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Zeraattalab‐Motlagh S, Ghoreishy SM, Arab A, Mahmoodi S, Hemmati A, Mohammadi H. Fruit and Vegetable Consumption and the Risk of Bone Fracture: A Grading of Recommendations, Assessment, Development, and Evaluations (GRADE)-Assessed Systematic Review and Dose-Response Meta-Analysis. JBMR Plus 2023; 7:e10840. [PMID: 38130771 PMCID: PMC10731112 DOI: 10.1002/jbm4.10840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 09/23/2023] [Accepted: 10/17/2023] [Indexed: 12/23/2023] Open
Abstract
Researchers have examined the link between consuming fruit and vegetables and the incidence of fractures for many years. Nevertheless, their findings have been unclear. Furthermore, the dose-dependent relationship has not been examined, and the level of certainty in the evidence was not evaluated. We carried out a dose-dependent meta-analysis examining the relation between fruit and vegetables intake and fracture incidence. PubMed, Web of Sciences, and Scopus were searched until April 2023 for cohort studies evaluating the relation between fruit and vegetables and fracture incidence. Summary relative risks (RRs) were computed from complied data by applying random effects analysis. To examine the level of evidence, we utilized the approach called the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE). Ten cohort studies comprising 511,716 individuals were entered. There was a nonsignificant relation between fruit and vegetables, as well as only fruit intake and any fracture risk. In contrast, high versus low analysis presented that vegetables consumption was linked to a 16% decrease in any type of fracture incidence (RR 0.84; 95% confidence interval [CI], 0.75 to 0.95; I 2 = 83.1%; n = 6). Also, per one serving/day (200 g/day) increments in vegetables consumption, there was a 14% decline in the fracture risk (RR 0.86; 95% CI, 0.77 to 0.97; I 2 = 84.7%; n = 5; GRADE = moderate). With moderate certainty, a greater consumption of only vegetables, but not total fruit and vegetables or only fruit, might reduce the risk of fracture. These associations were also evident in dose-response analysis. Large intervention trials are demanded to approve our findings. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Sheida Zeraattalab‐Motlagh
- Department of Community Nutrition, School of Nutritional Sciences and DieteticsTehran University of Medical SciencesTehranIran
| | - Seyed Mojtaba Ghoreishy
- Department of Nutrition, School of Public HealthIran University of Medical SciencesTehranIran
- Student Research Committee, School of Public HealthIran University of Medical SciencesTehranIran
| | - Arman Arab
- Division of Sleep MedicineHarvard Medical SchoolBostonMassachusettsUSA
- Medical Chronobiology Program, Division of Sleep and Circadian DisordersDepartments of Medicine and Neurology, Brigham and Women's HospitalBostonMassachusettsUSA
| | - Sara Mahmoodi
- Department of Clinical Nutrition, School of Nutritional Sciences and DieteticsTehran University of Medical SciencesTehranIran
| | - Amirhossein Hemmati
- Department of Clinical Nutrition, School of Nutritional Sciences and DieteticsTehran University of Medical SciencesTehranIran
| | - Hamed Mohammadi
- Department of Clinical Nutrition, School of Nutritional Sciences and DieteticsTehran University of Medical SciencesTehranIran
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Jiang C, Yan C, Duan J. Bone Mineral Density Is Inversely Associated With Mortality in Chronic Kidney Disease Patients: A Meta-Analysis. J Bone Miner Res 2022; 37:2094-2102. [PMID: 36055677 DOI: 10.1002/jbmr.4681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 08/09/2022] [Accepted: 08/14/2022] [Indexed: 11/09/2022]
Abstract
Low bone mineral density (BMD) is suggested to be associated with increased mortality in the general health population, but the relationship in chronic kidney disease (CKD) patients is still unclear. We performed a meta-analysis to investigate the association of BMD in different sites with risk of all-cause mortality in CKD patients. We searched PubMed, EMBASE, and Web of Science to identify eligible cohort studies that evaluated the association between BMD at different sites and risk of all-cause mortality in CKD patients. Twelve cohort studies were identified, which included 2828 CKD patients and 1052 deaths. Compared with normal/high level of total body BMD, lower total body BMD was associated with 25% higher risk of all-cause mortality. The pooled relative risk (RR) was 1.25 (95% confidence interval [CI] 1.09, 1.42) with little heterogeneity across studies. Regarding BMD measured at different sites, the risk of all-cause mortality was highest for lower BMD at hip/femoral neck (pooled RR = 1.69; 95% CI 1.20, 2.40). The pooled RRs were 1.26 (95% CI 1.04, 1.53) and 1.17 (95% CI 1.00, 1.37) for lower BMD at arm and spine, respectively. Similarly, the risk of death for per SD decrease in BMD was also higher at hip/femoral neck (pooled RR = 1.43, 95% CI 1.15, 1.77) compared with arm (pooled RR = 1.03, 95% CI 1.00, 1.06) and spine (pooled RR = 1.17, 95% CI 0.98, 1.39). In conclusion, lower BMD values at hip, arm, spine, as well as the whole body are associated with increased risk of all-cause mortality in CKD patients. The excess risk is highest for patients with lower BMD at hip/femoral neck, suggesting BMD measured at hip region may be the best indicator of mortality risk in CKD patients. © 2022 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Chao Jiang
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Chongnan Yan
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jingzhu Duan
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
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Wei J, Lane NE, Bolster MB, Dubreuil M, Zeng C, Misra D, Lu N, Choi HK, Lei G, Zhang Y. Association of Tramadol Use With Risk of Hip Fracture. J Bone Miner Res 2020; 35:631-640. [PMID: 32020683 PMCID: PMC8282603 DOI: 10.1002/jbmr.3935] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 11/19/2019] [Accepted: 12/01/2019] [Indexed: 12/21/2022]
Abstract
Several professional organizations have recommended tramadol as one of the first-line or second-line therapies for patients with chronic noncancer pain and its prescription has been increasing rapidly worldwide; however, the safety profile of tramadol, such as risk of fracture, remains unclear. This study aimed to examine the association of tramadol with risk of hip fracture. Among individuals age 50 years or older without a history of hip fracture, cancer, or opioid use disorder in The Health Improvement Network (THIN) database in the United Kingdom general practice (2000-2017), five sequential propensity score-matched cohort studies were assembled, ie, participants who initiated tramadol or those who initiated one of the following medications: codeine (n = 146,956) (another commonly used weak opioid), naproxen (n = 115,109) or ibuprofen (n = 107,438) (commonly used nonselective nonsteroidal anti-inflammatory drugs [NSAIDs]), celecoxib (n = 43,130), or etoricoxib (n = 27,689) (cyclooxygenase-2 inhibitors). The outcome was incident hip fracture over 1 year. After propensity-score matching, the included participants had a mean age of 65.7 years and 56.9% were women. During the 1-year follow-up, 518 hip fracture (3.7/1000 person-years) occurred in the tramadol cohort and 401 (2.9/1000 person-years) occurred in the codeine cohort. Compared with codeine, hazard ratio (HR) of hip fracture for tramadol was 1.28 (95% confidence interval [CI] 1.13 to 1.46). Risk of hip fracture was also higher in the tramadol cohort than in the naproxen (2.9/1000 person-years for tramadol, 1.7/1000 person-years for naproxen; HR = 1.69, 95% CI 1.41 to 2.03), ibuprofen (3.4/1000 person-years for tramadol, 2.0/1000 person-years for ibuprofen; HR = 1.65, 95% CI 1.39 to 1.96), celecoxib (3.4/1000 person-years for tramadol, 1.8/1000 person-years for celecoxib; HR = 1.85, 95% CI 1.40 to 2.44), or etoricoxib (2.9/1000 person-years for tramadol, 1.5/1000 person-years for etoricoxib; HR = 1.96, 95% CI 1.34 to 2.87) cohort. In this population-based cohort study, the initiation of tramadol was associated with a higher risk of hip fracture than initiation of codeine and commonly used NSAIDs, suggesting a need to revisit several guidelines on tramadol use in clinical practice. © 2020 American Society for Bone and Mineral Research.
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Affiliation(s)
- Jie Wei
- Health Management Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- The Mongan Institute, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Nancy E. Lane
- Center for Musculoskeletal Health and Department of Medicine, University of California School of Medicine, Sacramento, California, USA
| | - Marcy B. Bolster
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Maureen Dubreuil
- Boston University School of Medicine, Boston, Massachusetts, USA
- VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Chao Zeng
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- The Mongan Institute, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Devyani Misra
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Na Lu
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Arthritis Research Canada, Richmond, British Columbia, Canada
| | - Hyon K. Choi
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- The Mongan Institute, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Guanghua Lei
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yuqing Zhang
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- The Mongan Institute, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Braisch U, Muche R, Rothenbacher D, Landwehrmeyer GB, Long JD, Orth M. Identification of symbol digit modality test score extremes in Huntington's disease. Am J Med Genet B Neuropsychiatr Genet 2019; 180:232-245. [PMID: 30788902 DOI: 10.1002/ajmg.b.32719] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 12/14/2018] [Accepted: 02/08/2019] [Indexed: 11/09/2022]
Abstract
Studying individuals with extreme phenotypes could facilitate the understanding of disease modification by genetic or environmental factors. Our aim was to identify Huntington's disease (HD) patients with extreme symbol digit modality test (SDMT) scores. We first examined in HD the contribution of cognitive measures of the Unified Huntington's Disease Rating Scale (UHDRS) in predicting clinical endpoints. The language-independent SDMT was used to identify patients performing very well or very poorly relative to their CAG and age cohort. We used data from REGISTRY and COHORT observational study participants (5,603 HD participants with CAG repeats above 39 with 13,868 visits) and of 1,006 healthy volunteers (with 2,241 visits), included to identify natural aging and education effects on cognitive measures. Separate Cox proportional hazards models with CAG, age at study entry, education, sex, UHDRS total motor score and cognitive (SDMT, verbal fluency, Stroop tests) scores as covariates were used to predict clinical endpoints. Quantile regression for longitudinal language-independent SDMT data was used for boundary (2.5% and 97.5% quantiles) estimation and extreme score analyses stratified by age, education, and CAG repeat length. Ten percent of HD participants had an extreme SDMT phenotype for at least one visit. In contrast, only about 3% of participants were consistent SDMT extremes at two or more visits. The thresholds for the one-visit and two-visit extremes can be used to classify existing and new individuals. The identification of these phenotype extremes can be useful in the search for disease modifiers.
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Affiliation(s)
- Ulrike Braisch
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Rainer Muche
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | | | | | - Jeffrey D Long
- Department of Psychiatry, University of Iowa, Iowa City, Iowa.,Department of Biostatistics, University of Iowa, Iowa City, Iowa
| | - Michael Orth
- Department of Neurology, Ulm University, Ulm, Germany
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Macfarlane GJ, Shim J, Jones GT, Walker-Bone K, Pathan E, Dean LE. Identifying Persons with Axial Spondyloarthritis At Risk of Poor Work Outcome: Results from the British Society for Rheumatology Biologics Register. J Rheumatol 2018; 46:145-152. [PMID: 30385702 DOI: 10.3899/jrheum.180477] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE First, to test the hypothesis that, among working patients with axial spondyloarthritis (axSpA), those who report issues with reduced productivity at work (presenteeism) are at higher risk of work absence (absenteeism), and patients who report absenteeism are at higher risk of subsequently leaving the workforce. Second, to identify characteristics of workers at high risk of poor work outcome. METHODS The British Society for Rheumatology Biologics Register in Ankylosing Spondylitis has recruited patients meeting Assessment of Spondyloarthritis international Society criteria for axSpA from 83 centers. Data collection involved clinical and patient-reported measures at recruitment and annually thereafter, including the Work Productivity and Activity Impairment scale. Generalized estimating equations were used to identify factors associated with poor work outcomes. RESULTS Of the 1188 participants in this analysis who were working at recruitment, 79% reported some presenteeism and 19% some absenteeism in the past week owing to their axSpA. Leaving employment was most strongly associated with previous absenteeism (RR 1.02 per % increase in absenteeism, 95% CI 1.01-1.03), which itself was most strongly associated with previous presenteeism, a labor-intensive job, and peripheral joint involvement. High disease activity, fatigue, a labor-intensive job, and poorer physical function were all independently associated with future presenteeism. CONCLUSION Clinical and patient-reported factors along with aspects of work are associated with an increased risk of axSpA patients having a poor outcome in relation to work. This study has identified modifiable factors as targets, facilitating patients with axSpA to remain productive at work.
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Affiliation(s)
- Gary J Macfarlane
- From the Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, and the Aberdeen Centre for Arthritis and Musculoskeletal Health, and the Medical Research Council (MRC)/Arthritis Research UK Centre for Musculoskeletal Health and Work, University of Aberdeen, Aberdeen, UK; MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; Spondylitis Program, Department of Rheumatology, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada. .,G.J. Macfarlane, MD, Dean of Research and Knowledge Exchange (Life Sciences and Medicine) and Chair in Epidemiology, Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, and Aberdeen Centre for Arthritis and Musculoskeletal Health, and MRC/Arthritis Research UK Centre for Musculoskeletal Health and Work, University of Aberdeen; J. Shim, PhD, Research Fellow (Epidemiology), Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, and Aberdeen Centre for Arthritis and Musculoskeletal Health, and MRC/Arthritis Research UK Centre for Musculoskeletal Health and Work, University of Aberdeen; G.T. Jones, PhD, Reader of Epidemiology, Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, and Aberdeen Centre for Arthritis and Musculoskeletal Health, and MRC/Arthritis Research UK Centre for Musculoskeletal Health and Work, University of Aberdeen; K. Walker-Bone, PhD, Professor of Occupational Rheumatology, MRC/Arthritis Research UK Centre for Musculoskeletal Health and Work, and MRC Lifecourse Epidemiology Unit, University of Southampton; E. Pathan, PhD, Research Fellow (Rheumatology), Spondylitis Program, Department of Rheumatology, Toronto Western Hospital, University Health Network; L.E. Dean, PhD, Research Assistant, Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, and Aberdeen Centre for Arthritis and Musculoskeletal Health, and MRC/Arthritis Research UK Centre for Musculoskeletal Health and Work, University of Aberdeen.
| | - Joanna Shim
- From the Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, and the Aberdeen Centre for Arthritis and Musculoskeletal Health, and the Medical Research Council (MRC)/Arthritis Research UK Centre for Musculoskeletal Health and Work, University of Aberdeen, Aberdeen, UK; MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; Spondylitis Program, Department of Rheumatology, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.,G.J. Macfarlane, MD, Dean of Research and Knowledge Exchange (Life Sciences and Medicine) and Chair in Epidemiology, Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, and Aberdeen Centre for Arthritis and Musculoskeletal Health, and MRC/Arthritis Research UK Centre for Musculoskeletal Health and Work, University of Aberdeen; J. Shim, PhD, Research Fellow (Epidemiology), Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, and Aberdeen Centre for Arthritis and Musculoskeletal Health, and MRC/Arthritis Research UK Centre for Musculoskeletal Health and Work, University of Aberdeen; G.T. Jones, PhD, Reader of Epidemiology, Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, and Aberdeen Centre for Arthritis and Musculoskeletal Health, and MRC/Arthritis Research UK Centre for Musculoskeletal Health and Work, University of Aberdeen; K. Walker-Bone, PhD, Professor of Occupational Rheumatology, MRC/Arthritis Research UK Centre for Musculoskeletal Health and Work, and MRC Lifecourse Epidemiology Unit, University of Southampton; E. Pathan, PhD, Research Fellow (Rheumatology), Spondylitis Program, Department of Rheumatology, Toronto Western Hospital, University Health Network; L.E. Dean, PhD, Research Assistant, Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, and Aberdeen Centre for Arthritis and Musculoskeletal Health, and MRC/Arthritis Research UK Centre for Musculoskeletal Health and Work, University of Aberdeen
| | - Gareth T Jones
- From the Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, and the Aberdeen Centre for Arthritis and Musculoskeletal Health, and the Medical Research Council (MRC)/Arthritis Research UK Centre for Musculoskeletal Health and Work, University of Aberdeen, Aberdeen, UK; MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; Spondylitis Program, Department of Rheumatology, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.,G.J. Macfarlane, MD, Dean of Research and Knowledge Exchange (Life Sciences and Medicine) and Chair in Epidemiology, Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, and Aberdeen Centre for Arthritis and Musculoskeletal Health, and MRC/Arthritis Research UK Centre for Musculoskeletal Health and Work, University of Aberdeen; J. Shim, PhD, Research Fellow (Epidemiology), Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, and Aberdeen Centre for Arthritis and Musculoskeletal Health, and MRC/Arthritis Research UK Centre for Musculoskeletal Health and Work, University of Aberdeen; G.T. Jones, PhD, Reader of Epidemiology, Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, and Aberdeen Centre for Arthritis and Musculoskeletal Health, and MRC/Arthritis Research UK Centre for Musculoskeletal Health and Work, University of Aberdeen; K. Walker-Bone, PhD, Professor of Occupational Rheumatology, MRC/Arthritis Research UK Centre for Musculoskeletal Health and Work, and MRC Lifecourse Epidemiology Unit, University of Southampton; E. Pathan, PhD, Research Fellow (Rheumatology), Spondylitis Program, Department of Rheumatology, Toronto Western Hospital, University Health Network; L.E. Dean, PhD, Research Assistant, Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, and Aberdeen Centre for Arthritis and Musculoskeletal Health, and MRC/Arthritis Research UK Centre for Musculoskeletal Health and Work, University of Aberdeen
| | - Karen Walker-Bone
- From the Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, and the Aberdeen Centre for Arthritis and Musculoskeletal Health, and the Medical Research Council (MRC)/Arthritis Research UK Centre for Musculoskeletal Health and Work, University of Aberdeen, Aberdeen, UK; MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; Spondylitis Program, Department of Rheumatology, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.,G.J. Macfarlane, MD, Dean of Research and Knowledge Exchange (Life Sciences and Medicine) and Chair in Epidemiology, Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, and Aberdeen Centre for Arthritis and Musculoskeletal Health, and MRC/Arthritis Research UK Centre for Musculoskeletal Health and Work, University of Aberdeen; J. Shim, PhD, Research Fellow (Epidemiology), Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, and Aberdeen Centre for Arthritis and Musculoskeletal Health, and MRC/Arthritis Research UK Centre for Musculoskeletal Health and Work, University of Aberdeen; G.T. Jones, PhD, Reader of Epidemiology, Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, and Aberdeen Centre for Arthritis and Musculoskeletal Health, and MRC/Arthritis Research UK Centre for Musculoskeletal Health and Work, University of Aberdeen; K. Walker-Bone, PhD, Professor of Occupational Rheumatology, MRC/Arthritis Research UK Centre for Musculoskeletal Health and Work, and MRC Lifecourse Epidemiology Unit, University of Southampton; E. Pathan, PhD, Research Fellow (Rheumatology), Spondylitis Program, Department of Rheumatology, Toronto Western Hospital, University Health Network; L.E. Dean, PhD, Research Assistant, Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, and Aberdeen Centre for Arthritis and Musculoskeletal Health, and MRC/Arthritis Research UK Centre for Musculoskeletal Health and Work, University of Aberdeen
| | - Ejaz Pathan
- From the Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, and the Aberdeen Centre for Arthritis and Musculoskeletal Health, and the Medical Research Council (MRC)/Arthritis Research UK Centre for Musculoskeletal Health and Work, University of Aberdeen, Aberdeen, UK; MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; Spondylitis Program, Department of Rheumatology, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.,G.J. Macfarlane, MD, Dean of Research and Knowledge Exchange (Life Sciences and Medicine) and Chair in Epidemiology, Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, and Aberdeen Centre for Arthritis and Musculoskeletal Health, and MRC/Arthritis Research UK Centre for Musculoskeletal Health and Work, University of Aberdeen; J. Shim, PhD, Research Fellow (Epidemiology), Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, and Aberdeen Centre for Arthritis and Musculoskeletal Health, and MRC/Arthritis Research UK Centre for Musculoskeletal Health and Work, University of Aberdeen; G.T. Jones, PhD, Reader of Epidemiology, Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, and Aberdeen Centre for Arthritis and Musculoskeletal Health, and MRC/Arthritis Research UK Centre for Musculoskeletal Health and Work, University of Aberdeen; K. Walker-Bone, PhD, Professor of Occupational Rheumatology, MRC/Arthritis Research UK Centre for Musculoskeletal Health and Work, and MRC Lifecourse Epidemiology Unit, University of Southampton; E. Pathan, PhD, Research Fellow (Rheumatology), Spondylitis Program, Department of Rheumatology, Toronto Western Hospital, University Health Network; L.E. Dean, PhD, Research Assistant, Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, and Aberdeen Centre for Arthritis and Musculoskeletal Health, and MRC/Arthritis Research UK Centre for Musculoskeletal Health and Work, University of Aberdeen
| | - Linda E Dean
- From the Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, and the Aberdeen Centre for Arthritis and Musculoskeletal Health, and the Medical Research Council (MRC)/Arthritis Research UK Centre for Musculoskeletal Health and Work, University of Aberdeen, Aberdeen, UK; MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; Spondylitis Program, Department of Rheumatology, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.,G.J. Macfarlane, MD, Dean of Research and Knowledge Exchange (Life Sciences and Medicine) and Chair in Epidemiology, Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, and Aberdeen Centre for Arthritis and Musculoskeletal Health, and MRC/Arthritis Research UK Centre for Musculoskeletal Health and Work, University of Aberdeen; J. Shim, PhD, Research Fellow (Epidemiology), Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, and Aberdeen Centre for Arthritis and Musculoskeletal Health, and MRC/Arthritis Research UK Centre for Musculoskeletal Health and Work, University of Aberdeen; G.T. Jones, PhD, Reader of Epidemiology, Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, and Aberdeen Centre for Arthritis and Musculoskeletal Health, and MRC/Arthritis Research UK Centre for Musculoskeletal Health and Work, University of Aberdeen; K. Walker-Bone, PhD, Professor of Occupational Rheumatology, MRC/Arthritis Research UK Centre for Musculoskeletal Health and Work, and MRC Lifecourse Epidemiology Unit, University of Southampton; E. Pathan, PhD, Research Fellow (Rheumatology), Spondylitis Program, Department of Rheumatology, Toronto Western Hospital, University Health Network; L.E. Dean, PhD, Research Assistant, Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, and Aberdeen Centre for Arthritis and Musculoskeletal Health, and MRC/Arthritis Research UK Centre for Musculoskeletal Health and Work, University of Aberdeen
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Chin C, Sayre EC, Guermazi A, Nicolaou S, Esdaile JM, Kopec J, Thorne A, Singer J, Wong H, Cibere J. Quadriceps Weakness and Risk of Knee Cartilage Loss Seen on Magnetic Resonance Imaging in a Population-based Cohort with Knee Pain. J Rheumatol 2018; 46:198-203. [PMID: 30275263 DOI: 10.3899/jrheum.170875] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To determine whether baseline quadriceps weakness predicts cartilage loss assessed on magnetic resonance imaging (MRI). METHODS Subjects aged 40-79 with knee pain (n = 163) were recruited from a random population sample and examined for quadriceps weakness with manual isometric strength testing, using a 3-point scoring system (0 = poor resistance, 1 = moderate resistance, 2 = full resistance), which was dichotomized as normal (grade 2) versus weak (grade 0/1). MRI of the more symptomatic knee was obtained at baseline and at mean of 3.3 years. Cartilage was graded 0-4 on MRI. Exponential regression analysis was used to evaluate whether quadriceps weakness was associated with whole knee cartilage loss, and in secondary analyses with compartment-specific cartilage loss, adjusted for age, sex, body mass index, Western Ontario and McMaster Universities Osteoarthritis Arthritis Index pain score, and baseline MRI cartilage score. RESULTS Of 163 subjects, 54% were female, with a mean age of 57.7 years. Quadriceps weakness was seen in 11.9% of the subjects. Weakness was a predictor of whole knee cartilage loss (HR 3.48, 95% CI 1.30-9.35). Quadriceps weakness was associated with cartilage loss in the medial tibiofemoral (TF) compartment (HR 4.60, 95% CI 1.25-17.02), while no significant association was found with lateral TF (HR 1.53, 95% CI 0.24-9.78) or patellofemoral compartment (HR 2.76, 95% CI 0.46-16.44). CONCLUSION In this symptomatic, population-based cohort, quadriceps weakness predicted whole knee and medial TF cartilage loss after 3 years. To our knowledge, this is the first study to show that a simple clinical examination of quadriceps strength can predict the risk of knee cartilage loss.
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Affiliation(s)
- Carson Chin
- From the Department of Medicine, the Division of Rheumatology, the Department of Radiology and the School of Population and Public Health, University of British Columbia, Vancouver; Arthritis Research Canada, Vancouver; Canadian Institutes of Health Research HIV Trials Network, Vancouver; Centre for Health Evaluation and Outcomes Sciences, Vancouver, British Columbia, Canada; Department of Radiology, Boston University Medical Center, Boston, Massachusetts, USA. .,C. Chin, MD, FRCPC, Division of Rheumatology, University of British Columbia; E.C. Sayre, PhD, Research Associate, Arthritis Research Canada; A. Guermazi, MD, Professor, Department of Radiology, Boston University Medical Center; S. Nicolaou, MD, Assistant Professor, Department of Radiology, University of British Columbia (UBC), Director of Emergency/Trauma Imaging, Vancouver General Hospital; H. Wong, PhD, Associate Professor, School of Population and Public Health, UBC, and Associate Head, Data and Methodology, CIHR Canadian HIV Trials Network; A. Thorne, MSc, Senior Biostatistician, CIHR Canadian HIV Trials Network, School of Population and Public Health, UBC; J. Singer, PhD, Professor, School of Population and Public Health, UBC, and Centre for Health Evaluation and Outcome Sciences; J.A. Kopec, MD, MSc, PhD, Associate Professor, School of Population and Public Health, UBC, and Research Scientist, Arthritis Research Canada; J.M. Esdaile, MD, MPH, Professor, Department of Medicine, UBC, and Scientific Director, Arthritis Research Canada; J. Cibere, MD, PhD, Associate Professor, Department of Medicine, UBC, and Senior Research Scientist, Arthritis Research Canada.
| | - Eric C Sayre
- From the Department of Medicine, the Division of Rheumatology, the Department of Radiology and the School of Population and Public Health, University of British Columbia, Vancouver; Arthritis Research Canada, Vancouver; Canadian Institutes of Health Research HIV Trials Network, Vancouver; Centre for Health Evaluation and Outcomes Sciences, Vancouver, British Columbia, Canada; Department of Radiology, Boston University Medical Center, Boston, Massachusetts, USA.,C. Chin, MD, FRCPC, Division of Rheumatology, University of British Columbia; E.C. Sayre, PhD, Research Associate, Arthritis Research Canada; A. Guermazi, MD, Professor, Department of Radiology, Boston University Medical Center; S. Nicolaou, MD, Assistant Professor, Department of Radiology, University of British Columbia (UBC), Director of Emergency/Trauma Imaging, Vancouver General Hospital; H. Wong, PhD, Associate Professor, School of Population and Public Health, UBC, and Associate Head, Data and Methodology, CIHR Canadian HIV Trials Network; A. Thorne, MSc, Senior Biostatistician, CIHR Canadian HIV Trials Network, School of Population and Public Health, UBC; J. Singer, PhD, Professor, School of Population and Public Health, UBC, and Centre for Health Evaluation and Outcome Sciences; J.A. Kopec, MD, MSc, PhD, Associate Professor, School of Population and Public Health, UBC, and Research Scientist, Arthritis Research Canada; J.M. Esdaile, MD, MPH, Professor, Department of Medicine, UBC, and Scientific Director, Arthritis Research Canada; J. Cibere, MD, PhD, Associate Professor, Department of Medicine, UBC, and Senior Research Scientist, Arthritis Research Canada
| | - Ali Guermazi
- From the Department of Medicine, the Division of Rheumatology, the Department of Radiology and the School of Population and Public Health, University of British Columbia, Vancouver; Arthritis Research Canada, Vancouver; Canadian Institutes of Health Research HIV Trials Network, Vancouver; Centre for Health Evaluation and Outcomes Sciences, Vancouver, British Columbia, Canada; Department of Radiology, Boston University Medical Center, Boston, Massachusetts, USA.,C. Chin, MD, FRCPC, Division of Rheumatology, University of British Columbia; E.C. Sayre, PhD, Research Associate, Arthritis Research Canada; A. Guermazi, MD, Professor, Department of Radiology, Boston University Medical Center; S. Nicolaou, MD, Assistant Professor, Department of Radiology, University of British Columbia (UBC), Director of Emergency/Trauma Imaging, Vancouver General Hospital; H. Wong, PhD, Associate Professor, School of Population and Public Health, UBC, and Associate Head, Data and Methodology, CIHR Canadian HIV Trials Network; A. Thorne, MSc, Senior Biostatistician, CIHR Canadian HIV Trials Network, School of Population and Public Health, UBC; J. Singer, PhD, Professor, School of Population and Public Health, UBC, and Centre for Health Evaluation and Outcome Sciences; J.A. Kopec, MD, MSc, PhD, Associate Professor, School of Population and Public Health, UBC, and Research Scientist, Arthritis Research Canada; J.M. Esdaile, MD, MPH, Professor, Department of Medicine, UBC, and Scientific Director, Arthritis Research Canada; J. Cibere, MD, PhD, Associate Professor, Department of Medicine, UBC, and Senior Research Scientist, Arthritis Research Canada
| | - Savvas Nicolaou
- From the Department of Medicine, the Division of Rheumatology, the Department of Radiology and the School of Population and Public Health, University of British Columbia, Vancouver; Arthritis Research Canada, Vancouver; Canadian Institutes of Health Research HIV Trials Network, Vancouver; Centre for Health Evaluation and Outcomes Sciences, Vancouver, British Columbia, Canada; Department of Radiology, Boston University Medical Center, Boston, Massachusetts, USA.,C. Chin, MD, FRCPC, Division of Rheumatology, University of British Columbia; E.C. Sayre, PhD, Research Associate, Arthritis Research Canada; A. Guermazi, MD, Professor, Department of Radiology, Boston University Medical Center; S. Nicolaou, MD, Assistant Professor, Department of Radiology, University of British Columbia (UBC), Director of Emergency/Trauma Imaging, Vancouver General Hospital; H. Wong, PhD, Associate Professor, School of Population and Public Health, UBC, and Associate Head, Data and Methodology, CIHR Canadian HIV Trials Network; A. Thorne, MSc, Senior Biostatistician, CIHR Canadian HIV Trials Network, School of Population and Public Health, UBC; J. Singer, PhD, Professor, School of Population and Public Health, UBC, and Centre for Health Evaluation and Outcome Sciences; J.A. Kopec, MD, MSc, PhD, Associate Professor, School of Population and Public Health, UBC, and Research Scientist, Arthritis Research Canada; J.M. Esdaile, MD, MPH, Professor, Department of Medicine, UBC, and Scientific Director, Arthritis Research Canada; J. Cibere, MD, PhD, Associate Professor, Department of Medicine, UBC, and Senior Research Scientist, Arthritis Research Canada
| | - John M Esdaile
- From the Department of Medicine, the Division of Rheumatology, the Department of Radiology and the School of Population and Public Health, University of British Columbia, Vancouver; Arthritis Research Canada, Vancouver; Canadian Institutes of Health Research HIV Trials Network, Vancouver; Centre for Health Evaluation and Outcomes Sciences, Vancouver, British Columbia, Canada; Department of Radiology, Boston University Medical Center, Boston, Massachusetts, USA.,C. Chin, MD, FRCPC, Division of Rheumatology, University of British Columbia; E.C. Sayre, PhD, Research Associate, Arthritis Research Canada; A. Guermazi, MD, Professor, Department of Radiology, Boston University Medical Center; S. Nicolaou, MD, Assistant Professor, Department of Radiology, University of British Columbia (UBC), Director of Emergency/Trauma Imaging, Vancouver General Hospital; H. Wong, PhD, Associate Professor, School of Population and Public Health, UBC, and Associate Head, Data and Methodology, CIHR Canadian HIV Trials Network; A. Thorne, MSc, Senior Biostatistician, CIHR Canadian HIV Trials Network, School of Population and Public Health, UBC; J. Singer, PhD, Professor, School of Population and Public Health, UBC, and Centre for Health Evaluation and Outcome Sciences; J.A. Kopec, MD, MSc, PhD, Associate Professor, School of Population and Public Health, UBC, and Research Scientist, Arthritis Research Canada; J.M. Esdaile, MD, MPH, Professor, Department of Medicine, UBC, and Scientific Director, Arthritis Research Canada; J. Cibere, MD, PhD, Associate Professor, Department of Medicine, UBC, and Senior Research Scientist, Arthritis Research Canada
| | - Jacek Kopec
- From the Department of Medicine, the Division of Rheumatology, the Department of Radiology and the School of Population and Public Health, University of British Columbia, Vancouver; Arthritis Research Canada, Vancouver; Canadian Institutes of Health Research HIV Trials Network, Vancouver; Centre for Health Evaluation and Outcomes Sciences, Vancouver, British Columbia, Canada; Department of Radiology, Boston University Medical Center, Boston, Massachusetts, USA.,C. Chin, MD, FRCPC, Division of Rheumatology, University of British Columbia; E.C. Sayre, PhD, Research Associate, Arthritis Research Canada; A. Guermazi, MD, Professor, Department of Radiology, Boston University Medical Center; S. Nicolaou, MD, Assistant Professor, Department of Radiology, University of British Columbia (UBC), Director of Emergency/Trauma Imaging, Vancouver General Hospital; H. Wong, PhD, Associate Professor, School of Population and Public Health, UBC, and Associate Head, Data and Methodology, CIHR Canadian HIV Trials Network; A. Thorne, MSc, Senior Biostatistician, CIHR Canadian HIV Trials Network, School of Population and Public Health, UBC; J. Singer, PhD, Professor, School of Population and Public Health, UBC, and Centre for Health Evaluation and Outcome Sciences; J.A. Kopec, MD, MSc, PhD, Associate Professor, School of Population and Public Health, UBC, and Research Scientist, Arthritis Research Canada; J.M. Esdaile, MD, MPH, Professor, Department of Medicine, UBC, and Scientific Director, Arthritis Research Canada; J. Cibere, MD, PhD, Associate Professor, Department of Medicine, UBC, and Senior Research Scientist, Arthritis Research Canada
| | - Anona Thorne
- From the Department of Medicine, the Division of Rheumatology, the Department of Radiology and the School of Population and Public Health, University of British Columbia, Vancouver; Arthritis Research Canada, Vancouver; Canadian Institutes of Health Research HIV Trials Network, Vancouver; Centre for Health Evaluation and Outcomes Sciences, Vancouver, British Columbia, Canada; Department of Radiology, Boston University Medical Center, Boston, Massachusetts, USA.,C. Chin, MD, FRCPC, Division of Rheumatology, University of British Columbia; E.C. Sayre, PhD, Research Associate, Arthritis Research Canada; A. Guermazi, MD, Professor, Department of Radiology, Boston University Medical Center; S. Nicolaou, MD, Assistant Professor, Department of Radiology, University of British Columbia (UBC), Director of Emergency/Trauma Imaging, Vancouver General Hospital; H. Wong, PhD, Associate Professor, School of Population and Public Health, UBC, and Associate Head, Data and Methodology, CIHR Canadian HIV Trials Network; A. Thorne, MSc, Senior Biostatistician, CIHR Canadian HIV Trials Network, School of Population and Public Health, UBC; J. Singer, PhD, Professor, School of Population and Public Health, UBC, and Centre for Health Evaluation and Outcome Sciences; J.A. Kopec, MD, MSc, PhD, Associate Professor, School of Population and Public Health, UBC, and Research Scientist, Arthritis Research Canada; J.M. Esdaile, MD, MPH, Professor, Department of Medicine, UBC, and Scientific Director, Arthritis Research Canada; J. Cibere, MD, PhD, Associate Professor, Department of Medicine, UBC, and Senior Research Scientist, Arthritis Research Canada
| | - Joel Singer
- From the Department of Medicine, the Division of Rheumatology, the Department of Radiology and the School of Population and Public Health, University of British Columbia, Vancouver; Arthritis Research Canada, Vancouver; Canadian Institutes of Health Research HIV Trials Network, Vancouver; Centre for Health Evaluation and Outcomes Sciences, Vancouver, British Columbia, Canada; Department of Radiology, Boston University Medical Center, Boston, Massachusetts, USA.,C. Chin, MD, FRCPC, Division of Rheumatology, University of British Columbia; E.C. Sayre, PhD, Research Associate, Arthritis Research Canada; A. Guermazi, MD, Professor, Department of Radiology, Boston University Medical Center; S. Nicolaou, MD, Assistant Professor, Department of Radiology, University of British Columbia (UBC), Director of Emergency/Trauma Imaging, Vancouver General Hospital; H. Wong, PhD, Associate Professor, School of Population and Public Health, UBC, and Associate Head, Data and Methodology, CIHR Canadian HIV Trials Network; A. Thorne, MSc, Senior Biostatistician, CIHR Canadian HIV Trials Network, School of Population and Public Health, UBC; J. Singer, PhD, Professor, School of Population and Public Health, UBC, and Centre for Health Evaluation and Outcome Sciences; J.A. Kopec, MD, MSc, PhD, Associate Professor, School of Population and Public Health, UBC, and Research Scientist, Arthritis Research Canada; J.M. Esdaile, MD, MPH, Professor, Department of Medicine, UBC, and Scientific Director, Arthritis Research Canada; J. Cibere, MD, PhD, Associate Professor, Department of Medicine, UBC, and Senior Research Scientist, Arthritis Research Canada
| | - Hubert Wong
- From the Department of Medicine, the Division of Rheumatology, the Department of Radiology and the School of Population and Public Health, University of British Columbia, Vancouver; Arthritis Research Canada, Vancouver; Canadian Institutes of Health Research HIV Trials Network, Vancouver; Centre for Health Evaluation and Outcomes Sciences, Vancouver, British Columbia, Canada; Department of Radiology, Boston University Medical Center, Boston, Massachusetts, USA.,C. Chin, MD, FRCPC, Division of Rheumatology, University of British Columbia; E.C. Sayre, PhD, Research Associate, Arthritis Research Canada; A. Guermazi, MD, Professor, Department of Radiology, Boston University Medical Center; S. Nicolaou, MD, Assistant Professor, Department of Radiology, University of British Columbia (UBC), Director of Emergency/Trauma Imaging, Vancouver General Hospital; H. Wong, PhD, Associate Professor, School of Population and Public Health, UBC, and Associate Head, Data and Methodology, CIHR Canadian HIV Trials Network; A. Thorne, MSc, Senior Biostatistician, CIHR Canadian HIV Trials Network, School of Population and Public Health, UBC; J. Singer, PhD, Professor, School of Population and Public Health, UBC, and Centre for Health Evaluation and Outcome Sciences; J.A. Kopec, MD, MSc, PhD, Associate Professor, School of Population and Public Health, UBC, and Research Scientist, Arthritis Research Canada; J.M. Esdaile, MD, MPH, Professor, Department of Medicine, UBC, and Scientific Director, Arthritis Research Canada; J. Cibere, MD, PhD, Associate Professor, Department of Medicine, UBC, and Senior Research Scientist, Arthritis Research Canada
| | - Jolanda Cibere
- From the Department of Medicine, the Division of Rheumatology, the Department of Radiology and the School of Population and Public Health, University of British Columbia, Vancouver; Arthritis Research Canada, Vancouver; Canadian Institutes of Health Research HIV Trials Network, Vancouver; Centre for Health Evaluation and Outcomes Sciences, Vancouver, British Columbia, Canada; Department of Radiology, Boston University Medical Center, Boston, Massachusetts, USA.,C. Chin, MD, FRCPC, Division of Rheumatology, University of British Columbia; E.C. Sayre, PhD, Research Associate, Arthritis Research Canada; A. Guermazi, MD, Professor, Department of Radiology, Boston University Medical Center; S. Nicolaou, MD, Assistant Professor, Department of Radiology, University of British Columbia (UBC), Director of Emergency/Trauma Imaging, Vancouver General Hospital; H. Wong, PhD, Associate Professor, School of Population and Public Health, UBC, and Associate Head, Data and Methodology, CIHR Canadian HIV Trials Network; A. Thorne, MSc, Senior Biostatistician, CIHR Canadian HIV Trials Network, School of Population and Public Health, UBC; J. Singer, PhD, Professor, School of Population and Public Health, UBC, and Centre for Health Evaluation and Outcome Sciences; J.A. Kopec, MD, MSc, PhD, Associate Professor, School of Population and Public Health, UBC, and Research Scientist, Arthritis Research Canada; J.M. Esdaile, MD, MPH, Professor, Department of Medicine, UBC, and Scientific Director, Arthritis Research Canada; J. Cibere, MD, PhD, Associate Professor, Department of Medicine, UBC, and Senior Research Scientist, Arthritis Research Canada
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Burns AR, Hussong AM, Solis JM, Curran PJ, McGinley JS, Bauer DJ, Chassin L, Zucker RA. Examining Cohort Effects in Developmental Trajectories of Substance Use. Int J Behav Dev 2017; 41:621-631. [PMID: 29056800 DOI: 10.1177/0165025416651734] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The current study demonstrates the application of an analytic approach for incorporating multiple time trends in order to examine the impact of cohort effects on individual trajectories of eight drugs of abuse. Parallel analysis of two independent, longitudinal studies of high-risk youth that span ages 10 to 40 across 23 birth cohorts between 1968 and 1991 was conducted. The two studies include the Michigan Longitudinal Study (current analytic sample of n=579 over 12 cohorts between 1980-1991 and ages 10-27) and the Adolescent/Adult and Family Development Project (current analytic sample of n=849 over 11 cohorts between 1968-1978 and ages 10-40). A series of nonlinear, multi-level growth models controlled simultaneously for cohort and age trends in substance use trajectories. Evidence was found for both age and cohort effects across most outcomes as well as several significant age-by-cohort interactions. Findings suggest cohort trends in developmental trajectories of substance use are sample and drug-specific in the adolescent and early to mid-adult years. Thus, studies that do not control for both trends may confound cohort and developmental trends in substance use. For this reason, demonstration of one analytic approach that can be used to examine both time trends simultaneously is informative for future multi-cohort longitudinal studies where change over time is of interest.
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Affiliation(s)
- Alison R Burns
- Children's National Health System; Division of Neuropsychology; 15245 Shady Grove Road, Suite 350; Rockville, MD 20850
| | - Andrea M Hussong
- University of North Carolina at Chapel Hill; Department of Psychology; Davie Hall, CB#3270; Chapel Hill, NC 27599
| | - Jessica M Solis
- University of North Carolina at Chapel Hill; Department of Psychology; Davie Hall, CB#3270; Chapel Hill, NC 27599
| | - Patrick J Curran
- University of North Carolina at Chapel Hill; Department of Psychology; Davie Hall, CB#3270; Chapel Hill, NC 27599
| | - James S McGinley
- McGinley Statistical Consulting; 610 Vincent Drive, North Huntingdon, PA 15642
| | - Daniel J Bauer
- University of North Carolina at Chapel Hill; Department of Psychology; Davie Hall, CB#3270; Chapel Hill, NC 27599
| | - Laurie Chassin
- Arizona State University; Department of Psychology; PO Box 871104, 950 S. McAllister, Room 237; Tempe, AZ 85287
| | - Robert A Zucker
- University of Michigan, Department of Psychiatry & Addiction Research Center; Rachel Upjohn Building; 4250 Plymouth Road; Ann Arbor, MI 48109
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Mauz E, Gößwald A, Kamtsiuris P, Hoffmann R, Lange M, von Schenck U, Allen J, Butschalowsky H, Frank L, Hölling H, Houben R, Krause L, Kuhnert R, Lange C, Müters S, Neuhauser H, Poethko-Müller C, Richter A, Rosario AS, Schaarschmidt J, Schlack R, Schlaud M, Schmich P, Schöne G, Wetzstein M, Ziese T, Kurth BM. New data for action. Data collection for KiGGS Wave 2 has been completed. J Health Monit 2017; 2:2-27. [PMID: 37377941 PMCID: PMC10291840 DOI: 10.17886/rki-gbe-2017-105] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
The fieldwork of the second follow-up to the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) was completed in August 2017. KiGGS is part of the Robert Koch Institute's Federal Health Monitoring. The study consists of the KiGGS cross-sectional component (a nationally representative, periodic cross-sectional survey of children and adolescents aged between 0 and 17) and the KiGGS cohort (the follow-up into adulthood of participants who took part in the KiGGS baseline study). KiGGS collects data on health status, health-related behaviour, psychosocial risk and protective factors, health care and the living conditions of children and adolescents in Germany. The first interview and examination survey (the KiGGS baseline study; undertaken between 2003 and 2006; n=17,641; age range: 0-17) was carried out in a total of 167 sample points in Germany. Physical examinations, laboratory analyses of blood and urine samples and various physical tests were conducted with the participants and, in addition, all parents and participants aged 11 or above were interviewed. The first follow-up was conducted via telephone-based interviews (KiGGS Wave 1 2009-2012; n=11,992; age range: 6-24) and an additional sample was included (n=4,455; age range: 0-6). KiGGS Wave 2 (2014-2017) was conducted as an interview and examination survey and consisted of a new, nationwide, representative cross-sectional sample of 0- to 17-year-old children and adolescents in Germany, and the second KiGGS cohort follow-up. The completion of the cross-sectional component of KiGGS Wave 2 means that the health of children and adolescents in Germany can now be assessed using representative data gained from three study waves. Trends can therefore be analysed over a period stretching to over ten years now. As the data collected from participants of the KiGGS cohort can be individually linked across the various surveys, in-depth analyses can be conducted for a period ranging from childhood to young adulthood and developmental processes associated with physical and mental health and the associated risk and protective factors can be explored. As such, KiGGS Wave 2 expands the resources available to health reporting, as well as policy planning and research, with regard to assessing the health of children and adolescents in Germany.
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Affiliation(s)
- Elvira Mauz
- Corresponding author Elvira Mauz, Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 62–66, D-12101 Berlin, Germany, E-mail:
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9
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Braisch U, Hay B, Muche R, Rothenbacher D, Landwehrmeyer GB, Long JD, Orth M. Identification of extreme motor phenotypes in Huntington's disease. Am J Med Genet B Neuropsychiatr Genet 2017; 174:283-294. [PMID: 27868347 DOI: 10.1002/ajmg.b.32514] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 10/27/2016] [Indexed: 11/05/2022]
Abstract
The manifestation of motor signs in Huntington's disease (HD) has a well-known inverse relationship with HTT CAG repeat length, but the prediction is far from perfect. The probability of finding disease modifiers is enhanced in individuals with extreme HD phenotypes. We aimed to identify extreme HD motor phenotypes conditional on CAG and age, such as patients with very early or very late onset of motor manifestation. Retrospective data were available from 1,218 healthy controls and 9,743 HD participants with CAG repeats ≥40, and a total of about 30,000 visits. Boundaries (2.5% and 97.5% quantiles) for extreme motor phenotypes (UHDRS total motor score (TMS) and motor age-at-onset) were estimated using quantile regression for longitudinal data. More than 15% of HD participants had an extreme TMS phenotype for at least one visit. In contrast, only about 4% of participants were consistent TMS extremes at two or more visits. Data from healthy controls revealed an upper cut-off of 13 for the TMS representing the extreme of motor ratings for a normal aging population. In HD, boundaries of motor age-at-onset based on diagnostic confidence or derived from the TMS data cut-off in controls were similar. In summary, a UHDRS TMS of more than 13 in an individual carrying the HD mutation indicates a high likelihood of motor manifestations of HD irrespective of CAG repeat length or age. The identification of motor phenotype extremes can be useful in the search for disease modifiers, for example, genetic or environmental such as medication. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Ulrike Braisch
- Institute of Epidemiology and Medical Biometry, Ulm University, Germany
| | - Birgit Hay
- Institute of Epidemiology and Medical Biometry, Ulm University, Germany
| | - Rainer Muche
- Institute of Epidemiology and Medical Biometry, Ulm University, Germany
| | | | | | - Jeffrey D Long
- Department of Psychiatry, University of Iowa, Iowa City, Iowa.,Department of Biostatistics, University of Iowa, Iowa City, Iowa
| | - Michael Orth
- Department of Neurology, Ulm University, Germany
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Abstract
OBJECTIVES To examine how population-level socioeconomic health inequalities developed during childhood, for children born at the turn of the 21st century and who grew up with major initiatives to tackle health inequalities (under the New Labour Government). SETTING The UK. PARTICIPANTS Singleton children in the Millennium Cohort Study at ages 3 (n=15 381), 5 (n=15 041), 7 (n=13 681) and 11 (n=13 112) years. PRIMARY OUTCOMES Relative (prevalence ratios (PR)) and absolute health inequalities (prevalence differences (PD)) were estimated in longitudinal models by socioeconomic circumstances (SEC; using highest maternal academic attainment, ranging from 'no academic qualifications' to 'degree' (baseline)). Three health outcomes were examined: overweight (including obesity), limiting long-standing illness (LLSI), and socio-emotional difficulties (SED). RESULTS Relative and absolute inequalities in overweight, across the social gradient, emerged by age 5 and increased with age. By age 11, children with mothers who had no academic qualifications were considerably more likely to be overweight as compared with those with degree-educated mothers (PR=1.6 (95% CI 1.4 to 1.8), PD=12.9% (9.1% to 16.8%)). For LLSI, inequalities emerged by age 7 and remained at 11, but only for children whose mothers had no academic qualifications (PR=1.7 (1.3 to 2.3), PD=4.8% (2% to 7.5%)). Inequalities in SED (observed across the social gradient and at all ages) declined between 3 and 11, although remained large at 11 (eg, PR=2.4 (1.9 to 2.9), PD=13.4% (10.2% to 16.7%) comparing children whose mothers had no academic qualifications with those of degree-educated mothers). CONCLUSIONS Although health inequalities have been well documented in cross-sectional and trend data in the UK, it is less clear how they develop during childhood. We found that relative and absolute health inequalities persisted, and in some cases widened, for a cohort of children born at the turn of the century. Further research examining and comparing the pathways through which SECs influence health may further our understanding of how inequalities could be prevented in future generations of children.
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Affiliation(s)
- Emeline Rougeaux
- Department of Population Policy and Practice, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Steven Hope
- Department of Population Policy and Practice, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Catherine Law
- Department of Population Policy and Practice, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Anna Pearce
- Department of Population Policy and Practice, UCL Great Ormond Street Institute of Child Health, London, UK
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Orth M, Bronzova J, Tritsch C, Ray Dorsey E, Ferreira JJ, Gemperli A. Comparison of Huntington's Disease in Europe and North America. Mov Disord Clin Pract 2016; 4:358-367. [PMID: 30363400 DOI: 10.1002/mdc3.12442] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 07/06/2016] [Accepted: 08/07/2016] [Indexed: 11/09/2022] Open
Abstract
Background In a rare disorder such as Huntington's disease (HD), a global network of clinical trial sites with access to patients speeds up recruitment into clinical trials. The objective was to test the hypothesis that demographics, HTT genotype, clinical spectrum, and progression are similar in HD participants of two large observational HD studies, the European Huntington's Disease Network's European REGISTRY study and the North American COHORT study. Methods REGISTRY cross-sectional data were available from a total of 7,384 participants (1,125 [15.2%] premanifest and 6,259 [84.8%] manifest HD). COHORT cross-sectional data from 1,499 participants at 44 study sites were available (175 pre-HD [11.7%], 1,324 manifest HD [88.3%]). Participants were assessed clinically using the Unified Huntington's Disease Rating Scale (UHDRS). Longitudinal data were available for total motor score and cognitive performance in more than 50% of REGISTRY participants and more than 70% of COHORT participants. Results Demographics, HTT genotypes, phenotype, and progression were similar in the two studies. Patients in Europe were prescribed antidyskinetics more frequently, and antidepressants less frequently, than in North America. In either study, participants on antidyskinetic medication had higher UHDRS total motor scores, worse function assessment scores, and worse cognitive scores than those taking antidepressants or no medication. In contrast, motor, function assessment, and cognitive scores were broadly similar in participants taking antidepressants or no medication. The differences in cognitive performances between languages were small. Conclusions Our data suggest that HD patients, and the way they are assessed, are similar across two continents with different cultures and languages.
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Affiliation(s)
- Michael Orth
- Department of Neurology Ulm University Hospital Ulm Germany
| | | | | | - E Ray Dorsey
- Department of Neurology University of Rochester Medical Center Rochester New York USA
| | - Joaquim J Ferreira
- Clinical Pharmacology Unit Instituto de Medicina Molecular Faculty of Medicine University of Lisbon Lisbon Portugal
| | - Armin Gemperli
- Department of Health Sciences and Health Policy University of Lucerne Lucerne Switzerland.,Swiss Paraplegic Research Nottwil Switzerland
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Saleh Y, El-Shazly M, Adly S, El-Oteify M. Different surgical reconstruction modalities of the post-burn mutilated hand based on a prospective review of a cohort of patients*. Ann Burns Fire Disasters 2008; 21:141-149. [PMID: 21991127 PMCID: PMC3188171] [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] [Subscribe] [Scholar Register] [Received: 12/11/2007] [Indexed: 05/31/2023]
Abstract
This study covered 40 patients (22 females and 18 males) suffering from post-burn hand deformities admitted to Assiut University Hospital and Luxor International Hospital (Egypt) from June 2004 to May 2006. Their ages ranged between 4 and 45 yr (mean, 24.5 yr). They presented a variety of post-burn hand deformities, e.g. dorsal hand contracture (14 cases), volar contracture (10 cases), first web space contracture (3 cases), post-burn syndactyly (2 cases), wrist deformity (3 cases), skin and tendon affection (2 cases), and complex deformity (6 cases). All the patients underwent a variety of surgical procedures specific to the individual post-burn hand deformity. Post-operative splinting of the hand for 10 days was performed in patients with skin graft to prevent recontracture. The post-operative physiotherapy programme started in the second week in order to achieve good functional results. The follow-up period ranged from 6 to 20 months. The results were satisfactory in most of the cases as regards the quality of coverage, which was achieved in the majority of cases. In one case there was partial loss of the skin graft, which healed by secondary intention; full range of motion was achieved in most patients, but not those with joint affections. On the basis of our results, we can conclude that the management of post-burn hand deformities depends on several factors. Initial treatment of the burned hand is of great importance for the prevention of secondary deformities. In secondary burn management the first step is the release of the contracture, which should be complete and include all contracted structures. The second step is the proper selection of methods of coverage for resultant defects, using either skin grafts or flaps depending on the presence of exposed tendons, nerves, or joints. The third step in order to obtain a very good function is the activation of an intensive physiotherapy programme immediately after the operation.
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Affiliation(s)
- Y Saleh
- Plastic Surgery Department, Assiut University Hospital, Assiut, Egypt
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Saleh Y, El-Shazly M, Adly S, El-Oteify M. Different surgical reconstruction modalities of the post-burn mutilated hand based on a prospective review of a cohort of patients. Ann Burns Fire Disasters 2008; 21:81-89. [PMID: 21991117 PMCID: PMC3188156] [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] [Subscribe] [Scholar Register] [Received: 12/11/2007] [Indexed: 05/31/2023]
Abstract
This study covered 40 patients (22 females and 18 males) suffering from post-burn hand deformities admitted to Assiut University Hospital and Luxor International Hospital (Egypt) from June 2004 to May 2006. Their ages ranged between 4 and 45 yr (mean, 24.5 yr). They presented a variety of post-burn hand deformities, e.g. dorsal hand contracture (14 cases), volar contracture (10 cases), first web space contracture (3 cases), post-burn syndactyly (2 cases), wrist deformity (3 cases), skin and tendon affection (2 cases), and complex deformity (6 cases). All the patients underwent a variety of surgical procedures specific to the individual post-burn hand deformity. Post-operative splinting of the hand for 10 days was performed in patients with skin graft to prevent recontracture. The post-operative physiotherapy programme started in the second week in order to achieve good functional results. The follow-up period ranged from 6 to 20 months. The results were satisfactory in most of the cases as regards the quality of coverage, which was achieved in the majority of cases. In one case there was partial loss of the skin graft, which healed by secondary intention; full range of motion was achieved in most patients, but not those with joint affections. On the basis of our results, we can conclude that the management of post-burn hand deformities depends on several factors. Initial treatment of the burned hand is of great importance for the prevention of secondary deformities. In secondary burn management the first step is the release of the contracture, which should be complete and include all contracted structures. The second step is the proper selection of methods of coverage for resultant defects, using either skin grafts or flaps depending on the presence of exposed tendons, nerves, or joints. The third step in order to obtain a very good function is the activation of an intensive physiotherapy programme immediately after the operation.
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Affiliation(s)
- Y Saleh
- Plastic Surgery Department, Assiut University Hospital, Assiut, Egypt
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