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Wellmann J, Wilms J, Hartmann B, Zirpel B, Brückner SI, Hillebrand S, Ley J, Winterhalter P. Novel α-glycosyl compounds from glycosylation of rubusoside. Food Chem 2023; 406:135033. [PMID: 36450197 DOI: 10.1016/j.foodchem.2022.135033] [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] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/11/2022] [Accepted: 11/20/2022] [Indexed: 11/27/2022]
Abstract
In this work we investigated mixtures from α-glycosylation of rubusoside with cyclodextrin glycosyltransferases. In addition to the previously known α-1,4 glycosylated derivatives, nine new compounds with rare α-1,3-glycosidic bonds were identified based on nuclear magnetic resonance spectroscopy and mass spectrometric analysis. Furthermore, sensory properties of monoglycosylated rubusoside derivatives were investigated and compared to previously described monoglycosylated compounds. Additionally, digestion with α-amylase from human saliva was investigated for different glycosylated rubusoside derivatives.
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Affiliation(s)
- J Wellmann
- Institute of Food Chemistry, Schleinitzstraße 20, 38106 Braunschweig, Germany.
| | - J Wilms
- Fresenius University of Applied Sciences, Limburger Straße 2, 65510 Idstein, Germany
| | - B Hartmann
- Symrise AG, Mühlenfeldstraße 1, 37603 Holzminden, Germany
| | - B Zirpel
- Symrise AG, Mühlenfeldstraße 1, 37603 Holzminden, Germany
| | - S I Brückner
- Symrise AG, Mühlenfeldstraße 1, 37603 Holzminden, Germany
| | - S Hillebrand
- Symrise AG, Mühlenfeldstraße 1, 37603 Holzminden, Germany
| | - J Ley
- Symrise AG, Mühlenfeldstraße 1, 37603 Holzminden, Germany
| | - P Winterhalter
- Institute of Food Chemistry, Schleinitzstraße 20, 38106 Braunschweig, Germany
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Moerschel K, De Bacquer D, De Backer G, Wood D, Kotseva K, Wellmann J, Prugger C. Predicting risk factor control in patients with coronary heart disease using patients' individual and large-area residential characteristics: results from the ESC-EORP EUROASPIRE V survey. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
The impact of small-area residential characteristics on the development of coronary heart disease (CHD) and cardiovascular risk factors is well established. Evidence is so far lacking on the predictive value of large-area residential characteristics for cardiovascular risk.
Purpose
In CHD patients, we aimed to study the predictive value of large-area residential characteristics beyond patients' individual characteristics for the control of major cardiovascular risk factors (blood pressure, cholesterol and smoking).
Methods
Patients hospitalised for coronary events or interventions from 16 European countries were interviewed and examined for risk factor control (EUROASPIRE V survey). Based on patients' postal codes, we merged individual patient data with large-area residential data routinely provided by Eurostat for NUTS regions (Nomenclature of Territorial Units for Statistics). We selected patient characteristics recorded at hospitalisation (2015–16) and socioeconomic characteristics of their residential NUTS 2 and 3 regions (2015–16) to predict risk factor control at interview (2016–17). We developed risk prediction models using multi-level logistic regression: 1) baseline models (BMs) with patient data only and 2) extended models (EMs) with patient data (level 1) and large-area residential data (level 2). We employed multiple imputation to overcome sparse data and internally validated results using cross-validation. We used the c-index corresponding to the area under the curve as performance measure to assess the discriminative ability of prediction models.
Results
Data from 2562 CHD patients in 16 countries could be linked to 60 NUTS 2 and 121 NUTS 3 regions by postal codes. Median time between hospitalisation and interview was 14 (range 6 to 28) months. BMs included 34 patient variables, covering demographic, socioeconomic and clinical characteristics, and EMs additionally included 11 regional socioeconomic variables concerning gross domestic product, income, education, occupation, population density, and health care. For blood pressure control, BMs and EMs showed validated c-indices ranging from 0.71 to 0.73 and from 0.73 to 0.77, respectively. Analyses for cholesterol control yielded c-indices ranging from 0.69 to 0.70 in BMs and from 0.71 to 0.73 in EMs. For smoking cessation, the c-indices ranged from 0.80 to 0.84 in BMs and from 0.83 to 0.84 in EMs.
Conclusions
Prediction models based on CHD patients' individual characteristics showed a high discriminative ability regarding the control of major cardiovascular risk factors. Further consideration of large-area residential characteristics provided an additive predictive value, markedly increasing the discriminative ability of prediction models for blood pressure and cholesterol control. Socioeconomic characteristics of CHD patients' residential regions can thus help identify patients requiring more intense risk factor management.
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): German Heart Foundation
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Affiliation(s)
- K Moerschel
- Charite - Universitaetsmedizin Berlin, Berlin, Germany
| | | | | | - D Wood
- Imperial College London, London, United Kingdom
| | - K Kotseva
- Imperial College London, London, United Kingdom
| | - J Wellmann
- Westfaelische Wilhelms-Universitaet Muenster, Muenster, Germany
| | - C Prugger
- Charite - Universitaetsmedizin Berlin, Berlin, Germany
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Neuner B, Busch M, Wellmann J, Nowak-Göttl U, Hense HW. Sense of coherence as a predictor of quality of life in adolescents with congenital heart defects: A register-based 1-year follow-up study. Eur Psychiatry 2020. [DOI: 10.1016/s0924-9338(11)72267-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
ObjectiveSense of coherence (SOC) is a resource for health and quality of life (QoL) in adults. Aim of this investigation was to evaluate the association of SOC and QoL in adolescents with congenital heart defects (CHD).MethodObservational study among 770 adolescents aged 14 – 17 years from a national CHD register. SOC was measured at baseline with the SOC-L9 questionnaire. At baseline and at 12-months follow-up, QoL was measured with the KINDL-R questionnaire, evaluating overall well-being and six subscales. The association of SOC with QoL was evaluated in multi-level linear models separately for overall well-being and KINDL-R subscales. Initial models comprised SOC as only fixed effect while the final models were adjusted for age, gender, medical and socioeconomic status and behavioral factors.ResultsOverall well-being, self-esteem and school-related well-being was significantly higher at follow-up compared with baseline. SOC at baseline (median 50 [range: 16 – 63] points) was positively associated with overall well-being and all KINDL-R subscales. There were significant negative interactions between SOC at baseline and time to follow-up for overall well-being and all KINDL-R subscales except psychological well-being. But even in fully adjusted models associations of SOC at baseline with overall well-being and all KINDL-R subscales at follow-up remained significant.ConclusionSOC is an independent predictor of QoL in adolescents with CHD. Except for psychological well-being, this effect attenuates over one year but remains positive inoverall QoL and sub-dimensions. Further studies should evaluate whether interventions aimed to increase SOC in children with CHD improve QoL.
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Abstract
Summary
Objectives:
According to results from the epidemiological literature, it can be expected that the prevalence odds ratio (POR) and the prevalence ratio (PR) differ with increasing disease prevalence. We illustrate different concepts to calculate these effect measures in cross-sectional studies and discuss their advantages and weaknesses, using actual data from the ISAAC Phase III cross-sectional survey in Münster, Germany.
Methods:
We analyzed data on the association between self-reported traffic density and wheeze and asthma by means of the POR, obtained from a logistic regression, and the PR, which was estimated from a log-linear binomial model and from different variants of a Poisson regression.
Results:
The analysis based on the less frequent disease, i.e. asthma with an overall prevalence of 7.8%, yielded similar results for all estimates. When wheezing with a prevalence of 17.5% was analyzed, the POR produced the highest estimates with the widest confidence intervals. While the point estimates were similar in the log-binomial model and Poisson regression, the latter showed wider confidence intervals. When we calculated the Poisson regression with robust variances, confidence intervals narrowed.
Conclusions:
Since cross-sectional studies often deal with frequent diseases, we encourage analyzing cross-sectional data based on log-linear binomial models, which is the ‘natural method’ for estimating prevalence ratios. If algorithms fail to converge, a useful alternative is to define appropriate starting values or, if models still do not converge, to calculate a Poisson regression with robust estimates to control for overestimation of errors in the binomial data.
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Nashef A, Qabaja R, Salaymeh Y, Botzman M, Munz M, Dommisch H, Krone B, Hoffmann P, Wellmann J, Laudes M, Berger K, Kocher T, Loos B, van der Velde N, Uitterlinden AG, de Groot LCPGM, Franke A, Offenbacher S, Lieb W, Divaris K, Mott R, Gat-Viks I, Wiess E, Schaefer A, Iraqi FA, Haddad YH. Integration of Murine and Human Studies for Mapping Periodontitis Susceptibility. J Dent Res 2018; 97:537-546. [PMID: 29294296 DOI: 10.1177/0022034517744189] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Periodontitis is one of the most common inflammatory human diseases with a strong genetic component. Due to the limited sample size of available periodontitis cohorts and the underlying trait heterogeneity, genome-wide association studies (GWASs) of chronic periodontitis (CP) have largely been unsuccessful in identifying common susceptibility factors. A combination of quantitative trait loci (QTL) mapping in mice with association studies in humans has the potential to discover novel risk loci. To this end, we assessed alveolar bone loss in response to experimental periodontal infection in 25 lines (286 mice) from the Collaborative Cross (CC) mouse population using micro-computed tomography (µCT) analysis. The orthologous human chromosomal regions of the significant QTL were analyzed for association using imputed genotype data (OmniExpress BeadChip arrays) derived from case-control samples of aggressive periodontitis (AgP; 896 cases, 7,104 controls) and chronic periodontitis (CP; 2,746 cases, 1,864 controls) of northwest European and European American descent, respectively. In the mouse genome, QTL mapping revealed 2 significant loci (-log P = 5.3; false discovery rate = 0.06) on chromosomes 1 ( Perio3) and 14 ( Perio4). The mapping resolution ranged from ~1.5 to 3 Mb. Perio3 overlaps with a previously reported QTL associated with residual bone volume in F2 cross and includes the murine gene Ccdc121. Its human orthologue showed previously a nominal significant association with CP in humans. Use of variation data from the genomes of the CC founder strains further refined the QTL and suggested 7 candidate genes ( CAPN8, DUSP23, PCDH17, SNORA17, PCDH9, LECT1, and LECT2). We found no evidence of association of these candidates with the human orthologues. In conclusion, the CC populations enabled mapping of confined QTL that confer susceptibility to alveolar bone loss in mice and larger human phenotype-genotype samples and additional expression data from gingival tissues are likely required to identify true positive signals.
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Affiliation(s)
- A Nashef
- 1 Department of Prosthodontics, Hadassah Faculty of Dental Medicine, Hebrew University, Jerusalem, Israel
| | - R Qabaja
- 1 Department of Prosthodontics, Hadassah Faculty of Dental Medicine, Hebrew University, Jerusalem, Israel
| | - Y Salaymeh
- 2 Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - M Botzman
- 3 Department of Cell Research and Immunology, George S. Wise Faculty of Life Sciences, Tel Aviv University, Tel Aviv, Israel
| | - M Munz
- 4 Department of Periodontology and Synoptic Medicine, Institute for Dental and Craniofacial Sciences, Charité-University Medicine Berlin, Berlin, Germany
- 5 Institute for Integrative and Experimental Genomics, University Medical Center Schleswig-Holstein-Campus, Lübeck, Germany
| | - H Dommisch
- 4 Department of Periodontology and Synoptic Medicine, Institute for Dental and Craniofacial Sciences, Charité-University Medicine Berlin, Berlin, Germany
| | - B Krone
- 6 Institute of Medical Informatics, Biometry and Epidemiology, University Clinic Essen, Essen, Germany
| | - P Hoffmann
- 7 Institute of Human Genetics, University of Bonn, Bonn, Germany
- 8 Germany und Human Genomics Research Group, Department of Biomedicine, University Hospital of Basel, Basel, Switzerland
| | - J Wellmann
- 9 Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - M Laudes
- 10 Clinic of Internal Medicine, University Clinic Schleswig-Holstein, Kiel, Germany
| | - K Berger
- 9 Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - T Kocher
- 11 Unit of Periodontology, Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pedodontics, Dental School, University Medicine Greifswald, Greifswald, Germany
| | - B Loos
- 12 Department of Periodontology and Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands
| | - N van der Velde
- 13 Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
- 14 Department of Internal Medicine Section of Geriatrics, Amsterdam Medical Center, Amsterdam, the Netherlands
| | - A G Uitterlinden
- 13 Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | - L C P G M de Groot
- 15 Department of Epidemiology and the EMGO Institute of Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - A Franke
- 16 Institute of Clinical Molecular Biology, Christian-Albrechts-University, Kiel, Germany
| | - S Offenbacher
- 17 School of Dentistry, Department of Periodontology, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | - W Lieb
- 18 Institute of Epidemiology, Biobank popgen, Christian-Albrechts-University, Kiel, Germany
| | - K Divaris
- 19 Gillings School of Global Public Health, Department of Epidemiology, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
- 20 School of Dentistry, Department of Pediatric Dentistry, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | - R Mott
- 21 Genetics Institute, University Collage of London, London, UK
| | - I Gat-Viks
- 3 Department of Cell Research and Immunology, George S. Wise Faculty of Life Sciences, Tel Aviv University, Tel Aviv, Israel
| | - E Wiess
- 22 Maurice and Gabriella Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A Schaefer
- 4 Department of Periodontology and Synoptic Medicine, Institute for Dental and Craniofacial Sciences, Charité-University Medicine Berlin, Berlin, Germany
| | - F A Iraqi
- 2 Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Y H Haddad
- 1 Department of Prosthodontics, Hadassah Faculty of Dental Medicine, Hebrew University, Jerusalem, Israel
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Simbrich A, Wellmann J, Kajüter H, Heidinger O, Hense HW. Ursachenspezifische Mortalität im Kontext konkurrierender Ereignisse am Beispiel Kolorektaler Karzinome. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- A Simbrich
- Westfälische Wilhelms-Universität Münster, Institut für Epidemiologie und Sozialmedizin, Münster
| | - J Wellmann
- Westfälische Wilhelms-Universität Münster, Institut für Epidemiologie und Sozialmedizin, Münster
| | - H Kajüter
- Landeskrebsregister NRW gGmbH, Münster
| | | | - HW Hense
- Westfälische Wilhelms-Universität Münster, Institut für Epidemiologie und Sozialmedizin, Münster
- Landeskrebsregister NRW gGmbH, Münster
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7
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Shusterman A, Munz M, Richter G, Jepsen S, Lieb W, Krone B, Hoffman P, Laudes M, Wellmann J, Berger K, Kocher T, Offenbacher S, Divaris K, Franke A, Schreiber S, Dommisch H, Weiss E, Schaefer AS, Houri-Haddad Y, Iraqi FA. The PF4/PPBP/CXCL5 Gene Cluster Is Associated with Periodontitis. J Dent Res 2017; 96:945-952. [PMID: 28467728 DOI: 10.1177/0022034517706311] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Periodontitis is a common dysbiotic inflammatory disease with an estimated heritability of 50%. Due to the limited sample size of available periodontitis cohorts and the underlying trait heterogeneity, genome-wide association studies (GWAS) of chronic periodontitis (CP) have been unsuccessful in discovering susceptibility factors. A strategy that combines agnostic GWAS with a well-powered candidate-gene approach has the potential to discover novel loci. We combined RNA-seq data from gingival tissues with quantitative trait loci (QTLs) that were identified in a F2-cross of mice resistant and susceptible to infection with oral bacterial pathogens. Four genes, which were located within the mapped QTLs, showed differential expression. The chromosomal regions across the human orthologous were interrogated for putative periodontitis-associated variants using existing GWAS data from a German case-control sample of aggressive periodontitis (AgP; 651 cases, 4,001 controls), the most severe and early onset form of periodontitis. Two haplotype blocks, one upstream to the coding region of UGT2A1 (rs146712414, P = 9.1 × 10-5; odds ratio [OR], 1.34; 95% confidence interval [CI], 1.16-1.56) and one downstream of the genes PF4/PPBP/CXCL5 (rs1595009, P = 1.3 × 10-4; OR, 1.32; 95% CI, 1.15-1.52), were associated with AgP. The association of rs1595009 was validated in an independent cohort of CP of European Americans (1,961 cases and 1,864 controls; P = 0.03; OR, 1.45; 95% CI, 1.01-1.29). This association was further replicated in another sample of 399 German CP cases (disease onset <60 y of age) and 1,633 controls ( P = 0.03; OR, 1.75; 95% CI, 1.06-2.90). The combined estimates of association from all samples were P = 2.9 × 10-5 (OR, 1.2; 95% CI, 1.1-1.3). This study shows the strength of combining QTL mapping and RNA-Seq data from a mouse model with association studies in human case-control samples to identify genetic risk variants of periodontitis.
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Affiliation(s)
- A Shusterman
- 1 Department of Prosthodontics, Hadassah Faculty of Dental Medicine, Hebrew University, Jerusalem, Israel
| | - M Munz
- 2 Department of Periodontology and Synoptic Medicine, Institute for Dental and Craniofacial Sciences, Charité-University Medicine Berlin, Berlin, Germany
- 3 Institute for Integrative and Experimental Genomics, University Medical Center Schleswig-Holstein-Campus Lübeck, Lübeck, Germany
| | - G Richter
- 2 Department of Periodontology and Synoptic Medicine, Institute for Dental and Craniofacial Sciences, Charité-University Medicine Berlin, Berlin, Germany
| | - S Jepsen
- 4 Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
| | - W Lieb
- 5 Institute of Epidemiology, Biobank popgen, Christian-Albrechts-University, Kiel, Germany
| | - B Krone
- 6 Institute of Medical Informatics, Biometry and Epidemiology, University Clinic Essen, Essen, Germany
| | - P Hoffman
- 7 Institute of Human Genetics, University of Bonn, Bonn, Germany
- 8 Germany und Human Genomics Research Group, Department of Biomedicine, University Hospital of Basel, Basel, Switzerland
| | - M Laudes
- 9 Clinic of Internal Medicine, University Clinic Schleswig-Holstein, Kiel, Germany
| | - J Wellmann
- 10 Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - K Berger
- 10 Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - T Kocher
- 11 Unit of Periodontology, Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pedodontics, Dental School, University Medicine Greifswald, Greifswald, Germany
| | - S Offenbacher
- 12 University of North Carolina-Chapel Hill, School of Dentistry, Department of Periodontology, Chapel Hill, NC, USA
| | - K Divaris
- 13 University of North Carolina-Chapel Hill, School of Dentistry, Department of Pediatric Dentistry, Chapel Hill, NC, USA
- 14 University of North Carolina-Chapel Hill, Gillings School of Global Public Health, Department of Epidemiology, Chapel Hill, NC, USA
| | - A Franke
- 15 Institute of Clinical Molecular Biology, Christian-Albrechts-University, Kiel, Germany
| | - S Schreiber
- 9 Clinic of Internal Medicine, University Clinic Schleswig-Holstein, Kiel, Germany
- 15 Institute of Clinical Molecular Biology, Christian-Albrechts-University, Kiel, Germany
| | - H Dommisch
- 2 Department of Periodontology and Synoptic Medicine, Institute for Dental and Craniofacial Sciences, Charité-University Medicine Berlin, Berlin, Germany
| | - E Weiss
- 16 Maurice and Gabriella Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A S Schaefer
- 2 Department of Periodontology and Synoptic Medicine, Institute for Dental and Craniofacial Sciences, Charité-University Medicine Berlin, Berlin, Germany
| | - Y Houri-Haddad
- 1 Department of Prosthodontics, Hadassah Faculty of Dental Medicine, Hebrew University, Jerusalem, Israel
| | - F A Iraqi
- 17 Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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8
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Demirkan A, Lahti J, Direk N, Viktorin A, Lunetta KL, Terracciano A, Nalls MA, Tanaka T, Hek K, Fornage M, Wellmann J, Cornelis MC, Ollila HM, Yu L, Smith JA, Pilling LC, Isaacs A, Palotie A, Zhuang WV, Zonderman A, Faul JD, Sutin A, Meirelles O, Mulas A, Hofman A, Uitterlinden A, Rivadeneira F, Perola M, Zhao W, Salomaa V, Yaffe K, Luik AI, Liu Y, Ding J, Lichtenstein P, Landén M, Widen E, Weir DR, Llewellyn DJ, Murray A, Kardia SLR, Eriksson JG, Koenen K, Magnusson PKE, Ferrucci L, Mosley TH, Cucca F, Oostra BA, Bennett DA, Paunio T, Berger K, Harris TB, Pedersen NL, Murabito JM, Tiemeier H, van Duijn CM, Räikkönen K. Somatic, positive and negative domains of the Center for Epidemiological Studies Depression (CES-D) scale: a meta-analysis of genome-wide association studies. Psychol Med 2016; 46:1613-1623. [PMID: 26997408 PMCID: PMC5812462 DOI: 10.1017/s0033291715002081] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is moderately heritable, however genome-wide association studies (GWAS) for MDD, as well as for related continuous outcomes, have not shown consistent results. Attempts to elucidate the genetic basis of MDD may be hindered by heterogeneity in diagnosis. The Center for Epidemiological Studies Depression (CES-D) scale provides a widely used tool for measuring depressive symptoms clustered in four different domains which can be combined together into a total score but also can be analysed as separate symptom domains. METHOD We performed a meta-analysis of GWAS of the CES-D symptom clusters. We recruited 12 cohorts with the 20- or 10-item CES-D scale (32 528 persons). RESULTS One single nucleotide polymorphism (SNP), rs713224, located near the brain-expressed melatonin receptor (MTNR1A) gene, was associated with the somatic complaints domain of depression symptoms, with borderline genome-wide significance (p discovery = 3.82 × 10-8). The SNP was analysed in an additional five cohorts comprising the replication sample (6813 persons). However, the association was not consistent among the replication sample (p discovery+replication = 1.10 × 10-6) with evidence of heterogeneity. CONCLUSIONS Despite the effort to harmonize the phenotypes across cohorts and participants, our study is still underpowered to detect consistent association for depression, even by means of symptom classification. On the contrary, the SNP-based heritability and co-heritability estimation results suggest that a very minor part of the variation could be captured by GWAS, explaining the reason of sparse findings.
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Affiliation(s)
- A. Demirkan
- Genetic Epidemiology Unit, Departments of Epidemiology and Clinical Genetics, Erasmus MC, Rotterdam, The Netherlands
| | - J. Lahti
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
| | - N. Direk
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - A. Viktorin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - K. L. Lunetta
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - A. Terracciano
- National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
- College of Medicine, Florida State University, Tallahassee, FL, USA
| | - M. A. Nalls
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - T. Tanaka
- National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - K. Hek
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- Department of Psychiatry, Epidemiological and Social Psychiatric Research Institute, Erasmus MC, Rotterdam, The Netherlands
| | - M. Fornage
- Houston Institute of Molecular Medicine, University of Texas, Houston, TX, USA
| | - J. Wellmann
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - M. C. Cornelis
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - H. M. Ollila
- Public Health Genomics Unit and Institute for Molecular Medicine Finland (FIMM), National Institute for Health and Welfare, Helsinki, Finland
| | - L. Yu
- Department of Neurological Sciences, Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - J. A. Smith
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | | | - A. Isaacs
- Genetic Epidemiology Unit, Departments of Epidemiology and Clinical Genetics, Erasmus MC, Rotterdam, The Netherlands
| | - A. Palotie
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Cambridge, UK
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - W. V. Zhuang
- Department of Preventive Medicine and Public Health, School of Medicine, Creighton University, Omaha, NE, USA
| | - A. Zonderman
- National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - J. D. Faul
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - A. Sutin
- National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - O. Meirelles
- National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - A. Mulas
- Istituto di Ricerca Genetica e Biomedica, CNR, Monserrato, Cagliari, Italy
| | - A. Hofman
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - A. Uitterlinden
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- Member of Netherlands Consortium for Healthy Aging sponsored by Netherlands Genomics Initiative, Leiden, The Netherlands
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - F. Rivadeneira
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- Member of Netherlands Consortium for Healthy Aging sponsored by Netherlands Genomics Initiative, Leiden, The Netherlands
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - M. Perola
- Public Health Genomics Unit and Institute for Molecular Medicine Finland (FIMM), National Institute for Health and Welfare, Helsinki, Finland
| | - W. Zhao
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - V. Salomaa
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
| | - K. Yaffe
- Departments of Psychiatry, University of California, San Francisco, CA, USA
| | - A. I. Luik
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - NABEC
- North American Brain Expression Consortium, USA
| | - UKBEC
- UK Brain Expression Consortium, UK
| | - Y. Liu
- Center for Human Genomics, Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, USA
| | - J. Ding
- Geriatrics & Gerontology, Sticht Center on Aging, Wake Forest University, Primate Center, Epidemiology & Prevention, Winston-Salem, NC, USA
| | - P. Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - M. Landén
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - E. Widen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - D. R. Weir
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | | | - A. Murray
- University of Exeter Medical School, Exeter, UK
| | - S. L. R. Kardia
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - J. G. Eriksson
- National Institute for Health and Welfare, Helsinki, Finland
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - K. Koenen
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - P. K. E. Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - L. Ferrucci
- National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - T. H. Mosley
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - F. Cucca
- Istituto di Ricerca Genetica e Biomedica, CNR, Monserrato, Cagliari, Italy
| | - B. A. Oostra
- Genetic Epidemiology Unit, Departments of Epidemiology and Clinical Genetics, Erasmus MC, Rotterdam, The Netherlands
- Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - D. A. Bennett
- Department of Neurological Sciences, Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - T. Paunio
- Public Health Genomics Unit and Institute for Molecular Medicine Finland (FIMM), National Institute for Health and Welfare, Helsinki, Finland
| | - K. Berger
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - T. B. Harris
- Laboratory of Epidemiology, Demography, and Biometry, National Institute on Ageing, National Institutes of Health, Bethesda, MD, USA
| | - N. L. Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - J. M. Murabito
- Department of Medicine, Section of General Internal Medicine, Boston University School of Medicine, Boston, MA, USA
| | - H. Tiemeier
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - C. M. van Duijn
- Genetic Epidemiology Unit, Departments of Epidemiology and Clinical Genetics, Erasmus MC, Rotterdam, The Netherlands
- Member of Netherlands Consortium for Healthy Aging sponsored by Netherlands Genomics Initiative, Leiden, The Netherlands
| | - K. Räikkönen
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
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9
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Boniol M, Koechlin A, Świątkowska B, Sorahan T, Wellmann J, Taeger D, Jakobsson K, Pira E, Boffetta P, La Vecchia C, Pizot C, Boyle P. Cancer mortality in cohorts of workers in the European rubber manufacturing industry first employed since 1975. Ann Oncol 2016; 27:933-41. [PMID: 26884594 DOI: 10.1093/annonc/mdw061] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 02/08/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Increased cancer risk has been reported among workers in the rubber manufacturing industry employed before the 1960s. It is unclear whether risk remains increased among workers hired subsequently. The present study focused on risk of cancer mortality for rubber workers first employed since 1975 in 64 factories. PATIENTS AND METHODS Anonymized data from cohorts of rubber workers employed for at least 1 year from Germany, Italy, Poland, Sweden, and the UK were pooled. Standardized mortality ratios (SMRs), based on country-specific death rates, were reported for bladder and lung cancer (primary outcomes of interest), for other selected cancer sites, and for cancer sites with a minimum of 10 deaths in men or women. Analyses stratified by type of industry, period, and duration of employment were carried out. RESULTS A total of 38 457 individuals (29 768 men; 8689 women) contributed to 949 370 person-years. No increased risk of bladder cancer was observed [SMR = 0.80, 95% confidence interval (CI) 0.46; 1.38]. The risk of lung cancer death was reduced (SMR = 0.81, 95% CI 0.70; 0.94). No statistically significant increased risk was observed for any other cause of death. A reduced risk was evident for total cancer mortality (SMR = 0.81, 95% CI 0.76; 0.87). Risks were lower for workers in the tyre industry compared with workers in the general rubber goods sector. Analysis by employment duration showed a negative trend with SMRs decreasing with increasing duration of employment. In an analysis of secondary end points, when stratified by type of industry and period of first employment, excess risks of myeloma and gastric cancer were observed each due, essentially, to results from one centre. CONCLUSION No consistent increased risk of cancer death was observed among rubber workers first employed since 1975, no overall analysis of the pooled cohort produced significantly increased risk. Continued surveillance of the present cohorts is required to confirm the absence of long-term risk.
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Affiliation(s)
- M Boniol
- University of Strathclyde Institute of Global Public Health, Lyon ouest Ecully International Prevention Research Institute, iPRI, Lyon, France
| | - A Koechlin
- University of Strathclyde Institute of Global Public Health, Lyon ouest Ecully International Prevention Research Institute, iPRI, Lyon, France
| | - B Świątkowska
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - T Sorahan
- Institute of Occupational and Environmental Medicine, University of Birmingham, Birmingham, UK
| | - J Wellmann
- Institute of Epidemiology and Social Medicine, University of Muenster, Münster, Germany
| | - D Taeger
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bochum, Germany
| | - K Jakobsson
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - E Pira
- Department of Public Health Sciences and Pediatrics, University of Turin, Turin, Italy
| | - P Boffetta
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, USA
| | - C La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - C Pizot
- International Prevention Research Institute, iPRI, Lyon, France
| | - P Boyle
- University of Strathclyde Institute of Global Public Health, Lyon ouest Ecully International Prevention Research Institute, iPRI, Lyon, France
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10
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Müller G, Wellmann J, Hartwig S, Greiser KH, Moebus S, Jöckel KH, Schipf S, Völzke H, Maier W, Meisinger C, Tamayo T, Rathmann W, Berger K. Association of neighbourhood unemployment rate with incident Type 2 diabetes mellitus in five German regions. Diabet Med 2015; 32:1017-22. [PMID: 25440771 DOI: 10.1111/dme.12652] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/25/2014] [Indexed: 01/28/2023]
Abstract
AIM To analyse the association of neighbourhood unemployment with incident self-reported physician-diagnosed Type 2 diabetes in a population aged 45-74 years from five German regions. METHODS Study participants were linked via their addresses at baseline to particular neighbourhoods. Individual-level data from five population-based studies were pooled and combined with contextual data on neighbourhood unemployment. Type 2 diabetes was assessed according to a self-reported physician diagnosis of diabetes. We estimated proportional hazard models (Weibull distribution) in order to obtain hazard ratios and 95% CIs of Type 2 diabetes mellitus, taking into account interval-censoring and clustering. RESULTS We included 7250 participants residing in 228 inner city neighbourhoods in five German regions in our analysis. The incidence rate was 12.6 per 1000 person-years (95% CI 11.4-13.8). The risk of Type 2 diabetes mellitus was higher in men [hazard ratio 1.79 (95% CI 1.47-2.18)] than in women and higher in people with a low education level [hazard ratio 1.55 (95% CI 1.18-2.02)] than in those with a high education level. Independently of individual-level characteristics, we found a higher risk of Type 2 diabetes mellitus in neighbourhoods with high levels of unemployment [quintile 5; hazard ratio 1.72 (95% CI 1.23-2.42)] than in neighbourhoods with low unemployment (quintile 1). CONCLUSIONS Low education level and high neighbourhood unemployment were independently associated with an elevated risk of Type 2 diabetes mellitus. Studies examining the impact of the residential environment on Type 2 diabetes mellitus will provide knowledge that is essential for the identification of high-risk populations.
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Affiliation(s)
- G Müller
- Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany
| | - J Wellmann
- Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany
| | - S Hartwig
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - K H Greiser
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- Division of Cancer Epidemiology, German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - S Moebus
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
| | - K-H Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
| | - S Schipf
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - H Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- German Centre of Cardiovascular Research, Site Greifswald, Germany
| | - W Maier
- Helmholtz Zentrum München, German Research Centre for Environmental Health, Institute of Health Economics and Health Care Management, Neuherberg, Germany
| | - C Meisinger
- Helmholtz Zentrum München, German Research Centre for Environmental Health, Institute of Epidemiology II, Neuherberg, Germany
| | - T Tamayo
- Institute of Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany
| | - W Rathmann
- Institute of Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany
| | - K Berger
- Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany
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11
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Geier AS, Wellmann I, Wellmann J, Kajüter H, Heidinger O, Hempel G, Hense HW. Patterns and determinants of new first-line antihyperglycaemic drug use in patients with type 2 diabetes mellitus. Diabetes Res Clin Pract 2014; 106:73-80. [PMID: 25139631 DOI: 10.1016/j.diabres.2014.07.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 04/16/2014] [Accepted: 07/20/2014] [Indexed: 01/13/2023]
Abstract
AIMS We evaluated the patterns and determinants that influence the selection, timing and duration of first-line antihyperglycaemic drug (AHD) treatment in patients with type 2 diabetes in Germany, focusing specifically on treatment-naive AHD initiators. METHODS Pharmacy dispensing claims data were linked with a cohort of patients newly enrolled in a German Disease Management Program for type 2 diabetes (DMP-DM2) between 2003 and 2009. We examined uptake of first-line pharmacotherapy in previously unmedicated patients and identified predictors of receiving AHD therapy in general and metformin in particular using multivariable regression analyses. RESULTS There were 27,138 unmedicated patients with type 2 diabetes and 47.0% of them were started on AHD treatment within 5 years after enrollment. Initial severity of diabetes was the major predictor of receiving first-line pharmacotherapy. Metformin accounted for 63% of newly prescribed AHD in 2003 and more than 80% in 2009 while sulfonylureas accounted for only 10%. Initiating metformin as first-line AHD was associated with younger age, higher BMI, lower HbA1c, and shorter diabetes duration (multivariate p<0.001 for all). Therapy switch or step-up was less frequent among metformin initiators than sulfonylurea initiators. CONCLUSIONS The majority of patients were not started on AHD therapy within 5 years after enrollment. In line with recent therapy guidelines, current first-line antihyperglycaemic treatment was increasingly based on metformin. AHD initiators started on sulfonylurea were generally more advanced in their disease and were started later on primary pharmacotherapy.
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Affiliation(s)
- A S Geier
- Institute of Epidemiology and Social Medicine, Westfälische Wilhelms-Universität Münster, Albert-Schweitzer-Campus 1 D3, 48149 Münster, Germany.
| | - I Wellmann
- Institute of Epidemiology and Social Medicine, Westfälische Wilhelms-Universität Münster, Albert-Schweitzer-Campus 1 D3, 48149 Münster, Germany
| | - J Wellmann
- Institute of Epidemiology and Social Medicine, Westfälische Wilhelms-Universität Münster, Albert-Schweitzer-Campus 1 D3, 48149 Münster, Germany
| | - H Kajüter
- Epidemiological Cancer Registry of North Rhine-Westphalia, Münster, Germany
| | - O Heidinger
- Epidemiological Cancer Registry of North Rhine-Westphalia, Münster, Germany
| | - G Hempel
- Institute of Pharmaceutical and Medical Chemistry, University of Münster, Germany
| | - H W Hense
- Institute of Epidemiology and Social Medicine, Westfälische Wilhelms-Universität Münster, Albert-Schweitzer-Campus 1 D3, 48149 Münster, Germany; Epidemiological Cancer Registry of North Rhine-Westphalia, Münster, Germany
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12
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Geier AS, Wellmann J, Wellmann I, Kajüter H, Heidinger O, Hempel G, Hense HW. Cancer detection rates following enrolment in a disease management programme for type 2 diabetes. Diabetologia 2013; 56:1944-8. [PMID: 23722623 DOI: 10.1007/s00125-013-2947-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Accepted: 04/26/2013] [Indexed: 01/10/2023]
Abstract
AIMS/HYPOTHESIS Recent prospective studies found an elevated cancer risk shortly after diabetes diagnosis, and this was probably due to increased ascertainment. This study investigated whether site-specific cancer risks are also raised following enrolment in a disease management programme for type 2 diabetes mellitus (DMP-DM2). METHODS We linked records from a DMP-DM2 to population cancer registry data. The study period was from June 2003 to December 2009. Standardised incidence ratios (SIRs) were calculated for time intervals following DMP enrolment using the cancer incidence rates of the general source population. Additionally, Poisson regression with natural splines was used to assess time-dependent cancer incidence by diabetes duration. RESULTS There were 2,034 first invasive cancer cases identified over 163,738 person-years of follow-up. Pancreatic cancer risk was significantly increased mainly in the first year after enrolment (SIR 1.62); the increment was only seen for patients in whom diabetes had been diagnosed less than 1 year before DMP-DM2 enrolment. Risk of endometrial cancer was similarly raised in the first year after DMP-DM2 enrolment among individuals newly diagnosed with diabetes but decreased rapidly thereafter. There was no time dependence in the incidence of cancers of the liver, lung, colon, breast and prostate. CONCLUSIONS/INTERPRETATION Enrolment in a DMP-DM2 did not appear to induce ascertainment bias for most cancers. Cancer risks were initially increased, especially for pancreatic cancer, potentially as a result of reverse causality. Ascertainment bias and time-dependent incidence of cancer appear to be less of a problem in settings using DMP-like structures for the study of the association between diabetes duration, glucose-lowering medication and cancer incidence.
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Affiliation(s)
- A S Geier
- Institute of Epidemiology and Social Medicine, Westfälische Wilhelms-Universität Münster, Albert-Schweitzer-Campus 1 D3, 48149 Münster, Germany.
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13
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Hense HW, Kalueter H, Wellmann J, Batzler WU. O4-4.3 Cancer incidence and insulin therapy in a cohort of diabetic patients. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976b.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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14
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Markus MRP, Stritzke J, Wellmann J, Duderstadt S, Siewert U, Lieb W, Luchner A, Döring A, Keil U, Schunkert H, Hense HW. Implications of prevalent and incident diabetes mellitus on left ventricular geometry and function in the ageing heart: the MONICA/KORA Augsburg cohort study. Nutr Metab Cardiovasc Dis 2011; 21:189-196. [PMID: 19939647 DOI: 10.1016/j.numecd.2009.09.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2008] [Revised: 06/04/2009] [Accepted: 09/10/2009] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND AIM It is unclear to what extent diabetes modulates the ageing-related adaptations of cardiac geometry and function. METHODS AND RESULTS We examined 1005 adults, aged 25-74 years, from a population-based survey at baseline in 1994/5 and at follow-up in 2004/5. We compared persistently non-diabetic individuals (ND; no diabetes at baseline and at follow-up, n=833) with incident (ID; non-diabetic at baseline and diabetic at follow-up, n=36) and with prevalent diabetics (PD; diabetes at baseline and follow-up examination, n=21). Left ventricular (LV) geometry and function were evaluated by echocardiography. Statistical analyses were performed with multivariate linear regression models. Over ten years the PD group displayed a significantly stronger relative increase of LV mass (+9.34% vs. +23.7%) that was mediated by a more pronounced increase of LV end-diastolic diameter (+0% vs. +6.95%) compared to the ND group. In parallel, LA diameter increased (+4.50% vs. +12.7%), whereas ejection fraction decreased (+3.02% vs. -4.92%) more significantly in the PD group. Moreover, at the follow-up examination the PD and ID groups showed a significantly worse diastolic function, indicated by a higher E/EM ratio compared with the ND group (11.6 and 11.8 vs. 9.79, respectively). CONCLUSIONS Long-standing diabetes was associated with an acceleration of age-related changes of left ventricular geometry accumulating in an eccentric remodelling of the left ventricle. Likewise, echocardiographic measures of systolic and diastolic ventricular function deteriorated more rapidly in individuals with diabetes.
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Affiliation(s)
- M R Paulista Markus
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
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15
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Neuner B, Busch M, Wellmann J, Berger K. Die Assoziation von depressiven Symptomen und soziökonomischen Wohnumfeldindikatoren mit Bewegungsmangel: eine populationsbezogene kleinräumige Analyse in der Stadt Dortmund. Gesundheitswesen 2010. [DOI: 10.1055/s-0030-1266328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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16
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Farwick A, Wellmann J, Stoll M, Berger K. Kombination von genetischen Varianten erhöht das individuelle Schlaganfallrisiko. Gesundheitswesen 2010. [DOI: 10.1055/s-0030-1266731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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17
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Ertmer C, Rehberg S, Morelli A, Kampmeier TG, Wellmann J, Volkert T, Lange M, Hüsing AK, Van Aken H, Westphal M. Are different hydroxyethyl starch solutions an independent risk factor for acute kidney injury in surgical critically ill patients? A retrospective analysis of 3,591 patients. Crit Care 2010. [PMCID: PMC2934326 DOI: 10.1186/cc8737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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18
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Minnerup J, Heidrich J, Wellmann J, Rogalewski A, Schäbitz W. Die Wirkung hämatopoetischer Wachstumsfaktoren auf die funktionelle Erholung nach einem Schlaganfall – eine Meta-Analyse experimenteller Studien am Beispiel von G-CSF. Akt Neurol 2008. [DOI: 10.1055/s-0028-1086527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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19
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Reinecke H, Fobker M, Wellmann J, Becke B, Fleiter J, Heitmeyer C, Breithardt G, Hense HW, Schaefer RM. A randomized controlled trial comparing hydration therapy to additional hemodialysis or N-acetylcysteine for the prevention of contrast medium-induced nephropathy: the Dialysis-versus-Diuresis (DVD) Trial. Clin Res Cardiol 2006; 96:130-9. [PMID: 17180572 DOI: 10.1007/s00392-007-0473-4] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2006] [Accepted: 10/20/2006] [Indexed: 12/18/2022]
Abstract
Contrast medium-induced nephropathy (CIN) is a serious complication with increasing frequency and an unfavorable prognosis. Previous analyses of surrogate parameters have suggested beneficial effects of hemodialysis that are assessed in this randomized clinical trial. We performed a prospective single-center trial in 424 consecutive patients with serum creatinine concentrations between 1.3- 3.5 mg/dl who underwent elective coronary angiography. Patients were randomized to one of three treatment strategies with all patients receiving pre- and postprocedural hydration: One group received no additional therapy, patients in the second group were hemodialyzed once, and the third group received oral N-acetylcysteine. The frequency of CIN (defined as an increase in serum creatinine>or=0.5 mg/dl) from 48 to 72 h after catheterization was 6.1% in the hydration-only group, 15.9% with hemodialysis treatment, and 5.3% in the N-ACC group (intention-to-treat analysis; P=0.008). There were no differences between the treatment groups with regard to increased (>or=0.5 mg/dl) serum creatinine concentrations after 30-60 days (4.8%, 5.1%, and 3.1%, respectively; P=0.700). Analyses of long-term follow-up (range 63 to 1316 days) by Cox regressions models of the study groups found quite similar survival rates (P=0.500). In contrast to other (retrospective) studies, long-term survival of patients with vs those without CIN within 72 h was not different, but patients who still had elevated creatinine concentrations at 30-60 days suffered from a markedly higher 2-year mortality (46% vs 17%, P=0.002). In conclusion, hemodialysis in addition to hydration therapy for the prevention of CIN provided no evidence for any outcome benefit but evidence for probable harm. Increased creatinine concentrations at 30-60 days, but not within 72 h, were associated with markedly reduced long-term survival.
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Affiliation(s)
- H Reinecke
- Department of Cardiology and Angiology, University Hospital of Muenster, Germany.
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20
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Abstract
BACKGROUND Few studies have investigated cancer risks in carbon black workers and the findings were inconclusive. METHODS The current study explores the mortality of a cohort of 1535 male German blue-collar workers employed at a carbon black manufacturing plant for at least one year between 1960 and 1998. Vital status and causes of death were assessed for the period 1976-98. Occupational histories and information on smoking were abstracted from company records. Standardised mortality ratios (SMR) and Poisson regression models were calculated. RESULTS The SMRs for all cause mortality (observed deaths (obs) 332, SMR 120, 95% CI 108 to 134), and mortality from lung cancer (obs 50, SMR 218, 95% CI 161 to 287) were increased using national rates as reference. Comparisons to regional rates from the federal state gave SMRs of 120 (95% CI 107 to 133) and 183 (95% CI 136 to 241), respectively. However, there was no apparent dose response relationship between lung cancer mortality and several indicators of occupational exposure, including years of employment and carbon black exposure. CONCLUSIONS The mortality from lung cancer among German carbon black workers was increased. The high lung cancer SMR can not fully be explained by selection, smoking, or other occupational risk factors, but the results also provide little evidence for an effect of carbon black exposure.
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Affiliation(s)
- J Wellmann
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.
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21
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Wellmann J. Markov models for repeated ordinal data. Methods Inf Med 2006; 45:414-8. [PMID: 16964358] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
OBJECTIVES To demonstrate the application of Markov models, especially for ordinal outcomes, within the context of regression models for correlated data. METHODS A brief review of regression methods for correlated data is given. A proportional odds model and a continuation ratio model is applied to repeated measurements of macular pigment density, obtained in an intervention study on the supplementation of macular carotenoids. The correlation between repeated assessments is assumed to follow a first-order Markov model. The models are implemented with standard statistical software. RESULTS Both models, though not directly comparable, provide a similar conclusion. The application of these models with standard statistical software is straightforward. CONCLUSIONS Markov models can be valuable alternatives to random effects modes or procedures based on generalized estimation equations.
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Affiliation(s)
- J Wellmann
- University of Münster, Institute of Epidemiology and Social Medicine, Domagkstr. 3, 48149 Münster, Germany.
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22
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Wellmann J. Markov Models for Repeated Ordinal Data. Methods Inf Med 2006. [DOI: 10.1055/s-0038-1634097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Summary
Objectives:
To demonstrate the application of Markov models, especially for ordinal outcomes, within the context of regression models for correlated data.
Methods:
A brief review of regression methods for correlated data is given. A proportional odds model and a continuation ratio model is applied to repeated measurements of macular pigment density, obtained in an intervention study on the supplementation of macular carotenoids. The correlation between repeated assessments is assumed to follow a first-order Markov model. The models are implemented with standard statistical software.
Results:
Both models, though not directly comparable, provide a similar conclusion. The application of these models with standard statistical software is straightforward.
Conclusions:
Markov models can be valuable alternatives to random effects modes or procedures based on generalized estimation equations.
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23
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Behrens T, Taeger D, Wellmann J, Keil U. Different methods to calculate effect estimates in cross-sectional studies. A comparison between prevalence odds ratio and prevalence ratio. Methods Inf Med 2004; 43:505-9. [PMID: 15702210] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
OBJECTIVES According to results from the epidemiological literature, it can be expected that the prevalence odds ratio (POR) and the prevalence ratio (PR) differ with increasing disease prevalence. We illustrate different concepts to calculate these effect measures in cross-sectional studies and discuss their advantages and weaknesses, using actual data from the ISAAC Phase III cross-sectional survey in Münster, Germany. METHODS We analyzed data on the association between self-reported traffic density and wheeze and asthma by means of the POR, obtained from a logistic regression, and the PR, which was estimated from a log-linear binomial model and from different variants of a Poisson regression. RESULTS The analysis based on the less frequent disease, i.e. asthma with an overall prevalence of 7.8%, yielded similar results for all estimates. When wheezing with a prevalence of 17.5% was analyzed, the POR produced the highest estimates with the widest confidence intervals. While the point estimates were similar in the log-binomial model and Poisson regression, the latter showed wider confidence intervals. When we calculated the Poisson regression with robust variances, confidence intervals narrowed. CONCLUSIONS Since cross-sectional studies often deal with frequent diseases, we encourage analyzing cross-sectional data based on log-linear binomial models, which is the 'natural method' for estimating prevalence ratios. If algorithms fail to converge, a useful alternative is to define appropriate starting values or, if models still do not converge, to calculate a Poisson regression with robust estimates to control for overestimation of errors in the binomial data.
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Affiliation(s)
- T Behrens
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.
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Heidrich J, Wellmann J, Hense HW, Siebert E, Liese AD, Löwel H, Keil U. [Classical risk factors for myocardial infarction and total mortality in the community--13-year follow-up of the MONICA Augsburg cohort study]. Z Kardiol 2003; 92:445-54. [PMID: 12819993 DOI: 10.1007/s00392-003-0930-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE The MONICA (MONItoring of trends and determinants in CArdiovascular disease) project in the region of Augsburg, Southern Germany, is the first population-based cohort study in Germany investigating the association of the risk factors hypertension, hypercholesterolemia and smoking with incident myocardial infarction and total mortality, and to assess their impact at the population level. METHODS At baseline, 1074 men and 1013 women aged 45-64 years were randomly selected from the population in the Augsburg region and extensively interviewed and examined regarding their cardiovascular risk profile. They were traced over 13 years from 1984-1997. We calculated incidence rates, hazard rate ratios, population attributable risks (PAR), and rate advancement periods (RAP) according to the three risk factors and their combinations. RESULTS Among men, 107 myocardial infarctions and 204 total mortality events occurred during the study period; in women the number of total mortality cases was 102. The three classical risk factors were associated with incident myocardial infarction in men and with total mortality in men and women over a period of 13 years. Heavily smoking men had a particularly high risk of total mortality (HRR=4.2; 95% CI 2.5-7.0) and myocardial infarction (HRR=3.8; 1.9-7.6). Men with treated hypertension were at equally high risk for both total mortality (HRR=2.4; 1.5-3.7) and myocardial infarction (HRR=2.4; 1.3-4.3). In women, treated hypertension (HRR=2.5; 1.5-4.1) and hypercholesterolemia (HRR=2.0; 1.2-3.3) were most strongly related to total mortality. Regarding the association of risk factor combinations and myocardial infarction among men, the presence of all three risk factors simultaneously (HRR=7.9; 3.6-17.3) and the combination smoking/hypercholesterolemia (HRR=5.8; 3.2-10.5) were particularly hazardous. In total, the three risk factors contributed 54% of the burden of myocardial infarction in the male study population. The rate advancement periods for myocardial infarction related to treated hypertension, hypercholesterolemia and heavy smoking were 10.5, 5.8 and 15.8 years, respectively. CONCLUSIONS Our results confirm the outstanding impact of the classical risk factors on myocardial infarction and total mortality in a southern German population. Coronary heart disease is largely preventable through risk factor reduction. Therefore, risk factor counselling, education and treatment are crucial to prevent people from developing the disease or dying prematurely.
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Affiliation(s)
- J Heidrich
- Institut für Epidemiologie und Sozialmedizin, Universität Münster, Domagkstr. 3, 48129 Münster, Germany.
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Heid IM, Küchenhoff H, Wellmann J, Gerken M, Kreienbrock L, Wichmann HE. On the potential of measurement error to induce differential bias on odds ratio estimates: an example from radon epidemiology. Stat Med 2002; 21:3261-78. [PMID: 12375303 DOI: 10.1002/sim.1252] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
It is well established that odds ratios estimated by logistic regression are subject to bias if exposure is measured with error. The dependence of this bias on exposure parameter values, particularly for multiplicative measurement error, and its implications in epidemiology are not, however, as fully acknowledged. We have been motivated by a German West case-control study on lung cancer and residential radon, where restriction to a subgroup exhibiting larger mean and variance of exposure than the entire group has shown higher odds ratio estimates as compared to the full analysis. By means of correction formulae and simulations, we show that bias from additive classical type error depends on the exposure variance, not on the exposure mean, and that bias from multiplicative classical type error depends on the geometric standard deviation (in other words on the coefficient of variation of exposure), but not on the geometric mean of exposure. Bias from additive or multiplicative Berkson type error is independent of exposure distribution parameters. This indicates that there is a potential of differential bias between groups where these parameters vary. Such groups are commonly compared in epidemiology: for example when the results of subgroup analyses are contrasted or meta-analyses are performed. For the German West radon study, we show that the difference of measurement error bias between the subgroup and the entire group exhibits the same direction but not the same dimension as the observed results. Regarding meta-analysis of five European radon studies, we find that a study such as this German study will necessarily result in smaller odds ratio estimates than other studies due to the smaller exposure variance and coefficient of variation of exposure. Therefore, disregard of measurement error can not only lead to biased estimates, but also to inconsistent results and wrongly concluded effect differences between groups.
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Affiliation(s)
- I M Heid
- GSF-National Research Center for Environment and Health, Neuherberg, Germany.
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Abstract
The two-step clonal expansion (TSCE) model is applied to large case-control studies, frequency matched for age, which allow estimation of the RR of lung tumour risk caused by smoking. For estimating background hazard rates, mortality data from the study areas are used to supplement the case-control data. Two approaches are used to analyse the data, based on the unconditional and the conditional likelihoods. They are demonstrated to give nearly identical results. Some model diagnostics are performed and demonstrate a good model fit. Our results indicate that smoking acts on the promotion and transformation parameters, but not on the initiation parameter of the TSCE model. The fitted relative risk of current smokers peaks between ages 50 and 60 years. The relative risk of male ex-smokers decreases strongly with time since end of exposure, but does not reach the risk of non-smokers, and does not decrease as much as for female ex-smokers.
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Affiliation(s)
- W F Heidenreich
- GSF-Institute for Radiation Protection, 85758 Neuherberg, Germany.
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Heidrich J, Liese AD, Kalic M, Winter-Enbergs A, Wellmann J, Roeder N, Kerber S, Breithardt G, Scheld HH, Kleine-Katthöfer P, Keil U. [Secondary prevention of coronary heart disease. Results from EuroASPIRE I and II in the region of Münster, Germany]. Dtsch Med Wochenschr 2002; 127:667-72. [PMID: 11928058 DOI: 10.1055/s-2002-23480] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND EuroASPIRE (European Action on Secondary Prevention through Intervention to Reduce Events) is a European multicenter study on secondary prevention in patients with coronary heart disease (CHD). The first cross-sectional survey was undertaken in 1995/96 among 3569 patients from nine countries. A second cross-sectional survey (EuroASPIRE II) was conducted in 1999/2000 among 5556 patients from 15 countries to evaluate among others whether coronary prevention had improved since the first. METHODS The present study was conducted in the region of Münster, Germany, as part of the EuroASPIRE study. Consecutive patients, men and women up to 70 years of age with established CHD, were identified retrospectively. A total of 392 (EuroASPIRE I) and 402 (EuroASPIRE II) patients participated. Information on cardiovascular risk factors, lifestyle and medication were obtained through medical records, interviews and examinations. RESULTS Both studies demonstrate a high prevalence of risk factors among CHD patients. At the time of the interview more than 60% of the patients in both surveys had two or more risk factors. The comparison of EuroASPIRE I and II reveals a substantial decrease of 20% in the prevalence of hypercholesterolemia, but an increase in the prevalence of hypertension and obesity. ACE-inhibitors, betablockers and lipid lowering drugs, especially statins, were used more frequently in EuroASPIRE II. CONCLUSIONS We conclude that secondary prevention of CHD in the region of Münster like in the other European study regions is less than optimal and has not substantially improved between 1996 and 2000. Potential reasons are discussed.
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Affiliation(s)
- J Heidrich
- Institut für Epidemiologie und Sozialmedizin, Universitätsklinikum Münster, Germany.
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Wellmann J. Culture and character: some perspectives from psychological anthropology for psychohistorians. Newsl Group Use Psychol Hist 2001; 4:12-30. [PMID: 11614521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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Kreienbrock L, Kreuzer M, Gerken M, Dingerkus G, Wellmann J, Keller G, Wichmann HE. Case-control study on lung cancer and residential radon in western Germany. Am J Epidemiol 2001; 153:42-52. [PMID: 11159146 DOI: 10.1093/aje/153.1.42] [Citation(s) in RCA: 92] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
In a 1990-1996 case-control study in western Germany, the authors investigated lung cancer risk due to exposure to residential radon. Confirmed lung cancer cases from hospitals and a random sample of community controls were interviewed by trained interviewers regarding different risk factors. For 1 year, alpha track detectors were placed in dwellings to measure radon gas concentrations. The evaluation included 1,449 cases and 2,297 controls recruited from the entire study area and a subsample of 365 cases and 595 controls from radon-prone areas of the basic study region. Rate ratios were estimated by using conditional logistic regression adjusted for smoking and for asbestos exposure. In the entire study area, no rate ratios different from 1.0 were found; in the radon-prone areas, the adjusted rate ratios for exposure in the present dwelling were 1.59 (95% confidence interval (CI): 1.08, 2.27), 1.93 (95% CI: 1.19, 3.13), and 1.93 (95% CI: 0.99, 3.77) for 50-80, 80-140, and >140 Bq/m3, respectively, compared with 0-50 Bq/m3. The excess rate ratio for an increase of 100 Bq/m3 was 0.13 (-0.12 to 0.46). An analysis based on cumulative exposure produced similar results. The results provide additional evidence that residential radon is a risk factor for lung cancer, although a risk was detected in radon-prone areas only, not in the entire study area.
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Affiliation(s)
- L Kreienbrock
- Institute of Epidemiology, GSF-National Research Center for Environment and Health, Neuherberg, Federal Republic of Germany.
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Abstract
Epidemiological studies of lung cancer among nonsmoking men are few. This case-control study was conducted among lifetime nonsmoking men between 1990 and 1996 in Germany to examine lung cancer risk in relation to occupation, environmental tobacco smoke, residential radon, family history of cancer and previous lung disease. A total of 58 male cases with confirmed primary lung cancer and 803 male population controls who had never smoked more than 400 cigarettes in their lifetime were personally interviewed by a standardized questionnaire. In addition, 1-year radon measurements in the living and bedroom of the subjects' last dwelling were carried out. Unconditional logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI). Having ever worked in a job with known lung carcinogens was associated with a two-fold significantly increased lung cancer risk (OR = 2.2; CI = 1.0-5.0), adjusted for age and region. The linear trend test for lung-cancer risk associated with radon exposure was close to statistical significance, demonstrating an excess relative risk for an increase in exposure of 100 Bq m(-3)of 0.43 (P = 0.052). Nonsignificantly elevated effects of exposure to environmental tobacco smoke in public transportation and in social settings were observed. No associations with a family history of cancer or previous lung diseases were found. Our results indicate that occupational carcinogens and indoor radon may play a role in some lung cancers in nonsmoking men.
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Affiliation(s)
- M Kreuzer
- BfS - Federal Office of Radiation Protection, Institute of Radiation Hygiene, Ingolstaedter Landstrasse 1, Neuherberg, 85764
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Abstract
To examine the time-dependent effects of exposure histories on disease, we estimate a weight function within a generalized linear model. The shape of the weight function, which is modeled as a cubic B-spline, gives information about the impact of exposure increments at different times on disease risk. The method is evaluated in a simulation study and is applied to data on smoking histories and lung cancer from a recent case-control study in Germany.
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Affiliation(s)
- M Hauptmann
- GSF National Research Center for Environment and Health, Institute of Epidemiology, Ingolstädter Landstrasse 1, 85764 Neuherberg, Germany.
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Abstract
To examine the time-dependent effects of exposure histories on disease we use sliding time windows as an exploratory alternative to the analysis of variables like time since last exposure and duration of exposure. The method fits a series of risk models which contain total cumulative exposure and an additional covariate for exposures received during fixed time intervals. Characteristics of the fitted models provide insight into the influence of exposure increments at different times on disease risk. A simulation study is performed to check the validity of the approach. We apply the method to data from a recent German case-control study on smoking and lung cancer risk with about 4300 lung cancer cases and a similiar number of controls. The sliding time window approach indicates that the amount of cigarettes smoked from two to 11 years before disease incidence is most predicitive of lung cancer incidence. Among different smoking profiles that result in the same lifelong cumulative number of cigarettes smoked, those with a concentration of smoked cigarettes within 20 years before interview bear substantially larger risk than others.
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Affiliation(s)
- M Hauptmann
- GSF National Research Center for Environment and Health, Institute of Epidemiology, Neuherberg, Germany.
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Gerken M, Kreienbrock L, Wellmann J, Kreuzer M, Wichmann HE. Models for retrospective quantification of indoor radon exposure in case-control studies. Health Phys 2000; 78:268-278. [PMID: 10688449 DOI: 10.1097/00004032-200003000-00004] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
In epidemiologic studies on lung cancer risk due to indoor radon the quantification of individual radon exposure over a long time period is one of the main issues. Therefore, radon measurements in one or more dwellings, which in total have been inhabited by the participants for a sufficient time-period, are necessary as well as consideration of changes of building characteristics and ventilation habits, which influence radon concentration. Given data on 1-y alpha-track measurements and personal information from 6,000 participants of case-control studies in West and East Germany, an improved method is developed to assess individual radon exposure histories. Times spent in different rooms of the dwelling, which are known from a personal questionnaire, are taken into account. The time spent outside the house (average fraction 45%) varies substantially among the participants. Therefore, assuming a substantially lower radon exposure outside the dwelling, the residence time constitutes an important aspect of total radon exposure. By means of an analysis of variance, important determinants of indoor radon are identified, namely constant conditions such as type of house (one family house or multiple dwelling), type of construction (half-timbered, massive construction, lightweight construction), year of construction, floor and type of basement, and changeable conditions such as heating system, window insulation, and airing habits. A correction of measurements in former dwellings by factors derived from the analysis is applied if current living conditions differ from those of the participants at the time when they were living in the particular dwellings. In rare cases the adjustment for changes leads to a correction of the measurements with a factor of about 1.4, but a reduction of 5% on average only. Exposure assessment can be improved by considering time at home and changes of building and ventilation conditions that affect radon concentration. The major concern that changes in ventilation habits and building conditions lead to substantial errors in exposure (and therefore risk) assessment cannot be confirmed in the data analyzed.
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Affiliation(s)
- M Gerken
- GSF-National Research Center for Environment and Health, Neuherberg, Institute of Epidemiology, Germany.
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Wjst M, Trepka M, Wellmann J, Heinrich J, Stiller-Winkler R, Wichmann H. Serum immunoglobulin level and skin prick test response. Eur J Med Res 1997; 2:177-81. [PMID: 9110926] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE The relation of viral infections and allergic diseases is inconclusive. The objective of the analysis therefore was to examine the relation between immunoglobulin levels and sensitization to common allergens as measured by the skin prick test (SPT). METHODS In a population-based study of 2,470 children, 2,188 skin prick tests, and 2,042 blood samples could be analyzed. RESULTS At least one positive SPT was observed in 19.2% of the children. IgA und IgG levels did not show any association with SPT response. As expected, there was a sharp increase in the two highest quartile groups of IgE (p for trend <0.0001), while the prevalence of positive SPT continuously decreased with higher IgM levels (p for trend 0.002). This effect of IgM could be seen for all allergens examined. If an upper respiratory tract infection was reported one week prior to testing, the prevalence of a positive SPT was also reduced by nearly one half, however, this association was not significant. CONCLUSIONS Since IgM has a half-life of approximately 5 days, the inverse association found between IgM and the prevalence of positive SPT seems to be a transient effect of a prior infection.
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Affiliation(s)
- M Wjst
- GSF - Forschungszentrum fuer Umwelt und Gesundheit, Institut fuer Epidemiologie, Ingolstaedter Landstrasse 1, Neuherberg, D-85758, Germany.
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Bojti E, Grezal G, Abermann M, Wellmann J, Verczkey L, Klebovich I. 13-week oral toxicokinetic study on deramciclane (EGIS-3886) in dogs. Pharmacol Res 1995. [DOI: 10.1016/1043-6618(95)86851-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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