of a Special Collection on Environmental Epidemiology.
Collapse
Affiliation(s)
- Jordan R Kuiper
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC 20037, United States
| | - Shelley H Liu
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
| | - Bruce P Lanphear
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
| | - Antonia M Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30333, United States
| | - Kim M Cecil
- Department of Radiology, College of Medicine, and Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH 45267, United States
| | - Yingying Xu
- Department of Pediatrics, College of Medicine, and Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH 45267, United States
| | - Kimberly Yolton
- Department of Pediatrics, College of Medicine, and Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH 45267, United States
- Department of Environmental and Public Health Sciences, College of Medicine, and Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH 45267, United States
| | - Heidi J Kalkwarf
- Department of Pediatrics, College of Medicine, and Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH 45267, United States
| | - Aimin Chen
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Joseph M Braun
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI 02903, United States
| | - Jessie P Buckley
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| |
Collapse
|
3
|
van Zandwijk N, Marshall HM, Fong KM. Lung cancer: Removing toxic dust from our environment. Respirology 2023; 28:511-512. [PMID: 37105901 DOI: 10.1111/resp.14512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 04/19/2023] [Indexed: 04/29/2023]
Affiliation(s)
- Nico van Zandwijk
- Department of Cell and Molecular Therapies, Royal Prince Alfred Hospital/Sydney Local Health District, Camperdown, New South Wales, Australia
- Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Henry M Marshall
- The Prince Charles Hospital and Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Kwun M Fong
- The Prince Charles Hospital and Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| |
Collapse
|
4
|
Christensen GM, Marcus M, Vanker A, Eick SM, Malcolm-Smith S, Suglia SF, Chang HH, Zar HJ, Stein DJ, Hüls A. Joint Effects of Indoor Air Pollution and Maternal Psychosocial Factors During Pregnancy on Trajectories of Early Childhood Psychopathology. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.07.23288289. [PMID: 37066323 PMCID: PMC10104216 DOI: 10.1101/2023.04.07.23288289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
Background Prenatal indoor air pollution and maternal psychosocial factors have been associated with adverse psychopathology. We used environmental exposure mixture methodology to investigate joint effects of both exposure classes on child behavior trajectories. Methods For 360 children from the South African Drakenstein Child Health Study, we created trajectories of Child Behavior Checklist scores (24, 42, 60 months) using latent class linear mixed effects models. Indoor air pollutants and psychosocial factors were measured during pregnancy (2 nd trimester). After adjusting for confounding, single-exposure effects (per natural log-1 unit increase) were assessed using polytomous logistic regression models; joint effects using self-organizing maps (SOM), and principal component (PC) analysis. Results High externalizing trajectory was associated with increased particulate matter (PM 10 ) exposure (OR [95%-CI]: 1.25 [1.01,1.55]) and SOM exposure profile most associated with smoking (2.67 [1.14,6.27]). Medium internalizing trajectory was associated with increased emotional intimate partner violence (2.66 [1.17,5.57]), increasing trajectory with increased benzene (1.24 [1.02,1.51]) and toluene (1.21 [1.02,1.44]) and the PC most correlated with benzene and toluene (1.25 [1.02, 1.54]). Conclusions Prenatal exposure to environmental pollutants and psychosocial factors was associated with internalizing and externalizing child behavior trajectories. Understanding joint effects of adverse exposure mixtures will facilitate targeted interventions to prevent childhood psychopathology.
Collapse
|
5
|
Adams AE, Saville A, Shriver TE. Race, Toxic Exposures, and Environmental Health: The Contestation of Lupus among Farmworkers. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2023; 64:136-151. [PMID: 36440572 DOI: 10.1177/00221465221132787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Extant research has established that low-wage workers of color are at higher risk for occupational exposures. While the medical sociology literature regarding contested illness provides insights into the dynamics surrounding workplace exposures, some environmental illnesses such as lupus have gotten scant analytical attention. This is a significant gap because women of color, who are more likely to hold these high-risk jobs, are disproportionately affected by the disease. We examine a case of pesticide exposure among Black women farmworkers in Florida. We investigate how race and occupation intersect to shape lived experiences with toxics and what role race plays in the process of contesting exposures and illness. Our data include in-depth interviews (N = 36), media coverage, and archival materials. Our findings indicate that race-related factors played an important part in shaping the farmworkers' experiences with exposures, illness, and interaction with elite actors.
Collapse
|
6
|
Lergenmuller S, Rueegg CS, Perrier F, Robsahm TE, Green AC, Lund E, Ghiasvand R, Veierød MB. Lifetime Sunburn Trajectories and Associated Risks of Cutaneous Melanoma and Squamous Cell Carcinoma Among a Cohort of Norwegian Women. JAMA Dermatol 2022; 158:1367-1377. [PMID: 36197657 PMCID: PMC9535508 DOI: 10.1001/jamadermatol.2022.4053] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/31/2022] [Indexed: 01/13/2023]
Abstract
Importance To our knowledge, no study has prospectively investigated sunburn patterns over age periods from childhood to adulthood and their associations with skin cancer risk. Objective To identify lifetime trajectories of sunburns and compare the association between these trajectories and subsequent risk of cutaneous melanoma and squamous cell carcinoma (cSCC). Design, Setting, and Participants This population-based cohort study included participants from the Norwegian Women and Cancer Study, established in 1991, with follow-up through 2018. Baseline questionnaires were issued from 1991 to 2007, with follow-up questionnaires every 5 to 7 years. Data analysis was performed from March 16, 2021, to December 4, 2021. Exposures Participants reported pigmentation factors, sunbathing vacations, and indoor tanning. Annual frequencies of sunburns were reported for childhood, adolescence, and adulthood. Main Outcomes and Measures Information on cancer diagnoses, emigration, and death were obtained through linkage to the Cancer Registry of Norway using the unique personal identification number of Norwegian citizens. Results Of the 172 472 women (age range, 31-70 years) who returned questionnaires, 169 768 received questions about sunburns at study inclusion. Five classes (stable low, low-moderate-low, low to high, high to low, and stable high) of individual lifetime sunburn trajectories with similar shapes were estimated in 3 samples up to 39 years (n = 159 773), up to 49 years (n = 153 297), and up to 59 years (n = 119 170). Mean follow-up ranged from 14.3 to 19.5 years in the 3 samples, during which 1252 to 1774 women were diagnosed with incident primary melanoma and 739 to 871 women with incident primary cSCC. With hazard ratios (HRs) and 95% CIs estimated using a Cox proportional hazards model, the stable high and high to low trajectories showed statistically significant increased melanoma and cSCC risks compared with the stable low trajectory across all samples (≤39 years for stable high and high to low trajectories: melanoma: HR, 1.50 [95% CI, 1.28-1.75] and HR, 1.44 [95% CI, 1.20-1.73]; cSCC: HR, 1.51 [95% CI, 1.22-1.87] and HR, 1.47 [95% CI, 1.14-1.91]). Other trajectories showed increased risk, though generally weaker and mainly estimates that were not statistically significant. There was no statistically significant heterogeneity between melanoma and cSCC estimates. Conclusion and Relevance This cohort study showed that high sunburn frequency throughout life was associated with increased melanoma and cSCC risk. Furthermore, sunburns in childhood are especially important for subsequent risk of these skin cancers. Avoiding sunburns throughout life, in particular in childhood, is therefore crucial.
Collapse
Affiliation(s)
- Simon Lergenmuller
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Now with Department of Clinical and Registry-Based Research, Institute of Population-Based Cancer Research, Cancer Registry of Norway, Oslo, Norway
| | - Corina S. Rueegg
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Flavie Perrier
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Trude E. Robsahm
- Department of Research, Institute of Population-Based Cancer Research, Cancer Registry of Norway, Oslo, Norway
| | - Adele C. Green
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- Cancer Research UK Manchester and Faculty of Biology, Medicine and Health, University of Manchester, Manchester, England, United Kingdom
| | - Eiliv Lund
- Department of Research, Institute of Population-Based Cancer Research, Cancer Registry of Norway, Oslo, Norway
- Department of Public Health, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway
| | - Reza Ghiasvand
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
- Department of Research, Institute of Population-Based Cancer Research, Cancer Registry of Norway, Oslo, Norway
| | - Marit B. Veierød
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| |
Collapse
|
7
|
Ngai ZN, Chok KC, Ng KY, Koh RY, Chye SM. Potential role of melatonin in prevention and treatment of lung cancer. Horm Mol Biol Clin Investig 2022; 43:485-503. [PMID: 35728260 DOI: 10.1515/hmbci-2022-0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 05/14/2022] [Indexed: 12/24/2022]
Abstract
Lung cancer is the second most common cancer and the most lethal cancer worldwide. Melatonin, an indoleamine produced in the pineal gland, shows anticancer effects on a variety of cancers, especially lung cancer. Herein, we clarify the pathophysiology of lung cancer, the association of circadian rhythm with lung, and the relationship between shift work and the incidence of lung cancer. Special focus is placed on the role of melatonin receptors in lung cancer, the relationship between inflammation and lung cancer, control of cell proliferation, apoptosis, autophagy, and immunomodulation in lung cancer by melatonin. A review of the drug synergy of melatonin with other anticancer drugs suggests its usefulness in combination therapy. In summary, the information compiled may serve as a comprehensive reference for the various mechanisms of action of melatonin against lung cancer, as a guide for the design of future experimental research and for advancing melatonin as a therapeutic agent for lung cancer.
Collapse
Affiliation(s)
- Zi Ni Ngai
- School of Health Science, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia
| | - Kian Chung Chok
- School of Health Science, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia
| | - Khuen Yen Ng
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
| | - Rhun Yian Koh
- Division of Applied Biomedical Science and Biotechnology, School of Health Science, International Medical University, Kuala Lumpur, Malaysia
| | - Soi Moi Chye
- Division of Applied Biomedical Science and Biotechnology, School of Health Science, International Medical University, Kuala Lumpur, Malaysia
| |
Collapse
|
8
|
Li H, Zhao M, Fei G, Wang Z, Wang S, Wei P, Li W. Epidemiological trends and incidence prediction of lung cancer in China based on the Global Burden of Disease study 2019. Front Med (Lausanne) 2022; 9:969487. [PMID: 36203776 PMCID: PMC9530458 DOI: 10.3389/fmed.2022.969487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 09/01/2022] [Indexed: 12/02/2022] Open
Abstract
Lung cancer remains the most common malignancy in China. This study aims to provide scientific support for the prevention and treatment of lung cancer by analyzing the epidemiological trends of lung cancer in China from 1990 to 2019. Based on the global health exchange database (GHDx), joinpoint and age-period-cohort analyses were performed to explore the trend of lung cancer incidence and mortality rates from 1990 to 2019. According to incidence rates from 1990 to 2019, a model was constructed to predict the incidence rates in the next 5 years. In addition, changes in risk factors associated with lung cancer deaths were compared between 1990 and 2019 and between males and females in 2019. The results are as follows. The age-standardized incidence rates (ASIRs), and age-standardized death rates (ASDRs) of lung cancer among Chinese had overall upward trends from 1990 to 2019. The ASDRs of females and males in China decreased since 2010. Interestingly, from 2016 to 2019, the ASIRs and ASDRs of females rose significantly. The age-period-cohort model showed that the incidence and mortality rates of lung cancer in China increased with age, and the growth rate accelerated after 45 years old. After 2004, the relative risks of lung cancer incidence increased with the passage of the period. Also, after the 1950-1954 birth cohort, the risks of lung cancer incidence and death began to decrease. The autoregressive integrated moving average (ARIMA) model predicted that the incidence rates of lung cancer in China would continue to rise in the next 5 years. The top five risk factors for lung cancer deaths of both genders in 2019 were smoking, ambient particulate matter pollution, secondhand smoke, high fasting plasma glucose, and household air pollution from solid fuels. The above results provided precise clues for the prevention and treatment of lung cancer in China.
Collapse
Affiliation(s)
- Han Li
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Meng Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Gaoqiang Fei
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Zemin Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Shuai Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Pingmin Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Wei Li
- Department of Quality Management, Children's Hospital of Nanjing Medical University, Nanjing, China
| |
Collapse
|
9
|
Elhakeem A, Hughes RA, Tilling K, Cousminer DL, Jackowski SA, Cole TJ, Kwong ASF, Li Z, Grant SFA, Baxter-Jones ADG, Zemel BS, Lawlor DA. Using linear and natural cubic splines, SITAR, and latent trajectory models to characterise nonlinear longitudinal growth trajectories in cohort studies. BMC Med Res Methodol 2022; 22:68. [PMID: 35291947 PMCID: PMC8925070 DOI: 10.1186/s12874-022-01542-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 02/11/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Longitudinal data analysis can improve our understanding of the influences on health trajectories across the life-course. There are a variety of statistical models which can be used, and their fitting and interpretation can be complex, particularly where there is a nonlinear trajectory. Our aim was to provide an accessible guide along with applied examples to using four sophisticated modelling procedures for describing nonlinear growth trajectories. METHODS This expository paper provides an illustrative guide to summarising nonlinear growth trajectories for repeatedly measured continuous outcomes using (i) linear spline and (ii) natural cubic spline linear mixed-effects (LME) models, (iii) Super Imposition by Translation and Rotation (SITAR) nonlinear mixed effects models, and (iv) latent trajectory models. The underlying model for each approach, their similarities and differences, and their advantages and disadvantages are described. Their application and correct interpretation of their results is illustrated by analysing repeated bone mass measures to characterise bone growth patterns and their sex differences in three cohort studies from the UK, USA, and Canada comprising 8500 individuals and 37,000 measurements from ages 5-40 years. Recommendations for choosing a modelling approach are provided along with a discussion and signposting on further modelling extensions for analysing trajectory exposures and outcomes, and multiple cohorts. RESULTS Linear and natural cubic spline LME models and SITAR provided similar summary of the mean bone growth trajectory and growth velocity, and the sex differences in growth patterns. Growth velocity (in grams/year) peaked during adolescence, and peaked earlier in females than males e.g., mean age at peak bone mineral content accrual from multicohort SITAR models was 12.2 years in females and 13.9 years in males. Latent trajectory models (with trajectory shapes estimated using a natural cubic spline) identified up to four subgroups of individuals with distinct trajectories throughout adolescence. CONCLUSIONS LME models with linear and natural cubic splines, SITAR, and latent trajectory models are useful for describing nonlinear growth trajectories, and these methods can be adapted for other complex traits. Choice of method depends on the research aims, complexity of the trajectory, and available data. Scripts and synthetic datasets are provided for readers to replicate trajectory modelling and visualisation using the R statistical computing software.
Collapse
Affiliation(s)
- Ahmed Elhakeem
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK.
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
| | - Rachael A Hughes
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Kate Tilling
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Diana L Cousminer
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Genetics, University of Pennsylvania, Philadelphia, PA, USA
- Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Stefan A Jackowski
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Tim J Cole
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Alex S F Kwong
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Zheyuan Li
- School of Mathematics and Statistics, Henan University, Kaifeng, Henan, China
- Department of Statistics and Actuarial Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Struan F A Grant
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Genetics, University of Pennsylvania, Philadelphia, PA, USA
- Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | | | - Babette S Zemel
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| |
Collapse
|