1
|
Yammine SG, Huybrechts I, Biessy C, Dossus L, Panico S, Sánchez MJ, Benetou V, Turzanski-Fortner R, Katzke V, Idahl A, Skeie G, Olsen KS, Tjønneland A, Halkjaer J, Colorado-Yohar S, Heath AK, Sonestedt E, Sartor H, Schulze MB, Palli D, Crous-Bou M, Dorronsoro A, Overvad K, Gurrea AB, Severi G, Vermeulen RCH, Sandanger TM, Travis RC, Key T, Amiano P, Van Guelpen B, Johansson M, Sund M, Tumino R, Wareham N, Sacerdote C, Krogh V, Brennan P, Riboli E, Weiderpass E, Gunter MJ, Chajès V. Dietary fatty acids and endometrial cancer risk within the European Prospective Investigation into Cancer and Nutrition. BMC Cancer 2023; 23:159. [PMID: 36797668 PMCID: PMC9936701 DOI: 10.1186/s12885-023-10611-0] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 02/06/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Diet may impact important risk factors for endometrial cancer such as obesity and inflammation. However, evidence on the role of specific dietary factors is limited. We investigated associations between dietary fatty acids and endometrial cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). METHODS This analysis includes 1,886 incident endometrial cancer cases and 297,432 non-cases. All participants were followed up for a mean of 8.8 years. Multivariable Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) of endometrial cancer across quintiles of individual fatty acids estimated from various food sources quantified through food frequency questionnaires in the entire EPIC cohort. The false discovery rate (q-values) was computed to control for multiple comparisons. RESULTS Consumption of n-6 γ-linolenic acid was inversely associated with endometrial cancer risk (HR comparing 5th with 1st quintileQ5-Q1=0.77, 95% CI = 0.64; 0.92, ptrend=0.01, q-value = 0.15). This association was mainly driven by γ-linolenic acid derived from plant sources (HRper unit increment=0.94, 95%CI= (0.90;0.98), p = 0.01) but not from animal sources (HRper unit increment= 1.00, 95%CI = (0.92; 1.07), p = 0.92). In addition, an inverse association was found between consumption of n-3 α-linolenic acid from vegetable sources and endometrial cancer risk (HRper unit increment= 0.93, 95%CI = (0.87; 0.99), p = 0.04). No significant association was found between any other fatty acids (individual or grouped) and endometrial cancer risk. CONCLUSION Our results suggest that higher consumption of γ-linolenic acid and α-linoleic acid from plant sources may be associated with lower risk of endometrial cancer.
Collapse
Affiliation(s)
- S G Yammine
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS) , Nutritional Epidemiology Research Team (EREN), F-93017, Bobigny, France.
| | - I Huybrechts
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - C Biessy
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - L Dossus
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - S Panico
- Dipartimento di medicina clinica e chirurgia, Federico II University, Naples, Italy
| | - M J Sánchez
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - V Benetou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Grèce
| | | | - V Katzke
- The German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - A Idahl
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden
| | - G Skeie
- Faculty of Health Sciences, Department of Community Medicine, UiT The Arctic University of Norway, N - 9037, Tromsø, Norway
| | - K Standahl Olsen
- Faculty of Health Sciences, Department of Community Medicine, UiT The Arctic University of Norway, N - 9037, Tromsø, Norway
| | - A Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - J Halkjaer
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - S Colorado-Yohar
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
- Research Group on Demography and Health, National Faculty of Public Health, University of Antioquia, Medellín, Colombia
| | - A K Heath
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - E Sonestedt
- Department of Clinical Sciences Malmö, Lund University, Sweden
| | - H Sartor
- Department of Clinical Sciences Malmö, Lund University, Sweden
| | - M B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam- Rehbruecke, Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
| | - D Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - M Crous-Bou
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO) - Bellvitge Biomedical Research Institute (IDIBELL). L'Hospitalet de Llobregat, 08908, Barcelona, Spain
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 02115, Boston, MA, USA
| | - A Dorronsoro
- Ministry of Health of the Basque Government, Sub-Directorate for Public Health and Addictions of Gipuzkoa, San Sebastian, Spain
| | - K Overvad
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - A Barricarte Gurrea
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Navarra Public Health Institute, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - G Severi
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Research in Epidemiology and Population Health, INSERM U1018, Université Paris-Saclay, Villejuif, France
- Human Genetics Foundation, Turin, Italy
| | - R C H Vermeulen
- Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
- Institute for Risk Assessment Sciences (IRAS), Department of Population Health Sciences, Utrecht University, Utrecht, The Netherlands
| | - T M Sandanger
- Faculty of Health Sciences, Department of Community Medicine, UiT The Arctic University of Norway, N - 9037, Tromsø, Norway
| | - R C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - T Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - P Amiano
- Ministry of Health of the Basque Government, Sub-Directorate for Public Health and Addictions of Gipuzkoa, San Sebastian, Spain
| | - B Van Guelpen
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden
| | - M Johansson
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - M Sund
- Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden
| | - R Tumino
- Cancer Registry and Histopathology Department, Provincial Health Authority (ASP 7), Ragusa, Italy
| | - N Wareham
- MRC Epidemiology Unit, University of Cambridge, Cambridge, England, U.K
| | - C Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital, Via Santena 7, 10126, Turin, Italy
| | - V Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori Di, Milano, Italy
| | - P Brennan
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - E Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - E Weiderpass
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - M J Gunter
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - V Chajès
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| |
Collapse
|
2
|
Robbins H, Alcala K, Swerdlow A, Schoemaker M, Wareham N, Key T, Travis R, Brennan P, Crosbie P, Callister M, Baldwin D, Landy R, Johansson M. P42.07 Comparative Performance of Lung Cancer Risk Models to Define Lung Screening Eligibility in the United Kingdom. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.831] [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: 11/28/2022]
|
3
|
Nüesch E, Dale C, Palmer TM, White J, Keating BJ, van Iperen EP, Goel A, Padmanabhan S, Asselbergs FW, Verschuren WM, Wijmenga C, Van der Schouw YT, Onland-Moret NC, Lange LA, Hovingh GK, Sivapalaratnam S, Morris RW, Whincup PH, Wannamethe GS, Gaunt TR, Ebrahim S, Steel L, Nair N, Reiner AP, Kooperberg C, Wilson JF, Bolton JL, McLachlan S, Price JF, Strachan MW, Robertson CM, Kleber ME, Delgado G, März W, Melander O, Dominiczak AF, Farrall M, Watkins H, Leusink M, Maitland-van der Zee AH, de Groot MC, Dudbridge F, Hingorani A, Ben-Shlomo Y, Lawlor DA, Amuzu A, Caufield M, Cavadino A, Cooper J, Davies TL, Drenos F, Engmann J, Finan C, Giambartolomei C, Hardy R, Humphries SE, Hypponen E, Kivimaki M, Kuh D, Kumari M, Ong K, Plagnol V, Power C, Richards M, Shah S, Shah T, Sofat R, Talmud PJ, Wareham N, Warren H, Whittaker JC, Wong A, Zabaneh D, Davey Smith G, Wells JC, Leon DA, Holmes MV, Casas JP. Adult height, coronary heart disease and stroke: a multi-locus Mendelian randomization meta-analysis. Int J Epidemiol 2018; 45:1927-1937. [PMID: 25979724 PMCID: PMC5841831 DOI: 10.1093/ije/dyv074] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [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] [Accepted: 04/15/2015] [Indexed: 11/12/2022] Open
Abstract
Background: We investigated causal effect of completed growth, measured by adult height, on coronary heart disease (CHD), stroke and cardiovascular traits, using instrumental variable (IV) Mendelian randomization meta-analysis. Methods: We developed an allele score based on 69 single nucleotide polymorphisms (SNPs) associated with adult height, identified by the IBCCardioChip, and used it for IV analysis against cardiovascular risk factors and events in 21 studies and 60 028 participants. IV analysis on CHD was supplemented by summary data from 180 height-SNPs from the GIANT consortium and their corresponding CHD estimates derived from CARDIoGRAMplusC4D. Results: IV estimates from IBCCardioChip and GIANT-CARDIoGRAMplusC4D showed that a 6.5-cm increase in height reduced the odds of CHD by 10% [odds ratios 0.90; 95% confidence intervals (CIs): 0.78 to 1.03 and 0.85 to 0.95, respectively],which agrees with the estimate from the Emerging Risk Factors Collaboration (hazard ratio 0.93; 95% CI: 0.91 to 0.94). IV analysis revealed no association with stroke (odds ratio 0.97; 95% CI: 0.79 to 1.19). IV analysis showed that a 6.5-cm increase in height resulted in lower levels of body mass index (P < 0.001), triglycerides (P < 0.001), non high-density (non-HDL) cholesterol (P < 0.001), C-reactive protein (P = 0.042), and systolic blood pressure (P = 0.064) and higher levels of forced expiratory volume in 1 s and forced vital capacity (P < 0.001 for both). Conclusions: Taller individuals have a lower risk of CHD with potential explanations being that taller people have a better lung function and lower levels of body mass index, cholesterol and blood pressure.
Collapse
Affiliation(s)
- Eveline Nüesch
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.,CTU Bern, Department of Clinical Research and Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Caroline Dale
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Tom M Palmer
- Warwick Medical School, University of Warwick, Coventry, UK.,Department of Mathematics and Statistics, Lancaster University, Lancaster, UK
| | - Jon White
- UCL Genetics Institute, Department of Genetics, Evolution and Environment, University College London, London, UK
| | - Brendan J Keating
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Department of Surgery.,Division of Genetics, University of Pennsylvania, Philadelphia
| | - Erik Pa van Iperen
- Department of Biostatistics, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.,Durrer Center for Cardiogenetic Research, ICIN-Netherlands Heart Institute, Utrecht, The Netherlands
| | - Anuj Goel
- Wellcome Trust Centre for Human Genetics and Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Sandosh Padmanabhan
- Institute of Cardiovascular and Medical Sciences, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Folkert W Asselbergs
- Department of Cardiology, Division Heart and Lungs, University Medical Centre Utrecht, Utrecht, The Netherlands.,Durrer Center for Cardiogenetic Research, ICIN-Netherlands Heart Institute, Utrecht, The Netherlands.,Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, UK
| | | | | | | | | | | | - Leslie A Lange
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - G K Hovingh
- Department of Vascular Medicine, Academic Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Suthesh Sivapalaratnam
- Department of Vascular Medicine, Academic Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Richard W Morris
- Department of Primary Care & Population Health, University College London, London, UK
| | - Peter H Whincup
- Population Health Research Institute, St George's, University of London, London, UK
| | - Goya S Wannamethe
- Department of Primary Care & Population Health, University College London, London, UK
| | - Tom R Gaunt
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, UK.,School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Shah Ebrahim
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Laura Steel
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Nikhil Nair
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Alexander P Reiner
- Department of Epidemiology, University of Washington, Seattle, WA, USA / Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Charles Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - James F Wilson
- Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.,MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Jennifer L Bolton
- Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Stela McLachlan
- Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Jacqueline F Price
- Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | | | - Christine M Robertson
- Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Marcus E Kleber
- Fifth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Graciela Delgado
- Fifth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Winfried März
- Medical Clinic V (Nephrology, Hypertensiology, Endocrinology, Diabetolgy, and Rheumatology), Mannheim Medical Faculty, University of Heidelberg, Germany, Synlab Academy, Synlab Services GmbH, Mannheim and Augsburg, Germany, Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Austria
| | | | - Anna F Dominiczak
- Institute of Cardiovascular and Medical Sciences, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Martin Farrall
- Wellcome Trust Centre for Human Genetics and Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Hugh Watkins
- Wellcome Trust Centre for Human Genetics and Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Maarten Leusink
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Anke H Maitland-van der Zee
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Mark Ch de Groot
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Frank Dudbridge
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Aroon Hingorani
- Department of Epidemiology and Public Health, University College London Medical School, London, UK
| | - Yoav Ben-Shlomo
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Debbie A Lawlor
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, UK.,School of Social and Community Medicine, University of Bristol, Bristol, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - D Zabaneh
- UCLEB, London, Edinburgh and Bristol, UK
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, UK.,School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Jonathan C Wells
- Childhood Nutrition Research Centre, UCL Institute of Child Health, London, UK
| | - David A Leon
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.,Department of Community Medicine, Arctic University of Norway, UiT
| | - Michael V Holmes
- Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, UK.,Department of Surgery and Clinical Epidemiology Unit, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Juan P Casas
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.,Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, UK
| |
Collapse
|
4
|
Arsenault B, Perrot N, Wareham N, Khaw K, Boekholdt S. P182Ideal cardiovascular health and aortic valve stenosis incidence in apparently healthy men and women. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p182] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
5
|
Jay R, Brennan P, Brenner, Overvad K, Olsen A, Tjønneland A, Boutron-Ruault MC, Clavel-Chapelon F, Fagherazzi, Katzke V, Kühn T, Boeing H, Bergmann MM, Steffen A, Naska A, Trichopoulou A, Trichopoulos D, Saieva C, Grioni S, Panico S, Tumino R, Vineis P, Bueno-de-Mesquita HB, Peeters PH, Hjartåker A, Weiderpass E, Arriola L, Molina-Montes E, Duell EJ, Santiuste C, Alonso de la Torre R, Barricarte Gurrea A, Stocks T, Johansson M, Ljungberg B, Wareham N, Khaw KT, Travis RC, Cross AJ, Murphy N, Riboli E, Scelo G. Alcohol consumption and the risk of renal cancers in the European Prospective Investigation into Cancer and Nutrition (EPIC). Wozniak MB, Brennan P, Brenner DR, Overvad K, Olsen A, Tjønneland A, Boutron-Ruault MC, Clavel-Chapelon F, Fagherazzi G, Katzke V, Kühn T, Boeing H, Bergmann MM, Steffen A, Naska A, Trichopoulou A, Trichopoulos D, Saieva C, Grioni S, Panico S, Tumino R, Vineis P, Bueno-de-Mesquita HB, Peeters PH, Hjartåker A, Weiderpass E, Arriola L, Molina-Montes E, Duell EJ, Santiuste C, Alonso de la Torre R, Barricarte Gurrea A, Stocks T, Johansson M, Ljungberg B, Wareham N, Khaw KT, Travis RC, Cross AJ, Murphy N, Riboli E, Scelo G.Int J Cancer. 2015 Oct 15;137(8):1953-66. [Epub 2015 Apr 28]. doi: 10.1002/ijc.29559. Urol Oncol 2017; 35:117. [PMID: 28159493 DOI: 10.1016/j.urolonc.2016.12.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Epidemiologic studies have reported that moderate alcohol consumption is inversely associated with the risk of renal cancer. However, there is no information available on the associations in renal cancer subsites. From 1992 to 2010, 477,325 men and women in the European Prospective Investigation into Cancer and Nutrition cohort were followed for incident renal cancers (n = 931). Baseline and lifetime alcohol consumption was assessed by country-specific, validated dietary questionnaires. Information on past alcohol consumption was collected by lifestyle questionnaires. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated from Cox proportional hazard models. In multivariate analysis, total alcohol consumption at baseline was inversely associated with renal cancer; the HR and 95% CI for the increasing categories of total alcohol consumption at recruitment vs. the light drinkers category were 0.78 (0.62-0.99), 0.82 (0.64-1.04), 0.70 (0.55-0.90), and 0.91 (0.63-1.30), respectively, (ptrend = 0.001). A similar relationship was observed for average lifetime alcohol consumption and for all renal cancer subsites combined or for renal parenchyma subsite. The trend was not observed in hypertensive individuals and not significant in smokers. In conclusion, moderate alcohol consumption was associated with a decreased risk of renal cancer.
Collapse
|
6
|
Barr AL, Young EH, Smeeth L, Newton R, Seeley J, Ripullone K, Hird TR, Thornton JRM, Nyirenda MJ, Kapiga S, Adebamowo CA, Amoah AG, Wareham N, Rotimi CN, Levitt NS, Ramaiya K, Hennig BJ, Mbanya JC, Tollman S, Motala AA, Kaleebu P, Sandhu MS. The need for an integrated approach for chronic disease research and care in Africa. Glob Health Epidemiol Genom 2016; 1:e19. [PMID: 29868211 PMCID: PMC5870416 DOI: 10.1017/gheg.2016.16] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 08/09/2016] [Accepted: 09/11/2016] [Indexed: 02/06/2023] Open
Abstract
With the changing distribution of infectious diseases, and an increase in the burden of non-communicable diseases, low- and middle-income countries, including those in Africa, will need to expand their health care capacities to effectively respond to these epidemiological transitions. The interrelated risk factors for chronic infectious and non-communicable diseases and the need for long-term disease management, argue for combined strategies to understand their underlying causes and to design strategies for effective prevention and long-term care. Through multidisciplinary research and implementation partnerships, we advocate an integrated approach for research and healthcare for chronic diseases in Africa.
Collapse
Affiliation(s)
- A. L. Barr
- Department of Medicine, University of Cambridge, Cambridge, UK
- Wellcome Trust Sanger Institute, Genome Campus, Hinxton, UK
| | - E. H. Young
- Department of Medicine, University of Cambridge, Cambridge, UK
- Wellcome Trust Sanger Institute, Genome Campus, Hinxton, UK
| | - L. Smeeth
- Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - R. Newton
- Medical Research Council/Uganda Virus Research Institute (MRC/UVRI), Uganda Research Unit on AIDS, Entebbe, Uganda
| | - J. Seeley
- Medical Research Council/Uganda Virus Research Institute (MRC/UVRI), Uganda Research Unit on AIDS, Entebbe, Uganda
- Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - K. Ripullone
- Department of Medicine, University of Cambridge, Cambridge, UK
- Wellcome Trust Sanger Institute, Genome Campus, Hinxton, UK
| | - T. R. Hird
- Department of Medicine, University of Cambridge, Cambridge, UK
- Wellcome Trust Sanger Institute, Genome Campus, Hinxton, UK
| | - J. R. M. Thornton
- Department of Medicine, University of Cambridge, Cambridge, UK
- Wellcome Trust Sanger Institute, Genome Campus, Hinxton, UK
| | - M. J. Nyirenda
- Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
| | - S. Kapiga
- Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
| | - C. A. Adebamowo
- Department of Epidemiology and Public Health, Greenebaum Comprehensive Cancer Center and Institute of Human Virology, University of Maryland School of Medicine, Baltimore MD 21201 USA
- Institute of Human Virology, Nigeria
| | - A. G. Amoah
- Department of Medicine, University of Ghana Medical School, Korlebu, Ghana
| | - N. Wareham
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - C. N. Rotimi
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, USA
| | - N. S. Levitt
- Division of Diabetic Medicine and Endocrinology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - K. Ramaiya
- Shree Hindu Mandal Hospital, Dar es Salaam, Tanzania
| | - B. J. Hennig
- MRC Unit, The Gambia, Fajara, The Gambia
- MRC International Nutrition Group, London School of Hygiene & Tropical Medicine, London, UK
| | - J. C. Mbanya
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - S. Tollman
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- INDEPTH Network, Accra, Ghana
| | - A. A. Motala
- Department of Diabetes and Endocrinology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - P. Kaleebu
- Medical Research Council/Uganda Virus Research Institute (MRC/UVRI), Uganda Research Unit on AIDS, Entebbe, Uganda
| | - M. S. Sandhu
- Department of Medicine, University of Cambridge, Cambridge, UK
- Wellcome Trust Sanger Institute, Genome Campus, Hinxton, UK
| |
Collapse
|
7
|
Wu YT, Luben R, Wareham N, Griffin S, Jones A. Weather, day length and physical activity in older adults: Results from the EPIC Norfolk cohort. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw166.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
8
|
Brand JS, Onland-Moret NC, Eijkemans MJC, Tjønneland A, Roswall N, Overvad K, Fagherazzi G, Clavel-Chapelon F, Dossus L, Lukanova A, Grote V, Bergmann MM, Boeing H, Trichopoulou A, Tzivoglou M, Trichopoulos D, Grioni S, Mattiello A, Masala G, Tumino R, Vineis P, Bueno-de-Mesquita HB, Weiderpass E, Redondo ML, Sánchez MJ, Castaño JMH, Arriola L, Ardanaz E, Duell EJ, Rolandsson O, Franks PW, Butt S, Nilsson P, Khaw KT, Wareham N, Travis R, Romieu I, Gunter MJ, Riboli E, van der Schouw YT. Diabetes and onset of natural menopause: results from the European Prospective Investigation into Cancer and Nutrition. Hum Reprod 2015; 30:1491-8. [PMID: 25779698 PMCID: PMC6284789 DOI: 10.1093/humrep/dev054] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 12/05/2014] [Indexed: 01/10/2023] Open
Abstract
STUDY QUESTION Do women who have diabetes before menopause have their menopause at an earlier age compared with women without diabetes? SUMMARY ANSWER Although there was no overall association between diabetes and age at menopause, our study suggests that early-onset diabetes may accelerate menopause. WHAT IS KNOWN ALREADY Today, more women of childbearing age are being diagnosed with diabetes, but little is known about the impact of diabetes on reproductive health. STUDY DESIGN, SIZE, DURATION We investigated the impact of diabetes on age at natural menopause (ANM) in 258 898 women from the European Prospective Investigation into Cancer and Nutrition (EPIC), enrolled between 1992 and 2000. PARTICIPANTS/MATERIALS, SETTING, METHODS Determinant and outcome information was obtained through questionnaires. Time-dependent Cox regression analyses were used to estimate the associations of diabetes and age at diabetes diagnosis with ANM, stratified by center and adjusted for age, smoking, reproductive and diabetes risk factors and with age from birth to menopause or censoring as the underlying time scale. MAIN RESULTS AND THE ROLE OF CHANCE Overall, no association between diabetes and ANM was found (hazard ratio (HR) = 0.94; 95% confidence interval (CI) 0.89-1.01). However, women with diabetes before the age of 20 years had an earlier menopause (10-20 years: HR = 1.43; 95% CI 1.02-2.01, <10 years: HR = 1.59; 95% CI 1.03-2.43) compared with non-diabetic women, whereas women with diabetes at age 50 years and older had a later menopause (HR = 0.81; 95% CI 0.70-0.95). None of the other age groups were associated with ANM. LIMITATIONS, REASONS FOR CAUTION Strengths of the study include the large sample size and the broad set of potential confounders measured. However, results may have been underestimated due to survival bias. We cannot be sure about the sequence of the events in women with a late age at diabetes, as both events then occur in a short period. We could not distinguish between type 1 and type 2 diabetes. WIDER IMPLICATIONS OF THE FINDINGS Based on the literature, an accelerating effect of early-onset diabetes on ANM might be plausible. A delaying effect of late-onset diabetes on ANM has not been reported before, and is not in agreement with recent studies suggesting the opposite association. STUDY FUNDING/COMPETING INTERESTS The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l'Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France); German Cancer Aid, German Cancer Research Center (DKFZ) and Federal Ministry of Education and Research (BMMF) (Germany); Ministry of Health and Social Solidarity, Stavros Niarchos Foundation and Hellenic Health Foundation (Greece); Italian Association for Research on Cancer (AIRC) and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands); ERC-2009-AdG 232997 and Nordforsk, Nordic Centre of Excellence programme on Food, Nutrition and Health (Norway); Health Research Fund (FIS), Regional Governments of Andalucía, Asturias, Basque Country, Murcia (no. 6236) and Navarra, ISCIII RETIC (RD06/0020) (Spain); Swedish Cancer Society, Swedish Scientific Council and Regional Government of Skåne and Västerbotten (Sweden); Cancer Research UK, Medical Research Council, Stroke Association, British Heart Foundation, Department of Health, Food Standards Agency, and Wellcome Trust (UK). None of the authors reported a conflict of interest.
Collapse
Affiliation(s)
- J S Brand
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - N C Onland-Moret
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M J C Eijkemans
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - A Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - N Roswall
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - K Overvad
- Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - G Fagherazzi
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health Team, F-94805 Villejuif, France
| | - F Clavel-Chapelon
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health Team, F-94805 Villejuif, France
| | - L Dossus
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health Team, F-94805 Villejuif, France
| | - A Lukanova
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany Department of Medical Biosciences, University of Umeå, Umeå, Sweden
| | - V Grote
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - M M Bergmann
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Potsdam, Germany
| | - H Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Potsdam, Germany
| | - A Trichopoulou
- WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, 75 M. Asias Street, Goudi GR-115 27, Athens, Greece Hellenic Health Foundation, 13 Kaisareias Street, Athens GR-115 27, Greece
| | - M Tzivoglou
- Hellenic Health Foundation, 13 Kaisareias Street, Athens GR-115 27, Greece
| | - D Trichopoulos
- Hellenic Health Foundation, 13 Kaisareias Street, Athens GR-115 27, Greece Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA Bureau of Epidemiologic Research, Academy of Athens, 28 Panepistimiou Street, Athens GR-106 79, Greece
| | - S Grioni
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A Mattiello
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - G Masala
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy
| | - R Tumino
- Cancer Registry and Histopathology Unit, 'Civic - M.P. Arezzo' Hospital, ASP Ragusa, Italy
| | - P Vineis
- School of Public Health, Imperial College, London, UK HuGeF Foundation, Torino, Italy
| | - H B Bueno-de-Mesquita
- Dt. for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands Dt. of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands Dt. of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, United Kingdom Dt. of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - E Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway Cancer Registry of Norway, Oslo, Norway Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden Samfundet Folkhälsan, Helsinki, Finland
| | | | - M J Sánchez
- Andalusian School of Public Health, Instituto de Investigación Biosanitaria ibs.GRANADA. Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - J M Huerta Castaño
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain
| | - L Arriola
- Public Health Department of Gipuzkoa, Instituto BIO-Donostia, Basque Government, CIBERESP, San Sebastian, Spain
| | - E Ardanaz
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain Navarre Public Health Institute, Pamplona, Spain
| | - E J Duell
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - O Rolandsson
- Department of Public Health and Clinical Medicine, Family Medicine Umeå University, 901 87 Umeå, Sweden
| | - P W Franks
- Department of Clinical Sciences, Genetic & Molecular Epidemiology Unit, Clinical Research Center, Skåne University Hospital, Lund University, Malmö, Sweden Department of Medicine, Umeå University, Umeå, Sweden
| | - S Butt
- Department of Surgery, Institute of Clinical Sciences, Skåne University Hospital, Lund University, Malmö, Sweden
| | - P Nilsson
- Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmo, Sweden
| | - K T Khaw
- University of Cambridge, Cambridge, UK
| | - N Wareham
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - R Travis
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK
| | - I Romieu
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - M J Gunter
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - E Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Y T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| |
Collapse
|
9
|
Verstappen S, Sergeant J, Luben R, Bhaniani A, Anuj S, MacGregor A, Wareham N, Symmons D, Khaw K, Bruce I. OP0268 Anti-Citrullinated Protein Antibody (ACPA) Status in the General Population and as a Predictor of Future Inflammatory Polyarthritis: The EPIC-2-Noar Study. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4793] [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: 11/03/2022]
|
10
|
Sergeant J, Verstappen S, Morgan C, Luben R, Bhaniani A, Anuj S, MacGregor A, Wareham N, Symmons D, Khaw KT, Bruce I. OP0047 Metabolic and Lifestyle Predictors of Inflammatory Polyarthritis in the EPIC-2-NOAR Study. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3174] [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: 11/04/2022]
|
11
|
Bamia C, Lagiou P, Jenab M, Aleksandrova K, Fedirko V, Trichopoulos D, Overvad K, Tjønneland A, Olsen A, Clavel-Chapelon F, Boutron-Ruault MC, Kvaskoff M, Katzke VA, Kühn T, Boeing H, Nöthlings U, Palli D, Sieri S, Panico S, Tumino R, Naccarati A, Bueno-de-Mesquita HB, Peeters PHM, Weiderpass E, Skeie G, Quirós JR, Agudo A, Chirlaque MD, Sanchez MJ, Ardanaz E, Dorronsoro M, Ericson U, Nilsson LM, Wennberg M, Khaw KT, Wareham N, Key TJ, Travis RC, Ferrari P, Stepien M, Duarte-Salles T, Norat T, Murphy N, Riboli E, Trichopoulou A. Fruit and vegetable consumption in relation to hepatocellular carcinoma in a multi-centre, European cohort study. Br J Cancer 2015; 112:1273-82. [PMID: 25742480 PMCID: PMC4385950 DOI: 10.1038/bjc.2014.654] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 11/19/2014] [Accepted: 12/03/2014] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Vegetable and/or fruit intakes in association with hepatocellular carcinoma (HCC) risk have been investigated in case-control studies conducted in specific European countries and cohort studies conducted in Asia, with inconclusive results. No multi-centre European cohort has investigated the indicated associations. METHODS In 486,799 men/women from the European Prospective Investigation into Cancer and nutrition, we identified 201 HCC cases after 11 years median follow-up. We calculated adjusted hazard ratios (HRs) for HCC incidence for sex-specific quintiles and per 100 g d(-1) increments of vegetable/fruit intakes. RESULTS Higher vegetable intake was associated with a statistically significant, monotonic reduction of HCC risk: HR (100 g d(-1) increment): 0.83; 95% CI: 0.71-0.98. This association was consistent in sensitivity analyses with no apparent heterogeneity across strata of HCC risk factors. Fruit intake was not associated with HCC incidence: HR (100 g d(-1) increment): 1.01; 95% CI: 0.92-1.11. CONCLUSIONS Vegetable, but not fruit, intake is associated with lower HCC risk with no evidence for heterogeneity of this association in strata of important HCC risk factors. Mechanistic studies should clarify pathways underlying this association. Given that HCC prognosis is poor and that vegetables are practically universally accessible, our results may be important, especially for those at high risk for the disease.
Collapse
Affiliation(s)
- C Bamia
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens 115 27, Greece
| | - P Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens 115 27, Greece
- Department of Epidemiology, Harvard School of Public Health, 02115 Boston, MA, USA
- Bureau of Epidemiologic Research, Academy of Athens, Athens 106 79, Greece
| | - M Jenab
- International Agency for Research on Cancer (IARC-WHO), 69372 Lyon, France
| | - K Aleksandrova
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal 14558, Germany
| | - V Fedirko
- Department of Epidemiology, Rollins School of Public Health, Winship Cancer Institute, Emory University, Atlanta 30322, GA, USA
| | - D Trichopoulos
- Department of Epidemiology, Harvard School of Public Health, 02115 Boston, MA, USA
- Bureau of Epidemiologic Research, Academy of Athens, Athens 106 79, Greece
- Hellenic Health Foundation, Athens 115 27, Greece
| | - K Overvad
- Department of Public Health, Section for Epidemiology, Aarhus University, DK-8000 Aarhus C, Denmark
| | - A Tjønneland
- Danish Cancer Society Research Center, DK-2100 Copenhagen, Denmark
| | - A Olsen
- Danish Cancer Society Research Center, DK-2100 Copenhagen, Denmark
| | - F Clavel-Chapelon
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health Team, Villejuif, F-94805 Paris, France
- Paris South University, UMRS 1018, Villejuif, F-94805 Paris, France
- IGR, Villejuif, F-94805 Paris, France
| | - M-C Boutron-Ruault
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health Team, Villejuif, F-94805 Paris, France
- Paris South University, UMRS 1018, Villejuif, F-94805 Paris, France
- IGR, Villejuif, F-94805 Paris, France
| | - M Kvaskoff
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health Team, Villejuif, F-94805 Paris, France
- Paris South University, UMRS 1018, Villejuif, F-94805 Paris, France
- IGR, Villejuif, F-94805 Paris, France
| | - V A Katzke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - T Kühn
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - H Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal 14558, Germany
| | - U Nöthlings
- Department of Nutrition and Food Sciences, University of Bonn, 53111 Bonn, Germany
| | - D Palli
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute–ISPO, 50139 Florence, Italy
| | - S Sieri
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | - S Panico
- Dipartimento di Medicina Clinica e Chirurgia Federico II University, 80131 Naples, Italy
| | - R Tumino
- Cancer Registry and Histopathology Unit, ‘Civic–M.P. Arezzo' Hospital, ASP 97100 Ragusa, Italy
| | - A Naccarati
- HuGeF–Human Genetics Foundation–Torino Molecular and Genetic Epidemiology Unit, 10126 Torino, Italy
| | - HB(as) Bueno-de-Mesquita
- Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), 3720 BA Bilthoven, The Netherlands
- Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, 3508 GA Utrecht, The Netherlands
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
- Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, Imperial College, W2 1NY UK London, UK
| | - P H M Peeters
- Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, Imperial College, W2 1NY UK London, UK
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands
| | - E Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, N-9037 Tromsø, Norway
- Cancer Registry of Norway, NO-0304 Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 Stockholm, Sweden
- Department of Genetic Epidemiology, Folkhälsan Research Center, 00250 Helsinki, Finland
| | - G Skeie
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, N-9037 Tromsø, Norway
| | - J R Quirós
- Public Health Directorate, CP 33006 Oviedo, Asturias, Spain
| | - A Agudo
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), 08908 Barcelona, Spain
| | - M-D Chirlaque
- Epidemiology Department, Murcia Regional Health Council, E-30008 Murcia, Spain
- CIBER Epidemiology and Public Health CIBERESP, 28029 Madrid, Spain
| | - M-J Sanchez
- CIBER Epidemiology and Public Health CIBERESP, 28029 Madrid, Spain
- Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs, GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, 18080 Granada, Spain
| | - E Ardanaz
- CIBER Epidemiology and Public Health CIBERESP, 28029 Madrid, Spain
- Navarre Public Health Institute, 31003 Pamplona, Spain
| | - M Dorronsoro
- Basque Regional Health Department, Public Health Direction, 4-20013 Donostia, San Sebastian, Spain
- Biodonostia Research Institute CIBER Epidemiology and Public Health CIBERESP, s/n 20014 San Sebastian, Spain
| | - U Ericson
- Diabetes and Cardiovascular disease, Genetic Epidemiology Department of Clinical Sciences in Malmö Lund University, SE-205 92 Malmo, Sweden
| | - L M Nilsson
- Department of Nutritional Research, Public Health and Clinical Medicine, Umeå University, SE-901 85 Umeå, Sweden
- Arcum, Arctic Research Centre at Umeå University, SE-901 85 Umeå, Sweden
| | - M Wennberg
- Department of Nutritional Research, Public Health and Clinical Medicine, Umeå University, SE-901 85 Umeå, Sweden
| | - K-T Khaw
- University of Cambridge, CB2 0SR Cambridge, UK
| | - N Wareham
- University of Cambridge, CB2 0SR Cambridge, UK
- MRC Epidemiology Unit, CB2 0QQ Cambridge, UK
| | - T J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, OX3 7LF Oxford, UK
| | - R C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, OX3 7LF Oxford, UK
| | - P Ferrari
- International Agency for Research on Cancer (IARC-WHO), 69372 Lyon, France
| | - M Stepien
- International Agency for Research on Cancer (IARC-WHO), 69372 Lyon, France
| | - T Duarte-Salles
- International Agency for Research on Cancer (IARC-WHO), 69372 Lyon, France
| | - T Norat
- Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, Imperial College, W2 1NY UK London, UK
| | - N Murphy
- Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, Imperial College, W2 1NY UK London, UK
| | - E Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, Imperial College, W2 1NY UK London, UK
| | - A Trichopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens 115 27, Greece
- Hellenic Health Foundation, Athens 115 27, Greece
| |
Collapse
|
12
|
Lauria A, Barker A, Schloot N, Hosszufalusi N, Ludvigsson J, Mathieu C, Mauricio D, Nordwall M, Van der Schueren B, Mandrup-Poulsen T, Scherbaum WA, Weets I, Gorus FK, Wareham N, Leslie RD, Pozzilli P. BMI is an important driver of β-cell loss in type 1 diabetes upon diagnosis in 10 to 18-year-old children. Eur J Endocrinol 2015; 172:107-13. [PMID: 25378371 DOI: 10.1530/eje-14-0522] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Body weight-related insulin resistance probably plays a role in progression to type 1 diabetes, but has an uncertain impact following diagnosis. In this study, we investigated whether BMI measured at diagnosis was an independent predictor of C-peptide decline 1-year post-diagnosis. DESIGN Multicentre longitudinal study carried out at diagnosis and up to 1-year follow-up. METHODS Data on C-peptide were collected from seven diabetes centres in Europe. Patients were grouped according to age at diagnosis (<5 years, n=126; >5 years <10 years, n=295; >10 years <18 years, n=421; >18 years, n=410). Linear regression was used to investigate whether BMI was an independent predictor of change in fasting C-peptide over 1 year. Models were additionally adjusted for baseline insulin dose and HbA1c. RESULTS In individuals diagnosed between 0 and 5 years, 5 and 10 years and those diagnosed >18 years, we found no association between BMI and C-peptide decline. In patients aged 10-18 years, higher BMI at baseline was associated with a greater decline in fasting C-peptide over 1 year with a decrease (β 95% CI; P value) of 0.025 (0.010, 0.041) nM/kg per m(2) higher baseline BMI (P=0.001). This association remained significant after adjusting for gender and differences in HbA1c and insulin dose (β=0.026, 95% CI=0.0097, 0.042; P=0.002). CONCLUSIONS These observations indicate that increased body weight and increased insulin demand are associated with more rapid disease progression after diagnosis of type 1 diabetes in an age group 10-18 years. This should be considered in studies of β-cell function in type 1 diabetes.
Collapse
Affiliation(s)
- A Lauria
- Department of Endocrinology and DiabetesUniversity Campus Bio-Medico, Via Alvaro del Portillo, Rome 21 00128, ItalyMRC Epidemiology UnitCambridge, UKInstitute for Clinical DiabetologyGerman Diabetes Centre, Leibniz-Institute for Diabetes Research and Clinic for Metabolic Diseases Heinrich Heine University, Dusseldorf, GermanySemmelweis University3rd Department of Internal Medicine, Linkoping University, Linkoping, SwedenDivision of PediatricsDepartment of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, SwedenLaboratory for Experimental Medicine and EndocrinologyKatholieke Universiteit Leuven, Leuven, BelgiumDepartment EndocrinologyHospital Arnau de Vilanova, Lleida, SpainPediatric ClinicVrinnevi Hospital, Norrköping, SwedenDepartment of Biomedical SciencesUniversity of Copenhagen, Copenhagen, DenmarkDepartment of EndocrinologyDiabetes and Rheumatology, Heinrich Heine University, Dusseldorf, GermanyDiabetes Research Center and Academic Hospital (UZ Brussel)Vrije Universiteit Brussel (VUB), Brussel, BelgiumBelgian Diabetes Registry (BDR)Brussels, BelgiumCentre of DiabetesBlizard Institute, Barts and The London School of Medicine, Queen Mary University of London, London, UKDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, Sweden
| | - A Barker
- Department of Endocrinology and DiabetesUniversity Campus Bio-Medico, Via Alvaro del Portillo, Rome 21 00128, ItalyMRC Epidemiology UnitCambridge, UKInstitute for Clinical DiabetologyGerman Diabetes Centre, Leibniz-Institute for Diabetes Research and Clinic for Metabolic Diseases Heinrich Heine University, Dusseldorf, GermanySemmelweis University3rd Department of Internal Medicine, Linkoping University, Linkoping, SwedenDivision of PediatricsDepartment of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, SwedenLaboratory for Experimental Medicine and EndocrinologyKatholieke Universiteit Leuven, Leuven, BelgiumDepartment EndocrinologyHospital Arnau de Vilanova, Lleida, SpainPediatric ClinicVrinnevi Hospital, Norrköping, SwedenDepartment of Biomedical SciencesUniversity of Copenhagen, Copenhagen, DenmarkDepartment of EndocrinologyDiabetes and Rheumatology, Heinrich Heine University, Dusseldorf, GermanyDiabetes Research Center and Academic Hospital (UZ Brussel)Vrije Universiteit Brussel (VUB), Brussel, BelgiumBelgian Diabetes Registry (BDR)Brussels, BelgiumCentre of DiabetesBlizard Institute, Barts and The London School of Medicine, Queen Mary University of London, London, UKDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, Sweden
| | - N Schloot
- Department of Endocrinology and DiabetesUniversity Campus Bio-Medico, Via Alvaro del Portillo, Rome 21 00128, ItalyMRC Epidemiology UnitCambridge, UKInstitute for Clinical DiabetologyGerman Diabetes Centre, Leibniz-Institute for Diabetes Research and Clinic for Metabolic Diseases Heinrich Heine University, Dusseldorf, GermanySemmelweis University3rd Department of Internal Medicine, Linkoping University, Linkoping, SwedenDivision of PediatricsDepartment of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, SwedenLaboratory for Experimental Medicine and EndocrinologyKatholieke Universiteit Leuven, Leuven, BelgiumDepartment EndocrinologyHospital Arnau de Vilanova, Lleida, SpainPediatric ClinicVrinnevi Hospital, Norrköping, SwedenDepartment of Biomedical SciencesUniversity of Copenhagen, Copenhagen, DenmarkDepartment of EndocrinologyDiabetes and Rheumatology, Heinrich Heine University, Dusseldorf, GermanyDiabetes Research Center and Academic Hospital (UZ Brussel)Vrije Universiteit Brussel (VUB), Brussel, BelgiumBelgian Diabetes Registry (BDR)Brussels, BelgiumCentre of DiabetesBlizard Institute, Barts and The London School of Medicine, Queen Mary University of London, London, UKDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, Sweden
| | - N Hosszufalusi
- Department of Endocrinology and DiabetesUniversity Campus Bio-Medico, Via Alvaro del Portillo, Rome 21 00128, ItalyMRC Epidemiology UnitCambridge, UKInstitute for Clinical DiabetologyGerman Diabetes Centre, Leibniz-Institute for Diabetes Research and Clinic for Metabolic Diseases Heinrich Heine University, Dusseldorf, GermanySemmelweis University3rd Department of Internal Medicine, Linkoping University, Linkoping, SwedenDivision of PediatricsDepartment of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, SwedenLaboratory for Experimental Medicine and EndocrinologyKatholieke Universiteit Leuven, Leuven, BelgiumDepartment EndocrinologyHospital Arnau de Vilanova, Lleida, SpainPediatric ClinicVrinnevi Hospital, Norrköping, SwedenDepartment of Biomedical SciencesUniversity of Copenhagen, Copenhagen, DenmarkDepartment of EndocrinologyDiabetes and Rheumatology, Heinrich Heine University, Dusseldorf, GermanyDiabetes Research Center and Academic Hospital (UZ Brussel)Vrije Universiteit Brussel (VUB), Brussel, BelgiumBelgian Diabetes Registry (BDR)Brussels, BelgiumCentre of DiabetesBlizard Institute, Barts and The London School of Medicine, Queen Mary University of London, London, UKDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, Sweden
| | - J Ludvigsson
- Department of Endocrinology and DiabetesUniversity Campus Bio-Medico, Via Alvaro del Portillo, Rome 21 00128, ItalyMRC Epidemiology UnitCambridge, UKInstitute for Clinical DiabetologyGerman Diabetes Centre, Leibniz-Institute for Diabetes Research and Clinic for Metabolic Diseases Heinrich Heine University, Dusseldorf, GermanySemmelweis University3rd Department of Internal Medicine, Linkoping University, Linkoping, SwedenDivision of PediatricsDepartment of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, SwedenLaboratory for Experimental Medicine and EndocrinologyKatholieke Universiteit Leuven, Leuven, BelgiumDepartment EndocrinologyHospital Arnau de Vilanova, Lleida, SpainPediatric ClinicVrinnevi Hospital, Norrköping, SwedenDepartment of Biomedical SciencesUniversity of Copenhagen, Copenhagen, DenmarkDepartment of EndocrinologyDiabetes and Rheumatology, Heinrich Heine University, Dusseldorf, GermanyDiabetes Research Center and Academic Hospital (UZ Brussel)Vrije Universiteit Brussel (VUB), Brussel, BelgiumBelgian Diabetes Registry (BDR)Brussels, BelgiumCentre of DiabetesBlizard Institute, Barts and The London School of Medicine, Queen Mary University of London, London, UKDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, Sweden
| | - C Mathieu
- Department of Endocrinology and DiabetesUniversity Campus Bio-Medico, Via Alvaro del Portillo, Rome 21 00128, ItalyMRC Epidemiology UnitCambridge, UKInstitute for Clinical DiabetologyGerman Diabetes Centre, Leibniz-Institute for Diabetes Research and Clinic for Metabolic Diseases Heinrich Heine University, Dusseldorf, GermanySemmelweis University3rd Department of Internal Medicine, Linkoping University, Linkoping, SwedenDivision of PediatricsDepartment of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, SwedenLaboratory for Experimental Medicine and EndocrinologyKatholieke Universiteit Leuven, Leuven, BelgiumDepartment EndocrinologyHospital Arnau de Vilanova, Lleida, SpainPediatric ClinicVrinnevi Hospital, Norrköping, SwedenDepartment of Biomedical SciencesUniversity of Copenhagen, Copenhagen, DenmarkDepartment of EndocrinologyDiabetes and Rheumatology, Heinrich Heine University, Dusseldorf, GermanyDiabetes Research Center and Academic Hospital (UZ Brussel)Vrije Universiteit Brussel (VUB), Brussel, BelgiumBelgian Diabetes Registry (BDR)Brussels, BelgiumCentre of DiabetesBlizard Institute, Barts and The London School of Medicine, Queen Mary University of London, London, UKDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, Sweden
| | - D Mauricio
- Department of Endocrinology and DiabetesUniversity Campus Bio-Medico, Via Alvaro del Portillo, Rome 21 00128, ItalyMRC Epidemiology UnitCambridge, UKInstitute for Clinical DiabetologyGerman Diabetes Centre, Leibniz-Institute for Diabetes Research and Clinic for Metabolic Diseases Heinrich Heine University, Dusseldorf, GermanySemmelweis University3rd Department of Internal Medicine, Linkoping University, Linkoping, SwedenDivision of PediatricsDepartment of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, SwedenLaboratory for Experimental Medicine and EndocrinologyKatholieke Universiteit Leuven, Leuven, BelgiumDepartment EndocrinologyHospital Arnau de Vilanova, Lleida, SpainPediatric ClinicVrinnevi Hospital, Norrköping, SwedenDepartment of Biomedical SciencesUniversity of Copenhagen, Copenhagen, DenmarkDepartment of EndocrinologyDiabetes and Rheumatology, Heinrich Heine University, Dusseldorf, GermanyDiabetes Research Center and Academic Hospital (UZ Brussel)Vrije Universiteit Brussel (VUB), Brussel, BelgiumBelgian Diabetes Registry (BDR)Brussels, BelgiumCentre of DiabetesBlizard Institute, Barts and The London School of Medicine, Queen Mary University of London, London, UKDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, Sweden
| | - M Nordwall
- Department of Endocrinology and DiabetesUniversity Campus Bio-Medico, Via Alvaro del Portillo, Rome 21 00128, ItalyMRC Epidemiology UnitCambridge, UKInstitute for Clinical DiabetologyGerman Diabetes Centre, Leibniz-Institute for Diabetes Research and Clinic for Metabolic Diseases Heinrich Heine University, Dusseldorf, GermanySemmelweis University3rd Department of Internal Medicine, Linkoping University, Linkoping, SwedenDivision of PediatricsDepartment of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, SwedenLaboratory for Experimental Medicine and EndocrinologyKatholieke Universiteit Leuven, Leuven, BelgiumDepartment EndocrinologyHospital Arnau de Vilanova, Lleida, SpainPediatric ClinicVrinnevi Hospital, Norrköping, SwedenDepartment of Biomedical SciencesUniversity of Copenhagen, Copenhagen, DenmarkDepartment of EndocrinologyDiabetes and Rheumatology, Heinrich Heine University, Dusseldorf, GermanyDiabetes Research Center and Academic Hospital (UZ Brussel)Vrije Universiteit Brussel (VUB), Brussel, BelgiumBelgian Diabetes Registry (BDR)Brussels, BelgiumCentre of DiabetesBlizard Institute, Barts and The London School of Medicine, Queen Mary University of London, London, UKDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, Sweden Department of Endocrinology and DiabetesUniversity Campus Bio-Medico, Via Alvaro del Portillo, Rome 21 00128, ItalyMRC Epidemiology UnitCambridge, UKInstitute for Clinical DiabetologyGerman Diabetes Centre, Leibniz-Institute for Diabetes Research and Clinic for Metabolic Diseases Heinrich Heine University, Dusseldorf, GermanySemmelweis University3rd Department of Internal Medicine, Linkoping University, Linkoping, SwedenDivision of PediatricsDepartment of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, SwedenLaboratory for Experimental Medicine and EndocrinologyKatholieke Universiteit Leuven, Leuven, BelgiumDepartme
| | - B Van der Schueren
- Department of Endocrinology and DiabetesUniversity Campus Bio-Medico, Via Alvaro del Portillo, Rome 21 00128, ItalyMRC Epidemiology UnitCambridge, UKInstitute for Clinical DiabetologyGerman Diabetes Centre, Leibniz-Institute for Diabetes Research and Clinic for Metabolic Diseases Heinrich Heine University, Dusseldorf, GermanySemmelweis University3rd Department of Internal Medicine, Linkoping University, Linkoping, SwedenDivision of PediatricsDepartment of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, SwedenLaboratory for Experimental Medicine and EndocrinologyKatholieke Universiteit Leuven, Leuven, BelgiumDepartment EndocrinologyHospital Arnau de Vilanova, Lleida, SpainPediatric ClinicVrinnevi Hospital, Norrköping, SwedenDepartment of Biomedical SciencesUniversity of Copenhagen, Copenhagen, DenmarkDepartment of EndocrinologyDiabetes and Rheumatology, Heinrich Heine University, Dusseldorf, GermanyDiabetes Research Center and Academic Hospital (UZ Brussel)Vrije Universiteit Brussel (VUB), Brussel, BelgiumBelgian Diabetes Registry (BDR)Brussels, BelgiumCentre of DiabetesBlizard Institute, Barts and The London School of Medicine, Queen Mary University of London, London, UKDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, Sweden
| | - T Mandrup-Poulsen
- Department of Endocrinology and DiabetesUniversity Campus Bio-Medico, Via Alvaro del Portillo, Rome 21 00128, ItalyMRC Epidemiology UnitCambridge, UKInstitute for Clinical DiabetologyGerman Diabetes Centre, Leibniz-Institute for Diabetes Research and Clinic for Metabolic Diseases Heinrich Heine University, Dusseldorf, GermanySemmelweis University3rd Department of Internal Medicine, Linkoping University, Linkoping, SwedenDivision of PediatricsDepartment of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, SwedenLaboratory for Experimental Medicine and EndocrinologyKatholieke Universiteit Leuven, Leuven, BelgiumDepartment EndocrinologyHospital Arnau de Vilanova, Lleida, SpainPediatric ClinicVrinnevi Hospital, Norrköping, SwedenDepartment of Biomedical SciencesUniversity of Copenhagen, Copenhagen, DenmarkDepartment of EndocrinologyDiabetes and Rheumatology, Heinrich Heine University, Dusseldorf, GermanyDiabetes Research Center and Academic Hospital (UZ Brussel)Vrije Universiteit Brussel (VUB), Brussel, BelgiumBelgian Diabetes Registry (BDR)Brussels, BelgiumCentre of DiabetesBlizard Institute, Barts and The London School of Medicine, Queen Mary University of London, London, UKDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, Sweden Department of Endocrinology and DiabetesUniversity Campus Bio-Medico, Via Alvaro del Portillo, Rome 21 00128, ItalyMRC Epidemiology UnitCambridge, UKInstitute for Clinical DiabetologyGerman Diabetes Centre, Leibniz-Institute for Diabetes Research and Clinic for Metabolic Diseases Heinrich Heine University, Dusseldorf, GermanySemmelweis University3rd Department of Internal Medicine, Linkoping University, Linkoping, SwedenDivision of PediatricsDepartment of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, SwedenLaboratory for Experimental Medicine and EndocrinologyKatholieke Universiteit Leuven, Leuven, BelgiumDepartme
| | - W A Scherbaum
- Department of Endocrinology and DiabetesUniversity Campus Bio-Medico, Via Alvaro del Portillo, Rome 21 00128, ItalyMRC Epidemiology UnitCambridge, UKInstitute for Clinical DiabetologyGerman Diabetes Centre, Leibniz-Institute for Diabetes Research and Clinic for Metabolic Diseases Heinrich Heine University, Dusseldorf, GermanySemmelweis University3rd Department of Internal Medicine, Linkoping University, Linkoping, SwedenDivision of PediatricsDepartment of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, SwedenLaboratory for Experimental Medicine and EndocrinologyKatholieke Universiteit Leuven, Leuven, BelgiumDepartment EndocrinologyHospital Arnau de Vilanova, Lleida, SpainPediatric ClinicVrinnevi Hospital, Norrköping, SwedenDepartment of Biomedical SciencesUniversity of Copenhagen, Copenhagen, DenmarkDepartment of EndocrinologyDiabetes and Rheumatology, Heinrich Heine University, Dusseldorf, GermanyDiabetes Research Center and Academic Hospital (UZ Brussel)Vrije Universiteit Brussel (VUB), Brussel, BelgiumBelgian Diabetes Registry (BDR)Brussels, BelgiumCentre of DiabetesBlizard Institute, Barts and The London School of Medicine, Queen Mary University of London, London, UKDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, Sweden
| | - I Weets
- Department of Endocrinology and DiabetesUniversity Campus Bio-Medico, Via Alvaro del Portillo, Rome 21 00128, ItalyMRC Epidemiology UnitCambridge, UKInstitute for Clinical DiabetologyGerman Diabetes Centre, Leibniz-Institute for Diabetes Research and Clinic for Metabolic Diseases Heinrich Heine University, Dusseldorf, GermanySemmelweis University3rd Department of Internal Medicine, Linkoping University, Linkoping, SwedenDivision of PediatricsDepartment of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, SwedenLaboratory for Experimental Medicine and EndocrinologyKatholieke Universiteit Leuven, Leuven, BelgiumDepartment EndocrinologyHospital Arnau de Vilanova, Lleida, SpainPediatric ClinicVrinnevi Hospital, Norrköping, SwedenDepartment of Biomedical SciencesUniversity of Copenhagen, Copenhagen, DenmarkDepartment of EndocrinologyDiabetes and Rheumatology, Heinrich Heine University, Dusseldorf, GermanyDiabetes Research Center and Academic Hospital (UZ Brussel)Vrije Universiteit Brussel (VUB), Brussel, BelgiumBelgian Diabetes Registry (BDR)Brussels, BelgiumCentre of DiabetesBlizard Institute, Barts and The London School of Medicine, Queen Mary University of London, London, UKDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, Sweden Department of Endocrinology and DiabetesUniversity Campus Bio-Medico, Via Alvaro del Portillo, Rome 21 00128, ItalyMRC Epidemiology UnitCambridge, UKInstitute for Clinical DiabetologyGerman Diabetes Centre, Leibniz-Institute for Diabetes Research and Clinic for Metabolic Diseases Heinrich Heine University, Dusseldorf, GermanySemmelweis University3rd Department of Internal Medicine, Linkoping University, Linkoping, SwedenDivision of PediatricsDepartment of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, SwedenLaboratory for Experimental Medicine and EndocrinologyKatholieke Universiteit Leuven, Leuven, BelgiumDepartme
| | - F K Gorus
- Department of Endocrinology and DiabetesUniversity Campus Bio-Medico, Via Alvaro del Portillo, Rome 21 00128, ItalyMRC Epidemiology UnitCambridge, UKInstitute for Clinical DiabetologyGerman Diabetes Centre, Leibniz-Institute for Diabetes Research and Clinic for Metabolic Diseases Heinrich Heine University, Dusseldorf, GermanySemmelweis University3rd Department of Internal Medicine, Linkoping University, Linkoping, SwedenDivision of PediatricsDepartment of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, SwedenLaboratory for Experimental Medicine and EndocrinologyKatholieke Universiteit Leuven, Leuven, BelgiumDepartment EndocrinologyHospital Arnau de Vilanova, Lleida, SpainPediatric ClinicVrinnevi Hospital, Norrköping, SwedenDepartment of Biomedical SciencesUniversity of Copenhagen, Copenhagen, DenmarkDepartment of EndocrinologyDiabetes and Rheumatology, Heinrich Heine University, Dusseldorf, GermanyDiabetes Research Center and Academic Hospital (UZ Brussel)Vrije Universiteit Brussel (VUB), Brussel, BelgiumBelgian Diabetes Registry (BDR)Brussels, BelgiumCentre of DiabetesBlizard Institute, Barts and The London School of Medicine, Queen Mary University of London, London, UKDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, Sweden Department of Endocrinology and DiabetesUniversity Campus Bio-Medico, Via Alvaro del Portillo, Rome 21 00128, ItalyMRC Epidemiology UnitCambridge, UKInstitute for Clinical DiabetologyGerman Diabetes Centre, Leibniz-Institute for Diabetes Research and Clinic for Metabolic Diseases Heinrich Heine University, Dusseldorf, GermanySemmelweis University3rd Department of Internal Medicine, Linkoping University, Linkoping, SwedenDivision of PediatricsDepartment of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, SwedenLaboratory for Experimental Medicine and EndocrinologyKatholieke Universiteit Leuven, Leuven, BelgiumDepartme
| | - N Wareham
- Department of Endocrinology and DiabetesUniversity Campus Bio-Medico, Via Alvaro del Portillo, Rome 21 00128, ItalyMRC Epidemiology UnitCambridge, UKInstitute for Clinical DiabetologyGerman Diabetes Centre, Leibniz-Institute for Diabetes Research and Clinic for Metabolic Diseases Heinrich Heine University, Dusseldorf, GermanySemmelweis University3rd Department of Internal Medicine, Linkoping University, Linkoping, SwedenDivision of PediatricsDepartment of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, SwedenLaboratory for Experimental Medicine and EndocrinologyKatholieke Universiteit Leuven, Leuven, BelgiumDepartment EndocrinologyHospital Arnau de Vilanova, Lleida, SpainPediatric ClinicVrinnevi Hospital, Norrköping, SwedenDepartment of Biomedical SciencesUniversity of Copenhagen, Copenhagen, DenmarkDepartment of EndocrinologyDiabetes and Rheumatology, Heinrich Heine University, Dusseldorf, GermanyDiabetes Research Center and Academic Hospital (UZ Brussel)Vrije Universiteit Brussel (VUB), Brussel, BelgiumBelgian Diabetes Registry (BDR)Brussels, BelgiumCentre of DiabetesBlizard Institute, Barts and The London School of Medicine, Queen Mary University of London, London, UKDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, Sweden
| | - R D Leslie
- Department of Endocrinology and DiabetesUniversity Campus Bio-Medico, Via Alvaro del Portillo, Rome 21 00128, ItalyMRC Epidemiology UnitCambridge, UKInstitute for Clinical DiabetologyGerman Diabetes Centre, Leibniz-Institute for Diabetes Research and Clinic for Metabolic Diseases Heinrich Heine University, Dusseldorf, GermanySemmelweis University3rd Department of Internal Medicine, Linkoping University, Linkoping, SwedenDivision of PediatricsDepartment of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, SwedenLaboratory for Experimental Medicine and EndocrinologyKatholieke Universiteit Leuven, Leuven, BelgiumDepartment EndocrinologyHospital Arnau de Vilanova, Lleida, SpainPediatric ClinicVrinnevi Hospital, Norrköping, SwedenDepartment of Biomedical SciencesUniversity of Copenhagen, Copenhagen, DenmarkDepartment of EndocrinologyDiabetes and Rheumatology, Heinrich Heine University, Dusseldorf, GermanyDiabetes Research Center and Academic Hospital (UZ Brussel)Vrije Universiteit Brussel (VUB), Brussel, BelgiumBelgian Diabetes Registry (BDR)Brussels, BelgiumCentre of DiabetesBlizard Institute, Barts and The London School of Medicine, Queen Mary University of London, London, UKDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, Sweden
| | - P Pozzilli
- Department of Endocrinology and DiabetesUniversity Campus Bio-Medico, Via Alvaro del Portillo, Rome 21 00128, ItalyMRC Epidemiology UnitCambridge, UKInstitute for Clinical DiabetologyGerman Diabetes Centre, Leibniz-Institute for Diabetes Research and Clinic for Metabolic Diseases Heinrich Heine University, Dusseldorf, GermanySemmelweis University3rd Department of Internal Medicine, Linkoping University, Linkoping, SwedenDivision of PediatricsDepartment of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, SwedenLaboratory for Experimental Medicine and EndocrinologyKatholieke Universiteit Leuven, Leuven, BelgiumDepartment EndocrinologyHospital Arnau de Vilanova, Lleida, SpainPediatric ClinicVrinnevi Hospital, Norrköping, SwedenDepartment of Biomedical SciencesUniversity of Copenhagen, Copenhagen, DenmarkDepartment of EndocrinologyDiabetes and Rheumatology, Heinrich Heine University, Dusseldorf, GermanyDiabetes Research Center and Academic Hospital (UZ Brussel)Vrije Universiteit Brussel (VUB), Brussel, BelgiumBelgian Diabetes Registry (BDR)Brussels, BelgiumCentre of DiabetesBlizard Institute, Barts and The London School of Medicine, Queen Mary University of London, London, UKDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, Sweden Department of Endocrinology and DiabetesUniversity Campus Bio-Medico, Via Alvaro del Portillo, Rome 21 00128, ItalyMRC Epidemiology UnitCambridge, UKInstitute for Clinical DiabetologyGerman Diabetes Centre, Leibniz-Institute for Diabetes Research and Clinic for Metabolic Diseases Heinrich Heine University, Dusseldorf, GermanySemmelweis University3rd Department of Internal Medicine, Linkoping University, Linkoping, SwedenDivision of PediatricsDepartment of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, SwedenLaboratory for Experimental Medicine and EndocrinologyKatholieke Universiteit Leuven, Leuven, BelgiumDepartme
| |
Collapse
|
13
|
Obón-Santacana M, Kaaks R, Slimani N, Lujan-Barroso L, Freisling H, Ferrari P, Dossus L, Chabbert-Buffet N, Baglietto L, Fortner RT, Boeing H, Tjønneland A, Olsen A, Overvad K, Menéndez V, Molina-Montes E, Larrañaga N, Chirlaque MD, Ardanaz E, Khaw KT, Wareham N, Travis RC, Lu Y, Merritt MA, Trichopoulou A, Benetou V, Trichopoulos D, Saieva C, Sieri S, Tumino R, Sacerdote C, Galasso R, Bueno-de-Mesquita HB, Wirfält E, Ericson U, Idahl A, Ohlson N, Skeie G, Gram IT, Weiderpass E, Onland-Moret NC, Riboli E, Duell EJ. Dietary intake of acrylamide and endometrial cancer risk in the European Prospective Investigation into Cancer and Nutrition cohort. Br J Cancer 2014; 111:987-97. [PMID: 24937665 PMCID: PMC4150262 DOI: 10.1038/bjc.2014.328] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 05/12/2014] [Accepted: 05/14/2014] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Three prospective studies have evaluated the association between dietary acrylamide intake and endometrial cancer (EC) risk with inconsistent results. The objective of this study was to evaluate the association between acrylamide intake and EC risk: for overall EC, for type-I EC, and in never smokers and never users of oral contraceptives (OCs). Smoking is a source of acrylamide, and OC use is a protective factor for EC risk. METHODS Cox regression was used to estimate hazard ratios (HRs) for the association between acrylamide intake and EC risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Acrylamide intake was estimated from the EU acrylamide monitoring database, which was matched with EPIC questionnaire-based food consumption data. Acrylamide intake was energy adjusted using the residual method. RESULTS No associations were observed between acrylamide intake and overall EC (n=1382) or type-I EC risk (n=627). We observed increasing relative risks for type-I EC with increasing acrylamide intake among women who both never smoked and were non-users of OCs (HRQ5vsQ1: 1.97, 95% CI: 1.08-3.62; likelihood ratio test (LRT) P-value: 0.01, n=203). CONCLUSIONS Dietary intake of acrylamide was not associated with overall or type-I EC risk; however, positive associations with type I were observed in women who were both non-users of OCs and never smokers.
Collapse
Affiliation(s)
- M Obón-Santacana
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), Avda Gran Via Barcelona 199-203, 08908L'Hospitalet de Llobregat, Barcelona, Spain
| | - R Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, Heidelberg 69120, Germany
| | - N Slimani
- Dietary Exposure Assessment Group, International Agency for Research on Cancer, 150 Cours Albert Thomas, Lyon 69372, France
| | - L Lujan-Barroso
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), Avda Gran Via Barcelona 199-203, 08908L'Hospitalet de Llobregat, Barcelona, Spain
| | - H Freisling
- Dietary Exposure Assessment Group, International Agency for Research on Cancer, 150 Cours Albert Thomas, Lyon 69372, France
| | - P Ferrari
- Nutritional Epidemiology Group, International Agency for Research on Cancer, 150 Cours Albert Thomas, Lyon 69372, France
| | - L Dossus
- Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health team, F-94805 Villejuif, France
- Paris-Sud University, UMRS 1018, F-94805 Villejuif, France
- Institut Gustave Roussy, F-94805 Villejuif, France
| | - N Chabbert-Buffet
- Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health team, F-94805 Villejuif, France
- Paris-Sud University, UMRS 1018, F-94805 Villejuif, France
- Institut Gustave Roussy, F-94805 Villejuif, France
- Obstetrics and Gynecology Department AP-HP, Hopital Tenon, F-75020 Paris, France
| | - L Baglietto
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Molecular, Environmental, Genetic, and Analytic Epidemiology, The University of Melbourne, Melbourne, VIC, Australia
| | - R T Fortner
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, Heidelberg 69120, Germany
| | - H Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114/116, Nuthetal 14558, Germany
| | - A Tjønneland
- Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen 2100, Denmark
| | - A Olsen
- Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen 2100, Denmark
| | - K Overvad
- Department of Public Health, Section for Epidemiology, Aarhus University, Nordre Ringgade 1, Aarhus 8000, Denmark
| | - V Menéndez
- Public Health and Participation Directorate, Ciriaco Miguel Vigil 9, Asturias 33009, Spain
| | - E Molina-Montes
- CIBER Epidemiology and Public Health CIBERESP, Melchor Fernández Almagro 3-5, Madrid 28029, Spain
| | - N Larrañaga
- CIBER Epidemiology and Public Health CIBERESP, Melchor Fernández Almagro 3-5, Madrid 28029, Spain
- Public Health Division of Gipuzkoa-BIODONOSTIA, Basque Regional Health Department, Avda. Navarra, 4, San Sebastian 20013, Spain
| | - M-D Chirlaque
- CIBER Epidemiology and Public Health CIBERESP, Melchor Fernández Almagro 3-5, Madrid 28029, Spain
- Department of Epidemiology, Murcia Regional Health Authority, Ronda de Levante, 11, Murcia 30008, Spain
| | - E Ardanaz
- CIBER Epidemiology and Public Health CIBERESP, Melchor Fernández Almagro 3-5, Madrid 28029, Spain
- Navarre Public Health Institute, Polígono de Landaben C/F, Pamplona 31012, Spain
| | - K-T Khaw
- University of Cambridge School of Clinical Medicine, Robinson Way, Cambridge CB2 0SR, UK
| | - N Wareham
- MRC Epidemiology Unit, University of Cambridge, 184 Hills Road, Cambridge CB2 8PQ, UK
| | - R C Travis
- Cancer Epidemiology Unit, University of Oxford, Old Road Campus, Oxford OX3 7LF, UK
| | - Y Lu
- Department of Epidemiology & Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK
| | - M A Merritt
- Department of Epidemiology & Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK
| | - A Trichopoulou
- Hellenic Health Foundation, 13 Kaisareias Street, Athens GR-115 27, Greece
- Bureau of Epidemiologic Research, Academy of Athens, 23 Alexandroupoleos Street, Athens GR-115 27, Greece
| | - V Benetou
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, 75M. Asias Street, Goudi GR-115 27, Athens, Greece
| | - D Trichopoulos
- Hellenic Health Foundation, 13 Kaisareias Street, Athens GR-115 27, Greece
- Bureau of Epidemiologic Research, Academy of Athens, 23 Alexandroupoleos Street, Athens GR-115 27, Greece
- Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - C Saieva
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute—ISPO, Ponte Nuovo, Via delle Oblate n.2, Florence 50141, Italy
| | - S Sieri
- Epidemiology and Prevention Unit, Fondazione IRCSS Istituto Nazionale dei Tumori, Via Venezian, 1, Milano 20133, Italy
| | - R Tumino
- Cancer Registry and Histopathology Unit, "Civic-M.P.Arezzo" Hospital, Via Civile, Ragusa 97100, Italy
| | - C Sacerdote
- Unit of Cancer Epidemiology, AO Citta' della Salute e della Scienza-University of Turin and Center for Cancer Prevention (CPO-Piemonte), Via Santena 7, 10126 Turin, Italy
- Human Genetics Foundation (HuGeF), Via Nizza 52, 10126 Turin, Italy
| | - R Galasso
- Unit of Clinical Epidemiology, Biostatistics and Cancer Registry IRCCS, Referral Cancer Center of Basilicata, Rionero in Vulture (Pz), Italy
| | - H B Bueno-de-Mesquita
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Department of Gastroenterology and Hepatology, University Medical Centre, Heidelberglaan 100, Utrecht 3584 CX, The Netherlands
- The School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK
| | - E Wirfält
- Department of Clinical Sciences, Nutrition Epidemiology, Lund University, Box 117, Malmö 205 02, Sweden
| | - U Ericson
- Department of Clinical Sciences, Diabetes and Cardiovascular Disease, Genetic Epidemiology, Lund University, Clinical Research Centre, Box 117, Malmö 205 02, Sweden
| | - A Idahl
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, 1A, 9 tr, Kirurgcentrum, 952, Umeå 901 85, Sweden
- Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, 1A, 9 tr, Kirurgcentrum, 952, Umeå 901 85, Sweden
| | - N Ohlson
- Departament of Medical Biosciences, Pathology, Umeå University, 1A, 9 tr, Kirurgcentrum, 952, Umeå 901 85, Sweden
| | - G Skeie
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Breivika N-9037, Norway
| | - I T Gram
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Breivika N-9037, Norway
| | - E Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Breivika N-9037, Norway
- Department of Research, Cancer Registry of Norway, P.O. box 5313 Majorstuen Oslo, N-0304 Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Box 281, Stockholm 171 77, Sweden
- Public Health Research Center, Public Health Association, Topeliusgatan 20 (PB 211), 00250 Helsinki, Finland
| | - N C Onland-Moret
- Julius Center for Health Sciences and Primary Care, University Medical Center, Huispost Str. 6.131, 3508GA Utrecht, The Netherlands
| | - E Riboli
- Department of Epidemiology & Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK
| | - E J Duell
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), Avda Gran Via Barcelona 199-203, 08908L'Hospitalet de Llobregat, Barcelona, Spain
| |
Collapse
|
14
|
Nitter M, Norgård B, de Vogel S, Eussen SJPM, Meyer K, Ulvik A, Ueland PM, Nygård O, Vollset SE, Bjørge T, Tjønneland A, Hansen L, Boutron-Ruault M, Racine A, Cottet V, Kaaks R, Kühn T, Trichopoulou A, Bamia C, Naska A, Grioni S, Palli D, Panico S, Tumino R, Vineis P, Bueno-de-Mesquita HB, van Kranen H, Peeters PH, Weiderpass E, Dorronsoro M, Jakszyn P, Sánchez M, Argüelles M, Huerta JM, Barricarte A, Johansson M, Ljuslinder I, Khaw K, Wareham N, Freisling H, Duarte-Salles T, Stepien M, Gunter MJ, Riboli E. Plasma methionine, choline, betaine, and dimethylglycine in relation to colorectal cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). Ann Oncol 2014; 25:1609-15. [PMID: 24827130 DOI: 10.1093/annonc/mdu185] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Disturbances in one carbon metabolism may contribute to carcinogenesis by affecting methylation and synthesis of DNA. Choline and its oxidation product betaine are involved in this metabolism and can serve as alternative methyl group donors when folate status is low. PATIENTS AND METHODS We conducted a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC), to investigate plasma concentrations of the methyl donors methionine, choline, betaine (trimethylglycine), and dimethylglycine (DMG) in relation to colorectal cancer (CRC) risk. Our study included 1367 incident CRC cases (965 colon and 402 rectum) and 2323 controls matched by gender, age group, and study center. Multivariate-adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) for CRC risk were estimated by conditional logistic regression, comparing the fifth to the first quintile of plasma concentrations. RESULTS Overall, methionine (OR: 0.79, 95% CI: 0.63-0.99, P-trend = 0.05), choline (OR: 0.77, 95% CI: 0.60-0.99, P-trend = 0.07), and betaine (OR: 0.85, 95% CI: 0.66-1.09, P-trend = 0.06) concentrations were inversely associated with CRC risk of borderline significance. In participants with folate concentration below the median of 11.3 nmol/l, high betaine concentration was associated with reduced CRC risk (OR: 0.71, 95% CI: 0.50-1.00, P-trend = 0.02), which was not observed for those having a higher folate status. Among women, but not men, high choline concentration was associated with decreased CRC risk (OR: 0.62, 95% CI: 0.43-0.88, P-trend = 0.01). Plasma DMG was not associated with CRC risk. CONCLUSIONS Individuals with high plasma concentrations of methionine, choline, and betaine may be at reduced risk of CRC.
Collapse
Affiliation(s)
- M Nitter
- Departments of Global Public Health and Primary Care
| | - B Norgård
- Departments of Global Public Health and Primary Care
| | - S de Vogel
- Departments of Global Public Health and Primary Care
| | - S J P M Eussen
- Departments of Global Public Health and Primary Care Clinical Science, Section for Pharmacology, University of Bergen, Bergen, Norway Department of Epidemiology, School for Public Health and Primary Care, CAPHRI, Maastricht University, Maastricht, The Netherlands
| | | | | | - P M Ueland
- Clinical Science, Section for Pharmacology, University of Bergen, Bergen, Norway Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen
| | - O Nygård
- Departments of Clinical Science, Section of Cardiology, University of Bergen, Bergen Heart Disease, Haukeland University Hospital, Bergen
| | - S E Vollset
- Departments of Global Public Health and Primary Care Norwegian Institute of Public Health, Bergen, Norway
| | - T Bjørge
- Departments of Global Public Health and Primary Care Norwegian Institute of Public Health, Bergen, Norway
| | - A Tjønneland
- Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark
| | - L Hansen
- Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark
| | - M Boutron-Ruault
- INSERM, Centre for Research in Epidemiology and Population Health (CESP), Nutrition, Hormones and Women's Health Team, Villejuif Paris South University, Villejuif IGR, Villejuif
| | - A Racine
- INSERM, Centre for Research in Epidemiology and Population Health (CESP), Nutrition, Hormones and Women's Health Team, Villejuif Paris South University, Villejuif IGR, Villejuif
| | - V Cottet
- INSERM, Research Centre 'Lipids, Nutrition, Cancer', Dijon, France
| | - R Kaaks
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - T Kühn
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - A Trichopoulou
- Hellenic Health Foundation, Athens WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece
| | - C Bamia
- Hellenic Health Foundation, Athens WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece
| | - A Naska
- Hellenic Health Foundation, Athens WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece
| | - S Grioni
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano
| | - D Palli
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute-ISPO, Florence
| | - S Panico
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples
| | - R Tumino
- Cancer Registry and Histopathology Unit, 'Civile - M.P. Arezzo' Hospital, ASP, Ragusa
| | - P Vineis
- School of Public Health and HuGeF Foundation, Torino, Italy The School of Public Health, Imperial College London, London, UK
| | - H B Bueno-de-Mesquita
- The School of Public Health, Imperial College London, London, UK National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands Department of Gastroenterology and Hepatology
| | - H van Kranen
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - P H Peeters
- The School of Public Health, Imperial College London, London, UK Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands
| | - E Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, UIT The Arctic University of Norway, Tromsø Department of Research, Cancer Registry of Norway, Oslo, Norway Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden Department of Genetic Epidemiology, Samfundet Folkhälsan, Helsinki, Finland
| | - M Dorronsoro
- Basque Regional Health Department, Public Health Direction and Biodonostia Research Institute (CIBERESP), San Sebastian
| | - P Jakszyn
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Barcelona
| | - M Sánchez
- Andalusian School of Public Health, Granada CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid Instituto de Investigación Biosanitaria de Granada (Granada.ibs), Granada
| | | | - J M Huerta
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid Department of Epidemiology, Regional Health Council, Murcia
| | - A Barricarte
- Public Health Institute of Navarra, Pamplona Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
| | - M Johansson
- Department of Biobank Research, Umeå University, Umeå, Sweden International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - I Ljuslinder
- Department of Radiation Sciences, Oncology, University of Umeå, Umeå, Sweden
| | - K Khaw
- University of Cambridge School of Clinical Medicine, Cambridge
| | - N Wareham
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - H Freisling
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - T Duarte-Salles
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - M Stepien
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - M J Gunter
- The School of Public Health, Imperial College London, London, UK
| | - E Riboli
- The School of Public Health, Imperial College London, London, UK
| |
Collapse
|
15
|
Buckland G, Ros MM, Roswall N, Bueno-de-Mesquita HB, Travier N, Tjonneland A, Kiemeney LA, Sacerdote C, Tumino R, Ljungberg B, Gram IT, Weiderpass E, Skeie G, Malm J, Ehrnström R, Chang-Claude J, Mattiello A, Agnoli C, Peeters PH, Boutron-Ruault MC, Fagherazzi G, Clavel-Chapelon F, Nilsson LM, Amiano P, Trichopoulou A, Oikonomou E, Tsiotas K, Sánchez MJ, Overvad K, Quirós JR, Chirlaque MD, Barricarte A, Key TJ, Allen NE, Khaw KT, Wareham N, Riboli E, Kaaks R, Boeing H, Palli D, Romieu I, Romaguera D, Gonzalez CA. Adherence to the Mediterranean diet and risk of bladder cancer in the EPIC cohort study. Int J Cancer 2014; 134:2504-11. [PMID: 24226765 DOI: 10.1002/ijc.28573] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 09/09/2013] [Accepted: 09/11/2013] [Indexed: 12/19/2022]
Abstract
There is growing evidence of the protective role of the Mediterranean diet (MD) on cancer. However, to date no epidemiological study has investigated the influence of the MD on bladder cancer. We evaluated the association between adherence to the MD and risk of urothelial cell bladder cancer (UCC), according to tumor aggressiveness, in the European Prospective Investigation into Cancer and Nutrition (EPIC). The analysis included 477,312 participants, recruited from ten European countries between 1991 and 2000. Information from validated dietary questionnaires was used to develop a relative Mediterranean diet score (rMED), including nine dietary components. Cox regression models were used to assess the effect of the rMED on UCC risk, while adjusting for dietary energy and tobacco smoking of any kind. Stratified analyses were performed by sex, BMI, smoking status, European region and age at diagnosis. During an average follow-up of 11 years, 1,425 participants (70.9% male) were diagnosed with a first primary UCC. There was a negative but non-significant association between a high versus low rMED score and risk of UCC overall (HR: 0.84 [95% CI 0.69, 1.03]) and risk of aggressive (HR: 0.88 [95% CI 0.61, 1.28]) and non-aggressive tumors (HR: 0.78 [95% CI 0.54, 1.14]). Although there was no effect modification in the stratified analyses, there was a significant 34% (p = 0.043) decreased risk of UCC in current smokers with a high rMED score. In EPIC, the MD was not significantly associated with risk of UCC, although we cannot exclude that a MD may reduce risk in current smokers.
Collapse
Affiliation(s)
- G Buckland
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Barker A, Lauria A, Schloot N, Hosszufalusi N, Ludvigsson J, Mathieu C, Mauricio D, Nordwall M, Van der Schueren B, Mandrup-Poulsen T, Scherbaum WA, Weets I, Gorus FK, Wareham N, Leslie RD, Pozzilli P. Age-dependent decline of β-cell function in type 1 diabetes after diagnosis: a multi-centre longitudinal study. Diabetes Obes Metab 2014; 16:262-7. [PMID: 24118704 DOI: 10.1111/dom.12216] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Revised: 09/14/2013] [Accepted: 09/14/2013] [Indexed: 01/12/2023]
Abstract
AIMS C-peptide secretion is currently the only available clinical biomarker to measure residual β-cell function in type 1 diabetes. However, the natural history of C-peptide decline after diagnosis can vary considerably dependent upon several variables. We investigated the shape of C-peptide decline over time from type 1 diabetes onset in relation to age at diagnosis, haemoglobin A1c (HbA1c) levels and insulin dose. METHODS We analysed data from 3929 type 1 diabetes patients recruited from seven European centres representing all age groups at disease onset (childhood, adolescence and adulthood). The influence of the age at onset on β-cell function was investigated in a longitudinal analysis at diagnosis and up to 5-years follow-up. RESULTS Fasting C-peptide (FCP) data at diagnosis were available in 3668 patients stratified according to age at diagnosis in four groups (<5 years, n = 344; >5 years < 10 years, n = 668; >10 years < 18 years, n = 991; >18 years, n = 1655). FCP levels were positively correlated with age (p < 0.001); the subsequent decline in FCP over time was log-linear with a greater decline rate in younger age groups (p < 0.0001). CONCLUSIONS This study reveals a positive correlation between age at diagnosis of type 1 diabetes and FCP with a more rapid decline of β-cell function in the very young patients. These data can inform the design of clinical trials using C-peptide values as an end-point for the effect of a given treatment.
Collapse
Affiliation(s)
- A Barker
- Department MRC Epidemiology Unit, Cambridge Institute of Public Health, Cambridge, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Rinaldi S, Kaaks R, Friedenreich CM, Key TJ, Travis R, Biessy C, Slimani N, Overvad K, Østergaard JN, Tjønneland A, Olsen A, Mesrine S, Fournier A, Dossus L, Lukanova A, Johnson T, Boeing H, Vigl M, Trichopoulou A, Benetou V, Trichopoulos D, Masala G, Krogh V, Tumino R, Ricceri F, Panico S, Bueno-de-Mesquita HB, Monninkhof EM, May AM, Weiderpass E, Quirós JR, Travier N, Molina-Montes E, Amiano P, Huerta JM, Ardanaz E, Sund M, Johansson M, Khaw KT, Wareham N, Scalbert A, Gunter MJ, Riboli E, Romieu I. Physical activity, sex steroid, and growth factor concentrations in pre- and post-menopausal women: a cross-sectional study within the EPIC cohort. Cancer Causes Control 2014; 25:111-24. [PMID: 24173534 DOI: 10.1007/s10552-013-0314-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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: 07/03/2013] [Accepted: 10/14/2013] [Indexed: 01/13/2023]
Abstract
PURPOSE Increased physical activity (PA) is associated with a reduced risk of several cancers. PA may reduce cancer risk by changing endogenous hormones levels, but relatively little research has focused on this topic. The purpose of this study was to elucidate the relation between PA and endogenous hormone concentrations. METHODS A cross-sectional analysis of 798 pre- and 1,360 post-menopausal women included as controls in case-control studies on endogenous hormones (steroids, progesterone, sex-hormone-binding globulin (SHBG), and growth factors) levels, and cancer risk nested within European Prospective Investigation into Cancer and Nutrition cohort was performed. Multivariate regression analyses were performed to compare geometric mean levels of hormones and SHBG by categories of PA. RESULTS In pre-menopausal women, active women had 19 % significantly lower concentrations of androstenedione, 14 % lower testosterone, and 20 % lower free testosterone than inactive women, while no differences were observed for estrogens, progesterone, SHBG, and growth factors. In post-menopausal women, active women had 18 % significantly lower estradiol and 20 % lower free estradiol concentrations than inactive women, while no differences were observed for the other hormones and SHBG. More vigorous forms of physical activity were associated with higher insulin-like growth factor-I concentrations. Adjustment for body mass index did not alter the associations. Overall, the percentage of variance in hormone concentrations explained by PA levels was <2 %. CONCLUSIONS Our results support the hypothesis of an influence, although small in magnitude, of PA on sex hormone levels in blood, independent of body size.
Collapse
Affiliation(s)
- S Rinaldi
- International Agency for Research on Cancer (IARC), Lyon, France,
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Obón-Santacana M, Slimani N, Lujan-Barroso L, Travier N, Hallmans G, Freisling H, Ferrari P, Boutron-Ruault M, Racine A, Clavel F, Saieva C, Pala V, Tumino R, Mattiello A, Vineis P, Argüelles M, Ardanaz E, Amiano P, Navarro C, Sánchez M, Molina Montes E, Key T, Khaw KT, Wareham N, Peeters P, Trichopoulou A, Bamia C, Trichopoulos D, Boeing H, Kaaks R, Katzke V, Ye W, Sund M, Ericson U, Wirfält E, Overvad K, Tjønneland A, Olsen A, Skeie G, Åsli L, Weiderpass E, Riboli E, Bueno-de-Mesquita H, Duell E. Dietary intake of acrylamide and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Ann Oncol 2013; 24:2645-2651. [DOI: 10.1093/annonc/mdt255] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
|
19
|
Conklin A, Forouhi N, Wareham N, Monsivais P. OP78 The Role of Social Relationships in Understanding Healthful Dietary Behaviours: Evidence from People Aged 50 and over in the Epic-Norfolk Cohort. Br J Soc Med 2013. [DOI: 10.1136/jech-2013-203126.78] [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: 11/03/2022]
|
20
|
Pfister R, Michels G, Wilfred J, Luben R, Wareham N, Khaw KT. Does ICD-10 hospital discharge code I50 identify people with heart failure? a validation study within the EPIC-Norfolk study. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p4213] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
21
|
Pfister R, Michels G, Sharp S, Luben R, Wareham N, Khaw KT. Urinary sodium excretion and risk of heart failure in men and women in the EPIC-Norfolk study. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p2478] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
22
|
Schlesinger S, Aleksandrova K, Pischon T, Jenab M, Fedirko V, Trepo E, Overvad K, Roswall N, Tjønneland A, Boutron-Ruault MC, Fagherazzi G, Racine A, Kaaks R, Grote VA, Boeing H, Trichopoulou A, Pantzalis M, Kritikou M, Mattiello A, Sieri S, Sacerdote C, Palli D, Tumino R, Peeters PH, Bueno-de-Mesquita HB, Weiderpass E, Quirós JR, Zamora-Ros R, Sánchez MJ, Arriola L, Ardanaz E, Tormo MJ, Nilsson P, Lindkvist B, Sund M, Rolandsson O, Khaw KT, Wareham N, Travis RC, Riboli E, Nöthlings U. Diabetes mellitus, insulin treatment, diabetes duration, and risk of biliary tract cancer and hepatocellular carcinoma in a European cohort. Ann Oncol 2013; 24:2449-55. [PMID: 23720454 DOI: 10.1093/annonc/mdt204] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [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: 12/20/2022] Open
Abstract
BACKGROUND Evidence on associations between self-reported diabetes mellitus, diabetes duration, age at diabetes diagnosis, insulin treatment, and risk of biliary tract cancer (BTC) and hepatocellular carcinoma (HCC), independent of general and abdominal obesity is scarce. PATIENTS AND METHODS We conducted a prospective analysis in the EPIC-cohort study among 363 426 participants with self-reported diabetes data. Multivariable adjusted relative risks and 95% confidence intervals were estimated from Cox regression models. In a nested case-control subset, analyses were carried out in HCV/HBV-negative individuals. RESULTS During 8.5 years of follow-up, 204 BTC cases [including 75 gallbladder cancer (GBC) cases], and 176 HCC cases were identified. Independent of body mass index and waist-to-height ratio diabetes status was associated with higher risk of BTC and HCC [1.77 (1.00-3.13) and 2.17 (1.36-3.47)]. For BTC, the risk seemed to be higher in participants with shorter diabetes duration and those not treated with insulin. Regarding cancer subsites, diabetes was only associated with GBC [2.72 (1.17-6.31)]. The risk for HCC was particularly higher in participants treated with insulin. The results were not appreciably different in HCV/HBV-negative individuals. CONCLUSION(S) This study supports the hypothesis that diabetes is a risk factor for BTC (particularly GBC) and HCC. Further research is required to establish whether diabetes treatment or duration is associated with these cancers.
Collapse
Affiliation(s)
- S Schlesinger
- Institute of Epidemiology, Christian-Albrechts University of Kiel, Kiel, Germany.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Buckland G, Travier N, Cottet V, González C, Luján-Barroso L, Agudo A, Trichopoulou A, Lagiou P, Trichopoulos D, Peeters P, May A, Bueno-de-Mesquita H, Bvan Duijnhoven F, Key T, Allen N, Khaw K, Wareham N, Romieu I, McCormack V, Boutron-Ruault M, Clavel-Chapelon F, Panico S, Agnoli C, Palli D, Tumino R, Vineis P, Amiano P, Barricarte A, Rodríguez L, Sanchez M, Chirlaque M, Kaaks R, Teucher B, Boeing H, Bergmann M, Overvad K, Dahm C, Tjønneland A, Olsen A, Manjer J, Wirfält E, Hallmans G, Johansson I, Lund E, Hjartåker A, Skeie G, Vergnaud A, Norat T, Romaguera D, Riboli E. Adherence to the mediterranean diet and risk of breast cancer in the European prospective investigation into cancer and nutrition cohort study. Int J Cancer 2012. [DOI: 10.1002/ijc.27958] [Citation(s) in RCA: 154] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
|
24
|
Golubic R, Ekelund U, Luben R, Khaw K, Wareham N, Brage S. Does total physical activity modify the association between working hours and all-cause mortality? The EPIC-Norfolk cohort. J Sci Med Sport 2012. [DOI: 10.1016/j.jsams.2012.11.067] [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: 10/27/2022]
|
25
|
Sahlqvist S, Ogilvie D, Goodman A, Simmons R, Khaw K, Cavill N, Foster C, Wareham N. The impact of cycling on cardiovascular disease: 8 year follow-up of the population-based EPIC-Norfolk cohort. J Sci Med Sport 2012. [DOI: 10.1016/j.jsams.2012.11.063] [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: 10/27/2022]
|
26
|
Trichopoulos D, Bamia C, Lagiou P, Fedirko V, Trepo E, Jenab M, Pischon T, Nothlings U, Overvad K, Tjonneland A, Outzen M, Clavel-Chapelon F, Kaaks R, Lukanova A, Boeing H, Aleksandrova K, Benetou V, Zylis D, Palli D, Pala V, Panico S, Tumino R, Sacerdote C, Bueno-De-Mesquita HB, Van Kranen HJ, Peeters PHM, Lund E, Quiros JR, Gonzalez CA, Sanchez Perez MJ, Navarro C, Dorronsoro M, Barricarte A, Lindkvist B, Regner S, Werner M, Hallmans G, Khaw KT, Wareham N, Key T, Romieu I, Chuang SC, Murphy N, Boffetta P, Trichopoulou A, Riboli E. Response. J Natl Cancer Inst 2012. [DOI: 10.1093/jnci/djs384] [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: 11/14/2022] Open
|
27
|
Crowe FL, Key TJ, Appleby PN, Overvad K, Schmidt EB, Egeberg R, Tjønneland A, Kaaks R, Teucher B, Boeing H, Weikert C, Trichopoulou A, Ouranos V, Valanou E, Masala G, Sieri S, Panico S, Tumino R, Matullo G, Bueno-de-Mesquita HB, Boer JMA, Beulens JWJ, van der Schouw YT, Quirós JR, Buckland G, Sánchez MJ, Dorronsoro M, Huerta JM, Moreno-Iribas C, Hedblad B, Jansson JH, Wennberg P, Khaw KT, Wareham N, Ferrari P, Illner AK, Chuang SC, Norat T, Danesh J, Riboli E. Dietary fibre intake and ischaemic heart disease mortality: the European Prospective Investigation into Cancer and Nutrition-Heart study. Eur J Clin Nutr 2012; 66:950-6. [DOI: 10.1038/ejcn.2012.51] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
28
|
González CA, Megraud F, Buissonniere A, Lujan Barroso L, Agudo A, Duell EJ, Boutron-Ruault MC, Clavel-Chapelon F, Palli D, Krogh V, Mattiello A, Tumino R, Sacerdote C, Quirós JR, Sanchez-Cantalejo E, Navarro C, Barricarte A, Dorronsoro M, Khaw KT, Wareham N, Allen NE, Tsilidis KK, Bas Bueno-de-Mesquita H, Jeurnink SM, Numans ME, Peeters PHM, Lagiou P, Valanou E, Trichopoulou A, Kaaks R, Lukanova-McGregor A, Bergman MM, Boeing H, Manjer J, Lindkvist B, Stenling R, Hallmans G, Mortensen LM, Overvad K, Olsen A, Tjonneland A, Bakken K, Dumeaux V, Lund E, Jenab M, Romieu I, Michaud D, Mouw T, Carneiro F, Fenge C, Riboli E. Helicobacter pylori infection assessed by ELISA and by immunoblot and noncardia gastric cancer risk in a prospective study: the Eurgast-EPIC project. Ann Oncol 2012; 23:1320-1324. [PMID: 21917738 DOI: 10.1093/annonc/mdr384] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [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] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND In epidemiological studies, Helicobacter pylori infection is usually detected by enzyme-linked immunosorbent assay (ELISA). However, infection can spontaneously clear from the mucosa during the progression of atrophy and could lead to substantial under-detection of infection and underestimation of its effect on gastric cancer (GC) risk. Antibodies detected by western blot are known to persist longer after the loss of the infection. METHODS In a nested case-control study from the Eurogast-EPIC cohort, including 88 noncardia GC cases and 338 controls, we assessed the association between noncardia GC and H. pylori infection comparing antibodies detected by western blot (HELICOBLOT2.1) to those detected by ELISA (Pyloriset EIA-GIII(®)). RESULTS By immunoblot, 82 cases (93.2%) were H. pylori positive, 10 of these cases (11.4%) were negative by ELISA and only 6 cases (6.8%) were negative by both ELISA and immunoblot. Multivariable odds ratio (OR) for noncardia GC comparing immunoglobulin G positive versus negative by ELISA was 6.8 [95% confidence interval (CI) 3.0-15.1], and by immunoblot, the OR was 21.4 (95% CI 7.1-64.4). CONCLUSIONS Using a western blot assay, nearly all noncardia GC were classified as H. pylori positive and the OR was more than threefold higher than the OR assessed by ELISA, supporting the hypothesis that H. pylori infection is a necessary condition for noncardia GC.
Collapse
Affiliation(s)
- C A González
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Bellvitge Biomedical Research Institute (IDIBELL), Catalan Institute of Oncology, Barcelona, Spain.
| | | | | | - L Lujan Barroso
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Bellvitge Biomedical Research Institute (IDIBELL), Catalan Institute of Oncology, Barcelona, Spain
| | - A Agudo
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Bellvitge Biomedical Research Institute (IDIBELL), Catalan Institute of Oncology, Barcelona, Spain
| | - E J Duell
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Bellvitge Biomedical Research Institute (IDIBELL), Catalan Institute of Oncology, Barcelona, Spain
| | - M C Boutron-Ruault
- Centre for Research in Epidemiology and Population Health, Institut Gustave Roussy, Villejuif; Paris South University, Villejuif, France
| | - F Clavel-Chapelon
- Centre for Research in Epidemiology and Population Health, Institut Gustave Roussy, Villejuif; Paris South University, Villejuif, France
| | - D Palli
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence
| | - V Krogh
- Department of Preventive & Predictive Medicine, Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei TumoriMilan
| | - A Mattiello
- Department Of Clinical And Experimental Medicine, Federico Ii University, Naples
| | - R Tumino
- Cancer Registry and Histopathology Unit, "Civile M.P. Arezzo" Hospital, Ragusa
| | - C Sacerdote
- Centre for Cancer Epidemiology and Prevention (CPO Piemonte), Turin, Italy
| | - J R Quirós
- Public Health and Participation Directorate, Health and Health Care Services Council, Asturias
| | - E Sanchez-Cantalejo
- Andalusian School of Public Health, CIBER Epidemiología y Salud Pública (CIBERESP), Granada
| | - C Navarro
- Department of Epidemiology, Murcia Health Council, CIBER Epidemiología y Salud Pública (CIBERESP) Murcia, Murcia
| | - A Barricarte
- Navarre Public Health Institute, CIBER Epidemiología y Salud Pública (CIBERESP), Pamplona
| | - M Dorronsoro
- Public Health Division of Gipuzkoa and Ciberesp, Basque Regional Health Department, San Sebastián, Spain
| | - K-T Khaw
- Department of Public Health and Primary Care, University of Cambridge, Cambridge
| | - N Wareham
- Department of Public Health and Primary Care, University of Cambridge, Cambridge
| | - N E Allen
- Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - K K Tsilidis
- Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - H Bas Bueno-de-Mesquita
- National Institute for Public Health and the Environment (RIVM), Bilthoven; Department of Gastroenterology and Hepatology, University Medical Centre Utrecht (UMCU), Utrecht
| | - S M Jeurnink
- National Institute for Public Health and the Environment (RIVM), Bilthoven; Department of Gastroenterology and Hepatology, University Medical Centre Utrecht (UMCU), Utrecht
| | - M E Numans
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - P H M Peeters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - P Lagiou
- WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens
| | - E Valanou
- Hellenic Health Foundation, Athens, Greece
| | | | - R Kaaks
- Department of Cancer Epidemiology, German Cancer Research Center, Heidelberg
| | - A Lukanova-McGregor
- Department of Cancer Epidemiology, German Cancer Research Center, Heidelberg
| | - M M Bergman
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Potsdam, Germany
| | - H Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Potsdam, Germany
| | - J Manjer
- Department of Surgery, Skåne University Hospital Malmö, Lund University, Malmö
| | - B Lindkvist
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Sahlgrenska University Hospital, Gothenburg
| | - R Stenling
- Department of Medical Biosciences, Pathology, Umea University, Umea, Sweden
| | - G Hallmans
- Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden
| | - L M Mortensen
- Department of Epidemiology, School of Public Health, Aarhus University, Aarhus
| | - K Overvad
- Department of Epidemiology, School of Public Health, Aarhus University, Aarhus
| | - A Olsen
- Danish Cancer Society, Institute of Cancer Epidemiology, Diet Cancer and Health, Copenhagen, Denmark
| | - A Tjonneland
- Danish Cancer Society, Institute of Cancer Epidemiology, Diet Cancer and Health, Copenhagen, Denmark
| | - K Bakken
- Department of Community Medicine, University of Tromsø, Tromso, Norway
| | - V Dumeaux
- Department of Community Medicine, University of Tromsø, Tromso, Norway
| | - E Lund
- Department of Community Medicine, University of Tromsø, Tromso, Norway
| | - M Jenab
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - I Romieu
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - D Michaud
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - T Mouw
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - F Carneiro
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP) and Medical Faculty/HS João, Porto, Portugal
| | - C Fenge
- Department of Clinical Pathology, Odense University Hospital, Odense, Denmark
| | - E Riboli
- School of Public Health, St Mary's Campus, Imperial College London, London, UK
| |
Collapse
|
29
|
Grote VA, Kaaks R, Nieters A, Tjønneland A, Halkjær J, Overvad K, Skjelbo Nielsen MR, Boutron-Ruault MC, Clavel-Chapelon F, Racine A, Teucher B, Becker S, Pischon T, Boeing H, Trichopoulou A, Cassapa C, Stratigakou V, Palli D, Krogh V, Tumino R, Vineis P, Panico S, Rodríguez L, Duell EJ, Sánchez MJ, Dorronsoro M, Navarro C, Gurrea AB, Siersema PD, Peeters PHM, Ye W, Sund M, Lindkvist B, Johansen D, Khaw KT, Wareham N, Allen NE, Travis RC, Fedirko V, Jenab M, Michaud DS, Chuang SC, Romaguera D, Bueno-de-Mesquita HB, Rohrmann S. Inflammation marker and risk of pancreatic cancer: a nested case-control study within the EPIC cohort. Br J Cancer 2012; 106:1866-74. [PMID: 22617158 PMCID: PMC3364108 DOI: 10.1038/bjc.2012.172] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [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] [Indexed: 12/16/2022] Open
Abstract
Background: Established risk factors for pancreatic cancer include smoking, long-standing diabetes, high body fatness, and chronic pancreatitis, all of which can be characterised by aspects of inflammatory processes. However, prospective studies investigating the relation between inflammatory markers and pancreatic cancer risk are scarce. Methods: We conducted a nested case–control study within the European Prospective Investigation into Cancer and Nutrition, measuring prediagnostic blood levels of C-reactive protein (CRP), interleukin-6 (IL-6), and soluble receptors of tumour necrosis factor-α (sTNF-R1, R2) in 455 pancreatic cancer cases and 455 matched controls. Odds ratios (ORs) were estimated using conditional logistic regression models. Results: None of the inflammatory markers were significantly associated with risk of pancreatic cancer overall, although a borderline significant association was observed for higher circulating sTNF-R2 (crude OR=1.52 (95% confidence interval (CI) 0.97–2.39), highest vs lowest quartile). In women, however, higher sTNF-R1 levels were significantly associated with risk of pancreatic cancer (crude OR=1.97 (95% CI 1.02–3.79)). For sTNF-R2, risk associations seemed to be stronger for diabetic individuals and those with a higher BMI. Conclusion: Prospectively, CRP and IL-6 do not seem to have a role in our study with respect to risk of pancreatic cancer, whereas sTNF-R1 seemed to be a risk factor in women and sTNF-R2 might be a mediator in the risk relationship between overweight and diabetes with pancreatic cancer. Further large prospective studies are needed to clarify the role of proinflammatory proteins and cytokines in the pathogenesis of exocrine pancreatic cancer.
Collapse
Affiliation(s)
- V A Grote
- Division of Cancer Epidemiology (c020), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, Heidelberg 69120, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Jeurnink SM, Büchner FL, Bueno-de-Mesquita HB, Siersema PD, Boshuizen HC, Numans ME, Dahm CC, Overvad K, Tjønneland A, Roswall N, Clavel-Chapelon F, Boutron-Ruault MC, Morois S, Kaaks R, Teucher B, Boeing H, Buijsse B, Trichopoulou A, Benetou V, Zylis D, Palli D, Sieri S, Vineis P, Tumino R, Panico S, Ocké MC, Peeters PHM, Skeie G, Brustad M, Lund E, Sánchez-Cantalejo E, Navarro C, Amiano P, Ardanaz E, Ramón Quirós J, Hallmans G, Johansson I, Lindkvist B, Regnér S, Khaw KT, Wareham N, Key TJ, Slimani N, Norat T, Vergnaud AC, Romaguera D, Gonzalez CA. Variety in vegetable and fruit consumption and the risk of gastric and esophageal cancer in the European Prospective Investigation into Cancer and Nutrition. Int J Cancer 2012; 131:E963-73. [PMID: 22392502 DOI: 10.1002/ijc.27517] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2011] [Accepted: 01/12/2012] [Indexed: 01/13/2023]
Abstract
Diets high in vegetables and fruits have been suggested to be inversely associated with risk of gastric cancer. However, the evidence of the effect of variety of consumption is limited. We therefore investigated whether consumption of a variety of vegetables and fruit is associated with gastric and esophageal cancer in the European Prospective Investigation into Cancer and Nutrition study. Data on food consumption and follow-up on cancer incidence were available for 452,269 participants from 10 European countries. After a mean follow-up of 8.4 years, 475 cases of gastric and esophageal adenocarcinomas (180 noncardia, 185 cardia, gastric esophageal junction and esophagus, 110 not specified) and 98 esophageal squamous cell carcinomas were observed. Diet Diversity Scores were used to quantify the variety in vegetable and fruit consumption. We used multivariable Cox proportional hazard models to calculate risk ratios. Independent from quantity of consumption, variety in the consumption of vegetables and fruit combined and of fruit consumption alone were statistically significantly inversely associated with the risk of esophageal squamous cell carcinoma (continuous hazard ratio per 2 products increment 0.88; 95% CI 0.79-0.97 and 0.76; 95% CI 0.62-0.94, respectively) with the latter particularly seen in ever smokers. Variety in vegetable and/or fruit consumption was not associated with risk of gastric and esophageal adenocarcinomas. Independent from quantity of consumption, more variety in vegetable and fruit consumption combined and in fruit consumption alone may decrease the risk of esophageal squamous cell carcinoma. However, residual confounding by lifestyle factors cannot be excluded.
Collapse
Affiliation(s)
- S M Jeurnink
- Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Webb DR, Khunti K, Gray LJ, Srinivasan BT, Farooqi A, Wareham N, Griffin SC, Davies MJ. Intensive multifactorial intervention improves modelled coronary heart disease risk in screen-detected Type 2 diabetes mellitus: a cluster randomized controlled trial. Diabet Med 2012; 29:531-40. [PMID: 21913966 DOI: 10.1111/j.1464-5491.2011.03441.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS To compare the effects of intensive multifactorial cardiovascular risk intervention with standard care in screen-detected Type 2 diabetes. METHODS Twenty general practices randomly invited 30 950 adults without diagnosed diabetes for screening (World Health Organization, 1999). In a cluster randomized controlled trial, screen-detected cases were assigned by practice allocation to receive intensive protocol-driven cardiovascular risk management (n = 146) or standard care (n = 199) according to local guidelines. Intensive intervention was designed to achieve an HbA(1c) of 48 mmol/mol (6.5%), blood pressure < 130/80 mmHg and total cholesterol < 3.5 mmol/l. Primary outcome was modelled 5-year coronary heart disease risk (UKPDS-CHD). Analysis was via intention to treat. RESULTS After 1.1 years 339 (98%) individuals were still participating. There were significant reductions in HbA(1c) , blood pressure and total cholesterol from baseline in both groups [mean change for total study population -27.7 mmol/mol (-0.62%), -11.64/10.01 mmHg, -1.11 mmol/l]. After adjustment for baseline and clustering, significant inter-group differences were observed in mean changes from baseline for HbA(1c) {-28.5 mmol/mol [-0.7% (1.4)] vs. -27.5 mmol/mol [-0.6% (1.6)], P = 0.001}, blood pressure [systolic -16.2 (19.6) vs. -8.4 (18.6) mmHg, P < 0.001], total cholesterol [-1.3 (1.3) vs. -1.0 (1.2) mmol/l, P < 0.001] and weight [-3.8 (5.5) vs. -2.2 (5.5) kg, P = 0.01] in favour of intensive treatment. UKPDS 5-year coronary heart disease risk was reduced by 3.2% and 2.3%, respectively (P < 0.0001). Intensive intervention was associated with more lipid-lowering and anti-hypertensive but not hypoglycaemic medication use [odds ratios 2.5 (1.4-4.4), 5.5 (2.4-11.5), 1.6 (0.8-2.3); compared with standard care, P < 0.001, P = 0.003, P = 0.65]. Treatment satisfaction responses were superior with intensive intervention, with no increase in self-reported hypoglycaemia. CONCLUSION Intensive intervention in patients with diabetes identified through systematic non-risk-factor-based screening significantly reduces modelled coronary heart disease risk. This is achieved predominantly with lipid-lowering and anti-hypertensive treatments with no adverse effect on quality of life or hypoglycaemia.
Collapse
Affiliation(s)
- D R Webb
- Department of Cardiovascular Sciences, Leicester Royal Infirmary, University of Leicester, Leicester, UK.
| | | | | | | | | | | | | | | |
Collapse
|
32
|
Harvey NC, Cole ZA, Crozier SR, Kim M, Ntani G, Goodfellow L, Robinson SM, Inskip HM, Godfrey KM, Dennison EM, Wareham N, Ekelund U, Cooper C. Physical activity, calcium intake and childhood bone mineral: a population-based cross-sectional study. Osteoporos Int 2012; 23:121-30. [PMID: 21562877 PMCID: PMC3685136 DOI: 10.1007/s00198-011-1641-y] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2010] [Accepted: 04/04/2011] [Indexed: 10/18/2022]
Abstract
UNLABELLED In a free-living cohort of 4-year old children, mean daily time in moderate-vigorous physical activity and daily calcium intake at 3 years, were positively related to hip bone size and density. Relationships between physical activity and bone indices were stronger when calcium intake was above compared with below median (966 mg/day). INTRODUCTION We examined the cross-sectional relationships between childhood physical activity, dietary calcium intake and bone size and density. METHODS Children aged 4 years were recruited from the Southampton Women's Survey. They underwent measurement of bone mass by DXA (Hologic Discovery). Physical activity was assessed by accelerometry (Actiheart, Cambridge Neurotechnology Ltd, Cambridge, UK) for seven continuous days. RESULTS Four hundred twenty-two children (212 boys) participated. In a cross-sectional analysis, after adjusting for gender, daily mean time(minutes per day) spent in moderate to very vigorous activity (MVPA) was positively related to hip BA (R(2) = 3%, p < 0.001), BMC (R(2) = 4%, p < 0.001), aBMD (R (2) = 3%, p = 0.001) and estimated vBMD (R(2) = 2%, p = 0.01), but not height (r (s) = 0.04, p = 0.42) or weight (r(s) = 0.01, p = 0.76). Mean daily calcium intake (assessed at 3 years old) positively predicted bone indices in those with a calcium intake below the median (966 mg/day), but there was a much attenuated relationship in those above this. These associations persisted after inclusion of total energy, protein and phosphorus in multivariate models. The relationships between MVPA and bone indices were stronger in children with calcium intakes above the median. Thus, for aBMD, the variance explained by MVPA when daily calcium intake was below the median was 2% (p = 0.1) and above median was 6% (p = 0.001). CONCLUSIONS These results support the notion that adequate calcium intake may be required for optimal action of physical activity on bone development and that improving levels of physical activity and calcium intake in childhood may help to optimise accrual of bone mass.
Collapse
Affiliation(s)
- N C Harvey
- MRC Lifecourse Epidemiology Unit, (University of Southampton), Southampton General Hospital, Southampton SO16 6YD, UK.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Grote VA, Rohrmann S, Nieters A, Dossus L, Tjønneland A, Halkjær J, Overvad K, Fagherazzi G, Boutron-Ruault MC, Morois S, Teucher B, Becker S, Sluik D, Boeing H, Trichopoulou A, Lagiou P, Trichopoulos D, Palli D, Pala V, Tumino R, Vineis P, Panico S, Rodríguez L, Duell EJ, Molina-Montes E, Dorronsoro M, Huerta JM, Ardanaz E, Jeurnink SM, Beulens JWJ, Peeters PHM, Sund M, Ye W, Lindkvist B, Johansen D, Khaw KT, Wareham N, Allen N, Crowe F, Jenab M, Romieu I, Michaud DS, Riboli E, Romaguera D, Bueno-de-Mesquita HB, Kaaks R. Diabetes mellitus, glycated haemoglobin and C-peptide levels in relation to pancreatic cancer risk: a study within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Diabetologia 2011; 54:3037-46. [PMID: 21953276 DOI: 10.1007/s00125-011-2316-0] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Accepted: 08/31/2011] [Indexed: 02/06/2023]
Abstract
AIMS/HYPOTHESIS There has been long-standing debate about whether diabetes is a causal risk factor for pancreatic cancer or a consequence of tumour development. Prospective epidemiological studies have shown variable relationships between pancreatic cancer risk and blood markers of glucose and insulin metabolism, overall and as a function of lag times between marker measurements (blood donation) and date of tumour diagnosis. METHODS Pre-diagnostic levels of HbA(1c) and C-peptide were measured for 466 participants with pancreatic cancer and 466 individually matched controls within the European Prospective Investigation into Cancer and Nutrition. Conditional logistic regression models were used to estimate ORs for pancreatic cancer. RESULTS Pancreatic cancer risk gradually increased with increasing pre-diagnostic HbA(1c) levels up to an OR of 2.42 (95% CI 1.33, 4.39 highest [≥ 6.5%, 48 mmol/mol] vs lowest [≤ 5.4%, 36 mmol/mol] category), even for individuals with HbA(1c) levels within the non-diabetic range. C-peptide levels showed no significant relationship with pancreatic cancer risk, irrespective of fasting status. Analyses showed no clear trends towards increasing hyperglycaemia (as marked by HbA(1c) levels) or reduced pancreatic beta cell responsiveness (as marked by C-peptide levels) with decreasing time intervals from blood donation to cancer diagnosis. CONCLUSIONS/INTERPRETATION Our data on HbA(1c) show that individuals who develop exocrine pancreatic cancer tend to have moderate increases in HbA(1c) levels, relatively independently of obesity and insulin resistance-the classic and major risk factors for type 2 diabetes. While there is no strong difference by lag time, more data are needed on this in order to reach a firm conclusion.
Collapse
Affiliation(s)
- V A Grote
- Division of Cancer Epidemiology c020, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Wareham N. O2-2.5 Lifestyle exposure measurement in cohort studies. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976a.56] [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: 11/04/2022]
|
35
|
|
36
|
McFadden E, Luben R, Bingham S, Wareham N, Kinmonth AL, Khaw KT. Self-rated health does not explain the socioeconomic differential in mortality: a prospective study in the EPIC-Norfolk cohort. J Epidemiol Community Health 2009; 63:329-31. [PMID: 19147634 DOI: 10.1136/jech.2008.078139] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Self-rated health (SRH), a subjective measure of health, is strongly predictive of mortality, independently of objective measures of health status and existing known disease. There is a strong social gradient in SRH. An investigation was carried to determine whether SRH can explain the well-known socioeconomic gradient in mortality. METHODS The effect of adjusting for SRH on the socioeconomic differential in mortality was examined in a prospective study of 20 754 men and women aged 39-79 years, without prevalent disease, living in the general community in Norfolk, UK, recruited using general practice age-sex registers for 1993-1997 and followed up for an average of 10 years. RESULTS Mortality risk increased with decreasing social class in men and women. There was some attenuation after adjustment for covariates age, body mass index, smoking, history of diabetes, systolic blood pressure, cholesterol level, alcohol consumption, physical activity and educational level, but a gradient remained. Further adjustment for SRH attenuated the association slightly more, but there was still some evidence of a socioeconomic differential in mortality, particularly in class V compared with class I (age- and sex-adjusted hazard ratio 1.57; 95% CI 1.19 to 2.06). CONCLUSIONS SRH does not substantially explain the socioeconomic differential in mortality beyond that explained by health-related covariates.
Collapse
Affiliation(s)
- E McFadden
- Institute of Public Health,University of Cambridge, Strangeways Research Laboratory, Wort's Causeway, Cambridge, UK.
| | | | | | | | | | | |
Collapse
|
37
|
McFadden E, Luben R, Bingham S, Wareham N, Kinmonth AL, Khaw KT. Does the association between self-rated health and mortality vary by social class? Soc Sci Med 2009; 68:275-80. [DOI: 10.1016/j.socscimed.2008.10.012] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2008] [Indexed: 11/26/2022]
|
38
|
Lakshman R, Forouhi N, Luben R, Bingham S, Khaw K, Wareham N, Ong KK. Association between age at menarche and risk of diabetes in adults: results from the EPIC-Norfolk cohort study. Diabetologia 2008; 51:781-6. [PMID: 18320165 DOI: 10.1007/s00125-008-0948-5] [Citation(s) in RCA: 150] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2007] [Accepted: 01/18/2008] [Indexed: 11/25/2022]
Abstract
AIMS/HYPOTHESIS Earlier age at menarche is associated with increased BMI and obesity risk from early childhood through to adulthood. We hypothesised that earlier age at menarche would also predict subsequent diabetes risk. METHODS This was a population-based prospective cohort study of 13,308 women, who were aged 40 to 75 years between 1993 and 1997 and participating in the Norfolk cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Norfolk). We used data on age at menarche and ascertained diabetes incidence to 2005. RESULTS There were 734 cases of diabetes (363 incident and 371 prevalent cases). Mean age at menarche was lower in women with diabetes than in non-diabetic women (12.8 vs 13.0 years, p = 0.008). Compared with the earliest quintile (menarche at 8-11 years), women in the oldest quintile (menarche at 15-18 years) had lower BMI (25.5 vs 27.4 kg/m2, p < 0.0001) and a reduced risk of diabetes (OR 0.66 [95% CI 0.51-0.86] adjusted for age, family history, physical activity, smoking, occupational social class, parity and use of hormonal preparations). The association between age at menarche and diabetes was linear (adjusted OR 0.91 [95% CI 0.87-0.96] per 1 year later menarche) and appeared to be completely mediated by adult BMI or waist circumference (OR 0.98 [95% CI 0.93-1.03], further adjusted for BMI at age 40-75 years). CONCLUSIONS/INTERPRETATION Earlier age at menarche increases the risk of diabetes in women and this association appears to be mediated by increased adiposity. History of earlier menarche may help to identify women with increased subsequent risk of diabetes.
Collapse
Affiliation(s)
- R Lakshman
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Box 285, Cambridge, CB2 0QQ, UK
| | | | | | | | | | | | | |
Collapse
|
39
|
Holt HB, Wild SH, Wareham N, Ekelund U, Umpleby M, Shojaee-Moradie F, Holt RIG, Phillips DI, Byrne CD. Differential effects of fatness, fitness and physical activity energy expenditure on whole-body, liver and fat insulin sensitivity. Diabetologia 2007; 50:1698-706. [PMID: 17534596 DOI: 10.1007/s00125-007-0705-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2007] [Accepted: 04/17/2007] [Indexed: 10/23/2022]
Abstract
AIMS/HYPOTHESIS The relative contributions of fitness (maximal oxygen uptake), physical activity energy expenditure (PAEE) and fatness to whole-body, liver and fat insulin sensitivity is uncertain. The aim of this study was to determine whether fitness and PAEE are associated with whole-body, liver and fat insulin sensitivity independently of body fat. MATERIALS AND METHODS We recruited 25 men (mean [SD] age 53 [6] years). Whole-body (M value) and liver (percentage suppression of endogenous glucose output) insulin sensitivity were estimated using a hyperinsulinaemic-euglycaemic clamp. Insulin sensitivity in fat (insulin sensitivity index for NEFA) was estimated during an OGTT. Total and truncal fat were measured by dual-energy X-ray absorptiometry, fitness by treadmill, and PAEE (n = 21) by 3 day heart rate monitoring and Baecke questionnaire. RESULTS In univariate analyses, fatness was strongly associated with insulin sensitivity (whole-body, liver and fat). Fitness was associated with whole-body (r = 0.53, p < 0.007) and liver (0.42, p = 0.04) insulin sensitivity, while PAEE was associated with liver insulin sensitivity (r = 0.55, p = 0.01). Regression models were established to describe associations between fatness, fitness and physical activity and measures of insulin sensitivity (whole-body, fat and liver) as outcomes. Only fatness was independently associated with whole-body insulin sensitivity (B coefficient -0.01, p = 0.001). Fitness was not associated with any outcome. Only PAEE was independently associated with liver insulin sensitivity (B coefficient 13.5, p = 0.02). CONCLUSIONS/INTERPRETATION Fatness explains most of the variance in whole-body insulin sensitivity. In contrast, PAEE explains most of the variance in liver insulin sensitivity.
Collapse
Affiliation(s)
- H B Holt
- Endocrinology and Metabolism, DOHaD Division,School of Medicine, University of Southampton, Southampton, UK
| | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Affiliation(s)
- N Wareham
- MRC Epidemiology Unit, Elsie Widdowson Laboratories, Cambridge, UK.
| |
Collapse
|
41
|
Kaptoge S, Jakes RW, Dalzell N, Wareham N, Khaw KT, Loveridge N, Beck TJ, Reeve J. Effects of physical activity on evolution of proximal femur structure in a younger elderly population. Bone 2007; 40:506-15. [PMID: 17098489 DOI: 10.1016/j.bone.2006.09.021] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2006] [Accepted: 09/06/2006] [Indexed: 10/23/2022]
Abstract
INTRODUCTION For a fixed weight, a wider bone of standardised length is stiffer. But moving the cortices away from the centre of mass risks creating structural (elastic) instability, and hip fractures have been postulated to occur as a consequence of buckling of the thinned supero-lateral femoral neck cortex during a fall. We hypothesised that stereotyped physical activity (e.g., walking) may help conserve bending resistance (section modulus, Z) through redistribution of bone tissue, but it might be at the expense of supero-lateral cortical stability. METHODS Hip structural analysis (HSA) software applied to DXA scans was used to derive measurements of section modulus and distances of a cross-section's centre of mass from the supero-lateral cortical margin (lateral distance, in cm). DXA scans were obtained on 1361 men and women in the EPIC-Norfolk population-based prospective cohort study. Up to 4 repeat DXA scans were done in 8 years of follow-up. Weight, height and activities of daily living were assessed on each occasion. A detailed physical activity and lifestyle questionnaire was administered at baseline. The lateral distance was measured on three narrow cross-sections with good precision: narrow neck (NN, coefficient of variation 2.6%), intertrochanter (IT) and shaft (S). A linear mixed model was used to assess associations with predictors. RESULTS Ageing was associated with medial shifting of the centre of mass, so that lateral distance increased. Both greater weight and height were associated with greater lateral distance (P<0.0001). Among physical activity-related variables, walking/cycling for >1 h/day (P=0.025), weekly time spent on moderate impact activity (P=0.003), forced expiratory volume in 1 s (NN and IT, P<0.026) and lifetime physical activity (IT, P<0.0001) were associated with higher lateral distance. However, after adjusting for these variables, activities of daily living scores (NN, P<0.0001) and weekly time spent on low impact hip flexing activities were associated with shorter lateral distance (P=0.001). Greater baseline lateral distance was significantly associated with increased risk of subsequent hip fracture (n=26) in females (P<0.05, all regions) independently of age, height and bone mineral content. CONCLUSION The age-related shift medially of the centre of mass of the femoral neck and trochanter may have adverse effects on fracture resistance in the event of a fall, so compromising the beneficial effects of walking on fitness, strength and risk of falling. The role of more diverse physical activity patterns in old age that impose loading on the supero-lateral cortex of the femur, involving for example hip flexion and stretching, needs investigation for their ability to correct this medial shifting of the centre of mass.
Collapse
Affiliation(s)
- S Kaptoge
- Institute of Public Health, Strangeways Research Laboratory, University of Cambridge, Cambridge, UK.
| | | | | | | | | | | | | | | |
Collapse
|
42
|
Shohaimi S, Welch A, Bingham S, Luben R, Day N, Wareham N, Khaw KT. Area deprivation predicts lung function independently of education and social class. Eur Respir J 2005; 24:157-61. [PMID: 15293619 DOI: 10.1183/09031936.04.00088303] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.4] [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: 11/05/2022]
Abstract
The cross-sectional association between socioeconomic status (at both the individual and area-based level) and lung function, as measured by forced expiratory volume in one second, in a large population-based cohort was investigated. The study population consisted of 22,675 males and females aged 39-79 yrs. They were recruited from the general community in Norfolk, UK using general practice age/sex registers, as part of the European Prospective Investigation into Cancer (EPIC-Norfolk). It was found that being in a manual occupational social class, having no educational qualifications and living in a deprived area all independently predicted significantly lower lung function, even after controlling for smoking habit. The influence of area-deprivation on lung function, independent of individual socioeconomic status and of individual smoking habit, suggests that apart from targeting individuals who are at high-risk, such as smokers, environmental determinants also need to be examined when considering measures to improve respiratory health.
Collapse
Affiliation(s)
- S Shohaimi
- Institute of Public Health, University of Cambridge, Cambridge, UK
| | | | | | | | | | | | | |
Collapse
|
43
|
Canoy D, Luben R, Welch A, Bingham S, Wareham N, Day N, Khaw KT. Abdominal obesity and respiratory function in men and women in the EPIC-Norfolk Study, United Kingdom. Am J Epidemiol 2004; 159:1140-9. [PMID: 15191931 DOI: 10.1093/aje/kwh155] [Citation(s) in RCA: 156] [Impact Index Per Article: 7.8] [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: 12/21/2022] Open
Abstract
Poor respiratory function and obesity are associated with all-cause and cardiovascular disease mortality. Obese persons may also have impaired lung function, but the mechanism is unclear. The authors investigated the relation between abdominal pattern of obesity and respiratory function in the European Prospective Investigation into Cancer and Nutrition-Norfolk (EPIC-Norfolk) cohort in Norfolk, United Kingdom. This analysis included 9,674 men and 11,876 women aged 45-79 years with no known preexisting serious illness who had complete anthropometric and respiratory function measures obtained at a health visit between 1993 and 1997. Waist:hip ratio was used to assess abdominal obesity, and forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC), obtained by spirometry, were used to assess respiratory function. Both FEV1 and FVC were linearly and inversely related across the entire range of waist:hip ratio in both men and women. This relation persisted after adjustment for age, body mass index, cigarette smoking, social class, physical activity index, prevalent bronchitis/emphysema, and prevalent asthma. The association remained significant among nonobese nonsmokers without preexisting respiratory disease. In the general adult population, abdominal fat deposition may play a role in the impairment of respiratory function among the abdominally obese.
Collapse
Affiliation(s)
- D Canoy
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.
| | | | | | | | | | | | | |
Collapse
|
44
|
Shohaimi S, Bingham S, Welch A, Luben R, Day N, Wareham N, Khaw KT. Occupational social class, educational level and area deprivation independently predict plasma ascorbic acid concentration: a cross-sectional population based study in the Norfolk cohort of the European Prospective Investigation into Cancer (EPIC-Norfolk). Eur J Clin Nutr 2004; 58:1432-5. [PMID: 15054419 DOI: 10.1038/sj.ejcn.1601979] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [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: 02/05/2023]
Abstract
OBJECTIVE To investigate the independent association between three different measures of socioeconomic status and plasma ascorbic acid level. DESIGN Cross-sectional population based study. SETTING AND PARTICIPANTS 20 292 men and women aged 39-79 y who participated in the EPIC-Norfolk study. RESULTS Individuals in manual social classes, who had no educational qualifications or those who lived in the most deprived areas had significantly lower levels of plasma ascorbic acid compared to those in nonmanual social classes, with at least O-level qualifications or who lived in less deprived areas. The magnitude of effect for each measure of socioeconomic status was greater in current smokers compared to current nonsmokers. CONCLUSION Education and social class were stronger predictors of differences in ascorbic acid levels, an indicator of dietary health behaviour, than a deprivation index based on the Townsend score. This suggests that education could be particularly important in influencing large socioeconomic differentials in health related behaviours and potentially, health outcomes in the UK.
Collapse
Affiliation(s)
- S Shohaimi
- Institute of Public Health, University of Cambridge, UK.
| | | | | | | | | | | | | |
Collapse
|
45
|
Kaptoge S, Dalzell N, Jakes RW, Wareham N, Day NE, Khaw KT, Beck TJ, Loveridge N, Reeve J. Hip section modulus, a measure of bending resistance, is more strongly related to reported physical activity than BMD. Osteoporos Int 2003; 14:941-9. [PMID: 12955315 DOI: 10.1007/s00198-003-1484-2] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.0] [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: 01/16/2003] [Accepted: 05/26/2003] [Indexed: 10/26/2022]
Abstract
We hypothesized that measures of physical activity would have a closer relationship with section modulus (SM), an indicator of bending resistance, than with bone mineral density (BMD) because physical activity might expand the bony envelope, which tends to reduce BMD for a constant bone mineral content. Four hundred twenty-three men and 436 women (mean age 72 years, SD =3) were recruited from a prospective population-based cohort study to a study of hip bone loss. Hip BMD was measured on two occasions 2-5 years apart (mean 2.7, DXA-Hologic 1,000 W). Hip structural analysis (HSA) software was used to calculate SM and BMD from the DXA scans on three narrow regions: the narrow neck (NN), intertrochanter (IT) and shaft (S). A physical activity and lifestyle questionnaire was administered at baseline. Multivariate repeated measures analysis of variance was used to model the associations between personal attributes (weight, height, age), physical activity and lifestyle variables with SM, cross-sectional area (CSA), sub-periosteal diameter (PD) and BMD. Men and women were analysed together after tests for interactions with gender, which were found not to be significant. In all regions female gender was associated with having lower values of all outcomes, and body weight was positively associated with all outcomes, i.e., SM, CSA, PD and BMD ( P<0.0001). Sub-periosteal diameter was positively associated with reported lifetime physical activity (IT and S, P<0.0001). There was a significant decline of BMD with age at the NN and S regions ( P<0.026), and the PD increased with age (NN and S, P<0.019). Previous fracture history was associated with having lower values of BMD, SM and CSA (except for S; P<0.022). Both section modulus and CSA were positively associated with heavy physical activity after age 50 years in all regions ( P<0.019), whereas NN BMD was the only BMD associate of heavy physical activity after 50 ( P=0.036). Time spent per week on recreational activities classified as no impact activity was positively associated with BMD, CSA and SM (multivariate P<0.016). In conclusion, proximal femur diameter is associated positively with reported life-long physical activity. If this is mediated through a loading related effect on sub-periosteal expansion, BMD would be an unsatisfactory outcome measure in physical activity studies since it is inversely related to projected bone area. SM in contrast was associated with several measures of recent physical activity and relates more directly to the bending experienced by the proximal femur in response to a given load. These data are consistent with an effect of mechanical loading to regulate bone strength through an anabolic effect maximal in the subperiosteal cortex, where the highest loading-related strains are experienced.
Collapse
Affiliation(s)
- S Kaptoge
- Strangeways Research Laboratory, Cambridge University, Worts' Causeway, CB1 8RN, Cambridge, UK.
| | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Shohaimi S, Luben R, Wareham N, Day N, Bingham S, Welch A, Oakes S, Khaw KT. Residential area deprivation predicts smoking habit independently of individual educational level and occupational social class. A cross sectional study in the Norfolk cohort of the European Investigation into Cancer (EPIC-Norfolk). J Epidemiol Community Health 2003; 57:270-6. [PMID: 12646543 PMCID: PMC1732421 DOI: 10.1136/jech.57.4.270] [Citation(s) in RCA: 144] [Impact Index Per Article: 6.9] [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: 11/04/2022]
Abstract
OBJECTIVES To investigate the independent association between individual and area based measures of socioeconomic status and cigarette smoking habit. DESIGN AND SETTING Cross sectional, population based study. PARTICIPANTS AND METHODS 12 579 men and 15 132 women aged 39-79 years living in the general community participating in the EPIC-Norfolk Study in 1993-1997. The association between social class, educational status, Townsend residential deprivation level, and cigarette smoking status was examined. MAIN OUTCOME MEASURES Cigarette smoking status at baseline survey. RESULTS Social class, educational level, and residential deprivation level independently related to cigarette smoking habit in both men and women. Multivariate age adjusted odds ratios for current smoking in men were 1.62 (95% CI 1.45 to 1.81) for manual compared with non-manual social class, 1.32 (95% CI 1.17 to 1.48) for those with educational level less than O level compared with those with O level qualifications or higher and 1.84 (95% CI 1.62 to 2.08) for high versus low area deprivation level. For women, the odds ratios for current smoking for manual social class were 1.14 (95% CI 1.03 to 1.27); 1.31 (95% CI 1.18 to 1.46) for low educational level and 1.68 (95% CI 1.49 to 1.90) for high residential deprivation respectively. CONCLUSIONS Residential deprivation level using the Townsend score, individual social class, and educational level all independently predict smoking habit in both men and women. Efforts to reduce cigarette smoking need to tackle not just individual but also area based factors. Understanding the specific factors in deprived areas that influence smoking habit may help inform preventive efforts.
Collapse
Affiliation(s)
- S Shohaimi
- Institute of Public Health, University of Cambridge, UK MRC Dunn Human Nutrition Unit, Cambridge, UK
| | | | | | | | | | | | | | | |
Collapse
|
47
|
Haftenberger M, Schuit AJ, Tormo MJ, Boeing H, Wareham N, Bueno-de-Mesquita HB, Kumle M, Hjartåker A, Chirlaque MD, Ardanaz E, Andren C, Lindahl B, Peeters PHM, Allen NE, Overvad K, Tjønneland A, Clavel-Chapelon F, Linseisen J, Bergmann MM, Trichopoulou A, Lagiou P, Salvini S, Panico S, Riboli E, Ferrari P, Slimani N. Physical activity of subjects aged 50-64 years involved in the European Prospective Investigation into Cancer and Nutrition (EPIC). Public Health Nutr 2002; 5:1163-76. [PMID: 12639225 DOI: 10.1079/phn2002397] [Citation(s) in RCA: 125] [Impact Index Per Article: 5.7] [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: 11/11/2022]
Abstract
OBJECTIVE To describe physical activity of participants in the European Prospective Investigation into Cancer and Nutrition (EPIC). DESIGN A cross-sectional analysis of baseline data of a European prospective cohort study. SUBJECTS This analysis was restricted to participants in the age group 50-64 years, which was represented in all EPIC centres. It involved 236 386 participants from 25 centres in nine countries. In each EPIC centre, physical activity was assessed by standardised and validated questions. Frequency distribution of type of professional activity and participation in non-professional activities, and age-adjusted means, medians and percentiles of time dedicated to non-professional activities are presented for men and women from each centre. RESULTS Professional activity was most frequently classified as sedentary or standing in all centres. There was a wide variation regarding participation in different types of non-professional activities and time dedicated to these activities across EPIC centres. Over 80% of all EPIC participants engaged in walking, while less than 50% of the subjects participated in sport. Total time dedicated to recreational activities was highest among the Dutch participants and lowest among men from Malmö (Sweden) and women from Naples (Italy). In all centres, total time dedicated to recreational activity in the summer was higher than in the winter. Women from southern Europe spent the most time on housekeeping. CONCLUSIONS There is a considerable variation of physical activity across EPIC centres. This variation was especially evident for recreational activities in both men and women.
Collapse
Affiliation(s)
- M Haftenberger
- German Institute of Human Nutrition, Department of Epidemiology, Arthur Scheunert Allee 114-116, D-14558 Potsdam-Rehbrücke, Germany.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Luben R, Khaw KT, Welch A, Bingham S, Wareham N, Oakes S, Day NE. Plasma vitamin C, cancer mortality and incidence in men and women: a prospective study. IARC Sci Publ 2002; 156:117-8. [PMID: 12484141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Affiliation(s)
- R Luben
- Dept. of Public Health and Primary Care, University of Cambridge, UK
| | | | | | | | | | | | | |
Collapse
|
49
|
Bingham SA, Welch AA, McTaggart A, Mulligan AA, Runswick SA, Luben R, Oakes S, Khaw KT, Wareham N, Day NE. Nutritional methods in the European Prospective Investigation of Cancer in Norfolk. Public Health Nutr 2001; 4:847-58. [PMID: 11415493 DOI: 10.1079/phn2000102] [Citation(s) in RCA: 300] [Impact Index Per Article: 13.0] [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: 11/11/2022]
Abstract
OBJECTIVE To describe methods and dietary habits of a large population cohort. DESIGN Prospective assessment of diet using diet diaries and food-frequency questionnaires, and biomarkers of diet in 24-h urine collections and blood samples. SETTING Free living individuals aged 45 to 75 years living in Norfolk, UK. SUBJECTS Food and nutrient intake from a food-frequency questionnaire on 23 003 men and women, and from a 7-day diet diary from 2117 men and women. Nitrogen, sodium and potassium excretion was obtained from single 24-h urine samples from 300 individuals in the EPIC cohort. Plasma vitamin C was measured for 20 846 men and women. RESULTS The food-frequency questionnaire (FFQ) and the food diary were able to determine differences in foods and nutrients between the sexes and were reliable as judged by repeated administrations of each method. Plasma vitamin C was significantly higher in women than men. There were significant differences in mean intake of all nutrients measured by the two different methods in women but less so in men. The questionnaire overestimated dairy products and vegetables in both men and women when compared with intakes derived from the diary, but underestimated cereal and meat intake in men. There were some consistent trends with age in food and nutrient intakes assessed by both methods, particularly in men. Correlation coefficients between dietary intake assessed from the diary and excretion of nitrogen and potassium in a single 24-h urine sample ranged from 0.36 to 0.47. Those comparing urine excretion and intake assessed from the FFQ were 0.09 to 0.26. The correlations between plasma vitamin C and dietary intake from the first FFQ, 24-h recall or diary were 0.28, 0.35 and 0.40. CONCLUSIONS EPIC Norfolk is one of the largest epidemiological studies of nutrition in the UK and the largest on which plasma vitamin C has been obtained. Methods for obtaining food and nutrient intake are described in detail. The results shown here for food and nutrient intakes can be compared with results from other population studies utilising different methods of assessing dietary intake. The utility of different methods used in different settings within the main EPIC cohort is described. The FFQ is to be used particularly in pooled analyses of risk from diet in relation to cancer incidence within the larger European EPIC study, where measurement error is more likely to be overcome by large dietary heterogeneity on an international basis. Findings in the UK, where dietary variation between individuals is smaller and hence the need to use a more accurate individual method greater, will be derived from the 7-day diary information on a nested case-control basis. 24-h recalls can be used in the event that diary information should not be forthcoming from some eventual cases. Combinations of results utilising all dietary methods and biomarkers may also be possible.
Collapse
Affiliation(s)
- S A Bingham
- EPIC, Institute of Public Health and Strangeways Research Laboratories, Worts Causeway, Cambridge CB1 4RN, UK.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Khaw KT, Bingham S, Welch A, Luben R, Wareham N, Oakes S, Day N. Relation between plasma ascorbic acid and mortality in men and women in EPIC-Norfolk prospective study: a prospective population study. European Prospective Investigation into Cancer and Nutrition. Lancet 2001; 357:657-63. [PMID: 11247548 DOI: 10.1016/s0140-6736(00)04128-3] [Citation(s) in RCA: 411] [Impact Index Per Article: 17.9] [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] [Indexed: 02/07/2023]
Abstract
BACKGROUND Ascorbic acid (vitamin C) might be protective for several chronic diseases. However, findings from prospective studies that relate ascorbic acid to cardiovascular disease or cancer are not consistent. We aimed to assess the relation between plasma ascorbic acid and subsequent mortality due to all causes, cardiovascular disease, ischaemic heart disease, and cancer. METHODS We prospectively examined for 4 years the relation between plasma ascorbic acid concentrations and mortality due to all causes, and to cardiovascular disease, ischaemic heart disease, and cancer in 19 496 men and women aged 45-79 years. We recruited individuals by post using age-sex registers of general practices. Participants completed a health and lifestyle questionnaire and were examined at a clinic visit. They were followed-up for causes of death for about 4 years. Individuals were divided into sex-specific quintiles of plasma ascorbic acid. We used the Cox proportional hazard model to determine the effect of ascorbic acid and other risk factors on mortality. FINDINGS Plasma ascorbic acid concentration was inversely related to mortality from all-causes, and from cardiovascular disease, and ischaemic heart disease in men and women. Risk of mortality in the top ascorbic acid quintile was about half the risk in the lowest quintile (p<0.0001). The relation with mortality was continuous through the whole distribution of ascorbic acid concentrations. 20 micromol/L rise in plasma ascorbic acid concentration, equivalent to about 50 g per day increase in fruit and vegetable intake, was associated with about a 20% reduction in risk of all-cause mortality (p<0.0001), independent of age, systolic blood pressure, blood cholesterol, cigarette smoking habit, diabetes, and supplement use. Ascorbic acid was inversely related to cancer mortality in men but not women. INTERPRETATION Small increases in fruit and vegetable intake of about one serving daily has encouraging prospects for possible prevention of disease.
Collapse
Affiliation(s)
- K T Khaw
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, UK.
| | | | | | | | | | | | | |
Collapse
|