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Xu X, Huang F, Guo Y, Zheng L, Yan J. Interactive effect of prepregnancy overweight/obesity and GDM history on prevalence of GDM in biparous women. Front Endocrinol (Lausanne) 2023; 14:1084288. [PMID: 36875471 PMCID: PMC9978813 DOI: 10.3389/fendo.2023.1084288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 02/02/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Prepregnancy overweight/obesity (OWO) and gestational diabetes mellitus (GDM) history may increase the prevalence of GDM in parous women, but little is known about their potential combined effect on the prevalence of GDM in biparous women. OBJECTIVE This study aims to explore the interactive effect of prepregnancy overweight/obesity (OWO) and GDM history on the prevalence of GDM in biparous women. METHODS A retrospective study was conducted on 16,282 second-birth women who delivered a single neonate at ≧28 weeks of gestation twice. Logistic regression was used to assess the independent and multiplicative interactions of prepregnancy overweight/obesity (OWO) and GDM history on the risk of GDM in biparous women. Additive interactions were calculated using an Excel sheet that was made by Anderson to calculate relative excess risk. RESULTS A total of 14,998 participants were included in this study. Both prepregnancy OWO and GDM history were independently associated with an increased risk of GDM in biparous women (odds ratio (OR) = 19.225, 95% confidence interval (CI) = 17.106, 21.607 and OR = 6.826, 95% CI = 6.085, 7.656, respectively). The coexistence of prepregnancy OWO and GDM history was associated with GDM, with an adjusted OR of 1.754 (95% CI, 1.625, 1.909) compared to pregnant women without either condition. The additive interaction between prepregnancy OWO and GDM history was found to be not significant with regard to GDM in biparous women. CONCLUSIONS Prepregnancy OWO and GDM history both increase the risk of GDM in biparous women and have multiplicative interactions but not additive interactions.
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Watanabe D, Yamada Y, Yoshida T, Watanabe Y, Hatamoto Y, Fujita H, Miyachi M, Kimura M. Association of the interaction between physical activity and sitting time with mortality in older Japanese adults. Scand J Med Sci Sports 2022; 32:1757-1767. [PMID: 36112073 PMCID: PMC9826454 DOI: 10.1111/sms.14234] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 02/09/2022] [Revised: 08/04/2022] [Accepted: 09/12/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE To examine how physical activity (PA) and sitting time (ST) are associated with mortality in older Japanese adults. METHODOLOGY We used the data of 10 233 older Japanese adults aged ≥65 years who provided valid responses to the International Physical Activity Questionnaire-Short Form (IPAQ-SF) by a mail survey. Both PA and ST were assessed using the IPAQ-SF. The results were classified into high or low categories using ≥3.0 metabolic equivalent PA (150 min/week) and ST (300 min/day) into the following four groups: High PA (HPA)/Low ST (LST), HPA/High ST (HST), Low PA (LPA)/LST, and LPA/HST. Mortality data were collected from July 30, 2011, to November 30, 2016. We assessed the interaction of PA and ST status with the risk of all-cause mortality using the multivariable Cox proportional-hazards model. RESULTS A total of 1014 people were recorded to have died during a median follow-up period of 5.3 years (51 553 person-years). After adjustment for confounders, the risk of mortality was higher in the LPA/HST group than in all other groups (HPA/LST: reference; HPA/HST group: hazard ratio [HR] 0.86 (95% confidence interval [CI]: 0.66 to 1.12); LPA/LST group: HR 1.09 (95% CI: 0.88 to 1.35); LPA/HST group: HR 1.36 (95% CI: 1.10 to 1.67); and multiplicative interaction: HR 1.44 (95% CI: 1.07 to 1.94)). CONCLUSIONS The risk of mortality associated with LPA/HST depends on the level of PA, duration of ST, and their interaction with each other. Our results may be useful in ameliorating the adverse effects leading to mortality in individuals with lower PA, by reducing ST.
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Affiliation(s)
- Daiki Watanabe
- Faculty of Sport SciencesWaseda UniversitySaitamaJapan,National Institute of Health and NutritionNational Institutes of Biomedical Innovation, Health and NutritionTokyoJapan,Institute of Interdisciplinary Research, Institute for Active HealthKyoto University of Advanced ScienceKyotoJapan
| | - Yosuke Yamada
- National Institute of Health and NutritionNational Institutes of Biomedical Innovation, Health and NutritionTokyoJapan,Institute of Interdisciplinary Research, Institute for Active HealthKyoto University of Advanced ScienceKyotoJapan
| | - Tsukasa Yoshida
- National Institute of Health and NutritionNational Institutes of Biomedical Innovation, Health and NutritionTokyoJapan,Institute of Interdisciplinary Research, Institute for Active HealthKyoto University of Advanced ScienceKyotoJapan,Senior Citizen's Welfare Section, Kameoka City GovernmentKyotoJapan
| | - Yuya Watanabe
- National Institute of Health and NutritionNational Institutes of Biomedical Innovation, Health and NutritionTokyoJapan,Institute of Interdisciplinary Research, Institute for Active HealthKyoto University of Advanced ScienceKyotoJapan,Physical Fitness Research InstituteMeiji Yasuda Life Foundation of Health and WelfareTokyoJapan
| | - Yoichi Hatamoto
- National Institute of Health and NutritionNational Institutes of Biomedical Innovation, Health and NutritionTokyoJapan
| | - Hiroyuki Fujita
- Institute of Interdisciplinary Research, Institute for Active HealthKyoto University of Advanced ScienceKyotoJapan
| | - Motohiko Miyachi
- Faculty of Sport SciencesWaseda UniversitySaitamaJapan,National Institute of Health and NutritionNational Institutes of Biomedical Innovation, Health and NutritionTokyoJapan
| | - Misaka Kimura
- Institute of Interdisciplinary Research, Institute for Active HealthKyoto University of Advanced ScienceKyotoJapan,Department of Nursing, Doshisha Women's College of Liberal ArtsKyotoJapan,Laboratory of Applied Health SciencesKyoto Prefectural University of MedicineKyotoJapan
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Yang K, Li D, Xu L, Pang C, Zhao D, Ren S. Independent and interactive effects of eye rubbing and atopy on keratoconus. Front Immunol 2022; 13:999435. [PMID: 36248837 PMCID: PMC9558125 DOI: 10.3389/fimmu.2022.999435] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/13/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose To evaluate the independent and interactive effects of eye rubbing and atopy on keratoconus (KC) in central China. Methods A total of 330 KC patients and 330 controls were recruited in the case-control study. Eye rubbing and history of atopy were recorded through face-to-face interviews. The association between KC and eye rubbing, atopy, interactive effects of eye rubbing and atopy were analyzed by logistic regression, and the odds ratios (OR), relative excess risk due to interaction (RERI), attributable proportion (AP), synergy (S) index, and 95% confidence intervals (95% CI) were calculated. Results A total of 228 patients (69.09%) had an eye rubbing history, and 53 (16.06%) had an atopy history in the KC group, which were both higher than that in the control group (p<0.001). Eye rubbing and atopy were positively associated with KC in multivariate analysis, with ORs (95% CIs) of 15.11 (10.02, 22.80) and 5.30 (2.59, 10.84), respectively. Compared to non-eye rubbing and non-atopy eyes, the risk for eye rubbing coexisted with atopy was 52.31 (12.25, 223.35). No significant associations were found between KC and multiplicative interaction (p=0.608). The RERI, AP, and S values were 32.89 (-43.35, 109.14), 0.63 (0.05, 1.21), and 2.79 (0.56, 13.96), respectively, with no significant association between additive interaction and KC. No significant associations were found between eye rubbing, atopy and the severity of KC (p>0.05). Conclusion Eye rubbing and atopy were separately positively associated with KC, and there was a strong impact of coexistent eye rubbing and atopy on KC in China. Further multi-center and cohort study need to be conducted to explore the role of eye rubbing and atopy in the occurrence and development of KC.
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Affiliation(s)
| | | | | | | | | | - Shengwei Ren
- Henan Provincial People’s Hospital, Henan Eye Hospital, Henan Eye Institute, People’s Hospital of Zhengzhou University, Henan University People’s Hospital, Zhengzhou, China
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Folesani G, Galetti M, Ranzieri S, Petronini PG, La Monica S, Corradi M, Cavallo D. Interaction between occupational radon exposure and tobacco smoke: a systematic review. Expert Rev Respir Med 2022; 16:787-800. [PMID: 35912519 DOI: 10.1080/17476348.2022.2108795] [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] [Indexed: 11/04/2022]
Abstract
INTRODUCTION : The risk of lung cancer from radon exposure was small compared to tobacco smoking (BEIR VI), but the relationship between these two carcinogenic agents has yet to be quantitatively estimated. The objective of this systematic review was to evaluate the last evidences on the role of radon occupational exposures and tobacco smoke on lung cancer risk. AREAS COVERED : Thirteen articles were selected using two different databases, PubMed and Scifinder, and were limited to those published from 2010 to 2021. The reference list of selected studies was reviewed to identify other relevant papers. EXPERT OPINION : Seven papers included in this systematic review did not deal with the multiplicative or the additive type of interaction between radon exposure and smoking habit. Six papers discussed the nature of this interaction with a prevalence of the sub-multiplicative model compared to the additive one. Altogether, smoking adjustment did not change significantly lung cancer risk. The included studies might constitute a starting point for updating the models for risk assessment in occupational and residential scenarios, promoting concomitantly the exposure reduction to radon and other cofactors, as recently introduced by Italian Legislative Decree number 101 of 31 July 2020, an application of Euratom Directive 59/2013.
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Affiliation(s)
- Giuseppina Folesani
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL - Italian Workers' Compensation Authority, Via Fontana Candida 1, 00078 Monte Porzio Catone, Rome, Italy
| | - Maricla Galetti
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL - Italian Workers' Compensation Authority, Via Fontana Candida 1, 00078 Monte Porzio Catone, Rome, Italy
| | - Silvia Ranzieri
- Department of Medicine and Surgery, University of Parma, Viale Gramsci 14, 43126 Parma, Italy
| | - Pier Giorgio Petronini
- Department of Medicine and Surgery, University of Parma, Viale Gramsci 14, 43126 Parma, Italy
| | - Silvia La Monica
- Department of Medicine and Surgery, University of Parma, Viale Gramsci 14, 43126 Parma, Italy
| | - Massimo Corradi
- Department of Medicine and Surgery, University of Parma, Viale Gramsci 14, 43126 Parma, Italy.,Center of Excellence for Toxicological Research (CERT) at University of Parma, Viale Gramsci 14, 43126 Parma, Italy
| | - Delia Cavallo
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL - Italian Workers' Compensation Authority, Via Fontana Candida 1, 00078 Monte Porzio Catone, Rome, Italy
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Lin LH, Lin J, Yan JY. Interactive Affection of Pre-Pregnancy Overweight or Obesity, Excessive Gestational Weight Gain and Glucose Tolerance Test Characteristics on Adverse Pregnancy Outcomes Among Women With Gestational Diabetes Mellitus. Front Endocrinol (Lausanne) 2022; 13:942271. [PMID: 35872998 PMCID: PMC9301308 DOI: 10.3389/fendo.2022.942271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 06/07/2022] [Indexed: 12/16/2022] Open
Abstract
Purpose To examine the combined effect of pre-pregnancy overweight or obesity, excessive gestational weight gain, and glucose tolerance status on the incidence of adverse pregnancy outcomes among women with gestational diabetes mellitus. Methods A observational study including 5529 gestational diabetes mellitus patients was performed. Logistic regression were used to assess the independent and multiplicative interactions of overweight or obese, excessive gestational weight gain, abnormal items of oral glucose tolerance test and adverse pregnancy outcomes. Additive interactions were calculated using an Excel sheet developed by Anderson to calculate relative excess risk. Results Overall 1076(19.46%) study subject were overweight or obese and 1858(33.60%) women gained weight above recommended. Based on IADPSG criteria, more than one-third women with two, or three abnormal glucose values. Preconception overweight or obesity, above recommended gestational weight gain, and two or more abnormal items of oral glucose tolerance test parameters significantly increased the risk of adverse pregnancy outcomes, separately. After accounting for confounders, each two of overweight or obesity, excessive gestational weight gain, two or more abnormal items of OGTT parameters, the pairwise interactions on adverse pregnancy outcomes appear to be multiplicative. Coexistence of preconception overweight or obesity, above recommended gestational weight gain and two or more abnormal items of oral glucose tolerance test parameters increased the highest risk for adverse pregnancy outcomes. No additive interaction was found. Conclusions Pre-pregnancy overweight or obesity, excessive gestational weight gain, two or more abnormal items of OGTT parameters contribute to adverse pregnancy outcomes independently among women with gestational diabetes mellitus. Additionally, the combined effect between these three factors and adverse pregnancy outcomes appear to be multiplicative. Interventions focus on maternal overweight or obesity and gestational weight gain should be offered to improve pregnancy outcomes.
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Affiliation(s)
- Li-hua Lin
- Department of Healthcare, Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Juan Lin
- Department of Obstetrics, Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Jian-ying Yan
- Department of Obstetrics, Fujian Maternity and Child Health Hospital, Fuzhou, China
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Chen H, Yaghjyan L, Li C, Peters U, Rosner B, Lindström S, Tamimi RM. Association of Interactions Between Mammographic Density Phenotypes and Established Risk Factors With Breast Cancer Risk, by Tumor Subtype and Menopausal Status. Am J Epidemiol 2021; 190:44-58. [PMID: 32639533 DOI: 10.1093/aje/kwaa131] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 06/29/2020] [Accepted: 06/30/2020] [Indexed: 12/11/2022] Open
Abstract
Previous studies suggest that the association between mammographic density (MD) and breast cancer risk might be modified by other breast cancer risk factors. In this study, we assessed multiplicative interactions between MD measures and established risk factors on the risk of invasive breast cancer overall and according to menopausal and estrogen receptor status. We used data on 2,137 cases and 4,346 controls from a nested case-control study within the Nurses' Health Study (1976-2004) and Nurses' Health Study II (1989-2007), whose data on percent mammographic density (PMD) and absolute area of dense tissue and nondense tissue (NDA) were available. No interaction remained statistically significant after adjusting for number of comparisons. For breast cancer overall, we observed nominally significant interactions (P < 0.05) between nulliparity and PMD/NDA, age at menarche and area of dense tissue, and body mass index and NDA. Individual nominally significant interactions across MD measures and risk factors were also observed in analyses stratified by either menopausal or estrogen receptor status. Our findings help provide further insights into potential mechanisms underlying the association between MD and breast cancer.
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Ding M, Ahmad S, Qi L, Hu Y, Bhupathiraju SN, Guasch-Ferré M, Jensen MK, Chavarro JE, Ridker PM, Willett WC, Chasman DI, Hu FB, Kraft P. Additive and Multiplicative Interactions Between Genetic Risk Score and Family History and Lifestyle in Relation to Risk of Type 2 Diabetes. Am J Epidemiol 2020; 189:445-460. [PMID: 31647510 DOI: 10.1093/aje/kwz251] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Revised: 11/09/2018] [Accepted: 10/17/2019] [Indexed: 12/28/2022] Open
Abstract
We examined interactions between lifestyle factors and genetic risk of type 2 diabetes (T2D-GR), captured by genetic risk score (GRS) and family history (FH). Our initial study cohort included 20,524 European-ancestry participants, of whom 1,897 developed incident T2D, in the Nurses' Health Study (1984-2016), Nurses' Health Study II (1989-2016), and Health Professionals Follow-up Study (1986-2016). The analyses were replicated in 19,183 European-ancestry controls and 2,850 incident T2D cases in the Women's Genome Health Study (1992-2016). We defined 2 categories of T2D-GR: high GRS (upper one-third) with FH and low GRS or without FH. Compared with participants with the healthiest lifestyle and low T2D-GR, the relative risk of T2D for participants with the healthiest lifestyle and high T2D-GR was 2.24 (95% confidence interval (CI): 1.76, 2.86); for participants with the least healthy lifestyle and low T2D-GR, it was 4.05 (95% CI: 3.56, 4.62); and for participants with the least healthy lifestyle and high T2D-GR, it was 8.72 (95% CI: 7.46, 10.19). We found a significant departure from an additive risk difference model in both the initial and replication cohorts, suggesting that adherence to a healthy lifestyle could lead to greater absolute risk reduction among those with high T2D-GR. The public health implication is that a healthy lifestyle is important for diabetes prevention, especially for individuals with high GRS and FH of T2D.
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Ma CC, Gu JK, Bhandari R, Charles LE, Violanti JM, Fekedulegn D, Andrew ME. Associations of objectively measured sleep characteristics and incident hypertension among police officers: The role of obesity. J Sleep Res 2020; 29:e12988. [PMID: 32049409 DOI: 10.1111/jsr.12988] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 08/27/2019] [Revised: 01/14/2020] [Accepted: 01/15/2020] [Indexed: 02/06/2023]
Abstract
This study investigated the associations of baseline sleep onset latency, wake after sleep onset, longest wake episode, number of awakenings, sleep efficiency and sleep duration with incident hypertension during a 7-year follow-up (n = 161, 68% men) and the joint effect of insufficient sleep and obesity on incident hypertension. Sleep parameters were derived from 15-day actigraphy data. Relative risks and 95% confidence intervals were estimated using a robust Poisson regression model. Each 10-min increase in sleep onset latency was associated with an 89% higher risk of hypertension (95% confidence interval [CI] = 1.12-3.20). Each 10-min increase in longest wake episode was associated with a 23% higher risk of hypertension (95% CI = 1.01-1.50) and each 10% decrease in sleep efficiency was associated with a 50% higher risk of hypertension (95% CI = 1.02-2.22). These associations were independent of demographic and lifestyle characteristics, depressive symptoms, shift work, sleep duration and body mass index. Having <6 hr of sleep and a body mass index ≥30 kg/m2 increased the risk of hypertension (relative risk = 2.81; 95% CI = 1.26-6.25) compared with having ≥6 hr of sleep and a body mass index <30 after controlling for confounders. Relative excess risk due to interaction was 3.49 (95% CI = -1.69-8.68) and ratio of relative risk was 3.21 (95% CI = 0.72-14.26). These results suggest that poor sleep quality is a risk factor for hypertension. Longitudinal studies with larger sample sizes are warranted to examine the joint effect of insufficient sleep and obesity on development of hypertension.
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Affiliation(s)
- Claudia C Ma
- Bioanalytics Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Ja Kook Gu
- Bioanalytics Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Ruchi Bhandari
- Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Luenda E Charles
- Bioanalytics Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - John M Violanti
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Desta Fekedulegn
- Bioanalytics Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Michael E Andrew
- Bioanalytics Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
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Meisner A, Kundu P, Chatterjee N. Case-Only Analysis of Gene-Environment Interactions Using Polygenic Risk Scores. Am J Epidemiol 2019; 188:2013-2020. [PMID: 31429870 DOI: 10.1093/aje/kwz175] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 07/25/2019] [Accepted: 07/25/2019] [Indexed: 12/11/2022] Open
Abstract
Investigations of gene (G)-environment (E) interactions have led to limited findings to date, possibly due to weak effects of individual genetic variants. Polygenic risk scores (PRS), which capture the genetic susceptibility associated with a set of variants, can be a powerful tool for detecting global patterns of interaction. Motivated by the case-only method for evaluating interactions with a single variant, we propose a case-only method for the analysis of interactions with a PRS in case-control studies. Assuming the PRS and E are independent, we show how a linear regression of the PRS on E in a sample of cases can be used to efficiently estimate the interaction parameter. Furthermore, if an estimate of the mean of the PRS in the underlying population is available, the proposed method can estimate the PRS main effect. Extensions allow for PRS-E dependence due to associations between variants in the PRS and E. Simulation studies indicate the proposed method offers appreciable gains in efficiency over logistic regression and can recover much of the efficiency of a cohort study. We applied the proposed method to investigate interactions between a PRS and epidemiologic factors on breast cancer risk in the UK Biobank (United Kingdom, recruited 2006-2010).
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Iwagami M, Tomlinson LA, Mansfield KE, Douglas IJ, Smeeth L, Nitsch D. Gastrointestinal bleeding risk of selective serotonin reuptake inhibitors by level of kidney function: A population-based cohort study. Br J Clin Pharmacol 2018; 84:2142-2151. [PMID: 29864791 PMCID: PMC6089824 DOI: 10.1111/bcp.13660] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [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: 11/27/2017] [Revised: 05/09/2018] [Accepted: 05/30/2018] [Indexed: 01/29/2023] Open
Abstract
Aim To estimate the risk of gastrointestinal (GI) bleeding associated with serotonin reuptake inhibitors (SSRIs) by level of kidney function. Methods We conducted a cohort study using the Clinical Practice Research Datalink linked to Hospital Episode Statistics. We identified patients with chronic kidney disease (CKD; estimated glomerular filtration rate <60 ml min–1 1.73 m–2 for ≥3 months), and a comparison group of patients without it. Patients with CKD were further classified as stage 3a (eGFR 45–59 ml min–1 1.73 m–2), 3b (30–44 ml min–1 1.73 m–2) and 4/5 (<30 ml min–1 1.73 m–2). We excluded prevalent SSRI users at cohort entry. Exposure was time‐dependent SSRI prescription and outcome was first hospitalization for GI bleeding. We estimated adjusted rate ratio (aRR) and rate difference (aRD) of GI bleeding comparing periods with and without SSRI prescription at each level of kidney function. Results The aRRs and aRDs were: (i) no CKD (n = 202 121) aRR: 1.66 (95%CI 1.37–2.01), aRD: 2.0/1000 person–years (5.5 vs. 3.5/1000 person–years in period with and without SSRIs); (ii) CKD stage 3a (n = 153 316) aRR: 1.86 (1.62–2.15), aRD: 4.2/1000 person–years (8.3 vs. 4.1/1000 person–years); (iii) CKD stage 3b (n = 46 482) aRR: 1.61 (1.27–2.04), aRD: 4.8/1000 person–years (9.9 vs. 5.1/1000 person–years); and (iv) CKD stage 4/5 (n = 11 197) aRR: 1.84 (1.14–2.96), aRD: 7.9/1000 person–years (15.3 vs. 7.4/1000 person–years). While there was no evidence of increase in the aRR (P = 0.922), there was strong evidence that the aRD increased as kidney function deteriorated (P = 0.001). Conclusions While the relative risk was constant, the excess risk of GI bleeding associated with SSRIs markedly increased among patients with decreased kidney function.
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Affiliation(s)
- Masao Iwagami
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Laurie A Tomlinson
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Kathryn E Mansfield
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Ian J Douglas
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Liam Smeeth
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Dorothea Nitsch
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
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Tran MM, Lefebvre DL, Dharma C, Dai D, Lou WYW, Subbarao P, Becker AB, Mandhane PJ, Turvey SE, Sears MR. Predicting the atopic march: Results from the Canadian Healthy Infant Longitudinal Development Study. J Allergy Clin Immunol 2017; 141:601-607.e8. [PMID: 29153857 DOI: 10.1016/j.jaci.2017.08.024] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 08/10/2017] [Accepted: 08/23/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND The atopic march describes the progression from atopic dermatitis during infancy to asthma and allergic rhinitis in later childhood. In a Canadian birth cohort we investigated whether concomitant allergic sensitization enhances subsequent development of these allergic diseases at age 3 years. METHODS Children completed skin prick testing at age 1 year. Children were considered sensitized if they produced a wheal 2 mm or larger than that elicited by the negative control to any of 10 inhalant or food allergens. Children were also assessed for atopic dermatitis by using the diagnostic criteria of the UK Working Party. At age 3 years, children were assessed for asthma, allergic rhinitis, food allergy, and atopic dermatitis. Data from 2311 children were available. RESULTS Atopic dermatitis without allergic sensitization was not associated with an increased risk of asthma at age 3 years after adjusting for common confounders (relative risk [RR], 0.46; 95% CI, 0.11-1.93). Conversely, atopic dermatitis with allergic sensitization increased the risk of asthma more than 7-fold (RR, 7.04; 95% CI, 4.13-11.99). Atopic dermatitis and allergic sensitization had significant interactions on both the additive (relative excess risk due to interaction, 5.06; 95% CI, 1.33-11.04) and multiplicative (ratio of RRs, 5.80; 95% CI, 1.20-27.83) scales in association with asthma risk. There was also a positive additive interaction between atopic dermatitis and allergic sensitization in their effects on food allergy risk (relative excess risk due to interaction, 15.11; 95% CI, 4.19-35.36). CONCLUSIONS Atopic dermatitis without concomitant allergic sensitization was not associated with an increased risk of asthma. In combination, atopic dermatitis and allergic sensitization had strong interactive effects on both asthma and food allergy risk at age 3 years.
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Affiliation(s)
- Maxwell M Tran
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Diana L Lefebvre
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | | | - David Dai
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Wendy Y W Lou
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Padmaja Subbarao
- Department of Pediatrics, University of Toronto and Hospital for Sick Children, Toronto, Ontario, Canada
| | - Allan B Becker
- Department of Pediatrics & Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Piush J Mandhane
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Stuart E Turvey
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Malcolm R Sears
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
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12
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Piepho HP, Madden LV, Williams ER. Multiplicative interaction in network meta-analysis. Stat Med 2014; 34:582-94. [PMID: 25410043 DOI: 10.1002/sim.6372] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 10/28/2014] [Accepted: 10/29/2014] [Indexed: 11/09/2022]
Abstract
Meta-analysis of a set of clinical trials is usually conducted using a linear predictor with additive effects representing treatments and trials. Additivity is a strong assumption. In this paper, we consider models for two or more treatments that involve multiplicative terms for interaction between treatment and trial. Multiplicative models provide information on the sensitivity of each treatment effect relative to the trial effect. In developing these models, we make use of a two-way analysis-of-variance approach to meta-analysis and consider fixed or random trial effects. It is shown using two examples that models with multiplicative terms may fit better than purely additive models and provide insight into the nature of the trial effect. We also show how to model inconsistency using multiplicative terms.
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Affiliation(s)
- Hans-Peter Piepho
- Biostatistics Unit, Institute of Crop Science, University of Hohenheim, Fruwirthstrasse 23, Stuttgart, 70599, Germany
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13
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Jadi MP, Behabadi BF, Poleg-Polsky A, Schiller J, Mel BW. An Augmented Two-Layer Model Captures Nonlinear Analog Spatial Integration Effects in Pyramidal Neuron Dendrites. Proc IEEE Inst Electr Electron Eng 2014; 102:1. [PMID: 25554708 PMCID: PMC4279447 DOI: 10.1109/jproc.2014.2312671] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
In pursuit of the goal to understand and eventually reproduce the diverse functions of the brain, a key challenge lies in reverse engineering the peculiar biology-based "technology" that underlies the brain's remarkable ability to process and store information. The basic building block of the nervous system is the nerve cell, or "neuron," yet after more than 100 years of neurophysiological study and 60 years of modeling, the information processing functions of individual neurons, and the parameters that allow them to engage in so many different types of computation (sensory, motor, mnemonic, executive, etc.) remain poorly understood. In this paper, we review both historical and recent findings that have led to our current understanding of the analog spatial processing capabilities of dendrites, the major input structures of neurons, with a focus on the principal cell type of the neocortex and hippocampus, the pyramidal neuron (PN). We encapsulate our current understanding of PN dendritic integration in an abstract layered model whose spatially sensitive branch-subunits compute multidimensional sigmoidal functions. Unlike the 1-D sigmoids found in conventional neural network models, multidimensional sigmoids allow the cell to implement a rich spectrum of nonlinear modulation effects directly within their dendritic trees.
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Affiliation(s)
- Monika P Jadi
- Computational Neurobiology Laboratory, Salk Institute for Biological Studies, La Jolla, CA 92037 USA
| | | | - Alon Poleg-Polsky
- Synaptic Physiology Section, National Institute of Neurobiological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892 USA
| | - Jackie Schiller
- Department of Physiology, Technion Medical School, Haifa 31096, Israel
| | - Bartlett W Mel
- Department of Biomedical Engineering and Neuroscience Graduate Program, University of Southern California, Los Angeles, CA 90089 USA
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