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Lehto US, Aromaa A, Tammela T. Psychological recovery and well-being of spouses of patients with prostate cancer 5 years after primary treatment in Finland: a follow-up survey. BMJ Open 2023; 13:e063435. [PMID: 37105703 PMCID: PMC10151865 DOI: 10.1136/bmjopen-2022-063435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
OBJECTIVE AND SETTING To study longitudinally cancer-related experiences of spouses of patients with prostate cancer and the predictors of their psychological recovery and quality of life (QOL) by following the participants of our previous survey at primary cancer treatment in a university hospital. DESIGN A 5-year longitudinal cohort design. PARTICIPANTS AND PROCEDURE A follow-up questionnaire was mailed to the female spouses/partners who participated in our previous survey (n=104). We quantitatively explored the spouses' prostate cancer-related experiences since the previous survey and measured their current psychological symptom distress and well-being/QOL. Seventy-seven (74%) of the initial participants responded. OUTCOMES The main outcome measures were the spouses' psychological recovery (psychological symptoms at the initial survey vs currently) and well-being/QOL (depressive symptoms, domains of QOL) at 5 years. We analysed their predictors with regression analyses. RESULTS The treatment had been prostatectomy in 70% of the patients. Psychological distress had alleviated in 76% of spouses (p<0.001) and emotional changes decreased (p=0.02), but a deteriorating impact on the partnership (from 4% to 16%) and on sex life ('strong impact' from 23% to 37%) had increased. The outcomes were inversely associated with negative depression-related psychological symptoms and emotional changes either initially or at follow-up. However, some early experiences also predicted the outcomes when other factors were controlled for. Prostate cancer-related information received by the spouses from several sources (leaflets/handouts, TV/radio, internet) predicted better recovery and well-being/QOL, whereas the patients' prostate cancer and treatment-related symptoms (pain, irritability/anger, bowel dysfunction) predicted poorer recovery and well-being/QOL in spouses. CONCLUSIONS A major negative impact of prostate cancer was experienced by the spouses still 5 years after primary treatment. Early prostate cancer-related experiences predicted long-term psychological recovery and QOL. Responding to the early information needs of spouses and effective symptom management for the patients are likely to enhance the spouses' long-term recovery and well-being.
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Affiliation(s)
- Ulla-Sisko Lehto
- Population Health/ Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Arpo Aromaa
- Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Teuvo Tammela
- Department of Surgery, Tampere University Hospital, Tampere, Finland
- Faculty of Medicine and Medical Technology, University of Tampere, Tampere, Finland
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Hautakangas H, Winsvold BS, Ruotsalainen SE, Bjornsdottir G, Harder AVE, Kogelman LJA, Thomas LF, Noordam R, Benner C, Gormley P, Artto V, Banasik K, Bjornsdottir A, Boomsma DI, Brumpton BM, Burgdorf KS, Buring JE, Chalmer MA, de Boer I, Dichgans M, Erikstrup C, Färkkilä M, Garbrielsen ME, Ghanbari M, Hagen K, Häppölä P, Hottenga JJ, Hrafnsdottir MG, Hveem K, Johnsen MB, Kähönen M, Kristoffersen ES, Kurth T, Lehtimäki T, Lighart L, Magnusson SH, Malik R, Pedersen OB, Pelzer N, Penninx BWJH, Ran C, Ridker PM, Rosendaal FR, Sigurdardottir GR, Skogholt AH, Sveinsson OA, Thorgeirsson TE, Ullum H, Vijfhuizen LS, Widén E, van Dijk KW, Aromaa A, Belin AC, Freilinger T, Ikram MA, Järvelin MR, Raitakari OT, Terwindt GM, Kallela M, Wessman M, Olesen J, Chasman DI, Nyholt DR, Stefánsson H, Stefansson K, van den Maagdenberg AMJM, Hansen TF, Ripatti S, Zwart JA, Palotie A, Pirinen M. Genome-wide analysis of 102,084 migraine cases identifies 123 risk loci and subtype-specific risk alleles. Nat Genet 2022; 54:152-160. [PMID: 35115687 PMCID: PMC8837554 DOI: 10.1038/s41588-021-00990-0] [Citation(s) in RCA: 120] [Impact Index Per Article: 60.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 11/22/2021] [Indexed: 12/11/2022]
Abstract
Migraine affects over a billion individuals worldwide but its genetic underpinning remains largely unknown. Here, we performed a genome-wide association study of 102,084 migraine cases and 771,257 controls and identified 123 loci, of which 86 are previously unknown. These loci provide an opportunity to evaluate shared and distinct genetic components in the two main migraine subtypes: migraine with aura and migraine without aura. Stratification of the risk loci using 29,679 cases with subtype information indicated three risk variants that seem specific for migraine with aura (in HMOX2, CACNA1A and MPPED2), two that seem specific for migraine without aura (near SPINK2 and near FECH) and nine that increase susceptibility for migraine regardless of subtype. The new risk loci include genes encoding recent migraine-specific drug targets, namely calcitonin gene-related peptide (CALCA/CALCB) and serotonin 1F receptor (HTR1F). Overall, genomic annotations among migraine-associated variants were enriched in both vascular and central nervous system tissue/cell types, supporting unequivocally that neurovascular mechanisms underlie migraine pathophysiology.
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Affiliation(s)
- Heidi Hautakangas
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE), University of Helsinki, Helsinki, Finland
| | - Bendik S Winsvold
- Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - Sanni E Ruotsalainen
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE), University of Helsinki, Helsinki, Finland
| | | | - Aster V E Harder
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Human Genetics, Leiden University Medical Center, Leiden, the Netherlands
| | - Lisette J A Kogelman
- Danish Headache Center, Department of Neurology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Laurent F Thomas
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- BioCore - Bioinformatics Core Facility, Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Laboratory Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Raymond Noordam
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands
| | - Christian Benner
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE), University of Helsinki, Helsinki, Finland
| | | | - Ville Artto
- Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland
| | - Karina Banasik
- Novo Nordic Foundation Center for Protein Research, Copenhagen University, Copenhagen, Denmark
| | | | - Dorret I Boomsma
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, the Netherlands
| | - Ben M Brumpton
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Julie E Buring
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Mona Ameri Chalmer
- Danish Headache Center, Department of Neurology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Irene de Boer
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, University Hospital, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology (Synergy), Munich, Germany
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Markus Färkkilä
- Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland
| | - Maiken Elvestad Garbrielsen
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Mohsen Ghanbari
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Knut Hagen
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Clinical Research Unit Central Norway, St. Olavs University Hospital, Trondheim, Norway
| | - Paavo Häppölä
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE), University of Helsinki, Helsinki, Finland
| | - Jouke-Jan Hottenga
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, the Netherlands
| | | | - Kristian Hveem
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- HUNT Research Center, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Marianne Bakke Johnsen
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Research and Communication Unit for Musculoskeletal Health (FORMI), Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital, and Finnish Cardiovascular Research Center - Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Espen S Kristoffersen
- Research and Communication Unit for Musculoskeletal Health (FORMI), Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | - Tobias Kurth
- Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories, and Finnish Cardiovascular Research Center - Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Lannie Lighart
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, the Netherlands
| | | | - Rainer Malik
- Institute for Stroke and Dementia Research, University Hospital, LMU Munich, Munich, Germany
| | - Ole Birger Pedersen
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
| | - Nadine Pelzer
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
- GGZ inGeest Specialized Mental Health Care, Amsterdam, the Netherlands
| | - Caroline Ran
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Paul M Ridker
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Anne Heidi Skogholt
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | | | | | - Henrik Ullum
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Lisanne S Vijfhuizen
- Department of Human Genetics, Leiden University Medical Center, Leiden, the Netherlands
| | - Elisabeth Widén
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE), University of Helsinki, Helsinki, Finland
| | - Ko Willems van Dijk
- Department of Human Genetics, Leiden University Medical Center, Leiden, the Netherlands
- Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands
| | - Arpo Aromaa
- National Public Health Institute (Finnish Institute for Health and Welfare - THL), Helsinki, Finland
| | | | - Tobias Freilinger
- Klinikum Passau, Department of Neurology, Passau, Germany
- Centre of Neurology, Hertie Institute for Clinical Brain Research, Tuebingen, Germany
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Marjo-Riitta Järvelin
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
- Unit of Primary Health Care, Oulu University Hospital, Oulu, Finland
- Department of Life Sciences, College of Health and Life Sciences, Brunel University London, London, UK
| | - Olli T Raitakari
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Gisela M Terwindt
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
| | - Mikko Kallela
- Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland
| | - Maija Wessman
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE), University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Jes Olesen
- Danish Headache Center, Department of Neurology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Daniel I Chasman
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Dale R Nyholt
- School of Biomedical Sciences and Centre for Genomics and Personalised Health, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | | | | | - Arn M J M van den Maagdenberg
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Human Genetics, Leiden University Medical Center, Leiden, the Netherlands
| | - Thomas Folkmann Hansen
- Danish Headache Center, Department of Neurology, Copenhagen University Hospital, Copenhagen, Denmark
- Novo Nordic Foundation Center for Protein Research, Copenhagen University, Copenhagen, Denmark
| | - Samuli Ripatti
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE), University of Helsinki, Helsinki, Finland
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - John-Anker Zwart
- Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Aarno Palotie
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE), University of Helsinki, Helsinki, Finland
- Analytic and Translational Genetics Unit, Department of Medicine, Department of Neurology and Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- The Stanley Center for Psychiatric Research and Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Matti Pirinen
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE), University of Helsinki, Helsinki, Finland.
- Department of Public Health, University of Helsinki, Helsinki, Finland.
- Department of Mathematics and Statistics, University of Helsinki, Helsinki, Finland.
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Knekt P, Järvinen R, Rissanen H, Heliövaara M, Aromaa A. Does sauna bathing protect against dementia? Prev Med Rep 2020; 20:101221. [PMID: 33088678 PMCID: PMC7560162 DOI: 10.1016/j.pmedr.2020.101221] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 09/15/2020] [Accepted: 09/25/2020] [Indexed: 12/29/2022] Open
Abstract
Frequent sauna bathing predicted decreased risk of dementia in a cohort from Finland. Result was independent of several dementia risk factors, and was not modified by sex. Findings support suggested benefits of sauna and passive body heating in the brain.
Repeated heat exposure like sauna bathing is suggested to beneficially affect against dementia development. The epidemiological evidence is, however, scarce. Therefore, we studied the association between heat exposure during sauna bathing (i.e., the frequency of sauna bathing, frequency of heat sessions, length of stay in heat, sauna temperature) and the subsequent risk of dementia. A prospective cohort study was conducted based on 13,994 men and women aged 30–69 and free from dementia diagnosis from the Finnish Mobile Clinic Follow-up Survey. During a follow-up of 39 years, a total of 1805 dementia patients were diagnosed. The sauna bathing data was gathered from a questionnaire. Analyses based on the Cox model included the sauna bathing variables and the potential confounding factors. Sauna bathing frequency was related to a reduced risk of dementia after adjustment for the potential sociodemographic, lifestyle, and metabolic risk factors of dementia considered. The hazard ratio of dementia between individuals sauna bathing 9–12 times per month in comparison with those not sauna bathing or sauna bathing less than four times per month was 0.47 (95% CI = 0.25–0.88) during the first 20 years of follow-up and 0.81 (95% CI = 0.69–0.97) during the whole follow-up. The results are in line with the hypothesis that sauna bathing provides protection against dementia. Further studies are required to verify the suggested benefits of sauna bathing.
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Affiliation(s)
- Paul Knekt
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Harri Rissanen
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Arpo Aromaa
- Finnish Institute for Health and Welfare, Helsinki, Finland
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Härkänen T, Sainio P, Stenholm S, Lundqvist A, Valkeinen H, Aromaa A, Koskinen S. Projecting long-term trends in mobility limitations: impact of excess weight, smoking and physical inactivity. J Epidemiol Community Health 2019; 73:443-450. [PMID: 30777889 DOI: 10.1136/jech-2017-210413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 12/20/2018] [Accepted: 01/10/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND Policy makers need disability projections for planning adequate services and measures for health promotion. The aim of this study is to provide projections on severe mobility limitations up to year 2044 and illustrate how the projected prevalence and the number of persons with severe mobility limitations are affected by potential changes in the modifiable risk factors, namely excess weight, physical inactivity and smoking. METHODS We analysed the nationally representative, repeated measures Health 2000 and 2011 Surveys (BRIF8901) with 8615 and 6740 participants, respectively, aged 18 years and older. Severe mobility limitations were defined as major difficulties or unable to walk about half a kilometre. We applied a multistate model on repeated measures to account for both individual risk factors and their changes over time. RESULTS The number of people with severe mobility limitations was projected to double by the year 2044 in Finland, due to the rapid ageing of the population. Eliminating half of the excess weight would reduce their number by one-fifth, while reductions in the prevalence of smoking and physical inactivity would have a minor impact. Even if excess weight, smoking and physical inactivity were completely eliminated, the number of persons with severe mobility limitations is projected to increase. CONCLUSIONS Designing and implementing strategies to promote healthy weight are important to slow down the rapid increase in mobility limitations due to population ageing. Providing adequate health and social services for the increasing population with disabilities will nevertheless be an increasing national challenge.
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Affiliation(s)
- Tommi Härkänen
- National Institute for Health and Welfare, Helsinki, Finland
| | - Päivi Sainio
- National Institute for Health and Welfare, Helsinki, Finland
| | - Sari Stenholm
- Department of Public Health, University of Turku, Turku, Finland
| | | | - Heli Valkeinen
- National Institute for Health and Welfare, Helsinki, Finland
| | - Arpo Aromaa
- National Institute for Health and Welfare, Helsinki, Finland
| | - Seppo Koskinen
- National Institute for Health and Welfare, Helsinki, Finland
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Gnatiuc L, Herrington WG, Halsey J, Tuomilehto J, Fang X, Kim HC, De Bacquer D, Dobson AJ, Criqui MH, Jacobs DR, Leon DA, Peters SAE, Ueshima H, Sherliker P, Peto R, Collins R, Huxley RR, Emberson JR, Woodward M, Lewington S, Aoki N, Arima H, Arnesen E, Aromaa A, Assmann G, Bachman DL, Baigent C, Bartholomew H, Benetos A, Bengtsson C, Bennett D, Björkelund C, Blackburn H, Bonaa K, Boyle E, Broadhurst R, Carstensen J, Chambless L, Chen Z, Chew SK, Clarke R, Cox C, Curb JD, D'Agostino R, Date C, Davey Smith G, De Backer G, Dhaliwal SS, Duan XF, Ducimetiere P, Duffy S, Eliassen H, Elwood P, Empana J, Garcia-Palmieri MH, Gazes P, Giles GG, Gillis C, Goldbourt U, Gu DF, Guasch-Ferre M, Guize L, Haheim L, Hart C, Hashimoto S, Hashimoto T, Heng D, Hjermann I, Ho SC, Hobbs M, Hole D, Holme I, Horibe H, Hozawa A, Hu F, Hughes K, Iida M, Imai K, Imai Y, Iso H, Jackson R, Jamrozik K, Jee SH, Jensen G, Jiang CQ, Johansen NB, Jorgensen T, Jousilahti P, Kagaya M, Keil J, Keller J, Kim IS, Kita Y, Kitamura A, Kiyohara Y, Knekt P, Knuiman M, Kornitzer M, Kromhout D, Kronmal R, Lam TH, Law M, Lee J, Leren P, Levy D, Li YH, Lissner L, Luepker R, Luszcz M, MacMahon S, Maegawa H, Marmot M, Matsutani Y, Meade T, Morris J, Morris R, Murayama T, Naito Y, Nakachi K, Nakamura M, Nakayama T, Neaton J, Nietert PJ, Nishimoto Y, Norton R, Nozaki A, Ohkubo T, Okayama A, Pan WH, Puska P, Qizilbash N, Reunanen A, Rimm E, Rodgers A, Saitoh S, Sakata K, Sato S, Schnohr P, Schulte H, Selmer R, Sharp D, Shifu X, Shimamoto K, Shipley M, Silbershatz H, Sorlie P, Sritara P, Suh I, Sutherland SE, Sweetnam P, Tamakoshi A, Tanaka H, Thomsen T, Tominaga S, Tomita M, Törnberg S, Tunstall-Pedoe H, Tverdal A, Ueshima H, Vartiainen E, Wald N, Wannamethee SG, Welborn TA, Whincup P, Whitlock G, Willett W, Woo J, Wu ZL, Yao SX, Yarnell J, Yokoyama T, Yoshiike N, Zhang XH. Sex-specific relevance of diabetes to occlusive vascular and other mortality: a collaborative meta-analysis of individual data from 980 793 adults from 68 prospective studies. Lancet Diabetes Endocrinol 2018; 6:538-546. [PMID: 29752194 PMCID: PMC6008496 DOI: 10.1016/s2213-8587(18)30079-2] [Citation(s) in RCA: 129] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 02/20/2018] [Accepted: 02/26/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND Several studies have shown that diabetes confers a higher relative risk of vascular mortality among women than among men, but whether this increased relative risk in women exists across age groups and within defined levels of other risk factors is uncertain. We aimed to determine whether differences in established risk factors, such as blood pressure, BMI, smoking, and cholesterol, explain the higher relative risks of vascular mortality among women than among men. METHODS In our meta-analysis, we obtained individual participant-level data from studies included in the Prospective Studies Collaboration and the Asia Pacific Cohort Studies Collaboration that had obtained baseline information on age, sex, diabetes, total cholesterol, blood pressure, tobacco use, height, and weight. Data on causes of death were obtained from medical death certificates. We used Cox regression models to assess the relevance of diabetes (any type) to occlusive vascular mortality (ischaemic heart disease, ischaemic stroke, or other atherosclerotic deaths) by age, sex, and other major vascular risk factors, and to assess whether the associations of blood pressure, total cholesterol, and body-mass index (BMI) to occlusive vascular mortality are modified by diabetes. RESULTS Individual participant-level data were analysed from 980 793 adults. During 9·8 million person-years of follow-up, among participants aged between 35 and 89 years, 19 686 (25·6%) of 76 965 deaths were attributed to occlusive vascular disease. After controlling for major vascular risk factors, diabetes roughly doubled occlusive vascular mortality risk among men (death rate ratio [RR] 2·10, 95% CI 1·97-2·24) and tripled risk among women (3·00, 2·71-3·33; χ2 test for heterogeneity p<0·0001). For both sexes combined, the occlusive vascular death RRs were higher in younger individuals (aged 35-59 years: 2·60, 2·30-2·94) than in older individuals (aged 70-89 years: 2·01, 1·85-2·19; p=0·0001 for trend across age groups), and, across age groups, the death RRs were higher among women than among men. Therefore, women aged 35-59 years had the highest death RR across all age and sex groups (5·55, 4·15-7·44). However, since underlying confounder-adjusted occlusive vascular mortality rates at any age were higher in men than in women, the adjusted absolute excess occlusive vascular mortality associated with diabetes was similar for men and women. At ages 35-59 years, the excess absolute risk was 0·05% (95% CI 0·03-0·07) per year in women compared with 0·08% (0·05-0·10) per year in men; the corresponding excess at ages 70-89 years was 1·08% (0·84-1·32) per year in women and 0·91% (0·77-1·05) per year in men. Total cholesterol, blood pressure, and BMI each showed continuous log-linear associations with occlusive vascular mortality that were similar among individuals with and without diabetes across both sexes. INTERPRETATION Independent of other major vascular risk factors, diabetes substantially increased vascular risk in both men and women. Lifestyle changes to reduce smoking and obesity and use of cost-effective drugs that target major vascular risks (eg, statins and antihypertensive drugs) are important in both men and women with diabetes, but might not reduce the relative excess risk of occlusive vascular disease in women with diabetes, which remains unexplained. FUNDING UK Medical Research Council, British Heart Foundation, Cancer Research UK, European Union BIOMED programme, and National Institute on Aging (US National Institutes of Health).
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Kontio T, Heliövaara M, Rissanen H, Knekt P, Aromaa A, Solovieva S. Risk factors for first hospitalization due to meniscal lesions - a population-based cohort study with 30 years of follow-up. BMC Musculoskelet Disord 2017; 18:528. [PMID: 29237499 PMCID: PMC5729412 DOI: 10.1186/s12891-017-1886-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 12/01/2017] [Indexed: 02/05/2023] Open
Abstract
Background Meniscal lesions are among the most common injuries of the knee, yet limited epidemiologic data is available on their risk factors. We investigated the association of lifestyle factors and physical strenuousness of work on knee injuries with a focus on meniscal lesions. Methods We examined a nationally representative sample of persons aged 30 to 59 years, who participated in a comprehensive health examination (the Mini-Finland Health Survey). Subjects without any injury or osteoarthritis in the knee joint at baseline (n = 4713) were subsequently followed via the National Hospital Discharge Register up to 30 years. Results During the follow-up, 338 knee injuries were identified of which 224 were meniscal lesions. Obesity and regular leisure time physical exercise were associated with an increased risk of first hospitalization due to meniscal lesions (hazard ratio (HR) 1.62 and 95% confidence interval (CI) 1.06–2.48 and 1.53, 95% CI 1.05–2.23, respectively). The types of sports predicting the highest risk of meniscal lesions were ballgames, gymnastics and jogging. Physical strenuousness of work did not predict meniscal lesion. The hazard of other knee injury was increased among those reporting irregular or regular physical exercise at baseline (HR 1.64, 95% CI 1.03–2.64 and 1.88 CI 1.05–2.36, respectively). Smoking or alcohol intake were not associated with knee injuries. Conclusions Better safety measures in high-risk sports and weight control would likely improve the prevention of meniscal lesions in populations.
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Affiliation(s)
- Tea Kontio
- University of Helsinki, Helsinki, Finland
| | - Markku Heliövaara
- National Institute for Health and Welfare, Helsinki and Turku, Finland
| | - Harri Rissanen
- National Institute for Health and Welfare, Helsinki and Turku, Finland
| | - Paul Knekt
- National Institute for Health and Welfare, Helsinki and Turku, Finland
| | - Arpo Aromaa
- National Institute for Health and Welfare, Helsinki and Turku, Finland
| | - Svetlana Solovieva
- Finnish Institute of Occupational Health, 40, 00251, Helsinki, PB, Finland.
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8
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Euro U, Knekt P, Rissanen H, Aromaa A, Karppinen J, Heliövaara M. Answer to the Letter to the Editor of T. Kawada concerning "Risk factors for sciatica leading to hospitalization" by U. Euro et al. Eur Spine J (2017). doi:10.1007/s00586-017-5182-8. Eur Spine J 2017; 27:514-515. [PMID: 29189953 DOI: 10.1007/s00586-017-5408-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Accepted: 11/20/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Ulla Euro
- Biocenter Oulu, University of Oulu, Oulu, Finland. .,Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland. .,Faculty of Biochemistry and Molecular Medicine, University of Oulu, Oulu, Finland. .,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland. .,Surgery Department, Hyvinkää Hospital, Hyvinkää, Finland.
| | - P Knekt
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - H Rissanen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - A Aromaa
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - J Karppinen
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.,Finnish Institute of Occupational Health, Health and Work Ability, Oulu, Finland
| | - M Heliövaara
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
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9
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Mehta N, Elo I, Stenholm S, Aromaa A, Heliövaara M, Koskinen S. International Differences in the Risk of Death from Smoking and Obesity: The Case of the United States and Finland. SSM Popul Health 2017; 3:141-152. [PMID: 28798949 PMCID: PMC5546741 DOI: 10.1016/j.ssmph.2016.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Revised: 10/31/2016] [Accepted: 12/06/2016] [Indexed: 11/17/2022] Open
Abstract
Despite much interest in the health risks associated with behavioral factors, little is known about whether individuals residing in different countries experience a different set of risks. International comparisons of the death risks from major behavioral factors can shed light on whether features of health systems and epidemiological histories modify the health effects of risky behaviors. We used nationally representative samples and mortality linkages spanning the 1971-2014 period from the United States and Finland to examine cross-national differences in the risks of death from cigarette smoking and obesity. We evaluated both current and former smoking and current and prior obesity. In 1990, the approximate midpoint of our study, the death risks from current smoking were about 55% higher in U.S. women compared to Finnish women, but similar for men in the two countries. Death risks from smoking significantly increased over the period for women in both countries and there was no parallel increase in risks among men. Death risks from obesity did not significantly differ in the two countries and no significant trend in the risks were detected in either country. Reasons for the relatively high and increasing risks from smoking among American women warrant further evaluation.
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Affiliation(s)
- Neil Mehta
- University of Michigan, Department of Health Management and Policy, University of Michigan, Ann Arbor, MI, USA
| | - Irma Elo
- University of Pennsylvania, Population Studies Center, Philadelphia, PA, USA
| | - Sari Stenholm
- University of Turku, Department of Public Health, Turku, Finland
- National Institute for Health and Welfare (THL), Department of Health, Functional Capacity and Welfare, Turku/Helsinki, Finland
| | - Arpo Aromaa
- National Institute for Health and Welfare (THL), Department of Health, Functional Capacity and Welfare, Turku/Helsinki, Finland
| | - Markku Heliövaara
- National Institute for Health and Welfare (THL), Department of Health, Functional Capacity and Welfare, Turku/Helsinki, Finland
| | - Seppo Koskinen
- National Institute for Health and Welfare (THL), Department of Health, Functional Capacity and Welfare, Turku/Helsinki, Finland
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10
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Lehto US, Aromaa A, Tammela TL. Experiences and psychological distress of spouses of prostate cancer patients at time of diagnosis and primary treatment. Eur J Cancer Care (Engl) 2017. [DOI: 10.1111/ecc.12729] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Ulla-Sisko Lehto
- Health Monitoring Unit; National Institute for Health and Welfare THL; Helsinki Finland
| | - Arpo Aromaa
- Health Monitoring Unit; National Institute for Health and Welfare THL; Helsinki Finland
| | - Teuvo L. Tammela
- Department of Surgery; Tampere University Hospital; Tampere Finland
- School of Medicine; University of Tampere; Tampere Finland
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11
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Euro U, Knekt P, Rissanen H, Aromaa A, Karppinen J, Heliövaara M. Risk factors for sciatica leading to hospitalization. Eur Spine J 2017; 27:1501-1508. [PMID: 28612193 DOI: 10.1007/s00586-017-5182-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 05/02/2017] [Accepted: 06/07/2017] [Indexed: 12/19/2022]
Abstract
PURPOSE To study the known or suspected risk factors for sciatica: Tallness, overweight, smoking, leisure-time physical exercise, self-reported health and occupation, and how they predict hospitalizations due to sciatica. Only a few cohort studies have previously focused on the risk factors for sciatica. METHODS The 13,095 subjects, free from low back disorders at the baseline in 1973-1976 were followed up to the end of 2011 via the Care Register for Health Care. Along with an invitation to the health examination, a basic questionnaire concerning lifestyle factors was sent to participants. The outcome measure was incident sciatica leading to hospitalization. RESULTS Altogether 702 incident sciatica cases occurred. Among men, the adjusted hazard ratio (HR) with 95% confidence interval (CI) was 2.57 (95% CI 1.47-4.50) in metal or machine work, and 1.44 (1.06-1.95) in other industrial work, compared to that in white-collar occupations. Among women, the corresponding risk estimates were 1.81 (1.18-2.78) for nurses and related occupations, 1.56 (1.05-2.31) for sales workers, and 1.46 (1.03-2.08) for industrial workers. Among men, physical exercise during leisure predicted a decrease in the risk of sciatica (0.74; 0.55-1.00); this association was significantly pronounced in white-collar occupations (0.38; 0.18-0.88). Among women, the association between body mass index and the risk of sciatica was only modest, but varied greatly between different occupations. CONCLUSIONS Physically demanding work is a strong risk factor for sciatica. Leisure-time physical activity seems to protect men against sciatica, while overweight is a risk factor among women. However, occupation substantially modifies these associations.
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Affiliation(s)
- Ulla Euro
- Biocenter Oulu, University of Oulu, Oulu, Finland. .,Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland. .,Faculty of Biochemistry and Molecular Medicine, University of Oulu, Oulu, Finland. .,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland. .,Hyvinkää Hospital, Surgery Department, Hyvinkää, Finland.
| | - P Knekt
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - H Rissanen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - A Aromaa
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - J Karppinen
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.,Finnish Institute of Occupational Health, Health and Work Ability, Oulu, Finland
| | - M Heliövaara
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
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12
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Lehto US, Tenhola H, Taari K, Aromaa A. Patients' perceptions of the negative effects following different prostate cancer treatments and the impact on psychological well-being: a nationwide survey. Br J Cancer 2017; 116:864-873. [PMID: 28222069 PMCID: PMC5379142 DOI: 10.1038/bjc.2017.30] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 12/27/2016] [Accepted: 01/19/2017] [Indexed: 12/23/2022] Open
Abstract
Background: Although the prognosis of localised prostate cancer is good, the negative effects of prostate cancer treatment often impair patient quality of life. A growing number of men experience these negative effects over a longer time because of the increased incidence of and prolonged survival in prostate cancer, and the ageing of the population. Only a few studies have investigated the adverse effects of different prostate cancer treatments using large population-based samples. Methods: We conducted a nationwide survey (n=1239) to collect detailed information regarding the negative effects (i.e., the occurrence, perceived level and perceived bother since the beginning of the treatment) of prostate cancer treatments: radical prostatectomy, external beam radiotherapy, brachytherapy, hormone therapy and surveillance. Furthermore, we measured patient satisfaction with the outcome of the treatment and their psychological well-being (i.e., psychological symptoms and satisfaction with life) 5 years after diagnosis. The negative effects between the treatments were compared, and the determinants of satisfaction and psychological well-being were investigated. Results: The negative effects of all types of active prostate cancer treatments were common and persistent (33–48% reported symptoms at 5 years) and showed the known differences between the treatments. Prostatectomy and the radiotherapies caused urinary leakage; radiotherapy also caused symptoms of urinary irritation; and external radiation also caused bowel dysfunction. Most symptoms were considered highly bothersome. Most respondents (81−93%) reported that their treatment negatively affected their sex lives; 70–92% reported sexual dysfunction; and 20–58% reported that their sex lives with their spouses had ended. Urinary symptoms were especially associated with poorer psychological outcomes. The perception of symptom level and bother had a greater effect on patient satisfaction and well-being than the symptoms per se. Conclusion: Multiple and persistent negative effects follow active prostate cancer treatment, and these effects predict long-term patient satisfaction and psychological well-being. The harms and benefits associated with prostate cancer treatments should be considered when selecting whether and how to actively treat prostate cancer.
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Affiliation(s)
- Ulla-Sisko Lehto
- National Institute for Health and Welfare THL, Health Monitoring Unit, Helsinki FI00271, Finland
| | - Heli Tenhola
- National Institute for Health and Welfare THL, Health Monitoring Unit, Helsinki FI00271, Finland.,University of Helsinki, Division of Social Pharmacy; DRA Consulting Oy, Helsinki FI01510, Finland
| | - Kimmo Taari
- University of Helsinki; Helsinki University Hospital, Department of Urology, Helsinki FI00029, Finland
| | - Arpo Aromaa
- National Institute for Health and Welfare THL, Health Monitoring Unit, Helsinki FI00271, Finland
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13
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Sainio P, Koskinen S, Heliövaara M, Martelin T, Härkänen T, Hurri H, Miilunpalo S, Aromaa A. Self-reported and test-based mobility limitations in a representative sample of Finns aged 30+. Scand J Public Health 2016; 34:378-86. [PMID: 16861188 DOI: 10.1080/14034940500489859] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Aims: The object of the present study was to acquire a comprehensive and accurate picture of mobility limitations in the Finnish adult population. Methods: A nationally representative sample of 8,028 persons aged 30+ with high participation was interviewed and examined in the Health 2000 Survey conducted in 2000—01. Mobility limitations were measured by self-reports and performance tests. Results: Perceived running difficulties were already common among persons in middle age, while difficulties in moving about indoors were frequent only among persons aged 75+. A third of women and a fifth of men aged 55+ could not reach a walking speed of 1.2 m/s. Working-aged women were more limited than men only in physically demanding tasks, but in the elderly the gender difference was evident in most mobility tasks. A substantial disagreement was found between the self-reported and test-based indicators in stair climbing. Supplementary data collection, carried out to increase participation in the health examination, as well as inclusion of institutionalized persons, provided a more complete estimate of the prevalence of mobility limitations among the elderly. Conclusions: Both self-reported and performance-based indicators are needed to achieve a comprehensive view of disability and its variation between population groups. Exclusion of institutionalized persons and low participation lead to underestimation of the occurrence of limitations. The number of persons suffering from mobility problems will increase with ageing of the population, which accentuates the importance of early intervention to maintain functional ability, especially in women.
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Affiliation(s)
- Päivi Sainio
- National Public Health Institute, Department of Health and Functional Capacity, Helsinki, Finland.
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14
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Raittio E, Aromaa A, Kiiskinen U, Helminen S, Suominen AL. Income-related inequality in perceived oral health among adult Finns before and after a major dental subsidization reform. Acta Odontol Scand 2016; 74:348-54. [PMID: 26980421 DOI: 10.3109/00016357.2016.1142113] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objectives In Finland, a dental subsidization reform, implemented in 2001-2002, abolished age restrictions on subsidized dental care. The aim of this study was to investigate income-related inequality in the perceived oral health and its determinants among adult Finns before and after the reform. Materials and methods Three identical cross-sectional nationally representative postal surveys, concerning perceived oral health and the use of dental services among people born before 1971, were conducted in 2001 (n = 2157), in 2004 (n = 1814) and in 2007 (n = 1671). Three measures of perceived oral health were used: toothache or oral discomfort during the past 12 months, current need for dental care and self-reported oral health status. Concentration index was used to analyse the income-related inequalities. Its decomposition was used to study factors related to the inequalities. Results The proportion of respondents reporting need for dental care decreased from 2001 to 2007, while no changes were seen in reports of toothache or self-reported oral health status. Income-related inequalities in reports of toothache and perceived need for care widened, while the inequality in self-reported oral health remained stable. Most of the inequalities were related to income itself, perceived general health and the time since the last visit to dental care. Conclusions It seems that the income-related inequalities in perceived oral health remained or even widened after the reform.
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Affiliation(s)
- Eero Raittio
- University of Eastern Finland, Institute of Dentistry, Kuopio, Finland
| | - Arpo Aromaa
- Institute for Health and Welfare (THL), Helsinki, Finland
| | | | | | - Anna Liisa Suominen
- University of Eastern Finland, Institute of Dentistry, Kuopio, Finland
- Institute for Health and Welfare (THL), Helsinki, Finland
- Department of Oral and Maxillofacial Surgery, Kuopio University Hospital, Kuopio, Finland
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15
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Raittio E, Lahti S, Kiiskinen U, Helminen S, Aromaa A, Suominen AL. Inequality in oral health-related quality of life before and after a major subsidization reform. Eur J Oral Sci 2015; 123:267-75. [PMID: 26015152 DOI: 10.1111/eos.12192] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Eero Raittio
- Institute of Dentistry; University of Eastern Finland; Kuopio Finland
| | - Satu Lahti
- Institute of Dentistry; University of Turku; Turku Finland
| | | | | | - Arpo Aromaa
- Institute for Health and Welfare (THL); Helsinki Finland
| | - Anna L. Suominen
- Institute of Dentistry; University of Eastern Finland; Kuopio Finland
- Institute for Health and Welfare (THL); Helsinki Finland
- Department of Oral and Maxillofacial Surgery; Kuopio University Hospital; Kuopio Finland
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16
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Reunanen A, Pyörälä K, Punsar S, Aromaa A. Predictive value of ECG findings with respect to coronary heart disease mortality. Adv Cardiol 2015; 21:310-2. [PMID: 619560 DOI: 10.1159/000400471] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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17
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Sivén SS, Niiranen TJ, Aromaa A, Koskinen S, Jula AM. Social, lifestyle and demographic inequalities in hypertension care. Scand J Public Health 2015; 43:246-53. [PMID: 25724469 DOI: 10.1177/1403494815571031] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2015] [Indexed: 11/16/2022]
Abstract
AIMS Recent nationwide in-depth analyses on inequalities in hypertension prevalence and care are scarce. This study assessed sociodemographic and lifestyle factors associated with the prevalence, awareness, treatment and control of hypertension in Finland. METHODS A representative nationwide sample (participation rate 58%) of the Finnish adult population underwent a health examination and interview in 2011. After excluding participants with missing data, 4230 people were included in the analyses. Weighted regression modelling was used to explore the associations of sociodemographic and lifestyle factors with the prevalence, awareness, treatment and control of hypertension. RESULTS The prevalence, awareness, treatment and control rates of hypertension (blood pressure ⩾140/90 mmHg or antihypertensive medication) in Finland were 47%, 57%, 51% and 48%, respectively. Older age, male sex, lower education, retirement, higher BMI, never-smoking and heavy alcohol use were associated with a higher prevalence of hypertension (p<0.05). In contrast, younger age, non-retirement, lower BMI, smoking and high physical activity were associated with lower awareness and treatment rates (p<0.05). In addition, male sex was associated with lower awareness rates (p<0.01). Hypertension control was better in younger participants (p<0.05). CONCLUSIONS In addition to high prevalence and moderate treatment rates of hypertension, serious sociodemographic and lifestyle inequities in hypertension care exist in Finland. Hypertension is more prevalent in older people of lower socio-economic status with adverse lifestyles. However, hypertension is more often unrecognised and untreated among people with low risk of hypertension.
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Affiliation(s)
- Sam Se Sivén
- Department of Health, National Institute for Health and Welfare, Finland Department of Medicine, Turku University Central Hospital, Finland
| | - Teemu J Niiranen
- Department of Health, National Institute for Health and Welfare, Finland
| | - Arpo Aromaa
- Department of Health, National Institute for Health and Welfare, Finland
| | - Seppo Koskinen
- Department of Health, National Institute for Health and Welfare, Finland
| | - Antti M Jula
- Department of Health, National Institute for Health and Welfare, Finland
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18
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Raittio E, Kiiskinen U, Helminen S, Aromaa A, Suominen AL. Income-related inequality and inequity in the use of dental services in Finland after a major subsidization reform. Community Dent Oral Epidemiol 2015; 43:240-54. [PMID: 25660515 DOI: 10.1111/cdoe.12148] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 12/21/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVES In Finland, a major oral healthcare reform (OHCR), implemented during 2001-2002, opened the public dental services (PDS) and extended subsidies for private dental services to entire adult population. Before the reform, adults born earlier than 1956 were not entitled to use PDS nor did they receive any reimbursements for their private dental costs. We aimed to examine changes in the income-related inequality and inequity in the use of dental services among the adult Finns after the reform. METHODS Representative data from Finnish adults born in 1970 or earlier were gathered from three identical postal surveys concerning the use of dental services and subjective perceptions of oral health. Those surveys were conducted before the OHCR in 2001 (n = 1907) and after the OHCR in 2004 (n = 1629) and 2007 (n = 1509). We used concentration index and its decomposition to analyse income-related inequality and inequity in the use of dental services and factors associated with them. RESULTS Results showed that pro-rich inequality and inequity in the overall use of dental services narrowed from 2001 to 2004. However, between 2004 and 2007, pro-rich inequality and inequity widened, so it returned to a rather similar level in 2007 as it had been in 2001. Most of the pro-rich inequality and inequity were related to regular dental visiting habit and income level. While there was pro-poor inequality and inequity in the use of PDS, there was pro-rich inequality and inequity in the use of private dental services throughout the study years. CONCLUSION It seems that income-related inequality and inequity in the use of dental services narrowed only temporarily after the reform.
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Lehto US, Helander S, Taari K, Aromaa A. Patient experiences at diagnosis and psychological well-being in prostate cancer: A Finnish national survey. Eur J Oncol Nurs 2014; 19:220-9. [PMID: 25547457 DOI: 10.1016/j.ejon.2014.10.018] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 07/22/2014] [Accepted: 10/27/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE Most cases of prostate cancer are diagnosed at an early stage, and men live for many years after diagnosis. Thus, their well-being and quality of life are of great importance. This study investigated patient experiences and psychological well-being in a Finnish national sample of prostate cancer patients who received various types of treatment. METHOD In a national sample (50%) of prostate cancer patients diagnosed in Finland in 2004, information was collected on the patients' experiences at diagnosis and choice of treatment (e.g. treatment selection, patient satisfaction with care and information, psychological reactions). In 2009, participants were asked about their experiences, and psychological well-being (psychological symptoms, satisfaction with life) was measured. In total, 1239 completed questionnaires (73%) were accepted for the study. Differences between treatments and predictors of psychological well-being were investigated using descriptive statistics and regression analysis. RESULTS Half of the respondents were satisfied with the care and information they received about the cancer and side effects of treatment. Experiences and psychological well-being were most positive among patients who received brachytherapy and poorest among patients who received hormonal therapy. Patients who underwent prostatectomy or brachytherapy were most likely to have been involved in treatment selection. Negative experiences, such as learning of the diagnosis in an impersonal way and dissatisfaction with the information and care received, were predictive of poorer well-being. CONCLUSIONS Unmet supportive care and informational needs were common. Experiences and well-being varied between treatments. Patients tended to prefer prostatectomy and brachytherapy. Unmet needs, which would probably be reduced by improvements in care, appear to have a long-lasting impact on patients' psychological well-being.
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Affiliation(s)
- Ulla-Sisko Lehto
- Population Health Unit, National Institute for Health and Welfare, Helsinki, Finland.
| | | | - Kimmo Taari
- Department of Urology, Helsinki University Central Hospital, Helsinki, Finland; Department of Surgery, University of Helsinki, Helsinki, Finland
| | - Arpo Aromaa
- National Institute for Health and Welfare, Helsinki, Finland
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20
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Sabbah W, Suominen AL, Vehkalahti MM, Aromaa A, Bernabé E. The Role of Behaviour in Inequality in Increments of Dental Caries among Finnish Adults. Caries Res 2014; 49:34-40. [DOI: 10.1159/000366491] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 08/06/2014] [Indexed: 11/19/2022] Open
Abstract
Background: Evidence from cross-sectional studies implies that dental behaviours partially explain inequalities in oral health. Objective: To assess whether dental behaviours completely eliminate inequality in increments of dental caries in a sample of Finnish adults. Methods: The baseline data were collected from the Health 2000 survey, a nationally representative survey of 8,028 individuals aged 30 years or older living in mainland Finland. Four years later, 1,248 subjects were invited for oral re-examination, and 1,049 agreed to participate (84% response rate). At baseline, participants provided information on demographics, education and dental behaviours (dental attendance, tooth brushing with fluoride toothpaste, sugar consumption and daily smoking). Oral examinations at baseline and follow-up were identical. Results: Adults with basic education had significantly greater increments of DMFT (incidence rate ratio 1.41, 95% CI 1.07-1.85) and DT (incidence rate ratio 2.23, 95% CI 1.27-3.90) than those with high education. Adjusting for single behaviours attenuated but did not eliminate education inequality in DMFT and DT increments, tooth brushing having the greatest impact on inequality. Simultaneous adjustment for all behaviours eliminated the significant relationship between education and caries increment. Conclusions: Accounting for important dental behaviours appears to explain all education inequality in dental caries in Finnish adults. The results should be interpreted with caution when applied to less egalitarian populations.
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Nyholt DR, Anttila V, Winsvold BS, Kurth T, Stefansson H, Kallela M, Malik R, Vries BD, Terwindt GM, Ikram MA, Stam AH, Ligthart L, Freilinger T, Alexander M, Muller-Myhsok B, Schreiber S, Meitinger T, Aromaa A, Eriksson JG, Kaprio J, Boomsma DI, Duijn CV, Raitakari O, Järvelin MR, Zwart JA, Quaye L, Strachan DP, Kubisch C, Ferrari MD, van den Maagdenberg AMJM, Dichgans M, Wessman M, Smith GD, Stefansson K, Chasman DI, Palotie A. Concordance of genetic risk across migraine subgroups: Impact on current and future genetic association studies. Cephalalgia 2014; 35:489-99. [PMID: 25179292 DOI: 10.1177/0333102414547784] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 07/23/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND There has been intensive debate whether migraine with aura (MA) and migraine without aura (MO) should be considered distinct subtypes or part of the same disease spectrum. There is also discussion to what extent migraine cases collected in specialised headache clinics differ from cases from population cohorts, and how female cases differ from male cases with respect to their migraine. To assess the genetic overlap between these migraine subgroups, we examined genome-wide association (GWA) results from analysis of 23,285 migraine cases and 95,425 population-matched controls. METHODS Detailed heterogeneity analysis of single-nucleotide polymorphism (SNP) effects (odds ratios) between migraine subgroups was performed for the 12 independent SNP loci significantly associated (p < 5 × 10(-8); thus surpassing the threshold for genome-wide significance) with migraine susceptibility. Overall genetic overlap was assessed using SNP effect concordance analysis (SECA) at over 23,000 independent SNPs. RESULTS Significant heterogeneity of SNP effects (p het < 1.4 × 10(-3)) was observed between the MA and MO subgroups (for SNP rs9349379), and between the clinic- and population-based subgroups (for SNPs rs10915437, rs6790925 and rs6478241). However, for all 12 SNPs the risk-increasing allele was the same, and SECA found the majority of genome-wide SNP effects to be in the same direction across the subgroups. CONCLUSIONS Any differences in common genetic risk across these subgroups are outweighed by the similarities. Meta-analysis of additional migraine GWA datasets, regardless of their major subgroup composition, will identify new susceptibility loci for migraine.
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Affiliation(s)
| | | | - Verneri Anttila
- Analytical and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, USA Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, USA Harvard Medical School, USA Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, USA
| | - Bendik S Winsvold
- FORMI and Department of Neurology, Oslo University Hospital and University of Oslo, Norway
| | - Tobias Kurth
- Institut National de la Santé et de la Recherche Médicale (INSERM) Research Center for Epidemiology and Biostatistics (U897) - Team Neuroepidemiology, France University of Bordeaux, France Department of Medicine, Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, USA
| | | | - Mikko Kallela
- Department of Neurology, Helsinki University Central Hospital, Finland
| | - Rainer Malik
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität, Germany
| | - Boukje de Vries
- Department of Human Genetics, Leiden University Medical Centre, the Netherlands
| | - Gisela M Terwindt
- Department of Neurology, Leiden University Medical Centre, the Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Centre, the Netherlands Department of Radiology, Erasmus University Medical Centre, the Netherlands Department of Neurology, Erasmus University Medical Centre, the Netherlands
| | - Anine H Stam
- Department of Neurology, Leiden University Medical Centre, the Netherlands
| | - Lannie Ligthart
- Department of Biological Psychology, VU University, the Netherlands EMGO+ Institute for Health and Care Research, VU University Medical Centre, the Netherlands
| | - Tobias Freilinger
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität, Germany Department of Neurology, Klinikum der Universität München, Germany
| | - Michael Alexander
- Department of Genomics, Life & Brain Center, University of Bonn, Germany Institute of Human Genetics, University of Bonn, Germany
| | - Bertram Muller-Myhsok
- Max Planck Institute of Psychiatry, Germany Munich Cluster for Systems Neurology (SyNergy), Germany
| | - Stefan Schreiber
- Institute of Clinical Molecular Biology, Christian Albrechts University, Germany Department of Internal Medicine I, Christian Albrechts University, Germany
| | - Thomas Meitinger
- Institute of Human Genetics, Helmholtz Center Munich, Germany Institute of Human Genetics, Klinikum Rechts der Isar, Technische Universität München, Germany
| | - Arpo Aromaa
- National Institute for Health and Welfare, Finland
| | - Johan G Eriksson
- National Institute for Health and Welfare, Finland Institute of Genetics, Folkhälsan Research Center, Finland Department of General Practice, Helsinki University Central Hospital, Helsinki, Finland Vaasa Central Hospital, Finland Department of General Practice and Primary Health Care, University of Helsinki, Finland
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Finland Department of Public Health, Hjelt Institute, University of Helsinki, Finland Department of Mental Health and Alcohol Research, National Institute for Health and Welfare, Finland
| | - Dorret I Boomsma
- Department of Biological Psychology, VU University, the Netherlands
| | - Cornelia van Duijn
- Department of Epidemiology, Erasmus University Medical Centre, the Netherlands
| | - Olli Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku University Hospital, Finland Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Finland
| | - Marjo-Riitta Järvelin
- Institute of Health Sciences, University of Oulu, Finland Unit of Primary Care, Oulu University Hospital, Finland Department of Children, Young People and Families, National Institute for Health and Welfare, Finland Department of Epidemiology and Biostatistics, School of Public Health, MRC-Health Protection Agency (HPA) Centre for Environment and Health, Faculty of Medicine, Imperial College, UK Biocenter Oulu, University of Oulu, Finland
| | - John-Anker Zwart
- FORMI and Department of Neurology, Oslo University Hospital and University of Oslo, Norway
| | - Lydia Quaye
- Department of Twin Research and Genetic Epidemiology, King's College London, UK
| | - David P Strachan
- Division of Population Health Sciences and Education, St George's, University of London, UK
| | - Christian Kubisch
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Germany Institute of Human Genetics, University of Ulm, Germany
| | - Michel D Ferrari
- Department of Neurology, Leiden University Medical Centre, the Netherlands
| | - Arn M J M van den Maagdenberg
- Department of Human Genetics, Leiden University Medical Centre, the Netherlands Department of Neurology, Leiden University Medical Centre, the Netherlands
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität, Germany Munich Cluster for Systems Neurology (SyNergy), Germany
| | - Maija Wessman
- Analytical and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, USA Institute of Genetics, Folkhälsan Research Center, Finland
| | - George Davey Smith
- Medical Research Council Integrative Epidemiology Unit (IEU) at the University of Bristol, School of Social and Community Medicine, UK
| | - Kari Stefansson
- deCODE Genetics, Iceland School of Medicine, University of Iceland, Iceland
| | - Daniel I Chasman
- Department of Medicine, Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, USA
| | - Aarno Palotie
- Analytical and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, USA Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, USA Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, USA Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Finland Psychiatric & Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, USA Department of Neurology, Massachusetts General Hospital, USA
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22
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Raittio E, Kiiskinen U, Helminen S, Aromaa A, Suominen AL. Dental attendance among adult Finns after a major oral health care reform. Community Dent Oral Epidemiol 2014; 42:591-602. [DOI: 10.1111/cdoe.12117] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Accepted: 05/26/2014] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | - Arpo Aromaa
- Institute for Health and Welfare (THL); Helsinki Finland
| | - Anna Liisa Suominen
- University of Eastern Finland; Kuopio Finland
- Institute for Health and Welfare (THL); Helsinki Finland
- Department of Oral and Maxillofacial Surgery; Kuopio University Hospital; Kuopio Finland
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23
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Kurki MI, Gaál EI, Kettunen J, Lappalainen T, Menelaou A, Anttila V, van 't Hof FNG, von und zu Fraunberg M, Helisalmi S, Hiltunen M, Lehto H, Laakso A, Kivisaari R, Koivisto T, Ronkainen A, Rinne J, Kiemeney LAL, Vermeulen SH, Kaunisto MA, Eriksson JG, Aromaa A, Perola M, Lehtimäki T, Raitakari OT, Salomaa V, Gunel M, Dermitzakis ET, Ruigrok YM, Rinkel GJE, Niemelä M, Hernesniemi J, Ripatti S, de Bakker PIW, Palotie A, Jääskeläinen JE. High risk population isolate reveals low frequency variants predisposing to intracranial aneurysms. PLoS Genet 2014; 10:e1004134. [PMID: 24497844 PMCID: PMC3907358 DOI: 10.1371/journal.pgen.1004134] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 12/10/2013] [Indexed: 11/18/2022] Open
Abstract
3% of the population develops saccular intracranial aneurysms (sIAs), a complex trait, with a sporadic and a familial form. Subarachnoid hemorrhage from sIA (sIA-SAH) is a devastating form of stroke. Certain rare genetic variants are enriched in the Finns, a population isolate with a small founder population and bottleneck events. As the sIA-SAH incidence in Finland is >2× increased, such variants may associate with sIA in the Finnish population. We tested 9.4 million variants for association in 760 Finnish sIA patients (enriched for familial sIA), and in 2,513 matched controls with case-control status and with the number of sIAs. The most promising loci (p<5E-6) were replicated in 858 Finnish sIA patients and 4,048 controls. The frequencies and effect sizes of the replicated variants were compared to a continental European population using 717 Dutch cases and 3,004 controls. We discovered four new high-risk loci with low frequency lead variants. Three were associated with the case-control status: 2q23.3 (MAF 2.1%, OR 1.89, p 1.42×10-9); 5q31.3 (MAF 2.7%, OR 1.66, p 3.17×10-8); 6q24.2 (MAF 2.6%, OR 1.87, p 1.87×10-11) and one with the number of sIAs: 7p22.1 (MAF 3.3%, RR 1.59, p 6.08×-9). Two of the associations (5q31.3, 6q24.2) replicated in the Dutch sample. The 7p22.1 locus was strongly differentiated; the lead variant was more frequent in Finland (4.6%) than in the Netherlands (0.3%). Additionally, we replicated a previously inconclusive locus on 2q33.1 in all samples tested (OR 1.27, p 1.87×10-12). The five loci explain 2.1% of the sIA heritability in Finland, and may relate to, but not explain, the increased incidence of sIA-SAH in Finland. This study illustrates the utility of population isolates, familial enrichment, dense genotype imputation and alternate phenotyping in search for variants associated with complex diseases.
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Affiliation(s)
- Mitja I. Kurki
- Neurosurgery, NeuroCenter, Kuopio University Hospital, Kuopio, Finland
- Neurosurgery, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Neurobiology, A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
- * E-mail:
| | - Emília Ilona Gaál
- Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Johannes Kettunen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
| | - Tuuli Lappalainen
- Department of Genetic Medicine and Development, University of Geneva Medical School, Geneva, Switzerland
| | - Androniki Menelaou
- Department of Medical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Verneri Anttila
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Analytical and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, United States of America
| | - Femke N. G. van 't Hof
- UMC Utrecht Stroke Center, Department of Neurology and Neurosurgery, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, The Netherlands
| | - Mikael von und zu Fraunberg
- Neurosurgery, NeuroCenter, Kuopio University Hospital, Kuopio, Finland
- Neurosurgery, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Seppo Helisalmi
- Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Mikko Hiltunen
- Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Hanna Lehto
- Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Aki Laakso
- Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Riku Kivisaari
- Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Timo Koivisto
- Neurosurgery, NeuroCenter, Kuopio University Hospital, Kuopio, Finland
| | - Antti Ronkainen
- Neurosurgery, NeuroCenter, Kuopio University Hospital, Kuopio, Finland
| | - Jaakko Rinne
- Neurosurgery, NeuroCenter, Kuopio University Hospital, Kuopio, Finland
| | - Lambertus A. L. Kiemeney
- Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
- Department for Health Evidence, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Sita H. Vermeulen
- Department for Health Evidence, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Mari A. Kaunisto
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Folkhälsan Research Centre, Helsinki, Finland
| | - Johan G. Eriksson
- Folkhälsan Research Centre, Helsinki, Finland
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Department of Internal Medicine, Vasa Central Hospital, Vasa, Finland
- Unit of General Practice, Helsinki University Central Hospital, Helsinki, Finland
| | - Arpo Aromaa
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
| | - Markus Perola
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
- Estonian Genome Center, University of Tartu, Tartu, Estonia
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere University Hospital and University of Tampere, Tampere, Finland
| | - Olli T. Raitakari
- Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Turku, Finland
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku and Turku University Central Hospital, Turku, Finland
| | - Veikko Salomaa
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
| | - Murat Gunel
- Department of Neurosurgery, Department of Neurobiology and Department of Genetics, Program on Neurogenetics, Howard Hughes Medical Institute, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Emmanouil T. Dermitzakis
- Department of Genetic Medicine and Development, University of Geneva Medical School, Geneva, Switzerland
| | - Ynte M. Ruigrok
- UMC Utrecht Stroke Center, Department of Neurology and Neurosurgery, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, The Netherlands
| | - Gabriel J. E. Rinkel
- UMC Utrecht Stroke Center, Department of Neurology and Neurosurgery, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, The Netherlands
| | - Mika Niemelä
- Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Juha Hernesniemi
- Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Samuli Ripatti
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
- Hjelt Institute, University of Helsinki, Helsinki, Finland
| | - Paul I. W. de Bakker
- Department of Medical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, United States of America
- Division of Genetics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Epidemiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Aarno Palotie
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Analytical and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, United States of America
- Department of Human Genetics, The Wellcome Trust Sanger Institute, Cambridge, United Kingdom
| | - Juha E. Jääskeläinen
- Neurosurgery, NeuroCenter, Kuopio University Hospital, Kuopio, Finland
- Neurosurgery, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
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24
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Bernabé E, Delgado-Angulo EK, Vehkalahti MM, Aromaa A, Suominen AL. Daily smoking and 4-year caries increment in Finnish adults. Community Dent Oral Epidemiol 2014; 42:428-34. [DOI: 10.1111/cdoe.12101] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 01/03/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Eduardo Bernabé
- Division of Population and Patient Health; King's College London Dental Institute; London UK
| | - Elsa K. Delgado-Angulo
- Division of Population and Patient Health; King's College London Dental Institute; London UK
- Departamento de Odontología Social; Facultad de Estomatología; Universidad Peruana Cayetano Heredia; Lima Perú
| | - Miira M. Vehkalahti
- Department of Oral Public Health; Institute of Dentistry; University of Helsinki; Helsinki Finland
- Department of Community Dentistry; Institute of Dentistry; University of Oulu; Oulu Finland
| | - Arpo Aromaa
- National Institute for Health and Welfare; Helsinki Finland
| | - Anna L. Suominen
- National Institute for Health and Welfare; Helsinki Finland
- Department of Oral Public Health; Institute of Dentistry; University of Eastern Finland; Kuopio Finland
- Department of Oral and Maxillofacial Surgery; Kuopio University Hospital; Kuopio Finland
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25
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Sainio P, Koskinen S, Sihvonen AP, Martelin T, Aromaa A. Prevalence of disability is declining in Finland. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt126.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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26
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Anttila V, Winsvold BS, Gormley P, Kurth T, Bettella F, McMahon G, Kallela M, Malik R, de Vries B, Terwindt G, Medland SE, Todt U, McArdle WL, Quaye L, Koiranen M, Ikram MA, Lehtimäki T, Stam AH, Ligthart L, Wedenoja J, Dunham I, Neale BM, Palta P, Hamalainen E, Schürks M, Rose LM, Buring JE, Ridker PM, Steinberg S, Stefansson H, Jakobsson F, Lawlor DA, Evans DM, Ring SM, Färkkilä M, Artto V, Kaunisto MA, Freilinger T, Schoenen J, Frants RR, Pelzer N, Weller CM, Zielman R, Heath AC, Madden PA, Montgomery GW, Martin NG, Borck G, Göbel H, Heinze A, Heinze-Kuhn K, Williams FM, Hartikainen AL, Pouta A, van den Ende J, Uitterlinden AG, Hofman A, Amin N, Hottenga JJ, Vink JM, Heikkilä K, Alexander M, Muller-Myhsok B, Schreiber S, Meitinger T, Wichmann HE, Aromaa A, Eriksson JG, Traynor B, Trabzuni D, Rossin E, Lage K, Jacobs SB, Gibbs JR, Birney E, Kaprio J, Penninx BW, Boomsma DI, van Duijn C, Raitakari O, Jarvelin MR, Zwart JA, Cherkas L, Strachan DP, Kubisch C, Ferrari MD, van den Maagdenberg AM, Dichgans M, Wessman M, Smith GD, Stefansson K, Daly MJ, Nyholt DR, Chasman D, Palotie A. Genome-wide meta-analysis identifies new susceptibility loci for migraine. Nat Genet 2013; 45:912-917. [PMID: 23793025 PMCID: PMC4041123 DOI: 10.1038/ng.2676] [Citation(s) in RCA: 276] [Impact Index Per Article: 25.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Accepted: 05/30/2013] [Indexed: 12/15/2022]
Abstract
Migraine is the most common brain disorder, affecting approximately 14% of the adult population, but its molecular mechanisms are poorly understood. We report the results of a meta-analysis across 29 genome-wide association studies, including a total of 23,285 individuals with migraine (cases) and 95,425 population-matched controls. We identified 12 loci associated with migraine susceptibility (P<5×10(-8)). Five loci are new: near AJAP1 at 1p36, near TSPAN2 at 1p13, within FHL5 at 6q16, within C7orf10 at 7p14 and near MMP16 at 8q21. Three of these loci were identified in disease subgroup analyses. Brain tissue expression quantitative trait locus analysis suggests potential functional candidate genes at four loci: APOA1BP, TBC1D7, FUT9, STAT6 and ATP5B.
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Affiliation(s)
- Verneri Anttila
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Cambridge, UK
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Analytical and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Bendik S. Winsvold
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Cambridge, UK
- Department of Neurology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Padhraig Gormley
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Cambridge, UK
| | - Tobias Kurth
- INSERM Unit 708 – Neuroepidemiology, F-33000 Bordeaux, France
- University of Bordeaux, F-33000 Bordeaux, France
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, USA
| | | | - George McMahon
- MRC Centre for Causal Analyses in Translational Epidemiology, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Mikko Kallela
- Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland
| | - Rainer Malik
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität, Munich, Germany
| | - Boukje de Vries
- Department of Human Genetics, Leiden University Medical Centre, Leiden, The Netherlands
| | - Gisela Terwindt
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Sarah E. Medland
- Queensland Institute of Medical Research, Brisbane, Queensland, Australia
| | - Unda Todt
- Institute of Human Genetics, University of Ulm, Ulm, Germany
| | - Wendy L. McArdle
- MRC Centre for Causal Analyses in Translational Epidemiology, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Lydia Quaye
- Department of Twin Research and Genetic Epidemiology, King’s College London, London, UK
| | - Markku Koiranen
- Institute of Health Sciences, University of Oulu, Oulu, Finland
| | - M. Arfan Ikram
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Radiology Erasmus University Medical Centre, Rotterdam, The Netherlands
- Department of Neurology Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories and University of Tampere School of Medicine, Tampere, Finland
| | - Anine H. Stam
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Lannie Ligthart
- Department of Biological Psychology, VU University, Amsterdam, The Netherlands
- EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Juho Wedenoja
- Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland
| | - Ian Dunham
- European Bioinformatics Insitute, Wellcome Trust Genome Campus, Cambridge, UK
| | - Benjamin M. Neale
- Analytical and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Priit Palta
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Cambridge, UK
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Eija Hamalainen
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Cambridge, UK
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Markus Schürks
- Department of Neurology, University Hospital Essen, Essen, Germany
| | - Lynda M Rose
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, USA
| | - Julie E. Buring
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, USA
| | - Paul M. Ridker
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, USA
- Harvard Medical School, Boston, MA 02215, USA
| | | | | | - Finnbogi Jakobsson
- Department of Neurology, Landspitali University Hospital, Reykjavik, Iceland
| | - Debbie A. Lawlor
- MRC Centre for Causal Analyses in Translational Epidemiology, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - David M. Evans
- MRC Centre for Causal Analyses in Translational Epidemiology, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Susan M. Ring
- MRC Centre for Causal Analyses in Translational Epidemiology, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Markus Färkkilä
- Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland
| | - Ville Artto
- Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland
| | - Mari A Kaunisto
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Tobias Freilinger
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität, Munich, Germany
- Department of Neurology, Klinikum der Universität München, Munich, Germany
| | - Jean Schoenen
- Headache Research Unit, Department of Neurology and Groupe Interdisciplinaire de Génoprotéomique Appliquée (GIGA)-Neurosciences, Liège University, Liège, Belgium
| | - Rune R. Frants
- Department of Human Genetics, Leiden University Medical Centre, Leiden, The Netherlands
| | - Nadine Pelzer
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Claudia M. Weller
- Department of Human Genetics, Leiden University Medical Centre, Leiden, The Netherlands
| | - Ronald Zielman
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Andrew C. Heath
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Pamela A.F. Madden
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | | | - Nicholas G. Martin
- Queensland Institute of Medical Research, Brisbane, Queensland, Australia
| | - Guntram Borck
- Institute of Human Genetics, University of Ulm, Ulm, Germany
| | | | - Axel Heinze
- Kiel Pain and Headache Center, Kiel, Germany
| | | | - Frances M.K. Williams
- Department of Twin Research and Genetic Epidemiology, King’s College London, London, UK
| | - Anna-Liisa Hartikainen
- Department of Clinical Sciences/Obstetrics and Gynecology, University Hospital of Oulu, Oulu, Finland
| | - Anneli Pouta
- Institute of Health Sciences, University of Oulu, Oulu, Finland
- Department of Clinical Sciences/Obstetrics and Gynecology, University Hospital of Oulu, Oulu, Finland
- Department of Children, Young People and Families, National Institute for Health and Welfare, Helsinki, Finland
| | - Joyce van den Ende
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | | | - Albert Hofman
- Genetic Epidemiology Unit, Department of Clinical Genetics, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Najaf Amin
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Jouke-Jan Hottenga
- Department of Biological Psychology, VU University, Amsterdam, The Netherlands
| | - Jacqueline M. Vink
- Department of Biological Psychology, VU University, Amsterdam, The Netherlands
| | - Kauko Heikkilä
- Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland
| | - Michael Alexander
- Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
- Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - Bertram Muller-Myhsok
- Max Planck Institute of Psychiatry, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Stefan Schreiber
- Department of Clinical Molecular Biology, Christian Albrechts University, Kiel, Germany
- Department of Internal Medicine I, Christian Albrechts University, Kiel, Germany
| | - Thomas Meitinger
- Institute of Human Genetics, Helmholtz Center Munich, Neuherberg, Germany
- Institute of Human Genetics, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Heinz Erich Wichmann
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie, Ludwig-Maximilians-Universität München, Munich, Germany
- Institute of Epidemiology I, HelmholtzCenter Munich, Neuherberg, Germany
- Klinikum Großhadern, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Arpo Aromaa
- National Institute for Health and Welfare, Helsinki, Finland
| | - Johan G. Eriksson
- Folkhälsan Research Center, Helsinki, Finland
- National Institute for Health and Welfare, Helsinki, Finland
- Department of General Practice, Helsinki University Central Hospital, Helsinki, Finland
- Vaasa Central Hospital, Vaasa, Finland
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - Bryan Traynor
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Daniah Trabzuni
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | | | | | - Elizabeth Rossin
- Analytical and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, USA
| | - Kasper Lage
- Analytical and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Pediatric Surgical Research Laboratories, Massachusetts General Hospital for Children, Massachusetts General Hospital, Boston, MA, USA
- Center for Biological Sequence Analysis, Department of Systems Biology, Technical University of Denmark, Lyngby, Denmark
- Center for Protein Research, University of Copenhagen, Copenhagen, Denmark
| | - Suzanne B.R. Jacobs
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - J. Raphael Gibbs
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK
| | - Ewan Birney
- European Bioinformatics Insitute, Wellcome Trust Genome Campus, Cambridge, UK
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland
- Department of Mental Health and Alcohol Research, National Institute for Health and Welfare, Helsinki, Finland
| | - Brenda W. Penninx
- EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Dorret I. Boomsma
- Department of Biological Psychology, VU University, Amsterdam, The Netherlands
| | - Cornelia van Duijn
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Olli Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku University Hospital, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Marjo-Riitta Jarvelin
- Institute of Health Sciences, University of Oulu, Oulu, Finland
- Department of Children, Young People and Families, National Institute for Health and Welfare, Helsinki, Finland
- Department of Epidemiology and Biostatistics, School of Public Health, MRC-HPA Centre for Environment and Health, Faculty of Medicine, Imperial College, London, UK
- Biocenter Oulu, University of Oulu, Oulu, Finland
| | - John-Anker Zwart
- Department of Neurology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Lynn Cherkas
- Department of Twin Research and Genetic Epidemiology, King’s College London, London, UK
| | - David P. Strachan
- Division of Population Health Sciences and Education, St George’s, University of London, London, UK
| | | | - Michel D. Ferrari
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Arn M.J.M. van den Maagdenberg
- Department of Human Genetics, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Maija Wessman
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - George Davey Smith
- MRC Centre for Causal Analyses in Translational Epidemiology, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Kari Stefansson
- deCODE genetics, Reykjavik, Iceland
- School of Medicine, University of Iceland, Reykjavik, Iceland
| | - Mark J. Daly
- Analytical and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Dale R. Nyholt
- Queensland Institute of Medical Research, Brisbane, Queensland, Australia
| | - Daniel Chasman
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, USA
- Harvard Medical School, Boston, MA 02215, USA
| | - Aarno Palotie
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Cambridge, UK
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
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Verschuuren M, Gissler M, Kilpeläinen K, Tuomi-Nikula A, Sihvonen AP, Thelen J, Gaidelyte R, Ghirini S, Kirsch N, Prochorskas R, Scafato E, Kramers P, Aromaa A. Public health indicators for the EU: the joint action for ECHIM (European Community Health Indicators & Monitoring). ACTA ACUST UNITED AC 2013; 71:12. [PMID: 23721296 PMCID: PMC3682857 DOI: 10.1186/0778-7367-71-12] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2013] [Accepted: 04/20/2013] [Indexed: 11/28/2022]
Abstract
Background Public health policies aim to improve and maintain the health of citizens. Relevant data and indicators are needed for a health policy that is based on factual information. After 14 years of work (1998–2012), the multi-phase action on European Community Health Indicators (ECHI) has created a health monitoring and reporting system. It has generated EU added value by defining the ECHI shortlist with 88 common and comparable key health indicators for Europe. Methods In the 2009-2012 Joint Action for ECHIM project the ECHI shortlist was updated through consultation with Member State representatives. Guidelines for implementation of the ECHI Indicators at national level were developed and a pilot data collection was carried out. Results 67 of the ECHI Indicators are already part of regular international data collections and thus available for a majority of Member States, 14 are close to ready and 13 still need development work. By mid-2012 half of the countries have incorporated ECHI indicators in their national health information systems and the process is ongoing in the majority of the countries. Twenty-five countries were able to provide data in a Pilot Data Collection for 20 ECHI Indicators that were not yet (fully) available in the international databases. Conclusions The EU needs a permanent health monitoring and reporting system. The Joint Action for ECHIM has set an example for the implementation of a system that can develop and maintain the ECHI indicators,, and promote and encourage the use of ECHI in health reporting and health policy making. The aim for sustainable public health monitoring is also supported by a Eurostat regulation on public health statistics requiring that health statistics shall be provided according to the ECHI methodology. Further efforts at DG SANCO and Eurostat are needed towards a permanent health monitoring system.
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Affiliation(s)
- Marieke Verschuuren
- RIVM, National Institute for Public Health and the Environment, P.O. Box 1, Bilthoven, BA, NL - 3720, the Netherlands
| | - Mika Gissler
- THL, National Institute for Health and Welfare, P.O. Box 30, Helsinki, FI - 00270, Finland
| | - Katri Kilpeläinen
- THL, National Institute for Health and Welfare, P.O. Box 30, Helsinki, FI - 00270, Finland
| | - Antti Tuomi-Nikula
- THL, National Institute for Health and Welfare, P.O. Box 30, Helsinki, FI - 00270, Finland
| | - Ari-Pekka Sihvonen
- THL, National Institute for Health and Welfare, P.O. Box 30, Helsinki, FI - 00270, Finland
| | - Jürgen Thelen
- Robert Koch Institute, P.O. Box 65 02 61, D-13302, Berlin, Germany
| | - Rita Gaidelyte
- Center of Health Information, Institute of Hygiene, Didzioji 22, Vilnius, LT - 01128, Lithuania
| | - Silvia Ghirini
- ISS, Istituto Superiore di Sanità, Viale Regina Elena, 299, Rome, IT - 00161, Italy
| | - Nils Kirsch
- Robert Koch Institute, P.O. Box 65 02 61, D-13302, Berlin, Germany
| | - Remigijus Prochorskas
- Center of Health Information, Institute of Hygiene, Didzioji 22, Vilnius, LT - 01128, Lithuania
| | - Emanuele Scafato
- ISS, Istituto Superiore di Sanità, Viale Regina Elena, 299, Rome, IT - 00161, Italy
| | - Pieter Kramers
- THL, National Institute for Health and Welfare, P.O. Box 30, Helsinki, FI - 00270, Finland
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Aromaa A. Implementation of joint health indicators in Europe - Joint Action for ECHIM. Arpo Aromaa on behalf of the ECHIM core group. ACTA ACUST UNITED AC 2012; 70:22. [PMID: 23043717 PMCID: PMC3523025 DOI: 10.1186/0778-7367-70-22] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Accepted: 08/30/2012] [Indexed: 11/10/2022]
Abstract
The story of the implementation of the joint EU health indicators (ECHI indicators) began in the 1990s after the Amsterdam Treaty. The first concrete step in establishing a health monitoring capacity for EU was the Commission working group set up in 1997. Several consecutive and parallel projects, notably the health indicator projects ECHI-1 and ECHI-2 between the years 2000 and 2005 led to a preparedness to implement the jointly agreed health indicators (ECHI shortlist) in all European countries. ECHIM (2005 – 2008) and the Joint Action for ECHIM (2009 - ) laid the foundation for the implementation of health indicators, and initiated Europe wide implementation proper. After the European recession of 2008 the circumstances in different countries were not optimal. Also the collaboration with the Commission could have been better. Nevertheless, the implementation process of the ECHI indicators is now well underway in most countries. By June 2012 half of the Member States had incorporated the ECHI indicators into their national health information system, and, if work can continue, by 2014 most countries are likely to have done so. Unfortunately, a gap may occur between the current programme and the next public health programme. The current momentum must not be lost. Therefore, all those responsible need to urge that the Commission (DG SANCO) together with the Member States helps to bridge the gap from June 2012 to January 2014. The new Public Health Programme provides the necessary financial instruments for setting up a permanent EU health information and reporting system.
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Affiliation(s)
- Arpo Aromaa
- Arpo Aromaa, National Institute for Health and Welfare, Helsinki, Finland.
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Karppelin M, Siljander T, Huhtala H, Aromaa A, Vuopio J, Hannula-Jouppi K, Kere J, Syrjänen J. Recurrent cellulitis with benzathine penicillin prophylaxis is associated with diabetes and psoriasis. Eur J Clin Microbiol Infect Dis 2012; 32:369-72. [DOI: 10.1007/s10096-012-1751-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Accepted: 09/05/2012] [Indexed: 11/29/2022]
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Bernabé E, Newton JT, Uutela A, Aromaa A, Suominen AL. Sense of coherence and four-year caries incidence in Finnish adults. Caries Res 2012; 46:523-9. [PMID: 22889725 DOI: 10.1159/000341219] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Accepted: 06/17/2012] [Indexed: 11/19/2022] Open
Abstract
This study assesses whether sense of coherence (SOC) predicts incidence of tooth decay over 4 years and the role of dental behaviours in explaining the effect of SOC on incidence of tooth decay. Data from 994 adults who participated in both the Health 2000 survey and the Follow-Up Study of Finnish Adults' Oral Health were analysed for this study. At baseline, participants provided information on demographic characteristics, education level, the SOC scale and dental behaviours (tooth brushing frequency, dental attendance and sugar intake frequency). The 4-year incidence of tooth decay was calculated using data from baseline and follow-up clinical oral examinations. Baseline SOC was significantly related to 4-year incidence of tooth decay after adjustment for demographic factors and education (relative risk: 0.79, 95% CI: 0.63-0.98). This effect was fully attenuated after further adjustment for the three dental behaviours. Tooth brushing frequency and dental attendance were the only dental behaviours significantly related to incidence of tooth decay. This prospective study suggests that SOC predicts incidence of tooth decay and that dental behaviours may help explaining why adults with strong SOC have lower risk of developing tooth decay than those with weak SOC.
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Affiliation(s)
- E Bernabé
- Unit of Dental Public Health, King's College London Dental Institute, London, UK.
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Ahola K, Sirén I, Kivimäki M, Ripatti S, Aromaa A, Lönnqvist J, Hovatta I. Work-related exhaustion and telomere length: a population-based study. PLoS One 2012; 7:e40186. [PMID: 22808115 PMCID: PMC3394788 DOI: 10.1371/journal.pone.0040186] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Accepted: 06/01/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Psychological stress is suggested to accelerate the rate of biological aging. We investigated whether work-related exhaustion, an indicator of prolonged work stress, is associated with accelerated biological aging, as indicated by shorter leukocyte telomeres, that is, the DNA-protein complexes that cap chromosomal ends in cells. METHODS We used data from a representative sample of the Finnish working-age population, the Health 2000 Study. Our sample consisted of 2911 men and women aged 30-64. Work-related exhaustion was assessed using the Maslach Burnout Inventory--General Survey. We determined relative leukocyte telomere length using a quantitative real-time polymerase chain reaction (PCR) -based method. RESULTS After adjustment for age and sex, individuals with severe exhaustion had leukocyte telomeres on average 0.043 relative units shorter (standard error of the mean 0.016) than those with no exhaustion (p = 0.009). The association between exhaustion and relative telomere length remained significant after additional adjustment for marital and socioeconomic status, smoking, body mass index, and morbidities (adjusted difference 0.044 relative units, standard error of the mean 0.017, p = 0.008). CONCLUSIONS These data suggest that work-related exhaustion is related to the acceleration of the rate of biological aging. This hypothesis awaits confirmation in a prospective study measuring changes in relative telomere length over time.
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Affiliation(s)
- Kirsi Ahola
- Work Organizations, Finnish Institute of Occupational Health, Helsinki, Finland.
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Lehto US, Ojanen M, Dyba T, Aromaa A, Kellokumpu-Lehtinen P. Impact of life events on survival of patients with localized melanoma. Psychother Psychosom 2012; 81:191-3. [PMID: 22433748 DOI: 10.1159/000334486] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Accepted: 10/09/2011] [Indexed: 11/19/2022]
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Parmar AS, Lappalainen M, Paavola-Sakki P, Halme L, Färkkilä M, Turunen U, Kontula K, Aromaa A, Salomaa V, Peltonen L, Halfvarson J, Törkvist L, D'Amato M, Saavalainen P, Einarsdottir E. Association of celiac disease genes with inflammatory bowel disease in Finnish and Swedish patients. Genes Immun 2012; 13:474-80. [DOI: 10.1038/gene.2012.21] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Kilpeläinen K, Tuomi-Nikula A, Thelen J, Gissler M, Sihvonen AP, Kramers P, Aromaa A. Health indicators in Europe: availability and data needs. Eur J Public Health 2012; 22:716-21. [PMID: 22294775 DOI: 10.1093/eurpub/ckr195] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The European Union (EU) lacks adequate capacity for public health monitoring. The creation of a stable European Health Information System would help Member States to carry out evidence-based health policy. Such a system would also benefit EU health priorities by providing European wide comparable information. This study is the first comprehensive assessment of the availability of general health data in Europe. METHODS The main aim was to assess the availability of the European Community Health Indicators (ECHI) in each EU Member State. This was done by means of a review of international health databases, an online survey and face-to-face discussions with experts in 31 European countries. RESULTS The European average availability score for all ECHI indicators was 74% ranging from 56% to 84%. In most countries, about half of the ECHI indicators can be derived from routinely collected health information. This is true for demographic information, mortality and hospital discharge-based morbidity. However, many important ECHI indicators are lacking in most European countries. These include population representative data for health determinants, the provision and use of health care services, injuries, the quality of health care and health promotion. CONCLUSION Valid health information is essential for improving people's health across Europe. There is an urgent need to develop harmonized methods for gathering and disseminating representative health data. These methods should be developed jointly by DG Health and Consumers, Eurostat and EU Member States.
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Affiliation(s)
- Katri Kilpeläinen
- National Institute for Health and Welfare THL, Department of Health, Functional Capacity and Welfare, PO Box 30, FI-00271 Helsinki, Finland.
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Ahola K, Virtanen M, Honkonen T, Isometsä E, Aromaa A, Lönnqvist J. Common mental disorders and subsequent work disability: a population-based Health 2000 Study. J Affect Disord 2011; 134:365-72. [PMID: 21664696 DOI: 10.1016/j.jad.2011.05.028] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Revised: 05/16/2011] [Accepted: 05/16/2011] [Indexed: 02/05/2023]
Abstract
BACKGROUND Work disability due to common mental disorders has increased in Western countries during the past decade. The contribution of depressive, anxiety, and alcohol use disorders to all disability pensions at the population level is not known. METHODS Epidemiological health data from the Finnish Health 2000 Study, gathered in 2000-2001, was linked to the national register on disability pensions granted due to the ICD-10 diagnoses up to December 2007. Mental health at baseline was assessed using the Composite International Diagnostic Interview (CIDI). Sociodemographic, clinical, and work-related factors, health behaviors, and treatment setting were used as covariates in the logistic regression analyses among the 3164 participants aged 30-58 years. RESULTS Anxiety, depressive, and comorbid common mental disorders predicted disability pension when adjusted for sex and age. In the fully adjusted multivariate model, comorbid common mental disorders, as well as physical illnesses, age over 45 years, short education, high job strain, and previous long-term sickness absence predicted disability pension. LIMITATIONS The study population included persons aged 30 or over. Sub groups according to mental disorders were quite small which may have diminished statistical power in some sub groups. Baseline predictors were measured only once and the length of exposure could not be determined. The systems regarding financial compensation to employees differ between countries. CONCLUSIONS Comorbid mental disorders pose a high risk for disability pension. Other independent predictors of work disability include socio-demographic, clinical, work-related, and treatment factors, but not health behavior. More attention should be paid to work-related factors in order to prevent chronic work disability.
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Affiliation(s)
- Kirsi Ahola
- Work Organizations, Finnish Institute of Occupational Health, Helsinki, Finland.
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Keskitalo-Vuokko K, Pitkäniemi J, Broms U, Heliövaara M, Aromaa A, Perola M, Ripatti S, Salminen O, Salomaa V, Loukola A, Kaprio J. Associations of nicotine intake measures with CHRN genes in Finnish smokers. Nicotine Tob Res 2011; 13:686-90. [PMID: 21498873 PMCID: PMC3150688 DOI: 10.1093/ntr/ntr059] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2010] [Accepted: 03/10/2011] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Genetic effects contribute to individual differences in smoking behavior. Persistence to smoke despite known harmful health effects is mostly driven by nicotine addiction. As the physiological effects of nicotine are mediated by nicotinic acetylcholine receptors (nAChRs), we aimed at examining whether single nucleotide polymorphisms (SNPs) residing in nAChR subunit (CHRN) genes, other than CHRNA3/CHRNA5/CHRNB4 gene cluster previously showing association in our sample, are associated with smoking quantity or serum cotinine levels. METHODS The study sample consisted of 485 Finnish adult daily smokers (age 30-75 years, 59% men) assessed for the number of cigarettes smoked per day (CPD) and serum cotinine level. We first studied SNPs residing on selected nAChR subunit genes (CHRNA2, CHRNA4, CHRNA6/CHRNB3, CHRNA7, CHRNA9, CHRNA10, CHRNB2, CHRNG/CHRND) genotyped within a genome-wide association study for single SNP and multiple SNP associations by ordinal regression. Next, we explored individual haplotype associations using sliding window technique. RESULTS At one of the 8 loci studied, CHRNG/CHRND (chr2), single SNP (rs1190452), multiple SNP, and 2-SNP haplotype analyses (SNPs rs4973539-rs1190452) all showed statistically significant association with cotinine level. The median cotinine levels varied between the 2-SNP haplotypes from 220 ng/ml (AA haplotype) to 249 ng/ml (AG haplotype). We did not observe significant associations with CPD. CONCLUSIONS These results provide further evidence that the γ-δ nAChR subunit gene region is associated with cotinine levels but not with the number of CPD, illustrating the usefulness of biomarkers in genetic analyses.
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Affiliation(s)
| | - Janne Pitkäniemi
- Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland
| | - Ulla Broms
- Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland
- Department of Mental Health and Alcohol Abuse Services, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Markku Heliövaara
- Department of Mental Health and Alcohol Abuse Services, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Arpo Aromaa
- Department of Mental Health and Alcohol Abuse Services, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Markus Perola
- Department of Mental Health and Alcohol Abuse Services, National Institute for Health and Welfare (THL), Helsinki, Finland
- Research Program's Unit, Institute for Molecular Medicine Finland FIMM, Helsinki, Finland
| | - Samuli Ripatti
- Department of Mental Health and Alcohol Abuse Services, National Institute for Health and Welfare (THL), Helsinki, Finland
- Research Program's Unit, Institute for Molecular Medicine Finland FIMM, Helsinki, Finland
| | - Outi Salminen
- Division of Pharmacology and Toxicology, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland
| | - Veikko Salomaa
- Department of Mental Health and Alcohol Abuse Services, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Anu Loukola
- Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland
- Department of Mental Health and Alcohol Abuse Services, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Jaakko Kaprio
- Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland
- Department of Mental Health and Alcohol Abuse Services, National Institute for Health and Welfare (THL), Helsinki, Finland
- Research Program's Unit, Institute for Molecular Medicine Finland FIMM, Helsinki, Finland
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Puisto V, Rissanen H, Heliövaara M, Impivaara O, Jalanko T, Kröger H, Knekt P, Aromaa A, Helenius I. Vertebral fracture and cause-specific mortality: a prospective population study of 3,210 men and 3,730 women with 30 years of follow-up. Eur Spine J 2011; 20:2181-6. [PMID: 21611851 DOI: 10.1007/s00586-011-1852-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2010] [Revised: 03/29/2011] [Accepted: 05/12/2011] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Vertebral fractures predict mortality, but little is known about their associations with the causes of death. We studied vertebral fractures for prediction of cause-specific mortality. MATERIAL AND METHODS A nationally representative sample of 3,210 men and 3,730 women participated Mini-Finland health survey in 1978-1980. Vertebral fractures at the Th1-Th12 levels were identified from chest radiographs at baseline. Cox's proportional hazard model was used to estimate the strength of association between vertebral fracture and mortality. RESULTS The relative risk (95% confidence interval) of death from natural causes was 1.49 (0.89-2.48) in men and 0.89 (0.60-1.31) in women with vertebral fractures (adjusted for age, body mass index, serum 25-hydroxyvitamin D, educational level, smoking, alcohol intake, physical activity and self-rated general health). Among women the adjusted relative risk of an injury death was 8.51 (3.48-20.77), whereas none of the men with vertebral fracture died due to an injury. CONCLUSION The patterns of mortality predicted by fracture in the thoracic spine differ between men and women.
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Affiliation(s)
- Ville Puisto
- National Institute for Health and Welfare, Mannerheimintie 166, 00271 Helsinki, Finland.
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Era P, Sainio P, Koskinen S, Ohlgren J, Härkänen T, Aromaa A. Psychomotor speed in a random sample of 7,979 subjects aged 30 years and over. Aging Clin Exp Res 2011; 23:135-44. [PMID: 21743291 DOI: 10.1007/bf03351077] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIMS Slowing of psychomotor speed among older individuals has been shown in numerous studies. However, in most cases these studies were based on small and selected groups of people and, in some cases, the test procedures did not allow separation of decision time and motor components of the overall performance. The purpose of the present study was to analyse in a large, randomly selected population sample the differences in decision and movement times in simple and multiple-choice test conditions. The association of educational background with psychomotor speed was also examined. METHODS Data on psychomotor speed were collected from a representative nation- wide sample of the Finnish population aged 30 years and over (n=7979) with the help of a computerized device in simple and multiple-choice test conditions, with visual stimuli. Background information (education) was collected by a structured interview. RESULTS Results showed a systematic and significant decline in both decision time and movement time when proceeding from the youngest (30-39-year-olds) to the oldest (80+ yrs) age groups. This decline was more pronounced in the multiple-choice test than in the simple test. In both test conditions, movement times were shorter in men than in women. In the young and middle-aged groups, participants with longer formal education were faster than the less educated subjects. CONCLUSIONS On the basis of the large representative random sample of this study, it may be concluded that decline in psychomotor speed during aging can already be seen at a quite young age. Decline accelerates after the age of about 70. Differences in socio-economic background factors, such as education, may modify the differences observed between younger and older individuals. These results emphasize the need for the separation of decision time and movement time in psychomotor speed tests, when differences between age groups as well as between men and women are analysed.
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Affiliation(s)
- Pertti Era
- GeroCenter Foundation for Research and Development, and Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
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Kerkhof HJ, Meulenbelt I, Akune T, Arden NK, Aromaa A, Bierma-Zeinstra SM, Carr A, Cooper C, Dai J, Doherty M, Doherty SA, Felson D, Gonzalez A, Gordon A, Harilainen A, Hart DJ, Hauksson VB, Heliovaara M, Hofman A, Ikegawa S, Ingvarsson T, Jiang Q, Jonsson H, Jonsdottir I, Kawaguchi H, Kloppenburg M, Kujala UM, Lane NE, Leino-Arjas P, Lohmander S, Luyten FP, Malizos KN, Nakajima M, Nevitt MC, Pols HA, Rivadeneira F, Shi D, Slagboom E, Spector TD, Stefansson K, Sudo A, Tamm A, Tamm AE, Tsezou A, Uchida A, Uitterlinden AG, Wilkinson JM, Yoshimura N, Valdes AM, van Meurs JB. Recommendations for standardization and phenotype definitions in genetic studies of osteoarthritis: the TREAT-OA consortium. Osteoarthritis Cartilage 2011; 19:254-64. [PMID: 21059398 PMCID: PMC3236091 DOI: 10.1016/j.joca.2010.10.027] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2010] [Revised: 10/15/2010] [Accepted: 10/26/2010] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To address the need for standardization of osteoarthritis (OA) phenotypes by examining the effect of heterogeneity among symptomatic (SOA) and radiographic osteoarthritis (ROA) phenotypes. METHODS Descriptions of OA phenotypes of the 28 studies involved in the TREAT-OA consortium were collected. We investigated whether different OA definitions result in different association results by creating various hip OA definitions in one large population based cohort (the Rotterdam Study I (RSI)) and testing those for association with gender, age and body mass index using one-way ANOVA. For ROA, we standardized the hip-, knee- and hand ROA definitions and calculated prevalence's of ROA before and after standardization in nine cohort studies. This procedure could only be performed in cohort studies and standardization of SOA definitions was not feasible at this moment. RESULTS In this consortium, all studies with SOA phenotypes (knee, hip and hand) used a different definition and/or assessment of OA status. For knee-, hip- and hand ROA five, four and seven different definitions were used, respectively. Different hip ROA definitions do lead to different association results. For example, we showed in the RSI that hip OA defined as "at least definite joint space narrowing (JSN) and one definite osteophyte" was not associated with gender (P =0.22), but defined as "at least one definite osteophyte" was significantly associated with gender (P=3×10(-9)). Therefore, a standardization process was undertaken for ROA definitions. Before standardization a wide range of ROA prevalence's was observed in the nine cohorts studied. After standardization the range in prevalence of knee- and hip ROA was small. CONCLUSION Phenotype definitions influence the prevalence of OA and association with clinical variables. ROA phenotypes within the TREAT-OA consortium were standardized to reduce heterogeneity and improve power in future genetics studies.
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Affiliation(s)
- Hanneke J.M. Kerkhof
- Department of Internal Medicine, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands,The Netherlands Genomics Initiative-sponsored Netherlands Consortium for Healthy Aging (NGI-NCHA), Rotterdam/Leiden, the Netherlands
| | - Ingrid Meulenbelt
- The Netherlands Genomics Initiative-sponsored Netherlands Consortium for Healthy Aging (NGI-NCHA), Rotterdam/Leiden, the Netherlands,Department of Molecular Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Toru Akune
- Department of Clinical Motor System Medicine, 22nd Century Medical and Research Center, The University of Tokyo, Tokyo, Japan
| | - Nigel K. Arden
- MRC Epidemiology Resource Centre University of Southampton, Southampton General Hospital, Southampton, United Kingdom,NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford England Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences University of Oxford, Oxford, United Kingdom
| | - Arpo Aromaa
- The National Institute for Health and Welfare (THL), Helsinki, Finland
| | | | - Andrew Carr
- NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford England Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences University of Oxford, Oxford, United Kingdom
| | - Cyrus Cooper
- MRC Epidemiology Resource Centre University of Southampton, Southampton General Hospital, Southampton, United Kingdom,NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford England Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences University of Oxford, Oxford, United Kingdom
| | - Jin Dai
- Center of Diagnosis and Treatment for Joint Disease, Nanjing DrumTower Hospital, The affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Michael Doherty
- Academic Rheumatology, Clinical Sciences Building, Nottingham City Hospital Hucknall Road, Nottingham, United Kingdom
| | - Sally A. Doherty
- Academic Rheumatology, Clinical Sciences Building, Nottingham City Hospital Hucknall Road, Nottingham, United Kingdom
| | - David Felson
- Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, MA, United States of America
| | - Antonio Gonzalez
- Laboratorio Investigacion and Rheumatology Unit, Hospital Clinico Universitario Santiago, Santiago de Compostela, Spain
| | - Andrew Gordon
- Academic Unit of Bone Metabolism, Department of Human Metabolism, University of Sheffield, Sheffield, United Kingdom,Sheffield NIHR Bone Biomedical research Unit, Centre for Biomedical Research, Northern General Hospital, Sheffield, United Kingdom
| | - Arsi Harilainen
- ORTON Orthopedic Hospital, Invalid Foundation, Helsinki, Finland
| | - Deborah J. Hart
- Department of Twin Research and Genetic Epidemiology, St. Thomas' Hospital, King's College London, London, United Kingdom
| | | | - Markku Heliovaara
- The National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Albert Hofman
- The Netherlands Genomics Initiative-sponsored Netherlands Consortium for Healthy Aging (NGI-NCHA), Rotterdam/Leiden, the Netherlands,Department of Epidemiology, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Shiro Ikegawa
- Laboratory for Bone and Joint Diseases, Center for Genomic Medicine, RIKEN, Japan
| | - Thorvaldur Ingvarsson
- FSA University Hospital, Institution of Health Science, University of Akureyri, Akureyri, Iceland
| | - Qing Jiang
- Center of Diagnosis and Treatment for Joint Disease, Nanjing DrumTower Hospital, The affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Helgi Jonsson
- Department of Medicine, Landspitali University Hospital and Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Ingileif Jonsdottir
- deCODE Genetics, Reykjavik, Iceland,Department of Medicine, Landspitali University Hospital and Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Hiroshi Kawaguchi
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Margreet Kloppenburg
- Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Urho M. Kujala
- Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Nancy E. Lane
- University of California at San Francisco and University of California at Davis, Sacramento, United States of America
| | | | - Stefan Lohmander
- Department of Orthopedics, Clinical Sciences, Lund University, Lund, Sweden
| | - Frank P. Luyten
- Laboratory for Skeletal Development and Joint Disorders, Division of Rheumatology, Katholieke Universiteit Leuven, Belgium
| | | | - Masahiro Nakajima
- Laboratory for Bone and Joint Diseases, Center for Genomic Medicine, RIKEN, Japan
| | - Michael C. Nevitt
- University of California at San Francisco and University of California at Davis, Sacramento, United States of America
| | - Huibert A.P. Pols
- Department of Internal Medicine, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Fernando Rivadeneira
- Department of Internal Medicine, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands,The Netherlands Genomics Initiative-sponsored Netherlands Consortium for Healthy Aging (NGI-NCHA), Rotterdam/Leiden, the Netherlands,Department of Epidemiology, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Dongquan Shi
- Center of Diagnosis and Treatment for Joint Disease, Nanjing DrumTower Hospital, The affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Eline Slagboom
- The Netherlands Genomics Initiative-sponsored Netherlands Consortium for Healthy Aging (NGI-NCHA), Rotterdam/Leiden, the Netherlands,Department of Molecular Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Tim D. Spector
- Department of Twin Research and Genetic Epidemiology, St. Thomas' Hospital, King's College London, London, United Kingdom
| | - Kari Stefansson
- deCODE Genetics, Reykjavik, Iceland,Department of Medicine, Landspitali University Hospital and Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Akihiro Sudo
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Japan
| | - Agu Tamm
- Department of Internal Medicine, University of Tartu, Estonia
| | - Ann E. Tamm
- Department of Sport Medicine and Rehabilitation, Univerity of Tartu, Estonia
| | - Aspasia Tsezou
- Department of Biology and Genetics, University of Thessaly, Larissa, Greece
| | - Atsumasa Uchida
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Japan
| | - André G. Uitterlinden
- Department of Internal Medicine, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands,The Netherlands Genomics Initiative-sponsored Netherlands Consortium for Healthy Aging (NGI-NCHA), Rotterdam/Leiden, the Netherlands,Department of Epidemiology, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Jeremy Mark Wilkinson
- Academic Unit of Bone Metabolism, Department of Human Metabolism, University of Sheffield, Sheffield, United Kingdom,Sheffield NIHR Bone Biomedical research Unit, Centre for Biomedical Research, Northern General Hospital, Sheffield, United Kingdom
| | - Noriko Yoshimura
- Department of Joint Disease Research, 22nd Century Medical and Research Center, The University of Tokyo Hospital, The University of Tokyo, Tokyo, Japan
| | - Ana M. Valdes
- Department of Twin Research and Genetic Epidemiology, St. Thomas' Hospital, King's College London, London, United Kingdom
| | - Joyce B.J. van Meurs
- Department of Internal Medicine, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands,The Netherlands Genomics Initiative-sponsored Netherlands Consortium for Healthy Aging (NGI-NCHA), Rotterdam/Leiden, the Netherlands
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Puisto V, Heliövaara M, Impivaara O, Jalanko T, Kröger H, Knekt P, Aromaa A, Rissanen H, Helenius I. Severity of vertebral fracture and risk of hip fracture: a nested case-control study. Osteoporos Int 2011; 22:63-8. [PMID: 20195843 DOI: 10.1007/s00198-010-1195-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2009] [Accepted: 01/14/2010] [Indexed: 11/30/2022]
Abstract
UNLABELLED Severe vertebral fractures strongly predicted subsequent hip fracture in this population-based study. Such high-risk patients should be provided with clinical evaluation and care for osteoporosis. INTRODUCTION Vertebral fractures are commonly osteoporotic and known to predict hip fracture. The aim of this study was to evaluate associations between the severity of vertebral fractures and the risk of subsequent hip fracture. METHODS Chest radiographs were obtained of 7,095 Finnish men and women aged 30 years or over in the Mini-Finland Health Survey in 1978-1980. Record linkage to the National Hospital Discharge Register identified 182 subjects from the survey who had subsequently been hospitalized for primary treatment of hip fracture by the end of 1994. A nested case-control setting was adopted, where three controls individually matched for age, gender, and place of residence were drawn for 169 subjects with hip fracture from the same cohort. Baseline vertebral fractures were identified at levels T3 to T12, and their morphology was categorized to mild, moderate, or severe according to Genant's classification. RESULTS Severe vertebral fracture (>40% reduction in vertebral body height) strongly predicted hip fracture. After controlling for education, physical activity, smoking, alcohol consumption, and self-rated general health, the adjusted relative odds was 12.06 (95% confidence interval, 3.80-38.26). Mild to moderate fracture grades and the number of compressed vertebral bodies showed no prediction for hip fracture. CONCLUSIONS The presence of a severe vertebral fracture in the thoracic spine strongly predicts subsequent hip fracture. Such high-risk patients should be clinically evaluated and provided with care for osteoporosis and measures to reduce the risk of falling as required.
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Affiliation(s)
- V Puisto
- National Institute for Health and Welfare, Helsinki, Finland.
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Saxlin T, Ylöstalo P, Suominen-Taipale L, Aromaa A, Knuuttila M. Overweight and obesity weakly predict the development of periodontal infection. J Clin Periodontol 2010; 37:1059-67. [PMID: 20969609 DOI: 10.1111/j.1600-051x.2010.01633.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM The aim of this study was to investigate the association between body weight and periodontal infection in a longitudinal setting. MATERIAL AND METHODS This study was based on a subpopulation of the Health 2000 Survey that included dentate, non-diabetic subjects aged 30-59 years, who had never smoked and who had participated in the Follow-Up Study on Finnish Adults' Oral Health approximately 4 years later (n=396). The number of new teeth with deepened (4 mm deep or deeper) periodontal pockets in the follow-up examination was used as the outcome variable. Body weight was measured using body mass index, categorized into three categories: <25.0 (normal weight), 25.0-29.9 (overweight) and 30.0 or more (obesity). Incidence rate ratios were estimated using Poisson's regression models. RESULTS Body weight was weakly, but not statistically significantly, associated with the number of new teeth with deepened periodontal pockets among subjects who were periodontally healthy in the baseline examinations, whereas only a minuscule association was found among subjects who had periodontal infection at baseline. CONCLUSIONS The results of this follow-up study do not provide evidence that overweight and obesity can be considered significant risk factors in the pathogenesis of periodontal infection.
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Affiliation(s)
- Tuomas Saxlin
- Department of Periodontology and Geriatric Dentistry, Institute of Dentistry, University of Oulu, Oulu, Finland.
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Kovanen L, Saarikoski ST, Haukka J, Pirkola S, Aromaa A, Lönnqvist J, Partonen T. Circadian clock gene polymorphisms in alcohol use disorders and alcohol consumption. Alcohol Alcohol 2010; 45:303-11. [PMID: 20554694 DOI: 10.1093/alcalc/agq035] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
AIMS Circadian clock genes are involved in the development of drug-induced behaviors and regulate neurotransmission pathways in addiction. Our aim was to study whether circadian clock gene polymorphisms predispose to alcohol dependence or abuse or other alcohol-related characteristics. METHODS The study sample comprised of 512 individuals having alcohol dependence or alcohol abuse (according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV)) and their 511 age- and sex-matched controls. This population-based sample was drawn from a cohort (n = 7415), representative of the Finnish general population aged 30 and over. Altogether 42 single-nucleotide polymorphisms of 19 genes related to the circadian pacemaker system were genotyped. RESULTS ARNTL rs6486120 T(+) allelic status (P = 0.0007, q = 0.17), ADCYAP1 rs2856966 GG genotype (P = 0.0006, q = 0.17) and VIP CC haplotype (rs3823082-rs688136) (P = 0.0006) were suggestively associated with alcohol consumption in socially drinking controls. ARNTL2 GT haplotype (rs7958822-rs4964057) associated suggestively with alcohol abuse diagnosis (P = 0.0013). Earlier findings on the associations of DRD2 and NPY with alcohol dependence were supported: DRD2/ANKK1 Taq1A(1) increased (P = 0.04) and NPY Pro7 decreased (P = 0.01) the risk of alcohol dependence. CONCLUSIONS ARNTL, ARNTL2, VIP and ADCYAP1 were indicated as having influence on alcohol use or abuse. The role of DRD2 and NPY on alcohol dependence was also supported.
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Affiliation(s)
- Leena Kovanen
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland.
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Laitinen A, Laatikainen L, Härkänen T, Koskinen S, Reunanen A, Aromaa A. Prevalence of major eye diseases and causes of visual impairment in the adult Finnish population: a nationwide population-based survey. Acta Ophthalmol 2010; 88:463-71. [PMID: 19878108 DOI: 10.1111/j.1755-3768.2009.01566.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE To estimate the prevalence of cataract, glaucoma, age-related maculopathy (ARM) and diabetic retinopathy (DR) in the adult Finnish population. METHODS A representative cross-sectional sample of the Finnish population aged 30 years and older. Of the 7979 eligible people, 7413 (93%) were interviewed and/or examined. The interview included self-reported doctor-made diagnoses of cataract, glaucoma, degenerative fundus changes (mainly ARM) or DR. Information on self-reported eye diseases was complemented with data from national registers, and case records were gathered for non-participants and persons with visual acuity (VA) < 0.5 or reporting difficulties in vision or eye diseases without assessed VA. RESULTS Based on self-reported and/or register-based data the estimated total prevalences of cataract, glaucoma, ARM and DR in the study population were 10%, 5%, 4% and 1%, respectively. All these chronic eye diseases increased with age (p < 0.001). The corresponding prevalences for persons aged 65 and older were 34%, 13%, 12% and 2%, respectively. Cataract and glaucoma were more common in women than in men [odds ratio (OR) 1.55, 95% confidence interval (CI) 1.26-1.91; OR 1.57, 95% CI 1.24-1.98, respectively]. The most prevalent eye diseases in people with visual impairment (VA < or = 0.25) were ARM (37%), unoperated cataract (27%), glaucoma (22%) and DR (7%). CONCLUSION The high prevalence of these mainly age-related eye diseases, together with increasing life expectancy, mean that continuous efforts are needed to identify and treat eye diseases in order to maintain patients' quality of life and to alleviate the social and economic burden of serious eye diseases.
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Affiliation(s)
- Arja Laitinen
- Department of Health and Functional Capacity, National Public Health Institute, Helsinki, Finland.
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Salomaa V, Havulinna A, Saarela O, Zeller T, Jousilahti P, Jula A, Muenzel T, Aromaa A, Evans A, Kuulasmaa K, Blankenberg S. Thirty-one novel biomarkers as predictors for clinically incident diabetes. PLoS One 2010; 5:e10100. [PMID: 20396381 PMCID: PMC2852424 DOI: 10.1371/journal.pone.0010100] [Citation(s) in RCA: 132] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2010] [Accepted: 03/16/2010] [Indexed: 12/25/2022] Open
Abstract
Background The prevalence of diabetes is increasing in all industrialized countries and its prevention has become a public health priority. However, the predictors of diabetes risk are insufficiently understood. We evaluated, whether 31 novel biomarkers could help to predict the risk of incident diabetes. Methods and Findings The biomarkers were evaluated primarily in the FINRISK97 cohort (n = 7,827; 417 cases of clinically incident diabetes during the follow-up). The findings were replicated in the Health 2000 cohort (n = 4,977; 179 cases of clinically incident diabetes during the follow-up). We used Cox proportional hazards models to calculate the relative risk of diabetes, after adjusting for the classic risk factors, separately for each biomarker. Next, we assessed the discriminatory ability of single biomarkers using receiver operating characteristic curves and C-statistics, integrated discrimination improvement (IDI) and net reclassification improvement (NRI). Finally, we derived a biomarker score in the FINRISK97 cohort and validated it in the Health 2000 cohort. A score consisting of adiponectin, apolipoprotein B, C-reactive protein and ferritin almost doubled the relative risk of diabetes in the validation cohort (HR per one standard deviation increase 1.88, p = 2.8 e-5). It also improved discrimination of the model (IDI = 0.0149, p<0.0001) and reclassification of diabetes risk (NRI = 11.8%, p = 0.006). Gender-specific analyses suggested that the best score differed between men and women. Among men, the best results were obtained with the score of four biomarkers: adiponectin, apolipoprotein B, ferritin and interleukin-1 receptor antagonist, which gave an NRI of 25.4% (p<0.0001). Among women, the best score included adiponectin, apolipoprotein B, C-reactive protein and insulin. It gave an NRI of 13.6% (p = 0.041). Conclusions We identified novel biomarkers that were associated with the risk of clinically incident diabetes over and above the classic risk factors. This gives new insights into the pathogenesis of diabetes and may help with targeting prevention and treatment.
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Affiliation(s)
- Veikko Salomaa
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
- * E-mail: (VS); (SB)
| | - Aki Havulinna
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
| | - Olli Saarela
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
| | - Tanja Zeller
- Department of Medicine II, Johannes Gutenberg-University, Mainz, Germany
| | - Pekka Jousilahti
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
| | - Antti Jula
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
| | - Thomas Muenzel
- Department of Medicine II, Johannes Gutenberg-University, Mainz, Germany
| | - Arpo Aromaa
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
| | - Alun Evans
- The UKCRC Centre of Excellence for Public Health, Queen's University of Belfast, Belfast, United Kingdom
| | - Kari Kuulasmaa
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
| | - Stefan Blankenberg
- Department of Medicine II, Johannes Gutenberg-University, Mainz, Germany
- * E-mail: (VS); (SB)
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Yasuno K, Bilguvar K, Bijlenga P, Low SK, Krischek B, Auburger G, Simon M, Krex D, Arlier Z, Nayak N, Ruigrok YM, Niemelä M, Tajima A, von und zu Fraunberg M, Dóczi T, Wirjatijasa F, Hata A, Blasco J, Oszvald A, Kasuya H, Zilani G, Schoch B, Singh P, Stüer C, Risselada R, Beck J, Sola T, Ricciardi F, Aromaa A, Illig T, Schreiber S, van Duijn CM, van den Berg LH, Perret C, Proust C, Roder C, Ozturk AK, Gaál E, Berg D, Geisen C, Friedrich CM, Summers P, Frangi AF, State MW, Wichmann HE, Breteler MMB, Wijmenga C, Mane S, Peltonen L, Elio V, Sturkenboom MCJM, Lawford P, Byrne J, Macho J, Sandalcioglu EI, Meyer B, Raabe A, Steinmetz H, Rüfenacht D, Jääskeläinen JE, Hernesniemi J, Rinkel GJE, Zembutsu H, Inoue I, Palotie A, Cambien F, Nakamura Y, Lifton RP, Günel M. Genome-wide association study of intracranial aneurysm identifies three new risk loci. Nat Genet 2010; 42:420-5. [PMID: 20364137 PMCID: PMC2861730 DOI: 10.1038/ng.563] [Citation(s) in RCA: 239] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2009] [Accepted: 03/09/2010] [Indexed: 11/18/2022]
Abstract
Saccular intracranial aneurysms (IAs) are balloon-like dilations of the intracranial arterial wall; their hemorrhage commonly results in severe neurologic impairment and death. We report a second genome-wide association study with discovery and replication cohorts from Europe and Japan comprising 5,891 cases and 14,181 controls with ∼832,000 genotyped and imputed SNPs across discovery cohorts. We identified three new loci showing strong evidence for association with IA in the combined data set, including intervals near RBBP8 on 18q11.2 (OR=1.22, P=1.1×10-12), STARD13/KL on 13q13.1 (OR=1.20, P=2.5×10-9) and a gene-rich region on 10q24.32 (OR=1.29, P=1.2×10-9). We also confirmed prior associations near SOX17 (8q11.23-q12.1; OR=1.28, P=1.3×10-12) and CDKN2A/B (9p21.3; OR=1.31, P=1.5×10-22). It is noteworthy that several putative risk genes play a role in cell-cycle progression, potentially affecting proliferation and senescence of progenitor cell populations that are responsible for vascular formation and repair.
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Affiliation(s)
- Katsuhito Yasuno
- Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut, USA
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Kosunen TU, Pukkala E, Sarna S, Seppälä K, Aromaa A, Knekt P, Rautelin H. Gastric cancers in Finnish patients after cure of Helicobacter pylori infection: A cohort study. Int J Cancer 2010; 128:433-9. [PMID: 20309944 DOI: 10.1002/ijc.25337] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2009] [Accepted: 03/09/2010] [Indexed: 12/20/2022]
Abstract
Helicobacter pylori infection is associated with gastric cancer. A total of 97% of the infected subjects have elevated levels of H. pylori antibodies. The antibody titers have been shown to decline rapidly (40-60% within 4-12 months) only after successful eradication therapy. We allocated 26,700 consecutive patients tested during 1986-1998 for H. pylori antibodies to 3 subcohorts: seropositive patients with rapidly falling antibody titers (Hp+CURED, n = 3,650), seropositive patients where no serological information indicating cure was obtained (Hp+NoInfo, n = 11,638) and seronegative patients (Hp-, n = 11,422). In the subcohorts, the standardised incidence ratios (SIRs) with 95% confidence intervals (CI) were defined for subsequent cancers of stomach, pancreas, colon, rectum, breast and prostate separately and for all cancers except stomach combined. The mean follow-up time was 10.1 years and the number of gastric cancers was 72. For the Hp+CURED, the SIR for gastric cancers for the first 5 follow-up years was 1.62 but decreased from the sixth follow-up year thereon to 0.14 (CI: 0.00-0.75). Likewise, the risk ratio, defined in a Poisson regression analysis using the Hp+NoInfo group as the reference, decreased from 1.60 to 0.13 (CI: 0.02-1.00, p = 0.049). The SIR for Hp- was not significantly higher than that for Hp+NoInfo for any of the cancers analysed. To conclude, cured H. pylori infection led to a significantly decreased incidence of gastric cancers from the sixth follow-up year. Advanced atrophic gastritis would be a plausible contributor to the elevated SIR in elderly Hp- patients.
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Affiliation(s)
- Timo U Kosunen
- Department of Bacteriology and Immunology, Haartman Institute, University of Helsinki, Helsinki, Finland.
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Laaksonen MA, Knekt P, Rissanen H, Härkänen T, Virtala E, Marniemi J, Aromaa A, Heliövaara M, Reunanen A. The relative importance of modifiable potential risk factors of type 2 diabetes: a meta-analysis of two cohorts. Eur J Epidemiol 2009; 25:115-24. [PMID: 20012885 DOI: 10.1007/s10654-009-9405-0] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2009] [Accepted: 11/18/2009] [Indexed: 10/20/2022]
Abstract
Lifestyle factors predict type 2 diabetes occurrence, but their effect in high- and low-risk populations is poorly known. This study determines the prediction of low-risk lifestyle on type 2 diabetes in those with and without metabolic syndrome in a pooled sample of two representative Finnish cohorts, collected in 1978-1980 and 2000-2001. Altogether 8,627 individuals, aged 40-79 years, and free of diabetes and cardiovascular disease at baseline were included in this study. A low-risk lifestyle was defined based on body mass index, exercise, alcohol consumption, smoking, and serum vitamin D concentration. The metabolic syndrome was defined according to the International Diabetes Federation including obesity, blood pressure, serum HDL cholesterol, serum triglycerides, and fasting glucose. During a 10-year follow-up, altogether 226 type 2 diabetes cases occurred. Overweight was the strongest predictor of type 2 diabetes (population attributable fraction (PAF) = 77%, 95% confidence interval (CI): 53, 88%). Together with lack of exercise, unsatisfactory alcohol consumption, smoking, and low vitamin D concentration it explained 82% of the cases. Altogether 62% (CI: 47, 73%) of the cases were attributable to the metabolic syndrome and 92% (CI: 67, 98%) to the most unfavourable combination of its components. The metabolic syndrome did not modify the prediction of lifestyle factors but persons with normal blood pressure benefited more from positive changes in exercise, alcohol consumption, and smoking than those with elevated blood pressure (P for interaction = 0.01). In conclusion, modification of lifestyle factors apparently reduces type 2 diabetes risk, especially in persons with normal blood pressure.
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Seppänen-Nuijten E, Lahti-Koski M, Männistö S, Knekt P, Rissanen H, Aromaa A, Heliövaara M. Fat free mass and obesity in relation to educational level. BMC Public Health 2009; 9:448. [PMID: 19961589 PMCID: PMC2801678 DOI: 10.1186/1471-2458-9-448] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2009] [Accepted: 12/04/2009] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The aim of the study was to describe the body composition of Finnish adults, especially by education, and to investigate whether fat-free mass (FFM) can explain educational gradients relating to body mass index (BMI) and waist-to-hip ratio (WHR). METHODS Data for this cross-sectional study were based on data collected in 2000-2001 for the Health 2000 Survey. Of the nationally representative sample of 8,028 Finnish men and women aged 30 years and older, 6,300 (78.5%) were included in the study. Body composition measurements were carried out in the health examination, where FFM was assessed with eight-polar bioelectrical impedance analysis. Questions on education were included in the health interview. RESULTS The mean FFM varied by education in older (>or= 65 y.) men only. In the middle-aged group (30-64 y.), highly educated men were less likely to belong to the lowest quintile of FFM (OR 0.67, 95%CI 0.48-0.93) compared with the least educated subjects. The level of education was inversely associated with the prevalence of high BMI and WHR in middle-aged men. In women, the respective associations were found both in middle-aged women and their older counterparts. Adjustment for FFM slightly strengthened the associations of education with BMI and WHR. CONCLUSIONS The association between education and FFM is weak. Educational gradients of high BMI and high WHR cannot be explained by FFM.
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Affiliation(s)
| | - Marjaana Lahti-Koski
- National Institute for Health and Welfare, Mannerheimintie 166, 00300 Helsinki, Finland
- Finnish Heart Association, Oltermannintie 8, P.O.Box 50, 00621 Helsinki, Finland
| | - Satu Männistö
- National Institute for Health and Welfare, Mannerheimintie 166, 00300 Helsinki, Finland
| | - Paul Knekt
- National Institute for Health and Welfare, Mannerheimintie 166, 00300 Helsinki, Finland
| | - Harri Rissanen
- National Institute for Health and Welfare, Mannerheimintie 166, 00300 Helsinki, Finland
| | - Arpo Aromaa
- National Institute for Health and Welfare, Mannerheimintie 166, 00300 Helsinki, Finland
| | - Markku Heliövaara
- National Institute for Health and Welfare, Mannerheimintie 166, 00300 Helsinki, Finland
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Savolainen J, Suominen-Taipale A, Uutela A, Aromaa A, Härkänen T, Knuuttila M. Sense of coherence associates with oral and general health behaviours. Community Dent Health 2009; 26:197-203. [PMID: 20088216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE Our aim was to investigate the mutual relationship between oral and general health behaviours and oral and general subjective health among adults, and to explore whether sense of coherence (SOC) could be a common health-promoting correlate for them. PARTICIPANTS The present study included data for 4096 30- to 64-year-old dentate adults (2177 females and 1919 males). BASIC RESEARCH DESIGN In the nationally representative, cross-sectional sample including 8028 persons aged 30, or more, 88% were surveyed. The questionnaire and home interview included information about socio-economic and demographic factors, behavioural and psycho-social variables. Chi-square test and logistic regression models were used in the data analysis. MAIN OUTCOME MEASURES The main outcome measures were oral health behaviours (regular dental attendance, twice a day tooth-brushing frequency), general health behaviours (non-smoking habits, physical activity at least twice a week), subjective oral and general health and the SOC (12-item) scale. RESULTS Among females, positive health behaviours tended to occur together significantly more often than among males. Thus, 83% of females with more than once a week physical exercise frequency, and 79% of the non-smoking females, brushed their teeth at least twice a day, while the corresponding figures for the males were merely 55% and 50%. A strong SOC was associated with uniformly positive health behaviours and subjective oral and general health. CONCLUSIONS Our results suggest that a strong SOC has a universal positive association with several health behaviours and subjective health measures, also concerning oral health. Thus, the role of psycho-social factors should not be underestimated in health promotion.
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Affiliation(s)
- J Savolainen
- Department of Periodontology and Geriatric Dentistry, Institute of Dentistry, University of Oulu, Oulu, Finland.
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Keskitalo K, Broms U, Heliövaara M, Ripatti S, Surakka I, Perola M, Pitkäniemi J, Peltonen L, Aromaa A, Kaprio J. Association of serum cotinine level with a cluster of three nicotinic acetylcholine receptor genes (CHRNA3/CHRNA5/CHRNB4) on chromosome 15. Hum Mol Genet 2009; 18:4007-12. [PMID: 19628476 PMCID: PMC2748889 DOI: 10.1093/hmg/ddp322] [Citation(s) in RCA: 140] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2009] [Revised: 07/02/2009] [Accepted: 07/13/2009] [Indexed: 11/14/2022] Open
Abstract
A cluster of three nicotinic acetylcholine receptor genes on chromosome 15 (CHRNA5/CHRNA3/CHRNB4) has been shown to be associated with nicotine dependence and smoking quantity. The aim of this study was to clarify whether the variation at this locus regulates nicotine intake among smokers by using the level of a metabolite of nicotine, cotinine, as an outcome. The number of cigarettes smoked per day (CPD) and immune-reactive serum cotinine level were determined in 516 daily smokers (age 30-75 years, 303 males) from the population-based Health2000 study. Association of 21 SNPs from a 100 kb region of chromosome 15 with cotinine and CPD was examined. SNP rs1051730 showed the strongest association to both measures. However, this SNP accounted for nearly a five-fold larger proportion of variance in cotinine levels than in CPD (R(2) 4.3% versus 0.9%). The effect size of the SNP was 0.30 for cotinine level, whereas it was 0.13 for CPD. Variation at CHRNA5/CHRNA3/CHRNB4 cluster influences nicotine level, measured as cotinine, more strongly than smoking quantity, measured by CPD, and appears thus to be involved in regulation of nicotine levels among smokers.
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Affiliation(s)
- Kaisu Keskitalo
- Department of Public Health, University of Helsinki, Finland.
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