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Pastorino R, Pezzullo AM, Osti T, Adany R, Borry P, Barnhoorn F, Fadil E, Kroese M, Metspalu A, Perez-Gomez B, Perola M, Quaggia D, Scollen S, Shabani M, Swartling Peterson S, van El C, Vicente A, Boccia S. The PROPHET project paves the way for personalized prevention in the future healthcare. Eur J Cancer Prev 2024:00008469-990000000-00127. [PMID: 38598497 DOI: 10.1097/cej.0000000000000873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Affiliation(s)
- Roberta Pastorino
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Angelo Maria Pezzullo
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Tommaso Osti
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Roza Adany
- ELKH DE Public Health Research Group, Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Pascal Borry
- Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Floris Barnhoorn
- European Public Health Association (EUPHA), Utrecht, Netherlands
| | - Eva Fadil
- G.A.C., Innovation Department., G.A.C. Group, Issy-les-Moulineaux, France
| | - Mark Kroese
- PHG Foundation, University of Cambridge, Cambridge, UK
| | | | - Beatriz Perez-Gomez
- Consortium for Biomedical Research in Epidemiology and Public Health
- Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Markus Perola
- Genomics and Biomarkers Unit, Department of Health, National Institute for Health and Welfare (THL), Helsinki, Finland
| | | | | | - Mahsa Shabani
- Department of Criminology, Criminal Law and Social Law, University of Gent, Gent, Belgium
| | | | - Carla van El
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Clinical Genetics, Section Community Genetics, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Astrid Vicente
- Departamento de Promoção da Saúde e Doenças Não Transmissíveis, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Stefania Boccia
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Woman and Child Health and Public Health-Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Kovacs N, Piko P, Juhasz A, Nagy C, Oroszi B, Ungvari Z, Adany R. Comparative analysis of health status and health service utilization patterns among rural and urban elderly populations in Hungary: a study on the challenges of unhealthy aging. GeroScience 2024; 46:2017-2031. [PMID: 37798385 PMCID: PMC10828334 DOI: 10.1007/s11357-023-00926-y] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 08/27/2023] [Indexed: 10/07/2023] Open
Abstract
The demographic transition poses a significant challenge for health systems, especially in Central and Eastern European (CEE) countries, where the healthcare needs of aging populations are on the rise. This study aimed to describe and compare the health status and utilization of health services among the elderly residing in urban and rural areas of the most deprived region in Hungary. A comprehensive health survey was conducted in 2022, involving a randomly selected sample of 443 older adults (≥ 65 years) in Northeast Hungary. Multivariable logistic regression models adjusting for age, sex, education, financial status, chronic diseases, and activity limitations were used to investigate the association between type of residence and health service use. Among the study participants, 62.3% were female, 38.3% attained primary education, 12.5% reported a bad or very bad financial situation and 52.6% lived in urban areas. Overall, 24% of the elderly rated their health as very good or good (27.8% in urban and 19.7% in rural areas), while 57.8% (52.6% and 63.5% in urban and rural areas) reported limitations in daily activities. Compared to urban residents, rural residents reported lower rates of dentist visits (p = 0.006), specialist visits (p = 0.028), faecal occult blood testing (p < 0.001), colorectal cancer screening with colonoscopy (p = 0.014), and breast cancer screening (p = 0.035), and a higher rate of blood pressure measurement (p = 0.042). Multivariable models indicated that urban residence was positively associated with faecal occult blood testing (OR = 2.32, p = 0.014), but negatively associated with blood pressure (OR = 0.42, p = 0.017) and blood glucose measurements (OR = 0.48, p = 0.009). These findings highlight the influence of residence on health service utilization among older adults in Hungary. Further comprehensive studies are needed to better understand the health needs of the elderly population and to develop policies aimed at promoting healthy aging in CEE countries.
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Affiliation(s)
- Nora Kovacs
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- ELKH-DE Public Health Research Group, Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Peter Piko
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Center for Epidemiology and Surveillance, National Laboratory for Health Security, Semmelweis University, Budapest, Hungary
| | - Attila Juhasz
- Center for Epidemiology and Surveillance, National Laboratory for Health Security, Semmelweis University, Budapest, Hungary
| | - Csilla Nagy
- Center for Epidemiology and Surveillance, National Laboratory for Health Security, Semmelweis University, Budapest, Hungary
| | - Beatrix Oroszi
- Center for Epidemiology and Surveillance, National Laboratory for Health Security, Semmelweis University, Budapest, Hungary
| | - Zoltan Ungvari
- Vascular Cognitive Impairment and Neurodegeneration Program, Oklahoma Center for Geroscience and Healthy Brain Aging, Department of Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine, Departments of Public Health and Translational Medicine, Semmelweis University, Budapest, Hungary
- The Peggy and Charles Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Roza Adany
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
- ELKH-DE Public Health Research Group, Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
- Center for Epidemiology and Surveillance, National Laboratory for Health Security, Semmelweis University, Budapest, Hungary.
- Department of Public Health, Semmelweis University, Budapest, Hungary.
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3
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Ungvari Z, Tabák AG, Adany R, Purebl G, Kaposvári C, Fazekas-Pongor V, Csípő T, Szarvas Z, Horváth K, Mukli P, Balog P, Bodizs R, Ujma P, Stauder A, Belsky DW, Kovács I, Yabluchanskiy A, Maier AB, Moizs M, Östlin P, Yon Y, Varga P, Vokó Z, Papp M, Takács I, Vásárhelyi B, Torzsa P, Ferdinandy P, Csiszar A, Benyó Z, Szabó AJ, Dörnyei G, Kivimäki M, Kellermayer M, Merkely B. The Semmelweis Study: a longitudinal occupational cohort study within the framework of the Semmelweis Caring University Model Program for supporting healthy aging. GeroScience 2024; 46:191-218. [PMID: 38060158 PMCID: PMC10828351 DOI: 10.1007/s11357-023-01018-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 09/07/2023] [Accepted: 11/11/2023] [Indexed: 12/08/2023] Open
Abstract
The Semmelweis Study is a prospective occupational cohort study that seeks to enroll all employees of Semmelweis University (Budapest, Hungary) aged 25 years and older, with a population of 8866 people, 70.5% of whom are women. The study builds on the successful experiences of the Whitehall II study and aims to investigate the complex relationships between lifestyle, environmental, and occupational risk factors, and the development and progression of chronic age-associated diseases. An important goal of the Semmelweis Study is to identify groups of people who are aging unsuccessfully and therefore have an increased risk of developing age-associated diseases. To achieve this, the study takes a multidisciplinary approach, collecting economic, social, psychological, cognitive, health, and biological data. The Semmelweis Study comprises a baseline data collection with open healthcare data linkage, followed by repeated data collection waves every 5 years. Data are collected through computer-assisted self-completed questionnaires, followed by a physical health examination, physiological measurements, and the assessment of biomarkers. This article provides a comprehensive overview of the Semmelweis Study, including its origin, context, objectives, design, relevance, and expected contributions.
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Affiliation(s)
- Zoltan Ungvari
- International Training Program in Geroscience/Healthy Aging Program, Doctoral School of Basic and Translational Medicine/Department of Public Health, Semmelweis University, Budapest, Hungary.
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
- Department of Health Promotion Sciences, The Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
| | - Adam G Tabák
- International Training Program in Geroscience/Healthy Aging Program, Doctoral School of Basic and Translational Medicine/Department of Public Health, Semmelweis University, Budapest, Hungary
- Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- UCL Brain Sciences, University College London, London, UK
- Department of Internal Medicine and Oncology, Semmelweis University, Faculty of Medicine, Budapest, Hungary
| | - Roza Adany
- International Training Program in Geroscience/Healthy Aging Program, Doctoral School of Basic and Translational Medicine/Department of Public Health, Semmelweis University, Budapest, Hungary
- Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- HUN-REN-UD Public Health Research Group, Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - György Purebl
- Institute of Behavioral Sciences, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Csilla Kaposvári
- Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Vince Fazekas-Pongor
- Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Tamás Csípő
- International Training Program in Geroscience/Healthy Aging Program, Doctoral School of Basic and Translational Medicine/Department of Public Health, Semmelweis University, Budapest, Hungary
- Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Zsófia Szarvas
- International Training Program in Geroscience/Healthy Aging Program, Doctoral School of Basic and Translational Medicine/Department of Public Health, Semmelweis University, Budapest, Hungary
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Health Promotion Sciences, The Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Krisztián Horváth
- Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Peter Mukli
- International Training Program in Geroscience/Healthy Aging Program, Doctoral School of Basic and Translational Medicine/Department of Public Health, Semmelweis University, Budapest, Hungary
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Piroska Balog
- Institute of Behavioral Sciences, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Robert Bodizs
- Institute of Behavioral Sciences, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Peter Ujma
- Institute of Behavioral Sciences, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Adrienne Stauder
- Institute of Behavioral Sciences, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Daniel W Belsky
- Robert N. Butler Columbia Aging Center, Columbia University, New York, NY, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Illés Kovács
- Department of Ophthalmology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- Department of Ophthalmology, Weill Cornell Medical College, New York City, NY, USA
- Department of Clinical Ophthalmology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
| | - Andriy Yabluchanskiy
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Health Promotion Sciences, The Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Andrea B Maier
- Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Centre for Healthy Longevity, National University Health System, Singapore, Singapore
- Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Mariann Moizs
- Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- Ministry of Interior of Hungary, Budapest, Hungary
| | | | - Yongjie Yon
- WHO Regional Office for Europe, Copenhagen, Denmark
| | - Péter Varga
- Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- Clinical Center, Semmelweis University, Budapest, Hungary
| | - Zoltán Vokó
- Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary
| | - Magor Papp
- Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - István Takács
- UCL Brain Sciences, University College London, London, UK
| | - Barna Vásárhelyi
- Department of Laboratory Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Torzsa
- Department of Family Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Ferdinandy
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Anna Csiszar
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Health Promotion Sciences, The Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Zoltán Benyó
- Department of Translational Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- HUN-REN-SU Cerebrovascular and Neurocognitive Diseases Research Group, Budapest, Hungary
| | - Attila J Szabó
- First Department of Pediatrics, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- HUN-REN-SU Pediatrics and Nephrology Research Group, Semmelweis University, Budapest, Hungary
| | - Gabriella Dörnyei
- Department of Morphology and Physiology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
| | - Mika Kivimäki
- UCL Brain Sciences, University College London, London, UK
| | - Miklos Kellermayer
- Department of Biophysics and Radiation Biology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Bela Merkely
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
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4
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Pandics T, Major D, Fazekas-Pongor V, Szarvas Z, Peterfi A, Mukli P, Gulej R, Ungvari A, Fekete M, Tompa A, Tarantini S, Yabluchanskiy A, Conley S, Csiszar A, Tabak AG, Benyo Z, Adany R, Ungvari Z. Exposome and unhealthy aging: environmental drivers from air pollution to occupational exposures. GeroScience 2023; 45:3381-3408. [PMID: 37688657 PMCID: PMC10643494 DOI: 10.1007/s11357-023-00913-3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/14/2023] [Indexed: 09/11/2023] Open
Abstract
The aging population worldwide is facing a significant increase in age-related non-communicable diseases, including cardiovascular and brain pathologies. This comprehensive review paper delves into the impact of the exposome, which encompasses the totality of environmental exposures, on unhealthy aging. It explores how environmental factors contribute to the acceleration of aging processes, increase biological age, and facilitate the development and progression of a wide range of age-associated diseases. The impact of environmental factors on cognitive health and the development of chronic age-related diseases affecting the cardiovascular system and central nervous system is discussed, with a specific focus on Alzheimer's disease, Parkinson's disease, stroke, small vessel disease, and vascular cognitive impairment (VCI). Aging is a major risk factor for these diseases. Their pathogenesis involves cellular and molecular mechanisms of aging such as increased oxidative stress, impaired mitochondrial function, DNA damage, and inflammation and is influenced by environmental factors. Environmental toxicants, including ambient particulate matter, pesticides, heavy metals, and organic solvents, have been identified as significant contributors to cardiovascular and brain aging disorders. These toxicants can inflict both macro- and microvascular damage and many of them can also cross the blood-brain barrier, inducing neurotoxic effects, neuroinflammation, and neuronal dysfunction. In conclusion, environmental factors play a critical role in modulating cardiovascular and brain aging. A deeper understanding of how environmental toxicants exacerbate aging processes and contribute to the pathogenesis of neurodegenerative diseases, VCI, and dementia is crucial for the development of preventive strategies and interventions to promote cardiovascular, cerebrovascular, and brain health. By mitigating exposure to harmful environmental factors and promoting healthy aging, we can strive to reduce the burden of age-related cardiovascular and brain pathologies in the aging population.
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Affiliation(s)
- Tamas Pandics
- Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- Department of Public Health Laboratory, National Public Health Centre, Budapest, Hungary
- Department of Public Health Siences, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
| | - David Major
- Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Vince Fazekas-Pongor
- Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Zsofia Szarvas
- Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Anna Peterfi
- Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Peter Mukli
- Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Rafal Gulej
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Anna Ungvari
- Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Monika Fekete
- Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Anna Tompa
- Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Stefano Tarantini
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, USA
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Department of Public Health, Semmelweis University, Budapest, Hungary
| | - Andriy Yabluchanskiy
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, USA
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Department of Public Health, Semmelweis University, Budapest, Hungary
| | - Shannon Conley
- Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Anna Csiszar
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, USA
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Adam G Tabak
- Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- UCL Brain Sciences, University College London, London, UK
- Department of Internal Medicine and Oncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Zoltan Benyo
- Department of Translational Medicine, Semmelweis University, Budapest, Hungary
- Eötvös Loránd Research Network and Semmelweis University (ELKH-SE) Cerebrovascular and Neurocognitive Disorders Research Group, Budapest, H-1052, Hungary
| | - Roza Adany
- Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- ELKH-DE Public Health Research Group, Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032, Debrecen, Hungary
- Epidemiology and Surveillance Centre, Semmelweis University, 1085, Budapest, Hungary
| | - Zoltan Ungvari
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, USA.
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Department of Public Health, Semmelweis University, Budapest, Hungary.
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5
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Piko P, Jenei T, Kosa Z, Sandor J, Kovacs N, Seres I, Paragh G, Adany R. Association of HDL Subfraction Profile with the Progression of Insulin Resistance. Int J Mol Sci 2023; 24:13563. [PMID: 37686368 PMCID: PMC10488248 DOI: 10.3390/ijms241713563] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 08/24/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) is a major global public health problem, as it is associated with increased morbidity, mortality, and healthcare costs. Insulin resistance (IR) is a condition characterized by disturbances in carbohydrate and lipid metabolism that precedes T2DM. The aim of the present study was to investigate the association between HDL and its subfraction profile and the progression of IR, as assessed by the Homeostatic Model Assessment for IR (HOMA-IR) index, and to define cut-off values to identify an increased risk of IR. Individuals with a HOMA-IR greater than 3.63 were considered to have IR. The HDL subfractions were separated using the Lipoprint system, which identifies ten subfractions (HDL-1-10) in three subclasses as large (HDL-L), intermediate (HDL-I) and small (HDL-S). Analyses were performed on samples from 240 individuals without IR and 137 with IR from the Hungarian general and Roma populations. The HDL-1 to -6 subfractions and the HDL-L and -I classes showed a significant negative association with the progression and existence of IR. Among them, HDL-2 (B = -40.37, p = 2.08 × 10-11) and HDL-L (B = -14.85, p = 9.52 × 10-10) showed the strongest correlation. The optimal threshold was found to be 0.264 mmol/L for HDL-L and 0.102 mmol/L and above for HDL-2. Individuals with HDL-L levels below the reference value had a 5.1-fold higher risk of IR (p = 2.2 × 10-7), while those with HDL-2 levels had a 4.2-fold higher risk (p = 3.0 × 10-6). This study demonstrates that the HDL subfraction profile (especially the decrease in HDL-2 and -L) may be a useful marker for the early detection and intervention of atherogenic dyslipidemia in subjects with impaired glucose and insulin metabolism.
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Affiliation(s)
- Peter Piko
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (P.P.); (T.J.); (J.S.); (N.K.)
- National Laboratory for Health Security, Center for Epidemiology and Surveillance, Semmelweis University, 1089 Budapest, Hungary
| | - Tibor Jenei
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (P.P.); (T.J.); (J.S.); (N.K.)
| | - Zsigmond Kosa
- Department of Health Methodology and Public Health, Faculty of Health, University of Debrecen, 4400 Nyíregyháza, Hungary;
| | - Janos Sandor
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (P.P.); (T.J.); (J.S.); (N.K.)
- ELKH-DE Public Health Research Group, Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4028 Debrecen, Hungary
| | - Nora Kovacs
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (P.P.); (T.J.); (J.S.); (N.K.)
- ELKH-DE Public Health Research Group, Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4028 Debrecen, Hungary
| | - Ildiko Seres
- Institute of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (I.S.); (G.P.)
| | - Gyorgy Paragh
- Institute of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (I.S.); (G.P.)
| | - Roza Adany
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (P.P.); (T.J.); (J.S.); (N.K.)
- National Laboratory for Health Security, Center for Epidemiology and Surveillance, Semmelweis University, 1089 Budapest, Hungary
- ELKH-DE Public Health Research Group, Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4028 Debrecen, Hungary
- Department of Public Health, Semmelweis University, 1089 Budapest, Hungary
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6
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Piko P, Jenei T, Kosa Z, Sandor J, Kovacs N, Seres I, Paragh G, Adany R. Association of CETP Gene Polymorphisms and Haplotypes with Cardiovascular Risk. Int J Mol Sci 2023; 24:10281. [PMID: 37373432 DOI: 10.3390/ijms241210281] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/07/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
Cholesteryl ester transfer protein (CETP) is known to influence HDL-C levels, potentially altering the profile of HDL subfractions and consequently cardiovascular risk (CVR). This study aimed to investigate the effect of five single-nucleotide polymorphisms (SNPs; rs1532624, rs5882, rs708272, rs7499892, and rs9989419) and their haplotypes (H) in the CETP gene on 10-year CVR estimated by the Systematic Coronary Risk Evaluation (SCORE), the Framingham Risk Score for Coronary Heart Disease (FRSCHD) and Cardiovascular Disease (FRSCVD) algorithms. Adjusted linear and logistic regression analyses were used to investigate the association of SNPs and 10 haplotypes (H1-H10) on 368 samples from the Hungarian general and Roma populations. The T allele of rs7499892 showed a significant association with increased CVR estimated by FRS. H5, H7, and H8 showed a significant association with increased CVR based on at least one of the algorithms. The impact of H5 was due to its effect on TG and HDL-C levels, while H7 showed a significant association with FRSCHD and H8 with FRSCVD mediated by a mechanism affecting neither TG nor HDL-C levels. Our results suggest that polymorphisms in the CETP gene may have a significant effect on CVR and that this is not mediated exclusively by their effect on TG and HDL-C levels but also by presently unknown mechanisms.
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Affiliation(s)
- Peter Piko
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
- National Laboratory for Health Security, Center for Epidemiology and Surveillance, Semmelweis University, 1089 Budapest, Hungary
| | - Tibor Jenei
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Zsigmond Kosa
- Department of Health Methodology and Public Health, Faculty of Health, University of Debrecen, 4400 Nyíregyhza, Hungary
| | - Janos Sandor
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
- ELKH-DE Public Health Research Group, Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4028 Debrecen, Hungary
| | - Nora Kovacs
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
- ELKH-DE Public Health Research Group, Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4028 Debrecen, Hungary
| | - Ildiko Seres
- Institute of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Gyorgy Paragh
- Institute of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Roza Adany
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
- National Laboratory for Health Security, Center for Epidemiology and Surveillance, Semmelweis University, 1089 Budapest, Hungary
- ELKH-DE Public Health Research Group, Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4028 Debrecen, Hungary
- Department of Public Health, Semmelweis University, 1089 Budapest, Hungary
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Piko P, Llanaj E, Nagy K, Adany R. Genetic Background of Metabolically Healthy and Unhealthy Obesity Phenotypes in Hungarian Adult Sample Population. Int J Mol Sci 2023; 24:ijms24065209. [PMID: 36982283 PMCID: PMC10049500 DOI: 10.3390/ijms24065209] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 03/30/2023] Open
Abstract
A specific phenotypic variant of obesity is metabolically healthy (MHO), which is characterized by normal blood pressure and lipid and glucose profiles, in contrast to the metabolically unhealthy variant (MUO). The genetic causes underlying the differences between these phenotypes are not yet clear. This study aims to explore the differences between MHO and MUO and the contribution of genetic factors (single nucleotide polymorphisms-SNPs) in 398 Hungarian adults (81 MHO and 317 MUO). For this investigation, an optimized genetic risk score (oGRS) was calculated using 67 SNPs (related to obesity and to lipid and glucose metabolism). Nineteen SNPs were identified whose combined effect was strongly associated with an increased risk of MUO (OR = 1.77, p < 0.001). Four of them (rs10838687 in MADD, rs693 in APOB, rs1111875 in HHEX, and rs2000813 in LIPG) significantly increased the risk of MUO (OR = 1.76, p < 0.001). Genetic risk groups based on oGRS were significantly associated with the risk of developing MUO at a younger age. We have identified a cluster of SNPs that contribute to the development of the metabolically unhealthy phenotype among Hungarian adults suffering from obesity. Our findings emphasize the significance of considering the combined effect(s) of multiple genes and SNPs in ascertaining cardiometabolic risk in obesity in future genetic screening programs.
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Affiliation(s)
- Peter Piko
- ELKH-DE Public Health Research Group, Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
- Epidemiology and Surveillance Centre, Semmelweis University, 1085 Budapest, Hungary
| | - Erand Llanaj
- ELKH-DE Public Health Research Group, Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Karoly Nagy
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Roza Adany
- ELKH-DE Public Health Research Group, Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
- Epidemiology and Surveillance Centre, Semmelweis University, 1085 Budapest, Hungary
- Department of Public Health, Semmelweis University, 1089 Budapest, Hungary
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Pikó P, Werissa NA, Kosa Z, Sandor J, Seres I, Paragh G, Adany R. Association of HDL subfractions with cardiovascular risk in Hungarian general and Roma populations. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
High-density lipoprotein (HDL) cholesterol levels are inversely associated with cardiovascular risk (CVR). However, HDL cholesterol is not a homogeneous lipid and can be subdivided into subfractions, which are not uniformly associated with CVR. Among Roma populations, the prevalence of reduced HDL cholesterol levels and, consequently, that of cardiovascular diseases is very high. However, it is not known how this reduction affects the different HDL subfractions and whether changes in their representation are associated with changes in CVR.
Methods
The study aimed to investigate whether there is a difference in the HDL subfraction profile between the Hungarian general (HG) and Roma populations and to determine the association of the different subfractions with the CVR estimated by the Framingham Risk Score (FRS) and the Systematic COronary Risk Evaluation (SCORE) algorithms. HDL cholesterol was separated using the Lipoprint system, which separates 10 subfractions into three classes: large HDL (HDL-L), medium HDL (HDL-I), and small HDL (HDL-S). Analyses were carried out on samples of 100 control subjects (50 Hungarian general and 50 Roma individuals with normal lipid profiles) and 277 individuals with reduced HDL-C levels.
Results
Our results show that Roma has reduced levels of the overall HDL subfraction profile, with significant decreases in HDL-6, and -7. Regardless of the estimation method, elevated levels (in mmol/L) of HDL-1 to 3 and HDL-L were significantly associated with reduced risk. A higher representation (in %) of HDL-1 to 3 subfractions have a significant risk-reducing, while HDL-8 to 10 have a risk-increasing effect estimated by FRS.
Conclusions
The results of our study show that levels of CVR protective HDL subfractions are significantly lower in Roma individuals and their reduced levels are associated with increased CVR, suggesting that the distribution of HDL subfractions contributes to the overall unfavourable CVR profile of Roma.
Key messages
• Levels of HDL-6 and -7 subfractions were significantly lower in the Roma population than in the Hungarian general one.
• The HDL subfraction profile of the Roma population is associated with a higher cardiovascular risk among them.
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Affiliation(s)
- P Pikó
- ELKH-DE-Public Health Research Group, University of Debrecen , Debrecen, Hungary
| | - NA Werissa
- ELKH-DE-Public Health Research Group, University of Debrecen , Debrecen, Hungary
| | - Z Kosa
- Department of Health Methodology and Public Health, University of Debrecen , Debrecen, Hungary
| | - J Sandor
- Department of Public Health and Epidemiology, University of Debrecen , Debrecen, Hungary
| | - I Seres
- Department of Internal Medicine, University of Debrecen , Debrecen, Hungary
| | - G Paragh
- Department of Internal Medicine, University of Debrecen , Debrecen, Hungary
| | - R Adany
- ELKH-DE-Public Health Research Group, University of Debrecen , Debrecen, Hungary
- Department of Public Health and Epidemiology, University of Debrecen , Debrecen, Hungary
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Piko P, Kosa Z, Sandor J, Seres I, Paragh G, Adany R. SNPs and haplotypes in the CETP gene and their effects on cardiovascular risk estimated by FRS and score in the Hungarian general and Roma populations. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.740] [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: 11/02/2022]
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Piko P, Dioszegi J, Kosa Z, Sandor J, Adany R. Changes in the prevalence of MetS and its components between 2011 and 2018 in the Roma Population. Eur J Public Health 2021. [PMCID: PMC8574260 DOI: 10.1093/eurpub/ckab165.251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Metabolic syndrome (MetS) is a worldwide problem with severe health consequences, which are further exacerbated by the current COVID-19 pandemic. In this study, we examine the changes in the prevalence of MetS and its components among the Roma (one of the most vulnerable ethnic group in Europe) in two disadvantaged counties of North-eastern Hungary in the period between 2011 and 2018.
Methods
Two health examination surveys were performed in the Hungarian Roma population aged 20-64 years in 2011 (n = 458) and in 2018 (n = 374). The data from these surveys were used to examine how the prevalence of MetS and its components and the prevalence of relevant preventive medication changed during the study period.
Results
The increase in the prevalence of MetS itself in the whole Roma population was not found to be significant in the period examined (although it increased from 40.0% up to 46.0%, p = 0.080); however, there was a significant increase in the prevalence of central obesity (from 62.7% to 73.3%, p = 0.001) and raised blood pressure (BP) or treated hypertension (from 45.2% to 54.5%, p = 0.007). These changes were mainly observed in the younger age groups, so the risk for MetS increased significantly in the 20-34 (OR = 1.10, p = 0.038) and 35-49 (OR = 1.07, p = 0.048) year-old groups in the 2018 study population compared to the 2011 one. A favourable non-significant decrease was observed in the prevalence of raised fasting plasma glucose concentration (from 29.0% to 24.1%, p = 0.107) and reduced HDL-C levels (from 60.3% to 55.6%) over the study period.
Conclusions
The increasing prevalence of hidden hypertension and, consequently, the number of untreated individuals with raised BP (from 29.6% to 43.5%, p = 0.014) among women is quite alarming; therefore, a targeted public health strategy and targeted interventions are desperately needed to prevent further worsening of the current situation.
Key messages
Among Roma women, the prevalence of hidden hypertension and, consequently, of elevated blood pressure increased significantly over the study period. Stopping the increasing trend of MetS would require interventions which focus on the increasing prevalence of central obesity and hypertension in the Roma population.
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Affiliation(s)
- P Piko
- MTA-DE Public Health Research Group, University of Debrecen, Debrecen, Hungary
| | - J Dioszegi
- MTA-DE Public Health Research Group, University of Debrecen, Debrecen, Hungary
| | - Zs Kosa
- Department of Health Methodology and Public Health, University of Debrecen, Nyíregyháza, Hungary
| | - J Sandor
- Department of Public Health and Epidemiology, University of Debrecen, Debrecen, Hungary
| | - R Adany
- MTA-DE Public Health Research Group, University of Debrecen, Debrecen, Hungary
- Department of Public Health and Epidemiology, University of Debrecen, Debrecen, Hungary
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Carinci F, Štotl I, Cunningham SG, Poljicanin T, Pristas I, Traynor V, Olympios G, Scoutellas V, Azzopardi J, Doggen K, Sandor J, Adany R, Løvaas KF, Jarosz-Chobot P, Polanska J, Pruna S, de Lusignan S, Monesi M, Di Bartolo P, Scheidt-Nave C, Heidemann C, Zucker I, Maurina A, Lepiksone J, Rossing P, Arffman M, Keskimäki I, Gudbjornsdottir S, Di Iorio CT, Dupont E, de Sabata S, Klazinga N, Benedetti MM. Making Use of Comparable Health Data to Improve Quality of Care and Outcomes in Diabetes: The EUBIROD Review of Diabetes Registries and Data Sources in Europe. Front Clin Diabetes Healthc 2021; 2:744516. [PMID: 36994337 PMCID: PMC10012140 DOI: 10.3389/fcdhc.2021.744516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 09/08/2021] [Indexed: 12/16/2022]
Abstract
BackgroundRegistries and data sources contain information that can be used on an ongoing basis to improve quality of care and outcomes of people with diabetes. As a specific task of the EU Bridge Health project, we carried out a survey of diabetes-related data sources in Europe.ObjectivesWe aimed to report on the organization of different sources of diabetes information, including their governance, information infrastructure and dissemination strategies for quality control, service planning, public health, policy and research.MethodsSurvey using a structured questionnaire to collect targeted data from a network of collaborating institutions managing registries and data sources in 17 countries in the year 2017.ResultsThe 18 data sources participating in the study were most frequently academic centres (44.4%), national (72.2%), targeting all types of diabetes (61.1%) covering no more than 10% of the target population (44.4%). Although population-based in over a quarter of cases (27.8%), sources relied predominantly on provider-based datasets (38.5%), fewer using administrative data (16.6%). Data collection was continuous in the majority of cases (61.1%), but 50% could not perform data linkage. Public reports were more frequent (72.2%) as well as quality reports (77.8%), but one third did not provide feedback to policy and only half published ten or more peer reviewed papers during the last 5 years.ConclusionsThe heterogeneous implementation of diabetes registries and data sources hampers the comparability of quality and outcomes across Europe. Best practices exist but need to be shared more effectively to accelerate progress and deliver equitable results for people with diabetes.
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Affiliation(s)
- Fabrizio Carinci
- Department of Statistical Sciences, University of Bologna, Bologna, Italy
- *Correspondence: Fabrizio Carinci,
| | - Iztok Štotl
- Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Scott G. Cunningham
- Department of Population Health and Genomics, University of Dundee, Dundee, United Kingdom
| | - Tamara Poljicanin
- Division for Health Informatics and Biostatistics, Croatian Institute of Public Health, Zagreb, Croatia
| | - Ivan Pristas
- Division for Health Informatics and Biostatistics, Croatian Institute of Public Health, Zagreb, Croatia
| | - Vivie Traynor
- Diabetes Department, Larnaca Hospital Cyprus, Larnaca, Cyprus
| | - George Olympios
- Diabetes Department, Larnaca Hospital Cyprus, Larnaca, Cyprus
| | - Vasos Scoutellas
- Diabetes Department, Larnaca Hospital Cyprus, Larnaca, Cyprus
- Health Monitoring Unit, Ministry of Health, Nicosia, Cyprus
| | | | - Kris Doggen
- Health Services Research, Sciensano, Brussels, Belgium
| | - János Sandor
- Department of Public Health and Epidemiology, School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Roza Adany
- Department of Public Health and Epidemiology, School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Karianne F. Løvaas
- Norwegian Diabetes Register for Adults, Norwegian Organisation for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Przemka Jarosz-Chobot
- Department of Children’s Diabetology, Medical University of Silesia, Katowice, Poland
| | - Joanna Polanska
- Department of Data Science and Engineering, The Silesian University of Technology, Gliwice, Poland
| | | | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Marcello Monesi
- Diabetes Unit “Sant’Anna” Hospital Ferrara, Ferrara, Italy
- Associazione Medici Diabetologi (AMD), Rome, Italy
| | - Paolo Di Bartolo
- Associazione Medici Diabetologi (AMD), Rome, Italy
- Azienda Unità Sanitaria Locale (AUSL) Diabetes Unit Romagna, Ravenna, Italy
| | - Christa Scheidt-Nave
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Christin Heidemann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Inbar Zucker
- Israel Center for Disease Control, Ministry of Health, Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anita Maurina
- Research and Health Statistics Department, Centre for Disease Prevention and Control of Latvia, Riga, Latvia
| | - Jana Lepiksone
- Research and Health Statistics Department, Centre for Disease Prevention and Control of Latvia, Riga, Latvia
| | | | - Martti Arffman
- Welfare State Research and Reform Unit, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Ilmo Keskimäki
- Welfare State Research and Reform Unit, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Soffia Gudbjornsdottir
- Department of Molecular and Clinical Medicine, University of Gothenburg and Sahlgrenska Hospital, Gothenburg, Sweden
| | | | - Elisabeth Dupont
- International Diabetes Federation European Region, Brussels, Belgium
| | - Stella de Sabata
- International Diabetes Federation European Region, Brussels, Belgium
| | - Niek Klazinga
- Department of Public and Occupational Health, Amsterdam UMC, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Massimo Massi Benedetti
- International Diabetes Federation European Region, Brussels, Belgium
- Hub for International Health Research, Perugia, Italy
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Affiliation(s)
- Zoltan Ungvari
- Healthy Aging Program, Department of Public Health, Semmelweis University, Budapest, Hungary
- Vascular Cognitive Impairment and Neurodegeneration Program, Center for Geroscience and Healthy Brain Aging/Reynolds Oklahoma Center on Aging, Department of Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Health Promotion Sciences, The Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Roza Adany
- Healthy Aging Program, Department of Public Health, Semmelweis University, Budapest, Hungary
- Department of Public Health and Epidemiology, MTA-DE Public Health Research Group, University of Debrecen, Debrecen, Hungary
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13
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Piko P, Dioszegi J, Kosa Z, Sandor J, Moizs M, Adany R. Changes in the Prevalence of Metabolic Syndrome, Its Components, and Relevant Preventive Medication between 2011 and 2018 in the Northeast Hungarian Roma Population. J Pers Med 2021; 11:jpm11070595. [PMID: 34202560 PMCID: PMC8304367 DOI: 10.3390/jpm11070595] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 06/13/2021] [Accepted: 06/22/2021] [Indexed: 12/19/2022] Open
Abstract
Metabolic syndrome (MetS) is a cluster of clinical conditions that poses a major health burden worldwide. In the present study, we investigate the changes in the prevalence of MetS and its components among the Roma in two disadvantaged counties in Northeastern Hungary focusing on a seven-year-long period. The database of the present study is based on cross-sectional surveys of the Hungarian Roma population (aged 20-64 years) conducted in 2011 (n = 458) and 2018 (n = 374). The increase in the prevalence of MetS itself in the whole Roma population was not found to be significant in the period examined (although it increased from 40.0% up to 46.0%, p = 0.080); however, regarding its components, there was a significant increase in the prevalence of central obesity (from 62.7% to 73.3%, p = 0.001) and raised blood pressure (BP) or treated hypertension (from 45.2% to 54.5%, p = 0.007). These changes were mainly observed in the younger age groups, so the risk for MetS increased significantly in the 20-34 (OR = 1.10, p = 0.038) and 35-49 (OR = 1.07, p = 0.048) year age groups in the 2018 study population compared the 2011 one. The increasing prevalence of hidden hypertension and, consequently, untreated individuals with raised BP (from 29.6% to 43.5%, p = 0.014) among females is quite alarming; therefore, a targeted public health strategy and targeted interventions are desperately needed to prevent further worsening of the current situation.
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Affiliation(s)
- Peter Piko
- MTA-DE Public Health Research Group, University of Debrecen, 4032 Debrecen, Hungary; (P.P.); (J.D.)
| | - Judit Dioszegi
- MTA-DE Public Health Research Group, University of Debrecen, 4032 Debrecen, Hungary; (P.P.); (J.D.)
| | - Zsigmond Kosa
- Department of Health Methodology and Public Health, Faculty of Health, University of Debrecen, 4400 Nyíregyháza, Hungary;
| | - Janos Sandor
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary;
| | - Mariann Moizs
- Kaposi Mór Teaching Hospital, 7400 Kaposvár, Hungary;
| | - Roza Adany
- MTA-DE Public Health Research Group, University of Debrecen, 4032 Debrecen, Hungary; (P.P.); (J.D.)
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary;
- Correspondence: ; Tel.: +36-52-512-765 (ext. 77174)
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Piko P, Dioszegi J, Sandor J, Adany R. Changes in the Prevalence of Metabolic Syndrome and Its Components as Well as in Relevant Preventive Medication between 2006 and 2018 in the Northeast Hungarian Population. J Pers Med 2021; 11:jpm11010052. [PMID: 33467044 PMCID: PMC7829989 DOI: 10.3390/jpm11010052] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/06/2021] [Accepted: 01/13/2021] [Indexed: 12/21/2022] Open
Abstract
Metabolic syndrome (MetS) is a worldwide problem with severe health consequences. In this study, we examine the changes in the prevalence of MetS and its components in two disadvantaged counties of Northeastern Hungary. Two health examination surveys were performed in the Hungarian population aged 20–64 years in 2006 (n = 450) and 2018 (n = 397) and the data were compared to each other. It was found that the prevalence of MetS increased significantly in the period examined (from 34.9% to 42.2%, p = 0.035) due to the increased prevalence of raised blood pressure (from 45.6% to 57.0%, p = 0.002) and raised fasting glucose concentration (13.2% vs. 24.8%, p < 0.001). The increase mainly affects the younger (20–34 years old) age group (12.1% in 2006 vs. 31.6% in 2018, p = 0.001). It is quite alarming that the prevalence of MetS and its components has increased significantly in the last decade, while the prevalence of preventive medication is unchanged (antihypertensive and antidiabetic treatments) or even significantly decreased (lipid-lowering medication). Consequently, the number of individuals untreated for hypertension and metabolic disturbances is severely increased. A targeted public health strategy is desperately needed to prevent further worsening the situation.
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Affiliation(s)
- Peter Piko
- MTA-DE Public Health Research Group, University of Debrecen, 4032 Debrecen, Hungary; (P.P.); (J.D.)
| | - Judit Dioszegi
- MTA-DE Public Health Research Group, University of Debrecen, 4032 Debrecen, Hungary; (P.P.); (J.D.)
| | - Janos Sandor
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary;
| | - Roza Adany
- MTA-DE Public Health Research Group, University of Debrecen, 4032 Debrecen, Hungary; (P.P.); (J.D.)
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary;
- Correspondence: ; Tel.: +36-52-512-765 (ext. 77174)
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Piko P, Werissa NA, Fiatal S, Sandor J, Adany R. Impact of Genetic Factors on the Age of Onset for Type 2 Diabetes Mellitus in Addition to the Conventional Risk Factors. J Pers Med 2020; 11:jpm11010006. [PMID: 33375163 PMCID: PMC7822179 DOI: 10.3390/jpm11010006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 12/17/2020] [Accepted: 12/20/2020] [Indexed: 12/14/2022] Open
Abstract
It is generally accepted that the early detection of type 2 diabetes mellitus (T2DM) is important to prevent the development of complications and comorbidities, as well as premature death. The onset of type 2 diabetes mellitus results from a complex interplay between genetic, environmental, and lifestyle risk factors. Our study aims to evaluate the joint effect of T2DM associated single nucleotide polymorphisms (SNPs) on the age of onset for T2DM in combination with conventional risk factors (such as sex, body mass index (BMI), and TG/HDL-C ratio) in the Hungarian population. This study includes 881 T2DM patients (Case population) and 1415 samples from the Hungarian general population (HG). Twenty-three SNPs were tested on how they are associated with the age of onset for T2DM in the Case population and 12 of them with a certified effect on the age of T2DM onset were chosen for an optimized genetic risk score (GRS) analysis. Testing the validity of the GRS model developed was carried out on the HG population. The GRS showed a significant association with the age of onset for T2DM (β = -0.454, p = 0.001) in the Case population, as well as among T2DM patients in the HG one (β = -0.999, p = 0.003) in the replication study. The higher the GRS, the earlier was the T2DM onset. Individuals with more than eight risk alleles will presumably be diabetic six and a half years earlier than those with less than four risk alleles. Our results suggest that there is a considerable genetic predisposition for the early onset of T2DM; therefore, in addition to conventional risk factors, GRS can be used as a tool for estimating the risk of the earlier onset of T2DM and stratifying populations at risk in order to define preventive interventions.
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Affiliation(s)
- Peter Piko
- MTA-DE Public Health Research Group, University of Debrecen, 4028 Debrecen, Hungary; (P.P.); (N.A.W.)
| | - Nardos Abebe Werissa
- MTA-DE Public Health Research Group, University of Debrecen, 4028 Debrecen, Hungary; (P.P.); (N.A.W.)
- Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary
| | - Szilvia Fiatal
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (S.F.); (J.S.)
| | - Janos Sandor
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (S.F.); (J.S.)
| | - Roza Adany
- MTA-DE Public Health Research Group, University of Debrecen, 4028 Debrecen, Hungary; (P.P.); (N.A.W.)
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (S.F.); (J.S.)
- Correspondence: ; Tel.: +36-5251-2764
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Werissa NA, Piko P, Fiatal S, Kosa Z, Sandor J, Adany R. SNP-Based Genetic Risk Score Modeling Suggests No Increased Genetic Susceptibility of the Roma Population to Type 2 Diabetes Mellitus. Genes (Basel) 2019; 10:genes10110942. [PMID: 31752367 PMCID: PMC6896051 DOI: 10.3390/genes10110942] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 11/12/2019] [Accepted: 11/18/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND In a previous survey, an elevated fasting glucose level (FG) and/or known type 2 diabetes mellitus (T2DM) were significantly more frequent in the Roma population than in the Hungarian general population. We assessed whether the distribution of 16 single nucleotide polymorphisms (SNPs) with unequivocal effects on the development of T2DM contributes to this higher prevalence. METHODS Genetic risk scores, unweighted (GRS) and weighted (wGRS), were computed and compared between the study populations. Associations between GRSs and FG levels and T2DM status were investigated in separate and combined study populations. RESULTS The Hungarian general population carried a greater genetic risk for the development of T2DM (GRSGeneral = 15.38 ± 2.70 vs. GRSRoma = 14.80 ± 2.68, p < 0.001; wGRSGeneral = 1.41 ± 0.32 vs. wGRSRoma = 1.36 ± 0.31, p < 0.001). In the combined population models, GRSs and wGRSs showed significant associations with elevated FG (p < 0.001) and T2DM (p < 0.001) after adjusting for ethnicity, age, sex, body mass index (BMI), high-density Lipoprotein Cholesterol (HDL-C), and triglyceride (TG). In these models, the effect of ethnicity was relatively strong on both outcomes (FG levels: βethnicity = 0.918, p < 0.001; T2DM status: ORethnicity = 2.484, p < 0.001). CONCLUSIONS The higher prevalence of elevated FG and/or T2DM among Roma does not seem to be directly linked to their increased genetic load but rather to their environmental/cultural attributes. Interventions targeting T2DM prevention among Roma should focus on harmful environmental exposures related to their unhealthy lifestyle.
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Affiliation(s)
- Nardos Abebe Werissa
- MTA−DE Public Health Research Group of the Hungarian Academy of Sciences, Public Health Research Institute, University of Debrecen, 4028 Debrecen, Hungary; (N.A.W.); (P.P.)
- Doctorial School of Health Sciences, University of Debrecen, 4028 Debrecen, Hungary
| | - Peter Piko
- MTA−DE Public Health Research Group of the Hungarian Academy of Sciences, Public Health Research Institute, University of Debrecen, 4028 Debrecen, Hungary; (N.A.W.); (P.P.)
| | - Szilvia Fiatal
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4028 Debrecen, Hungary; (S.F.); (J.S.)
- WHO Collaborating Centre on Vulnerability and Health, University of Debrecen, 4028 Debrecen, Hungary
| | - Zsigmond Kosa
- Department of Health Visitor Methodology and Public Health, Faculty of Health, University of Debrecen, 4400 Nyíregyháza, Hungary;
| | - Janos Sandor
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4028 Debrecen, Hungary; (S.F.); (J.S.)
- WHO Collaborating Centre on Vulnerability and Health, University of Debrecen, 4028 Debrecen, Hungary
| | - Roza Adany
- MTA−DE Public Health Research Group of the Hungarian Academy of Sciences, Public Health Research Institute, University of Debrecen, 4028 Debrecen, Hungary; (N.A.W.); (P.P.)
- WHO Collaborating Centre on Vulnerability and Health, University of Debrecen, 4028 Debrecen, Hungary
- Correspondence: ; Tel: +36-5251-2764
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Piko P, Fiatal S, Kosa Z, Sandor J, Adany R. Increased risk of Roma for 10-year development of CVDs based on Framingham Risk Score calculation. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz187.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Increased mortality and short life expectancy of Roma are well known epidemiological findings which can be partially explained by the high prevalence of cardiovascular risk factors among them. This study assesses the prevalence of the cardiovascular disease (CVD) risk factors (age, sex, systolic blood pressure, smoking and diabetes status, elevated total and reduced high density lipoprotein cholesterol level (HDL-C)) and the estimation of 10-year risk of development of CVD (CVD in general, coronary heart disease (CHD), myocardial infarction (MI) and stroke) and that of death from CHD and CVD based on the Framingham Risk Score (FRS) in case of the Hungarian general (HG) and Roma (HR) populations.
Methods
A complex health survey incl. questionnaire based interview, physical examination and laboratory test was carried out in 2018 on the HG and HR populations. The prevalence of different cardiovascular risk factors was defined and FRS was computed and compared between the HG (n = 378) and HR (n = 386) populations.
Results
The prevalence of diabetes was significantly higher among Roma females compared to females of general population (17.8% vs. 7.7%; p = 0.001) while the average systolic blood pressure level was less elevated among Roma males (127.9 mmHg vs. 129.4 mmHg; p = 0.020). The prevalence of smoking (males: 63.1% vs. 33.7%; females: 67.6% vs. 31%; p < 0.001) and reduced HDL-C level (males: 40% vs. 25.9%, p = 0.014; females: 55.5% vs. 35.1%, p < 0.001) were significantly higher in both sexes among Roma. The 10-year estimated risk for development of CHD, MI and CVD and the death from CHD was significantly (P < 0.05) higher in both sexes among Roma compared to the general population while the average risk scores for stroke and death from CVD were significantly higher only among Roma men.
Conclusions
Our results show that both sexes in the Roma population have a significantly higher risk for 10-year development of CVD compared to the Hungarian general population.
Key messages
The Roma population have a significantly higher risk for 10-year development of cardiovascular diseases and death from them based on the Framingham Risk Score. The targeted cardiovascular interventions should be focus on reduce smoking and provide information on the recognition and treatment of diabetes and lipid disorders among Roma.
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Affiliation(s)
- P Piko
- MTA-DE, Public Health Research Group of the Hungarian Academy of Sciences, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - S Fiatal
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
- WHO Collaborating Centre on Vulnerability and Health, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Z Kosa
- Department of Health Visitor Methodology and Public Health, Faculty of Health, University of Debrecen, Nyíregyháza, Hungary
| | - J Sandor
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
- WHO Collaborating Centre on Vulnerability and Health, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - R Adany
- MTA-DE, Public Health Research Group of the Hungarian Academy of Sciences, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
- WHO Collaborating Centre on Vulnerability and Health, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
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Jakovljevic M, Jakab M, Gerdtham U, McDaid D, Ogura S, Varavikova E, Merrick J, Adany R, Okunade A, Getzen TE. Comparative financing analysis and political economy of noncommunicable diseases. J Med Econ 2019; 22:722-727. [PMID: 30913928 DOI: 10.1080/13696998.2019.1600523] [Citation(s) in RCA: 112] [Impact Index Per Article: 22.4] [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] [Indexed: 10/27/2022]
Abstract
The pandemic of chronic non-communicable diseases (NCDs) poses substantial challenges to the health financing sustainability in high-income and low/middle income countries (LMICs). The aim of this review is to identify the bottle neck inefficiencies in NCDs attributable spending and propose sustainable health financing solutions. The World Health Organization (WHO) introduced the "best buy" concept to scale up the core intervention package against NCDs targeted for LMICs. Population- and individual-based NCD best buy interventions are projected at US$170 billion over 2011-2025. Appropriately designed health financing arrangements can be powerful enablers to scale up the NCD best buys. Rapidly developing emerging nations dominate the landscape of LMICs. Their capability and willingness to invest resources for eradicating NCDs could strengthen WHO outreach efforts in Asia, Africa, and Latin America, much beyond current capacities. There has been a declining trend in international donor aid intended to cope with NCDs over the past decade. There is also a serious misalignment of these resources with the actual needs of recipient countries. Globally, the momentum towards the financing of intersectoral actions is growing, and this presents a cost-effective solution. A budget discrepancy of 10:1 in WHO and multilateral agencies remains in donor aid in favour of communicable diseases compared to NCDs. LMICs are likely to remain a bottleneck of NCDs imposed financing sustainability challenge in the long-run. Catastrophic household health expenditure from out of pocket spending on NCDs could plunge almost 150 million people into poverty worldwide. This epidemiological burden coupled with population ageing presents an exceptionally serious sustainability challenge, even among the richest countries which are members of the Organization for Economic Co-operation and Development (OECD). Strategic and political leadership of WHO and multilateral agencies would likely play essential roles in the struggle that has just begun.
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Affiliation(s)
- Mihajlo Jakovljevic
- a Department of Global Health Economics and Policy , University of Kragujevac , Kragujevac , Serbia
| | - Melitta Jakab
- b World Health Organization Regional Office for Europe , WHO Barcelona Office for Health Systems Strengthening , Barcelona , Spain
| | - Ulf Gerdtham
- c Division of Health Economics , Lund University , Lund , Sweden
| | - David McDaid
- d London School of Economics and Political Science , London , UK
| | - Seiritsu Ogura
- e Faculty of Economics , Hosei University , Tokyo , Japan
| | - Elena Varavikova
- f Federal Research Institute of Public Health , Moscow , Russian Federation
| | - Joav Merrick
- g Division of Pediatrics , Hadassah Hebrew University Medical Center , Mt Scopus Campus , Israel
| | - Roza Adany
- h Department of Preventive Medicine, Faculty of Public Health , University of Debrecen MTA-DE Public Health Research Group , Debrecen , Hungary
| | - Albert Okunade
- i Fogelman College of Business & Economics , University of Memphis , Memphis , TN , USA
| | - Thomas E Getzen
- j Insurance and Health Management at the Fox School of Business , Temple University , Philadelphia , PA , USA
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Petráková A, Horáková D, Kollárová H, Otok R, Majdan M, Paulik E, Adany R, Kiedik D, Gotlib J, Juszczyk G. ASPHER V4 Working Group established to support V4 public health capacity development. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Petráková
- Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic
| | - D Horáková
- Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic
| | - H Kollárová
- Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic
| | - R Otok
- ASPHER Office, Brussels, Belgium
| | - M Majdan
- Trnava University in Trnava, Trnava, Slovakia
| | - E Paulik
- University of Szeged, Szeged, Hungary
| | - R Adany
- University of Debrecen, Debrecen, Hungary
| | - D Kiedik
- Medical University of Wroclaw, Wroclav, Poland
| | - J Gotlib
- Medical University of Warsaw, Warsaw, Poland
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20
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Adany R. Predictive and discriminative accuracy of SNPs’ panels in NCD prevention, diagnosis and treatment. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- R Adany
- MTA-DE Public Health Research Group, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
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21
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Pastorino R, Adany R, Barnhoorn F, Boffetta P, Boretti F, Cornel M, Van Duijn C, Gray M, Roldan J, Villari P, Zawati M, Boccia S. The Personalized PREvention of Chronic Diseases (PRECeDI) recommendations on Personalized Medicine. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- R Pastorino
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - R Adany
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | | | - P Boffetta
- Icahn School of Medicine at Mount Sinai, New York, USA
| | - F Boretti
- Myriad Genetics Srl (MYRIAD), Milan, Italy
| | - M Cornel
- VU University Medical Center, Amsterdam, Netherlands
| | - C Van Duijn
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - M Gray
- Better Value Healthcare Ltd, Oxford, UK
| | - J Roldan
- Linkcare Health Services, Barcelona, Spain
| | - P Villari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - M Zawati
- Centre of Genomics and Policy, Department of Human Genetics, McGill University, Montreal, Canada
| | - S Boccia
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, IRCCS Fondazio, Rome, Italy
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Abstract
Background The continent of Europe has experienced remarkable changes in the past 25 years, providing scope for natural experiments that offer insight into the complex determinants of health. Methods We analysed trends in life expectancy at birth in three parts of Europe, those countries that were members of the European Union (EU) prior to 2004, countries that joined the European Union since then, and the twelve countries that emerged from the Soviet Union to form the Commonwealth of Independent States (CIS). The contribution of deaths at different ages to these changes was assessed using Arriaga's method of decomposing changes in life expectancy. Results Europe remains divided geographically, with an East-West gradient. The former Soviet countries experienced a marked initial decline in life expectancy and have only recovered after 2005. However, the situation for those of working ages is little better than in 1990. The pre-2004 EU has seen substantial gains throughout the past 25 years, although there is some evidence that this may be slowing, or even reversing, at older ages. The countries joining the EU in 2004 subsequently began to see some improvements in the early 1990s, but have experienced larger gains since 2000. Conclusions Europe offers a valuable natural laboratory for understanding the impact of political, economic, and social changes on health. While the historic divisions of Europe are still visible, there is also evidence that individual countries are doing better or worse than their neighbours, providing many lessons that can be learned from.
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Affiliation(s)
- Marina Karanikolos
- European Observatory on Health Systems and Policies, London School of Hygiene and Tropical Medicine, London, UK
| | - Roza Adany
- School of Public Health, University of Debrecen, Debrecen, Hungary
| | - Martin McKee
- European Observatory on Health Systems and Policies, London School of Hygiene and Tropical Medicine, London, UK
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23
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Jakovljevic MM, Netz Y, Buttigieg SC, Adany R, Laaser U, Varjacic M. Population aging and migration - history and UN forecasts in the EU-28 and its east and south near neighborhood - one century perspective 1950-2050. Global Health 2018; 14:30. [PMID: 29548339 PMCID: PMC5857107 DOI: 10.1186/s12992-018-0348-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 03/01/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is a gap in knowledge on long term pace of population aging acceleration and related net-migration rate changes in WHO European Region and its adjacent MENA countries. We decided to compare European Union (EU-28) region with the EU Near Neighborhood Policy Region East and EU Near Neighborhood Policy Region South in terms of these two essential features of third demographic transition. One century long perspective dating back to both historical data and towards reliable future forecasts was observed. METHODS United Nation's Department of Economic and Social Affairs estimates on indicators of population aging and migration were observed. Time horizon adopted was 1950-2050. Targeted 44 countries belong to either one of three regions named by EU diplomacy as: European Union or EU-28, EU Near Neighborhood Policy Region East (ENP East) and EU Near Neighborhood Policy Region South (ENP South). RESULTS European Union region currently experiences most advanced stage of demographic aging. The latter one is the ENP East region dominated by Slavic nations whose fertility decline continues since the USSR Era back in late 1980s. ENP South region dominated by Arab League nations remains rather young compared to their northern counterparts. However, as the Third Demographic Transition is inevitably coming to these societies they remain the spring of youth and positive net emigration rate. Probably the most prominent change will be the extreme fall of total fertility rate (children per woman) in ENP South countries (dominantly Arab League) from 6.72 back in 1950 to medium-scenario forecasted 2.10 in 2050. In the same time net number of migrants in the EU28 (both sexes combined) will grow from - 91,000 in 1950 to + 394,000 in 2050. CONCLUSIONS Long term migration from Eastern Europe westwards and from MENA region northwards is historically present for many decades dating back deep into the Cold War Era. Contemporary large-scale migrations outsourcing from Arab League nations towards rich European Protestant North is probably the peak of an iceberg in long migration routes history. However, in the decades to come acceleration of aging is likely to question sustainability of such movements of people.
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Affiliation(s)
- Mihajlo Michael Jakovljevic
- Global Health, Economics & Policy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia. .,Center for Health Trends and Forecasts, Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA. .,Academy of Medical Sciences, Belgrade, Serbia.
| | - Yael Netz
- Wingate College, Israel/EGREPA - The European Group for Research into Elderly and Physical Activity, Netaniya, Israel
| | - Sandra C Buttigieg
- Department of Health Services Management, Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Roza Adany
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Ulrich Laaser
- Faculty of Health Sciences, University of Bielefeld, Bielefeld, Germany
| | - Mirjana Varjacic
- Department of Fertility Pathology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
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24
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Kiss T, Ecsedi S, Vizkeleti L, Koroknai V, Emri G, Kovács N, Adany R, Balazs M. The role of osteopontin expression in melanoma progression. Tumour Biol 2015; 36:7841-7. [PMID: 25944164 DOI: 10.1007/s13277-015-3495-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 04/23/2015] [Indexed: 12/12/2022] Open
Abstract
It was shown that osteopontin (OPN), a glycophosphoprotein, plays divergent roles in cancer progression. In addition to multiple intra- and extracellular functions, it facilitates migration of tumour cells, has crucial role in cell adhesion and is associated with increased metastasis formation. In previous studies, we performed global gene expression profiling on a series of primary melanoma samples and found that OPN was significantly overexpressed in ulcerated melanomas. The major purpose of this study was to define OPN expression in primary melanomas with differing biological behaviours. OPN mRNA expression was analysed by quantitative reverse transcription polymerase chain reaction (qRT-PCR) in primary melanoma tissues. Immunohistochemistry was performed using a tissue microarray. Cox regression tests were used for survival analysis. Greater than 50 % of the tissues exhibited high protein expression that was significantly associated with tumour thickness and metastasis. OPN mRNA expression was significantly increased in thicker melanomas and lesions with an ulcerated surface. Increased expression was primarily detected in advanced-stage tumours. A multivariate Cox regression analysis revealed that high OPN expression, tumour thickness and metastasis were significantly associated with reduced relapse-free survival. In summary, high OPN mRNA and protein expression were associated with a less favourable clinical outcome of primary melanoma patients. We determined that OPN is a significant predictive factor for the survival of primary melanoma patients. Based on our and others data, the high expression of OPN may have a crucial stimulatory role in tumour progression and metastasis formation, which, thus, have been proposed as potential targets for cancer diagnosis and therapy.
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Affiliation(s)
- Timea Kiss
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Hungary, 4028, Debrecen, Kassai str. 26/b., Hungary.,MTA-DE Public Health Research Group, University of Debrecen, Debrecen, Hungary
| | - Szilvia Ecsedi
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Hungary, 4028, Debrecen, Kassai str. 26/b., Hungary.,MTA-DE Public Health Research Group, University of Debrecen, Debrecen, Hungary
| | - Laura Vizkeleti
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Hungary, 4028, Debrecen, Kassai str. 26/b., Hungary.,MTA-DE Public Health Research Group, University of Debrecen, Debrecen, Hungary
| | - Viktoria Koroknai
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Hungary, 4028, Debrecen, Kassai str. 26/b., Hungary.,MTA-DE Public Health Research Group, University of Debrecen, Debrecen, Hungary
| | - Gabriella Emri
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Nora Kovács
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Hungary, 4028, Debrecen, Kassai str. 26/b., Hungary
| | - Roza Adany
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Hungary, 4028, Debrecen, Kassai str. 26/b., Hungary.,MTA-DE Public Health Research Group, University of Debrecen, Debrecen, Hungary
| | - Margit Balazs
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Hungary, 4028, Debrecen, Kassai str. 26/b., Hungary. .,MTA-DE Public Health Research Group, University of Debrecen, Debrecen, Hungary.
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26
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Nagy K, Adany R, Szucs S, Adam B. Susceptibility of lung epithelial cells to alkylating genotoxic insult. Toxicol Lett 2014. [DOI: 10.1016/j.toxlet.2014.06.290] [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: 10/24/2022]
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27
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Boccia S, Mc Kee M, Adany R, Boffetta P, Burton H, Cambon-Thomsen A, Cornel MC, Gray M, Jani A, Knoppers BM, Khoury MJ, Meslin EM, Van Duijn CM, Villari P, Zimmern R, Cesario A, Puggina A, Colotto M, Ricciardi W. Beyond public health genomics: proposals from an international working group. Eur J Public Health 2014; 24:877-9. [PMID: 25168910 PMCID: PMC4245010 DOI: 10.1093/eurpub/cku142] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Stefania Boccia
- Section of Hygiene-Department of Public Health-Faculty of Medicine, Università Cattolica del Sacro Cuore, Rome, Italy, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, UK, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Hungary, Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA, PHG Foundation, Cambridge, UK, Institut National de la Santé et de la Recherche Médicale and Université Toulouse III Paul Sabatier, Joint Unit 1027 "Epidemiology and analyses in public health", Faculty of Medicine, Toulouse, France, Clinical Genetics & EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands, Better ValueHealthCare, UK, Centre of Genomics and Policy, Faculty of Medicine, Department of Human Genetics, McGill University, Montreal, Canada, CDC Office of Public Health Genomics, Atlanta, USA, Indiana University Center for Bioethics, School of Medicine, Indianapolis, USA, Genetic Epidemiology Unit, Departments of Epidemiology and Clinical Genetics, Erasmus University Medical Center, Rotterdam, Netherlands, Department of Public Health and Infectious Diseases, "Sapienza "University of Rome, Rome, Italy, PHG Foundation, Cambridge, UK and Area of Systems Medicine, IRCCS San Raffaele Pisana, Rome, Italy
| | - Martin Mc Kee
- Section of Hygiene-Department of Public Health-Faculty of Medicine, Università Cattolica del Sacro Cuore, Rome, Italy, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, UK, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Hungary, Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA, PHG Foundation, Cambridge, UK, Institut National de la Santé et de la Recherche Médicale and Université Toulouse III Paul Sabatier, Joint Unit 1027 "Epidemiology and analyses in public health", Faculty of Medicine, Toulouse, France, Clinical Genetics & EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands, Better ValueHealthCare, UK, Centre of Genomics and Policy, Faculty of Medicine, Department of Human Genetics, McGill University, Montreal, Canada, CDC Office of Public Health Genomics, Atlanta, USA, Indiana University Center for Bioethics, School of Medicine, Indianapolis, USA, Genetic Epidemiology Unit, Departments of Epidemiology and Clinical Genetics, Erasmus University Medical Center, Rotterdam, Netherlands, Department of Public Health and Infectious Diseases, "Sapienza "University of Rome, Rome, Italy, PHG Foundation, Cambridge, UK and Area of Systems Medicine, IRCCS San Raffaele Pisana, Rome, Italy
| | - Roza Adany
- Section of Hygiene-Department of Public Health-Faculty of Medicine, Università Cattolica del Sacro Cuore, Rome, Italy, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, UK, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Hungary, Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA, PHG Foundation, Cambridge, UK, Institut National de la Santé et de la Recherche Médicale and Université Toulouse III Paul Sabatier, Joint Unit 1027 "Epidemiology and analyses in public health", Faculty of Medicine, Toulouse, France, Clinical Genetics & EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands, Better ValueHealthCare, UK, Centre of Genomics and Policy, Faculty of Medicine, Department of Human Genetics, McGill University, Montreal, Canada, CDC Office of Public Health Genomics, Atlanta, USA, Indiana University Center for Bioethics, School of Medicine, Indianapolis, USA, Genetic Epidemiology Unit, Departments of Epidemiology and Clinical Genetics, Erasmus University Medical Center, Rotterdam, Netherlands, Department of Public Health and Infectious Diseases, "Sapienza "University of Rome, Rome, Italy, PHG Foundation, Cambridge, UK and Area of Systems Medicine, IRCCS San Raffaele Pisana, Rome, Italy
| | - Paolo Boffetta
- Section of Hygiene-Department of Public Health-Faculty of Medicine, Università Cattolica del Sacro Cuore, Rome, Italy, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, UK, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Hungary, Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA, PHG Foundation, Cambridge, UK, Institut National de la Santé et de la Recherche Médicale and Université Toulouse III Paul Sabatier, Joint Unit 1027 "Epidemiology and analyses in public health", Faculty of Medicine, Toulouse, France, Clinical Genetics & EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands, Better ValueHealthCare, UK, Centre of Genomics and Policy, Faculty of Medicine, Department of Human Genetics, McGill University, Montreal, Canada, CDC Office of Public Health Genomics, Atlanta, USA, Indiana University Center for Bioethics, School of Medicine, Indianapolis, USA, Genetic Epidemiology Unit, Departments of Epidemiology and Clinical Genetics, Erasmus University Medical Center, Rotterdam, Netherlands, Department of Public Health and Infectious Diseases, "Sapienza "University of Rome, Rome, Italy, PHG Foundation, Cambridge, UK and Area of Systems Medicine, IRCCS San Raffaele Pisana, Rome, Italy
| | - Hilary Burton
- Section of Hygiene-Department of Public Health-Faculty of Medicine, Università Cattolica del Sacro Cuore, Rome, Italy, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, UK, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Hungary, Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA, PHG Foundation, Cambridge, UK, Institut National de la Santé et de la Recherche Médicale and Université Toulouse III Paul Sabatier, Joint Unit 1027 "Epidemiology and analyses in public health", Faculty of Medicine, Toulouse, France, Clinical Genetics & EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands, Better ValueHealthCare, UK, Centre of Genomics and Policy, Faculty of Medicine, Department of Human Genetics, McGill University, Montreal, Canada, CDC Office of Public Health Genomics, Atlanta, USA, Indiana University Center for Bioethics, School of Medicine, Indianapolis, USA, Genetic Epidemiology Unit, Departments of Epidemiology and Clinical Genetics, Erasmus University Medical Center, Rotterdam, Netherlands, Department of Public Health and Infectious Diseases, "Sapienza "University of Rome, Rome, Italy, PHG Foundation, Cambridge, UK and Area of Systems Medicine, IRCCS San Raffaele Pisana, Rome, Italy
| | - Anne Cambon-Thomsen
- Section of Hygiene-Department of Public Health-Faculty of Medicine, Università Cattolica del Sacro Cuore, Rome, Italy, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, UK, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Hungary, Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA, PHG Foundation, Cambridge, UK, Institut National de la Santé et de la Recherche Médicale and Université Toulouse III Paul Sabatier, Joint Unit 1027 "Epidemiology and analyses in public health", Faculty of Medicine, Toulouse, France, Clinical Genetics & EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands, Better ValueHealthCare, UK, Centre of Genomics and Policy, Faculty of Medicine, Department of Human Genetics, McGill University, Montreal, Canada, CDC Office of Public Health Genomics, Atlanta, USA, Indiana University Center for Bioethics, School of Medicine, Indianapolis, USA, Genetic Epidemiology Unit, Departments of Epidemiology and Clinical Genetics, Erasmus University Medical Center, Rotterdam, Netherlands, Department of Public Health and Infectious Diseases, "Sapienza "University of Rome, Rome, Italy, PHG Foundation, Cambridge, UK and Area of Systems Medicine, IRCCS San Raffaele Pisana, Rome, Italy
| | - Martina C Cornel
- Section of Hygiene-Department of Public Health-Faculty of Medicine, Università Cattolica del Sacro Cuore, Rome, Italy, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, UK, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Hungary, Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA, PHG Foundation, Cambridge, UK, Institut National de la Santé et de la Recherche Médicale and Université Toulouse III Paul Sabatier, Joint Unit 1027 "Epidemiology and analyses in public health", Faculty of Medicine, Toulouse, France, Clinical Genetics & EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands, Better ValueHealthCare, UK, Centre of Genomics and Policy, Faculty of Medicine, Department of Human Genetics, McGill University, Montreal, Canada, CDC Office of Public Health Genomics, Atlanta, USA, Indiana University Center for Bioethics, School of Medicine, Indianapolis, USA, Genetic Epidemiology Unit, Departments of Epidemiology and Clinical Genetics, Erasmus University Medical Center, Rotterdam, Netherlands, Department of Public Health and Infectious Diseases, "Sapienza "University of Rome, Rome, Italy, PHG Foundation, Cambridge, UK and Area of Systems Medicine, IRCCS San Raffaele Pisana, Rome, Italy
| | - Muir Gray
- Section of Hygiene-Department of Public Health-Faculty of Medicine, Università Cattolica del Sacro Cuore, Rome, Italy, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, UK, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Hungary, Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA, PHG Foundation, Cambridge, UK, Institut National de la Santé et de la Recherche Médicale and Université Toulouse III Paul Sabatier, Joint Unit 1027 "Epidemiology and analyses in public health", Faculty of Medicine, Toulouse, France, Clinical Genetics & EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands, Better ValueHealthCare, UK, Centre of Genomics and Policy, Faculty of Medicine, Department of Human Genetics, McGill University, Montreal, Canada, CDC Office of Public Health Genomics, Atlanta, USA, Indiana University Center for Bioethics, School of Medicine, Indianapolis, USA, Genetic Epidemiology Unit, Departments of Epidemiology and Clinical Genetics, Erasmus University Medical Center, Rotterdam, Netherlands, Department of Public Health and Infectious Diseases, "Sapienza "University of Rome, Rome, Italy, PHG Foundation, Cambridge, UK and Area of Systems Medicine, IRCCS San Raffaele Pisana, Rome, Italy
| | - Anant Jani
- Section of Hygiene-Department of Public Health-Faculty of Medicine, Università Cattolica del Sacro Cuore, Rome, Italy, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, UK, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Hungary, Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA, PHG Foundation, Cambridge, UK, Institut National de la Santé et de la Recherche Médicale and Université Toulouse III Paul Sabatier, Joint Unit 1027 "Epidemiology and analyses in public health", Faculty of Medicine, Toulouse, France, Clinical Genetics & EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands, Better ValueHealthCare, UK, Centre of Genomics and Policy, Faculty of Medicine, Department of Human Genetics, McGill University, Montreal, Canada, CDC Office of Public Health Genomics, Atlanta, USA, Indiana University Center for Bioethics, School of Medicine, Indianapolis, USA, Genetic Epidemiology Unit, Departments of Epidemiology and Clinical Genetics, Erasmus University Medical Center, Rotterdam, Netherlands, Department of Public Health and Infectious Diseases, "Sapienza "University of Rome, Rome, Italy, PHG Foundation, Cambridge, UK and Area of Systems Medicine, IRCCS San Raffaele Pisana, Rome, Italy
| | - Bartha Maria Knoppers
- Section of Hygiene-Department of Public Health-Faculty of Medicine, Università Cattolica del Sacro Cuore, Rome, Italy, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, UK, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Hungary, Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA, PHG Foundation, Cambridge, UK, Institut National de la Santé et de la Recherche Médicale and Université Toulouse III Paul Sabatier, Joint Unit 1027 "Epidemiology and analyses in public health", Faculty of Medicine, Toulouse, France, Clinical Genetics & EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands, Better ValueHealthCare, UK, Centre of Genomics and Policy, Faculty of Medicine, Department of Human Genetics, McGill University, Montreal, Canada, CDC Office of Public Health Genomics, Atlanta, USA, Indiana University Center for Bioethics, School of Medicine, Indianapolis, USA, Genetic Epidemiology Unit, Departments of Epidemiology and Clinical Genetics, Erasmus University Medical Center, Rotterdam, Netherlands, Department of Public Health and Infectious Diseases, "Sapienza "University of Rome, Rome, Italy, PHG Foundation, Cambridge, UK and Area of Systems Medicine, IRCCS San Raffaele Pisana, Rome, Italy
| | - Muin J Khoury
- Section of Hygiene-Department of Public Health-Faculty of Medicine, Università Cattolica del Sacro Cuore, Rome, Italy, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, UK, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Hungary, Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA, PHG Foundation, Cambridge, UK, Institut National de la Santé et de la Recherche Médicale and Université Toulouse III Paul Sabatier, Joint Unit 1027 "Epidemiology and analyses in public health", Faculty of Medicine, Toulouse, France, Clinical Genetics & EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands, Better ValueHealthCare, UK, Centre of Genomics and Policy, Faculty of Medicine, Department of Human Genetics, McGill University, Montreal, Canada, CDC Office of Public Health Genomics, Atlanta, USA, Indiana University Center for Bioethics, School of Medicine, Indianapolis, USA, Genetic Epidemiology Unit, Departments of Epidemiology and Clinical Genetics, Erasmus University Medical Center, Rotterdam, Netherlands, Department of Public Health and Infectious Diseases, "Sapienza "University of Rome, Rome, Italy, PHG Foundation, Cambridge, UK and Area of Systems Medicine, IRCCS San Raffaele Pisana, Rome, Italy
| | - Eric M Meslin
- Section of Hygiene-Department of Public Health-Faculty of Medicine, Università Cattolica del Sacro Cuore, Rome, Italy, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, UK, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Hungary, Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA, PHG Foundation, Cambridge, UK, Institut National de la Santé et de la Recherche Médicale and Université Toulouse III Paul Sabatier, Joint Unit 1027 "Epidemiology and analyses in public health", Faculty of Medicine, Toulouse, France, Clinical Genetics & EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands, Better ValueHealthCare, UK, Centre of Genomics and Policy, Faculty of Medicine, Department of Human Genetics, McGill University, Montreal, Canada, CDC Office of Public Health Genomics, Atlanta, USA, Indiana University Center for Bioethics, School of Medicine, Indianapolis, USA, Genetic Epidemiology Unit, Departments of Epidemiology and Clinical Genetics, Erasmus University Medical Center, Rotterdam, Netherlands, Department of Public Health and Infectious Diseases, "Sapienza "University of Rome, Rome, Italy, PHG Foundation, Cambridge, UK and Area of Systems Medicine, IRCCS San Raffaele Pisana, Rome, Italy
| | - Cornelia M Van Duijn
- Section of Hygiene-Department of Public Health-Faculty of Medicine, Università Cattolica del Sacro Cuore, Rome, Italy, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, UK, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Hungary, Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA, PHG Foundation, Cambridge, UK, Institut National de la Santé et de la Recherche Médicale and Université Toulouse III Paul Sabatier, Joint Unit 1027 "Epidemiology and analyses in public health", Faculty of Medicine, Toulouse, France, Clinical Genetics & EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands, Better ValueHealthCare, UK, Centre of Genomics and Policy, Faculty of Medicine, Department of Human Genetics, McGill University, Montreal, Canada, CDC Office of Public Health Genomics, Atlanta, USA, Indiana University Center for Bioethics, School of Medicine, Indianapolis, USA, Genetic Epidemiology Unit, Departments of Epidemiology and Clinical Genetics, Erasmus University Medical Center, Rotterdam, Netherlands, Department of Public Health and Infectious Diseases, "Sapienza "University of Rome, Rome, Italy, PHG Foundation, Cambridge, UK and Area of Systems Medicine, IRCCS San Raffaele Pisana, Rome, Italy
| | - Paolo Villari
- Section of Hygiene-Department of Public Health-Faculty of Medicine, Università Cattolica del Sacro Cuore, Rome, Italy, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, UK, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Hungary, Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA, PHG Foundation, Cambridge, UK, Institut National de la Santé et de la Recherche Médicale and Université Toulouse III Paul Sabatier, Joint Unit 1027 "Epidemiology and analyses in public health", Faculty of Medicine, Toulouse, France, Clinical Genetics & EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands, Better ValueHealthCare, UK, Centre of Genomics and Policy, Faculty of Medicine, Department of Human Genetics, McGill University, Montreal, Canada, CDC Office of Public Health Genomics, Atlanta, USA, Indiana University Center for Bioethics, School of Medicine, Indianapolis, USA, Genetic Epidemiology Unit, Departments of Epidemiology and Clinical Genetics, Erasmus University Medical Center, Rotterdam, Netherlands, Department of Public Health and Infectious Diseases, "Sapienza "University of Rome, Rome, Italy, PHG Foundation, Cambridge, UK and Area of Systems Medicine, IRCCS San Raffaele Pisana, Rome, Italy
| | - Ron Zimmern
- Section of Hygiene-Department of Public Health-Faculty of Medicine, Università Cattolica del Sacro Cuore, Rome, Italy, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, UK, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Hungary, Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA, PHG Foundation, Cambridge, UK, Institut National de la Santé et de la Recherche Médicale and Université Toulouse III Paul Sabatier, Joint Unit 1027 "Epidemiology and analyses in public health", Faculty of Medicine, Toulouse, France, Clinical Genetics & EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands, Better ValueHealthCare, UK, Centre of Genomics and Policy, Faculty of Medicine, Department of Human Genetics, McGill University, Montreal, Canada, CDC Office of Public Health Genomics, Atlanta, USA, Indiana University Center for Bioethics, School of Medicine, Indianapolis, USA, Genetic Epidemiology Unit, Departments of Epidemiology and Clinical Genetics, Erasmus University Medical Center, Rotterdam, Netherlands, Department of Public Health and Infectious Diseases, "Sapienza "University of Rome, Rome, Italy, PHG Foundation, Cambridge, UK and Area of Systems Medicine, IRCCS San Raffaele Pisana, Rome, Italy
| | - Alfredo Cesario
- Section of Hygiene-Department of Public Health-Faculty of Medicine, Università Cattolica del Sacro Cuore, Rome, Italy, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, UK, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Hungary, Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA, PHG Foundation, Cambridge, UK, Institut National de la Santé et de la Recherche Médicale and Université Toulouse III Paul Sabatier, Joint Unit 1027 "Epidemiology and analyses in public health", Faculty of Medicine, Toulouse, France, Clinical Genetics & EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands, Better ValueHealthCare, UK, Centre of Genomics and Policy, Faculty of Medicine, Department of Human Genetics, McGill University, Montreal, Canada, CDC Office of Public Health Genomics, Atlanta, USA, Indiana University Center for Bioethics, School of Medicine, Indianapolis, USA, Genetic Epidemiology Unit, Departments of Epidemiology and Clinical Genetics, Erasmus University Medical Center, Rotterdam, Netherlands, Department of Public Health and Infectious Diseases, "Sapienza "University of Rome, Rome, Italy, PHG Foundation, Cambridge, UK and Area of Systems Medicine, IRCCS San Raffaele Pisana, Rome, Italy
| | - Anna Puggina
- Section of Hygiene-Department of Public Health-Faculty of Medicine, Università Cattolica del Sacro Cuore, Rome, Italy, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, UK, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Hungary, Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA, PHG Foundation, Cambridge, UK, Institut National de la Santé et de la Recherche Médicale and Université Toulouse III Paul Sabatier, Joint Unit 1027 "Epidemiology and analyses in public health", Faculty of Medicine, Toulouse, France, Clinical Genetics & EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands, Better ValueHealthCare, UK, Centre of Genomics and Policy, Faculty of Medicine, Department of Human Genetics, McGill University, Montreal, Canada, CDC Office of Public Health Genomics, Atlanta, USA, Indiana University Center for Bioethics, School of Medicine, Indianapolis, USA, Genetic Epidemiology Unit, Departments of Epidemiology and Clinical Genetics, Erasmus University Medical Center, Rotterdam, Netherlands, Department of Public Health and Infectious Diseases, "Sapienza "University of Rome, Rome, Italy, PHG Foundation, Cambridge, UK and Area of Systems Medicine, IRCCS San Raffaele Pisana, Rome, Italy
| | - Marco Colotto
- Section of Hygiene-Department of Public Health-Faculty of Medicine, Università Cattolica del Sacro Cuore, Rome, Italy, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, UK, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Hungary, Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA, PHG Foundation, Cambridge, UK, Institut National de la Santé et de la Recherche Médicale and Université Toulouse III Paul Sabatier, Joint Unit 1027 "Epidemiology and analyses in public health", Faculty of Medicine, Toulouse, France, Clinical Genetics & EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands, Better ValueHealthCare, UK, Centre of Genomics and Policy, Faculty of Medicine, Department of Human Genetics, McGill University, Montreal, Canada, CDC Office of Public Health Genomics, Atlanta, USA, Indiana University Center for Bioethics, School of Medicine, Indianapolis, USA, Genetic Epidemiology Unit, Departments of Epidemiology and Clinical Genetics, Erasmus University Medical Center, Rotterdam, Netherlands, Department of Public Health and Infectious Diseases, "Sapienza "University of Rome, Rome, Italy, PHG Foundation, Cambridge, UK and Area of Systems Medicine, IRCCS San Raffaele Pisana, Rome, Italy
| | - Walter Ricciardi
- Section of Hygiene-Department of Public Health-Faculty of Medicine, Università Cattolica del Sacro Cuore, Rome, Italy, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, UK, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Hungary, Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA, PHG Foundation, Cambridge, UK, Institut National de la Santé et de la Recherche Médicale and Université Toulouse III Paul Sabatier, Joint Unit 1027 "Epidemiology and analyses in public health", Faculty of Medicine, Toulouse, France, Clinical Genetics & EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands, Better ValueHealthCare, UK, Centre of Genomics and Policy, Faculty of Medicine, Department of Human Genetics, McGill University, Montreal, Canada, CDC Office of Public Health Genomics, Atlanta, USA, Indiana University Center for Bioethics, School of Medicine, Indianapolis, USA, Genetic Epidemiology Unit, Departments of Epidemiology and Clinical Genetics, Erasmus University Medical Center, Rotterdam, Netherlands, Department of Public Health and Infectious Diseases, "Sapienza "University of Rome, Rome, Italy, PHG Foundation, Cambridge, UK and Area of Systems Medicine, IRCCS San Raffaele Pisana, Rome, Italy
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28
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Ecsedi S, Hernandez-Vargas H, Lima SC, Vizkeleti L, Toth R, Lazar V, Koroknai V, Kiss T, Emri G, Herceg Z, Adany R, Balazs M. DNA methylation characteristics of primary melanomas with distinct biological behaviour. PLoS One 2014; 9:e96612. [PMID: 24832207 PMCID: PMC4022506 DOI: 10.1371/journal.pone.0096612] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 04/09/2014] [Indexed: 12/29/2022] Open
Abstract
In melanoma, the presence of promoter related hypermethylation has previously been reported, however, no methylation-based distinction has been drawn among the diverse melanoma subtypes. Here, we investigated DNA methylation changes associated with melanoma progression and links between methylation patterns and other types of somatic alterations, including the most frequent mutations and DNA copy number changes. Our results revealed that the methylome, presenting in early stage samples and associated with the BRAF(V600E) mutation, gradually decreased in the medium and late stages of the disease. An inverse relationship among the other predefined groups and promoter methylation was also revealed except for histologic subtype, whereas the more aggressive, nodular subtype melanomas exhibited hypermethylation as well. The Breslow thickness, which is a continuous variable, allowed for the most precise insight into how promoter methylation decreases from stage to stage. Integrating our methylation results with a high-throughput copy number alteration dataset, local correlations were detected in the MYB and EYA4 genes. With regard to the effects of DNA hypermethylation on melanoma patients' survival, correcting for clinical cofounders, only the KIT gene was associated with a lower overall survival rate. In this study, we demonstrate the strong influence of promoter localized DNA methylation changes on melanoma initiation and show how hypermethylation decreases in melanomas associated with less favourable clinical outcomes. Furthermore, we establish the methylation pattern as part of an integrated apparatus of somatic DNA alterations.
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Affiliation(s)
- Szilvia Ecsedi
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
- MTA-DE- Public Health Research Group, University of Debrecen, Debrecen, Hungary
| | - Hector Hernandez-Vargas
- International Agency for Research on Cancer, Section of Mechanisms of Carcinogenesis, Epigenetics Group, Lyon, France
| | - Sheila C. Lima
- International Agency for Research on Cancer, Section of Mechanisms of Carcinogenesis, Epigenetics Group, Lyon, France
| | - Laura Vizkeleti
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
- MTA-DE- Public Health Research Group, University of Debrecen, Debrecen, Hungary
| | - Reka Toth
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Viktoria Lazar
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Viktoria Koroknai
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Timea Kiss
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Gabriella Emri
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Zdenko Herceg
- International Agency for Research on Cancer, Section of Mechanisms of Carcinogenesis, Epigenetics Group, Lyon, France
| | - Roza Adany
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
- MTA-DE- Public Health Research Group, University of Debrecen, Debrecen, Hungary
| | - Margit Balazs
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
- MTA-DE- Public Health Research Group, University of Debrecen, Debrecen, Hungary
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29
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Ecsedi SI, Hernandez-Vargas H, Lima SC, Herceg Z, Adany R, Balazs M. Transposable hypomethylation is associated with metastatic capacity of primary melanomas. Int J Clin Exp Pathol 2013; 6:2943-2948. [PMID: 24294382 PMCID: PMC3843276] [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] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Accepted: 10/13/2013] [Indexed: 06/02/2023]
Abstract
Despite the strong progress has been made in the field of melanoma epigenetics, the importance of genome-wide demethylation or hypomethylation remains underestimated. However, this phenomenon might also reflect important epigenetic alterations due to its ability to cause genetic instability. Furthermore, no methylation-based distinction has been drawn among the diverse primary melanoma subtypes. To assess global methylation we measured the methylation level on the 6 CpG sites of LINE1 sequences in 46 primary melanomas in association with patients' survivals and the clinicopathological characteristics of specimens. We demonstrate that LINE1 hypomethylation is accompanied by the shortened relapse-free survival of melanoma patients; however, Cox regression analysis shows a direct relationship between the overall loss of 5-methylcytosine and metastatic potential of primary melanomas, which is confirmed by Kruskal-Wallis tests with Dunn's Multiple Comparison Post-test showing that not only the presence but the number of metastases during the 5-year follow-up period is associated with the transposon demethylation. In this study, we demonstrate the strong influence of global DNA demethylation in the metastatic formation of primary melanomas during the follow-up period.
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Affiliation(s)
- Szilvia I Ecsedi
- Department of Preventive Medicine, Faculty of Public Health, Medical and Health Science Centre, University of DebrecenHungary
- Public Health Research Group of The Hungarian Academy of Sciences, University of DebrecenHungary
| | | | - Sheila C Lima
- International Agency for Research on Cancer, Epigenetics GroupLyon, France
| | - Zdenko Herceg
- International Agency for Research on Cancer, Epigenetics GroupLyon, France
| | - Roza Adany
- Department of Preventive Medicine, Faculty of Public Health, Medical and Health Science Centre, University of DebrecenHungary
- Public Health Research Group of The Hungarian Academy of Sciences, University of DebrecenHungary
| | - Margit Balazs
- Department of Preventive Medicine, Faculty of Public Health, Medical and Health Science Centre, University of DebrecenHungary
- Public Health Research Group of The Hungarian Academy of Sciences, University of DebrecenHungary
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30
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Nagy A, Nagy B, Adany R, Sandor J. Determinants of low referral rates for ophthalmologic examination in people with type 2 diabetes in Hungary. Diabetes Res Clin Pract 2013; 102:e29-31. [PMID: 24125864 DOI: 10.1016/j.diabres.2013.09.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 05/03/2013] [Accepted: 09/22/2013] [Indexed: 11/20/2022]
Abstract
GPs' and patients' socio-demographic characteristics were investigated as possible, determinants of ophthalmologic examination referral rates among type 2 diabetes mellitus patients. Female GPs were more effective among retinopathy-free patients, while male GPs among patients with retinopathy. It could be explained by the gender related authority-empathy balance, manifested, through communication style.
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Affiliation(s)
- Attila Nagy
- Department of Preventive Medicine, Faculty of Public Health, Medical and Health Science Centre, University of Debrecen, Debrecen, Hungary
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31
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Rakosy Z, Ecsedi S, Toth R, Vizkeleti L, Herandez-Vargas H, Lazar V, Emri G, Szatmari I, Herceg Z, Adany R, Balazs M. Integrative genomics identifies gene signature associated with melanoma ulceration. PLoS One 2013; 8:e54958. [PMID: 23383013 PMCID: PMC3559846 DOI: 10.1371/journal.pone.0054958] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Accepted: 12/18/2012] [Indexed: 12/31/2022] Open
Abstract
Background Despite the extensive research approaches applied to characterise malignant melanoma, no specific molecular markers are available that are clearly related to the progression of this disease. In this study, our aims were to define a gene expression signature associated with the clinical outcome of melanoma patients and to provide an integrative interpretation of the gene expression -, copy number alterations -, and promoter methylation patterns that contribute to clinically relevant molecular functional alterations. Methods Gene expression profiles were determined using the Affymetrix U133 Plus2.0 array. The NimbleGen Human CGH Whole-Genome Tiling array was used to define CNAs, and the Illumina GoldenGate Methylation platform was applied to characterise the methylation patterns of overlapping genes. Results We identified two subclasses of primary melanoma: one representing patients with better prognoses and the other being characteristic of patients with unfavourable outcomes. We assigned 1,080 genes as being significantly correlated with ulceration, 987 genes were downregulated and significantly enriched in the p53, Nf-kappaB, and WNT/beta-catenin pathways. Through integrated genome analysis, we defined 150 downregulated genes whose expression correlated with copy number losses in ulcerated samples. These genes were significantly enriched on chromosome 6q and 10q, which contained a total of 36 genes. Ten of these genes were downregulated and involved in cell-cell and cell-matrix adhesion or apoptosis. The expression and methylation patterns of additional genes exhibited an inverse correlation, suggesting that transcriptional silencing of these genes is driven by epigenetic events. Conclusion Using an integrative genomic approach, we were able to identify functionally relevant molecular hotspots characterised by copy number losses and promoter hypermethylation in distinct molecular subtypes of melanoma that contribute to specific transcriptomic silencing and might indicate a poor clinical outcome of melanoma.
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Affiliation(s)
- Zsuzsa Rakosy
- Department of Preventive Medicine, Faculty of Public Health, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
- Public Health Research Group of the Hungarian Academy of Sciences, University of Debrecen, Debrecen, Hungary
| | - Szilvia Ecsedi
- Department of Preventive Medicine, Faculty of Public Health, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
- Public Health Research Group of the Hungarian Academy of Sciences, University of Debrecen, Debrecen, Hungary
| | - Reka Toth
- Department of Preventive Medicine, Faculty of Public Health, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
| | - Laura Vizkeleti
- Department of Preventive Medicine, Faculty of Public Health, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
- Public Health Research Group of the Hungarian Academy of Sciences, University of Debrecen, Debrecen, Hungary
| | - Hector Herandez-Vargas
- World Health Organization International Agency for Research on Cancer, Epigenetics Group, Lyon, France
| | - Viktoria Lazar
- Department of Preventive Medicine, Faculty of Public Health, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
| | - Gabriella Emri
- Department of Dermatology, Faculty of Medicine, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
| | - Istvan Szatmari
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
| | - Zdenko Herceg
- World Health Organization International Agency for Research on Cancer, Epigenetics Group, Lyon, France
| | - Roza Adany
- Department of Preventive Medicine, Faculty of Public Health, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
- Public Health Research Group of the Hungarian Academy of Sciences, University of Debrecen, Debrecen, Hungary
| | - Margit Balazs
- Department of Preventive Medicine, Faculty of Public Health, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
- Public Health Research Group of the Hungarian Academy of Sciences, University of Debrecen, Debrecen, Hungary
- * E-mail:
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Adam B, Molnar A, Gulis G, Adany R. Integrating a quantitative risk appraisal in a health impact assessment: analysis of the novel smoke-free policy in Hungary. Eur J Public Health 2012; 23:211-7. [DOI: 10.1093/eurpub/cks018] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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McKee M, Adany R, Leon DA. Authors' reply to Lachenmeier and Rehm. West J Med 2012. [DOI: 10.1136/bmj.e2255] [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]
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Vizkeleti L, Ecsedi S, Rakosy Z, Begany A, Emri G, Toth R, Orosz A, Szollosi AG, Mehes G, Adany R, Balazs M. Prognostic relevance of the expressions of CAV1 and TES genes on 7q31 in melanoma. Front Biosci (Elite Ed) 2012; 4:1802-12. [PMID: 22201996 DOI: 10.2741/501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The 7q31 locus contains several genes affected in cancer progression. Although evidences exist regarding its impact on tumorigenesis, the role of genetic alterations and the expressions of locus-related genes are still controversial. Our study aimed to define the 7q31 copy number alterations in primary melanomas, primary-metastatic tumor pairs and cell lines. Data were correlated with clinical-pathological parameters. Genetic data show that 7q31 copy number distribution was heterogeneous in both primary and metastatic tumors. Extra copies were highly accompanied by chromosome 7 polisomy, and significantly increased in primary lesions with poor prognosis. Additionally, we determined the mRNA and protein levels of the locus-related CAV1 and TES genes. TES mRNA level was associated with metastatic location. CAV1 mRNA and protein levels were significantly higher in thicker tumors, however, lack of protein was also observed in a subpopulation of thin lesions. Expressions of CAV1 and TES were not associated with 7q31 alterations. In conclusion, 7q31 amplification can predict unfavorable outcome. Alterations of TES mRNA level may predict the location of metastasis. CAV1 possibly affect the cancer cell invasion.
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Affiliation(s)
- Laura Vizkeleti
- Department of Preventive Medicine, Faculty of Public Health, Medical and Health Science Center, University of Debrecen, Hungary
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Nagy A, Adany R, Sandor J. Effect of diagnosis-time and initial treatment on the onset of type 2 diabetes mellitus complications: a population-based representative cross-sectional study in Hungary. Diabetes Res Clin Pract 2011; 94:e65-7. [PMID: 21880389 DOI: 10.1016/j.diabres.2011.08.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Accepted: 08/08/2011] [Indexed: 10/17/2022]
Abstract
We estimated the risk-increasing role of late-diagnosis on the onset of complications among 1168 patients representative of above 50 Hungarian diabetic population. Higher occurrence of retinopathy has been found in the late-diagnosis group (OR=1.62, 95% CI: 1.06-2.49). Clinically significant benefit of early-diagnosis was not observable in case of other complications.
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Affiliation(s)
- Attila Nagy
- Preventive Medicine Department, University of Debrecen, Debrecen, Hungary
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Kitoh Y, Saio M, Gotoh N, Umemura N, Nonaka K, Bai J, Vizkeleti L, Torocsik D, Balazs M, Adany R, Takami T. Combined GM-CSF treatment and M-CSF inhibition of tumor-associated macrophages induces dendritic cell-like signaling in vitro. Int J Oncol 2011; 38:1409-19. [PMID: 21373754 DOI: 10.3892/ijo.2011.960] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2010] [Accepted: 01/21/2011] [Indexed: 11/06/2022] Open
Abstract
Macrophages demonstrate plasticity, and tumor-associated macrophages (TAM) can function as immunosuppressive cells in the tumor microenvironment. Therefore, in this study, we aimed to reprogram TAM in vitro with cytokine signal alteration. Granulocyte macrophage colony stimulating factor (GM-CSF) treatment alone did not lead to changes in the expression of M1 (including IL-1β, TNFα and CXCL-10) or M2 (including CD36, CD206 and CCL17) molecules by TAM in vitro, although they adopted a round morphology and were less adhesive to the culture dish. When macrophage colony stimulating factor (M-CSF) signals were suppressed by siRNA against the M-CSF receptor (M-CSFR) in conjunction with GM-CSF treatment, the signal transduction pathway of TAM was altered, and the expression of STAT1, STAT5 and STAT6, which are usually expressed by dendritic cells, was increased. However, the same treatment did not alter the TAM expression pattern of M1/M2 marker molecules. With respect to the NF-κB pathway, GM-CSF and M-CSFR siRNA combination treatment significantly induced the expression of p65, which is usually not expressed by TAM, while p50 and p105 expression by TAM was not affected by the treatment. These findings indicate that our model could not redirect TAM to a monocyte-derived dendritic cell-like phenotype based on the analysis of M1/M2 marker expression, but it was able to modify cell signaling pathways toward a dendritic cell-like pattern. Therefore, the present data suggest that TAM demonstrate plasticity toward dendritic cell-like signal transduction patterns, and that the alteration of the tumor microenvironment has the potential to reverse the immunosuppressive properties of TAM.
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Affiliation(s)
- Yusuke Kitoh
- Department of Immunopathology, Gifu University Graduate School of Medicine, Yanagido, Gifu city, Gifu 501-1194, Japan.
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Toth R, Pocsai Z, Fiatal S, Szeles G, Kardos L, Petrovski B, McKee M, Adany R. ADH1B*2 allele is protective against alcoholism but not chronic liver disease in the Hungarian population. Addiction 2010; 105:891-6. [PMID: 20219057 DOI: 10.1111/j.1360-0443.2009.02876.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Standardized death rates from chronic liver diseases (CLDs) in Hungary are much higher than the European Union average. Carrying the alcohol dehydrogenase 1B 48His allele (rs1229984 or ADH1B*2) could decrease the risk of alcoholism, but with persistent drinking may confer a greater risk of CLDs. The aim of this study was to assess the prevalence of this polymorphism in the Hungarian population and its association with alcohol consumption and with CLDs. METHODS AND RESULTS A total of 278 cases with diagnosed CLDs and 752 controls without any alterations in liver function, all males aged 45-64, were screened for ADH1B Arg48His polymorphism. ADH1B*2 allele frequencies in controls and cases were 8.31% and 4.50%, respectively (chi(2) = 9.2; P = 0.01). Carrying the ADH1B*2 allele was associated with significantly lower odds ratio (OR) for drinking frequency (OR = 0.63; P = 0.003), the number of positive answers on CAGE (Cut-down, Annoyed, Guilt, Eye-opener) assessment (OR = 0.58; P = 0.005) and a positive CAGE status (OR = 0.55; P = 0.007). There was a significant association between ADH1B*2 and CLDs (OR = 0.50; P = 0.003), but it disappeared after adjusting for CAGE status and scores (OR = 0.67 P = 0.134; OR = 0.67 P = 0.148, respectively) and weakened after adjusting for drinking frequency (OR = 0.61; P = 0.045). Among heavy drinkers the presence of ADH1B*2 did not increase the risk of cirrhosis but there was a significant interaction between genotype and CAGE status (P = 0.003, P = 0.042), with ADH1B*2 conferring reduced risk of CLDs in CAGE negatives. CONCLUSION In Hungarians, the ADH1B 48His allele reduces the risk of alcoholism, but not the risk of chronic liver disease among heavy drinkers.
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Affiliation(s)
- Reka Toth
- Department of Preventive Medicine, Faculty of Public Health, Medical and Health Science Centre, University of Debrecen, PO Box 9, Debrecen, H-4012 Hungary
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Kosa K, Darago L, Adany R. Environmental survey of segregated habitats of Roma in Hungary: a way to be empowering and reliable in minority research. Eur J Public Health 2009; 21:463-8. [DOI: 10.1093/eurpub/ckp097] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Paragh G, Seres I, Harangi M, Pocsai Z, Asztalos L, Locsey L, Szeles G, Kardos L, Varga E, Karpati I, Adany R. Discordance in human paraoxonase-1 gene between phenotypes and genotypes in chronic kidney disease. Nephron Clin Pract 2009; 113:c46-53. [PMID: 19602899 DOI: 10.1159/000228075] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2008] [Accepted: 12/15/2008] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Human serum paraoxonase-1 (PON1) is a high-density lipoprotein-associated ester hydrolase which can inhibit low-density lipoprotein oxidation and has an antiatherogenic effect. Two common polymorphisms are known in the PON1 gene in humans (at positions 55 and 192), from which the latter gene alteration has been mainly attributed to alter the activity of the protein. Moreover, significantly reduced PON1 activity was found in chronic kidney disease (CKD) and renal transplant patients. METHODS The aim of the present study was to investigate the genotype and phenotype distribution of the PON1 gene as well as its end product activity in patients with CKD (n = 117), in renal transplant recipients (n = 146) and in reference subjects (n = 1,180). RESULTS Unexpectedly high discordances between phenotype and genotype assessments were observed in all studied groups (28.2% in the CKD, 20.55% in the transplant and 30.9% in the reference group). Arylesterase activity was significantly lower in the CKD group compared to the reference sample. There were no significant differences between patients and the reference group in the frequencies of polymorphisms PON1-55 and PON1-192. PON1 activity did not differ in patients compared to the reference group. CONCLUSIONS Both PON1 phenotype and genotype determinations are necessary to estimate PON1 status.
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Affiliation(s)
- Gyorgy Paragh
- 1st Department of Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
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Nonaka K, Saio M, Suwa T, Frey AB, Umemura N, Imai H, Ouyang GF, Osada S, Balazs M, Adany R, Kawaguchi Y, Yoshida K, Takami T. Skewing the Th cell phenotype toward Th1 alters the maturation of tumor-infiltrating mononuclear phagocytes. J Leukoc Biol 2008; 84:679-88. [PMID: 18566103 DOI: 10.1189/jlb.1107729] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Mononuclear phagocytes (MPCs) at the tumor site can be divided into subclasses, including monocyte-lineage myeloid-derived suppressor cells (MDSCs) and the immunosuppressive tumor-infiltrating macrophages (TIMs). Cancer growth coincides with the expansion of MDSCs found in the blood, secondary lymphoid organs, and tumor tissue. These MDSCs are thought to mature into macrophages and to promote tumor development by a combination of growth-enhancing properties and suppression of local antitumor immunoresponses. As little is known about either subset of MPCs, we investigated MPCs infiltrating into murine adenocarcinoma MCA38 tumors. We found that these MPCs displayed immunosuppressive characteristics and a MDSC cell-surface phenotype. Over 70% of the MPCs were mature (F4/80(+)Ly6C(-)) macrophages, and the rest were immature (F480(+) Ly6C(+)) monocytes. MPC maturation was inhibited when the cells infiltrated a tumor variant expressing IL-2 and soluble TNF type II receptor (sTNFRII). In addition, the IL-2/sTNFRII MCA38 tumor microenvironment altered the MPC phenotype; these cells did not survive culturing in vitro as a result of Fas-mediated apoptosis and negligible M-CSFR expression. Furthermore, CD4(+) tumor-infiltrating lymphocytes (TILs) in wild-type tumors robustly expressed IL-13, IFN-gamma, and GM-CSF, and CD4(+) TILs in IL-2/sTNFRII-expressing tumors expressed little IL-13. These data suggest that immunotherapy-altered Th cell balance in the tumor microenvironment can affect the differentiation and maturation of MPCs in vivo. Furthermore, as neither the designation MDSC nor TIM can sufficiently describe the status of monocytes/macrophages in this tumor microenvironment, we believe these cells are best designated as MPCs.
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Affiliation(s)
- Kenichi Nonaka
- Departments of Surgical Oncology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
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Umemura N, Saio M, Suwa T, Kitoh Y, Bai J, Nonaka K, Ouyang GF, Okada M, Balazs M, Adany R, Shibata T, Takami T. Tumor-infiltrating myeloid-derived suppressor cells are pleiotropic-inflamed monocytes/macrophages that bear M1- and M2-type characteristics. J Leukoc Biol 2008; 83:1136-44. [PMID: 18285406 DOI: 10.1189/jlb.0907611] [Citation(s) in RCA: 261] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Here, tumor-infiltrating CD11b(+) myelomonocytoid cells in murine colon adenocarcinoma-38 and GL261 murine glioma were phenotypically characterized. Over 90% were of the CD11b(+)F4/80(+) monocyte/macrophage lineage. They also had a myeloid-derived suppressor cell (MDSC) phenotype, as they suppressed the proliferation of activated splenic CD8(+) T cells and had a CD11b(+)CD11c(+)Gr-1(low)IL-4Ralpha(+) phenotype. In addition, the cells expressed CX(3)CR1 and CCR2 simultaneously, which are the markers of an inflammatory monocyte. The MDSCs expressed CD206, CXCL10, IL-1beta, and TNF-alpha mRNAs. They also simultaneously expressed CXCL10 and CD206 proteins, which are typical, classical (M1) and alternative (M2) macrophage activation markers, respectively. Peritoneal exudate cells (PECs) strongly expressed CD36, CD206, and TGF-beta mRNA, which is characteristic of deactivated monocytes. The MDSCs also secreted TGF-beta, and in vitro culture of MDSCs and PECs with anti-TGF-beta antibody recovered their ability to secrete NO. However, as a result of secretion of proinflammatory cytokines, MDSCs could not be categorized into deactivated monocyte/macrophages. Thus, tumor-infiltrating MDSCs bear pleiotropic characteristics of M1 and M2 monocytes/macrophages. Furthermore, CD206 expression by tumor-infiltrating MDSCs appears to be regulated by an autocrine mechanism that involves TGF-beta.
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Affiliation(s)
- Naoki Umemura
- Department of Oral and Maxillofacial Sciences, Gifu University Graduate School of Medicine, Gifu-city, Gifu, Japan
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Bereczky Z, Bardos H, Komaromi I, Kiss C, Haramura G, Ajzner E, Adany R, Muszbek L. Factor XDebrecen: Gly204Arg mutation in factor X causes the synthesis of a non-secretable protein and severe factor X deficiency. Haematologica 2008; 93:299-302. [DOI: 10.3324/haematol.11746] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Koskinen LLE, Korponay-Szabo IR, Viiri K, Juuti-Uusitalo K, Kaukinen K, Lindfors K, Mustalahti K, Kurppa K, Adany R, Pocsai Z, Szeles G, Einarsdottir E, Wijmenga C, Maki M, Partanen J, Kere J, Saavalainen P. Myosin IXB gene region and gluten intolerance: linkage to coeliac disease and a putative dermatitis herpetiformis association. J Med Genet 2007; 45:222-7. [DOI: 10.1136/jmg.2007.053991] [Citation(s) in RCA: 25] [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: 11/03/2022]
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Treszl A, Ladanyi A, Rakosy Z, Buczko Z, Adany R, Balazs M. Molecular cytogenetic characterization of a novel cell line established from a superficial spreading melanoma. FRONT BIOSCI-LANDMRK 2006; 11:1844-53. [PMID: 16368560 DOI: 10.2741/1927] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [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: 11/22/2022]
Abstract
We report the complex cytogenetic analysis of a novel melanoma cell line (M35/01) established from a vertical growth phase of a superficial spreading melanoma. Similarly to its parental tumor, this cell line metastasizes to the liver. Using combined molecular cytogenetic techniques, we could identify a reservoir of chromosomal alterations in M35/01. In addition, we had sufficient amount of DNA from both the original primary tumor and the cell line which allowed for the comparison of their genetic patterns by chromosomal CGH. Several common alterations were found indicating the same clonal origin. These alterations included gains of 6p, 7q, 15q and deletions of 9, 10, 16q and 17p. Chromosomal losses present only in the cell line were detected on chromosome 4, 16p, 18 and gains on 20p12-qter. Array CGH analysis of the M35/01 cell line provided similar results with a much higher resolution, representing relatively high level gains on 7q31.2-q31.31, 15q25, 20q, and losses on 4q28, 9p21-p24, 9q21-q22, 10q25, 16q13-q23, 17p12-13 and 18q12-23. Using SKY-FISH, several structural alterations could be detected which were not recognized by conventional cytogenetics. Except for chromosome 18, none of the centromeres showed normal distribution by FISH. Our analysis shows that a high number of chromosomal alterations, which are known to be nonrandomly associated with melanoma progression, can be found by the combined use of different molecular genetic techniques. This new melanoma cell line would be an excellent model for investigating the mechanism of organ specific-metastatic events of malignant melanoma.
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Affiliation(s)
- Andrea Treszl
- Department of Preventive Medicine, School of Public Health, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
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Paragh G, Seres I, Harangi M, Pocsai Z, Mirdamadi H, Asztalos L, Locsey L, Kardos L, Varga E, Adany R. Tu-P10:489 Discordance between phenotypic and genotypic determinations of human paraoxonase-1 in uremic and kidney transplanted patients. ATHEROSCLEROSIS SUPP 2006. [DOI: 10.1016/s1567-5688(06)81190-6] [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]
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McKee M, Suzcs S, Sárváry A, Adany R, Kiryanov N, Saburova L, Tomkins S, Andreev E, Leon DA. The composition of surrogate alcohols consumed in Russia. Alcohol Clin Exp Res 2005; 29:1884-8. [PMID: 16269919 DOI: 10.1097/01.alc.0000183012.93303.90] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND In the course of a case-control study examining determinants of premature death among working age men, it became clear that a significant percentage of the population (7.3%) were drinking a variety of surrogate alcohol products (products not legally sold for consumption). In this population, where there is a high death rate from alcohol-related causes, including acute alcohol poisoning, it was important to know what these products contained. METHODS The identity of products being consumed was identified from the survey of controls. Representative samples were obtained and subjected to analysis using gas chromatography and mass spectrometry to determine their composition. RESULTS Three broad groups of product were identified: samogon (home-produced spirits); medicinal compounds; and other spirits (mainly sold as aftershaves). Commercially produced vodkas were used for comparison. Samogon contained lower quantities of ethanol than vodka [mean, 39 vs. 44 volumetric percentage (v/v%), respectively] but in addition contained certain toxic long-chain alcohols. Medicinal compounds contained only ethanol, at a higher concentration that vodka (mean, 66 v/v%), while the other spirits, which were also essentially pure ethanol, contained a mean of 94 v/v%. CONCLUSIONS A significant number of Russian men are drinking products that have either very high concentrations of ethanol or contaminants known to be toxic. These products are untaxed and thus much less expensive than vodka. There is an urgent need for policy responses that target their production and consumption.
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Affiliation(s)
- Martin McKee
- European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, London, United Kingdom.
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Adany R. Eu enlargement: major public health issues in the acceding countries. Eur J Public Health 2003. [DOI: 10.1093/eurpub/13.suppl_2.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Torok O, Zsupan I, Buezico Z, Adany R, Balazs M. Fluorescence in situ hybridization on uncultured amniocytes. Int J Gynaecol Obstet 2000. [DOI: 10.1016/s0020-7292(00)84665-2] [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: 10/26/2022]
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