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Toimela J, Halt A, Kerkelä M, Kampman O, Suvisaari J, Kieseppä T, Lähteenvuo M, Tiihonen J, Ahola-Olli A, Veijola J, Holm M. Association of obesity to reaction time and visual memory in schizophrenia. Schizophr Res Cogn 2024; 37:100316. [PMID: 38764744 PMCID: PMC11101897 DOI: 10.1016/j.scog.2024.100316] [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] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 05/05/2024] [Indexed: 05/21/2024]
Abstract
Background Both overweight and cognitive deficits are common among people with schizophrenia (SZ) and schizoaffective disorder. The results in earlier studies have been inconsistent on whether overweight is associated with cognitive deficits in psychotic disorders. Aims Our aim in this study was to detect possible associations between obesity and cognitive deficits among study participants with SZ and schizoaffective disorder. Methods The study sample included 5382 participants with a clinical diagnosis of SZ or schizoaffective disorder selected from the Finnish SUPER study. Obesity was measured both with body-mass index and waist circumference. The cognitive performance was evaluated with two tests from the Cambridge automated neuropsychological test battery: Reaction time was evaluated with the 5-choice serial reaction time task. Visual memory was evaluated with the paired associative learning test. The final analysis included a total sample of 4498 participants applicable for the analysis of the reaction time and 3967 participants for the analysis of the visual memory. Results Obesity measured with body-mass index was associated with better performance in reaction time task among both female and male participants. Among male participants, overweight was associated with better performance in the visual memory test. The waist circumference was not associated with cognitive measures. Conclusions The results suggest that obesity in people with SZ or schizoaffective disorder might not be associated with cognitive deficits but instead with better cognitive performance. The results were opposite from earlier literature on the general population. More research is required to better understand whether the results might be partly caused by the differences in the etiology of obesity between the general population and people with SZ.
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Affiliation(s)
- J.S. Toimela
- Research Unit of Clinical Medicine, University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland
| | - A.H. Halt
- Research Unit of Clinical Medicine, University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, FI-90220 Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - M. Kerkelä
- Research Unit of Clinical Medicine, University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland
| | - O. Kampman
- Department of Clinical Sciences, Psychiatry, Umeå University, Umeå SE-90187, Sweden
- University of Turku, Faculty of Medicine, Department of Clinical Medicine (Psychiatry), Turku, Finland
- The Wellbeing Services Country of Ostrobothnia, Department of Psychiatry, Vaasa, Finland
- The Pirkanmaa Wellbeing Services Country, Department of Psychiatry, Tampere, Finland
| | - J. Suvisaari
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), FI-00271 Helsinki, Finland
| | - T. Kieseppä
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), FI-00271 Helsinki, Finland
- University of Helsinki, Helsinki University Hospital, Psychiatry, FI-00029 Helsinki, Finland
| | - M. Lähteenvuo
- Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, FI-70240 Kuopio, Finland
| | - J. Tiihonen
- Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, FI-70240 Kuopio, Finland
- Department of Clinical Neuroscience, Karolinska Institutet, SE-17177 Stockholm, Sweden
- Center for Psychiatry Research, Stockholm City Council, SE-11364 Stockholm, Sweden
| | - A. Ahola-Olli
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, FI-00014 Helsinki, Finland
- Department of Internal Medicine, Satasairaala Hospital, Pori, Finland
| | - J. Veijola
- Research Unit of Clinical Medicine, University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, FI-90220 Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - M. Holm
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), FI-00271 Helsinki, Finland
| | - The SUPER researchers listed in the Acknowledgements
- Research Unit of Clinical Medicine, University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, FI-90220 Oulu, Finland
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), FI-00271 Helsinki, Finland
- University of Helsinki, Helsinki University Hospital, Psychiatry, FI-00029 Helsinki, Finland
- Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, FI-70240 Kuopio, Finland
- Department of Clinical Neuroscience, Karolinska Institutet, SE-17177 Stockholm, Sweden
- Center for Psychiatry Research, Stockholm City Council, SE-11364 Stockholm, Sweden
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, FI-00014 Helsinki, Finland
- Department of Internal Medicine, Satasairaala Hospital, Pori, Finland
- Department of Clinical Sciences, Psychiatry, Umeå University, Umeå SE-90187, Sweden
- University of Turku, Faculty of Medicine, Department of Clinical Medicine (Psychiatry), Turku, Finland
- The Wellbeing Services Country of Ostrobothnia, Department of Psychiatry, Vaasa, Finland
- The Pirkanmaa Wellbeing Services Country, Department of Psychiatry, Tampere, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
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Kämpe A, Suvisaari J, Lähteenvuo M, Singh T, Ahola-Olli A, Urpa L, Haaki W, Hietala J, Isometsä E, Jukuri T, Kampman O, Kieseppä T, Lahdensuo K, Lönnqvist J, Männynsalo T, Paunio T, Niemi-Pynttäri J, Suokas K, Tuulio-Henriksson A, Veijola J, Wegelius A, Daly M, Taylor J, Kendler KS, Palotie A, Pietiläinen O. Genetic contribution to disease-course severity and progression in the SUPER-Finland study, a cohort of 10,403 individuals with psychotic disorders. Mol Psychiatry 2024:10.1038/s41380-024-02516-6. [PMID: 38556557 DOI: 10.1038/s41380-024-02516-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 02/28/2024] [Accepted: 03/04/2024] [Indexed: 04/02/2024]
Abstract
Genetic factors contribute to the susceptibility of psychotic disorders, but less is known how they affect psychotic disease-course development. Utilizing polygenic scores (PGSs) in combination with longitudinal healthcare data with decades of follow-up we investigated the contributing genetics to psychotic disease-course severity and diagnostic shifts in the SUPER-Finland study, encompassing 10 403 genotyped individuals with a psychotic disorder. To longitudinally track the study participants' past disease-course severity, we created a psychiatric hospitalization burden metric using the full-coverage and nation-wide Finnish in-hospital registry (data from 1969 and onwards). Using a hierarchical model, ranking the psychotic diagnoses according to clinical severity, we show that high schizophrenia PGS (SZ-PGS) was associated with progression from lower ranked psychotic disorders to schizophrenia (OR = 1.32 [1.23-1.43], p = 1.26e-12). This development manifested already at psychotic illness onset as a higher psychiatric hospitalization burden, the proxy for disease-course severity. In schizophrenia (n = 5 479), both a high SZ-PGS and a low educational attainment PGS (EA-PGS) were associated with increased psychiatric hospitalization burden (p = 1.00e-04 and p = 4.53e-10). The SZ-PGS and the EA-PGS associated with distinct patterns of hospital usage. In individuals with high SZ-PGS, the increased hospitalization burden was composed of longer individual hospital stays, while low EA-PGS associated with shorter but more frequent hospital visits. The negative effect of a low EA-PGS was found to be partly mediated via substance use disorder, a major risk factor for hospitalizations. In conclusion, we show that high SZ-PGS and low EA-PGS both impacted psychotic disease-course development negatively but resulted in different disease-course trajectories.
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Affiliation(s)
- Anders Kämpe
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland.
- Department of Molecular Medicine and surgery (MMK), Karolinska Institutet, Stockholm, Sweden.
| | - Jaana Suvisaari
- National Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Helsinki, Finland
| | - Markku Lähteenvuo
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Department of Forensic Psychiatry, University of Eastern Finland School of Medicine, Niuvanniemi hospital, Kuopio, Finland
| | - Tarjinder Singh
- Broad Institute, Stanley Center for Psychiatric Research, Cambridge, MA, USA
- Massachusetts General Hospital, Analytic and Translational Genetics Unit, Boston, MA, USA
| | - Ari Ahola-Olli
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Lea Urpa
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Willehard Haaki
- Department of Psychiatry, University of Turku, Turku, Finland
| | - Jarmo Hietala
- Department of Psychiatry, University of Turku, Turku, Finland
| | - Erkki Isometsä
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Tuomas Jukuri
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Olli Kampman
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Psychiatry, The Wellbeing Services County of Ostrobothnia, Ostrobothnia, Finland
- Department of Clinical Sciences, Psychiatry, Umeå University, Umeå, Sweden
- Department of Clinical Medicine (Psychiatry), Faculty of Medicine, University of Turku, Turku, Finland
| | - Tuula Kieseppä
- Hospital District of Helsinki and Uusimaa, Helsinki, Finland
| | | | - Jouko Lönnqvist
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- National Institute for Health and Welfare, Helsinki, Finland
| | - Teemu Männynsalo
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Tiina Paunio
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- National Institute for Health and Welfare, Helsinki, Finland
- SleepWell Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jussi Niemi-Pynttäri
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Kimmo Suokas
- Tampere University, Tampere, Finland
- Department of Psychiatry, Tampere University Hospital, Tampere, Finland
| | | | - Juha Veijola
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
| | - Asko Wegelius
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Mark Daly
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Broad Institute, Stanley Center for Psychiatric Research, Cambridge, MA, USA
- Massachusetts General Hospital, Analytic and Translational Genetics Unit, Boston, MA, USA
- Broad Institute Harvard, Program in Medical and Population Genetics, Cambridge, MA, USA
| | - Jacob Taylor
- Harvard Medical School, Department of Medicine, Boston, USA
| | - Kenneth S Kendler
- Virginia Institute of Psychiatric and Behavioral Genetics, Richmond, VA, USA
- Medical College of Virginia/Virginia Commonwealth University, Department of Psychiatry, Richmond, VA, USA
| | - Aarno Palotie
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Broad Institute, Stanley Center for Psychiatric Research, Cambridge, MA, USA
| | - Olli Pietiläinen
- Broad Institute, Stanley Center for Psychiatric Research, Cambridge, MA, USA
- Neuroscience Center, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
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Lähteenvuo M, Ahola-Olli A, Suokas K, Holm M, Misiewicz Z, Jukuri T, Männynsalo T, Wegelius A, Haaki W, Kajanne R, Kyttälä A, Tuulio-Henriksson A, Lahdensuo K, Häkkinen K, Hietala J, Paunio T, Niemi-Pynttäri J, Kieseppä T, Veijola J, Lönnqvist J, Isometsä E, Kampman O, Tiihonen J, Hyman S, Neale B, Daly M, Suvisaari J, Palotie A. Cohort profile: SUPER-Finland - the Finnish study for hereditary mechanisms of psychotic disorders. BMJ Open 2023; 13:e070710. [PMID: 37045567 PMCID: PMC10106053 DOI: 10.1136/bmjopen-2022-070710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
PURPOSE SUPER-Finland is a large Finnish collection of psychosis cases. This cohort also represents the Finnish contribution to the Stanley Global Neuropsychiatric Genetics Initiative, which seeks to diversify genetic sample collection to include Asian, Latin American and African populations in addition to known population isolates, such as Finland. PARTICIPANTS 10 474 individuals aged 18 years or older were recruited throughout the country. The subjects have been genotyped with a genome-wide genotyping chip and exome sequenced. A subset of 897 individuals selected from known population sub-isolates were selected for whole-genome sequencing. Recruitment was done between November 2015 and December 2018. FINDINGS TO DATE 5757 (55.2%) had a diagnosis of schizophrenia, 944 (9.1%) schizoaffective disorder, 1612 (15.5%) type I or type II bipolar disorder, 532 (5.1 %) psychotic depression, 1047 (10.0%) other psychosis and for 530 (5.1%) self-reported psychosis at recruitment could not be confirmed from register data. Mean duration of schizophrenia was 22.0 years at the time of the recruitment. By the end of the year 2018, 204 of the recruited individuals had died. The most common cause of death was cardiovascular disease (n=61) followed by neoplasms (n=40). Ten subjects had psychiatric morbidity as the primary cause of death. FUTURE PLANS Compare the effects of common variants, rare variants and copy number variations (CNVs) on severity of psychotic illness. In addition, we aim to track longitudinal course of illness based on nation-wide register data to estimate how phenotypic and genetic differences alter it.
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Affiliation(s)
- Markku Lähteenvuo
- Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Ari Ahola-Olli
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Kimmo Suokas
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Minna Holm
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Zuzanna Misiewicz
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Tuomas Jukuri
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Teemu Männynsalo
- Psychiatric and Substance Abuse Services, City of Helsinki, Helsinki, Finland
| | - Asko Wegelius
- Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
- Department of Mental Health and Substance Abuse Services, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Willehard Haaki
- Department of Psychiatry, University of Turku, Turku, Finland
- Department of Psychiatry, TYKS Turku University Hospital, Turku, Finland
| | - Risto Kajanne
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Aija Kyttälä
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Kaisla Lahdensuo
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Mehiläinen Oy, Helsinki, Finland
| | - Katja Häkkinen
- Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland
| | - Jarmo Hietala
- Department of Psychiatry, University of Turku, Turku, Finland
- Department of Psychiatry, TYKS Turku University Hospital, Turku, Finland
| | - Tiina Paunio
- Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
- SleepWell Research Program, Faculty of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | | | - Tuula Kieseppä
- Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
| | - Juha Veijola
- Research Unit of Clinical Neuroscience, Department of Psychiatry, University of Oulu, Oulu, Finland
- Medical Research Centre Oulu, University Hospital of Oulu and University of Oulu, Oulu, Finland
| | - Jouko Lönnqvist
- Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
| | - Erkki Isometsä
- Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
| | - Olli Kampman
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Psychiatry, The Pirkanmaa Wellbeing Services County, Tampere, Finland
- Department of Clinical Sciences, Psychiatry, Umeå University, Umeå, Sweden
- Department of Clinical Medicine (Psychiatry), Faculty of Medicine, University of Turku, Turku, Finland
- Department of Psychiatry, The Wellbeing Services County of Ostrobothnia, Vaasa, Finland
| | - Jari Tiihonen
- Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Center for Psychiatry Research, Stockholm City Council, Stockholm, Sweden
| | - Steven Hyman
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, Massachusetts, USA
| | - Benjamin Neale
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Mark Daly
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | | | - Aarno Palotie
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
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4
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Karhunen V, Gill D, Huang J, Bouras E, Malik R, Ponsford MJ, Ahola-Olli A, Papadopoulou A, Palaniswamy S, Sebert S, Wielscher M, Auvinen J, Veijola J, Herzig KH, Timonen M, Keinänen-Kiukaanniemi S, Dichgans M, Salmi M, Jalkanen S, Lehtimäki T, Salomaa V, Raitakari O, Jones SA, Hovingh GK, Tsilidis KK, Järvelin MR, Dehghan A. The interplay between inflammatory cytokines and cardiometabolic disease: bi-directional mendelian randomisation study. BMJ Med 2023; 2:e000157. [PMID: 36936266 PMCID: PMC9978757 DOI: 10.1136/bmjmed-2022-000157] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 11/25/2022] [Indexed: 02/16/2023]
Abstract
Objective To leverage large scale genetic association data to investigate the interplay between circulating cytokines and cardiometabolic traits, and thus identifying potential therapeutic targets. Design Bi-directional Mendelian randomisation study. Setting Genome-wide association studies from three Finnish cohorts (Northern Finland Birth Cohort 1966, Young Finns Study, or FINRISK study), and genetic association summary statistics pooled from observational studies for expression quantitative trait loci and cardiometabolic traits. Participants Data for 47 circulating cytokines in 13 365 individuals from genome-wide association studies, summary statistic data for up to 21 735 individuals on circulating cytokines, summary statistic gene expression data across 49 tissues in 838 individuals, and summary statistic data for up to 1 320 016 individuals on cardiometabolic traits. Interventions Relations between circulating cytokines and cardiovascular, anthropometric, lipid, or glycaemic traits (coronary artery disease, stroke, type 2 diabetes mellitus, body mass index, waist circumference, waist to hip ratio, systolic blood pressure, glycated haemoglobin, high density lipoprotein cholesterol, low density lipoprotein cholesterol, total cholesterol, triglycerides, C reactive protein, glucose, fasting insulin, and lifetime smoking). Main outcome methods Genetic instrumental variables that are biologically plausible for the circulating cytokines were generated. The effects of cardiometabolic risk factors on concentrations of circulating cytokines, circulating cytokines on other circulating cytokines, and circulating cytokines on cardiometabolic outcomes were investigated. Results Genetic evidence (mendelian randomisation P<0.0011) suggests that higher body mass index, waist circumference, smoking, higher concentrations of lipids, and systolic blood pressure increase circulating concentrations of several inflammatory cytokines and C reactive protein. Evidence for causal relations (mendelian randomisation P<0.0011) were noted between circulating cytokines, including a key role of vascular endothelial growth factor on influencing the concentrations of 10 other cytokines. Both mendelian randomisation (P<0.05) and colocalisation (posterior probability >0.5) suggested that coronary artery disease risk is increased by higher concentrations of circulating tumour necrosis factor related apoptosis-inducing ligand (TRAIL), interleukin-1 receptor antagonist (IL1RA), and macrophage colony-stimulating factor (MCSF). Conclusion This study offers insight into inflammatory mediators of cardiometabolic risk factors, cytokine signalling cascades, and effects of circulating cytokines on different cardiometabolic outcomes.
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Affiliation(s)
- Ville Karhunen
- Research Unit of Mathematical Sciences, University of Oulu, Oulu, Finland
- Research Unit of Population Health, University of Oulu, Oulu, Finland
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | - Dipender Gill
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | - Jian Huang
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- Singapore Institute for Clinical Sciences (SICS), Agency for Science Technology and Research (A*STAR), Singapore
| | - Emmanouil Bouras
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Ioannina, Ioannina, Epirus, Greece
| | - Rainer Malik
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Faculty of Medicine, Munchen, Bayern, Germany
| | - Mark J Ponsford
- Division of Immunology, Infection, and Inflammation, Tenovus Institute, Cardiff University, Cardiff, UK
| | - Ari Ahola-Olli
- The Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Analytical and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Areti Papadopoulou
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Ioannina, Ioannina, Epirus, Greece
| | | | - Sylvain Sebert
- Research Unit of Population Health, University of Oulu, Oulu, Finland
| | - Matthias Wielscher
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Juha Auvinen
- Research Unit of Population Health, University of Oulu, Oulu, Finland
| | - Juha Veijola
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
| | - Karl-Heinz Herzig
- Research Unit of Biomedicine, Medical Research Center (MRC), University of Oulu, University Hospital, Oulu, Finland
- Department of Gastroenterology and Metabolism, Poznan University of Medical Sciences, Poznan, Poland
| | - Markku Timonen
- Research Unit of Population Health, University of Oulu, Oulu, Finland
- Unit of Primary Care, Oulu University Hospital, Oulu, Finland
| | - Sirkka Keinänen-Kiukaanniemi
- Research Unit of Population Health, University of Oulu, Oulu, Finland
- Unit of Primary Care, Oulu University Hospital, Oulu, Finland
- Healthcare and Social Services of Selänne, Pyhäjärvi, Finland
| | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Faculty of Medicine, Munchen, Bayern, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- German Centre for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Marko Salmi
- MediCity and Institute of Biomedicine, University of Turku, Turku, Finland
| | - Sirpa Jalkanen
- MediCity and Institute of Biomedicine, University of Turku, Turku, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories, and Finnish Cardiovascular Research Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Veikko Salomaa
- Finnish Institute for Health and Welfare, Helsinki, Uusimaa, Finland
| | - Olli Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Simon A Jones
- Division of Immunology, Infection, and Inflammation, Tenovus Institute, Cardiff University, Cardiff, UK
| | - G Kees Hovingh
- Department of Vascular Medicine, Academic Medical Center, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Noord-Holland, Netherlands
| | - Konstantinos K Tsilidis
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Ioannina, Ioannina, Epirus, Greece
| | - Marjo-Riitta Järvelin
- Research Unit of Population Health, University of Oulu, Oulu, Finland
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- Unit of Primary Care, Oulu University Hospital, Oulu, Finland
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- Biocenter Oulu, University of Oulu, Oulu, Finland
- Department of Life Sciences, College of Health and Life Sciences, Brunel University London, London, UK
| | - Abbas Dehghan
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- UK Dementia Research Institute, Imperial College London, London, UK
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5
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Huang J, Su B, Karhunen V, Gill D, Zuber V, Ahola-Olli A, Palaniswamy S, Auvinen J, Herzig KH, Keinänen-Kiukaanniemi S, Salmi M, Jalkanen S, Lehtimäki T, Salomaa V, Raitakari OT, Matthews PM, Elliott P, Tsilidis KK, Jarvelin MR, Tzoulaki I, Dehghan A. Inflammatory Diseases, Inflammatory Biomarkers, and Alzheimer Disease: An Observational Analysis and Mendelian Randomization. Neurology 2023; 100:e568-e581. [PMID: 36384659 PMCID: PMC9946179 DOI: 10.1212/wnl.0000000000201489] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 09/14/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Whether chronic autoimmune inflammatory diseases causally affect the risk of Alzheimer disease (AD) is controversial. We characterized the relationship between inflammatory diseases and risk of AD and explored the role of circulating inflammatory biomarkers in the relationships between inflammatory diseases and AD. METHODS We performed observational analyses for chronic autoimmune inflammatory diseases and risk of AD using data from 2,047,513 participants identified in the UK Clinical Practice Research Datalink (CPRD). Using data of a total of more than 1,100,000 individuals from 15 large-scale genome-wide association study data sets, we performed 2-sample Mendelian randomizations (MRs) to investigate the relationships between chronic autoimmune inflammatory diseases, circulating inflammatory biomarker levels, and risk of AD. RESULTS Cox regression models using CPRD data showed that the overall incidence of AD was higher among patients with inflammatory bowel disease (hazard ratio [HR] 1.17; 95% CI 1.15-1.19; p = 2.1 × 10-4), other inflammatory polyarthropathies and systematic connective tissue disorders (HR 1.13; 95% CI 1.12-1.14; p = 8.6 × 10-5), psoriasis (HR 1.13; 95% CI 1.10-1.16; p = 2.6 × 10-4), rheumatoid arthritis (HR 1.08; 95% CI 1.06-1.11; p = 4.0 × 10-4), and multiple sclerosis (HR 1.06; 95% CI 1.04-1.07; p = 2.8 × 10-4) compared with the age (±5 years) and sex-matched comparison groups free from all inflammatory diseases under investigation. Bidirectional MR analysis identified relationships between chronic autoimmune inflammatory diseases and circulating inflammatory biomarkers. Particularly, circulating monokine induced by gamma interferon (MIG) level was suggestively associated with a higher risk of AD (odds ratio from inverse variance weighted [ORIVW] 1.23; 95% CI 1.06-1.42; p IVW = 0.007) and lower risk of Crohn disease (ORIVW 0.73; 95% CI -0.62 to 0.86; p IVW = 1.3 × 10-4). Colocalization supported a common causal single nucleotide polymorphism for MIG and Crohn disease (posterior probability = 0.74), but not AD (posterior probability = 0.03). Using a 2-sample MR approach, genetically predicted risks of inflammatory diseases were not associated with higher AD risk. DISCUSSION Our data suggest that the association between inflammatory diseases and risk of AD is unlikely to be causal and may be a result of confounding. In support, although inflammatory biomarkers showed evidence for causal associations with inflammatory diseases, evidence was weak that they affected both inflammatory disease and AD.
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Affiliation(s)
- Jian Huang
- From the Department of Epidemiology and Biostatistics (J.H., B.S., V.K., D.G., V.Z., S.P., P.E., K.K.T., M.-r.J., A.D.), School of Public Health, Imperial College London, United Kingdom; Singapore Institute for Clinical Sciences (SICS) (J.H.), Agency for Science, Technology and Research (A*STAR); Center for Life Course Health Research (V.K., S.P., J.A., S.K.-K., M.-r.J.), Faculty of Medicine, Research Unit of Mathematical Sciences (V.K.), University of Oulu, Finland; The Stanley Center for Psychiatric Research (A.A.-O.), Broad Institute of MIT and Harvard, Cambridge, MA; Analytical and Translational Genetics Unit (A.A.-O.), Massachusetts General Hospital, Boston; Institute for Molecular Medicine Finland (A.A.-O.), University of Helsinki; Research Unit of Biomedicine (K.-H.H.), Medical Research Center (MRC), University of Oulu, University Hospital, Finland; Department of Gastroenterology and Metabolism (K.-H.H.), Poznan University of Medical Sciences, Poland; Unit of Primary Care (S.K.-K., M.-r.J.), Oulu University Hospital; Healthcare and Social Services of Selänne (S.K.-K., I.T.), Pyhäjärvi, Finland and City of Oulu; MediCity and Institute of Biomedicine (M.S., S.J.), University of Turku; Department of Clinical Chemistry (T.L.), Fimlab Laboratories, and Finnish Cardiovascular Research Center, Tampere, Faculty of Medicine and Health Technology, Tampere University; Finnish Institute for Health and Welfare (V.S.), Helsinki; Research Centre of Applied and Preventive Cardiovascular Medicine (O.T.R.), University of Turku; Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital; Centre for Population Health Research (O.T.R.), University of Turku and Turku University Hospital, Finland; Department of Brain Sciences (P.M.M.), Faculty of Medicine, Imperial College London; UK Dementia Research Institute at Imperial College London (P.M.M., P.E.); MRC Centre for Environment and Health (P.E., M.-r.J.), School of Public Health, Imperial College London, United Kingdom; Department of Hygiene and Epidemiology (K.K.T.), University of Ioannina Medical School, Greece; Biocenter Oulu (M.-r.J.), University of Oulu, Finland; and Department of Life Sciences (M.-r.J.), College of Health and Life Sciences, Brunel University London, United Kingdom
| | - Bowen Su
- From the Department of Epidemiology and Biostatistics (J.H., B.S., V.K., D.G., V.Z., S.P., P.E., K.K.T., M.-r.J., A.D.), School of Public Health, Imperial College London, United Kingdom; Singapore Institute for Clinical Sciences (SICS) (J.H.), Agency for Science, Technology and Research (A*STAR); Center for Life Course Health Research (V.K., S.P., J.A., S.K.-K., M.-r.J.), Faculty of Medicine, Research Unit of Mathematical Sciences (V.K.), University of Oulu, Finland; The Stanley Center for Psychiatric Research (A.A.-O.), Broad Institute of MIT and Harvard, Cambridge, MA; Analytical and Translational Genetics Unit (A.A.-O.), Massachusetts General Hospital, Boston; Institute for Molecular Medicine Finland (A.A.-O.), University of Helsinki; Research Unit of Biomedicine (K.-H.H.), Medical Research Center (MRC), University of Oulu, University Hospital, Finland; Department of Gastroenterology and Metabolism (K.-H.H.), Poznan University of Medical Sciences, Poland; Unit of Primary Care (S.K.-K., M.-r.J.), Oulu University Hospital; Healthcare and Social Services of Selänne (S.K.-K., I.T.), Pyhäjärvi, Finland and City of Oulu; MediCity and Institute of Biomedicine (M.S., S.J.), University of Turku; Department of Clinical Chemistry (T.L.), Fimlab Laboratories, and Finnish Cardiovascular Research Center, Tampere, Faculty of Medicine and Health Technology, Tampere University; Finnish Institute for Health and Welfare (V.S.), Helsinki; Research Centre of Applied and Preventive Cardiovascular Medicine (O.T.R.), University of Turku; Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital; Centre for Population Health Research (O.T.R.), University of Turku and Turku University Hospital, Finland; Department of Brain Sciences (P.M.M.), Faculty of Medicine, Imperial College London; UK Dementia Research Institute at Imperial College London (P.M.M., P.E.); MRC Centre for Environment and Health (P.E., M.-r.J.), School of Public Health, Imperial College London, United Kingdom; Department of Hygiene and Epidemiology (K.K.T.), University of Ioannina Medical School, Greece; Biocenter Oulu (M.-r.J.), University of Oulu, Finland; and Department of Life Sciences (M.-r.J.), College of Health and Life Sciences, Brunel University London, United Kingdom
| | - Ville Karhunen
- From the Department of Epidemiology and Biostatistics (J.H., B.S., V.K., D.G., V.Z., S.P., P.E., K.K.T., M.-r.J., A.D.), School of Public Health, Imperial College London, United Kingdom; Singapore Institute for Clinical Sciences (SICS) (J.H.), Agency for Science, Technology and Research (A*STAR); Center for Life Course Health Research (V.K., S.P., J.A., S.K.-K., M.-r.J.), Faculty of Medicine, Research Unit of Mathematical Sciences (V.K.), University of Oulu, Finland; The Stanley Center for Psychiatric Research (A.A.-O.), Broad Institute of MIT and Harvard, Cambridge, MA; Analytical and Translational Genetics Unit (A.A.-O.), Massachusetts General Hospital, Boston; Institute for Molecular Medicine Finland (A.A.-O.), University of Helsinki; Research Unit of Biomedicine (K.-H.H.), Medical Research Center (MRC), University of Oulu, University Hospital, Finland; Department of Gastroenterology and Metabolism (K.-H.H.), Poznan University of Medical Sciences, Poland; Unit of Primary Care (S.K.-K., M.-r.J.), Oulu University Hospital; Healthcare and Social Services of Selänne (S.K.-K., I.T.), Pyhäjärvi, Finland and City of Oulu; MediCity and Institute of Biomedicine (M.S., S.J.), University of Turku; Department of Clinical Chemistry (T.L.), Fimlab Laboratories, and Finnish Cardiovascular Research Center, Tampere, Faculty of Medicine and Health Technology, Tampere University; Finnish Institute for Health and Welfare (V.S.), Helsinki; Research Centre of Applied and Preventive Cardiovascular Medicine (O.T.R.), University of Turku; Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital; Centre for Population Health Research (O.T.R.), University of Turku and Turku University Hospital, Finland; Department of Brain Sciences (P.M.M.), Faculty of Medicine, Imperial College London; UK Dementia Research Institute at Imperial College London (P.M.M., P.E.); MRC Centre for Environment and Health (P.E., M.-r.J.), School of Public Health, Imperial College London, United Kingdom; Department of Hygiene and Epidemiology (K.K.T.), University of Ioannina Medical School, Greece; Biocenter Oulu (M.-r.J.), University of Oulu, Finland; and Department of Life Sciences (M.-r.J.), College of Health and Life Sciences, Brunel University London, United Kingdom
| | - Dipender Gill
- From the Department of Epidemiology and Biostatistics (J.H., B.S., V.K., D.G., V.Z., S.P., P.E., K.K.T., M.-r.J., A.D.), School of Public Health, Imperial College London, United Kingdom; Singapore Institute for Clinical Sciences (SICS) (J.H.), Agency for Science, Technology and Research (A*STAR); Center for Life Course Health Research (V.K., S.P., J.A., S.K.-K., M.-r.J.), Faculty of Medicine, Research Unit of Mathematical Sciences (V.K.), University of Oulu, Finland; The Stanley Center for Psychiatric Research (A.A.-O.), Broad Institute of MIT and Harvard, Cambridge, MA; Analytical and Translational Genetics Unit (A.A.-O.), Massachusetts General Hospital, Boston; Institute for Molecular Medicine Finland (A.A.-O.), University of Helsinki; Research Unit of Biomedicine (K.-H.H.), Medical Research Center (MRC), University of Oulu, University Hospital, Finland; Department of Gastroenterology and Metabolism (K.-H.H.), Poznan University of Medical Sciences, Poland; Unit of Primary Care (S.K.-K., M.-r.J.), Oulu University Hospital; Healthcare and Social Services of Selänne (S.K.-K., I.T.), Pyhäjärvi, Finland and City of Oulu; MediCity and Institute of Biomedicine (M.S., S.J.), University of Turku; Department of Clinical Chemistry (T.L.), Fimlab Laboratories, and Finnish Cardiovascular Research Center, Tampere, Faculty of Medicine and Health Technology, Tampere University; Finnish Institute for Health and Welfare (V.S.), Helsinki; Research Centre of Applied and Preventive Cardiovascular Medicine (O.T.R.), University of Turku; Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital; Centre for Population Health Research (O.T.R.), University of Turku and Turku University Hospital, Finland; Department of Brain Sciences (P.M.M.), Faculty of Medicine, Imperial College London; UK Dementia Research Institute at Imperial College London (P.M.M., P.E.); MRC Centre for Environment and Health (P.E., M.-r.J.), School of Public Health, Imperial College London, United Kingdom; Department of Hygiene and Epidemiology (K.K.T.), University of Ioannina Medical School, Greece; Biocenter Oulu (M.-r.J.), University of Oulu, Finland; and Department of Life Sciences (M.-r.J.), College of Health and Life Sciences, Brunel University London, United Kingdom
| | - Verena Zuber
- From the Department of Epidemiology and Biostatistics (J.H., B.S., V.K., D.G., V.Z., S.P., P.E., K.K.T., M.-r.J., A.D.), School of Public Health, Imperial College London, United Kingdom; Singapore Institute for Clinical Sciences (SICS) (J.H.), Agency for Science, Technology and Research (A*STAR); Center for Life Course Health Research (V.K., S.P., J.A., S.K.-K., M.-r.J.), Faculty of Medicine, Research Unit of Mathematical Sciences (V.K.), University of Oulu, Finland; The Stanley Center for Psychiatric Research (A.A.-O.), Broad Institute of MIT and Harvard, Cambridge, MA; Analytical and Translational Genetics Unit (A.A.-O.), Massachusetts General Hospital, Boston; Institute for Molecular Medicine Finland (A.A.-O.), University of Helsinki; Research Unit of Biomedicine (K.-H.H.), Medical Research Center (MRC), University of Oulu, University Hospital, Finland; Department of Gastroenterology and Metabolism (K.-H.H.), Poznan University of Medical Sciences, Poland; Unit of Primary Care (S.K.-K., M.-r.J.), Oulu University Hospital; Healthcare and Social Services of Selänne (S.K.-K., I.T.), Pyhäjärvi, Finland and City of Oulu; MediCity and Institute of Biomedicine (M.S., S.J.), University of Turku; Department of Clinical Chemistry (T.L.), Fimlab Laboratories, and Finnish Cardiovascular Research Center, Tampere, Faculty of Medicine and Health Technology, Tampere University; Finnish Institute for Health and Welfare (V.S.), Helsinki; Research Centre of Applied and Preventive Cardiovascular Medicine (O.T.R.), University of Turku; Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital; Centre for Population Health Research (O.T.R.), University of Turku and Turku University Hospital, Finland; Department of Brain Sciences (P.M.M.), Faculty of Medicine, Imperial College London; UK Dementia Research Institute at Imperial College London (P.M.M., P.E.); MRC Centre for Environment and Health (P.E., M.-r.J.), School of Public Health, Imperial College London, United Kingdom; Department of Hygiene and Epidemiology (K.K.T.), University of Ioannina Medical School, Greece; Biocenter Oulu (M.-r.J.), University of Oulu, Finland; and Department of Life Sciences (M.-r.J.), College of Health and Life Sciences, Brunel University London, United Kingdom
| | - Ari Ahola-Olli
- From the Department of Epidemiology and Biostatistics (J.H., B.S., V.K., D.G., V.Z., S.P., P.E., K.K.T., M.-r.J., A.D.), School of Public Health, Imperial College London, United Kingdom; Singapore Institute for Clinical Sciences (SICS) (J.H.), Agency for Science, Technology and Research (A*STAR); Center for Life Course Health Research (V.K., S.P., J.A., S.K.-K., M.-r.J.), Faculty of Medicine, Research Unit of Mathematical Sciences (V.K.), University of Oulu, Finland; The Stanley Center for Psychiatric Research (A.A.-O.), Broad Institute of MIT and Harvard, Cambridge, MA; Analytical and Translational Genetics Unit (A.A.-O.), Massachusetts General Hospital, Boston; Institute for Molecular Medicine Finland (A.A.-O.), University of Helsinki; Research Unit of Biomedicine (K.-H.H.), Medical Research Center (MRC), University of Oulu, University Hospital, Finland; Department of Gastroenterology and Metabolism (K.-H.H.), Poznan University of Medical Sciences, Poland; Unit of Primary Care (S.K.-K., M.-r.J.), Oulu University Hospital; Healthcare and Social Services of Selänne (S.K.-K., I.T.), Pyhäjärvi, Finland and City of Oulu; MediCity and Institute of Biomedicine (M.S., S.J.), University of Turku; Department of Clinical Chemistry (T.L.), Fimlab Laboratories, and Finnish Cardiovascular Research Center, Tampere, Faculty of Medicine and Health Technology, Tampere University; Finnish Institute for Health and Welfare (V.S.), Helsinki; Research Centre of Applied and Preventive Cardiovascular Medicine (O.T.R.), University of Turku; Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital; Centre for Population Health Research (O.T.R.), University of Turku and Turku University Hospital, Finland; Department of Brain Sciences (P.M.M.), Faculty of Medicine, Imperial College London; UK Dementia Research Institute at Imperial College London (P.M.M., P.E.); MRC Centre for Environment and Health (P.E., M.-r.J.), School of Public Health, Imperial College London, United Kingdom; Department of Hygiene and Epidemiology (K.K.T.), University of Ioannina Medical School, Greece; Biocenter Oulu (M.-r.J.), University of Oulu, Finland; and Department of Life Sciences (M.-r.J.), College of Health and Life Sciences, Brunel University London, United Kingdom
| | - Saranya Palaniswamy
- From the Department of Epidemiology and Biostatistics (J.H., B.S., V.K., D.G., V.Z., S.P., P.E., K.K.T., M.-r.J., A.D.), School of Public Health, Imperial College London, United Kingdom; Singapore Institute for Clinical Sciences (SICS) (J.H.), Agency for Science, Technology and Research (A*STAR); Center for Life Course Health Research (V.K., S.P., J.A., S.K.-K., M.-r.J.), Faculty of Medicine, Research Unit of Mathematical Sciences (V.K.), University of Oulu, Finland; The Stanley Center for Psychiatric Research (A.A.-O.), Broad Institute of MIT and Harvard, Cambridge, MA; Analytical and Translational Genetics Unit (A.A.-O.), Massachusetts General Hospital, Boston; Institute for Molecular Medicine Finland (A.A.-O.), University of Helsinki; Research Unit of Biomedicine (K.-H.H.), Medical Research Center (MRC), University of Oulu, University Hospital, Finland; Department of Gastroenterology and Metabolism (K.-H.H.), Poznan University of Medical Sciences, Poland; Unit of Primary Care (S.K.-K., M.-r.J.), Oulu University Hospital; Healthcare and Social Services of Selänne (S.K.-K., I.T.), Pyhäjärvi, Finland and City of Oulu; MediCity and Institute of Biomedicine (M.S., S.J.), University of Turku; Department of Clinical Chemistry (T.L.), Fimlab Laboratories, and Finnish Cardiovascular Research Center, Tampere, Faculty of Medicine and Health Technology, Tampere University; Finnish Institute for Health and Welfare (V.S.), Helsinki; Research Centre of Applied and Preventive Cardiovascular Medicine (O.T.R.), University of Turku; Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital; Centre for Population Health Research (O.T.R.), University of Turku and Turku University Hospital, Finland; Department of Brain Sciences (P.M.M.), Faculty of Medicine, Imperial College London; UK Dementia Research Institute at Imperial College London (P.M.M., P.E.); MRC Centre for Environment and Health (P.E., M.-r.J.), School of Public Health, Imperial College London, United Kingdom; Department of Hygiene and Epidemiology (K.K.T.), University of Ioannina Medical School, Greece; Biocenter Oulu (M.-r.J.), University of Oulu, Finland; and Department of Life Sciences (M.-r.J.), College of Health and Life Sciences, Brunel University London, United Kingdom
| | - Juha Auvinen
- From the Department of Epidemiology and Biostatistics (J.H., B.S., V.K., D.G., V.Z., S.P., P.E., K.K.T., M.-r.J., A.D.), School of Public Health, Imperial College London, United Kingdom; Singapore Institute for Clinical Sciences (SICS) (J.H.), Agency for Science, Technology and Research (A*STAR); Center for Life Course Health Research (V.K., S.P., J.A., S.K.-K., M.-r.J.), Faculty of Medicine, Research Unit of Mathematical Sciences (V.K.), University of Oulu, Finland; The Stanley Center for Psychiatric Research (A.A.-O.), Broad Institute of MIT and Harvard, Cambridge, MA; Analytical and Translational Genetics Unit (A.A.-O.), Massachusetts General Hospital, Boston; Institute for Molecular Medicine Finland (A.A.-O.), University of Helsinki; Research Unit of Biomedicine (K.-H.H.), Medical Research Center (MRC), University of Oulu, University Hospital, Finland; Department of Gastroenterology and Metabolism (K.-H.H.), Poznan University of Medical Sciences, Poland; Unit of Primary Care (S.K.-K., M.-r.J.), Oulu University Hospital; Healthcare and Social Services of Selänne (S.K.-K., I.T.), Pyhäjärvi, Finland and City of Oulu; MediCity and Institute of Biomedicine (M.S., S.J.), University of Turku; Department of Clinical Chemistry (T.L.), Fimlab Laboratories, and Finnish Cardiovascular Research Center, Tampere, Faculty of Medicine and Health Technology, Tampere University; Finnish Institute for Health and Welfare (V.S.), Helsinki; Research Centre of Applied and Preventive Cardiovascular Medicine (O.T.R.), University of Turku; Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital; Centre for Population Health Research (O.T.R.), University of Turku and Turku University Hospital, Finland; Department of Brain Sciences (P.M.M.), Faculty of Medicine, Imperial College London; UK Dementia Research Institute at Imperial College London (P.M.M., P.E.); MRC Centre for Environment and Health (P.E., M.-r.J.), School of Public Health, Imperial College London, United Kingdom; Department of Hygiene and Epidemiology (K.K.T.), University of Ioannina Medical School, Greece; Biocenter Oulu (M.-r.J.), University of Oulu, Finland; and Department of Life Sciences (M.-r.J.), College of Health and Life Sciences, Brunel University London, United Kingdom
| | - Karl-Heinz Herzig
- From the Department of Epidemiology and Biostatistics (J.H., B.S., V.K., D.G., V.Z., S.P., P.E., K.K.T., M.-r.J., A.D.), School of Public Health, Imperial College London, United Kingdom; Singapore Institute for Clinical Sciences (SICS) (J.H.), Agency for Science, Technology and Research (A*STAR); Center for Life Course Health Research (V.K., S.P., J.A., S.K.-K., M.-r.J.), Faculty of Medicine, Research Unit of Mathematical Sciences (V.K.), University of Oulu, Finland; The Stanley Center for Psychiatric Research (A.A.-O.), Broad Institute of MIT and Harvard, Cambridge, MA; Analytical and Translational Genetics Unit (A.A.-O.), Massachusetts General Hospital, Boston; Institute for Molecular Medicine Finland (A.A.-O.), University of Helsinki; Research Unit of Biomedicine (K.-H.H.), Medical Research Center (MRC), University of Oulu, University Hospital, Finland; Department of Gastroenterology and Metabolism (K.-H.H.), Poznan University of Medical Sciences, Poland; Unit of Primary Care (S.K.-K., M.-r.J.), Oulu University Hospital; Healthcare and Social Services of Selänne (S.K.-K., I.T.), Pyhäjärvi, Finland and City of Oulu; MediCity and Institute of Biomedicine (M.S., S.J.), University of Turku; Department of Clinical Chemistry (T.L.), Fimlab Laboratories, and Finnish Cardiovascular Research Center, Tampere, Faculty of Medicine and Health Technology, Tampere University; Finnish Institute for Health and Welfare (V.S.), Helsinki; Research Centre of Applied and Preventive Cardiovascular Medicine (O.T.R.), University of Turku; Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital; Centre for Population Health Research (O.T.R.), University of Turku and Turku University Hospital, Finland; Department of Brain Sciences (P.M.M.), Faculty of Medicine, Imperial College London; UK Dementia Research Institute at Imperial College London (P.M.M., P.E.); MRC Centre for Environment and Health (P.E., M.-r.J.), School of Public Health, Imperial College London, United Kingdom; Department of Hygiene and Epidemiology (K.K.T.), University of Ioannina Medical School, Greece; Biocenter Oulu (M.-r.J.), University of Oulu, Finland; and Department of Life Sciences (M.-r.J.), College of Health and Life Sciences, Brunel University London, United Kingdom
| | - Sirkka Keinänen-Kiukaanniemi
- From the Department of Epidemiology and Biostatistics (J.H., B.S., V.K., D.G., V.Z., S.P., P.E., K.K.T., M.-r.J., A.D.), School of Public Health, Imperial College London, United Kingdom; Singapore Institute for Clinical Sciences (SICS) (J.H.), Agency for Science, Technology and Research (A*STAR); Center for Life Course Health Research (V.K., S.P., J.A., S.K.-K., M.-r.J.), Faculty of Medicine, Research Unit of Mathematical Sciences (V.K.), University of Oulu, Finland; The Stanley Center for Psychiatric Research (A.A.-O.), Broad Institute of MIT and Harvard, Cambridge, MA; Analytical and Translational Genetics Unit (A.A.-O.), Massachusetts General Hospital, Boston; Institute for Molecular Medicine Finland (A.A.-O.), University of Helsinki; Research Unit of Biomedicine (K.-H.H.), Medical Research Center (MRC), University of Oulu, University Hospital, Finland; Department of Gastroenterology and Metabolism (K.-H.H.), Poznan University of Medical Sciences, Poland; Unit of Primary Care (S.K.-K., M.-r.J.), Oulu University Hospital; Healthcare and Social Services of Selänne (S.K.-K., I.T.), Pyhäjärvi, Finland and City of Oulu; MediCity and Institute of Biomedicine (M.S., S.J.), University of Turku; Department of Clinical Chemistry (T.L.), Fimlab Laboratories, and Finnish Cardiovascular Research Center, Tampere, Faculty of Medicine and Health Technology, Tampere University; Finnish Institute for Health and Welfare (V.S.), Helsinki; Research Centre of Applied and Preventive Cardiovascular Medicine (O.T.R.), University of Turku; Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital; Centre for Population Health Research (O.T.R.), University of Turku and Turku University Hospital, Finland; Department of Brain Sciences (P.M.M.), Faculty of Medicine, Imperial College London; UK Dementia Research Institute at Imperial College London (P.M.M., P.E.); MRC Centre for Environment and Health (P.E., M.-r.J.), School of Public Health, Imperial College London, United Kingdom; Department of Hygiene and Epidemiology (K.K.T.), University of Ioannina Medical School, Greece; Biocenter Oulu (M.-r.J.), University of Oulu, Finland; and Department of Life Sciences (M.-r.J.), College of Health and Life Sciences, Brunel University London, United Kingdom
| | - Marko Salmi
- From the Department of Epidemiology and Biostatistics (J.H., B.S., V.K., D.G., V.Z., S.P., P.E., K.K.T., M.-r.J., A.D.), School of Public Health, Imperial College London, United Kingdom; Singapore Institute for Clinical Sciences (SICS) (J.H.), Agency for Science, Technology and Research (A*STAR); Center for Life Course Health Research (V.K., S.P., J.A., S.K.-K., M.-r.J.), Faculty of Medicine, Research Unit of Mathematical Sciences (V.K.), University of Oulu, Finland; The Stanley Center for Psychiatric Research (A.A.-O.), Broad Institute of MIT and Harvard, Cambridge, MA; Analytical and Translational Genetics Unit (A.A.-O.), Massachusetts General Hospital, Boston; Institute for Molecular Medicine Finland (A.A.-O.), University of Helsinki; Research Unit of Biomedicine (K.-H.H.), Medical Research Center (MRC), University of Oulu, University Hospital, Finland; Department of Gastroenterology and Metabolism (K.-H.H.), Poznan University of Medical Sciences, Poland; Unit of Primary Care (S.K.-K., M.-r.J.), Oulu University Hospital; Healthcare and Social Services of Selänne (S.K.-K., I.T.), Pyhäjärvi, Finland and City of Oulu; MediCity and Institute of Biomedicine (M.S., S.J.), University of Turku; Department of Clinical Chemistry (T.L.), Fimlab Laboratories, and Finnish Cardiovascular Research Center, Tampere, Faculty of Medicine and Health Technology, Tampere University; Finnish Institute for Health and Welfare (V.S.), Helsinki; Research Centre of Applied and Preventive Cardiovascular Medicine (O.T.R.), University of Turku; Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital; Centre for Population Health Research (O.T.R.), University of Turku and Turku University Hospital, Finland; Department of Brain Sciences (P.M.M.), Faculty of Medicine, Imperial College London; UK Dementia Research Institute at Imperial College London (P.M.M., P.E.); MRC Centre for Environment and Health (P.E., M.-r.J.), School of Public Health, Imperial College London, United Kingdom; Department of Hygiene and Epidemiology (K.K.T.), University of Ioannina Medical School, Greece; Biocenter Oulu (M.-r.J.), University of Oulu, Finland; and Department of Life Sciences (M.-r.J.), College of Health and Life Sciences, Brunel University London, United Kingdom
| | - Sirpa Jalkanen
- From the Department of Epidemiology and Biostatistics (J.H., B.S., V.K., D.G., V.Z., S.P., P.E., K.K.T., M.-r.J., A.D.), School of Public Health, Imperial College London, United Kingdom; Singapore Institute for Clinical Sciences (SICS) (J.H.), Agency for Science, Technology and Research (A*STAR); Center for Life Course Health Research (V.K., S.P., J.A., S.K.-K., M.-r.J.), Faculty of Medicine, Research Unit of Mathematical Sciences (V.K.), University of Oulu, Finland; The Stanley Center for Psychiatric Research (A.A.-O.), Broad Institute of MIT and Harvard, Cambridge, MA; Analytical and Translational Genetics Unit (A.A.-O.), Massachusetts General Hospital, Boston; Institute for Molecular Medicine Finland (A.A.-O.), University of Helsinki; Research Unit of Biomedicine (K.-H.H.), Medical Research Center (MRC), University of Oulu, University Hospital, Finland; Department of Gastroenterology and Metabolism (K.-H.H.), Poznan University of Medical Sciences, Poland; Unit of Primary Care (S.K.-K., M.-r.J.), Oulu University Hospital; Healthcare and Social Services of Selänne (S.K.-K., I.T.), Pyhäjärvi, Finland and City of Oulu; MediCity and Institute of Biomedicine (M.S., S.J.), University of Turku; Department of Clinical Chemistry (T.L.), Fimlab Laboratories, and Finnish Cardiovascular Research Center, Tampere, Faculty of Medicine and Health Technology, Tampere University; Finnish Institute for Health and Welfare (V.S.), Helsinki; Research Centre of Applied and Preventive Cardiovascular Medicine (O.T.R.), University of Turku; Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital; Centre for Population Health Research (O.T.R.), University of Turku and Turku University Hospital, Finland; Department of Brain Sciences (P.M.M.), Faculty of Medicine, Imperial College London; UK Dementia Research Institute at Imperial College London (P.M.M., P.E.); MRC Centre for Environment and Health (P.E., M.-r.J.), School of Public Health, Imperial College London, United Kingdom; Department of Hygiene and Epidemiology (K.K.T.), University of Ioannina Medical School, Greece; Biocenter Oulu (M.-r.J.), University of Oulu, Finland; and Department of Life Sciences (M.-r.J.), College of Health and Life Sciences, Brunel University London, United Kingdom
| | - Terho Lehtimäki
- From the Department of Epidemiology and Biostatistics (J.H., B.S., V.K., D.G., V.Z., S.P., P.E., K.K.T., M.-r.J., A.D.), School of Public Health, Imperial College London, United Kingdom; Singapore Institute for Clinical Sciences (SICS) (J.H.), Agency for Science, Technology and Research (A*STAR); Center for Life Course Health Research (V.K., S.P., J.A., S.K.-K., M.-r.J.), Faculty of Medicine, Research Unit of Mathematical Sciences (V.K.), University of Oulu, Finland; The Stanley Center for Psychiatric Research (A.A.-O.), Broad Institute of MIT and Harvard, Cambridge, MA; Analytical and Translational Genetics Unit (A.A.-O.), Massachusetts General Hospital, Boston; Institute for Molecular Medicine Finland (A.A.-O.), University of Helsinki; Research Unit of Biomedicine (K.-H.H.), Medical Research Center (MRC), University of Oulu, University Hospital, Finland; Department of Gastroenterology and Metabolism (K.-H.H.), Poznan University of Medical Sciences, Poland; Unit of Primary Care (S.K.-K., M.-r.J.), Oulu University Hospital; Healthcare and Social Services of Selänne (S.K.-K., I.T.), Pyhäjärvi, Finland and City of Oulu; MediCity and Institute of Biomedicine (M.S., S.J.), University of Turku; Department of Clinical Chemistry (T.L.), Fimlab Laboratories, and Finnish Cardiovascular Research Center, Tampere, Faculty of Medicine and Health Technology, Tampere University; Finnish Institute for Health and Welfare (V.S.), Helsinki; Research Centre of Applied and Preventive Cardiovascular Medicine (O.T.R.), University of Turku; Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital; Centre for Population Health Research (O.T.R.), University of Turku and Turku University Hospital, Finland; Department of Brain Sciences (P.M.M.), Faculty of Medicine, Imperial College London; UK Dementia Research Institute at Imperial College London (P.M.M., P.E.); MRC Centre for Environment and Health (P.E., M.-r.J.), School of Public Health, Imperial College London, United Kingdom; Department of Hygiene and Epidemiology (K.K.T.), University of Ioannina Medical School, Greece; Biocenter Oulu (M.-r.J.), University of Oulu, Finland; and Department of Life Sciences (M.-r.J.), College of Health and Life Sciences, Brunel University London, United Kingdom
| | - Veikko Salomaa
- From the Department of Epidemiology and Biostatistics (J.H., B.S., V.K., D.G., V.Z., S.P., P.E., K.K.T., M.-r.J., A.D.), School of Public Health, Imperial College London, United Kingdom; Singapore Institute for Clinical Sciences (SICS) (J.H.), Agency for Science, Technology and Research (A*STAR); Center for Life Course Health Research (V.K., S.P., J.A., S.K.-K., M.-r.J.), Faculty of Medicine, Research Unit of Mathematical Sciences (V.K.), University of Oulu, Finland; The Stanley Center for Psychiatric Research (A.A.-O.), Broad Institute of MIT and Harvard, Cambridge, MA; Analytical and Translational Genetics Unit (A.A.-O.), Massachusetts General Hospital, Boston; Institute for Molecular Medicine Finland (A.A.-O.), University of Helsinki; Research Unit of Biomedicine (K.-H.H.), Medical Research Center (MRC), University of Oulu, University Hospital, Finland; Department of Gastroenterology and Metabolism (K.-H.H.), Poznan University of Medical Sciences, Poland; Unit of Primary Care (S.K.-K., M.-r.J.), Oulu University Hospital; Healthcare and Social Services of Selänne (S.K.-K., I.T.), Pyhäjärvi, Finland and City of Oulu; MediCity and Institute of Biomedicine (M.S., S.J.), University of Turku; Department of Clinical Chemistry (T.L.), Fimlab Laboratories, and Finnish Cardiovascular Research Center, Tampere, Faculty of Medicine and Health Technology, Tampere University; Finnish Institute for Health and Welfare (V.S.), Helsinki; Research Centre of Applied and Preventive Cardiovascular Medicine (O.T.R.), University of Turku; Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital; Centre for Population Health Research (O.T.R.), University of Turku and Turku University Hospital, Finland; Department of Brain Sciences (P.M.M.), Faculty of Medicine, Imperial College London; UK Dementia Research Institute at Imperial College London (P.M.M., P.E.); MRC Centre for Environment and Health (P.E., M.-r.J.), School of Public Health, Imperial College London, United Kingdom; Department of Hygiene and Epidemiology (K.K.T.), University of Ioannina Medical School, Greece; Biocenter Oulu (M.-r.J.), University of Oulu, Finland; and Department of Life Sciences (M.-r.J.), College of Health and Life Sciences, Brunel University London, United Kingdom
| | - Olli T Raitakari
- From the Department of Epidemiology and Biostatistics (J.H., B.S., V.K., D.G., V.Z., S.P., P.E., K.K.T., M.-r.J., A.D.), School of Public Health, Imperial College London, United Kingdom; Singapore Institute for Clinical Sciences (SICS) (J.H.), Agency for Science, Technology and Research (A*STAR); Center for Life Course Health Research (V.K., S.P., J.A., S.K.-K., M.-r.J.), Faculty of Medicine, Research Unit of Mathematical Sciences (V.K.), University of Oulu, Finland; The Stanley Center for Psychiatric Research (A.A.-O.), Broad Institute of MIT and Harvard, Cambridge, MA; Analytical and Translational Genetics Unit (A.A.-O.), Massachusetts General Hospital, Boston; Institute for Molecular Medicine Finland (A.A.-O.), University of Helsinki; Research Unit of Biomedicine (K.-H.H.), Medical Research Center (MRC), University of Oulu, University Hospital, Finland; Department of Gastroenterology and Metabolism (K.-H.H.), Poznan University of Medical Sciences, Poland; Unit of Primary Care (S.K.-K., M.-r.J.), Oulu University Hospital; Healthcare and Social Services of Selänne (S.K.-K., I.T.), Pyhäjärvi, Finland and City of Oulu; MediCity and Institute of Biomedicine (M.S., S.J.), University of Turku; Department of Clinical Chemistry (T.L.), Fimlab Laboratories, and Finnish Cardiovascular Research Center, Tampere, Faculty of Medicine and Health Technology, Tampere University; Finnish Institute for Health and Welfare (V.S.), Helsinki; Research Centre of Applied and Preventive Cardiovascular Medicine (O.T.R.), University of Turku; Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital; Centre for Population Health Research (O.T.R.), University of Turku and Turku University Hospital, Finland; Department of Brain Sciences (P.M.M.), Faculty of Medicine, Imperial College London; UK Dementia Research Institute at Imperial College London (P.M.M., P.E.); MRC Centre for Environment and Health (P.E., M.-r.J.), School of Public Health, Imperial College London, United Kingdom; Department of Hygiene and Epidemiology (K.K.T.), University of Ioannina Medical School, Greece; Biocenter Oulu (M.-r.J.), University of Oulu, Finland; and Department of Life Sciences (M.-r.J.), College of Health and Life Sciences, Brunel University London, United Kingdom
| | - Paul M Matthews
- From the Department of Epidemiology and Biostatistics (J.H., B.S., V.K., D.G., V.Z., S.P., P.E., K.K.T., M.-r.J., A.D.), School of Public Health, Imperial College London, United Kingdom; Singapore Institute for Clinical Sciences (SICS) (J.H.), Agency for Science, Technology and Research (A*STAR); Center for Life Course Health Research (V.K., S.P., J.A., S.K.-K., M.-r.J.), Faculty of Medicine, Research Unit of Mathematical Sciences (V.K.), University of Oulu, Finland; The Stanley Center for Psychiatric Research (A.A.-O.), Broad Institute of MIT and Harvard, Cambridge, MA; Analytical and Translational Genetics Unit (A.A.-O.), Massachusetts General Hospital, Boston; Institute for Molecular Medicine Finland (A.A.-O.), University of Helsinki; Research Unit of Biomedicine (K.-H.H.), Medical Research Center (MRC), University of Oulu, University Hospital, Finland; Department of Gastroenterology and Metabolism (K.-H.H.), Poznan University of Medical Sciences, Poland; Unit of Primary Care (S.K.-K., M.-r.J.), Oulu University Hospital; Healthcare and Social Services of Selänne (S.K.-K., I.T.), Pyhäjärvi, Finland and City of Oulu; MediCity and Institute of Biomedicine (M.S., S.J.), University of Turku; Department of Clinical Chemistry (T.L.), Fimlab Laboratories, and Finnish Cardiovascular Research Center, Tampere, Faculty of Medicine and Health Technology, Tampere University; Finnish Institute for Health and Welfare (V.S.), Helsinki; Research Centre of Applied and Preventive Cardiovascular Medicine (O.T.R.), University of Turku; Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital; Centre for Population Health Research (O.T.R.), University of Turku and Turku University Hospital, Finland; Department of Brain Sciences (P.M.M.), Faculty of Medicine, Imperial College London; UK Dementia Research Institute at Imperial College London (P.M.M., P.E.); MRC Centre for Environment and Health (P.E., M.-r.J.), School of Public Health, Imperial College London, United Kingdom; Department of Hygiene and Epidemiology (K.K.T.), University of Ioannina Medical School, Greece; Biocenter Oulu (M.-r.J.), University of Oulu, Finland; and Department of Life Sciences (M.-r.J.), College of Health and Life Sciences, Brunel University London, United Kingdom
| | - Paul Elliott
- From the Department of Epidemiology and Biostatistics (J.H., B.S., V.K., D.G., V.Z., S.P., P.E., K.K.T., M.-r.J., A.D.), School of Public Health, Imperial College London, United Kingdom; Singapore Institute for Clinical Sciences (SICS) (J.H.), Agency for Science, Technology and Research (A*STAR); Center for Life Course Health Research (V.K., S.P., J.A., S.K.-K., M.-r.J.), Faculty of Medicine, Research Unit of Mathematical Sciences (V.K.), University of Oulu, Finland; The Stanley Center for Psychiatric Research (A.A.-O.), Broad Institute of MIT and Harvard, Cambridge, MA; Analytical and Translational Genetics Unit (A.A.-O.), Massachusetts General Hospital, Boston; Institute for Molecular Medicine Finland (A.A.-O.), University of Helsinki; Research Unit of Biomedicine (K.-H.H.), Medical Research Center (MRC), University of Oulu, University Hospital, Finland; Department of Gastroenterology and Metabolism (K.-H.H.), Poznan University of Medical Sciences, Poland; Unit of Primary Care (S.K.-K., M.-r.J.), Oulu University Hospital; Healthcare and Social Services of Selänne (S.K.-K., I.T.), Pyhäjärvi, Finland and City of Oulu; MediCity and Institute of Biomedicine (M.S., S.J.), University of Turku; Department of Clinical Chemistry (T.L.), Fimlab Laboratories, and Finnish Cardiovascular Research Center, Tampere, Faculty of Medicine and Health Technology, Tampere University; Finnish Institute for Health and Welfare (V.S.), Helsinki; Research Centre of Applied and Preventive Cardiovascular Medicine (O.T.R.), University of Turku; Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital; Centre for Population Health Research (O.T.R.), University of Turku and Turku University Hospital, Finland; Department of Brain Sciences (P.M.M.), Faculty of Medicine, Imperial College London; UK Dementia Research Institute at Imperial College London (P.M.M., P.E.); MRC Centre for Environment and Health (P.E., M.-r.J.), School of Public Health, Imperial College London, United Kingdom; Department of Hygiene and Epidemiology (K.K.T.), University of Ioannina Medical School, Greece; Biocenter Oulu (M.-r.J.), University of Oulu, Finland; and Department of Life Sciences (M.-r.J.), College of Health and Life Sciences, Brunel University London, United Kingdom
| | - Konstantinos K Tsilidis
- From the Department of Epidemiology and Biostatistics (J.H., B.S., V.K., D.G., V.Z., S.P., P.E., K.K.T., M.-r.J., A.D.), School of Public Health, Imperial College London, United Kingdom; Singapore Institute for Clinical Sciences (SICS) (J.H.), Agency for Science, Technology and Research (A*STAR); Center for Life Course Health Research (V.K., S.P., J.A., S.K.-K., M.-r.J.), Faculty of Medicine, Research Unit of Mathematical Sciences (V.K.), University of Oulu, Finland; The Stanley Center for Psychiatric Research (A.A.-O.), Broad Institute of MIT and Harvard, Cambridge, MA; Analytical and Translational Genetics Unit (A.A.-O.), Massachusetts General Hospital, Boston; Institute for Molecular Medicine Finland (A.A.-O.), University of Helsinki; Research Unit of Biomedicine (K.-H.H.), Medical Research Center (MRC), University of Oulu, University Hospital, Finland; Department of Gastroenterology and Metabolism (K.-H.H.), Poznan University of Medical Sciences, Poland; Unit of Primary Care (S.K.-K., M.-r.J.), Oulu University Hospital; Healthcare and Social Services of Selänne (S.K.-K., I.T.), Pyhäjärvi, Finland and City of Oulu; MediCity and Institute of Biomedicine (M.S., S.J.), University of Turku; Department of Clinical Chemistry (T.L.), Fimlab Laboratories, and Finnish Cardiovascular Research Center, Tampere, Faculty of Medicine and Health Technology, Tampere University; Finnish Institute for Health and Welfare (V.S.), Helsinki; Research Centre of Applied and Preventive Cardiovascular Medicine (O.T.R.), University of Turku; Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital; Centre for Population Health Research (O.T.R.), University of Turku and Turku University Hospital, Finland; Department of Brain Sciences (P.M.M.), Faculty of Medicine, Imperial College London; UK Dementia Research Institute at Imperial College London (P.M.M., P.E.); MRC Centre for Environment and Health (P.E., M.-r.J.), School of Public Health, Imperial College London, United Kingdom; Department of Hygiene and Epidemiology (K.K.T.), University of Ioannina Medical School, Greece; Biocenter Oulu (M.-r.J.), University of Oulu, Finland; and Department of Life Sciences (M.-r.J.), College of Health and Life Sciences, Brunel University London, United Kingdom
| | - Marjo-Riitta Jarvelin
- From the Department of Epidemiology and Biostatistics (J.H., B.S., V.K., D.G., V.Z., S.P., P.E., K.K.T., M.-r.J., A.D.), School of Public Health, Imperial College London, United Kingdom; Singapore Institute for Clinical Sciences (SICS) (J.H.), Agency for Science, Technology and Research (A*STAR); Center for Life Course Health Research (V.K., S.P., J.A., S.K.-K., M.-r.J.), Faculty of Medicine, Research Unit of Mathematical Sciences (V.K.), University of Oulu, Finland; The Stanley Center for Psychiatric Research (A.A.-O.), Broad Institute of MIT and Harvard, Cambridge, MA; Analytical and Translational Genetics Unit (A.A.-O.), Massachusetts General Hospital, Boston; Institute for Molecular Medicine Finland (A.A.-O.), University of Helsinki; Research Unit of Biomedicine (K.-H.H.), Medical Research Center (MRC), University of Oulu, University Hospital, Finland; Department of Gastroenterology and Metabolism (K.-H.H.), Poznan University of Medical Sciences, Poland; Unit of Primary Care (S.K.-K., M.-r.J.), Oulu University Hospital; Healthcare and Social Services of Selänne (S.K.-K., I.T.), Pyhäjärvi, Finland and City of Oulu; MediCity and Institute of Biomedicine (M.S., S.J.), University of Turku; Department of Clinical Chemistry (T.L.), Fimlab Laboratories, and Finnish Cardiovascular Research Center, Tampere, Faculty of Medicine and Health Technology, Tampere University; Finnish Institute for Health and Welfare (V.S.), Helsinki; Research Centre of Applied and Preventive Cardiovascular Medicine (O.T.R.), University of Turku; Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital; Centre for Population Health Research (O.T.R.), University of Turku and Turku University Hospital, Finland; Department of Brain Sciences (P.M.M.), Faculty of Medicine, Imperial College London; UK Dementia Research Institute at Imperial College London (P.M.M., P.E.); MRC Centre for Environment and Health (P.E., M.-r.J.), School of Public Health, Imperial College London, United Kingdom; Department of Hygiene and Epidemiology (K.K.T.), University of Ioannina Medical School, Greece; Biocenter Oulu (M.-r.J.), University of Oulu, Finland; and Department of Life Sciences (M.-r.J.), College of Health and Life Sciences, Brunel University London, United Kingdom
| | - Ioanna Tzoulaki
- From the Department of Epidemiology and Biostatistics (J.H., B.S., V.K., D.G., V.Z., S.P., P.E., K.K.T., M.-r.J., A.D.), School of Public Health, Imperial College London, United Kingdom; Singapore Institute for Clinical Sciences (SICS) (J.H.), Agency for Science, Technology and Research (A*STAR); Center for Life Course Health Research (V.K., S.P., J.A., S.K.-K., M.-r.J.), Faculty of Medicine, Research Unit of Mathematical Sciences (V.K.), University of Oulu, Finland; The Stanley Center for Psychiatric Research (A.A.-O.), Broad Institute of MIT and Harvard, Cambridge, MA; Analytical and Translational Genetics Unit (A.A.-O.), Massachusetts General Hospital, Boston; Institute for Molecular Medicine Finland (A.A.-O.), University of Helsinki; Research Unit of Biomedicine (K.-H.H.), Medical Research Center (MRC), University of Oulu, University Hospital, Finland; Department of Gastroenterology and Metabolism (K.-H.H.), Poznan University of Medical Sciences, Poland; Unit of Primary Care (S.K.-K., M.-r.J.), Oulu University Hospital; Healthcare and Social Services of Selänne (S.K.-K., I.T.), Pyhäjärvi, Finland and City of Oulu; MediCity and Institute of Biomedicine (M.S., S.J.), University of Turku; Department of Clinical Chemistry (T.L.), Fimlab Laboratories, and Finnish Cardiovascular Research Center, Tampere, Faculty of Medicine and Health Technology, Tampere University; Finnish Institute for Health and Welfare (V.S.), Helsinki; Research Centre of Applied and Preventive Cardiovascular Medicine (O.T.R.), University of Turku; Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital; Centre for Population Health Research (O.T.R.), University of Turku and Turku University Hospital, Finland; Department of Brain Sciences (P.M.M.), Faculty of Medicine, Imperial College London; UK Dementia Research Institute at Imperial College London (P.M.M., P.E.); MRC Centre for Environment and Health (P.E., M.-r.J.), School of Public Health, Imperial College London, United Kingdom; Department of Hygiene and Epidemiology (K.K.T.), University of Ioannina Medical School, Greece; Biocenter Oulu (M.-r.J.), University of Oulu, Finland; and Department of Life Sciences (M.-r.J.), College of Health and Life Sciences, Brunel University London, United Kingdom
| | - Abbas Dehghan
- From the Department of Epidemiology and Biostatistics (J.H., B.S., V.K., D.G., V.Z., S.P., P.E., K.K.T., M.-r.J., A.D.), School of Public Health, Imperial College London, United Kingdom; Singapore Institute for Clinical Sciences (SICS) (J.H.), Agency for Science, Technology and Research (A*STAR); Center for Life Course Health Research (V.K., S.P., J.A., S.K.-K., M.-r.J.), Faculty of Medicine, Research Unit of Mathematical Sciences (V.K.), University of Oulu, Finland; The Stanley Center for Psychiatric Research (A.A.-O.), Broad Institute of MIT and Harvard, Cambridge, MA; Analytical and Translational Genetics Unit (A.A.-O.), Massachusetts General Hospital, Boston; Institute for Molecular Medicine Finland (A.A.-O.), University of Helsinki; Research Unit of Biomedicine (K.-H.H.), Medical Research Center (MRC), University of Oulu, University Hospital, Finland; Department of Gastroenterology and Metabolism (K.-H.H.), Poznan University of Medical Sciences, Poland; Unit of Primary Care (S.K.-K., M.-r.J.), Oulu University Hospital; Healthcare and Social Services of Selänne (S.K.-K., I.T.), Pyhäjärvi, Finland and City of Oulu; MediCity and Institute of Biomedicine (M.S., S.J.), University of Turku; Department of Clinical Chemistry (T.L.), Fimlab Laboratories, and Finnish Cardiovascular Research Center, Tampere, Faculty of Medicine and Health Technology, Tampere University; Finnish Institute for Health and Welfare (V.S.), Helsinki; Research Centre of Applied and Preventive Cardiovascular Medicine (O.T.R.), University of Turku; Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital; Centre for Population Health Research (O.T.R.), University of Turku and Turku University Hospital, Finland; Department of Brain Sciences (P.M.M.), Faculty of Medicine, Imperial College London; UK Dementia Research Institute at Imperial College London (P.M.M., P.E.); MRC Centre for Environment and Health (P.E., M.-r.J.), School of Public Health, Imperial College London, United Kingdom; Department of Hygiene and Epidemiology (K.K.T.), University of Ioannina Medical School, Greece; Biocenter Oulu (M.-r.J.), University of Oulu, Finland; and Department of Life Sciences (M.-r.J.), College of Health and Life Sciences, Brunel University London, United Kingdom.
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Proietti R, Maranho Neto GA, Kunzova S, Lo Re O, Ahola-Olli A, Heliste J, Gonzalez-Rivas JP, Vinciguerra M. Pharmacogenomic profile of a central European urban random population-Czech population. PLoS One 2023; 18:e0284386. [PMID: 37079615 PMCID: PMC10118108 DOI: 10.1371/journal.pone.0284386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/29/2023] [Indexed: 04/21/2023] Open
Abstract
The genetic basis of variability in drug response is at the core of pharmacogenomics (PGx) studies, aiming at reducing adverse drug reaction (ADR), which have interethnic variability. This study used the Kardiovize Brno 2030 random urban Czech sample population to analyze polymorphisms in a wide spectrum of genes coding for liver enzymes involved in drug metabolism. We aimed at correlating real life drug consumption with pharmacogenomic profile, and at comparing these data with the SUPER-Finland Finnish PGx database. A total of 250 individuals representative of the Kardiovize Brno 2030 cohort were included in an observational study. Blood DNA was extracted and 59 single nucleotide polymorphisms within 13 genes (BCHE, CYP1A2, CYP2C9, CYP2C19, CYP2D6, CYP3A5, F2, F5, IFNL3, SLCO1B1, TPMT, UGT1A1, VKORC1), associated to different drug metabolizing rates, were characterized by genotyping using a genome wide commercial array. Widely used drugs such as anti-coagulant warfarin and lipid lowering agent atorvastatin were associated to an alarmingly high percentage of users with intermediate/poor metabolism for them. Significant differences in the frequency of normal/intermediate/poor/ultrarapid/rapid metabolizers were observed for CYPD26 (p<0.001), CYP2C19 (p<0.001) and UGT1A1 (p<0.001) between the Czech and the Finnish study populations. Our study demonstrated that administration of some popular drugs to a Czech random sample population is associated with different drug metabolizing rates and therefore exposing to risk for ADRs. We also highlight interethnic differentiation of some common pharmacogenetics variants between Central (Czech) and North European (Finnish) population studies, suggesting the utility of PGx-informed prescription based on variant genotyping.
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Affiliation(s)
- Riccardo Proietti
- Liverpool Centre for Cardiovascular Sciences (LCCS), University of Liverpool, Liverpool, United Kingdom
| | - Geraldo A Maranho Neto
- International Clinical Research Center, St Anne's University Hospital, Brno, Czech Republic
| | - Sarka Kunzova
- International Clinical Research Center, St Anne's University Hospital, Brno, Czech Republic
| | - Oriana Lo Re
- International Clinical Research Center, St Anne's University Hospital, Brno, Czech Republic
- Department of Stem Cell Biology and Transplantology, Research Institute of the Medical University of Varna (RIMUV), Varna, Bulgaria
| | - Ari Ahola-Olli
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
- Stanley Center for Psychiatric Research, The Broad Institute of MIT (Massachusetts Institute of Technology) and Harvard University, Cambridge, MA, United States of America
| | - Juho Heliste
- Institute of Biomedicine, University of Turku, Turku, Finland
| | - Juan Pablo Gonzalez-Rivas
- International Clinical Research Center, St Anne's University Hospital, Brno, Czech Republic
- Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, MA, United States of America
| | - Manlio Vinciguerra
- International Clinical Research Center, St Anne's University Hospital, Brno, Czech Republic
- Department of Stem Cell Biology and Transplantology, Research Institute of the Medical University of Varna (RIMUV), Varna, Bulgaria
- Liverpool Centre for Cardiovascular Sciences (LCCS), Liverpool John Moores University, Liverpool, United Kingdom
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7
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Ketvel L, Keltikangas-Järvinen L, Pahkala K, Juonala M, Ahola-Olli A, Lehtimäki T, Viikari J, Raitakari O, Rovio S, Saarinen A. Stress-Related Exhaustion, Polygenic Cognitive Potential, and Cognitive Test Performance - A General Population Study. Cognit Ther Res 2023; 47:155-167. [PMID: 36945257 PMCID: PMC10023621 DOI: 10.1007/s10608-023-10354-z] [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: 11/16/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 02/06/2023]
Abstract
Background We investigated whether stress-related exhaustion (chronic or short-term, and co-occurring with depression or not) is related to cognitive performance and whether polygenic cognitive potential modifies these associations. Methods The participants were from the Young Finns Study (N = 541-1273). Stress-related exhaustion was assessed using the Maastricht Questionnaire, depressive symptoms with the Beck Depression Inventory, and cognitive performance with subtests of the Cambridge Neuropsychological Test Automated Battery, measuring visuospatial learning, reaction time, sustained attention, and executive function. Cognitive performance and depression were assessed in 2011, and exhaustion in 2001, 2007, and 2011. A polygenic score for cognitive potential was calculated based on a GWAS on intelligence. Results High stress-related exhaustion, especially chronic, was associated with slower reaction time. Only clinical levels of depression were related to slower reaction time. Polygenic cognitive potential did not modify these associations. There were no differences in cognitive performance between individuals with co-occurring exhaustion and depression vs. those with only either condition. Conclusion Stress-related exhaustion, especially if chronic, seems to relate to slower reactions. Co-occurring exhaustion and depression may not have additive effects on cognitive performance. High polygenic cognitive potential may not protect from or predispose to harmful effects of exhaustion or depression on reaction time. Supplementary Information The online version contains supplementary material available at 10.1007/s10608-023-10354-z.
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Affiliation(s)
- Laila Ketvel
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014 Helsinki, Finland
| | - Liisa Keltikangas-Järvinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014 Helsinki, Finland
| | - Katja Pahkala
- Research Centre for Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Paavo Nurmi Centre and Unit for Health and Physical Activity, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku, Turku University Hospital, Turku, Finland
| | - Markus Juonala
- Department of Medicine, Division of Medicine, University of Turku, Turku University Hospital, Turku, Finland
| | - Ari Ahola-Olli
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Boston, MA USA
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Department of Clinical Chemistry, Finnish Cardiovascular Research Center, Fimlab Laboratories, Tampere, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Finnish Cardiovascular Research Center, Fimlab Laboratories, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Jorma Viikari
- Department of Medicine, Division of Medicine, University of Turku, Turku University Hospital, Turku, Finland
| | - Olli Raitakari
- Research Centre for Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku, Turku University Hospital, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Suvi Rovio
- Research Centre for Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku, Turku University Hospital, Turku, Finland
| | - Aino Saarinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014 Helsinki, Finland
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8
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Saarinen A, Keltikangas-Järvinen L, Dobewall H, Cloninger CR, Ahola-Olli A, Lehtimäki T, Hutri-Kähönen N, Raitakari O, Rovio S, Ravaja N. Does social intolerance vary according to cognitive styles, genetic cognitive capacity, or education? Brain Behav 2022; 12:e2704. [PMID: 36047482 PMCID: PMC9480910 DOI: 10.1002/brb3.2704] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 06/22/2022] [Accepted: 06/25/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Low education, low cognitive abilities, and certain cognitive styles are suggested to predispose to social intolerance and prejudices. Evidence is, however, restricted by comparatively small samples, neglect of confounding variables and genetic factors, and a narrow focus on a single sort of prejudice. We investigated the relationships of education, polygenic cognitive potential, cognitive performance, and cognitive styles with social intolerance in adulthood over a 15-year follow-up. METHODS We used data from the prospective population-based Young Finns Study (n = 960-1679). Social intolerance was evaluated with the Social Intolerance Scale in 1997, 2001, and 2011; cognitive performance with the Cambridge Neuropsychological Test Automated Battery in 2011; cognitive styles in 1997; and socioeconomic factors in 1980 (childhood) and 2011 (adulthood); and polygenic cognitive potential was calculated based on genome-wide association studies. RESULTS We found that nonrational thinking, polygenic cognitive potential, cognitive performance, or socioeconomic factors were not related to social intolerance. Regarding cognitive styles, low flexibility (B = -0.759, p < .001), high perseverance (B = 1.245, p < .001), and low persistence (B = -0.329, p < .001) predicted higher social intolerance consistently in the analyses. DISCUSSION When developing prejudice-reduction interventions, it should be considered that educational level or cognitive performance may not be crucial for development of social intolerance. Adopting certain cognitive styles may play more important roles in development of social intolerance.
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Affiliation(s)
- Aino Saarinen
- Faculty of Medicine, Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | | | - Henrik Dobewall
- Faculty of Medicine, Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland.,Research Unit of Psychology, University of Oulu, Oulu, Finland.,Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center, Tampere, Finland
| | | | - Ari Ahola-Olli
- Department of Internal Medicine, Satasairaala Central Hospital, Pori, Finland.,Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts.,Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Nina Hutri-Kähönen
- Tampere Centre for Skills Training and Simulation, Tampere University, Tampere, Finland
| | - Olli Raitakari
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Suvi Rovio
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Niklas Ravaja
- Faculty of Medicine, Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
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9
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Raitakari O, Kivelä A, Pahkala K, Rovio S, Mykkänen J, Ahola-Olli A, Loo BM, Lyytikäinen LP, Lehtimäki T, Kähönen M, Juonala M, Rönnemaa T, Lamina C, Kronenberg F, Viikari J. Long-term tracking and population characteristics of lipoprotein (a) in the cardiovascular risk in young finns study. Atherosclerosis 2022; 356:18-27. [DOI: 10.1016/j.atherosclerosis.2022.07.009] [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] [Received: 04/12/2022] [Revised: 06/01/2022] [Accepted: 07/13/2022] [Indexed: 11/16/2022]
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10
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Ahti J, Kieseppä T, Suvisaari J, Suokas K, Holm M, Wegelius A, Ahola-Olli A, Häkkinen K, Kampman O, Lähteenvuo M, Paunio T, Tiihonen J, Tuulio-Henriksson A, Isometsä E. Differences in psychosocial functioning between psychotic disorders in the Finnish SUPER study. Schizophr Res 2022; 244:10-17. [PMID: 35537381 DOI: 10.1016/j.schres.2022.04.008] [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: 12/20/2021] [Revised: 03/16/2022] [Accepted: 04/30/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Psychotic disorders differ in their impact on psychosocial functioning. However, few studies have directly compared psychosocial functioning and its determinants between schizophrenia, schizoaffective disorder (SAD), bipolar disorder (BD), and major depressive disorder with psychotic features (psychotic MDD). OBJECTIVE We compared rates of independent living, employment, marriage, and having children between these diagnostic groups in a large national sample of participants with psychotic disorders in Finland. METHODS A cross-sectional substudy of participants (N = 9148) aged 18 to 65 years in the Finnish SUPER study, recruited nationwide from health- and social care settings and with advertisements. Psychosis diagnoses, age of onset, and hospitalizations were collected from healthcare registers. Participants were interviewed for psychosocial functioning. Associations of age of onset, hospitalizations, gender, and education with psychosocial functioning were analyzed using logistic regression models. RESULTS Of participants, 13.8% were employed or studying, 72.0% living independently and 32.5% had children. Overall, BD was associated with best, SAD and psychotic MDD with intermediate, and schizophrenia with worst level of psychosocial functioning. Greatest differences were found in independent living (OR 4.06 for BD vs. schizophrenia). In multivariate models, gender and number of hospitalizations predicted employment, marriage, and independent living in all diagnostic categories, and age of onset in some diagnostic categories. CONCLUSIONS Level of functioning and psychosocial outcomes differed markedly between psychotic disorders, particularly in independent living. Outcomes were worst for schizophrenia and best for BD. Across all psychotic disorders, female gender and lifetime number of hospitalizations had strong independent associations with marriage, employment, and independent living.
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Affiliation(s)
- Johan Ahti
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Finland
| | - Tuula Kieseppä
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Finland; Mental Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jaana Suvisaari
- Mental Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Kimmo Suokas
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland; Tampere University Hospital, Tampere, Finland; Department of Psychiatry, Pirkanmaa Hospital District, Tampere, Finland
| | - Minna Holm
- Mental Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Asko Wegelius
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Finland; Mental Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland; Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Ari Ahola-Olli
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland; Stanley Center for Psychiatric Research, The Broad Institute of MIT (Massachusetts Institute of Technology) and Harvard, Cambridge, MA, USA; Analytical and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Katja Häkkinen
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland; Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, Kuopio, Finland
| | - Olli Kampman
- Tampere University Hospital, Tampere, Finland; Department of Psychiatry, Pirkanmaa Hospital District, Tampere, Finland; Department of Psychiatry, Pirkanmaa Hospital District, Tampere, Finland
| | - Markku Lähteenvuo
- Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, Kuopio, Finland
| | - Tiina Paunio
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Finland; Mental Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jari Tiihonen
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, Kuopio, Finland; Center for Psychiatry Research, Stockholm City Council, Stockholm, Sweden
| | | | - Erkki Isometsä
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Finland.
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11
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Wu F, Ahola-Olli A, Pahkala K, Hakala JO, Juonala M, Salo P, Lehtimäki T, Hutri-Kähönen N, Kähönen M, Laitinen T, Tossavainen P, Taittonen L, Jokinen E, Viikari JSA, Magnussen CG, Raitakari OT, Rovio SP. Risk Factor Profile in Youth, Genetic Risk and Adulthood Cognitive Function: The Cardiovascular Risk in Young Finns Study. Neuroepidemiology 2022; 56:201-211. [PMID: 35552281 DOI: 10.1159/000524986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 04/28/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The role of risk factor profile in childhood and adolescence on adulthood cognitive function and whether it differs by genetic risk is still obscure. To bring this evidence, we determined cognitive domain specific youth risk factor profiles leveraging the childhood/adolescence data from the Cardiovascular Risk in Young Finns Study, and examined whether genetic propensity for poor cognitive function modifies the association between the risk profiles and adulthood cognitive function. METHODS From 1980, a population-based cohort of 3596 children (age 3-18 years) have been repeatedly followed-up for 31 years. Computerized cognitive test measuring: 1) memory and learning, 2) short-term working memory, 3) reaction time, and 4) information processing was performed for N=2026 participants (age 34-49 years). Cognitive domain specific youth risk profile scores including physical and environmental factors were assessed from the data collected at baseline and categorised into favourable, intermediate, and unfavourable. A polygenic risk score for poor cognitive function was categorised into low, intermediate, and high risk. RESULTS At all genetic risk levels, a favourable youth risk factor profile associated with better learning and memory, short-term working memory and information processing compared to unfavourable risk profile (e.g. β=0.501SD, 95%CI 0.043-0.959 for memory and learning among participants with high genetic risk). However, no significant interactions were observed between the youth risk factor profile score and genetic propensity for any cognitive domain (P>0.299 for all). CONCLUSION A favourable youth risk factor profile may be beneficial for cognitive function in adulthood irrespective of genetic propensity for poor cognitive function.
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Affiliation(s)
- Feitong Wu
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Ari Ahola-Olli
- Institute for Molecular Medicine (FIMM), University of Helsinki, Helsinki, Finland
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Sports & Exercise Medicine Unit, Department of Physical Activity and Health, Paavo Nurmi Centre, University of Turku, Turku, Finland
| | - Juuso O Hakala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Sports & Exercise Medicine Unit, Department of Physical Activity and Health, Paavo Nurmi Centre, University of Turku, Turku, Finland
| | - Markus Juonala
- Department of Medicine, University of Turku, Turku, Finland
- Division of Medicine, Turku University Hospital, Turku, Finland
| | - Pia Salo
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories and Faculty of Medicine and Health Technology, Finnish Cardiovascular Research Center - Tampere, Tampere University, Tampere, Finland
| | - Nina Hutri-Kähönen
- Department of Pediatrics, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
| | - Päivi Tossavainen
- Department of Pediatrics, University of Oulu, Oulu, Finland
- PEDEGO Research Unit and Medical Research Center Oulu, University of Oulu, Oulu, Finland
| | - Leena Taittonen
- Department of Pediatrics, University of Oulu, Oulu, Finland
- Vaasa Central Hospital, Vaasa, Finland
| | - Eero Jokinen
- Department of Paediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland
| | - Jorma S A Viikari
- Department of Medicine, University of Turku, Turku, Finland
- Division of Medicine, Turku University Hospital, Turku, Finland
| | - Costan G Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Suvi P Rovio
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
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12
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Bouras E, Karhunen V, Gill D, Huang J, Haycock PC, Gunter MJ, Johansson M, Brennan P, Key T, Lewis SJ, Martin RM, Murphy N, Platz EA, Travis R, Yarmolinsky J, Zuber V, Martin P, Katsoulis M, Freisling H, Nøst TH, Schulze MB, Dossus L, Hung RJ, Amos CI, Ahola-Olli A, Palaniswamy S, Männikkö M, Auvinen J, Herzig KH, Keinänen-Kiukaanniemi S, Lehtimäki T, Salomaa V, Raitakari O, Salmi M, Jalkanen S, Jarvelin MR, Dehghan A, Tsilidis KK. Circulating inflammatory cytokines and risk of five cancers: a Mendelian randomization analysis. BMC Med 2022; 20:3. [PMID: 35012533 PMCID: PMC8750876 DOI: 10.1186/s12916-021-02193-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 11/18/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Epidemiological and experimental evidence has linked chronic inflammation to cancer aetiology. It is unclear whether associations for specific inflammatory biomarkers are causal or due to bias. In order to examine whether altered genetically predicted concentration of circulating cytokines are associated with cancer development, we performed a two-sample Mendelian randomisation (MR) analysis. METHODS Up to 31,112 individuals of European descent were included in genome-wide association study (GWAS) meta-analyses of 47 circulating cytokines. Single nucleotide polymorphisms (SNPs) robustly associated with the cytokines, located in or close to their coding gene (cis), were used as instrumental variables. Inverse-variance weighted MR was used as the primary analysis, and the MR assumptions were evaluated in sensitivity and colocalization analyses and a false discovery rate (FDR) correction for multiple comparisons was applied. Corresponding germline GWAS summary data for five cancer outcomes (breast, endometrial, lung, ovarian, and prostate), and their subtypes were selected from the largest cancer-specific GWASs available (cases ranging from 12,906 for endometrial to 133,384 for breast cancer). RESULTS There was evidence of inverse associations of macrophage migration inhibitory factor with breast cancer (OR per SD = 0.88, 95% CI 0.83 to 0.94), interleukin-1 receptor antagonist with endometrial cancer (0.86, 0.80 to 0.93), interleukin-18 with lung cancer (0.87, 0.81 to 0.93), and beta-chemokine-RANTES with ovarian cancer (0.70, 0.57 to 0.85) and positive associations of monokine induced by gamma interferon with endometrial cancer (3.73, 1.86 to 7.47) and cutaneous T-cell attracting chemokine with lung cancer (1.51, 1.22 to 1.87). These associations were similar in sensitivity analyses and supported in colocalization analyses. CONCLUSIONS Our study adds to current knowledge on the role of specific inflammatory biomarker pathways in cancer aetiology. Further validation is needed to assess the potential of these cytokines as pharmacological or lifestyle targets for cancer prevention.
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Affiliation(s)
- Emmanouil Bouras
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Ville Karhunen
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, W2 1PG, UK
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
- Research Unit of Mathematical Sciences, University of Oulu, Oulu, Finland
| | - Dipender Gill
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, W2 1PG, UK
- Novo Nordisk Research Centre Oxford, Old Road Campus, Oxford, UK
- Clinical Pharmacology Group, Pharmacy and Medicines Directorate, St George's University Hospitals NHS Foundation Trust, London, UK
- Clinical Pharmacology and Therapeutics Section, Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Jian Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, W2 1PG, UK
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Philip C Haycock
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Marc J Gunter
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Mattias Johansson
- Genomics Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Paul Brennan
- Genomics Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Tim Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Sarah J Lewis
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Richard M Martin
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research (NIHR) Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Neil Murphy
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Elizabeth A Platz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ruth Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - James Yarmolinsky
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Verena Zuber
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Paul Martin
- School of Biochemistry, University of Bristol, Bristol, UK
| | - Michail Katsoulis
- Institute of Health Informatics, University College London, London, UK
- Health Data Research UK, London, UK
| | - Heinz Freisling
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Therese Haugdahl Nøst
- Department of Community Medicine, Faculty of Health Sciences, Arctic University of Norway, Tromsø, Norway
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nutehtal, Germany
- Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
| | - Laure Dossus
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Rayjean J Hung
- Prosserman Centre for Population Health Research, Lunenfeld-Tanenbaum Research Institute of Sinai Health System, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | | | - Ari Ahola-Olli
- The Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Analytical and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Saranya Palaniswamy
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Minna Männikkö
- Northern Finland Birth Cohorts, Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Juha Auvinen
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Karl-Heinz Herzig
- Research Unit of Biomedicine, Medical Research Center, Faculty of Medicine, University of Oulu, and Oulu University Hospital, Oulu, Finland
| | | | - Terho Lehtimäki
- Department of Clinical Chemistry, Finnish Cardiovascular Research Center - Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Veikko Salomaa
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Olli Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Marko Salmi
- MediCity Research Laboratory, University of Turku, Turku, Finland
- Institute of Biomedicine, University of Turku, Turku, Finland
| | - Sirpa Jalkanen
- MediCity Research Laboratory, University of Turku, Turku, Finland
- Institute of Biomedicine, University of Turku, Turku, Finland
| | - Marjo-Riitta Jarvelin
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, W2 1PG, UK
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
- Unit of Primary Care, Oulu University Hospital, Oulu, Finland
| | - Abbas Dehghan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, W2 1PG, UK
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
- UK Dementia Research Institute at Imperial College London, London, UK
| | - Konstantinos K Tsilidis
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece.
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, W2 1PG, UK.
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13
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Mazumder AH, Barnett J, Isometsä ET, Lindberg N, Torniainen-Holm M, Lähteenvuo M, Lahdensuo K, Kerkelä M, Ahola-Olli A, Hietala J, Kampman O, Kieseppä T, Jukuri T, Häkkinen K, Cederlöf E, Haaki W, Kajanne R, Wegelius A, Männynsalo T, Niemi-Pynttäri J, Suokas K, Lönnqvist J, Tiihonen J, Paunio T, Vainio SJ, Palotie A, Niemelä S, Suvisaari J, Veijola J. Reaction Time and Visual Memory in Connection to Hazardous Drinking Polygenic Scores in Schizophrenia, Schizoaffective Disorder and Bipolar Disorder. Brain Sci 2021; 11:brainsci11111422. [PMID: 34827421 PMCID: PMC8615595 DOI: 10.3390/brainsci11111422] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/25/2021] [Accepted: 10/26/2021] [Indexed: 11/29/2022] Open
Abstract
The purpose of this study was to explore the association of cognition with hazardous drinking Polygenic Scores (PGS) in 2649 schizophrenia, 558 schizoaffective disorder, and 1125 bipolar disorder patients in Finland. Hazardous drinking PGS was computed using the LDPred program. Participants performed two computerized tasks from the Cambridge Automated Neuropsychological Test Battery (CANTAB) on a tablet computer: the 5-choice serial reaction time task, or Reaction Time (RT) test, and the Paired Associative Learning (PAL) test. The association between hazardous drinking PGS and cognition was measured using four cognition variables. Log-linear regression was used in Reaction Time (RT) assessment, and logistic regression was used in PAL assessment. All analyses were conducted separately for males and females. After adjustment of age, age of onset, education, household pattern, and depressive symptoms, hazardous drinking PGS was not associated with reaction time or visual memory in male or female patients with schizophrenia, schizoaffective, and bipolar disorder.
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Affiliation(s)
- Atiqul Haq Mazumder
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, 90014 Oulu, Finland; (M.K.); (T.J.); (J.V.)
- Correspondence:
| | - Jennifer Barnett
- Cambridge Cognition, University of Cambridge, Cambridge CB25 9TU, UK;
| | - Erkki Tapio Isometsä
- Department of Psychiatry, University Hospital and University of Helsinki, 00029 Helsinki, Finland; (E.T.I.); (N.L.); (T.K.); (A.W.); (T.P.)
| | - Nina Lindberg
- Department of Psychiatry, University Hospital and University of Helsinki, 00029 Helsinki, Finland; (E.T.I.); (N.L.); (T.K.); (A.W.); (T.P.)
| | - Minna Torniainen-Holm
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland; (M.T.-H.); (E.C.); (J.L.); (J.S.)
| | - Markku Lähteenvuo
- Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, 70240 Kuopio, Finland; (M.L.); (K.H.); (J.T.)
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
| | - Kaisla Lahdensuo
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Mehiläinen, Pohjoinen Hesperiankatu 17 C, 00260 Helsinki, Finland
| | - Martta Kerkelä
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, 90014 Oulu, Finland; (M.K.); (T.J.); (J.V.)
| | - Ari Ahola-Olli
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
| | - Jarmo Hietala
- Department of Psychiatry, University of Turku, 20014 Turku, Finland; (J.H.); (S.N.)
- Department of Psychiatry, Turku University Hospital, 20521 Turku, Finland
| | - Olli Kampman
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland;
- Department of Psychiatry, Pirkanmaa Hospital District, 33521 Tampere, Finland
| | - Tuula Kieseppä
- Department of Psychiatry, University Hospital and University of Helsinki, 00029 Helsinki, Finland; (E.T.I.); (N.L.); (T.K.); (A.W.); (T.P.)
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Mehiläinen, Pohjoinen Hesperiankatu 17 C, 00260 Helsinki, Finland
| | - Tuomas Jukuri
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, 90014 Oulu, Finland; (M.K.); (T.J.); (J.V.)
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
| | - Katja Häkkinen
- Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, 70240 Kuopio, Finland; (M.L.); (K.H.); (J.T.)
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
| | - Erik Cederlöf
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland; (M.T.-H.); (E.C.); (J.L.); (J.S.)
| | - Willehard Haaki
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Department of Psychiatry, University of Turku, 20014 Turku, Finland; (J.H.); (S.N.)
| | - Risto Kajanne
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
| | - Asko Wegelius
- Department of Psychiatry, University Hospital and University of Helsinki, 00029 Helsinki, Finland; (E.T.I.); (N.L.); (T.K.); (A.W.); (T.P.)
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland; (M.T.-H.); (E.C.); (J.L.); (J.S.)
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
| | - Teemu Männynsalo
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Social Services and Health Care Sector, City of Helsinki, 00099 Helsinki, Finland
| | - Jussi Niemi-Pynttäri
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Social Services and Health Care Sector, City of Helsinki, 00099 Helsinki, Finland
| | - Kimmo Suokas
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland;
| | - Jouko Lönnqvist
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland; (M.T.-H.); (E.C.); (J.L.); (J.S.)
- Department of Psychiatry, University of Helsinki, 00014 Helsinki, Finland
| | - Jari Tiihonen
- Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, 70240 Kuopio, Finland; (M.L.); (K.H.); (J.T.)
- Department of Clinical Neuroscience, Karolinska Institute, 17177 Stockholm, Sweden
- Center for Psychiatry Research, Stockholm City Council, 11364 Stockholm, Sweden
| | - Tiina Paunio
- Department of Psychiatry, University Hospital and University of Helsinki, 00029 Helsinki, Finland; (E.T.I.); (N.L.); (T.K.); (A.W.); (T.P.)
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland; (M.T.-H.); (E.C.); (J.L.); (J.S.)
- Department of Psychiatry, University of Helsinki, 00014 Helsinki, Finland
| | - Seppo Juhani Vainio
- Infotech Oulu, University of Oulu, 90014 Oulu, Finland;
- Northern Finland Biobank Borealis, Oulu University Hospital, 90220 Oulu, Finland
- Faculty of Biochemistry and Molecular Medicine, University of Oulu, 90014 Oulu, Finland
- Kvantum Institute, University of Oulu, 90014 Oulu, Finland
| | - Aarno Palotie
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Mehiläinen, Pohjoinen Hesperiankatu 17 C, 00260 Helsinki, Finland
- Stanley Center for Psychiatric Research, The Broad Institute of MIT (Massachusetts Institute of Technology) and Harvard, Cambridge, MA 02142, USA
- Analytical and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Solja Niemelä
- Department of Psychiatry, University of Turku, 20014 Turku, Finland; (J.H.); (S.N.)
- Department of Psychiatry, Turku University Hospital, 20521 Turku, Finland
| | - Jaana Suvisaari
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland; (M.T.-H.); (E.C.); (J.L.); (J.S.)
| | - Juha Veijola
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, 90014 Oulu, Finland; (M.K.); (T.J.); (J.V.)
- Department of Psychiatry, Oulu University Hospital, 90220 Oulu, Finland
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14
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Mazumder AH, Barnett J, Isometsä ET, Lindberg N, Torniainen-Holm M, Lähteenvuo M, Lahdensuo K, Kerkelä M, Ahola-Olli A, Hietala J, Kampman O, Kieseppä T, Jukuri T, Häkkinen K, Cederlöf E, Haaki W, Kajanne R, Wegelius A, Männynsalo T, Niemi-Pynttäri J, Suokas K, Lönnqvist J, Tiihonen J, Paunio T, Vainio SJ, Palotie A, Niemelä S, Suvisaari J, Veijola J. Reaction Time and Visual Memory in Connection to Alcohol Use in Persons with Bipolar Disorder. Brain Sci 2021; 11:brainsci11091154. [PMID: 34573174 PMCID: PMC8467646 DOI: 10.3390/brainsci11091154] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/23/2021] [Accepted: 08/27/2021] [Indexed: 11/17/2022] Open
Abstract
The purpose of this study was to explore the association of cognition with hazardous drinking and alcohol-related disorder in persons with bipolar disorder (BD). The study population included 1268 persons from Finland with bipolar disorder. Alcohol use was assessed through hazardous drinking and alcohol-related disorder including alcohol use disorder (AUD). Hazardous drinking was screened with the Alcohol Use Disorders Identification Test for Consumption (AUDIT-C) screening tool. Alcohol-related disorder diagnoses were obtained from the national registrar data. Participants performed two computerized tasks from the Cambridge Automated Neuropsychological Test Battery (CANTAB) on A tablet computer: the 5-choice serial reaction time task, or reaction time (RT) test and the Paired Associative Learning (PAL) test. Depressive symptoms were assessed with the Mental Health Inventory with five items (MHI-5). However, no assessment of current manic symptoms was available. Association between RT-test and alcohol use was analyzed with log-linear regression, and eβ with 95% confidence intervals (CI) are reported. PAL first trial memory score was analyzed with linear regression, and β with 95% CI are reported. PAL total errors adjusted was analyzed with logistic regression and odds ratios (OR) with 95% CI are reported. After adjustment of age, education, housing status and depression, hazardous drinking was associated with lower median and less variable RT in females while AUD was associated with a poorer PAL test performance in terms of the total errors adjusted scores in females. Our findings of positive associations between alcohol use and cognition in persons with bipolar disorder are difficult to explain because of the methodological flaw of not being able to separately assess only participants in euthymic phase.
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Affiliation(s)
- Atiqul Haq Mazumder
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, 90014 Oulu, Finland; (M.K.); (T.J.); (J.V.)
- Correspondence:
| | - Jennifer Barnett
- Cambridge Cognition, University of Cambridge, Cambridge CB25 9TU, UK;
| | - Erkki Tapio Isometsä
- Department of Psychiatry, University Hospital and University of Helsinki, 00029 Helsinki, Finland; (E.T.I.); (N.L.); (T.K.); (A.W.); (T.P.)
- Department of Psychiatry, University of Helsinki, 00014 Helsinki, Finland;
| | - Nina Lindberg
- Department of Psychiatry, University Hospital and University of Helsinki, 00029 Helsinki, Finland; (E.T.I.); (N.L.); (T.K.); (A.W.); (T.P.)
| | - Minna Torniainen-Holm
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland; (M.T.-H.); (E.C.); (J.S.)
| | - Markku Lähteenvuo
- Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, 70240 Kuopio, Finland; (M.L.); (K.H.); (J.T.)
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
| | - Kaisla Lahdensuo
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Mehiläinen, Pohjoinen Hesperiankatu 17 C, 00260 Helsinki, Finland
| | - Martta Kerkelä
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, 90014 Oulu, Finland; (M.K.); (T.J.); (J.V.)
| | - Ari Ahola-Olli
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
| | - Jarmo Hietala
- Department of Psychiatry, University of Turku, 20014 Turku, Finland; (J.H.); (S.N.)
- Department of Psychiatry, Turku University Hospital, 20521 Turku, Finland
| | - Olli Kampman
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland;
- Department of Psychiatry, Pirkanmaa Hospital District, 33521 Tampere, Finland
| | - Tuula Kieseppä
- Department of Psychiatry, University Hospital and University of Helsinki, 00029 Helsinki, Finland; (E.T.I.); (N.L.); (T.K.); (A.W.); (T.P.)
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Mehiläinen, Pohjoinen Hesperiankatu 17 C, 00260 Helsinki, Finland
| | - Tuomas Jukuri
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, 90014 Oulu, Finland; (M.K.); (T.J.); (J.V.)
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
| | - Katja Häkkinen
- Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, 70240 Kuopio, Finland; (M.L.); (K.H.); (J.T.)
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
| | - Erik Cederlöf
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland; (M.T.-H.); (E.C.); (J.S.)
| | - Willehard Haaki
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Department of Psychiatry, University of Turku, 20014 Turku, Finland; (J.H.); (S.N.)
| | - Risto Kajanne
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
| | - Asko Wegelius
- Department of Psychiatry, University Hospital and University of Helsinki, 00029 Helsinki, Finland; (E.T.I.); (N.L.); (T.K.); (A.W.); (T.P.)
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland; (M.T.-H.); (E.C.); (J.S.)
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
| | - Teemu Männynsalo
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Social Services and Health Care Sector, City of Helsinki, 00099 Helsinki, Finland
| | - Jussi Niemi-Pynttäri
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Social Services and Health Care Sector, City of Helsinki, 00099 Helsinki, Finland
| | - Kimmo Suokas
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland;
| | - Jouko Lönnqvist
- Department of Psychiatry, University of Helsinki, 00014 Helsinki, Finland;
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland; (M.T.-H.); (E.C.); (J.S.)
| | - Jari Tiihonen
- Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, 70240 Kuopio, Finland; (M.L.); (K.H.); (J.T.)
- Department of Clinical Neuroscience, Karolinska Institute, 17177 Stockholm, Sweden
- Center for Psychiatry Research, Stockholm City Council, 11364 Stockholm, Sweden
| | - Tiina Paunio
- Department of Psychiatry, University Hospital and University of Helsinki, 00029 Helsinki, Finland; (E.T.I.); (N.L.); (T.K.); (A.W.); (T.P.)
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland; (M.T.-H.); (E.C.); (J.S.)
- Social Services and Health Care Sector, City of Helsinki, 00099 Helsinki, Finland
| | - Seppo Juhani Vainio
- Infotech Oulu, University of Oulu, 90014 Oulu, Finland;
- Northern Finland Biobank Borealis, Oulu University Hospital, 90220 Oulu, Finland
- Faculty of Biochemistry and Molecular Medicine, University of Oulu, 90014 Oulu, Finland
- Kvantum Institute, University of Oulu, 90014 Oulu, Finland
| | - Aarno Palotie
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Mehiläinen, Pohjoinen Hesperiankatu 17 C, 00260 Helsinki, Finland
- Stanley Center for Psychiatric Research, The Broad Institute of MIT (Massachusetts Institute of Technology) and Harvard, Cambridge, MA 02142, USA
- Analytical and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Solja Niemelä
- Department of Psychiatry, University of Turku, 20014 Turku, Finland; (J.H.); (S.N.)
- Department of Psychiatry, Turku University Hospital, 20521 Turku, Finland
| | - Jaana Suvisaari
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland; (M.T.-H.); (E.C.); (J.S.)
| | - Juha Veijola
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, 90014 Oulu, Finland; (M.K.); (T.J.); (J.V.)
- Department of Psychiatry, Oulu University Hospital, 90220 Oulu, Finland
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15
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Ahlström S, Bergman P, Jokela R, Ottensmann L, Ahola-Olli A, Pirinen M, Olkkola KT, Kaunisto MA, Kalso E. First genome-wide association study on rocuronium dose requirements shows association with SLCO1A2. Br J Anaesth 2021; 126:949-957. [PMID: 33676726 PMCID: PMC8132880 DOI: 10.1016/j.bja.2021.01.029] [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] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 12/18/2020] [Accepted: 01/12/2021] [Indexed: 12/17/2022] Open
Abstract
Background Rocuronium, a common neuromuscular blocking agent, is mainly excreted unchanged in urine (10–25%) and bile (>70%). Age, sex, liver blood flow, smoking, medical conditions, and ethnic background can affect its pharmacological actions. However, reasons for the wide variation in rocuronium requirements are mostly unknown. We hypothesised that pharmacogenetic factors might explain part of the variation. Methods One thousand women undergoing surgery for breast cancer were studied. Anaesthesia was maintained with propofol (50–100 μg kg−1 min−1) and remifentanil (0.05–0.25 μg kg−1 min−1). Neuromuscular block was maintained with rocuronium to keep the train-of-four ratio at 0–10%. DNA was extracted from peripheral blood and genotyped with a next-generation genotyping array. The genome-wide association study (GWAS) was conducted using an additive linear regression model with PLINK software. The FINEMAP tool and data from the Genotype-Tissue Expression project v8 were utilised to study the locus further. Results The final patient population comprised 918 individuals. Of the clinical variables tested, age, BMI, ASA physical status, and total dose of propofol correlated significantly (all P<0.001) with the rocuronium dose in a linear regression model. The GWAS highlighted one genome-wide significant locus in chromosome 12. The single-nucleotide polymorphisms (SNPs) with the most significant evidence of association were located in or near SLCO1A2. The two top SNPs, rs7967354 (P=5.3e−11) and rs11045995 (P=1.4e−10), and the clinical variables accounted for 41% of the variability in rocuronium dosage. Conclusions Genetic variation in the gene SLCO1A2, encoding OATP1A2, an uptake transporter, accounted for 4% of the variability in rocuronium consumption. The underlying mechanism remains unknown.
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Affiliation(s)
- Sirkku Ahlström
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland.
| | - Paula Bergman
- Biostatistics Consulting, Department of Public Health, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland
| | - Ritva Jokela
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland
| | - Linda Ottensmann
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Ari Ahola-Olli
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Matti Pirinen
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland; Helsinki Institute for Information Technology and Department of Mathematics and Statistics, University of Helsinki, Helsinki, Finland; Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Klaus T Olkkola
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland
| | - Mari A Kaunisto
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Eija Kalso
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland; Department of Pharmacology, Faculty of Medicine, University of Helsinki, Helsinki, Finland; SleepWell Research Programme, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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16
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Ruotsalainen SE, Partanen JJ, Cichonska A, Lin J, Benner C, Surakka I, Reeve MP, Palta P, Salmi M, Jalkanen S, Ahola-Olli A, Palotie A, Salomaa V, Daly MJ, Pirinen M, Ripatti S, Koskela J. An expanded analysis framework for multivariate GWAS connects inflammatory biomarkers to functional variants and disease. Eur J Hum Genet 2021; 29:309-324. [PMID: 33110245 PMCID: PMC7868371 DOI: 10.1038/s41431-020-00730-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 12/07/2019] [Revised: 08/02/2020] [Accepted: 09/04/2020] [Indexed: 12/19/2022] Open
Abstract
Multivariate methods are known to increase the statistical power to detect associations in the case of shared genetic basis between phenotypes. They have, however, lacked essential analytic tools to follow-up and understand the biology underlying these associations. We developed a novel computational workflow for multivariate GWAS follow-up analyses, including fine-mapping and identification of the subset of traits driving associations (driver traits). Many follow-up tools require univariate regression coefficients which are lacking from multivariate results. Our method overcomes this problem by using Canonical Correlation Analysis to turn each multivariate association into its optimal univariate Linear Combination Phenotype (LCP). This enables an LCP-GWAS, which in turn generates the statistics required for follow-up analyses. We implemented our method on 12 highly correlated inflammatory biomarkers in a Finnish population-based study. Altogether, we identified 11 associations, four of which (F5, ABO, C1orf140 and PDGFRB) were not detected by biomarker-specific analyses. Fine-mapping identified 19 signals within the 11 loci and driver trait analysis determined the traits contributing to the associations. A phenome-wide association study on the 19 representative variants from the signals in 176,899 individuals from the FinnGen study revealed 53 disease associations (p < 1 × 10-4). Several reported pQTLs in the 11 loci provided orthogonal evidence for the biologically relevant functions of the representative variants. Our novel multivariate analysis workflow provides a powerful addition to standard univariate GWAS analyses by enabling multivariate GWAS follow-up and thus promoting the advancement of powerful multivariate methods in genomics.
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Affiliation(s)
- Sanni E Ruotsalainen
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Juulia J Partanen
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Anna Cichonska
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
- Department of Computer Science, Helsinki Institute for Information Technology HIIT, Aalto University, Espoo, Finland
- Department of Future Technologies, University of Turku, Turku, Finland
| | - Jake Lin
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Christian Benner
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Ida Surakka
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Mary Pat Reeve
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Priit Palta
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Marko Salmi
- MediCity Research Laboratory, University of Turku, Turku, Finland
- Institute of Biomedicine, University of Turku, Turku, Finland
| | - Sirpa Jalkanen
- MediCity Research Laboratory, University of Turku, Turku, Finland
- Institute of Biomedicine, University of Turku, Turku, Finland
| | - Ari Ahola-Olli
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
- The Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Aarno Palotie
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
- The Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Veikko Salomaa
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Mark J Daly
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
- The Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Matti Pirinen
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
- Department of Public Health, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Mathematics and Statistics, University of Helsinki, Helsinki, Finland
| | - Samuli Ripatti
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland.
- The Broad Institute of MIT and Harvard, Cambridge, MA, USA.
- Department of Public Health, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
| | - Jukka Koskela
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland.
- The Broad Institute of MIT and Harvard, Cambridge, MA, USA.
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17
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Saarinen A, Keltikangas-Järvinen L, Dobewall H, Ahola-Olli A, Salmi M, Lehtimäki T, Raitakari O, Jalkanen S, Hintsanen M. Risky emotional family environment in childhood and depression-related cytokines in adulthood: The protective role of compassion. Dev Psychobiol 2021; 63:1190-1201. [PMID: 33421111 DOI: 10.1002/dev.22070] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 10/16/2020] [Accepted: 11/06/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND Previously, compassion has been found to protect against depressive symptoms, while emotional adversities in childhood are suggested to increase inflammatory responses. The current study investigated (a) whether emotional family environment in childhood predicts levels of such cytokines in adulthood that are previously found to be elevated in depression (interleukin [IL]-2, IL-6, IL-1b, monocyte chemoattractant protein-1, interferon-gamma [IFN-γ], and tumor necrosis factor alpha [TNF-α]) and (b) whether these associations are modified by compassion in adulthood. METHODS The participants (N = 1,198-1,523) came from the prospective population-based Young Finns data. Emotional family environment and parental socioeconomic factors were evaluated in 1980; participants' compassion in 2001; and participants' cytokine levels and adulthood covariates in 2007. RESULTS Risky emotional family environment in childhood predicted higher levels of IL-2, IL-6, IFN-γ, and TNF-α in adulthood. Additionally, there were significant interaction effects between compassion and emotional risk in childhood, when predicting IL-2, IL-6, and TNF-α. Specifically, individuals who grew up in a risky emotional family environment had on average higher levels of IL-2, IL-6, and TNF-α in adulthood when combined with low compassion. CONCLUSIONS In individuals coming from risky emotional family environments, high compassion for others may protect against elevated levels of cytokines previously linked with depression.
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Affiliation(s)
- Aino Saarinen
- Research Unit of Psychology, University of Oulu, Oulu, Finland.,Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | | | - Henrik Dobewall
- Research Unit of Psychology, University of Oulu, Oulu, Finland
| | - Ari Ahola-Olli
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA.,Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Marko Salmi
- MediCity Research Laboratory and Institute of Biomedicine, University of Turku, Turku, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Olli Raitakari
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Sirpa Jalkanen
- MediCity Research Laboratory and Institute of Biomedicine, University of Turku, Turku, Finland
| | - Mirka Hintsanen
- Research Unit of Psychology, University of Oulu, Oulu, Finland
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18
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Saarentaus EC, Havulinna AS, Mars N, Ahola-Olli A, Kiiskinen TTJ, Partanen J, Ruotsalainen S, Kurki M, Urpa LM, Chen L, Perola M, Salomaa V, Veijola J, Männikkö M, Hall IM, Pietiläinen O, Kaprio J, Ripatti S, Daly M, Palotie A. Polygenic burden has broader impact on health, cognition, and socioeconomic outcomes than most rare and high-risk copy number variants. Mol Psychiatry 2021; 26:4884-4895. [PMID: 33526825 PMCID: PMC8589645 DOI: 10.1038/s41380-021-01026-z] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 12/18/2020] [Accepted: 01/11/2021] [Indexed: 12/29/2022]
Abstract
Copy number variants (CNVs) are associated with syndromic and severe neurological and psychiatric disorders (SNPDs), such as intellectual disability, epilepsy, schizophrenia, and bipolar disorder. Although considered high-impact, CNVs are also observed in the general population. This presents a diagnostic challenge in evaluating their clinical significance. To estimate the phenotypic differences between CNV carriers and non-carriers regarding general health and well-being, we compared the impact of SNPD-associated CNVs on health, cognition, and socioeconomic phenotypes to the impact of three genome-wide polygenic risk score (PRS) in two Finnish cohorts (FINRISK, n = 23,053 and NFBC1966, n = 4895). The focus was on CNV carriers and PRS extremes who do not have an SNPD diagnosis. We identified high-risk CNVs (DECIPHER CNVs, risk gene deletions, or large [>1 Mb] CNVs) in 744 study participants (2.66%), 36 (4.8%) of whom had a diagnosed SNPD. In the remaining 708 unaffected carriers, we observed lower educational attainment (EA; OR = 0.77 [95% CI 0.66-0.89]) and lower household income (OR = 0.77 [0.66-0.89]). Income-associated CNVs also lowered household income (OR = 0.50 [0.38-0.66]), and CNVs with medical consequences lowered subjective health (OR = 0.48 [0.32-0.72]). The impact of PRSs was broader. At the lowest extreme of PRS for EA, we observed lower EA (OR = 0.31 [0.26-0.37]), lower-income (OR = 0.66 [0.57-0.77]), lower subjective health (OR = 0.72 [0.61-0.83]), and increased mortality (Cox's HR = 1.55 [1.21-1.98]). PRS for intelligence had a similar impact, whereas PRS for schizophrenia did not affect these traits. We conclude that the majority of working-age individuals carrying high-risk CNVs without SNPD diagnosis have a modest impact on morbidity and mortality, as well as the limited impact on income and educational attainment, compared to individuals at the extreme end of common genetic variation. Our findings highlight that the contribution of traditional high-risk variants such as CNVs should be analyzed in a broader genetic context, rather than evaluated in isolation.
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Affiliation(s)
- Elmo Christian Saarentaus
- grid.7737.40000 0004 0410 2071Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland
| | - Aki Samuli Havulinna
- grid.7737.40000 0004 0410 2071Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland ,grid.14758.3f0000 0001 1013 0499Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Nina Mars
- grid.7737.40000 0004 0410 2071Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland
| | - Ari Ahola-Olli
- grid.7737.40000 0004 0410 2071Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland ,grid.66859.34Stanley Center for Psychiatric Research, The Broad Institute of Harvard and MIT, Cambridge, MA USA ,grid.32224.350000 0004 0386 9924Analytical and Translational Genetics Unit, Massachusetts General Hospital, Boston, USA
| | | | - Juulia Partanen
- grid.7737.40000 0004 0410 2071Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland
| | - Sanni Ruotsalainen
- grid.7737.40000 0004 0410 2071Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland
| | - Mitja Kurki
- grid.7737.40000 0004 0410 2071Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland ,grid.66859.34Stanley Center for Psychiatric Research, The Broad Institute of Harvard and MIT, Cambridge, MA USA ,grid.32224.350000 0004 0386 9924Analytical and Translational Genetics Unit, Massachusetts General Hospital, Boston, USA
| | - Lea Martta Urpa
- grid.7737.40000 0004 0410 2071Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland
| | - Lei Chen
- grid.47100.320000000419368710Department of Genetics, Yale School of Medicine, New Haven, CT USA ,grid.4367.60000 0001 2355 7002McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO USA
| | - Markus Perola
- grid.14758.3f0000 0001 1013 0499Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Veikko Salomaa
- grid.14758.3f0000 0001 1013 0499Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Juha Veijola
- grid.10858.340000 0001 0941 4873Research Unit of Clinical Neuroscience, University of Oulu & Oulu University Hospital, Oulu, Finland
| | - Minna Männikkö
- grid.10858.340000 0001 0941 4873Northern Finland Birth Cohorts, Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Ira M. Hall
- grid.47100.320000000419368710Department of Genetics, Yale School of Medicine, New Haven, CT USA ,grid.4367.60000 0001 2355 7002McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO USA
| | - Olli Pietiläinen
- grid.66859.34Stanley Center for Psychiatric Research, The Broad Institute of Harvard and MIT, Cambridge, MA USA ,grid.38142.3c000000041936754XStem Cell and Regenerative Biology, Harvard University, Cambridge, USA ,grid.7737.40000 0004 0410 2071Neuroscience Center, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Jaakko Kaprio
- grid.7737.40000 0004 0410 2071Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland ,grid.7737.40000 0004 0410 2071Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Samuli Ripatti
- grid.7737.40000 0004 0410 2071Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland ,grid.66859.34Stanley Center for Psychiatric Research, The Broad Institute of Harvard and MIT, Cambridge, MA USA ,grid.32224.350000 0004 0386 9924Analytical and Translational Genetics Unit, Massachusetts General Hospital, Boston, USA ,grid.7737.40000 0004 0410 2071Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Mark Daly
- grid.7737.40000 0004 0410 2071Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland ,grid.66859.34Stanley Center for Psychiatric Research, The Broad Institute of Harvard and MIT, Cambridge, MA USA ,grid.32224.350000 0004 0386 9924Analytical and Translational Genetics Unit, Massachusetts General Hospital, Boston, USA
| | - Aarno Palotie
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland. .,Stanley Center for Psychiatric Research, The Broad Institute of Harvard and MIT, Cambridge, MA, USA. .,Analytic and Translational Genetics Unit, Department of Medicine, Department of Neurology and Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
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19
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Rovio SP, Pihlman J, Pahkala K, Juonala M, Magnussen CG, Pitkänen N, Ahola-Olli A, Salo P, Kähönen M, Hutri-Kähönen N, Lehtimäki T, Jokinen E, Laitinen T, Taittonen L, Tossavainen P, Viikari JSA, Raitakari OT. Childhood Exposure to Parental Smoking and Midlife Cognitive Function. Am J Epidemiol 2020; 189:1280-1291. [PMID: 32242223 DOI: 10.1093/aje/kwaa052] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 03/23/2020] [Indexed: 11/14/2022] Open
Abstract
We studied whether exposure to parental smoking in childhood/adolescence is associated with midlife cognitive function, leveraging data from the Cardiovascular Risk in Young Finns Study. A population-based cohort of 3,596 children/adolescents aged 3-18 years was followed between 1980 and 2011. In 2011, cognitive testing was performed on 2,026 participants aged 34-49 years using computerized testing. Measures of secondhand smoke exposure in childhood/adolescence consisted of parental self-reports of smoking and participants' serum cotinine levels. Participants were classified into 3 exposure groups: 1) no exposure (nonsmoking parents, cotinine <1.0 ng/mL); 2) hygienic parental smoking (1-2 smoking parents, cotinine <1.0 ng/mL); and 3) nonhygienic parental smoking (1-2 smoking parents, cotinine ≥1.0 ng/mL). Analyses adjusted for sex, age, family socioeconomic status, polygenic risk score for cognitive function, adolescent/adult smoking, blood pressure, and serum total cholesterol level. Compared with the nonexposed, participants exposed to nonhygienic parental smoking were at higher risk of poor (lowest quartile) midlife episodic memory and associative learning (relative risk (RR) = 1.38, 95% confidence interval (CI): 1.08, 1.75), and a weak association was found for short-term and spatial working memory (RR = 1.25, 95% CI: 0.98, 1.58). Associations for those exposed to hygienic parental smoking were nonsignificant (episodic memory and associative learning: RR = 1.19, 95% CI: 0.92, 1.54; short-term and spatial working memory: RR = 1.10, 95% CI: 0.85, 1.34). We conclude that avoiding childhood/adolescence secondhand smoke exposure promotes adulthood cognitive function.
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20
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Sliz E, Kalaoja M, Ahola-Olli A, Raitakari O, Perola M, Salomaa V, Lehtimäki T, Karhu T, Viinamäki H, Salmi M, Santalahti K, Jalkanen S, Jokelainen J, Keinänen-Kiukaanniemi S, Männikkö M, Herzig KH, Järvelin MR, Sebert S, Kettunen J. Genome-wide association study identifies seven novel loci associating with circulating cytokines and cell adhesion molecules in Finns. J Med Genet 2019; 56:607-616. [PMID: 31217265 PMCID: PMC6817708 DOI: 10.1136/jmedgenet-2018-105965] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 04/10/2019] [Accepted: 04/20/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Inflammatory processes contribute to the pathophysiology of multiple chronic conditions. Genetic factors play a crucial role in modulating the inflammatory load, but the exact mechanisms are incompletely understood. OBJECTIVE To assess genetic determinants of 16 circulating cytokines and cell adhesion molecules (inflammatory phenotypes) in Finns. METHODS Genome-wide associations of the inflammatory phenotypes were studied in Northern Finland Birth Cohort 1966 (N=5284). A subsequent meta-analysis was completed for 10 phenotypes available in a previous genome-wide association study, adding up to 13 577 individuals in the study. Complementary association tests were performed to study the effect of the ABO blood types on soluble adhesion molecule levels. RESULTS We identified seven novel and six previously reported genetic associations (p<3.1×10-9). Three loci were associated with soluble vascular cell adhesion molecule-1 (sVCAM-1) level, one of which was the ABO locus that has been previously associated with soluble E-selectin (sE-selectin) and intercellular adhesion molecule-1 (sICAM-1) levels. Our findings suggest that the blood type B associates primarily with sVCAM-1 level, while the A1 subtype shows a robust effect on sE-selectin and sICAM-1 levels. The genotypes in the ABO locus associating with higher soluble adhesion molecule levels tend to associate with lower circulating cholesterol levels and lower cardiovascular disease risk. CONCLUSION The present results extend the knowledge about genetic factors contributing to the inflammatory load. Our findings suggest that two distinct mechanisms contribute to the soluble adhesion molecule levels in the ABO locus and that elevated soluble adhesion molecule levels per se may not increase risk for cardiovascular disease.
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Affiliation(s)
- Eeva Sliz
- Computational Medicine, Faculty of Medicine, University of Oulu, Oulu, Finland
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Biocenter Oulu, Oulu, Finland
| | - Marita Kalaoja
- Computational Medicine, Faculty of Medicine, University of Oulu, Oulu, Finland
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Biocenter Oulu, Oulu, Finland
| | - Ari Ahola-Olli
- Department of Internal Medicine, Satakunta Central Hospital, Pori, Finland
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Olli Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Markus Perola
- National Institute for Health and Welfare, Helsinki, Finland
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
- University of Tartu, Estonian Genome Center, Tartu, Estonia
| | - Veikko Salomaa
- National Institute for Health and Welfare, Helsinki, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories, and Finnish Cardiovascular Research Center - Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Toni Karhu
- Biocenter Oulu, Oulu, Finland
- Institute of Biomedicine, University of Oulu, Oulu, Finland
| | - Heimo Viinamäki
- Department of Psychiatry, University of Eastern Finland, and Kuopio University Hospital, Kuopio, Finland
| | - Marko Salmi
- Medicity Research Laboratory and Institute of Biomedicine, University of Turku, Turku, Finland
| | - Kristiina Santalahti
- Medicity Research Laboratory and Institute of Biomedicine, University of Turku, Turku, Finland
| | - Sirpa Jalkanen
- Medicity Research Laboratory and Institute of Biomedicine, University of Turku, Turku, Finland
| | - Jari Jokelainen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Unit of General Practice, Oulu University Hospital, Oulu, Finland
| | - Sirkka Keinänen-Kiukaanniemi
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Unit of General Practice, Oulu University Hospital, Oulu, Finland
- Oulu Deaconess Institute/Diapolis Oy Research Unit, Oulu, Finland
| | - Minna Männikkö
- Northern Finland Birth Cohorts, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Karl-Heinz Herzig
- Biocenter Oulu, Oulu, Finland
- Institute of Biomedicine, University of Oulu, Oulu, Finland
- Medical Research Center (MRC), University of Oulu, and Oulu University Hospital, Oulu, Finland
- Department of Gastroenterology and Metabolism, Poznan University of Medical Sciences, Poznan, Poland
| | - Marjo-Riitta Järvelin
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Biocenter Oulu, Oulu, Finland
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK
- Unit of Primary Care, Oulu University Hospital, Oulu, Finland
| | - Sylvain Sebert
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Biocenter Oulu, Oulu, Finland
- Department of Genomics and Complex Diseases, School of Public Health, Imperial College, London, UK
| | - Johannes Kettunen
- Computational Medicine, Faculty of Medicine, University of Oulu, Oulu, Finland
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Biocenter Oulu, Oulu, Finland
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21
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Suomela E, Oikonen M, Pitkänen N, Ahola-Olli A, Virtanen J, Parkkola R, Jokinen E, Laitinen T, Hutri-Kähönen N, Kähönen M, Lehtimäki T, Taittonen L, Tossavainen P, Jula A, Loo BM, Mikkilä V, Telama R, Viikari JSA, Juonala M, Raitakari OT. Childhood predictors of adult fatty liver. The Cardiovascular Risk in Young Finns Study. J Hepatol 2016; 65:784-790. [PMID: 27235307 DOI: 10.1016/j.jhep.2016.05.020] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 04/28/2016] [Accepted: 05/09/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Fatty liver is a potentially preventable cause of serious liver diseases. This longitudinal study aimed to identify childhood risk factors of fatty liver in adulthood in a population-based group of Finnish adults. METHODS Study cohort included 2,042 individuals from the Cardiovascular Risk in Young Finns Study aged 3-18years at baseline in 1980. During the latest follow-up in 2011, the liver was scanned by ultrasound. In addition to physical and environmental factors related to fatty liver, we examined whether the genetic risk posed by a single nucleotide polymorphism in the patatin-like phospholipase domain-containing protein 3 gene (PNPLA3) (rs738409) strengthens prediction of adult fatty liver. RESULTS Independent childhood predictors of adult fatty liver were small for gestational age, (odds ratio=1.71, 95% confidence interval=1.07-2.72), variant in PNPLA3 (1.63, 1.29-2.07 per one risk allele), variant in the transmembrane 6 superfamily 2 gene (TM6SF2) (1.57, 1.08-2.30), BMI (1.30, 1.07-1.59 per standard deviation) and insulin (1.25, 1.05-1.49 per standard deviation). Childhood blood pressure, physical activity, C-reactive protein, smoking, serum lipid levels or parental lifestyle factors did not predict fatty liver. Risk assessment based on childhood age, sex, BMI, insulin levels, birth weight, TM6SF2 and PNPLA3 was superior in predicting fatty liver compared with the approach using only age, sex, BMI and insulin levels (C statistics, 0.725 vs. 0.749; p=0.002). CONCLUSIONS Childhood risk factors on the development of fatty liver were small for gestational age, high insulin and high BMI. Prediction of adult fatty liver was enhanced by taking into account genetic variants in PNPLA3 and TM6SF2 genes. LAY SUMMARY The increase in pediatric obesity emphasizes the importance of identification of children and adolescents at high risk of fatty liver in adulthood. We used data from the longitudinal Cardiovascular Risk in Young Finns Study to examine the associations of childhood (3-18years) risk variables with fatty liver assessed in adulthood at the age of 34-49years. The findings suggest that a multifactorial approach with both lifestyle and genetic factors included would improve early identification of children with a high risk of adult fatty liver.
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Affiliation(s)
- Emmi Suomela
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
| | - Mervi Oikonen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Niina Pitkänen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Ari Ahola-Olli
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Johanna Virtanen
- Department of Radiology, Turku University Central Hospital, Medical Imaging Centre of Southwest Finland, Turku, Finland
| | - Riitta Parkkola
- Department of Radiology, Turku University Central Hospital, Medical Imaging Centre of Southwest Finland, Turku, Finland
| | - Eero Jokinen
- Department of Pediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland
| | - Tomi Laitinen
- Department of Clinical Physiology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Nina Hutri-Kähönen
- Department of Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital and University of Tampere, Tampere, Finland
| | - Terho Lehtimäki
- Fimlab Laboratories and Department of Clinical Chemistry, School of Medicine, University of Tampere, Tampere, Finland
| | - Leena Taittonen
- Vaasa Central Hospital, Vaasa, Finland and Department of Pediatrics, University of Oulu, Oulu, Finland
| | - Päivi Tossavainen
- Department of Children and Adolescents, Oulu University Hospital, PEDEGO Research Unit and Medical Research Centre Oulu, University of Oulu, Oulu, Finland
| | - Antti Jula
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Turku, Finland
| | - Britt-Marie Loo
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Turku, Finland
| | - Vera Mikkilä
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Division of Nutrition, Department of Applied Chemistry and Microbiology, University of Helsinki, Helsinki, Finland
| | - Risto Telama
- LIKES-Research Centre for Sport and Health Sciences, Jyväskylä, Finland
| | - Jorma S A Viikari
- Department of Medicine, University of Turku, and Division of Medicine, Turku University Hospital, Turku, Finland
| | - Markus Juonala
- Department of Medicine, University of Turku, and Division of Medicine, Turku University Hospital, Turku, Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
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22
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Rinne P, Ahola-Olli A, Nuutinen S, Koskinen E, Kaipio K, Eerola K, Juonala M, Kähönen M, Lehtimäki T, Raitakari OT, Savontaus E. Deficiency in Melanocortin 1 Receptor Signaling Predisposes to Vascular Endothelial Dysfunction and Increased Arterial Stiffness in Mice and Humans. Arterioscler Thromb Vasc Biol 2015; 35:1678-86. [DOI: 10.1161/atvbaha.114.305064] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 04/16/2015] [Indexed: 12/11/2022]
Abstract
Objective—
The melanocortin 1 receptor (MC1-R) is expressed by vascular endothelial cells and shown to enhance nitric oxide (NO) availability and vasodilator function on pharmacological stimulation. However, the physiological role of MC1-R in the endothelium and its contribution to vascular homeostasis remain unresolved. We investigated whether a lack of functional MC1-R signaling carries a phenotype with predisposition to vascular abnormalities.
Approach and Results—
Recessive yellow mice (MC1R
e/e
), deficient in MC1-R signaling, and their wild-type littermates were studied for morphology and functional characteristics of the aorta. MC1R
e/e
mice showed increased collagen deposition and arterial stiffness accompanied by an elevation in pulse pressure. Contractile capacity and NO-dependent vasodilatation were impaired in the aorta of MC1R
e/e
mice supported by findings of decreased NO availability. These mice also displayed elevated levels of systemic and local cytokines. Exposing the mice to high-sodium diet or acute endotoxemia revealed increased susceptibility to inflammation-driven vascular dysfunction. Finally, we investigated whether a similar phenotype can be found in healthy human subjects carrying variant
MC1-R
alleles known to attenuate receptor function. In a longitudinal analysis of 2001 subjects with genotype and ultrasound data (The Cardiovascular Risk in Young Finns Study), weak MC1-R function was associated with lower flow-mediated dilatation response of the brachial artery and increased carotid artery stiffness.
Conclusions—
The present study demonstrates that deficiency in MC1-R signaling is associated with increased arterial stiffness and impairment in endothelium-dependent vasodilatation, suggesting a physiological role for MC1-R in the regulation of arterial tone.
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Affiliation(s)
- Petteri Rinne
- From the Department of Pharmacology, Drug Development and Pharmaceutics (P.R., S.N., E.K., K.E.,E.S.), the Research Centre of Applied and Preventive Cardiovascular Medicine (A.A-O., O.T.R.), and Department of Pathology (K.K), University of Turku, Turku, Finland; Division of Medicine (M.J.), Department of Clinical Physiology and Nuclear Medicine (O.T.R), and the Unit of Clinical Pharmacology (E.S.), Turku University Hospital, Turku, Finland; Department of Clinical Physiology, University of Tampere
| | - Ari Ahola-Olli
- From the Department of Pharmacology, Drug Development and Pharmaceutics (P.R., S.N., E.K., K.E.,E.S.), the Research Centre of Applied and Preventive Cardiovascular Medicine (A.A-O., O.T.R.), and Department of Pathology (K.K), University of Turku, Turku, Finland; Division of Medicine (M.J.), Department of Clinical Physiology and Nuclear Medicine (O.T.R), and the Unit of Clinical Pharmacology (E.S.), Turku University Hospital, Turku, Finland; Department of Clinical Physiology, University of Tampere
| | - Salla Nuutinen
- From the Department of Pharmacology, Drug Development and Pharmaceutics (P.R., S.N., E.K., K.E.,E.S.), the Research Centre of Applied and Preventive Cardiovascular Medicine (A.A-O., O.T.R.), and Department of Pathology (K.K), University of Turku, Turku, Finland; Division of Medicine (M.J.), Department of Clinical Physiology and Nuclear Medicine (O.T.R), and the Unit of Clinical Pharmacology (E.S.), Turku University Hospital, Turku, Finland; Department of Clinical Physiology, University of Tampere
| | - Emilia Koskinen
- From the Department of Pharmacology, Drug Development and Pharmaceutics (P.R., S.N., E.K., K.E.,E.S.), the Research Centre of Applied and Preventive Cardiovascular Medicine (A.A-O., O.T.R.), and Department of Pathology (K.K), University of Turku, Turku, Finland; Division of Medicine (M.J.), Department of Clinical Physiology and Nuclear Medicine (O.T.R), and the Unit of Clinical Pharmacology (E.S.), Turku University Hospital, Turku, Finland; Department of Clinical Physiology, University of Tampere
| | - Katja Kaipio
- From the Department of Pharmacology, Drug Development and Pharmaceutics (P.R., S.N., E.K., K.E.,E.S.), the Research Centre of Applied and Preventive Cardiovascular Medicine (A.A-O., O.T.R.), and Department of Pathology (K.K), University of Turku, Turku, Finland; Division of Medicine (M.J.), Department of Clinical Physiology and Nuclear Medicine (O.T.R), and the Unit of Clinical Pharmacology (E.S.), Turku University Hospital, Turku, Finland; Department of Clinical Physiology, University of Tampere
| | - Kim Eerola
- From the Department of Pharmacology, Drug Development and Pharmaceutics (P.R., S.N., E.K., K.E.,E.S.), the Research Centre of Applied and Preventive Cardiovascular Medicine (A.A-O., O.T.R.), and Department of Pathology (K.K), University of Turku, Turku, Finland; Division of Medicine (M.J.), Department of Clinical Physiology and Nuclear Medicine (O.T.R), and the Unit of Clinical Pharmacology (E.S.), Turku University Hospital, Turku, Finland; Department of Clinical Physiology, University of Tampere
| | - Markus Juonala
- From the Department of Pharmacology, Drug Development and Pharmaceutics (P.R., S.N., E.K., K.E.,E.S.), the Research Centre of Applied and Preventive Cardiovascular Medicine (A.A-O., O.T.R.), and Department of Pathology (K.K), University of Turku, Turku, Finland; Division of Medicine (M.J.), Department of Clinical Physiology and Nuclear Medicine (O.T.R), and the Unit of Clinical Pharmacology (E.S.), Turku University Hospital, Turku, Finland; Department of Clinical Physiology, University of Tampere
| | - Mika Kähönen
- From the Department of Pharmacology, Drug Development and Pharmaceutics (P.R., S.N., E.K., K.E.,E.S.), the Research Centre of Applied and Preventive Cardiovascular Medicine (A.A-O., O.T.R.), and Department of Pathology (K.K), University of Turku, Turku, Finland; Division of Medicine (M.J.), Department of Clinical Physiology and Nuclear Medicine (O.T.R), and the Unit of Clinical Pharmacology (E.S.), Turku University Hospital, Turku, Finland; Department of Clinical Physiology, University of Tampere
| | - Terho Lehtimäki
- From the Department of Pharmacology, Drug Development and Pharmaceutics (P.R., S.N., E.K., K.E.,E.S.), the Research Centre of Applied and Preventive Cardiovascular Medicine (A.A-O., O.T.R.), and Department of Pathology (K.K), University of Turku, Turku, Finland; Division of Medicine (M.J.), Department of Clinical Physiology and Nuclear Medicine (O.T.R), and the Unit of Clinical Pharmacology (E.S.), Turku University Hospital, Turku, Finland; Department of Clinical Physiology, University of Tampere
| | - Olli T. Raitakari
- From the Department of Pharmacology, Drug Development and Pharmaceutics (P.R., S.N., E.K., K.E.,E.S.), the Research Centre of Applied and Preventive Cardiovascular Medicine (A.A-O., O.T.R.), and Department of Pathology (K.K), University of Turku, Turku, Finland; Division of Medicine (M.J.), Department of Clinical Physiology and Nuclear Medicine (O.T.R), and the Unit of Clinical Pharmacology (E.S.), Turku University Hospital, Turku, Finland; Department of Clinical Physiology, University of Tampere
| | - Eriika Savontaus
- From the Department of Pharmacology, Drug Development and Pharmaceutics (P.R., S.N., E.K., K.E.,E.S.), the Research Centre of Applied and Preventive Cardiovascular Medicine (A.A-O., O.T.R.), and Department of Pathology (K.K), University of Turku, Turku, Finland; Division of Medicine (M.J.), Department of Clinical Physiology and Nuclear Medicine (O.T.R), and the Unit of Clinical Pharmacology (E.S.), Turku University Hospital, Turku, Finland; Department of Clinical Physiology, University of Tampere
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