80 results on '"Tomi-Pekka Tuomainen"'
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2. Effects of accelerometer-based sedentary time and physical activity on DEXA-measured fat mass in 6059 children
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Andrew O. Agbaje, Wei Perng, and Tomi-Pekka Tuomainen
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Science - Abstract
Abstract Globally, childhood obesity is on the rise and the effect of objectively measured movement behaviour on body composition remains unclear. Longitudinal and causal mediation relationships of accelerometer-based sedentary time (ST), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) with dual-energy X-ray absorptiometry-measured fat mass were examined in 6059 children aged 11 years followed-up until age 24 years from the Avon Longitudinal Study of Parents and Children (ALSPAC), UK birth cohort. Over 13-year follow-up, each minute/day of ST was associated with 1.3 g increase in fat mass. However, each minute/day of LPA was associated with 3.6 g decrease in fat mass and each minute/day of MVPA was associated with 1.3 g decrease in fat mass. Persistently accruing ≥60 min/day of MVPA was associated with 2.8 g decrease in fat mass per each minute/day of MVPA, partly mediated by decrease insulin and low-density lipoprotein cholesterol. LPA elicited similar and potentially stronger fat mass-lowering effect than MVPA and thus may be targeted in obesity and ST prevention in children and adolescents, who are unable or unwilling to exercise.
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- 2023
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3. Frailty alone and interactively with obesity predicts heart failure: Kuopio Ischaemic Heart Disease Risk Factor Study
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Behnam Tajik, Ari Voutilainen, Rajiv Sankaranarayanan, Arja Lyytinen, Jussi Kauhanen, Gregory Y.H. Lip, Tomi‐Pekka Tuomainen, and Masoud Isanejad
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Frailty ,Heart failure ,Obesity ,Body mass index ,Population study ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Aims We aim to evaluate the association of frailty and high body mass index with risk of incident heart failure. Methods and results From the Kuopio Ischaemic Heart Disease Risk Factor Study, 408 women and 369 men, aged 61–74 years were included in this study. Frailty was ascertained with the presence of 3–5 and prefrailty 1–2 of the following criteria: weight loss (highest 20% over 7 years), self‐reported tiredness, weakness (measured by handgrip strength), slow walking speed (walking pace), and low physical activity (lowest 20%). At the baseline, participants were allocated to frail (n = 36), prefrail (n = 340), and robust (n = 441). HF incidents were obtained by record linkages from the national hospitalization registry in Finland up to 31 December 2019. Multivariate Cox proportional hazards regression estimated the hazard ratio (HR) of incident events, adjusted for potential confounders. Two hundred one HF events were recorded (111 in women and 90 in men) during the 14.2 years follow‐up. After adjustment for the age and sex, the risk of HF events was higher among prefrail (HR 1.42, 95% CI 1.08 to 1.79, P = 0.02) and frail (HR 3.39, 95% CI 1.89 to 4.79, P ≤ 0.001) compared with the robust group. After adjusting for multiple confounders result remained significant for HF indecent in prefrail [1.46 (HR 1.46, 95% CI 1.09 to 1.95, P = 0.01] and frail (HR 3.33, 95% CI 1.86 to 5.70, P ≤ 0.001). In the sensitivity analysis, significant interaction between high BMI (≥25 kg/m2) and frailty was observed (P for interaction = 0.02). The association of frailty [multivariate‐adjusted HR: 2.88 (1.56 to 5.33), P ≤ 0.001)] and prefrailty [multivariate‐adjusted HR: 1.40 (1.08 to 1.91), P = 0.03)] with risk of HF indecent was more pronounced in those with high BMI. Conclusions Frailty is highly common in older age, and our results indicated the high risk of HF incident in frail and prefrail groups. While frailty is clinically recognized by weight loss phenotype, our finding showed that frailly and high BMI can coexist and worsen the risk of HF incidence. Further research is warranted to substantiate these results in large studies and clinical settings.
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- 2023
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4. Epidemiological analysis of coronary heart disease and its main risk factors: are their associations multiplicative, additive, or interactive?
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Ari Voutilainen, Christina Brester, Mikko Kolehmainen, and Tomi-Pekka Tuomainen
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Additive ,coronary heart disease ,cohort study ,incidence ,multiplicative ,interactive ,Medicine - Abstract
Objective The purpose of this study was to discover how considering multiplicative, additive, and interactive effects modifies results of a prospective cohort study on coronary heart disease (CHD) incidence and its main risk factors.Material and methods The Kuopio Ischaemic Heart Disease Risk Factor (KIHD) Study provided the study material, 2682 Eastern Finnish middle-aged men, followed since the 1980s. We applied multiplicative and additive survival models together with different statistical metrics and confidence intervals for risk ratios and risk differences to estimate the nature of associations.Results The mean (SD) follow-up time among men who were free of CHD at baseline (n = 1958) was 21.4 (10.4) years, and 717 (37%) of them had the disease and 301 (15%) died for CHD before the end of follow-up. All tested non-modifiable and modifiable risk factors statistically significantly predicted CHD incidence. We detected three interactions: circulating low-density lipoprotein cholesterol (LDL-C) × age, obesity × age, and obesity × smoking of which LDL-C × age was the most evident one. High LDL-C increased the risk of CHD more among men younger than 50 [risk ratio (RR) 2.10] than those older than 50 (RR 1.22). LDL-C status was the only additive covariate. The additive effect of high LDL-C increased almost linearly up to 18 years and then reached a plateau. The simple multiplicative survival model stressed glycemic status as the strongest modifiable risk factor for developing CHD [hazard ratio (HR) for diabetes vs. normoglycemia was 2.69], whereas the model considering interactions and time dependence emphasised the role of LDL-C status (HR for high LDL-C vs. lower than borderline was 4.43). Age was the strongest non-modifiable predictor.Conclusions Including covariate interactions and time dependence in survival models potentially refine results of epidemiological analyses and ease to define the order of importance across CHD risk factors. KEY MESSAGESIncluding covariate interactions and time dependence in survival models potentially refine results of epidemiological analyses on coronary heart disease.Including covariate interactions and time dependence in survival models potentially ease to define the order of importance across coronary heart disease risk factors.
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- 2022
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5. Associations of reproductive factors with postmenopausal follicle stimulating hormone
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Rebecca Costa, Tomi-Pekka Tuomainen, Jyrki Virtanen, Leo Niskanen, and Elizabeth Bertone-Johnson
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Follicle stimulating hormone ,Postmenopause ,Reproductive history ,Hormone replacement therapy ,Medicine ,Gynecology and obstetrics ,RG1-991 - Abstract
Abstract Purpose Recent studies have suggested that higher postmenopausal follicle stimulating hormone (FSH) may be associated with lower risk of diabetes. However, relatively little is known about postmenopausal FSH levels, including the level of variation between women and whether reproductive factors are associated with this variation. Methods We assessed the relationship of multiple reproductive factors with FSH levels among 588 postmenopausal women in the Kuopio Ischaemic Heart Disease Risk Factor Study. Participants were aged 53 to 73 years and not using hormone therapy at study enrollment (1998–2001) when reproductive factors were assessed and FSH was measured. Results After adjustment for age, menopause timing, sex steroid levels, adiposity and behavioral factors, we observed numbers of pregnancies and age at first birth were each inversely associated with FSH levels. For example, women with ≥ 3 births and an age at first birth ≥ 25 years had mean FSH levels that were 7.8 IU/L lower than those of women with 1–2 births and an age at first birth ≤ 24 years (P = 0.003). Number of miscarriages was inversely associated with FSH levels (-2.7 IU/L per miscarriage; P = 0.02). Women reporting 4 or more years of past hormone therapy use had significantly higher mean FSH levels than women who had never used hormone therapy (P for trend = 0.006). Conclusion Multiple reproductive factors were associated with postmenopausal FSH, independent of estradiol, adiposity and other confounders. These findings warrant replication and further exploration of potential underlying mechanism.
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- 2022
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6. Urinary sodium concentration predicts time to major adverse coronary events and all-cause mortality in men with heart failure over a 28–33-year period: a prospective cohort study
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Anand Ganes, Jessica A. Davis, Jyrki K. Virtanen, Ari Voutilainen, Tomi-Pekka Tuomainen, John J. Atherton, John Amerena, Andrea Driscoll, Dave L. Hare, Gary Wittert, Anu Ruusunen, Wolfgang Marx, Mohammadreza Mohebbi, and Adrienne O’Neil
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Heart failure ,Biomarker ,Prognosis ,Translational medical research ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Lower urinary sodium concentrations (UNa) may be a biomarker for poor prognosis in chronic heart failure (HF). However, no data exist to determine its prognostic association over the long-term. We investigated whether UNa predicted major adverse coronary events (MACE) and all-cause mortality over 28–33 years. Methods One hundred and eighty men with chronic HF from the Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD) were included. Baseline data was collected between 1984 and 1989. MACE and all-cause outcomes were obtained using hospital linkage data (1984–2017) with a follow-up of 28–33 years. Cox proportional hazards models were generated using 24-h UNa tertiles at baseline (1 ≤ 173 mmol/day; 2 = 173-229 mmol/day; 3 = 230-491 mmol/day) as a predictor of time-to-MACE outcomes, adjusted for relevant covariates. Results Overall, 63% and 83% of participants (n = 114 and n = 150) had a MACE event (median 10 years) and all-cause mortality event (median 19 years), respectively. On multivariable Cox Model, relative to the lowest UNa tertile, no significant difference was noted in MACE outcome for individuals in tertiles 2 and 3 with events rates of 28% (HR:0.72; 95% CI: 0.46–1.12) and 21% (HR 0.79; 95% CI: 0.5–1.25) respectively.. Relative to the lowest UNa tertile, those in tertile 2 and 3 were 39% (HR: 0.61; 95% CIs: 0.41, 0.91) and 10% (HR: 0.90; 95% CIs: 0.62, 1.33) less likely to experience to experience all-cause mortality. The multivariable Cox model had acceptable prediction precision (Harrell's C concordance measure 0.72). Conclusion UNa was a significant predictor of all-cause mortality but not MACE outcomes over 28–33 years with 173–229 mmol/day appearing to be the optimal level. UNa may represent an emerging long-term prognostic biomarker that warrants further investigation.
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- 2022
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7. Economic Recession and the Risk of Cancer: A Cohort Study From Eastern Finland
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Rand Jarroch, Behnam Tajik, Tomi-Pekka Tuomainen, and Jussi Kauhanen
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economic recession ,socioeconomic position ,cancer ,population-based ,cohort study ,Medicine (General) ,R5-920 - Abstract
Background: Little is known about the role of economic recessions in the risk of cancer. Therefore, we evaluated the impact of the severe economic recession in Finland from 1991–1994 on the incidence of all cancers and cancer subtypes among a middle-age and older population. Methods: From the Kuopio Ischemic Heart Disease Risk Factor Study (KIHD), a population-based sample of 1,620 women and men aged 53–73 years were examined from 1998–2001. The cancer-free participants completed a questionnaire on the possible impact of the 1990s recession in Finland on their lives. Incident cases of cancer were obtained through record linkage with the Finnish Cancer Registry. Cox proportional hazards regression was used to estimate hazard ratios (HR) of incident cancer events after adjusting for possible confounders. Results: A total of 1,096 cancer-free participants had experienced socioeconomic hardships due to the recession at the baseline. During 20 years of follow-up, 473 participants developed cancer. After adjustment for age, baseline socioeconomic position, and lifestyle factors, the risk of all cancers was 32% higher among men who experienced socioeconomic hardships compared to those who did not (HR 1.32; 95% confidence interval [CI], 1.00–1.74, P = 0.05). Prostate-genital cancer was 71% higher among men with hardships (n = 103, HR 1.71; 95% CI, 1.06–2.74, P = 0.02). No association was observed between socioeconomic hardships and subsequent risk of total or any subtype of cancer among women. Conclusion: The 1990s economic recession was associated with increased risk of all cancers, especially prostate-genital cancer among Finnish middle-age and older men, but no association with cancer was observed in women.
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- 2022
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8. Association of Intima‐Media Thickness Measured at the Common Carotid Artery With Incident Carotid Plaque: Individual Participant Data Meta‐Analysis of 20 Prospective Studies
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Lena Tschiderer, Lisa Seekircher, Raffaele Izzo, Costantino Mancusi, Maria V. Manzi, Damiano Baldassarre, Mauro Amato, Elena Tremoli, Fabrizio Veglia, Tomi‐Pekka Tuomainen, Jussi Kauhanen, Ari Voutilainen, Bernhard Iglseder, Lars Lind, Tatjana Rundek, Moise Desvarieux, Akihiko Kato, Eric de Groot, Gülay Aşçi, Ercan Ok, Stefan Agewall, Joline W. J. Beulens, Christopher D. Byrne, Philip C. Calder, Hertzel C. Gerstein, Paolo Gresele, Gerhard Klingenschmid, Michiaki Nagai, Michael H. Olsen, Grace Parraga, Maya S. Safarova, Naveed Sattar, Michael Skilton, Coen D. A. Stehouwer, Heiko Uthoff, Michiel A. van Agtmael, Amber A. van der Heijden, Dorota A. Zozulińska‐Ziółkiewicz, Hyun‐Woong Park, Moo‐Sik Lee, Jang‐Ho Bae, Oscar Beloqui, Manuel F. Landecho, Matthieu Plichart, Pierre Ducimetiere, Jean Philippe Empana, Lena Bokemark, Göran Bergström, Caroline Schmidt, Samuela Castelnuovo, Laura Calabresi, Giuseppe D. Norata, Liliana Grigore, Alberico Catapano, Dong Zhao, Miao Wang, Jing Liu, M. Arfan Ikram, Maryam Kavousi, Michiel L. Bots, Michael J. Sweeting, Matthias W. Lorenz, and Peter Willeit
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carotid intima‐media thickness ,carotid plaque ,individual participant data meta‐analysis ,prospective studies ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background The association between common carotid artery intima‐media thickness (CCA‐IMT) and incident carotid plaque has not been characterized fully. We therefore aimed to precisely quantify the relationship between CCA‐IMT and carotid plaque development. Methods and Results We undertook an individual participant data meta‐analysis of 20 prospective studies from the Proof‐ATHERO (Prospective Studies of Atherosclerosis) consortium that recorded baseline CCA‐IMT and incident carotid plaque involving 21 494 individuals without a history of cardiovascular disease and without preexisting carotid plaque at baseline. Mean baseline age was 56 years (SD, 9 years), 55% were women, and mean baseline CCA‐IMT was 0.71 mm (SD, 0.17 mm). Over a median follow‐up of 5.9 years (5th–95th percentile, 1.9–19.0 years), 8278 individuals developed first‐ever carotid plaque. We combined study‐specific odds ratios (ORs) for incident carotid plaque using random‐effects meta‐analysis. Baseline CCA‐IMT was approximately log‐linearly associated with the odds of developing carotid plaque. The age‐, sex‐, and trial arm–adjusted OR for carotid plaque per SD higher baseline CCA‐IMT was 1.40 (95% CI, 1.31–1.50; I2=63.9%). The corresponding OR that was further adjusted for ethnicity, smoking, diabetes, body mass index, systolic blood pressure, low‐ and high‐density lipoprotein cholesterol, and lipid‐lowering and antihypertensive medication was 1.34 (95% CI, 1.24–1.45; I2=59.4%; 14 studies; 16 297 participants; 6381 incident plaques). We observed no significant effect modification across clinically relevant subgroups. Sensitivity analysis restricted to studies defining plaque as focal thickening yielded a comparable OR (1.38 [95% CI, 1.29–1.47]; I2=57.1%; 14 studies; 17 352 participants; 6991 incident plaques). Conclusions Our large‐scale individual participant data meta‐analysis demonstrated that CCA‐IMT is associated with the long‐term risk of developing first‐ever carotid plaque, independent of traditional cardiovascular risk factors.
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- 2023
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9. Serum ferritin and incident cardiometabolic diseases in Scottish adults
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Milton-Fabian Suárez-Ortegón, Stela McLachlan, José-Manuel Fernandez-Real, Tomi-Pekka Tuomainen, Alex Aregbesola, and Sarah H. Wild
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Metabolic syndrome ,Iron metabolism ,Obesity ,Type 2 diabetes ,Cardiovascular disease ,Cerebrovascular disease ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Iron stores, estimated as ferritin levels, and type 2 diabetes (T2D) have been associated previously, while findings regarding coronary heart disease (CHD) and cerebrovascular disease (CEVD) are still inconclusive. No study has focused on simultaneous evaluation of associations between iron stores and the above cardiometabolic diseases (CMD) in the same population. We aim to evaluate the association between serum ferritin and risk of T2D, CHD and CEVD in Scottish population over a wide range of ferritin levels. Methods Longitudinal study in 6,497 participants of the 1995 and 1998 Scottish health surveys, who were followed-up until 2011. Cox regression models were conducted adjusting for age, sex/menopausal status, fibrinogen, GGT levels, smoking, alcohol consumption, total cholesterol, HDL-cholesterol, blood pressure, and BMI. Ferritin was used as continuous (sex/menopausal status-specific Z score) and categorical variable (sex/menopausal status-specific quartiles, quintiles and sextiles). Results During follow-up, 4.9% of the participants developed T2D, 5.3% CHD, and 2.3% CEVD. By using ferritin quartiles, serum ferritin was positively associated with T2D, CHD and CEVD but only the association with T2D remained after adjustment for covariates [Quartile 4 v. 1: adjusted HR 95% CI 1.59 (1.10–2.34); P = 0.006]. When ferritin sextiles were used (6 v. 1), the ferritin-CEVD association became slightly stronger and significant [adjusted HR 95% CI 2.08 (1.09–3.94); P = 0.024]. Conclusions Iron stores relate differently to each CMD. Serum ferritin levels were positively and independently associated with incident T2D, and with incident CEVD if higher cut-off points for high ferritin levels were considered.
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- 2022
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10. Estimating Maximal Oxygen Uptake from the Ratio of Heart Rate at Maximal Exercise to Heart Rate at Rest in Middle-Aged Men
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Ari Voutilainen, Mounir Ould Setti, and Tomi-Pekka Tuomainen
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healthy lifestyle ,heart rate ,men’s health ,oxygen consumption ,physical exertion ,Medicine ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Purpose: To estimate the maximum mass-specific oxygen uptake (VO2max) from the ratio of the heart rate at maximal exercise (HRmax) to heart rate at rest (HRrest) in middle-aged men. VO2max is an essential measure of cardiorespiratory fitness, but it is difficult to utilize in clinical practice. The proportionality factor HRmax to HRrest is known to approximate 15 in young welltrained adults. Presumably, the same value is inaccurate for middle-aged men. Materials and Methods: Six-hundred thirty-four men belonging to the Kuopio Ischaemic Heart Disease Risk Factor Study. Their mean age, body mass index (BMI), the daily total physical activity (TPA), VO2max, HRmax, and HRrest were: 49.4±6.4 years, 26.3±3.2 kg/m2, 48.5±10.1 metabolic equivalent hours per day, 33.7±7.6 mL/min/kg, 170.1±15.4 beats/min, and 63.3±10.8 beats/min. They included never-smokers 38%, former smokers 29%, and current smokers 33%. Results: The proportionality factor HRmax to HRrest in around 50-year-old men approximated 12. One year in age, one step change in BMI (normal weight, overweight, obese), smoking status (never, former, current), and TPA (moderately active, active, highly active) reduced the proportionality factor by 0.1, 0.6, 0.4, and 0.1, respectively. The proportionality factor in obese or current smoking middle-aged men was one point lower compared to normal weight or never-smoking peers. This corresponds to approximately 10 years in chronological age. Conclusions: In around 50-year-old men with no cardiovascular diseases, bronchial asthma, or cancer, the HRmax to HRrest ratio should be multiplied by approximately 12 to estimate VO2max. BMI and smoking status can be considered in calculations to improve accuracy.
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- 2021
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11. Racial and Ethnic Differences in the Association Between Classical Cardiovascular Risk Factors and Common Carotid Intima‐Media Thickness: An Individual Participant Data Meta‐Analysis
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Engelbert A. Nonterah, Nigel J. Crowther, Kerstin Klipstein‐Grobusch, Abraham R. Oduro, Maryam Kavousi, Godfred Agongo, Todd J. Anderson, Gershim Asiki, Palwendé R. Boua, Solomon S. R. Choma, David J. Couper, Gunnar Engström, Jacqueline de Graaf, Jussi Kauhanen, Eva M. Lonn, Ellisiv B. Mathiesen, Lisa K. Micklesfield, Shuhei Okazaki, Joseph F. Polak, Tatjana Rundek, Jukka T. Salonen, Stephen M. Tollman, Tomi‐Pekka Tuomainen, Diederick E. Grobbee, Michéle Ramsay, and Michiel L. Bots
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atherosclerosis ,cardiovascular disease risk ,carotid intima‐media thickness ,ethnicity ,individual participant data meta‐analysis ,race ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background The major risk factors for atherosclerotic cardiovascular disease differ by race or ethnicity but have largely been defined using populations of European ancestry. Despite the rising prevalence of cardiovascular disease in Africa there are few related data from African populations. Therefore, we compared the association of established cardiovascular risk factors with carotid‐intima media thickness (CIMT), a subclinical marker of atherosclerosis, between African, African American, Asian, European, and Hispanic populations. Methods and Results Cross‐sectional analyses of 34 025 men and women drawn from 15 cohorts in Africa, Asia, Europe, and North America were undertaken. Classical cardiovascular risk factors were assessed and CIMT measured using B‐mode ultrasound. Ethnic differences in the association of established cardiovascular risk factors with CIMT were determined using a 1‐stage individual participant data meta‐analysis with beta coefficients expressed as a percentage using the White population as the reference group. CIMT adjusted for risk factors was the greatest among African American populations followed by Asian, European, and Hispanic populations with African populations having the lowest mean CIMT. In all racial or ethnic groups, men had higher CIMT levels compared with women. Age, sex, body mass index, and systolic blood pressure had a significant positive association with CIMT in all races and ethnicities at varying magnitudes. When compared with European populations, the association of age, sex, and systolic blood pressure with CIMT was weaker in all races and ethnicities. Smoking (beta coefficient, 0.39; 95% CI, 0.09–0.70), body mass index (beta coefficient, 0.05; 95% CI, 0.01–0.08) and glucose (beta coefficient, 0.13; 95% CI, 0.06–0.19) had the strongest positive association with CIMT in the Asian population when compared with all other racial and ethnic groups. High‐density lipoprotein‐cholesterol had significant protective effects in African American (beta coefficient, −0.31; 95% CI, −0.42 to −0.21) and African (beta coefficient, −0.26; 95% CI, −0.31 to −0.19) populations only. Conclusions The strength of association between established cardiovascular risk factors and CIMT differed across the racial or ethnic groups and may be due to lifestyle risk factors and genetics. These differences have implications for race‐ ethnicity‐specific primary prevention strategies and also give insights into the differential contribution of risk factors to the pathogenesis of cardiovascular disease. The greatest burden of subclinical atherosclerosis in African American individuals warrants further investigations.
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- 2022
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12. Effects of data preprocessing on results of the epidemiological analysis of coronary heart disease and behaviour-related risk factors
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Ari Voutilainen, Christina Brester, Mikko Kolehmainen, and Tomi-Pekka Tuomainen
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Categorical covariate ,continuous covariate ,coronary heart disease ,exclusion criterion ,outcome sensitivity ,Medicine - Abstract
AbstractBackground We carried out this study to demonstrate the effects of outcome sensitivity, participant exclusions, and covariate manipulations on results of the epidemiological analysis of coronary heart disease (CHD) and its behaviour-related risk factors.Material and methods Our study population consisted of 1592 54-year-old men, who participated in the Kuopio Ischaemic Heart Disease Risk Factor (KIHD) Study. We used the Cox proportional-hazards model to predict the hazard of CHD and applied different sets of outcomes concerning outcome sensitivity and data preprocessing procedures regarding participant exclusions and covariate manipulations.Results The mean follow-up time was 23 years, and 730 men received the CHD diagnosis. Cox regressions based on data with no participant exclusions most often discovered statistically significant associations. Loose inclusion criteria for study participants with any CVD during the follow-up and strict exclusion criteria for participants with no CVD were best in discovering the associations between risk factors and CHD. Outcome sensitivity affected the associations, whereas the covariate type, continuous or categorical, did not.Conclusions This study suggests that excluding study participants who are not disease-free at baseline is probably unnecessary for epidemiological analyses. Epidemiological research reports should present results based on no data exclusions together with results based on reasoned exclusions.
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- 2021
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13. Economic Recession and the Long Term Risk of Psychiatric Disorders and Alcohol Related Diseases—A Cohort Study From Eastern Finland
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Rand Jarroch, Behnam Tajik, Tomi-Pekka Tuomainen, and Jussi Kauhanen
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socioeconomic ,economic recession ,psychiatric disorders ,alcohol-related diseases ,population-based ,epidemiology ,Psychiatry ,RC435-571 - Abstract
BackgroundLong-term development of psychiatric disorders and alcohol-related diseases after economic recessions is insufficiently studied. We investigated the overall impact of the economic recession between 1991 and 1994 in Finland on the long-term incidence of psychiatric and alcohol-related diseases.MethodsA population-based sample of 1,774 women and men aged 53–73 years were examined between 1998 and 2001 from the Kuopio Ischemic Heart Disease Risk Factor Study (KIHD). Participants completed comprehensive questionnaires on the possible impact of the 1990s recession in Finland on their lives. They were followed-up until 2018. Cox proportional hazards regression was used to estimate hazard ratios (HR) of new incident psychiatric and alcohol-related disorders during the 20-years follow-up after linkage to the National Hospital Registry. Logistic regression was used to estimate odds ratios (OR) of psychiatric disorders at baseline.ResultsAt baseline, 93 participants had psychiatric disorders. During 20-years follow-up, 138 new psychiatric disorders and 45 alcohol-related diseases were developed. The covariate-adjusted risk of psychiatric disorders was over twice higher among men who experienced recession-induced hardships compared to those who did not (HR = 2.20, 95%CI = 1.04–4.70, p = 0.04). The risk of alcohol-related diseases was more than four times higher among men with hardships (HR = 4.44, 95%CI = 1.04–18.90, p = 0.04). No such associations were observed among women. No association was observed between recession-induced hardships and having psychiatric disorders at baseline in both genders (multivariate-adjusted p = 0.63 for women, multivariate-adjusted p = 0.36 for men).ConclusionLong-term risk of psychiatric disorders and alcohol-related diseases was increased after the 1990s economic recession in Finland, but only among middle-age and older men.
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- 2022
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14. Renal hyperfiltration, fatty liver index, and the hazards of all-cause and cardiovascular mortality in Finnish men
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Mounir Ould Setti, Ari Voutilainen, and Tomi-Pekka Tuomainen
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mortality ,cardiovascular diseases ,heart disease risk factors ,glomerular filtration rate ,fatty liver ,non-alcoholic fatty liver disease ,Medicine - Abstract
OBJECTIVES Renal hyperfiltration (RHF) and fatty liver are separately associated with adverse health outcomes. In this study, we investigated the mortality hazard of coexisting RHF and fatty liver. METHODS Middle-aged men from the Kuopio Ischaemic Disease Risk Factor Study (n=1,552) were followed up for a median of 29 years. Associations among RHF, fatty liver index (FLI) score, age, body mass index, smoking status, alcohol consumption, and hypertension status were assessed using logistic regression. Cox proportional hazards models were used to determine the hazard ratios (HRs) for all-cause and cardiovascular disease (CVD) mortality with respect to RHF and fatty liver. RESULTS Of the men, 5% had RHF (n=73), whereas a majority had fatty liver (n=848). RHF was associated specifically with smoking, and fatty liver was associated specifically with overweight. The all-cause mortality hazard was highest (HR, 1.96; 95% confidence interval [CI], 1.27 to 3.01) among men with RHF and fatty liver (n=33). Among men with RHF but normal FLI (n=40), the HR of all-cause mortality was 1.67 (95% CI, 1.15 to 2.42). Among men with fatty liver but a normal estimated glomerular filtration rate (n=527), the HR of all-cause mortality was 1.35 (95% CI, 1.09 to 1.66). CVD mortality hazard was associated with RHF, but not fatty liver. We detected no interaction effect between RHF and fatty liver for all-cause (synergy index, 0.74; 95% CI, 0.21 to 2.67) or CVD (synergy index, 0.94; 95% CI, 0.34 to 2.60) mortality. CONCLUSIONS RHF and fatty liver are independently associated with all-cause and CVD mortality
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- 2020
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15. Fatty acids in the de novo lipogenesis pathway and incidence of type 2 diabetes: A pooled analysis of prospective cohort studies.
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Fumiaki Imamura, Amanda M Fretts, Matti Marklund, Andres V Ardisson Korat, Wei-Sin Yang, Maria Lankinen, Waqas Qureshi, Catherine Helmer, Tzu-An Chen, Jyrki K Virtanen, Kerry Wong, Julie K Bassett, Rachel Murphy, Nathan Tintle, Chaoyu Ian Yu, Ingeborg A Brouwer, Kuo-Liong Chien, Yun-Yu Chen, Alexis C Wood, Liana C Del Gobbo, Luc Djousse, Johanna M Geleijnse, Graham G Giles, Janette de Goede, Vilmundur Gudnason, William S Harris, Allison Hodge, Frank Hu, InterAct Consortium, Albert Koulman, Markku Laakso, Lars Lind, Hung-Ju Lin, Barbara McKnight, Kalina Rajaobelina, Ulf Riserus, Jennifer G Robinson, Cecilia Samieri, Mackenzie Senn, David S Siscovick, Sabita S Soedamah-Muthu, Nona Sotoodehnia, Qi Sun, Michael Y Tsai, Tomi-Pekka Tuomainen, Matti Uusitupa, Lynne E Wagenknecht, Nick J Wareham, Jason H Y Wu, Renata Micha, Rozenn N Lemaitre, Dariush Mozaffarian, and Nita G Forouhi
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Medicine - Abstract
BackgroundDe novo lipogenesis (DNL) is the primary metabolic pathway synthesizing fatty acids from carbohydrates, protein, or alcohol. Our aim was to examine associations of in vivo levels of selected fatty acids (16:0, 16:1n7, 18:0, 18:1n9) in DNL with incidence of type 2 diabetes (T2D).Methods and findingsSeventeen cohorts from 12 countries (7 from Europe, 7 from the United States, 1 from Australia, 1 from Taiwan; baseline years = 1970-1973 to 2006-2010) conducted harmonized individual-level analyses of associations of DNL-related fatty acids with incident T2D. In total, we evaluated 65,225 participants (mean ages = 52.3-75.5 years; % women = 20.4%-62.3% in 12 cohorts recruiting both sexes) and 15,383 incident cases of T2D over the 9-year follow-up on average. Cohort-specific association of each of 16:0, 16:1n7, 18:0, and 18:1n9 with incident T2D was estimated, adjusted for demographic factors, socioeconomic characteristics, alcohol, smoking, physical activity, dyslipidemia, hypertension, menopausal status, and adiposity. Cohort-specific associations were meta-analyzed with an inverse-variance-weighted approach. Each of the 4 fatty acids positively related to incident T2D. Relative risks (RRs) per cohort-specific range between midpoints of the top and bottom quintiles of fatty acid concentrations were 1.53 (1.41-1.66; p < 0.001) for 16:0, 1.40 (1.33-1.48; p < 0.001) for 16:1n-7, 1.14 (1.05-1.22; p = 0.001) for 18:0, and 1.16 (1.07-1.25; p < 0.001) for 18:1n9. Heterogeneity was seen across cohorts (I2 = 51.1%-73.1% for each fatty acid) but not explained by lipid fractions and global geographical regions. Further adjusted for triglycerides (and 16:0 when appropriate) to evaluate associations independent of overall DNL, the associations remained significant for 16:0, 16:1n7, and 18:0 but were attenuated for 18:1n9 (RR = 1.03, 95% confidence interval (CI) = 0.94-1.13). These findings had limitations in potential reverse causation and residual confounding by imprecisely measured or unmeasured factors.ConclusionsConcentrations of fatty acids in the DNL were positively associated with T2D incidence. Our findings support further work to investigate a possible role of DNL and individual fatty acids in the development of T2D.
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- 2020
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16. Kuopio birth cohort – design of a Finnish joint research effort for identification of environmental and lifestyle risk factors for the wellbeing of the mother and the newborn child
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Pasi Huuskonen, Leea Keski-Nisula, Seppo Heinonen, Sari Voutilainen, Tomi-Pekka Tuomainen, Juha Pekkanen, Jussi Lampi, Soili M Lehto, Hannariikka Haaparanta, Antti-Pekka Elomaa, Raimo Voutilainen, Katri Backman, Hannu Kokki, Kirsti Kumpulainen, Jussi Paananen, Kirsi Vähäkangas, and Markku Pasanen
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Birth weight ,Environmental health ,Foetus ,Maternal smoking ,Mental health ,Metabolism ,Gynecology and obstetrics ,RG1-991 - Abstract
Abstract Background A Finnish joint research effort Kuopio Birth Cohort (KuBiCo) seeks to evaluate the effects of genetics, epigenetics and different risk factors (medication, nutrition, lifestyle factors and environmental aspects) during pregnancy on the somatic and psychological health status of the mother and the child. Methods KuBiCo will ultimately include information on 10,000 mother-child pairs who have given their informed consent to participate in this cohort. Identification of foetal health risk factors that can potentially later manifest as disease requires a repository of relevant biological samples and a flexible open up-to-date data handling system to register, store and analyse biological, clinical and questionnaire-based data. KuBiCo includes coded questionnaire-based maternal background data gathered before, during and after the pregnancy and bio-banking of maternal and foetal samples that will be stored in deep freezers. Data from the questionnaires and biological samples will be collected into one electronic database. KuBiCo consists of several work packages which are complementary to each other: Maternal, foetal and placental metabolism and omics; Paediatrics; Mental wellbeing; Prenatal period and delivery; Analgesics and anaesthetics during peripartum period; Environmental effects; Nutrition; and Research ethics. Discussion This report describes the set-up of the KuBiCo and descriptive analysis from 3532 parturients on response frequencies and feedback to KuBiCo questionnaires gathered from June 2012 to April 2016. Additionally, we describe basic demographic data of the participants (n = 1172). Based on the comparison of demographic data between official national statistics and our descriptive analysis, KuBiCo represents a cross-section of Finnish pregnant women.
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- 2018
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17. Evolutionary methods for variable selection in the epidemiological modeling of cardiovascular diseases
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Christina Brester, Jussi Kauhanen, Tomi-Pekka Tuomainen, Sari Voutilainen, Mauno Rönkkö, Kimmo Ronkainen, Eugene Semenkin, and Mikko Kolehmainen
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Variable selection ,Cardiovascular disease ,Predictive modeling ,Kuopio ischemic heart disease risk factor study ,Computer applications to medicine. Medical informatics ,R858-859.7 ,Analysis ,QA299.6-433 - Abstract
Abstract Background The redundancy of information is becoming a critical issue for epidemiologists. High-dimensional datasets require new effective variable selection methods to be developed. This study implements an advanced evolutionary variable selection method which is applied for cardiovascular predictive modeling. The epidemiological follow-up study KIHD (Kuopio Ischemic Heart Disease Risk Factor Study) was used to compare the designed variable selection method based on an evolutionary search with conventional stepwise selection. The sample contains in total 433 predictor variables and a response variable indicating incidents of cardiovascular diseases for 1465 study subjects. Results The effectiveness of variable selection methods was investigated in combination with two models: Generalized Linear Logistic Regression and Support Vector Machine. We managed to decrease the number of variables from 433 to 38 and save the predictive ability of the models used. Their performance was evaluated with an F-score metric. At most, we gained 65.6% and 67.4% of the F-score before and after variable selection respectively. All the results were averaged over 5-folds of a cross-validation procedure. Conclusions The presented evolutionary variable selection method allows a reduced set of variables to be chosen which are relevant to predicting cardiovascular diseases. A reference list of the most meaningful variables is introduced to be used as a basis for new epidemiological studies. In general, the multicollinearity of variables enables different combinations of predictors to be used and the same performance of models to be attained.
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- 2018
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18. Post-Analysis of Predictive Modeling with an Epidemiological Example
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Christina Brester, Ari Voutilainen, Tomi-Pekka Tuomainen, Jussi Kauhanen, and Mikko Kolehmainen
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post-analysis of data-driven models ,rule design ,multi-objective optimization ,model performance ,prediction of cardiovascular death ,Medicine - Abstract
Post-analysis of predictive models fosters their application in practice, as domain experts want to understand the logic behind them. In epidemiology, methods explaining sophisticated models facilitate the usage of up-to-date tools, especially in the high-dimensional predictor space. Investigating how model performance varies for subjects with different conditions is one of the important parts of post-analysis. This paper presents a model-independent approach for post-analysis, aiming to reveal those subjects’ conditions that lead to low or high model performance, compared to the average level on the whole sample. Conditions of interest are presented in the form of rules generated by a multi-objective evolutionary algorithm (MOGA). In this study, Lasso logistic regression (LLR) was trained to predict cardiovascular death by 2016 using the data from the 1984–1989 examination within the Kuopio Ischemic Heart Disease Risk Factor Study (KIHD), which contained 2682 subjects and 950 preselected predictors. After 50 independent runs of five-fold cross-validation, the model performance collected for each subject was used to generate rules describing “easy” and “difficult” cases. LLR with 61 selected predictors, on average, achieved 72.53% accuracy on the whole sample. However, during post-analysis, three categories of subjects were discovered: “Easy” cases with an LLR accuracy of 95.84%, “difficult” cases with an LLR accuracy of 48.11%, and the remaining cases with an LLR accuracy of 71.00%. Moreover, the rule analysis showed that medication was one of the main confusing factors that led to lower model performance. The proposed approach provides insightful information about subjects’ conditions that complicate predictive modeling.
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- 2021
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19. Association of fatty liver disease with mortality outcomes in an Eastern Finland male cohort
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Olubunmi O Olubamwo, Jyrki K Virtanen, Jussi Pihlajamäki, and Tomi-Pekka Tuomainen
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Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
ObjectiveFatty liver disease (FLD) has been associated with extrahepatic morbidity outcomes. However, reports on the association of FLD, assessed using fatty liver index (FLI), with mortality outcomes have been inconsistent. Our objective was to examine the effect of metabolic factors (blood pressure, insulin, fasting glucose, lipoproteins) on the associations of FLI with mortality outcomes among middle-aged men.Study designProspective cohort study.MethodsOur subjects were 1893 men at baseline from 1984 to 1989 in the Kuopio Ischaemic Heart Disease Risk Factor Study cohort. Multivariable Cox regression models were used to analyse the association of baseline FLI, with the HRs for all-cause, disease, cardiovascular, non-cardiovascular and cancer mortality outcomes.ResultsThe mean FLI in the FLI categories were 16.2 in the low and reference category (FLI
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- 2019
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20. Correction: Predictive value for cardiovascular events of common carotid intima media thickness and its rate of change in individuals at high cardiovascular risk - Results from the PROG-IMT collaboration.
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Matthias W Lorenz, Lu Gao, Kathrin Ziegelbauer, Giuseppe Danilo Norata, Jean Philippe Empana, Irene Schmidtmann, Hung-Ju Lin, Stela McLachlan, Lena Bokemark, Kimmo Ronkainen, Mauro Amato, Ulf Schminke, Sathanur R Srinivasan, Lars Lind, Shuhei Okazaki, Coen D A Stehouwer, Peter Willeit, Joseph F Polak, Helmuth Steinmetz, Dirk Sander, Holger Poppert, Moise Desvarieux, M Arfan Ikram, Stein Harald Johnsen, Daniel Staub, Cesare R Sirtori, Bernhard Iglseder, Oscar Beloqui, Gunnar Engström, Alfonso Friera, Francesco Rozza, Wuxiang Xie, Grace Parraga, Liliana Grigore, Matthieu Plichart, Stefan Blankenberg, Ta-Chen Su, Caroline Schmidt, Tomi-Pekka Tuomainen, Fabrizio Veglia, Henry Völzke, Giel Nijpels, Johann Willeit, Ralph L Sacco, Oscar H Franco, Heiko Uthoff, Bo Hedblad, Carmen Suarez, Raffaele Izzo, Dong Zhao, Thapat Wannarong, Alberico Catapano, Pierre Ducimetiere, Christine Espinola-Klein, Kuo-Liong Chien, Jackie F Price, Göran Bergström, Jussi Kauhanen, Elena Tremoli, Marcus Dörr, Gerald Berenson, Kazuo Kitagawa, Jacqueline M Dekker, Stefan Kiechl, Matthias Sitzer, Horst Bickel, Tatjana Rundek, Albert Hofman, Ellisiv B Mathiesen, Samuela Castelnuovo, Manuel F Landecho, Maria Rosvall, Rafael Gabriel, Nicola de Luca, Jing Liu, Damiano Baldassarre, Maryam Kavousi, Eric de Groot, Michiel L Bots, David N Yanez, Simon G Thompson, and PROG-IMT study group
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Medicine ,Science - Abstract
[This corrects the article DOI: 10.1371/journal.pone.0191172.].
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- 2018
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21. Predictive value for cardiovascular events of common carotid intima media thickness and its rate of change in individuals at high cardiovascular risk - Results from the PROG-IMT collaboration.
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Matthias W Lorenz, Lu Gao, Kathrin Ziegelbauer, Giuseppe Danilo Norata, Jean Philippe Empana, Irene Schmidtmann, Hung-Ju Lin, Stela McLachlan, Lena Bokemark, Kimmo Ronkainen, Mauro Amato, Ulf Schminke, Sathanur R Srinivasan, Lars Lind, Shuhei Okazaki, Coen D A Stehouwer, Peter Willeit, Joseph F Polak, Helmuth Steinmetz, Dirk Sander, Holger Poppert, Moise Desvarieux, M Arfan Ikram, Stein Harald Johnsen, Daniel Staub, Cesare R Sirtori, Bernhard Iglseder, Oscar Beloqui, Gunnar Engström, Alfonso Friera, Francesco Rozza, Wuxiang Xie, Grace Parraga, Liliana Grigore, Matthieu Plichart, Stefan Blankenberg, Ta-Chen Su, Caroline Schmidt, Tomi-Pekka Tuomainen, Fabrizio Veglia, Henry Völzke, Giel Nijpels, Johann Willeit, Ralph L Sacco, Oscar H Franco, Heiko Uthoff, Bo Hedblad, Carmen Suarez, Raffaele Izzo, Dong Zhao, Thapat Wannarong, Alberico Catapano, Pierre Ducimetiere, Christine Espinola-Klein, Kuo-Liong Chien, Jackie F Price, Göran Bergström, Jussi Kauhanen, Elena Tremoli, Marcus Dörr, Gerald Berenson, Kazuo Kitagawa, Jacqueline M Dekker, Stefan Kiechl, Matthias Sitzer, Horst Bickel, Tatjana Rundek, Albert Hofman, Ellisiv B Mathiesen, Samuela Castelnuovo, Manuel F Landecho, Maria Rosvall, Rafael Gabriel, Nicola de Luca, Jing Liu, Damiano Baldassarre, Maryam Kavousi, Eric de Groot, Michiel L Bots, David N Yanez, Simon G Thompson, and PROG-IMT study group
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Medicine ,Science - Abstract
AIMS:Carotid intima media thickness (CIMT) predicts cardiovascular (CVD) events, but the predictive value of CIMT change is debated. We assessed the relation between CIMT change and events in individuals at high cardiovascular risk. METHODS AND RESULTS:From 31 cohorts with two CIMT scans (total n = 89070) on average 3.6 years apart and clinical follow-up, subcohorts were drawn: (A) individuals with at least 3 cardiovascular risk factors without previous CVD events, (B) individuals with carotid plaques without previous CVD events, and (C) individuals with previous CVD events. Cox regression models were fit to estimate the hazard ratio (HR) of the combined endpoint (myocardial infarction, stroke or vascular death) per standard deviation (SD) of CIMT change, adjusted for CVD risk factors. These HRs were pooled across studies. In groups A, B and C we observed 3483, 2845 and 1165 endpoint events, respectively. Average common CIMT was 0.79mm (SD 0.16mm), and annual common CIMT change was 0.01mm (SD 0.07mm), both in group A. The pooled HR per SD of annual common CIMT change (0.02 to 0.43mm) was 0.99 (95% confidence interval: 0.95-1.02) in group A, 0.98 (0.93-1.04) in group B, and 0.95 (0.89-1.04) in group C. The HR per SD of common CIMT (average of the first and the second CIMT scan, 0.09 to 0.75mm) was 1.15 (1.07-1.23) in group A, 1.13 (1.05-1.22) in group B, and 1.12 (1.05-1.20) in group C. CONCLUSIONS:We confirm that common CIMT is associated with future CVD events in individuals at high risk. CIMT change does not relate to future event risk in high-risk individuals.
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- 2018
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22. Clustering of cardiovascular risk factors and carotid intima-media thickness: The USE-IMT study.
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Xin Wang, Geertje W Dalmeijer, Hester M den Ruijter, Todd J Anderson, Annie R Britton, Jacqueline Dekker, Gunnar Engström, Greg W Evans, Jacqueline de Graaf, Diederick E Grobbee, Bo Hedblad, Suzanne Holewijn, Ai Ikeda, Jussi Kauhanen, Kazuo Kitagawa, Akihiko Kitamura, Sudhir Kurl, Eva M Lonn, Matthias W Lorenz, Ellisiv B Mathiesen, Giel Nijpels, Shuhei Okazaki, Joseph F Polak, Jacqueline F Price, Christopher M Rembold, Maria Rosvall, Tatjana Rundek, Jukka T Salonen, Matthias Sitzer, Coen D A Stehouwer, Tomi-Pekka Tuomainen, Sanne A E Peters, and Michiel L Bots
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Medicine ,Science - Abstract
BACKGROUND:The relation of a single risk factor with atherosclerosis is established. Clinically we know of risk factor clustering within individuals. Yet, studies into the magnitude of the relation of risk factor clusters with atherosclerosis are limited. Here, we assessed that relation. METHODS:Individual participant data from 14 cohorts, involving 59,025 individuals were used in this cross-sectional analysis. We made 15 clusters of four risk factors (current smoking, overweight, elevated blood pressure, elevated total cholesterol). Multilevel age and sex adjusted linear regression models were applied to estimate mean differences in common carotid intima-media thickness (CIMT) between clusters using those without any of the four risk factors as reference group. RESULTS:Compared to the reference, those with 1, 2, 3 or 4 risk factors had a significantly higher common CIMT: mean difference of 0.026 mm, 0.052 mm, 0.074 mm and 0.114 mm, respectively. These findings were the same in men and in women, and across ethnic groups. Within each risk factor cluster (1, 2, 3 risk factors), groups with elevated blood pressure had the largest CIMT and those with elevated cholesterol the lowest CIMT, a pattern similar for men and women. CONCLUSION:Clusters of risk factors relate to increased common CIMT in a graded manner, similar in men, women and across race-ethnic groups. Some clusters seemed more atherogenic than others. Our findings support the notion that cardiovascular prevention should focus on sets of risk factors rather than individual levels alone, but may prioritize within clusters.
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- 2017
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23. Relevance of vitamin D receptor target genes for monitoring the vitamin D responsiveness of primary human cells.
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Maja Vukić, Antonio Neme, Sabine Seuter, Noora Saksa, Vanessa D F de Mello, Tarja Nurmi, Matti Uusitupa, Tomi-Pekka Tuomainen, Jyrki K Virtanen, and Carsten Carlberg
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Medicine ,Science - Abstract
Vitamin D3 has transcriptome- and genome-wide effects and activates, via the binding of its metabolite 1α,25-dihydroxyvitamin D3 to the transcription factor vitamin D receptor (VDR), several hundred target genes. Using samples from a 5-month vitamin D3 intervention study (VitDmet), we recently reported that the expression of 12 VDR target genes in peripheral blood mononuclear cells (PBMCs) as well as 12 biochemical and clinical parameters of the study participants are significantly triggered by vitamin D3. In this study, we performed a more focused selection of further 12 VDR target genes and demonstrated that changes of their mRNA expression in PBMCs of VitDmet subjects significantly correlate with alterations of 25-hydroxyvitamin D3 serum levels. Network and self-organizing map analysis of these datasets together with that of the other 24 parameters was followed by relevance calculations and identified changes in parathyroid hormone serum levels and the expression of the newly selected genes STS, BCL6, ITGAM, LRRC25, LPGAT1 and TREM1 as well as of the previously reported genes DUSP10 and CD14 as the most relevant parameters for describing vitamin D responsiveness in vivo. Moreover, parameter relevance ranking allowed the segregation of study subjects into high and low responders. Due to the long intervention period the vitamin D response was not too prominent on the level of transcriptional activation. Therefore, we performed in the separate VitDbol trial a short-term but high dose stimulation with a vitamin D3 bolus. In PBMCs of VitDbol subjects we observed direct transcriptional effects on the selected VDR target genes, such as an up to 2.1-fold increase already one day after supplementation onset. In conclusion, both long-term and short-term vitamin D3 supplementation studies allow monitoring the vitamin D responsiveness of human individuals and represent new types of human in vivo vitamin D3 investigations.
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- 2015
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24. Glucose Metabolism Effects of Vitamin D in Prediabetes: The VitDmet Randomized Placebo-Controlled Supplementation Study
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Tomi-Pekka Tuomainen, Jyrki K. Virtanen, Sari Voutilainen, Tarja Nurmi, Jaakko Mursu, Vanessa D. F. de Mello, Ursula Schwab, Martti Hakumäki, Kari Pulkki, and Matti Uusitupa
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Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 - Abstract
Epidemiological evidence suggests a role for vitamin D in type 2 diabetes prevention. We investigated the effects of vitamin D3 supplementation on glucose metabolism and inflammation in subjects with prediabetes. A 5-month randomized, double-blind, placebo-controlled intervention with three arms (placebo, 40 μg/d, or 80 μg/d vitamin D3) was carried out among sixty-eight overweight (BMI 25–35) and aging (≥60 years) subjects from Finland, with serum 25-hydroxyvitamin D3 [25(OH)D3] < 75 nmol/L and either impaired fasting glucose or impaired glucose tolerance. Analyses included 66 subjects who completed the trial. Glucose metabolism was evaluated by fasting and 2-hour oral glucose tolerance test-derived indices and glycated hemoglobin. Inflammation was evaluated by high-sensitive C-reactive protein and five cytokines. Although a dose-dependent increase in serum 25(OH)D3 over the supplementation period was observed (P trend < 0.001), there were no other statistically significant differences in changes in the 13 glucose homeostasis indicators between the study groups other than increase in the 120 min glucose concentration (P trend = 0.021) and a decreasing trend both in 30 min plasma insulin (P trend = 0.030) and glycated hemoglobin (P trend = 0.024) concentrations. A borderline statistically significant decreasing trend in interleukin-1 receptor antagonist concentration was observed (P = 0.070). Vitamin D3 supplementation does not improve glucose metabolism in ageing subjects with prediabetes but may have modest anti-inflammatory effects.
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- 2015
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25. Testosterone, sex hormone-binding globulin and the metabolic syndrome in men: an individual participant data meta-analysis of observational studies.
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Judith S Brand, Maroeska M Rovers, Bu B Yeap, Harald J Schneider, Tomi-Pekka Tuomainen, Robin Haring, Giovanni Corona, Altan Onat, Marcello Maggio, Claude Bouchard, Peter C Y Tong, Richard Y T Chen, Masahiro Akishita, Jourik A Gietema, Marie-Hélène Gannagé-Yared, Anna-Lena Undén, Aarno Hautanen, Nicolai P Goncharov, Philip Kumanov, S A Paul Chubb, Osvaldo P Almeida, Hans-Ulrich Wittchen, Jens Klotsche, Henri Wallaschofski, Henry Völzke, Jussi Kauhanen, Jukka T Salonen, Luigi Ferrucci, and Yvonne T van der Schouw
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Medicine ,Science - Abstract
BACKGROUND:Low total testosterone (TT) and sex hormone-binding globulin (SHBG) concentrations have been associated with the metabolic syndrome (MetS) in men, but the reported strength of association varies considerably. OBJECTIVES:We aimed to investigate whether associations differ across specific subgroups (according to age and body mass index (BMI)) and individual MetS components. DATA SOURCES:Two previously published meta-analyses including an updated systematic search in PubMed and EMBASE. STUDY ELIGIBILITY CRITERIA:Cross-sectional or prospective observational studies with data on TT and/or SHBG concentrations in combination with MetS in men. METHODS:We conducted an individual participant data meta-analysis of 20 observational studies. Mixed effects models were used to assess cross-sectional and prospective associations of TT, SHBG and free testosterone (FT) with MetS and its individual components. Multivariable adjusted odds ratios (ORs) and hazard ratios (HRs) were calculated and effect modification by age and BMI was studied. RESULTS:Men with low concentrations of TT, SHBG or FT were more likely to have prevalent MetS (ORs per quartile decrease were 1.69 (95% CI 1.60-1.77), 1.73 (95% CI 1.62-1.85) and 1.46 (95% CI 1.36-1.57) for TT, SHBG and FT, respectively) and incident MetS (HRs per quartile decrease were 1.25 (95% CI 1.16-1.36), 1.44 (95% 1.30-1.60) and 1.14 (95% 1.01-1.28) for TT, SHBG and FT, respectively). Overall, the magnitude of associations was largest in non-overweight men and varied across individual components: stronger associations were observed with hypertriglyceridemia, abdominal obesity and hyperglycaemia and associations were weakest for hypertension. CONCLUSIONS:Associations of testosterone and SHBG with MetS vary according to BMI and individual MetS components. These findings provide further insights into the pathophysiological mechanisms linking low testosterone and SHBG concentrations to cardiometabolic risk.
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- 2014
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26. Primary vitamin D target genes allow a categorization of possible benefits of vitamin D₃ supplementation.
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Carsten Carlberg, Sabine Seuter, Vanessa D F de Mello, Ursula Schwab, Sari Voutilainen, Kari Pulkki, Tarja Nurmi, Jyrki Virtanen, Tomi-Pekka Tuomainen, and Matti Uusitupa
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Medicine ,Science - Abstract
Vitamin D deficiency has been associated with an increased risk of developing a number of diseases. Here we investigated samples from 71 pre-diabetic individuals of the VitDmet study, a 5-month high dose vitamin D3 intervention trial during Finnish winter, for their changes in serum 25-hydroxyvitamin D3 (25(OH)D3) concentrations and the expression of primary vitamin D target genes in peripheral blood mononuclear cells and adipose tissue. A negative correlation between serum concentrations of parathyroid hormone and 25(OH)D3 suggested an overall normal physiological vitamin D response among the participants. The genes CD14 and thrombomodulin (THBD) are up-regulated primary vitamin D targets and showed to be suitable gene expression markers for vitamin D signaling in both primary tissues. However, in a ranking of the samples concerning their expected response to vitamin D only the top half showed a positive correlation between the changes of CD14 or THBD mRNA and serum 25(OH)D3 concentrations. Interestingly, this categorization allows unmasking a negative correlation between changes in serum concentrations of 25(OH)D3 and the inflammation marker interleukin 6. We propose the genes CD14 and THBD as transcriptomic biomarkers, from which the effects of a vitamin D3 supplementation can be evaluated. These biomarkers allow the classification of subjects into those, who might benefit from a vitamin D3 supplementation, and others who do not.
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- 2013
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27. Serum long-chain n-3 polyunsaturated fatty acids, mercury, and risk of sudden cardiac death in men: a prospective population-based study.
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Jyrki K Virtanen, Jari A Laukkanen, Jaakko Mursu, Sari Voutilainen, and Tomi-Pekka Tuomainen
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Medicine ,Science - Abstract
ObjectivesFish consumption has been associated with reduced risk of cardiovascular diseases (CVD), especially sudden cardiac death (SCD). Fish is the major source of long-chain n-3 polyunsaturated fatty acids (PUFA) eicosapentaenoic acid and docosahexaenoic acid. It is also a major source of methylmercury, which was associated with increased risk of CVD in this study population. Impact of interaction between long-chain n-3 PUFA and methylmercury on the SCD risk is unknown.MethodsA total of 1857 men from the prospective, population-based Kuopio Ischaemic Heart Disease Risk Factor study, aged 42-60 years and free of CVD at baseline in 1984-1989, were studied. Serum long-chain n-3 PUFA was used as the marker for long-chain n-3 PUFA intake and hair mercury as the marker for mercury exposure.ResultsDuring the mean follow-up of 20.1 years, 91 SCD events occurred. In the multivariate Cox proportional hazards regression models, serum long-chain n-3 PUFA concentration was not associated with the risk of SCD until hair mercury was accounted for; then the hazard ratio (HR) in the highest vs. lowest tertile was 0.54 [95% confidence interval (CI) 0.32 to 0.91, p for trend = 0.046]. When the analyses were stratified by hair mercury content, among those with lower hair mercury, each 0.5 percentage unit increase in the serum long-chain n-3 PUFA was associated with HR of 0.77 (95% CI 0.64 to 0.93), whereas no association was seen among those with higher hair mercury (p for interaction = 0.01). Among the individual long-chain n-3 PUFA, docosahexaenoic acid was most strongly associated with the risk.ConclusionHigh exposure to mercury may reduce the benefits of long-chain n-3 PUFA on SCD.
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- 2012
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28. Birth weight in relation to leisure time physical activity in adolescence and adulthood: meta-analysis of results from 13 nordic cohorts.
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Lise Geisler Andersen, Lars Angquist, Michael Gamborg, Liisa Byberg, Calle Bengtsson, Dexter Canoy, Johan G Eriksson, Marit Eriksson, Marjo-Riitta Järvelin, Lauren Lissner, Tom I Nilsen, Merete Osler, Kim Overvad, Finn Rasmussen, Minna K Salonen, Lene Schack-Nielsen, Tuija H Tammelin, Tomi-Pekka Tuomainen, Thorkild I A Sørensen, Jennifer L Baker, and NordNet Study Group
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Medicine ,Science - Abstract
Prenatal life exposures, potentially manifested as altered birth size, may influence the later risk of major chronic diseases through direct biologic effects on disease processes, but also by modifying adult behaviors such as physical activity that may influence later disease risk.We investigated the association between birth weight and leisure time physical activity (LTPA) in 43,482 adolescents and adults from 13 Nordic cohorts. Random effects meta-analyses were performed on categorical estimates from cohort-, age-, sex- and birth weight specific analyses. Birth weight showed a reverse U-shaped association with later LTPA; within the range of normal weight the association was negligible but weights below and above this range were associated with a lower probability of undertaking LTPA. Compared with the reference category (3.26-3.75 kg), the birth weight categories of 1.26-1.75, 1.76-2.25, 2.26-2.75, and 4.76-5.25 kg, had odds ratios of 0.67 (95% confidence interval: 0.47, 0.94), 0.72 (0.59, 0.88), 0.89 (0.79, 0.99), and 0.65 (0.50, 0.86), respectively. The shape and strength of the birth weight-LTPA association was virtually independent of sex, age, gestational age, educational level, concurrent body mass index, and smoking.The association between birth weight and undertaking LTPA is very weak within the normal birth weight range, but both low and high birth weights are associated with a lower probability of undertaking LTPA, which hence may be a mediator between prenatal influences and later disease risk.
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- 2009
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29. Functional COMT Val158Met polymorphism, risk of acute coronary events and serum homocysteine: the Kuopio ischaemic heart disease risk factor study.
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Sari Voutilainen, Tomi-Pekka Tuomainen, Maarit Korhonen, Jaakko Mursu, Jyrki K Virtanen, Pertti Happonen, Georg Alfthan, Iris Erlund, Kari E North, M J Mosher, Jussi Kauhanen, Jari Tiihonen, George A Kaplan, and Jukka T Salonen
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Medicine ,Science - Abstract
The role of circulating levels of total homocysteine tHcy in the development of coronary heart disease (CHD) is still under debate. One reason for conflicting results between previous studies on homocysteine and heart diseases could be consequence of different interactions between homocysteine and genes in different study populations. Many genetic factors play a role in folate-homocysteine metabolism, like functional polymorphism (Val108Met) in the Catechol-O-methyltransferase (COMT) gene.Our aim was to examine the role of COMT Val158Met polymorphism and interaction of this polymorphism with serum tHcy and folate concentration on the risk of acute coronary and events in middle-aged men from eastern Finland. A population-based prospective cohort of 792 men aged 46-64 years was examined as part of the Kuopio Ischaemic Heart Disease Risk Factor Study. During an average follow-up of 9.3 years, there were 69 acute coronary events in men with no previous history of CHD. When comparing the COMT low activity genotype with the others, we found an age and examination year adjusted hazard rate ratio (HRR) of 1.73 (95% confidence interval (CI), 1.07-2.79), and an age, examination year, serum LDL and HDL cholesterol, and triglyceride concentration, systolic blood pressure and smoking adjusted HRR of 1.77 (95% CI, 1.05-2.77). Although serum tHcy concentration was not statistically significantly associated with acute coronary events (HRR for the highest third versus others 1.52, 95% CI, 0.93-2.49), subjects with both high serum tHcy and the COMT low activity genotype had an additionally increased adjusted risk of HRR 2.94 (95% CI 1.50-5.76) as compared with other men.This prospective cohort study suggests that the functional COMT Val158Met polymorphism is associated with increased risk of acute coronary events and it may interact with high serum tHcy levels.
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- 2007
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30. Catechol-o-methyltransferase gene polymorphism modifies the effect of coffee intake on incidence of acute coronary events.
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Pertti Happonen, Sari Voutilainen, Tomi-Pekka Tuomainen, and Jukka T Salonen
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Medicine ,Science - Abstract
BACKGROUND: The role of coffee intake as a risk factor for coronary heart disease (CHD) has been debated for decades. We examined whether the relationship between coffee intake and incidence of CHD events is dependent on the metabolism of circulating catecholamines, as determined by functional polymorphism of the catechol-O-methyltransferase (COMT) gene. METHODOLOGY/PRINCIPAL FINDINGS: In a cohort of 773 men who were 42 to 60 years old and free of symptomatic CHD at baseline in 1984-89, 78 participants experienced an acute coronary event during an average follow-up of 13 years. In logistic regression adjusting for age, smoking, family history of CHD, vitamin C deficiency, blood pressure, plasma cholesterol concentration, and diabetes, the odds ratio (90% confidence interval) comparing heavy coffee drinkers with the low activity COMT genotype with those with the high activity or heterozygotic genotypes was 3.2 (1.2-8.4). Urinary adrenaline excretion increased with increasing coffee intake, being over two-fold in heavy drinkers compared with nondrinkers (p = 0.008 for trend). CONCLUSIONS/SIGNIFICANCE: Heavy coffee consumption increases the incidence of acute coronary events in men with low but not high COMT activity. Further studies are required to determine to which extent circulating catecholamines mediate the relationship between coffee intake and CHD.
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- 2006
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31. Efficacy of vitamin D(3) supplementation on cancer mortality: Systematic review and individual patient data meta-analysis of randomised controlled trials
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Sabine Kuznia, Anna Zhu, Taisuke Akutsu, Julie E. Buring, Carlos A. Camargo Jr, Nancy R. Cook, Li-Ju Chen, Ting-Yuan David Cheng, Sari Hantunen, I.-Min Lee, JoAnn E. Manson, Rachel E. Neale, Robert Scragg, Aladdin H. Shadyab, Sha Sha, John Sluyter, Tomi-Pekka Tuomainen, Mitsuyoshi Urashima, Jyrki K. Virtanen, Ari Voutilainen, Jean Wactawski-Wende, Mary Waterhouse, Hermann Brenner, and Ben Schöttker
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Aging ,Neurology ,Molecular Biology ,Biochemistry ,Article ,Biotechnology - Abstract
To evaluate the effect of vitamin D(3) supplementation on cancer mortality in the general population and on prognosis in cancer patients, a systematic review and meta-analysis of randomised, placebo-controlled trials (RCTs) and individual patient data (IPD) was conducted. Overall, 14 RCTs with a total of 104,727 participants (2015 cancer deaths) were identified and 7 RCTs, including 90 % of all study participants (n = 94,068), could be included in the IPD meta-analyses. The main meta-analysis of the 14 RCTs yielded a statistically non-significant reduction in cancer mortality by 6 % (risk ratio (RR) [95%-confidence interval (95%CI)]: 0.94 [0.86–1.02]). Subgroup analyses revealed a 12 % lower cancer mortality in the vitamin D(3) group compared with the placebo group in 10 trials with a daily dosing regimen (RR [95%CI]: 0.88 [0.78–0.98]), whereas no mortality reduction was seen in 4 trials using a bolus regimen (RR [95%CI]: 1.07 [0.91–1.24]; p-value for interaction: 0.042). The IPD meta-analysis (RR [95%CI]: 0.93 [0.84; 1.02]) confirmed the finding of all trials. The IPD were used to test effect modification by age, sex, body mass index, ethnicity, baseline serum 25-hydroxyvitamin D concentration, adherence and cancer-related factors but no statistically significant findings were obtained in meta-analyses of all trials. When restricted to trials with daily dosing in a post-hoc analysis, adults aged ≥ 70 years (RR [95%CI]: 0.83 [0.77; 0.98]) and subjects with vitamin D(3) therapy initiation before cancer diagnosis (RR [95%CI]: 0.87 [0.69; 0.99]) appeared to benefit most from daily vitamin D(3) supplementation. Measurements of baseline 25-hydroxyvitamin D levels and inclusion of other than non-Hispanic White adults were too sparse in the trials to draw conclusions. Results for all-cause and cancer-specific survival of participants with cancer were comparable to those obtained in the general population for cancer mortality. In conclusion, vitamin D(3) did not reduce cancer mortality in the main meta-analysis of all RCTs because the observed risk reduction by 6 % was not statistically significant. However, a subgroup analysis revealed that vitamin D(3) administered daily, in contrast to bolus supplementation, reduced cancer mortality by 12 %.
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- 2023
32. Mild-to-Moderate Kidney Dysfunction and Cardiovascular Disease: Observational and Mendelian Randomization Analyses
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Liam Gaziano, Luanluan Sun, Matthew Arnold, Steven Bell, Kelly Cho, Stephen K. Kaptoge, Rebecca J. Song, Stephen Burgess, Daniel C. Posner, Katja Mosconi, Cassianne Robinson-Cohen, Amy M. Mason, Thomas R. Bolton, Ran Tao, Elias Allara, Petra Schubert, Lingyan Chen, James R. Staley, Natalie Staplin, Servet Altay, Pilar Amiano, Volker Arndt, Johan Ärnlöv, Elizabeth L.M. Barr, Cecilia Björkelund, Jolanda M.A. Boer, Hermann Brenner, Edoardo Casiglia, Paolo Chiodini, Jackie A. Cooper, Josef Coresh, Mary Cushman, Rachel Dankner, Karina W. Davidson, Renate T. de Jongh, Chiara Donfrancesco, Gunnar Engström, Heinz Freisling, Agustín Gómez de la Cámara, Vilmundur Gudnason, Graeme J. Hankey, Per-Olof Hansson, Alicia K. Heath, Ewout J. Hoorn, Hironori Imano, Simerjot K. Jassal, Rudolf Kaaks, Verena Katzke, Jussi Kauhanen, Stefan Kiechl, Wolfgang Koenig, Richard A. Kronmal, Cecilie Kyrø, Deborah A. Lawlor, Börje Ljungberg, Conor MacDonald, Giovanna Masala, Christa Meisinger, Olle Melander, Conchi Moreno Iribas, Toshiharu Ninomiya, Dorothea Nitsch, Børge G. Nordestgaard, Charlotte Onland-Moret, Luigi Palmieri, Dafina Petrova, Jose Ramón Quirós Garcia, Annika Rosengren, Carlotta Sacerdote, Masaru Sakurai, Carmen Santiuste, Matthias B. Schulze, Sabina Sieri, Johan Sundström, Valérie Tikhonoff, Anne Tjønneland, Tammy Tong, Rosario Tumino, Ioanna Tzoulaki, Yvonne T. van der Schouw, W.M. Monique Verschuren, Henry Völzke, Robert B. Wallace, S. Goya Wannamethee, Elisabete Weiderpass, Peter Willeit, Mark Woodward, Kazumasa Yamagishi, Raul Zamora-Ros, Elvis A. Akwo, Saiju Pyarajan, David R. Gagnon, Philip S. Tsao, Sumitra Muralidhar, Todd L. Edwards, Scott M. Damrauer, Jacob Joseph, Lisa Pennells, Peter W.F. Wilson, Seamus Harrison, Thomas A. Gaziano, Michael Inouye, Colin Baigent, Juan P. Casas, Claudia Langenberg, Nick Wareham, Elio Riboli, J.Michael Gaziano, John Danesh, Adriana M. Hung, Adam S. Butterworth, Angela M. Wood, Emanuele Di Angelantonio, Anna Koettgen, Jonathan Shaw, Robert Atkins, Paul Zimmet, Peter Whincup, Johann Willeit, Christoph Leitner, Anne Tybjaerg-Hansen, Peter Schnohr, Shoaib Afzal, David Lora Pablos, Cristina Martin Arriscado, Carmen Romero Ferreiro, Hannah Stocker, Ben Schöttker, Bernd Holleczek, Angela Chetrit, Lennart Welin, Kurt Svärdsudd, Lauren Lissner, Dominique Hange, Kirsten Mehlig, Dorothea Nagel, Paul E. Norman, Osvaldo Almeida, Leon Flicker, Jun Hata, Takanori Honda, Yoshihiko Furuta, Hiroyasu Iso, Akihiko Kitamura, Isao Muraki, Jukka T. Salonen, Tomi-Pekka Tuomainen, E. M. van Zutphen, N. M. van Schoor, Cinzia Lo Noce, Richard Kronmal, Georg Lappas, Peter M. Nilsson, Bo Hedblad, Jonathan Shaffer, Joseph Schwartz, Daichi Shimbo, Shinichi Sato, Mina Hayama-Terada, Simerjot Jassal, Thor Aspelund, Bolli Thorsson, Gunnar Sigurdsson, Layal Chaker, Kamran M. Ikram, Maryam Kavousi, Hugh Tunstall-Pedoe, Günay Can, Hüsniye Yüksel, Uğur Özkan, Hideaki Nakagawa, Yuko Morikawa, Masao Ishizaki, Edith Feskens, Johanna M Geleijnse, Daan Kromhout, Internal Medicine, Neurology, Epidemiology, Bell, Steven [0000-0001-6774-3149], Posner, Daniel C [0000-0002-3056-6924], Mason, Amy M [0000-0002-8019-0777], Allara, Elias [0000-0002-1634-8330], Staplin, Natalie [0000-0003-4482-4418], Arndt, Volker [0000-0001-9320-8684], Ärnlöv, Johan [0000-0002-6933-4637], Barr, Elizabeth LM [0000-0003-4284-1716], Boer, Jolanda MA [0000-0002-9714-4304], Brenner, Hermann [0000-0002-6129-1572], Casiglia, Edoardo [0000-0002-0003-3289], Chiodini, Paolo [0000-0003-0139-2264], Coresh, Josef [0000-0002-4598-0669], Cushman, Mary [0000-0002-7871-6143], Davidson, Karina W [0000-0002-9162-477X], de Jongh, Renate T [0000-0001-8414-3938], Engström, Gunnar [0000-0002-8618-9152], de la Cámara, Agustín Gómez [0000-0001-6827-6319], Gudnason, Vilmundur [0000-0001-5696-0084], Hankey, Graeme J [0000-0002-6044-7328], Hansson, Per-Olof [0000-0001-6323-0506], Heath, Alicia K [0000-0001-6517-1300], Hoorn, Ewout J [0000-0002-8738-3571], Imano, Hironori [0000-0002-6661-4254], Katzke, Verena [0000-0002-6509-6555], Kiechl, Stefan [0000-0002-9836-2514], Koenig, Wolfgang [0000-0002-2064-9603], Kronmal, Richard A [0000-0002-9897-7076], Kyrø, Cecilie [0000-0002-9083-8960], Ljungberg, Börje [0000-0002-4121-3753], MacDonald, Conor [0000-0002-4989-803X], Masala, Giovanna [0000-0002-5758-9069], Ninomiya, Toshiharu [0000-0003-1345-9032], Nordestgaard, Børge G [0000-0002-1954-7220], Onland-Moret, Charlotte [0000-0002-2360-913X], Palmieri, Luigi [0000-0002-4298-2642], Rosengren, Annika [0000-0002-5409-6605], Schulze, Matthias B [0000-0002-0830-5277], Sieri, Sabina [0000-0001-5201-172X], Sundström, Johan [0000-0003-2247-8454], Tikhonoff, Valérie [0000-0001-7846-0101], Tong, Tammy [0000-0002-0284-8959], Tzoulaki, Ioanna [0000-0002-4275-9328], van der Schouw, Yvonne T [0000-0002-4605-435X], Wannamethee, S Goya [0000-0001-9484-9977], Weiderpass, Elisabete [0000-0003-2237-0128], Willeit, Peter [0000-0002-1866-7159], Woodward, Mark [0000-0001-9800-5296], Yamagishi, Kazumasa [0000-0003-3301-5519], Zamora-Ros, Raul [0000-0002-6236-6804], Gagnon, David R [0000-0002-6367-3179], Tsao, Philip S [0000-0001-7274-9318], Edwards, Todd L [0000-0003-4318-6119], Damrauer, Scott M [0000-0001-8009-1632], Joseph, Jacob [0000-0002-7279-4896], Pennells, Lisa [0000-0002-8594-3061], Gaziano, Thomas A [0000-0002-5985-345X], Langenberg, Claudia [0000-0002-5017-7344], Wareham, Nick [0000-0003-1422-2993], Hung, Adriana M [0000-0002-3203-1608], Butterworth, Adam S [0000-0002-6915-9015], Di Angelantonio, Emanuele [0000-0001-8776-6719], Apollo - University of Cambridge Repository, Gaziano, Liam, Sun, Luanluan, Arnold, Matthew, Bell, Steven, Cho, Kelly, Kaptoge, Stephen K, Song, Rebecca J, Burgess, Stephen, Posner, Daniel C, Mosconi, Katja, Robinson-Cohen, Cassianne, Mason, Amy M, Bolton, Thomas R, Tao, Ran, Allara, Elia, Schubert, Petra, Chen, Lingyan, Staley, James R, Staplin, Natalie, Altay, Servet, Amiano, Pilar, Arndt, Volker, Ärnlöv, Johan, Barr, Elizabeth L M, Björkelund, Cecilia, Boer, Jolanda M A, Brenner, Hermann, Casiglia, Edoardo, Chiodini, Paolo, Cooper, Jackie A, Coresh, Josef, Cushman, Mary, Dankner, Rachel, Davidson, Karina W, de Jongh, Renate T, Donfrancesco, Chiara, Engström, Gunnar, Freisling, Heinz, de la Cámara, Agustín Gómez, Gudnason, Vilmundur, Hankey, Graeme J, Hansson, Per-Olof, Heath, Alicia K, Hoorn, Ewout J, Imano, Hironori, Jassal, Simerjot K, Kaaks, Rudolf, Katzke, Verena, Kauhanen, Jussi, Kiechl, Stefan, Koenig, Wolfgang, Kronmal, Richard A, Kyrø, Cecilie, Lawlor, Deborah A, Ljungberg, Börje, Macdonald, Conor, Masala, Giovanna, Meisinger, Christa, Melander, Olle, Moreno Iribas, Conchi, Ninomiya, Toshiharu, Nitsch, Dorothea, Nordestgaard, Børge G, Onland-Moret, Charlotte, Palmieri, Luigi, Petrova, Dafina, Garcia, Jose Ramón Quiró, Rosengren, Annika, Sacerdote, Carlotta, Sakurai, Masaru, Santiuste, Carmen, Schulze, Matthias B, Sieri, Sabina, Sundström, Johan, Tikhonoff, Valérie, Tjønneland, Anne, Tong, Tammy, Tumino, Rosario, Tzoulaki, Ioanna, van der Schouw, Yvonne T, Monique Verschuren, W M, Völzke, Henry, Wallace, Robert B, Wannamethee, S Goya, Weiderpass, Elisabete, Willeit, Peter, Woodward, Mark, Yamagishi, Kazumasa, Zamora-Ros, Raul, Akwo, Elvis A, Pyarajan, Saiju, Gagnon, David R, Tsao, Philip S, Muralidhar, Sumitra, Edwards, Todd L, Damrauer, Scott M, Joseph, Jacob, Pennells, Lisa, Wilson, Peter W F, Harrison, Seamu, Gaziano, Thomas A, Inouye, Michael, Baigent, Colin, Casas, Juan P, Langenberg, Claudia, Wareham, Nick, Riboli, Elio, Gaziano, J Michael, Danesh, John, Hung, Adriana M, Butterworth, Adam S, Wood, Angela M, Di Angelantonio, Emanuele, Internal medicine, AMS - Ageing & Vitality, AMS - Musculoskeletal Health, Amsterdam Gastroenterology Endocrinology Metabolism, Epidemiology and Data Science, APH - Aging & Later Life, and APH - Personalized Medicine
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kidney disease ,General Practice ,Emerging Risk Factors Collaboration/EPIC-CVD/Million Veteran Program ,Coronary Disease ,coronary disease ,Kidney ,Malalties coronàries ,1117 Public Health and Health Services ,Coronary diseases ,SDG 3 - Good Health and Well-being ,cardiovascular disease ,Risk Factors ,Physiology (medical) ,Diabetes Mellitus ,Humans ,Cardiac and Cardiovascular Systems ,Prospective Studies ,1102 Cardiorespiratory Medicine and Haematology ,Kardiologi ,Kidney diseases ,Malalties cardiovasculars ,Cardiovascular Diseases ,Kidney Diseases ,Stroke ,1103 Clinical Sciences ,Mendelian Randomization Analysis ,kidney diseases ,stroke ,Allmänmedicin ,Cardiovascular diseases ,Cardiovascular System & Hematology ,Malalties del ronyó ,Cardiology and Cardiovascular Medicine ,cardiovascular diseases - Abstract
Background: End-stage renal disease is associated with a high risk of cardiovascular events. It is unknown, however, whether mild-to-moderate kidney dysfunction is causally related to coronary heart disease (CHD) and stroke. Methods: Observational analyses were conducted using individual-level data from 4 population data sources (Emerging Risk Factors Collaboration, EPIC-CVD [European Prospective Investigation into Cancer and Nutrition–Cardiovascular Disease Study], Million Veteran Program, and UK Biobank), comprising 648 135 participants with no history of cardiovascular disease or diabetes at baseline, yielding 42 858 and 15 693 incident CHD and stroke events, respectively, during 6.8 million person-years of follow-up. Using a genetic risk score of 218 variants for estimated glomerular filtration rate (eGFR), we conducted Mendelian randomization analyses involving 413 718 participants (25 917 CHD and 8622 strokes) in EPIC-CVD, Million Veteran Program, and UK Biobank. Results: There were U-shaped observational associations of creatinine-based eGFR with CHD and stroke, with higher risk in participants with eGFR values 105 mL·min –1 ·1.73 m –2 , compared with those with eGFR between 60 and 105 mL·min –1 ·1.73 m –2 . Mendelian randomization analyses for CHD showed an association among participants with eGFR –1 ·1.73 m –2 , with a 14% (95% CI, 3%–27%) higher CHD risk per 5 mL·min –1 ·1.73 m –2 lower genetically predicted eGFR, but not for those with eGFR >105 mL·min –1 ·1.73 m –2 . Results were not materially different after adjustment for factors associated with the eGFR genetic risk score, such as lipoprotein(a), triglycerides, hemoglobin A1c, and blood pressure. Mendelian randomization results for stroke were nonsignificant but broadly similar to those for CHD. Conclusions: In people without manifest cardiovascular disease or diabetes, mild-to-moderate kidney dysfunction is causally related to risk of CHD, highlighting the potential value of preventive approaches that preserve and modulate kidney function.
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- 2022
33. Associations of dairy, meat, and fish intakes with risk of incident dementia and with cognitive performance : the Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD)
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Maija P. T. Ylilauri, Sari Hantunen, Eija Lönnroos, Jukka T. Salonen, Tomi-Pekka Tuomainen, Jyrki K. Virtanen, and Department of Public Health
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POLYUNSATURATED FATTY-ACIDS ,ACUTE MYOCARDIAL-INFARCTION ,DECLINE ,Nutrition and Dietetics ,Meat ,Apolipoprotein E4 ,MEMORY ,Medicine (miscellaneous) ,CONSUMPTION ,IMPAIRMENT ,Dairy ,ALZHEIMERS-DISEASE ,Fish ,Dementia ,HEALTH ,3143 Nutrition ,Cognitive performance ,POPULATION - Abstract
Purpose To investigate if dairy, meat, and fish intakes associate with dementia and cognitive performance. Methods We included 2497 dementia-free men from Eastern Finland, aged 42–60 years in 1984–1989 at the baseline examinations. Data on cognitive tests [Mini Mental State Exam (MMSE), trail making test (TMT), verbal fluency test (VFL), selective reminding test (SRT), and Russell’s adaptation of the visual reproduction test (VRT)] at the 4-year re-examinations were available for 482 men and on the ApoE phenotype for 1259 men. Data on dementia events were obtained by linkage to national health registers. Diet was assessed with baseline 4-day food records. Cox regression and analysis of covariance were used for analyses. Results During a mean 22-year follow-up, 337 men had a dementia diagnosis. Among the foods, only cheese intake associated with dementia risk (hazard ratio in the highest vs. the lowest quartile = 0.72, 95% confidence interval = 0.52–0.99, P-trend = 0.05). In the cognitive tests, higher non-fermented dairy and milk intakes associated with worse verbal fluency (VFT). Higher processed red meat intake associated with worse verbal (SRT) and visual memory (VRT), whereas higher unprocessed red meat intake associated with better general cognitive functioning (MMSE) and processing speed and executive functioning (TMT). Higher fish intake associated with better verbal memory (SRT). Among APOE-ε4 carriers, especially non-fermented dairy intake associated with higher risk of dementia outcomes, and higher fish intake indicated better cognitive performance. Conclusion Although higher intake of some food groups associated with cognitive performance, we found little evidence for associations with dementia risk.
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- 2022
34. Adherence to a healthy Nordic diet and risk of type 2 diabetes among men: the Kuopio Ischaemic Heart Disease Risk Factor Study
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Jyrki K. Virtanen, Sari Hantunen, Tomi-Pekka Tuomainen, and Hanna-Mari Tertsunen
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Male ,medicine.medical_specialty ,Population ,Medicine (miscellaneous) ,Type 2 diabetes ,Cohort Studies ,Risk Factors ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Risk factor ,Prospective study ,education ,Prospective cohort study ,Aged ,education.field_of_study ,Nutrition and Dietetics ,business.industry ,Nordic diet ,Hazard ratio ,Original Contribution ,Middle Aged ,medicine.disease ,Diet ,Baltic Sea Diet Score ,Quartile ,Diabetes Mellitus, Type 2 ,Heart Disease Risk Factors ,Population study ,business ,Cohort study - Abstract
Purpose To investigate the association between healthy Nordic diet and risk of type 2 diabetes (T2D) in middle-aged and older men from eastern Finland. Methods A total of 2332 men aged 42–60 years and free of T2D at baseline in 1984–1989 were included. Diet was assessed with 4-day food records at baseline and the healthy Nordic diet score was calculated based on a modified Baltic Sea Diet Score. T2D diagnosis was based on self-administered questionnaires, fasting and 2-h oral glucose tolerance test blood glucose measurements, or by record linkage to national health registries. Cox proportional hazards regression and analysis of covariance were used for analyses. Results During the mean follow-up of 19.3 years, 432 men (18.5%) were diagnosed with T2D. The multivariable-adjusted hazard ratio for T2D in the lowest vs. the highest quartile of the healthy Nordic diet score was 1.35 (95% CI 1.03–1.76) (P trend across quartiles 0.028). Lower adherence to healthy Nordic diet was also associated with higher plasma glucose and insulin concentrations. Conclusions In this prospective population-based cohort study among middle-aged and older men from eastern Finland, lower adherence to healthy Nordic diet was associated with higher risk of T2D and higher plasma glucose and serum insulin concentrations.
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- 2021
35. Fatty acids in the de novo lipogenesis pathway and incidence of type 2 diabetes
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William S. Harris, Jason H Y Wu, Matti Uusitupa, Barbara McKnight, Tomi-Pekka Tuomainen, Amanda M. Fretts, Qi Sun, Julie K. Bassett, Allison M. Hodge, Fumiaki Imamura, Rozenn N. Lemaitre, David S. Siscovick, Hung-Ju Lin, Nona Sotoodehnia, Michael Y. Tsai, Lynne E. Wagenknecht, Kalina Rajaobelina, Kuo-Liong Chien, Sabita S. Soedamah-Muthu, Renata Micha, Liana C Del Gobbo, Rachel A. Murphy, Markku Laakso, Dariush Mozaffarian, Albert Koulman, Nita G. Forouhi, Ulf Risérus, Graham G. Giles, Janette de Goede, Andres V Ardisson Korat, Nathan L. Tintle, Nicholas J. Wareham, Waqas Qureshi, Johanna M. Geleijnse, Maria Lankinen, Mackenzie K Senn, Cécilia Samieri, Lars Lind, Wei-Sin Yang, Yun-yu Chen, Frank B. Hu, Matti Marklund, Jyrki K. Virtanen, Alexis C. Wood, Vilmundur Gudnason, Tzu-An Chen, Chaoyu Yu, Luc Djoussé, Jennifer G. Robinson, Catherine Helmer, Kerry L. M. Wong, Ingeborg A. Brouwer, Medical and Clinical Psychology, Imamura, Fumiaki [0000-0002-6841-8396], Marklund, Matti [0000-0002-3320-796X], Ardisson Korat, Andres V [0000-0003-4599-2245], Lankinen, Maria [0000-0002-9158-283X], Qureshi, Waqas [0000-0002-5189-4417], Wong, Kerry [0000-0002-4400-2257], Bassett, Julie K [0000-0003-0799-4821], Tintle, Nathan [0000-0003-1447-9107], Brouwer, Ingeborg A [0000-0002-8762-382X], Chien, Kuo-Liong [0000-0003-4979-8351], Chen, Yun-Yu [0000-0001-7009-7838], Wood, Alexis C [0000-0001-7616-2119], Geleijnse, Johanna M [0000-0001-7638-0589], Giles, Graham G [0000-0003-4946-9099], de Goede, Janette [0000-0002-6174-0681], Gudnason, Vilmundur [0000-0001-5696-0084], Harris, William S [0000-0003-3042-9353], Hodge, Allison [0000-0001-5464-2197], Koulman, Albert [0000-0001-9998-051X], McKnight, Barbara [0000-0002-3180-666X], Riserus, Ulf [0000-0002-8620-4586], Samieri, Cecilia [0000-0001-9809-7506], Senn, Mackenzie [0000-0002-0298-8142], Siscovick, David S [0000-0003-0461-175X], Soedamah-Muthu, Sabita S [0000-0002-8830-3502], Sun, Qi [0000-0002-8480-1563], Tuomainen, Tomi-Pekka [0000-0002-1949-3787], Wareham, Nick J [0000-0003-1422-2993], Wu, Jason HY [0000-0003-2073-3562], Micha, Renata [0000-0002-3983-1632], Mozaffarian, Dariush [0000-0001-7958-9492], Forouhi, Nita G [0000-0002-5041-248X], Apollo - University of Cambridge Repository, Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Health Sciences, APH - Health Behaviors & Chronic Diseases, APH - Mental Health, Ardisson Korat, Andres V. [0000-0003-4599-2245], Bassett, Julie K. [0000-0003-0799-4821], Brouwer, Ingeborg A. [0000-0002-8762-382X], Chen, Yun-yu [0000-0001-7009-7838], Wood, Alexis C. [0000-0001-7616-2119], Geleijnse, Johanna M. [0000-0001-7638-0589], Giles, Graham G. [0000-0003-4946-9099], Harris, William S. [0000-0003-3042-9353], Siscovick, David S. [0000-0003-0461-175X], Soedamah-Muthu, Sabita S. [0000-0002-8830-3502], Wareham, Nick J. [0000-0003-1422-2993], Wu, Jason H. Y. [0000-0003-2073-3562], and Forouhi, Nita G. [0000-0002-5041-248X]
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Male ,Nutrition and Disease ,Physiology ,Type 2 diabetes ,030204 cardiovascular system & hematology ,Biochemistry ,LEHA ,Geographical locations ,0302 clinical medicine ,Endocrinology ,Mathematical and Statistical Techniques ,Voeding en Ziekte ,Medicine and Health Sciences ,Macromolecular Structure Analysis ,Medicine ,030212 general & internal medicine ,Prospective Studies ,Prospective cohort study ,Human Nutrition & Health ,2. Zero hunger ,chemistry.chemical_classification ,RISK ,Lipid Analysis ,PLASMA ,Incidence (epidemiology) ,Incidence ,Fatty Acids ,Statistics ,Humane Voeding & Gezondheid ,General Medicine ,ASSOCIATION ,Middle Aged ,Metaanalysis ,Lipids ,CANCER ,3. Good health ,Type 2 Diabetes ,ADIPOSE-TISSUE ,BETA-CELL TURNOVER ,Lipogenesis ,Physical Sciences ,Endokrinologi och diabetes ,COFFEE CONSUMPTION ,Female ,Metabolic Networks and Pathways ,Research Article ,Endocrine Disorders ,BIOMARKERS ,Endocrinology and Diabetes ,Research and Analysis Methods ,03 medical and health sciences ,SDG 3 - Good Health and Well-being ,Diabetes mellitus ,Diabetes Mellitus ,Life Science ,Humans ,CORONARY-HEART-DISEASE ,Statistical Methods ,Molecular Biology ,Aged ,VLAG ,business.industry ,Fatty acid ,Biology and Life Sciences ,medicine.disease ,United States ,PHOSPHOLIPIDS ,Human nutrition ,Metabolism ,chemistry ,Diabetes Mellitus, Type 2 ,Metabolic Disorders ,North America ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,People and places ,business ,Dyslipidemia ,Mathematics - Abstract
Background De novo lipogenesis (DNL) is the primary metabolic pathway synthesizing fatty acids from carbohydrates, protein, or alcohol. Our aim was to examine associations of in vivo levels of selected fatty acids (16:0, 16:1n7, 18:0, 18:1n9) in DNL with incidence of type 2 diabetes (T2D). Methods and findings Seventeen cohorts from 12 countries (7 from Europe, 7 from the United States, 1 from Australia, 1 from Taiwan; baseline years = 1970–1973 to 2006–2010) conducted harmonized individual-level analyses of associations of DNL-related fatty acids with incident T2D. In total, we evaluated 65,225 participants (mean ages = 52.3–75.5 years; % women = 20.4%–62.3% in 12 cohorts recruiting both sexes) and 15,383 incident cases of T2D over the 9-year follow-up on average. Cohort-specific association of each of 16:0, 16:1n7, 18:0, and 18:1n9 with incident T2D was estimated, adjusted for demographic factors, socioeconomic characteristics, alcohol, smoking, physical activity, dyslipidemia, hypertension, menopausal status, and adiposity. Cohort-specific associations were meta-analyzed with an inverse-variance-weighted approach. Each of the 4 fatty acids positively related to incident T2D. Relative risks (RRs) per cohort-specific range between midpoints of the top and bottom quintiles of fatty acid concentrations were 1.53 (1.41–1.66; p < 0.001) for 16:0, 1.40 (1.33–1.48; p < 0.001) for 16:1n-7, 1.14 (1.05–1.22; p = 0.001) for 18:0, and 1.16 (1.07–1.25; p < 0.001) for 18:1n9. Heterogeneity was seen across cohorts (I2 = 51.1%–73.1% for each fatty acid) but not explained by lipid fractions and global geographical regions. Further adjusted for triglycerides (and 16:0 when appropriate) to evaluate associations independent of overall DNL, the associations remained significant for 16:0, 16:1n7, and 18:0 but were attenuated for 18:1n9 (RR = 1.03, 95% confidence interval (CI) = 0.94–1.13). These findings had limitations in potential reverse causation and residual confounding by imprecisely measured or unmeasured factors. Conclusions Concentrations of fatty acids in the DNL were positively associated with T2D incidence. Our findings support further work to investigate a possible role of DNL and individual fatty acids in the development of T2D., Fumiaki Imamura and colleagues investigate the association between concentrations of fatty acid involved in de-novo lipogensis and incidence of Type 2 diabetes., Author summary Why was this study done? De novo lipogenesis (DNL) is a metabolic pathway involved in the endogenous synthesis of specific fatty acids, such as 16:0, 16:1n7, 18:0, and 18:1n9, and it is linked to the pathophysiology of cardiometabolic diseases, including type 2 diabetes (T2D). Circulating or tissue concentrations of these fatty acids have been investigated for the associations with T2D incidence in epidemiological research. However, published studies reported inconsistent associations inconsistently and were subject to publication bias. Summary evidence is not available to date for the associations between these fatty acids and T2D incidence. An integration of available cohort studies would increase statistical power and allow assessment of generalizability, standardization of analytical strategies, and evidence synthesis with the potential publication bias minimized. What did the researchers do and find? As a part of the Fatty Acids and Outcomes Research Consortium (FORCE), we conducted new individual-participant data analyses of 17 cohort studies of a total of 65,225 adults free of T2D at baseline, among whom 15,383 developed incident T2D over up to 20 years of follow-up. The cohort studies analyzed the associations between fatty acids (16:0, 16:1n7, 18:0, and 18:1n9) and the risk of developing T2D with standardized analytic strategy. In pooled analyses, each of the fatty acids was positively associated with a higher risk of developing T2D. The associations were independent of major risk factors for T2D, such as age, sex, race/ethnicity, socioeconomic characteristics, smoking status, physical activity, and obesity. What do these findings mean? The findings provide the first summary evidence to date for the positive relationships of concentrations of the DNL-related fatty acids with a risk of T2D, indicating the strong relevance of DNL and its determinants to the development of T2D. These fatty acids potentially reflect the status of DNL activity, which may be stimulated or suppressed by a combination of carbohydrate intake, alcohol intake, polyunsaturated fatty acid intake, and other lifestyle and clinical factors. Therefore, the current findings indicate the need for investigation into determinants and consequences of elevated concentrations of these fatty acids. Despite several advantages of our individual-level data analysis in this pooling project, the results cannot establish whether elevated concentrations of these fatty acids caused the development of T2D or whether underlying peripheral or hepatic insulin resistance, for example, may elevate both the fatty acid concentrations and the risk of T2D independently.
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- 2020
36. Caffeine content in newborn hair correlates with maternal dietary intake
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Anni Lehtonen, Tomi-Pekka Tuomainen, Marko Lehtonen, Markku Pasanen, Katri Backman, Juha Pekkanen, Sari Hantunen, Lauri Uusitalo, Leea Keski-Nisula, Seppo Heinonen, Seppo Auriola, Raimo Voutilainen, HUS Gynecology and Obstetrics, Department of Obstetrics and Gynecology, University of Helsinki, Helsinki University Hospital Area, and Department of Public Health
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BIRTH ,Pregnancy Trimester, Third ,Medicine (miscellaneous) ,Cumulative Exposure ,Physiology ,Overweight ,01 natural sciences ,Coffee ,Child health ,Food safety ,03 medical and health sciences ,chemistry.chemical_compound ,Eating ,0302 clinical medicine ,Pregnancy ,Caffeine ,PARAXANTHINE ,Medicine ,Humans ,Child ,Paraxanthine ,2. Zero hunger ,RISK ,Fetus ,030219 obstetrics & reproductive medicine ,Nutrition and Dietetics ,Mass spectrometry ,business.industry ,Dietary intake ,010401 analytical chemistry ,Infant, Newborn ,CONSUMPTION ,ASSOCIATION ,Original Contribution ,medicine.disease ,Newborn ,3. Good health ,0104 chemical sciences ,Diet ,chemistry ,Female ,medicine.symptom ,3143 Nutrition ,business ,Hair - Abstract
Purpose High-maternal caffeine intake during pregnancy may be harmful for perinatal outcomes and future child health, but the level of fetal cumulative exposure has been difficult to measure thus far. Here, we present maternal dietary caffeine intake during the last trimester and its correlation to caffeine content in newborn hair after birth. Methods Maternal third trimester diets and dietary caffeine intake were prospectively collected in Kuopio Birth Cohort (KuBiCo) using a 160-item food frequency questionnaire (n = 2840). Newborn hair was collected within 48 h after birth and analyzed by high-resolution mass spectrometry (HRMS) for caffeine (n = 316). Correlation between dietary caffeine intake and neonatal hair caffeine content was evaluated from 203 mother–child pairs. Results Mean dietary caffeine intake was 167 mg/days (95% CI 162–172 mg/days), of which coffee comprised 81%. Caffeine in the maternal diet and caffeine content in newborn hair correlated significantly (r = 0.50; p Conclusion Caffeine exposure, estimated from newborn hair samples, reflects maternal third trimester dietary caffeine intake and introduces a new method to assess fetal cumulative caffeine exposure. Further studies to evaluate the effects of caffeine exposure on both perinatal and postnatal outcomes are warranted, since over 40% of pregnant women consume caffeine more than the current suggested recommendations (European Food Safety Association, EFSA recommendations).
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- 2020
37. Dietary intake of choline and phosphatidylcholine and risk of type 2 diabetes in men: The Kuopio Ischaemic Heart Disease Risk Factor Study
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Jyrki K. Virtanen, Sari Voutilainen, and Tomi-Pekka Tuomainen
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Male ,medicine.medical_specialty ,Short Communication ,Medicine (miscellaneous) ,030209 endocrinology & metabolism ,Type 2 diabetes ,030204 cardiovascular system & hematology ,Choline ,03 medical and health sciences ,chemistry.chemical_compound ,Eating ,0302 clinical medicine ,Risk Factors ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Risk factor ,Prospective study ,Prospective cohort study ,Finland ,Nutrition and Dietetics ,business.industry ,medicine.disease ,Diet ,Phosphatidylcholine ,chemistry ,Quartile ,Diabetes Mellitus, Type 2 ,Heart Disease Risk Factors ,Relative risk ,Phosphatidylcholines ,Population study ,business ,Record linkage - Abstract
Purpose To investigate associations of total dietary choline intake and its major dietary form, phosphatidylcholine, with type 2 diabetes risk. Methods We included 2332 men aged 42–60 years at baseline in 1984–1989 from the Kuopio Ischaemic Heart Disease Risk Factor Study in eastern Finland. Dietary intakes were assessed with 4-d food recording at baseline. Type 2 diabetes diagnosis was based on self-administered questionnaires, fasting and 2-h oral glucose tolerance test blood glucose measurements, or by record linkage to national health registries. Multivariable-adjusted Cox proportional hazards regression models were used for statistical analysis. Results During the mean 19.3-year follow-up, 432 men had type 2 diabetes diagnosis. After multivariable adjustments, those in the highest vs. lowest choline intake quartile had 25% (95% CI 2–43%) lower relative risk (P trend across quartiles = 0.02) and those in the highest vs. lowest phosphatidylcholine quartile had 41% (95% CI 22–55%) lower relative risk (P trend Conclusions Higher choline intake, especially phosphatidylcholine, was associated with lower type 2 diabetes risk among men.
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- 2020
38. The Prospective Studies of Atherosclerosis (Proof-ATHERO) Consortium: Design and Rationale
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Zhiyong Zou, Dorota A. Zozulińska-Ziółkiewicz, Raffaele Izzo, Lena Tschiderer, Manuel F. Landecho, Kuo Liong Chien, Stefan Kiechl, Damiano Baldassarre, Matthias W. Lorenz, Tatjana Rundek, Mario Fritsch Neves, Jing Liu, Dirk Sander, Caroline Schmidt, Matthew Walters, Enrique Bernal, Gulay Asci, Rafael Gabriel, Michiel L. Bots, Bernhard Iglseder, Eric de Groot, Hirokazu Honda, Mark A. Espeland, Grace Parraga, Joline W.J. Beulens, Paolo Gresele, Pythia T. Nieuwkerk, Dianna Magliano, Michael J. Sweeting, Lars Lind, Kostas Kapellas, Tomi-Pekka Tuomainen, Maryam Kavousi, Frank P. Brouwers, Jean Philippe Empana, Markolf Hanefeld, Shuhei Okazaki, Menno V. Huisman, Jang Ho Bae, Daniel Staub, Aikaterini Papagianni, Gerhard Klingenschmid, Lisa Seekircher, Peter Willeit, Prabath W.B. Nanayakkara, Jackie F. Price, Johann Willeit, Radojica Stolić, Akihiko Kato, Alberico L. Catapano, Naveed Sattar, Christopher D. Byrne, Göran Bergström, Laura Calabresi, Robert Ekart, Michael H. Olsen, Michiaki Nagai, Michiel A. Van Agtmael, Marat Ezhov, Stefan Agewall, Eiichi Sato, Miles D. Witham, Eva Lonn, Ege Üniversitesi, Epidemiology, Internal medicine, Epidemiology and Data Science, ACS - Diabetes & metabolism, APH - Health Behaviors & Chronic Diseases, ACS - Heart failure & arrhythmias, Tschiderer, Lena, Seekircher, Lisa, Klingenschmid, Gerhard, Izzo, Raffaele, Baldassarre, Damiano, Iglseder, Bernhard, Calabresi, Laura, Liu, Jing, Price, Jackie F, Bae, Jang-Ho, Brouwers, Frank P, de Groot, Eric, Schmidt, Caroline, Bergström, Göran, Aşçi, Gülay, Gresele, Paolo, Okazaki, Shuhei, Kapellas, Kosta, Landecho, Manuel F, Sattar, Naveed, Agewall, Stefan, Zou, Zhi-Yong, Byrne, Christopher D, Nanayakkara, Prabath W B, Papagianni, Aikaterini, Witham, Miles D, Bernal, Enrique, Ekart, Robert, van Agtmael, Michiel A, Neves, Mario F, Sato, Eiichi, Ezhov, Marat, Walters, Matthew, Olsen, Michael H, Stolić, Radojica, Zozulińska-Ziółkiewicz, Dorota A, Hanefeld, Markolf, Staub, Daniel, Nagai, Michiaki, Nieuwkerk, Pythia T, Huisman, Menno V, Kato, Akihiko, Honda, Hirokazu, Parraga, Grace, Magliano, Dianna, Gabriel, Rafael, Rundek, Tatjana, Espeland, Mark A, Kiechl, Stefan, Willeit, Johann, Lind, Lar, Empana, Jean Philippe, Lonn, Eva, Tuomainen, Tomi-Pekka, Catapano, Alberico, Chien, Kuo-Liong, Sander, Dirk, Kavousi, Maryam, Beulens, Joline W J, Bots, Michiel L, Sweeting, Michael J, Lorenz, Matthias W, Willeit, Peter, Austrian Science Fund, Gastroenterology and Hepatology, Medical Psychology, APH - Mental Health, APH - Personalized Medicine, and Amsterdam Gastroenterology Endocrinology Metabolism
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Male ,Aging ,Clinical tests ,medicine.medical_specialty ,Population ,Disease ,Pulse Wave Analysis ,Carotid Intima-Media Thickness ,Risk Assessment ,Predictive Value of Tests ,Risk Factors ,Internal medicine ,Humans ,Repeat measurements ,Medicine ,education ,Prospective cohort study ,Pulse wave velocity ,Stroke ,Aged ,education.field_of_study ,business.industry ,Incidence (epidemiology) ,Middle Aged ,Atherosclerosis ,Cardiovascular disease ,medicine.disease ,Clinical trial ,Cardiovascular Diseases ,Research Design ,Atherosclerosi ,Female ,Prospective studie ,Geriatrics and Gerontology ,business ,Prospective studies ,Consortium ,Individual-participant data - Abstract
Atherosclerosis - the pathophysiological mechanism shared by most cardiovascular diseases - can be directly or indirectly assessed by a variety of clinical tests including measurement of carotid intima-media thickness, carotid plaque, ankle-brachial index, pulse wave velocity, and coronary artery calcium. the Prospective Studies of Atherosclerosis (Proof-ATHERO) consortium (https://clinicalepi.i-med.ac.at/research/proof-athero/) collates de-identified individual-participant data of studies with information on atherosclerosis measures, risk factors for cardiovascular disease, and incidence of cardiovascular diseases. It currently comprises 74 studies that involve 106,846 participants from 25 countries and over 40 cities. in summary, 21 studies recruited participants from the general population (n = 67,784), 16 from high-risk populations (n = 22,677), and 37 as part of clinical trials (n = 16,385). Baseline years of contributing studies range from April 1980 to July 2014; the latest follow-up was until June 2019. Mean age at baseline was 59 years (standard deviation: 10) and 50% were female. Over a total of 830,619 person-years of follow-up, 17,270 incident cardiovascular events (including coronary heart disease and stroke) and 13,270 deaths were recorded, corresponding to cumulative incidences of 2.1% and 1.6% per annum, respectively. the consortium is coordinated by the Clinical Epidemiology Team at the Medical University of Innsbruck, Austria. Contributing studies undergo a detailed data cleaning and harmonisation procedure before being incorporated in the Proof-ATHERO central database. Statistical analyses are being conducted according to pre-defined analysis plans and use established methods for individual-participant data meta-analysis. Capitalising on its large sample size, the multi-institutional collaborative Proof-ATHERO consortium aims to better characterise, understand, and predict the development of atherosclerosis and its clinical consequences. (c) 2020 S. Karger AG, Basel, Austrian Science Fund (FWF)Austrian Science Fund (FWF) [P 32488]; Dr.-Johannes-and-Hertha-Tuba Foundation, This work was funded by the Austrian Science Fund (FWF) (P 32488) and the Dr.-Johannes-and-Hertha-Tuba Foundation. Funders of individual studies contributing to the present analysis arelisted onthe Proof-ATHERO webpage(https://clinicalepi.i-med.ac.at/research/proof-athero/studies/).
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- 2020
39. Vitamin D supplementation and prevention of cardiovascular disease and cancer in the Finnish Vitamin D Trial : a randomized controlled trial
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Jyrki K Virtanen, Tarja Nurmi, Antti Aro, Elizabeth R Bertone-Johnson, Elina Hyppönen, Heikki Kröger, Christel Lamberg-Allardt, JoAnn E Manson, Jaakko Mursu, Pekka Mäntyselkä, Sakari Suominen, Matti Uusitupa, Ari Voutilainen, Tomi-Pekka Tuomainen, Sari Hantunen, Department of Food and Nutrition, and University of Helsinki
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Male ,CALCIUM SUPPLEMENTATION ,25-HYDROXYVITAMIN D ,Medicine (miscellaneous) ,vitamin D ,supplementation study ,elderly ,Double-Blind Method ,cardiovascular disease ,Neoplasms ,Humans ,cancer ,Finland ,METAANALYSIS ,POPULATION ,Aged ,Cholecalciferol ,RISK ,Nutrition and Dietetics ,MORTALITY ,WOMEN ,vitamin d ,Public Health, Global Health, Social Medicine and Epidemiology ,Vitamins ,Vitamin D Deficiency ,Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi ,Cardiovascular Diseases ,Dietary Supplements ,randomized controlled trial ,Female ,3143 Nutrition - Abstract
BACKGROUND: Vitamin D insufficiency is associated with risk of cardiovascular diseases (CVD) and cancer in observational studies, but evidence for benefits with vitamin D supplementation is limited. OBJECTIVES: To investigate the effects of vitamin D3 supplementation on CVD and cancer incidence. DESIGN: The study was a 5-year randomized placebo-controlled trial among 2495 male participants ≥ 60 years and post-menopausal female participants ≥ 65 years from a general Finnish population who were free of prior CVD or cancer. The study had three arms: placebo, 1600 IU/day or 3200 IU/day vitamin D3. Follow-up was by annual study questionnaires and national registry data. A representative sub-cohort of 551 participants had more detailed in-person investigations. The primary endpoints were incident major CVD and invasive cancer. Secondary endpoints included the individual components of the primary CVD endpoint (myocardial infarction, stroke, and CVD mortality), site-specific cancers and cancer death. RESULTS: During the follow-up, there were 41 (4.9%), 42 (5.0%) and 36 (4.3%) major CVD events in the placebo, 1600 IU/d (vs. placebo: hazard ratio (HR), 0.97;95% CI, 0.63,1.49; P = 0.89), and 3200 IU/d (HR, 0.84;95% CI, 0.54,1.31; P = 0.44) arms, respectively. Invasive cancer was diagnosed in 41 (4.9%), 48 (5.8%) and 40 (4.8%) participants in the placebo, 1600 IU/d (HR, 1.14;95% CI, 0.75,1.72; P = 0.55), and 3200 IU/d (HR, 0.95;95% CI, 0.61,1.47; P = 0.81) arms, respectively. There were no significant differences in the secondary endpoints or total mortality. In the sub-cohort, the mean (standard deviation) baseline serum 25-hydroxyvitamin D concentration was 75 (18) nmol/L. After 12 months, the concentrations were 73 (18) nmol/L, 100 (21) nmol/L and 120 (22) nmol/L in the placebo, 1600 IU/d and 3200 IU/d arms, respectively. CONCLUSIONS: Vitamin D3 supplementation did not lower the incidence of major CVD events or invasive cancer among older adults, possibly due to sufficient vitamin D status in most participants at baseline. Clinical Trial Registry number: ClinicalTrials.gov: NCT01463813, https://clinicaltrials.gov/ct2/show/NCT01463813. CC BY 4.0Virtanen, Jyrki K.(corresponding author)Published: 04 January 2022This study was supported by funding from the Academy of Finland (#137826), University of Eastern Finland, Juho Vainio Foundation, Medicinska Understödsföreningen Liv och Hälsa, Finnish Foundation for Cardiovascular Research, Finnish Diabetes Research Foundation, and Finnish Cultural Foundation.
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- 2022
40. Long-term changes in sense of coherence and mortality among middle-aged men : A population -based follow-up study
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Ilkka Piiroinen, Tomi-Pekka Tuomainen, Tommi Tolmunen, Jussi Kauhanen, Sudhir Kurl, Charlotta Nilsen, Sakari Suominen, Tarja Välimäki, and Ari Voutilainen
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Aging ,Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi ,Sense of coherence ,Life span development ,Public Health, Global Health, Social Medicine and Epidemiology ,Mortality ,Life-span and Life-course Studies ,Salutogenesis ,Psycho-social change - Abstract
Sense of coherence (SOC) scale measures one’s orientation to life. SOC is the core construct in Antonovsky’ssalutogenic model of health. It has been shown that weak SOC correlates with poor perceived health, low qualityof life, and increased mortality. Some studies have indicated that SOC is not stable across life, but there are noprevious studies on how a change of SOC is reflected in mortality. However, there is some evidence that a changein perceived quality of life is associated with mortality. The study explores the association between the change inSOC and mortality using longitudinal data from a cohort of middle-aged Finnish men recruited between 1986and 1989. Approximately 11 years after the baseline examinations, between 1998 and 2001, 854 men returnedthe SOC questionnaire a second time. The baseline SOC was adjusted for the regression to the mean phenomenonbetween the two measurements. The hazard ratios of the SOC difference scores were adjusted for initial SOC ageand 12 somatic risk factors of mortality (alcohol consumption, blood pressure, body mass index, cholesterolconcentration, physical activity, education, smoking, marital status, employment status, history of cancer, his-tory of cardiovascular disease and diabetes). SOC was not stable among middle-aged Finnish men and a declinein SOC was associated with an increased hazard of all-cause mortality. In the fully adjusted model, a decrease ofone standard deviation (SD) of the SOC mean difference increased the mortality hazard by about 35 %, two SDsdecrease about 70 %, and 2.5 SDs about 100 %. Strengthening SOC showed a limited association with decreasingmortality hazards in the age-adjusted model. Policies, strategies, or plans, supporting SOC in the middle-age mayhelp to decrease mortality and increase quality of life in later years. CC BY 4.0Corresponding author: E-mail address: ilkkapi@uef.fi (I. Piiroinen)
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- 2022
41. Serum n-6 polyunsaturated fatty acids and risk of atrial fibrillation : the Kuopio Ischaemic Heart Disease Risk Factor Study
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Behnam Tajik, Tomi-Pekka Tuomainen, Masoud Isanejad, Jukka T. Salonen, Jyrki K. Virtanen, and Department of Public Health
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Male ,ACUTE MYOCARDIAL-INFARCTION ,HDL ,PATHOPHYSIOLOGY ,Medicine (miscellaneous) ,Coronary Disease ,BLOOD-PRESSURE ,n-6 PUFA ,Linoleic Acid ,Risk Factors ,DIETARY LINOLEIC-ACID ,Fatty Acids, Omega-6 ,Fatty Acids, Omega-3 ,Humans ,EPIDEMIOLOGY ,Prospective Studies ,METAANALYSIS ,Heart Failure ,Nutrition and Dietetics ,Atrial fibrillation ,3142 Public health care science, environmental and occupational health ,OMEGA-6 ,Heart Disease Risk Factors ,Fatty Acids, Unsaturated ,Polyunsaturated fatty acids ,3143 Nutrition ,Arrhythmia ,Population study ,Follow-Up Studies ,LIPIDS - Abstract
Purpose N-6 polyunsaturated fatty acids (PUFA), particularly linoleic acid (LA), have been associated with lower risk of coronary heart disease (CHD), but little is known about their antiarrhythmic properties. We investigated the association of the serum n-6 PUFAs with the risk of atrial fibrillation (AF), the most common type of cardiac arrhythmia. Methods The study included 2450 men from the Kuopio Ischaemic Heart Disease Risk Factor Study, aged 42–60 years at baseline. The total n-6 PUFA includes linoleic acid (LA), arachidonic acid (AA), γ-linolenic acid (GLA) and dihomo-γ-linolenic acid (DGLA). Cox proportional hazards regression was used to estimate hazard ratio (HR) of incident events. Results During the mean follow-up of 22.4 years, 486 AF cases occurred. The multivariable-adjusted HR in the highest versus the lowest quartile of total serum n-6 PUFA concentration was 0.79 (95% CI 0.58–1.08, P trend = 0.04). When evaluated individually, only serum LA concentration was inversely associated with AF risk (multivariable-adjusted extreme-quartile HR 0.69, 95% CI 0.51–0.94, P trend = 0.02). These associations were stronger among the men without history of CHD or congestive heart failure at baseline, compared to men with such disease history (P for interaction = 0.05 for total n-6 PUFA and LA). Similar associations were observed with dietary LA and AA intakes. No significant associations were observed with serum AA, GLA or DGLA concentrations. Conclusions Higher circulating concentration and dietary intake of n-6 PUFA, mainly LA, are associated with lower risk of AF, especially among men without history of CHD or congestive heart failure.
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- 2022
42. Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight
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Maryam Sharafkhah, Emanuel Zitt, Majid Ezzati, Luxia Zhang, Young-Ho Khang, Ellina Rakhimova, Kairit Mikkel, Tiina Vlasoff, Eruke E. Egbagbe, Sidsel Graff-Iversen, Ilona Nenko, Magdalena Klimek, Mathilde Savy, Sanjib Kumar Sharma, Alfonso Siani, Luís Lopes, Vanina Bongard, Gregor Jurak, Jacqueline F. Price, Christina-Paulina Lambrinou, Maria Lc Iurilli, Rainford J. Wilks, Bontha V. Babu, Fereidoun Azizi, Harunobu Nakamura, Marialaura Bonaccio, Angela Döring, Zhenyu Zhang, Naser Ahmadi, Jolanta Słowikowska-Hilczer, Ana Paula Carlos Cândido, Clive Osmond, Thirunavukkarasu Sathish, Robert J. Adams, Themistoklis Tzotzas, Reina Engle-Stone, Atul Trivedi, Shoichiro Tsugane, Niels Møller, Jorge Bezerra, Dénes Molnár, Muhammad Fadhli Mohd Yusoff, Badreya Al-Lahou, J. Jaime Miranda, Bahram Mohajer, Sigmund A. Anderssen, Lital Keinan Boker, Eero Kajantie, Martin Gulliford, Maties Torrent, Sumit Bharadwaj, Toshiharu Ninomiya, Zbigniew Gaciong, Nayu Ikeda, Li Juan Wu, Adrian Richter, Licia Iacoviello, Marc J. Gunter, Wenbin Wei, Norsyamlina Che Abdul Rahim, Eman Aly, Ambady Ramachandran, Nils Lehmann, Soile E. Puhakka, Giovanni Veronesi, Hongsheng Bi, Eiji Oda, Jia Li Duan, Per Tynelius, José María Huerta, Janne Schurmann Tolstrup, Rodrigo M. Carrillo-Larco, Rosangela Fernandes Lucena Batista, Victoria E Soto-Rojas, Hanno Ulmer, Shukri F. Mohamed, Anthony Kafatos, Suyeon Park, Mohsen Ibrahim, Hamed Pouraram, Bin Zhou, May Soe Aung, Lars Bo Andersen, Erfan Ghasemi, René Charles Sylva, Himanshu K. Chaturvedi, Luc Dauchet, Ahmad Ali Zainuddin, Angela Chetrit, Dan Zhu, Valérie Deschamps, Ko Ko Zaw, Peter Vollenweider, Tomas Vega, Yves Martin-Prével, Mahfuzar Rahman, Dorja Vočanec, Roman Topor-Madry, Vinay Nangia, Herculina S. Kruger, Asher Fawwad, Emily Sonestedt, Elena Pahomova, Aleksander Giwercman, Elżbieta Dziankowska-Zaborszczyk, Cecilia Björkelund, Tatjana Hejgaard, Maria Puiu, Maria Benedetta Donati, Andrew Wong, Carlos P. Boissonnet, Santosh K. Bhargava, Patrick Kolsteren, Dermot O'Reilly, Bahareh Kheiri, Wolfgang Kratzer, Susanne R. de Rooij, H. Bas Bueno-de-Mesquita, Günther Fink, José R. Banegas, Michele Monroy-Valle, Drude Molbo, Mahmudur Rahman, Hynek Pikhart, Rafael N. Pichardo, Massimo Salvetti, Hui Cai, Sarah Filippi, Georg Posch, Hung-Kwan So, Yonghua Hu, Katsuyasu Kouda, Joana Carvalho, Gailute Bernotiene, Hannu Uusitalo, Thein Thein Htay, Felix Kaducu, Maigeng Zhou, Lars Ängquist, Thi Tuyet-Hanh Tran, Charles Lunogelo, Michel Joffres, Sabina Zambon, Ronald D. Gregor, Vayia Rarra, Seyed Mohammad Hashemi-Shahri, Loreto Santa Marina, Galina Obreja, Rudolf Kaaks, Aya Mostafa, Maria do Carmo Franco, Beata Gurzkowska, Chien-Jen Chen, Marie Moitry, Nizal Sarrafzadegan, Xiangjun Wang, Diego Giulliano Destro Christofaro, Imperia Brajkovich, Fangfang Chen, Francesco Panza, Ling Yang, Holly E. Syddall, Cecily Kelleher, Michael Tornaritis, Ningli Wang, Lutgarde Thijs, Marjolein Visser, Angelika Schaffrath Rosario, María José Tormo, Jostein Steene-Johannessen, Norbert Amougou, Emmanuella Magriplis, Mar Alvarez-Pedrerol, Jingli Gao, Stig E. 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Magliano, Jitendra Jonnagaddala, Konstantinos Gkiouras, Paola Nardone, Alberto Barceló, Tomi-Pekka Tuomainen, Francesco Gianfagna, Stefania Maggi, Mohammad Hossein Somi, Behrooz Hamzeh, Miquel Porta, Vesna Jureša, Alexander D. Deev, David Faeh, Antonio Bernabe-Ortiz, Sirkka Keinänen-Kiukaanniemi, Ian Hambleton, Stefan Savin, Andre Pascal Kengne, R. Krishna Kumar, Kurt Widhalm, Marco M Ferrario, Parisa Amiri, Anjani Kumar Jha, Thamara Hubler Figueiró, Jana Kratenova, Claudia M. Hormiga, Maria Tsigga, Zivka Dika, Indrapal I. Meshram, Ei Ei K. Nang, Ian Rouse, Rusidah Selamat, Paul Korrovits, Grethe S. Tell, Julie Taylor, Anabela Mota-Pinto, Paolo Vineis, Kotsedi D Monyeki, Khuong Quynh Long, Frank J Rühli, Shelly R. McFarlane, Sara Santos Sanz, Edyta Łuszczki, Maria G. Stathopoulou, Tara Coppinger, Karin De Ridder, Lucie Viet, Anna Bugge, Mehdi Yaseri, Safiah Md Yusof, Sandra C. Fuchs, Muhammad Islam, Irfan Nuhoglu, Rui Providência, Bernard Maire, Leandra Abarca-Gómez, Sinead Brophy, Maria Ruiz-Castell, Daniela Pierannunzio, Cristina Taddei, Gowri Mahasampath, Gustavo Velasquez-Melendez, Hanna Tolonen, Sudhir Kowlessur, Bagher Larijani, Laura Torres-Collado, Susi Kriemler, Ali Akbar Shayesteh, Cynthia Robitaille, Jorge Escobedo-de la Peña, Yufang Bi, Chinh Nguyen Huu, Line Tang Møllehave, Vincent Jr DeGennaro, Noor Ani Ahmad, Anar Dushpanova, Agustinus Soemantri, Susana Sans, Ionela Pascanu, Gwenaëlle Le Coroller, Inger Ariansen, Kodanda R Kanala, Gert B. M. Mensink, Abhijit Sen, Sergej M. Ostojic, Hanan F. Abdul Rahim, Hélène Delisle, Francisco J. Félix-Redondo, Yadlapalli S. Kusuma, Michael Knoflach, Moein Yoosefi, Tanja G. M. Vrijkotte, Wolfgang Ahrens, Osvaldo Santos, Bethlehem D. Solomon, Erik Lykke Mortensen, Nikhil D. 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Aounallah-Skhiri , Joana Araújo , Inger Ariansen , Tahir Aris , Raphael E Arku , Nimmathota Arlappa , Krishna K Aryal , Thor Aspelund , Felix K Assah , Maria Cecília F Assunção , May Soe Aung , Juha Auvinen , Mária Avdicová , Shina Avi , Ana Azevedo , Mohsen Azimi-Nezhad , Fereidoun Azizi , Mehrdad Azmin , Bontha V Babu , Maja Bæksgaard Jørgensen , Azli Baharudin , Suhad Bahijri , Jennifer L Baker , Nagalla Balakrishna , Mohamed Bamoshmoosh , Maciej Banach , Piotr Bandosz , José R Banegas , Joanna Baran , Barbagallo CM, Alberto Barceló , Amina Barkat , Aluisio Jd Barros , Mauro Virgílio Gomes Barros , Abdul Basit , Joao Luiz D Bastos , Iqbal Bata , Anwar M Batieha , Rosangela L Batista , Zhamilya Battakova , Assembekov Batyrbek , Louise A Baur , Robert Beaglehole , Silvia Bel-Serrat , Antonisamy Belavendra , Habiba Ben Romdhane , Judith Benedics , Mikhail Benet , Ingunn Holden Bergh , Salim Berkinbayev , Antonio Bernabe-Ortiz , Gailute Bernotiene , Heloísa Bettiol , Jorge Bezerra , Aroor Bhagyalaxmi , Sumit Bharadwaj , Santosh K Bhargava , Zulfiqar A Bhutta , Hongsheng Bi , Yufang Bi , Daniel Bia , Elysée Claude Bika Lele, Mukharram M Bikbov , Bihungum Bista , Dusko J Bjelica , Peter Bjerregaard , Espen Bjertness , Marius B Bjertness , Cecilia Björkelund , Katia V Bloch , Anneke Blokstra , Simona Bo , Martin Bobak , Lynne M Boddy , Bernhard O Boehm , Heiner Boeing , Jose G Boggia , Elena Bogova , Carlos P Boissonnet , Stig E Bojesen , Marialaura Bonaccio , Vanina Bongard , Alice Bonilla-Vargas , Matthias Bopp , Herman Borghs , Lien Braeckevelt , Lutgart Braeckman , Marjolijn Ce Bragt , Imperia Brajkovich , Francesco Branca , Juergen Breckenkamp , João Breda , Hermann Brenner , Lizzy M Brewster , Garry R Brian , Lacramioara Brinduse , Sinead Brophy , Graziella Bruno , H Bas Bueno-de-Mesquita , Anna Bugge , Marta Buoncristiano , Genc Burazeri , Con Burns , Antonio Cabrera de León , Joseph Cacciottolo , Hui Cai , Tilema Cama , Christine Cameron , José Camolas , 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Cottel , Chris Cowell , Cora L Craig , Amelia C Crampin , Ana B Crujeiras , Semánová Csilla , Alexandra M Cucu , Liufu Cui , Felipe V Cureau , Ewelina Czenczek-Lewandowska , Graziella D'Arrigo , Eleonora d'Orsi , Liliana Dacica , María Ángeles Dal Re Saavedra , Jean Dallongeville , Camilla T Damsgaard , Rachel Dankner , Thomas M Dantoft , Parasmani Dasgupta , Saeed Dastgiri , Luc Dauchet , Kairat Davletov , Guy De Backer , Dirk De Bacquer , Giovanni de Gaetano , Stefaan De Henauw , Paula Duarte de Oliveira , David De Ridder , Karin De Ridder , Susanne R de Rooij , Delphine De Smedt , Mohan Deepa , Alexander D Deev , Vincent Jr DeGennaro , Abbas Dehghan , Hélène Delisle , Francis Delpeuch , Stefaan Demarest , Elaine Dennison , Katarzyna Dereń , Valérie Deschamps , Meghnath Dhimal , Augusto F Di Castelnuovo , Juvenal Soares Dias-da-Costa , María Elena Díaz-Sánchez , Alejandro Diaz , Zivka Dika , Shirin Djalalinia , Visnja Djordjic , Ha Tp Do , Annette J Dobson , Maria Benedetta Donati , 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, Daniel Fernández-Bergés , Daniel Ferrante , Thomas Ferrao , Marika Ferrari , Marco M Ferrario , Catterina Ferreccio , Eldridge Ferrer , Jean Ferrieres , Thamara Hubler Figueiró , Anna Fijalkowska , Günther Fink , Krista Fischer , Leng Huat Foo , Maria Forsner , Heba M Fouad , Damian K Francis , Maria do Carmo Franco , Ruth Frikke-Schmidt , Guillermo Frontera , Flavio D Fuchs , Sandra C Fuchs , Isti I Fujiati , Yuki Fujita , Matsuda Fumihiko , Takuro Furusawa , Zbigniew Gaciong , Mihai Gafencu , Andrzej Galbarczyk , Henrike Galenkamp , Daniela Galeone , Myriam Galfo , Fabio Galvano , Jingli Gao , Manoli Garcia-de-la-Hera , Marta García-Solano , Dickman Gareta , Sarah P Garnett , Jean-Michel Gaspoz , Magda Gasull , Adroaldo Cesar Araujo Gaya , Anelise Reis Gaya , Andrea Gazzinelli , Ulrike Gehring , Harald Geiger , Johanna M Geleijnse , Ali Ghanbari , Erfan Ghasemi , Oana-Florentina Gheorghe-Fronea , Simona Giampaoli , Francesco Gianfagna , Tiffany K Gill , Jonathan Giovannelli , Glen Gironella , Aleksander Giwercman , Konstantinos Gkiouras , Justyna Godos , Sibel Gogen , Marcel Goldberg , Rebecca A Goldsmith , David Goltzman , Santiago F Gómez , Aleksandra Gomula , Bruna Goncalves Cordeiro da Silva , Helen Gonçalves , David A Gonzalez-Chica , Marcela Gonzalez-Gross , Margot González-Leon , Juan P González-Rivas , Clicerio González-Villalpando , María-Elena González-Villalpando , Angel R Gonzalez , Frederic Gottrand , Antonio Pedro Graça , Sidsel Graff-Iversen , Dušan Grafnetter , Aneta Grajda , Maria G Grammatikopoulou , Ronald D Gregor , Tomasz Grodzicki , Else Karin Grøholt , Anders Grøntved , Giuseppe Grosso , Gabriella Gruden , Dongfeng Gu , Emanuela Gualdi-Russo , Pilar Guallar-Castillón , Andrea Gualtieri , Elias F Gudmundsson , Vilmundur Gudnason , Ramiro Guerrero , Idris Guessous , Andre L Guimaraes , Martin C Gulliford , Johanna Gunnlaugsdottir , Marc J Gunter , Xiu-Hua Guo , Yin Guo , Prakash C Gupta , Rajeev Gupta , Oye Gureje , Beata Gurzkowska , 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Huiart , Constanta Huidumac Petrescu , Martijn Huisman , Abdullatif Husseini , Chinh Nguyen Huu , Inge Huybrechts , Nahla Hwalla , Jolanda Hyska , Licia Iacoviello , Jesús M Ibarluzea , Mohsen M Ibrahim , Norazizah Ibrahim Wong , M Arfan Ikram , Violeta Iotova , Vilma E Irazola , Takafumi Ishida , Muhammad Islam , Sheikh Mohammed Shariful Islam , Masanori Iwasaki , Jeremy M Jacobs , Hashem Y Jaddou , Tazeen Jafar , Kenneth James , Kazi M Jamil , Konrad Jamrozik , Imre Janszky , Edward Janus , Juel Jarani , Marjo-Riitta Jarvelin , Grazyna Jasienska , Ana Jelakovic , Bojan Jelakovic , Garry Jennings , Anjani Kumar Jha , Chao Qiang Jiang , Ramon O Jimenez , Karl-Heinz Jöckel , Michel Joffres , Mattias Johansson , Jari J Jokelainen , Jost B Jonas , Jitendra Jonnagaddala , Torben Jørgensen , Pradeep Joshi , Farahnaz Joukar , Dragana P Jovic , Jacek J Jóźwiak , Anne Juolevi , Gregor Jurak , Iulia Jurca Simina , Vesna Juresa , Rudolf Kaaks , Felix O Kaducu , Anthony Kafatos , Eero O Kajantie , Zhanna Kalmatayeva , Ofra Kalter-Leibovici , Yves Kameli , Freja B Kampmann , Kodanda R Kanala , Srinivasan Kannan , Efthymios Kapantais , Argyro Karakosta , Line L Kårhus , Khem B Karki , Marzieh Katibeh , Joanne Katz , Peter T Katzmarzyk , Jussi Kauhanen , Prabhdeep Kaur , Maryam Kavousi , Gyulli M Kazakbaeva , Ulrich Keil , Lital Keinan Boker , Sirkka Keinänen-Kiukaanniemi , Roya Kelishadi , Cecily Kelleher , Han Cg Kemper , Andre P Kengne , Maryam Keramati , Alina Kerimkulova , Mathilde Kersting , Timothy Key , Yousef Saleh Khader , Davood Khalili , Kay-Tee Khaw , Bahareh Kheiri , Motahareh Kheradmand , Alireza Khosravi , Ilse Msl Khouw , Ursula Kiechl-Kohlendorfer , Stefan Kiechl , Japhet Killewo , Dong Wook Kim , Hyeon Chang Kim , Jeongseon Kim , Jenny M Kindblom , Heidi Klakk , Magdalena Klimek , Jeannette Klimont , Jurate Klumbiene , Michael Knoflach , Bhawesh Koirala , Elin Kolle , Patrick Kolsteren , Jürgen König , Raija Korpelainen , Paul Korrovits , Magdalena Korzycka , 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, Yves Martin-Prevel , Rosemarie Martin , Reynaldo Martorell , Eva Martos , Katharina Maruszczak , Stefano Marventano , Luis P Mascarenhas , Shariq R Masoodi , Ellisiv B Mathiesen , Prashant Mathur , Alicia Matijasevich , Tandi E Matsha , Christina Mavrogianni , Artur Mazur , Jean Claude N Mbanya , Shelly R McFarlane , Stephen T McGarvey , Martin McKee , Stela McLachlan , Rachael M McLean , Scott B McLean , Breige A McNulty , Sounnia Mediene Benchekor , Jurate Medzioniene , Parinaz Mehdipour , Kirsten Mehlig , Amir Houshang Mehrparvar , Aline Meirhaeghe , Jørgen Meisfjord , Christa Meisinger , Ana Maria B Menezes , Geetha R Menon , Gert Bm Mensink , Maria Teresa Menzano , Alibek Mereke , Indrapal I Meshram , Andres Metspalu , Haakon E Meyer , Jie Mi , Kim F Michaelsen , Nathalie Michels , Kairit Mikkel , Karolina Milkowska , Jody C Miller , Cláudia S Minderico , G K Mini , Juan Francisco Miquel , Mohammad Reza Mirjalili , Daphne Mirkopoulou , Erkin Mirrakhimov , Marjeta 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Theodoridis , Lutgarde Thijs , Nihal Thomas , Betina H Thuesen , Lubica Tichá , Erik J Timmermans , Anne Tjonneland , Hanna K Tolonen , Janne S Tolstrup , Murat Topbas , Roman Topór-Madry , Liv Elin Torheim , María José Tormo , Michael J Tornaritis , Maties Torrent , Laura Torres-Collado , Stefania Toselli , Giota Touloumi , Pierre Traissac , Thi Tuyet-Hanh Tran , Dimitrios Trichopoulos , Antonia Trichopoulou , Oanh Th Trinh , Atul Trivedi , Lechaba Tshepo , Maria Tsigga , Shoichiro Tsugane , Azaliia M Tuliakova , Marshall K Tulloch-Reid , Fikru Tullu , Tomi-Pekka Tuomainen , Jaakko Tuomilehto , Maria L Turley , Gilad Twig , Per Tynelius , Themistoklis Tzotzas , Christophe Tzourio , Peter Ueda , Eunice Ugel , Flora Am Ukoli , Hanno Ulmer , Belgin Unal , Zhamyila Usupova , Hannu Mt Uusitalo , Nalan Uysal , Justina Vaitkeviciute , Gonzalo Valdivia , Susana Vale , Damaskini Valvi , Rob M van Dam , Johan Van der Heyden , Yvonne T van der Schouw , Koen Van Herck , Hoang Van Minh , Natasja M Van Schoor , Irene Gm van Valkengoed , Dirk Vanderschueren , Diego Vanuzzo , Anette Varbo , Gregorio Varela-Moreiras , Patricia Varona-Pérez , Senthil K Vasan , Tomas Vega , Toomas Veidebaum , Gustavo Velasquez-Melendez , Biruta Velika , Giovanni Veronesi , Wm Monique Verschuren , Cesar G Victora , Giovanni Viegi , Lucie Viet , Salvador Villalpando , Paolo Vineis , Jesus Vioque , Jyrki K Virtanen , Marjolein Visser , Sophie Visvikis-Siest , Bharathi Viswanathan , Mihaela Vladulescu , Tiina Vlasoff , Dorja Vocanec , Peter Vollenweider , Henry Völzke , Ari Voutilainen , Sari Voutilainen , Martine Vrijheid , Tanja Gm Vrijkotte , Alisha N Wade , Aline Wagner , Thomas Waldhör , Janette Walton , Elvis Oa Wambiya , Wan Mohamad Wan Bebakar , Wan Nazaimoon Wan Mohamud , Rildo de Souza Wanderley Júnior , Ming-Dong Wang , Ningli Wang , Qian Wang , Xiangjun Wang , Ya Xing Wang , Ying-Wei Wang , S Goya Wannamethee , Nicholas Wareham , Adelheid Weber , Niels Wedderkopp , Deepa Weerasekera , Daniel Weghuber , Wenbin Wei , Aneta Weres , Bo Werner , Peter H Whincup , Kurt Widhalm , Indah S Widyahening , Andrzej Wiecek , Rainford J Wilks , Johann Willeit , Peter Willeit , Julianne Williams , Tom Wilsgaard , Bogdan Wojtyniak , Roy A Wong-McClure , Andrew Wong , Jyh Eiin Wong , Tien Yin Wong , Jean Woo , Mark Woodward , Frederick C Wu , Jianfeng Wu , Li Juan Wu , Shouling Wu , Haiquan Xu , Liang Xu , Nor Azwany Yaacob , Uruwan Yamborisut , Weili Yan , Ling Yang , Xiaoguang Yang , Yang Yang , Nazan Yardim , Mehdi Yaseri , Tabara Yasuharu , Xingwang Ye , Panayiotis K Yiallouros , Moein Yoosefi , Akihiro Yoshihara , Qi Sheng You , San-Lin You , Novie O Younger-Coleman , Safiah Md Yusof , Ahmad Faudzi Yusoff , Luciana Zaccagni , Vassilis Zafiropulos , Ahmad A Zainuddin , Seyed Rasoul Zakavi , Farhad Zamani , Sabina Zambon , Antonis Zampelas , Hana Zamrazilová , Maria Elisa Zapata , Abdul Hamid Zargar , Ko Ko Zaw , Tomasz Zdrojewski , Kristyna Zejglicova , Tajana Zeljkovic Vrkic , Yi Zeng , Luxia Zhang , Zhen-Yu Zhang , Dong Zhao , Ming-Hui Zhao , Wenhua Zhao , Shiqi Zhen , Wei Zheng , Yingfeng Zheng , Bekbolat Zholdin , Maigeng Zhou , Dan Zhu , Marie Zins , Emanuel Zitt , Yanina Zocalo , Julio Zuñiga Cisneros , Monika Zuziak , Majid Ezzati , Sarah Filippi, Epidemiology, Iurilli, Maria LC, Zhou, Bin, Bennett, James E, Carrillo-Larco, Rodrigo M, Sophiea, Marisa K, Rodriguez-Martinez, Andrea, Bixby, Honor, Solomon, Bethlehem D, Taddei, Cristina, Danaei, Goodarz, Di Cesare, Mariachiara, Stevens, Gretchen A, Riley, Leanne M, Savin, Stefan, Cowan, Melanie J, Bovet, Pascal, Damasceno, Albertino, Chirita-Emandi, Adela, Hayes, Alison J, Ikeda, Nayu, Jackson, Rod T, Khang, Young-Ho, Laxmaiah, Avula, Liu, Jing, Miranda, J Jaime, Saidi, Olfa, Sebert, Sylvain, Sorić, Maroje, Starc, Gregor, Gregg, Edward W, Abarca-Gómez, Leandra, Abdeen, Ziad A, Abdrakhmanova, Shynar, Ghaffar, Suhaila Abdul, Rahim, Hanan F Abdul, Abu-Rmeileh, Niveen M, Garba, Jamila Abubakar, Acosta-Cazares, 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Mohebbi, Iraj, Mohebi, Farnam, Moitry, Marie, Molbo, Drude, Møllehave, Line T, Møller, Niels C, Molnár, Déne, Momenan, Amirabba, Mondo, Charles K, Monroy-Valle, Michele, Monterrubio-Flores, Eric, Monyeki, Kotsedi Daniel K, Moon, Jin Soo, Moosazadeh, Mahmood, Moreira, Leila B, Morejon, Alain, Moreno, Luis A, Morgan, Karen, Morin, Suzanne N, Mortensen, Erik Lykke, Moschonis, George, Mossakowska, Malgorzata, Mostafa, Aya, Mota-Pinto, Anabela, Mota, Jorge, Motlagh, Mohammad Esmaeel, Motta, Jorge, Moura-dos-Santos, Marcos André, Mridha, Malay K, Msyamboza, Kelias P, Mu, Thet Thet, Muc, Magdalena, Mugoša, Boban, Muiesan, Maria L, Mukhtorova, Parvina, Müller-Nurasyid, Martina, Murphy, Neil, Mursu, Jaakko, Murtagh, Elaine M, Musa, Kamarul Imran, Milanovic, Sanja Music, Musil, Vera, Mustafa, Norlaila, Nabipour, Iraj, Naderimagham, Shohreh, Nagel, Gabriele, Naidu, Balkish M, Najafi, Farid, Nakamura, Harunobu, Námešná, Jana, Ei K Nang, Ei, Nangia, Vinay B, Nankap, Martin, Narake, Sameer, Nardone, Paola, Nauck, Matthia, Neal, William A, Nejatizadeh, Azim, Nekkantti, Chandini, Nelis, Keiu, Nelis, Lii, Nenko, Ilona, Neovius, Martin, Nervi, Flavio, Nguyen, Chung T, Nguyen, Nguyen D, Nguyen, Quang Ngoc, Nieto-Martínez, Ramfis E, Nikitin, Yury P, Ning, Guang, Ninomiya, Toshiharu, Nishtar, Sania, Noale, Marianna, Noboa, Oscar A, Nogueira, Helena, Norat, Teresa, Nordendahl, Maria, Nordestgaard, Børge G, Noto, Davide, Nowak-Szczepanska, Natalia, Al Nsour, Mohannad, Nuhoglu, Irfan, Nurk, Eha, O'Neill, Terence W, O'Reilly, Dermot, Obreja, Galina, Ochimana, Caleb, Ochoa-Avilés, Angélica M, Oda, Eiji, Oh, Kyungwon, Ohara, Kumiko, Ohlsson, Clae, Ohtsuka, Ryutaro, Olafsson, Örn, Olinto, Maria Teresa A, Oliveira, Isabel O, Omar, Mohd Azahadi, Onat, Altan, Ong, Sok King, Ono, Lariane M, Ordunez, Pedro, Ornelas, Rui, Ortiz, Ana P, Ortiz, Pedro J, Osler, Merete, Osmond, Clive, Ostojic, Sergej M, Ostovar, Afshin, Otero, Johanna A, Overvad, Kim, Owusu-Dabo, Elli, Paccaud, Fred Michel, Padez, Cristina, Pagkalos, Ioanni, Pahomova, Elena, de Paiva, Karina Mary, Pajak, Andrzej, Palli, Domenico, Palloni, Alberto, Palmieri, Luigi, Pan, Wen-Harn, Panda-Jonas, Songhomitra, Pandey, Arvind, Panza, Francesco, Papandreou, Dimitrio, Park, Soon-Woo, Park, Suyeon, Parnell, Winsome R, Parsaeian, Mahboubeh, Pascanu, Ionela M, Pasquet, Patrick, Patel, Nikhil D, Pecin, Ivan, Pednekar, Mangesh S, Peer, Nasheeta, Pei, Gao, Peixoto, Sergio Viana, Peltonen, Markku, Pereira, Alexandre C, Peres, Marco A, Pérez-Farinós, Napoleón, Pérez, Cynthia M, Peterkova, Valentina, Peters, Annette, Petersmann, Astrid, Petkeviciene, Janina, Petrauskiene, Ausra, Pettenuzzo, Emanuela, Peykari, Niloofar, Pham, Son Thai, Pichardo, Rafael N, Pierannunzio, Daniela, Pigeot, Iri, Pikhart, Hynek, Pilav, Aida, Pilotto, Lorenza, Pistelli, Francesco, Pitakaka, Freda, Piwonska, Aleksandra, Pizarro, Andreia N, Plans-Rubió, Pedro, Poh, Bee Koon, Pohlabeln, Hermann, Pop, Raluca M, Popovic, Stevo R, Porta, Miquel, Posch, Georg, Poudyal, Anil, Poulimeneas, Dimitrio, Pouraram, Hamed, Pourfarzi, Farhad, Pourshams, Akram, Poustchi, Hossein, Pradeepa, Rajendra, Price, Alison J, Price, Jacqueline F, Providencia, Rui, Puder, Jardena J, Pudule, Iveta, Puhakka, Soile E, Puiu, Maria, Punab, Margu, Qasrawi, Radwan F, Qorbani, Mostafa, Bao, Tran Quoc, Radic, Ivana, Radisauskas, Ricarda, Rahimikazerooni, Salar, Rahman, Mahfuzar, Rahman, Mahmudur, Raitakari, Olli, Raj, Manu, Rakhimova, Ellina, Rakhmatulloev, Sherali, Rakovac, Ivo, Rao, Sudha Ramachandra, Ramachandran, Ambady, Ramke, Jacqueline, Ramos, Elisabete, Ramos, Rafel, Rampal, Lekhraj, Rampal, Sanjay, Rarra, Vayia, Rascon-Pacheco, Ramon A, Rasmussen, Mette, Rech, Cassiano Ricardo, Redon, Josep, Reganit, Paul Ferdinand M, Regecová, Valéria, Revilla, Lui, Rezaianzadeh, Abba, Ribas-Barba, Lourde, Ribeiro, Robespierre, Riboli, Elio, Richter, Adrian, Rigo, Fernando, Rinaldo, Natascia, de Wit, Tobias F Rinke, Rito, Ana, Ritti-Dias, Raphael M, Rivera, Juan A, Robitaille, Cynthia, Roccaldo, Romana, Rodrigues, Daniela, Rodríguez-Artalejo, Fernando, del Cristo Rodriguez-Perez, María, Rodríguez-Villamizar, Laura A, Roggenbuck, Ulla, Rojas-Martinez, Rosalba, Rojroongwasinkul, Nipa, Romaguera, Dora, Romeo, Elisabetta L, Rosario, Rafaela V, Rosengren, Annika, Rouse, Ian, Roy, Joel GR, Rubinstein, Adolfo, Rühli, Frank J, Ruidavets, Jean-Bernard, Ruiz-Betancourt, Blanca Sandra, Ruiz-Castell, Maria, Moreno, Emma Ruiz, Rusakova, Iuliia A, Jonsson, Kenisha Russell, Russo, Paola, Rust, Petra, Rutkowski, Marcin, Sabanayagam, Charumathi, Sacchini, Elena, Sachdev, Harshpal S, Sadjadi, Alireza, Safarpour, Ali Reza, Safiri, Saeid, Saki, Nader, Salanave, Benoit, Martinez, Eduardo Salazar, Salmerón, Diego, Salomaa, Veikko, Salonen, Jukka T, Salvetti, Massimo, Samoutian, Margarita, Sánchez-Abanto, Jose, Sandjaja, null, Sans, Susana, Marina, Loreto Santa, Santos, Diana A, Santos, Ina S, Santos, Lèlita C, Santos, Maria Paula, Santos, Osvaldo, Santos, Rute, Sanz, Sara Santo, Saramies, Jouko L, Sardinha, Luis B, Sarrafzadegan, Nizal, Sathish, Thirunavukkarasu, Saum, Kai-Uwe, Savva, Savva, Savy, Mathilde, Sawada, Norie, Sbaraini, Mariana, Scazufca, Marcia, Schaan, Beatriz D, Rosario, Angelika Schaffrath, Schargrodsky, Herman, Schienkiewitz, Anja, Schipf, Sabine, Schmidt, Carsten O, Schmidt, Ida Maria, Schnohr, Peter, Schöttker, Ben, Schramm, Sara, Schramm, Stine, Schröder, Helmut, Schultsz, Constance, Schutte, Aletta E, Sein, Aye Aye, Selamat, Rusidah, Sember, Vedrana, Sen, Abhijit, Senbanjo, Idowu O, Sepanlou, Sadaf G, Sequera, Victor, Serra-Majem, Lui, Servais, Jennifer, Ševcíková, Ludmila, Shalnova, Svetlana A, Shamah-Levy, Teresa, Shamshirgaran, Morteza, Shanthirani, Coimbatore Subramaniam, Sharafkhah, Maryam, Sharma, Sanjib K, Shaw, Jonathan E, Shayanrad, Amaneh, Shayesteh, Ali Akbar, Shengelia, Lela, Shi, Zumin, Shibuya, Kenji, Shimizu-Furusawa, Hana, Shin, Dong Wook, Shirani, Majid, Shiri, Rahman, Shrestha, Namuna, Si-Ramlee, Khairil, Siani, Alfonso, Siantar, Rosalynn, Sibai, Abla M, Silva, Antonio M, Silva, Diego Augusto Santo, Simon, Mary, Simons, Judith, Simons, Leon A, Sjöberg, Agneta, Sjöström, Michael, Skodje, Gry, Slowikowska-Hilczer, Jolanta, Slusarczyk, Przemyslaw, Smeeth, Liam, So, Hung-Kwan, Soares, Fernanda Cunha, Sobek, Grzegorz, Sobngwi, Eugène, Sodemann, Morten, Söderberg, Stefan, Soekatri, Moesijanti YE, Soemantri, Agustinu, Sofat, Reecha, Solfrizzi, Vincenzo, Somi, Mohammad Hossein, Sonestedt, Emily, Song, Yi, Sørensen, Thorkild IA, Sørgjerd, Elin P, Jérome, Charles Sossa, Soto-Rojas, Victoria E, Soumaré, Aïcha, Sovic, Slavica, Sparboe-Nilsen, Bente, Sparrenberger, Karen, Spinelli, Angela, Spiroski, Igor, Staessen, Jan A, Stamm, Hanspeter, Stathopoulou, Maria G, Staub, Kaspar, Stavreski, Bill, Steene-Johannessen, Jostein, Stehle, Peter, Stein, Aryeh D, Stergiou, George S, Stessman, Jochanan, Stevanovic, Ranko, Stieber, Jutta, Stöckl, Dori, Stocks, Tanja, Stokwiszewski, Jakub, Stoyanova, Ekaterina, Stratton, Gareth, Stronks, Karien, Strufaldi, Maria Wany, Sturua, Lela, Suárez-Medina, Ramón, Suka, Machi, Sun, Chien-An, Sundström, Johan, Sung, Yn-Tz, Sunyer, Jordi, Suriyawongpaisal, Paibul, Swinburn, Boyd A, Sy, Rody G, Syddall, Holly E, Sylva, René Charle, Szklo, Moyse, Szponar, Lucjan, Tai, E Shyong, Tammesoo, Mari-Lii, Tamosiunas, Abdona, Tan, Eng Joo, Tang, Xun, Tanrygulyyeva, Maya, Tanser, Frank, Tao, Yong, Tarawneh, Mohammed Rasoul, Tarp, Jakob, Tarqui-Mamani, Carolina B, Braunerová, Radka Taxová, Taylor, Anne, Taylor, Julie, Tchibindat, Félicité, Tebar, William R, Tell, Grethe S, Tello, Tania, Tham, Yih Chung, Thankappan, KR, Theobald, Holger, Theodoridis, Xenophon, Thijs, Lutgarde, Thomas, Nihal, Thuesen, Betina H, Tichá, Lubica, Timmermans, Erik J, Tjonneland, Anne, Tolonen, Hanna K, Tolstrup, Janne S, Topbas, Murat, Topór-Madry, Roman, Torheim, Liv Elin, Tormo, María José, Tornaritis, Michael J, Torrent, Matie, Torres-Collado, Laura, Toselli, Stefania, Touloumi, Giota, Traissac, Pierre, Tran, Thi Tuyet-Hanh, Trichopoulos, Dimitrio, Trichopoulou, Antonia, Trinh, Oanh TH, Trivedi, Atul, Tshepo, Lechaba, Tsigga, Maria, Tsugane, Shoichiro, Tuliakova, Azaliia M, Tulloch-Reid, Marshall K, Tullu, Fikru, Tuomainen, Tomi-Pekka, Tuomilehto, Jaakko, Turley, Maria L, Twig, Gilad, Tynelius, Per, Tzotzas, Themistokli, Tzourio, Christophe, Ueda, Peter, Ugel, Eunice, Ukoli, Flora AM, Ulmer, Hanno, Unal, Belgin, Usupova, Zhamyila, Uusitalo, Hannu MT, Uysal, Nalan, Vaitkeviciute, Justina, Valdivia, Gonzalo, Vale, Susana, Valvi, Damaskini, van Dam, Rob M, Van der Heyden, Johan, van der Schouw, Yvonne T, Van Herck, Koen, Van Minh, Hoang, Van Schoor, Natasja M, van Valkengoed, Irene GM, Vanderschueren, Dirk, Vanuzzo, Diego, Varbo, Anette, Varela-Moreiras, Gregorio, Varona-Pérez, Patricia, Vasan, Senthil K, Vega, Toma, Veidebaum, Tooma, Velasquez-Melendez, Gustavo, Velika, Biruta, Veronesi, Giovanni, Verschuren, WM Monique, Victora, Cesar G, Viegi, Giovanni, Viet, Lucie, Villalpando, Salvador, Vineis, Paolo, Vioque, Jesu, Virtanen, Jyrki K, Visser, Marjolein, Visvikis-Siest, Sophie, Viswanathan, Bharathi, Vladulescu, Mihaela, Vlasoff, Tiina, Vocanec, Dorja, Vollenweider, Peter, Völzke, Henry, Voutilainen, Ari, Voutilainen, Sari, Vrijheid, Martine, Vrijkotte, Tanja GM, Wade, Alisha N, Wagner, Aline, Waldhör, Thoma, Walton, Janette, Wambiya, Elvis OA, Bebakar, Wan Mohamad Wan, Mohamud, Wan Nazaimoon Wan, de Souza Wanderley Júnior, Rildo, Wang, Ming-Dong, Wang, Ningli, Wang, Qian, Wang, Xiangjun, Wang, Ya Xing, Wang, Ying-Wei, Wannamethee, S Goya, Wareham, Nichola, Weber, Adelheid, Wedderkopp, Niel, Weerasekera, Deepa, Weghuber, Daniel, Wei, Wenbin, Weres, Aneta, Werner, Bo, Whincup, Peter H, Widhalm, Kurt, Widyahening, Indah S, Wiecek, Andrzej, Wilks, Rainford J, Willeit, Johann, Willeit, Peter, Williams, Julianne, Wilsgaard, Tom, Wojtyniak, Bogdan, Wong-McClure, Roy A, Wong, Andrew, Wong, Jyh Eiin, Wong, Tien Yin, Woo, Jean, Woodward, Mark, Wu, Frederick C, Wu, Jianfeng, Wu, Li Juan, Wu, Shouling, Xu, Haiquan, Xu, Liang, Yaacob, Nor Azwany, Yamborisut, Uruwan, Yan, Weili, Yang, Ling, Yang, Xiaoguang, Yang, Yang, Yardim, Nazan, Yaseri, Mehdi, Yasuharu, Tabara, Ye, Xingwang, Yiallouros, Panayiotis K, Yoosefi, Moein, Yoshihara, Akihiro, You, Qi Sheng, You, San-Lin, Younger-Coleman, Novie O, Md Yusof, Safiah, Yusoff, Ahmad Faudzi, Zaccagni, Luciana, Zafiropulos, Vassili, Zainuddin, Ahmad A, Zakavi, Seyed Rasoul, Zamani, Farhad, Zambon, Sabina, Zampelas, Antoni, Zamrazilová, Hana, Zapata, Maria Elisa, Zargar, Abdul Hamid, Ko Zaw, Ko, Zdrojewski, Tomasz, Zejglicova, Kristyna, Vrkic, Tajana Zeljkovic, Zeng, Yi, Zhang, Luxia, Zhang, Zhen-Yu, Zhao, Dong, Zhao, Ming-Hui, Zhao, Wenhua, Zhen, Shiqi, Zheng, Wei, Zheng, Yingfeng, Zholdin, Bekbolat, Zhou, Maigeng, Zhu, Dan, Zins, Marie, Zitt, Emanuel, Zocalo, Yanina, Cisneros, Julio Zuñiga, Zuziak, Monika, Ezzati, Majid, Filippi, Sarah, Cohortes épidémiologiques en population (CONSTANCES), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université Paris Cité (UPCité), Université Paris Cité (UPCité), Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut Agro - Montpellier SupAgro, and Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)
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Population -- Health aspects ,Leanness ,Baixo peso/Underweight ,none ,Double burden ,alipainoisuus ,tulotaso ,global health ,systematic analysis ,Sedentary behaviors ,RC1200 ,Prospective associations ,0302 clinical medicine ,underweight ,nälänhätä ,Biology (General) ,skin and connective tissue diseases ,Children ,ComputingMilieux_MISCELLANEOUS ,Body mass index ,Human Nutrition & Health ,education.field_of_study ,Humane Voeding & Gezondheid ,ylipaino ,General Medicine ,kansainvälinen vertailu ,3. Good health ,World health ,Medicine ,A100 Pre-clinical Medicine ,Population distribution ,medicine.medical_specialty ,QH301-705.5 ,Science ,Socio-culturale ,Nursing ,Social sciences ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,Thinness ,SDG 3 - Good Health and Well-being ,BMI ,epidemiology ,obesity ,None ,Humans ,Obesidade/Obesity ,SDG 2 - Zero Hunger ,education ,VLAG ,US adults ,Omvårdnad ,body mass index ,malnutrition ,obesity, underweight ,nutritional and metabolic diseases ,medicine.disease ,terveellisyys ,Obesity ,Faculdade de Ciências Sociais ,Body Mass Index ,Prevalence ,Risk Factors ,General Biochemistry ,WIAS ,lihavuus ,RA ,Demography ,N.A ,double burden ,Settore MED/09 - Medicina Interna ,alueelliset erot ,Nutrition and Disease ,Animal Nutrition ,[SDV]Life Sciences [q-bio] ,Medizin ,030204 cardiovascular system & hematology ,0601 Biochemistry and Cell Biology ,Change distribution of body mass index ,RA0421 ,Voeding en Ziekte ,Epidemiology ,Medicine and Health Sciences ,Global health ,Índice de massa corporal/Body Mass Index ,030212 general & internal medicine ,Underweight ,painoindeksi ,2. Zero hunger ,General Neuroscience ,aliravitsemus ,elintarvikkeet ,health ,Public Health, Global Health, Social Medicine and Epidemiology ,Diervoeding ,3142 Public health care science, environmental and occupational health ,purl.org/pe-repo/ocde/ford#3.01.03 [https] ,Chinese adults ,pooled analysis ,medicine.symptom ,Diet quality ,B120 Physiology ,Research Article ,trends ,purl.org/pe-repo/ocde/ford#1.06.03 [https] ,prevalence ,Population ,Mothers ,Genetics and Molecular Biology ,3121 Internal medicine ,medicine ,Life Science ,ddc:610 ,3125 Otorhinolaryngology, ophthalmology ,kehonkoostumus ,Nutrition ,Australian adults ,General Immunology and Microbiology ,purl.org/pe-repo/ocde/ford#3.01.04 [https] ,Ciências sociais ,Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi ,Malnutrition ,Epidemiology and Global Health ,sense organs ,Estilos de Vida e Impacto na Saúde - Abstract
From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions., Wellcome Trust, Medical Research Council, peer-reviewed
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- 2021
43. Association of fatty liver disease with mortality outcomes in an Eastern Finland male cohort
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Tomi-Pekka Tuomainen, Jyrki K. Virtanen, Jussi Pihlajamäki, and Olubunmi O Olubamwo
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medicine.medical_specialty ,fatty liver index ,Disease ,03 medical and health sciences ,0302 clinical medicine ,cardiovascular disease ,Internal medicine ,Medicine ,cancer ,030212 general & internal medicine ,Risk factor ,lcsh:RC799-869 ,Prospective cohort study ,Hepatology ,business.industry ,Proportional hazards model ,Fatty liver ,fungi ,Gastroenterology ,Cancer ,medicine.disease ,kuopio ischaemic heart disease risk factor study ,mortality ,Blood pressure ,Cohort ,fatty liver disease ,030211 gastroenterology & hepatology ,metabolic factors ,lcsh:Diseases of the digestive system. Gastroenterology ,business - Abstract
ObjectiveFatty liver disease (FLD) has been associated with extrahepatic morbidity outcomes. However, reports on the association of FLD, assessed using fatty liver index (FLI), with mortality outcomes have been inconsistent. Our objective was to examine the effect of metabolic factors (blood pressure, insulin, fasting glucose, lipoproteins) on the associations of FLI with mortality outcomes among middle-aged men.Study designProspective cohort study.MethodsOur subjects were 1893 men at baseline from 1984 to 1989 in the Kuopio Ischaemic Heart Disease Risk Factor Study cohort. Multivariable Cox regression models were used to analyse the association of baseline FLI, with the HRs for all-cause, disease, cardiovascular, non-cardiovascular and cancer mortality outcomes.ResultsThe mean FLI in the FLI categories were 16.2 in the low and reference category (FLIConclusionHigh FLI (FLD) is associated with increased risks of mortality outcomes. The FLI-CVD mortality association can be largely explained by metabolic factors. Persons with FLD should be monitored for metabolic deterioration and extrahepatic morbidity to improve their prognoses.
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- 2019
44. The dynamic course of peripartum depression across pregnancy and childbirth
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Tomi-Pekka Tuomainen, Markku Pasanen, Kirsti Kumpulainen, Soili M. Lehto, Sari Voutilainen, Tsachi Ein-Dor, Aleksi Ruohomäki, Leea Keski-Nisula, Sharon Dekel, Juha Pekkanen, Seppo Heinonen, Jussi Lampi, Department of Obstetrics and Gynecology, Clinicum, HUS Gynecology and Obstetrics, Department of Public Health, Department of Psychology and Logopedics, Medicum, and Department of Psychiatry
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Postpartum depression ,SYMPTOMS ,Databases, Factual ,Poison control ,3124 Neurology and psychiatry ,Cohort Studies ,0302 clinical medicine ,Pregnancy ,Surveys and Questionnaires ,Childbirth ,POSTNATAL DEPRESSION ,Depression (differential diagnoses) ,Finland ,SCALE ,Obstetrics ,3. Good health ,PREVALENCE ,Psychiatry and Mental health ,GROWTH ,Female ,Adult ,medicine.medical_specialty ,Prospective sample ,Pregnancy Trimester, Third ,Mothers ,Depression, Postpartum ,ANTENATAL DEPRESSION ,03 medical and health sciences ,medicine ,Peripartum Period ,Humans ,Growth modeling ,Symptom trajectory ,PERINATAL DEPRESSION ,Biological Psychiatry ,Psychiatric Status Rating Scales ,Depressive Disorder ,Peripartum depression ,business.industry ,POSTPARTUM DEPRESSION ,RESILIENCE ,medicine.disease ,Mental health ,030227 psychiatry ,Pregnancy Complications ,Pregnancy Trimester, First ,Antenatal depression ,TRAJECTORIES ,business ,030217 neurology & neurosurgery ,Perinatal Depression - Abstract
Objective Peripartum depression (PPD) pertaining to depression in pregnancy and postpartum is one of the most common complications around childbirth with enduring adverse effects on mother and child health. Although psychiatric symptoms may improve or worsen over time, relatively little is known about the course of PPD symptoms and possible fluctuations. Methods We applied a person-centered approach to examine PPD symptom patterns across pregnancy and childbirth. 824 women were assessed at three time points: first trimester (T1), third trimester (T2), and again at eight weeks (T3) postpartum. We assessed PPD symptoms, maternal mental health history, and childbirth variables. Results Growth mixture modeling (GMM) analysis revealed four discrete PPD symptom trajectory classes including chronic PPD (1.1%), delayed (10.2%), recovered (7.2%), and resilient (81.5%). Delivery complications were associated with chronic PPD but also with the recovered PPD trajectory class. History of mental health disorders was associated with chronic PPD and the delayed PPD class. Conclusion The findings underscore that significant changes in a woman's depression level can occur across pregnancy and childbirth. While a minority of women experience chronic PDD, for others depression symptoms appear to significantly alleviate over time, suggesting a form of recovery. Our findings support a personalized medicine approach based on the woman's symptom trajectory. Future research is warranted to identify the mechanisms underlying modifications in PPD symptoms severity and those implicated in recovery.
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- 2019
45. Progression of conventional cardiovascular risk factors and vascular disease risk in individuals: insights from the PROG-IMT consortium
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Wiek H. van Gilst, Fabrizio Veglia, Folkert W. Asselbergs, Matthias Sitzer, Gerald S. Berenson, Lars Lind, Joseph F. Polak, Tatjana Rundek, Jackie F. Price, Tomi-Pekka Tuomainen, Christos Savopoulos, Oscar H. Franco, Stefan Kiechl, Matthieu Plichart, Holger Poppert, Alberico L. Catapano, Peter Willeit, Helmuth Steinmetz, Damiano Baldassarre, Frank P. Brouwers, Marcus Dörr, Maryam Kavousi, Apostolos I. Hatzitolios, Martin Bahls, Lu Gao, Stefan Agewall, Stela McLachlan, Henry Völzke, Johann Willeit, Göran Bergström, Michael H. Olsen, Albert Hofman, Jussi Kauhanen, Eric de Groot, Ellisiv B. Mathiesen, Pierre Ducimetière, Dirk Sander, Heiko Uthoff, Horst Bickel, Michiel L. Bots, Kazuo Kitagawa, Liliana Grigore, Matthias W. Lorenz, Ralph L. Sacco, Caroline Schmidt, Giuseppe Danilo Norata, M. Arfan Ikram, Coen D.A. Stehouwer, Simon G. Thompson, Jean Philippe Empana, Moïse Desvarieux, Ulf Schminke, Michael R. Skilton, George Ntaios, Stein Harald Johnsen, PROG-IMT Study Group, Radiotherapy, Cardiology, Graduate School, APH - Personalized Medicine, APH - Methodology, Gastroenterology and Hepatology, Public and occupational health, MUMC+: Centrum voor Chronische Zieken (3), MUMC+: MA Med Staf Artsass Interne Geneeskunde (9), RS: Carim - V01 Vascular complications of diabetes and metabolic syndrome, MUMC+: MA Reumatologie (9), MUMC+: MA Nefrologie (9), MUMC+: MA Medische Oncologie (9), MUMC+: MA Hematologie (9), MUMC+: MA Maag Darm Lever (9), MUMC+: MA Endocrinologie (9), MUMC+: HVC Pieken Maastricht Studie (9), Interne Geneeskunde, MUMC+: MA Interne Geneeskunde (3), Cardiovascular Centre (CVC), Epidemiology, Neurology, and Radiology & Nuclear Medicine
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Carotid Artery Diseases ,Male ,Time Factors ,BASE-LINE ,Epidemiology ,Myocardial Infarction ,Blood Pressure ,030204 cardiovascular system & hematology ,Carotid Intima-Media Thickness ,INTIMA-MEDIA THICKNESS ,0302 clinical medicine ,Clinical endpoint ,Medicine ,Cardiac and Cardiovascular Systems ,Myocardial infarction ,Prospective cohort study ,Aged, 80 and over ,Kardiologi ,Hazard ratio ,Middle Aged ,Prognosis ,VDP::Medical disciplines: 700::Basic medical, dental and veterinary science disciplines: 710 ,ddc ,DIASTOLIC BLOOD-PRESSURE ,Cholesterol ,DENSITY-LIPOPROTEIN CHOLESTEROL ,Cardiovascular Diseases ,Hypertension ,Disease Progression ,Cardiology ,Female ,lipids (amino acids, peptides, and proteins) ,CAROTID-ARTERY INTIMA ,Cardiology and Cardiovascular Medicine ,STROKE ,Adult ,medicine.medical_specialty ,610 Medicine & health ,risk factor progression ,Lower risk ,Risk Assessment ,Young Adult ,03 medical and health sciences ,Predictive Value of Tests ,360 Social problems & social services ,Internal medicine ,Journal Article ,Humans ,CORONARY-HEART-DISEASE ,ddc:610 ,METAANALYSIS ,Aged ,Dyslipidemias ,business.industry ,Vascular disease ,Cholesterol, HDL ,VDP::Medisinske Fag: 700::Basale medisinske, odontologiske og veterinærmedisinske fag: 710 ,Cholesterol, LDL ,medicine.disease ,Blood pressure ,MYOCARDIAL-INFARCTION ,ATHEROSCLEROSIS ,Intima-media thickness ,Risk factors ,Heart Disease Risk Factors ,CVD biomarker ,business ,Biomarkers ,030217 neurology & neurosurgery - Abstract
AimsAveraged measurements, but not the progression based on multiple assessments of carotid intima-media thickness, (cIMT) are predictive of cardiovascular disease (CVD) events in individuals. Whether this is true for conventional risk factors is unclear.Methods and resultsAn individual participant meta-analysis was used to associate the annualised progression of systolic blood pressure, total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol with future cardiovascular disease risk in 13 prospective cohort studies of the PROG-IMT collaboration ( n = 34,072). Follow-up data included information on a combined cardiovascular disease endpoint of myocardial infarction, stroke, or vascular death. In secondary analyses, annualised progression was replaced with average. Log hazard ratios per standard deviation difference were pooled across studies by a random effects meta-analysis. In primary analysis, the annualised progression of total cholesterol was marginally related to a higher cardiovascular disease risk (hazard ratio (HR) 1.04, 95% confidence interval (CI) 1.00 to 1.07). The annualised progression of systolic blood pressure, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol was not associated with future cardiovascular disease risk. In secondary analysis, average systolic blood pressure (HR 1.20 95% CI 1.11 to 1.29) and low-density lipoprotein cholesterol (HR 1.09, 95% CI 1.02 to 1.16) were related to a greater, while high-density lipoprotein cholesterol (HR 0.92, 95% CI 0.88 to 0.97) was related to a lower risk of future cardiovascular disease events.ConclusionAveraged measurements of systolic blood pressure, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol displayed significant linear relationships with the risk of future cardiovascular disease events. However, there was no clear association between the annualised progression of these conventional risk factors in individuals with the risk of future clinical endpoints.
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- 2019
46. Predictive value for cardiovascular events of common carotid intima media thickness and its rate of change in individuals at high cardiovascular risk – Results from the PROG-IMT collaboration
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Sathanur R. Srinivasan, Christine Espinola-Klein, Albert Hofman, Jing Liu, Eric de Groot, Tomi-Pekka Tuomainen, Helmuth Steinmetz, Ta-Chen Su, Carmen Suárez, Maria Rosvall, Stela McLachlan, Raffaele Izzo, Marcus Dörr, Liliana Grigore, Gunnar Engström, Stein Harald Johnsen, David Yanez, Giel Nijpels, Giuseppe Danilo Norata, Fabrizio Veglia, Matthias W. Lorenz, Dong Zhao, Lu Gao, Wuxiang Xie, Damiano Baldassarre, Mauro Amato, Ellisiv B. Mathiesen, Michiel L. Bots, Dirk Sander, Joseph F. Polak, Matthieu Plichart, Holger Poppert, Matthias Sitzer, Ralph L. Sacco, Irene Schmidtmann, Heiko Uthoff, Manuel F. Landecho, Horst Bickel, Gerald S. Berenson, Oscar H. Franco, Bo Hedblad, Kazuo Kitagawa, Daniel Staub, Jackie F. Price, Caroline Schmidt, Alberico L. Catapano, Tatjana Rundek, Thapat Wannarong, M. Arfan Ikram, Kathrin Ziegelbauer, Alfonso Friera, Francesco Rozza, Kimmo Ronkainen, Jacqueline M. Dekker, Peter Willeit, Samuela Castelnuovo, Coen D.A. Stehouwer, Shuhei Okazaki, Pierre Ducimetière, Stefan Blankenberg, Johann Willeit, Oscar Beloqui, Maryam Kavousi, Henry Völzke, Kuo-Liong Chien, Grace Parraga, Bernhard Iglseder, Rafael Gabriel, Lena Bokemark, Stefan Kiechl, Cesare R. Sirtori, Göran Bergström, Jussi Kauhanen, Simon G. Thompson, Nicola De Luca, Lars Lind, Jean Philippe Empana, Moïse Desvarieux, Ulf Schminke, Hung-Ju Lin, Elena Tremoli, Lorenz, Matthias W, Gao, Lu, Ziegelbauer, Kathrin, Norata, Giuseppe Danilo, Empana, Jean Philippe, Schmidtmann, Irene, Lin, Hung-Ju, Mclachlan, Stela, Bokemark, Lena, Ronkainen, Kimmo, Amato, Mauro, Schminke, Ulf, Srinivasan, Sathanur R, Lind, Lar, Okazaki, Shuhei, Stehouwer, Coen D A, Willeit, Peter, Polak, Joseph F, Steinmetz, Helmuth, Sander, Dirk, Poppert, Holger, Desvarieux, Moise, Ikram, M Arfan, Johnsen, Stein Harald, Staub, Daniel, Sirtori, Cesare R, Iglseder, Bernhard, Beloqui, Oscar, Engström, Gunnar, Friera, Alfonso, Rozza, Francesco, Xie, Wuxiang, Parraga, Grace, Grigore, Liliana, Plichart, Matthieu, Blankenberg, Stefan, Su, Ta-Chen, Schmidt, Caroline, Tuomainen, Tomi-Pekka, Veglia, Fabrizio, Völzke, Henry, Nijpels, Giel, Willeit, Johann, Sacco, Ralph L, Franco, Oscar H, Uthoff, Heiko, Hedblad, Bo, Suarez, Carmen, Izzo, Raffaele, Zhao, Dong, Wannarong, Thapat, Catapano, Alberico, Ducimetiere, Pierre, Espinola-Klein, Christine, Chien, Kuo-Liong, Price, Jackie F, Bergström, Göran, Kauhanen, Jussi, Tremoli, Elena, Dörr, Marcu, Berenson, Gerald, Kitagawa, Kazuo, Dekker, Jacqueline M, Kiechl, Stefan, Sitzer, Matthia, Bickel, Horst, Rundek, Tatjana, Hofman, Albert, Mathiesen, Ellisiv B, Castelnuovo, Samuela, Landecho, Manuel F, Rosvall, Maria, Gabriel, Rafael, de Luca, Nicola, Liu, Jing, Baldassarre, Damiano, Kavousi, Maryam, de Groot, Eric, Bots, Michiel L, Yanez, David N, Thompson, Simon G, Lorenz, Matthias W [0000-0002-7565-1751], Apollo - University of Cambridge Repository, General practice, APH - Health Behaviors & Chronic Diseases, Epidemiology and Data Science, Interne Geneeskunde, RS: CARIM - R3.01 - Vascular complications of diabetes and the metabolic syndrome, MUMC+: HVC Pieken Maastricht Studie (9), MUMC+: MA Interne Geneeskunde (3), Epidemiology, Neurology, Radiology & Nuclear Medicine, Pirro, Matteo, and PROG-IMT study group
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Male ,Myocardial Infarction ,lcsh:Medicine ,PROGRESSION ,Cardiovascular Medicine ,030204 cardiovascular system & hematology ,Vascular Medicine ,Biochemistry ,Carotid Intima-Media Thickness ,Geographical locations ,DISEASE ,0302 clinical medicine ,Risk Factors ,Germany ,Medicine and Health Sciences ,Medicine ,Cardiac and Cardiovascular Systems ,Myocardial infarction ,skin and connective tissue diseases ,lcsh:Science ,ARTERY INTIMA ,Stroke ,Intersectoral Collaboration ,POPULATION ,Cardiovascular Diseases/diagnosis ,METABOLIC SYNDROME ,education.field_of_study ,Kardiologi ,Multidisciplinary ,Agricultural and Biological Sciences(all) ,VDP::Medical disciplines: 700::Clinical medical disciplines: 750 ,Hazard ratio ,VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750 ,Middle Aged ,Prognosis ,Predictive value ,3. Good health ,Europe ,Neurology ,Italy ,Cardiovascular Diseases ,HYPERTENSIVE MEN ,Cardiology ,cardiovascular system ,Female ,Research Article ,medicine.medical_specialty ,High cardiovascular risk ,Cerebrovascular Diseases ,Science ,Population ,030209 endocrinology & metabolism ,ATHEROSCLEROSIS RISK ,Arbetsmedicin och miljömedicin ,03 medical and health sciences ,Carotid intima media thickness (CIMT) ,Internal medicine ,Humans ,European Union ,ddc:610 ,cardiovascular diseases ,education ,Aged ,Sweden ,Biochemistry, Genetics and Molecular Biology(all) ,Proportional hazards model ,business.industry ,lcsh:R ,Health Risk Analysis ,Correction ,Occupational Health and Environmental Health ,Atherosclerosis ,medicine.disease ,Confidence interval ,Health Care ,Intima-media thickness ,MYOCARDIAL-INFARCTION ,Medical Biophysics ,lcsh:Q ,VASCULAR RISK ,sense organs ,Carotid intima media thickness , Cardiovascular risk ,People and places ,Metabolic syndrome ,business ,FOLLOW-UP ,030217 neurology & neurosurgery ,Genetics and Molecular Biology(all) - Abstract
AIMS: Carotid intima media thickness (CIMT) predicts cardiovascular (CVD) events, but the predictive value of CIMT change is debated. We assessed the relation between CIMT change and events in individuals at high cardiovascular risk. METHODS AND RESULTS: From 31 cohorts with two CIMT scans (total n = 89070) on average 3.6 years apart and clinical follow-up, subcohorts were drawn: (A) individuals with at least 3 cardiovascular risk factors without previous CVD events, (B) individuals with carotid plaques without previous CVD events, and (C) individuals with previous CVD events. Cox regression models were fit to estimate the hazard ratio (HR) of the combined endpoint (myocardial infarction, stroke or vascular death) per standard deviation (SD) of CIMT change, adjusted for CVD risk factors. These HRs were pooled across studies. In groups A, B and C we observed 3483, 2845 and 1165 endpoint events, respectively. Average common CIMT was 0.79mm (SD 0.16mm), and annual common CIMT change was 0.01mm (SD 0.07mm), both in group A. The pooled HR per SD of annual common CIMT change (0.02 to 0.43mm) was 0.99 (95% confidence interval: 0.95-1.02) in group A, 0.98 (0.93-1.04) in group B, and 0.95 (0.89-1.04) in group C. The HR per SD of common CIMT (average of the first and the second CIMT scan, 0.09 to 0.75mm) was 1.15 (1.07-1.23) in group A, 1.13 (1.05-1.22) in group B, and 1.12 (1.05-1.20) in group C. CONCLUSIONS: We confirm that common CIMT is associated with future CVD events in individuals at high risk. CIMT change does not relate to future event risk in high-risk individuals. The PROG-IMT project, which includes this publication, has been funded by the German Research Foundation (Deutsche Forschungsgemeinschaft, www.dfg.de) under the grants DFG Lo 1569/2-1 and DFG Lo 1569/2-3, received by MWL. The DFG had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. Simon Thompson is supported by the British heart Foundation (CH/12/2/29428). Some of the contributing studies were funded by different parties, as listed in the acknowledgement section. Here, too, the funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. Sí
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- 2018
47. Metabolic Profiling of High Egg Consumption and the Associated Lower Risk of Type 2 Diabetes in Middle-Aged Finnish Men
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Jussi Paananen, Kati Hanhineva, Jyrki K. Virtanen, Sari Voutilainen, Stefania Noerman, Tomi-Pekka Tuomainen, Tarja Nurmi, Marko Lehtonen, Olli Kärkkäinen, and Anton Mattsson
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Adult ,Male ,0301 basic medicine ,Population ,Physiology ,Type 2 diabetes ,Lower risk ,03 medical and health sciences ,Risk Factors ,eggs ,Humans ,Medicine ,education ,Finland ,liquid chromatography-mass spectrometry ,education.field_of_study ,ta112 ,business.industry ,Incidence ,Middle Aged ,Serum samples ,medicine.disease ,Egg intake ,metabolomics ,030104 developmental biology ,Diabetes Mellitus, Type 2 ,Case-Control Studies ,Ischaemic heart disease ,type 2 diabetes ,business ,serum ,Biomarkers ,Food Science ,Biotechnology - Abstract
SCOPE: Higher egg intake was previously associated with a lower risk of developing type 2 diabetes (T2D) in the prospective, population‐based Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD) in eastern Finland. Potential compounds that can explain this association are explored using nontargeted LC‐MS‐based metabolic profiling. METHODS AND RESULTS: Two hundred and thirty‐nine baseline serum samples from the KIHD are analyzed in four groups: subjects with higher (mean intake one egg per day) or lower (mean intake two eggs per week) egg intake who developed T2D (cases) or remained heatlhy (controls) during the mean follow‐up of 19.3 years. Different serum profiles of subjects who had either higher or lower egg intakes, and of those who developed type 2 diabetes or remained healthy, are observed. The higher baseline tyrosine level predicts higher odds of T2D (OR 1.94; 95% CI 1.45, 2.60; p < 0.001; FDR 0.023) along with an unknown hexose‐containing compound (OR 2.13; 95% CI 1.57, 2.88; p < 0.001; FDR 0.005). Certain predominant metabolites in T2D cases are correlated positively with ones in the lower‐egg‐intake group and negatively with ones in the higher‐egg‐intake group. CONCLUSION: Our current findings may underline some potential metabolites that can explain how egg intake is associated with a lower risk of T2D.
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- 2018
48. Low serum 25-hydroxyvitamin D is associated with higher risk of frequent headache in middle-aged and older men
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Tomi-Pekka Tuomainen, Rashid Giniatullin, Jyrki K. Virtanen, Jussi Kauhanen, Pekka Mäntyselkä, Jaakko Mursu, Tarja Nurmi, Sari Voutilainen, and School of Medicine / Public Health,School of Medicine / Clinical Nutrition,School of Medicine / Biomedicine
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0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,Cross-sectional study ,Population ,Article ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,medicine ,Vitamin D and neurology ,Humans ,Risk factor ,Vitamin D ,education ,Finland ,education.field_of_study ,Multidisciplinary ,business.industry ,Headache ,Odds ratio ,Middle Aged ,Vitamin D Deficiency ,3. Good health ,030104 developmental biology ,Endocrinology ,Cross-Sectional Studies ,Population study ,Headaches ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Cohort study - Abstract
Article, Vitamin D has been suggested to have a role in various neurovascular diseases, but the data regarding headache is inconclusive. Our aim was to investigate the associations between serum 25-hydroxyvitamin D [25(OH)D], a marker for vitamin D status, and risk of frequent headache. The study population consisted of 2601 men from the population-based Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD) from eastern Finland, aged 42–60 years in 1984–1989. The cross-sectional associations with prevalence of self-reported frequent headache (defined as weekly or daily headaches) were estimated with multivariable-adjusted odds ratios. The average serum 25(OH) concentration was 43.4 nmol/L (SD 18.9, min-max 7.8–136.1 nmol/L). A total of 250 men (9.6%) reported frequent headache. The average serum 25(OH)D concentration among those with frequent headache was 38.3 nmol/L (SD 18.8) and 43.9 nmol/L (SD 18.9) among those without frequent headache, after adjustment for age and year and month of blood draw (P for difference, published version, peerReviewed
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- 2017
- Full Text
- View/download PDF
49. Clustering of cardiovascular risk factors and carotid intima-media thickness: The USE-IMT study
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Jacqueline F. Price, Jacqueline de Graaf, Akihiko Kitamura, Todd J. Anderson, Hester M. den Ruijter, Matthias W. Lorenz, Michiel L. Bots, Annie Britton, Tatjana Rundek, Shuhei Okazaki, Matthias Sitzer, Jacqueline M. Dekker, Eva Lonn, Tomi-Pekka Tuomainen, Gunnar Engström, Ai Ikeda, Geertje W. Dalmeijer, Xin Wang, Jussi Kauhanen, Christopher M. Rembold, Diederick E. Grobbee, Sudhir Kurl, Suzanne Holewijn, Sanne A.E. Peters, Greg Evans, Bo Hedblad, Maria Rosvall, Kazuo Kitagawa, Giel Nijpels, Ellisiv B. Mathiesen, Jukka T. Salonen, Joseph F. Polak, Coen D.A. Stehouwer, School of Medicine / Public Health, Kiechl, S, Department of Public Health, University of Helsinki, Clinicum, APH - Health Behaviors & Chronic Diseases, APH - Aging & Later Life, General practice, Kiechl, Stefan, MUMC+: HVC Pieken Maastricht Studie (9), MUMC+: MA Interne Geneeskunde (3), RS: CARIM - R3.01 - Vascular complications of diabetes and the metabolic syndrome, and Interne Geneeskunde
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Male ,Gerontology ,Cross-sectional study ,PREDICTION ,Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] ,lcsh:Medicine ,Blood Pressure ,Reflection ,PROGRESSION ,Disease ,Cardiovascular Medicine ,030204 cardiovascular system & hematology ,Overweight ,SUBCLINICAL ATHEROSCLEROSIS ,Carotid Intima-Media Thickness ,Vascular Medicine ,Biochemistry ,DISEASE ,Cohort Studies ,Endocrinology ,0302 clinical medicine ,Risk Factors ,Medicine and Health Sciences ,Cluster Analysis ,Coronary Heart Disease ,030212 general & internal medicine ,lcsh:Science ,Medicine(all) ,GENERAL-POPULATION ,Multidisciplinary ,Agricultural and Biological Sciences(all) ,VDP::Medical disciplines: 700::Clinical medical disciplines: 750 ,Physics ,Smoking ,Age Factors ,VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750 ,Classical Mechanics ,Middle Aged ,Lipids ,3142 Public health care science, environmental and occupational health ,3. Good health ,Cholesterol ,Cardiovascular Diseases ,Hypertension ,Physical Sciences ,Female ,medicine.symptom ,Research Article ,Cohort study ,Endocrine Disorders ,Cardiology ,EVENTS ,03 medical and health sciences ,Sex Factors ,Meta-Analysis as Topic ,Linear regression ,Diabetes Mellitus ,medicine ,Journal Article ,Humans ,ddc:610 ,Risk factor ,Aged ,ARTERY ,business.industry ,Biochemistry, Genetics and Molecular Biology(all) ,lcsh:R ,Biology and Life Sciences ,Atherosclerosis ,ROTTERDAM ,Cross-Sectional Studies ,Intima-media thickness ,CLINICAL-PRACTICE ,Metabolic Disorders ,Linear Models ,lcsh:Q ,business ,MALMO DIET ,Demography ,Genetics and Molecular Biology(all) - Abstract
Background The relation of a single risk factor with atherosclerosis is established. Clinically we know of risk factor clustering within individuals. Yet, studies into the magnitude of the relation of risk factor clusters with atherosclerosis are limited. Here, we assessed that relation. Methods Individual participant data from 14 cohorts, involving 59,025 individuals were used in this cross-sectional analysis. We made 15 clusters of four risk factors (current smoking, overweight, elevated blood pressure, elevated total cholesterol). Multilevel age and sex adjusted linear regression models were applied to estimate mean differences in common carotid intima-media thickness (CIMT) between clusters using those without any of the four risk factors as reference group. Results Compared to the reference, those with 1, 2, 3 or 4 risk factors had a significantly higher common CIMT: mean difference of 0.026 mm, 0.052 mm, 0.074 mm and 0.114 mm, respectively. These findings were the same in men and in women, and across ethnic groups. Within each risk factor cluster (1, 2, 3 risk factors), groups with elevated blood pressure had the largest CIMT and those with elevated cholesterol the lowest CIMT, a pattern similar for men and women. Conclusion Clusters of risk factors relate to increased common CIMT in a graded manner, similar in men, women and across race-ethnic groups. Some clusters seemed more atherogenic than others. Our findings support the notion that cardiovascular prevention should focus on sets of risk factors rather than individual levels alone, but may prioritize within clusters., published version, peerReviewed
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- 2017
50. Inflammatory markers and extent and progression of early atherosclerosis: Meta-analysis of individual-participant-data from 20 prospective studies of the PROG-IMT collaboration
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Lars Lind, Liliana Grigore, Jing Liu, Johann Willeit, Matthias W. Lorenz, Aikaterini Papagianni, Ralph L. Sacco, Pierre Ducimetière, Björn Fagerberg, Caroline Schmidt, Kimmo Ronkainen, Stefan Kiechl, Kuo-Liong Chien, Ta-Chen Su, Göran Bergström, Thorleif Etgen, Moise Desvarieux, Jussi Kauhanen, Lena Bokemark, Holger Poppert, Alberico L. Catapano, Stein Harald Johnsen, David Yanez, Giuseppe Danilo Norata, Stefan Agewall, Jackie F. Price, Henry Völzke, Simon G. Thompson, Joseph F. Polak, Matthias Sitzer, Christine Robertson, Tomi-Pekka Tuomainen, Michael H. Olsen, Maryam Kavousi, Tatjana Rundek, M. Arfan Ikram, Jean-Philippe Empana, Peter Willeit, Matthieu Plichart, Marcus Dörr, Hung-Ju Lin, Bernhard Iglseder, Eric de Groot, Ulf Schminke, Dong Zhao, Oscar H. Franco, Albert Hofman, Ellisiv B. Mathiesen, Dirk Sander, Wuxiang Xie, Helmuth Steinmetz, Stela McLachlan, Alpaslan Bülbül, Horst Bickel, Other departments, and Epidemiology
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Oncology ,Carotid ultrasound ,medicine.medical_specialty ,Epidemiology ,Inflammation ,030204 cardiovascular system & hematology ,Fibrinogen ,Carotid Intima-Media Thickness ,Article ,Leukocyte Count ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Humans ,Medicine ,cardiovascular diseases ,Prospective cohort study ,biology ,business.industry ,Individual participant data ,C-reactive protein ,Atherosclerosis ,meta-analysis ,C-Reactive Protein ,Meta-analysis ,Immunology ,Disease Progression ,biology.protein ,cardiovascular system ,atherosclerosis ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers ,030217 neurology & neurosurgery ,medicine.drug - Abstract
BACKGROUND: Large-scale epidemiological evidence on the role of inflammation in early atherosclerosis, assessed by carotid ultrasound, is lacking. We aimed to quantify cross-sectional and longitudinal associations of inflammatory markers with common-carotid-artery intima-media thickness (CCA-IMT) in the general population.METHODS: Information on high-sensitivity C-reactive protein, fibrinogen, leucocyte count and CCA-IMT was available in 20 prospective cohort studies of the PROG-IMT collaboration involving 49,097 participants free of pre-existing cardiovascular disease. Estimates of associations were calculated within each study and then combined using random-effects meta-analyses.RESULTS: Mean baseline CCA-IMT amounted to 0.74 mm (SD = 0.18) and mean CCA-IMT progression over a mean of 3.9 years to 0.011 mm/year (SD = 0.039). Cross-sectional analyses showed positive linear associations between inflammatory markers and baseline CCA-IMT. After adjustment for traditional cardiovascular risk factors, mean differences in baseline CCA-IMT per one-SD higher inflammatory marker were: 0.0082 mm for high-sensitivity C-reactive protein (p CONCLUSION: Inflammation was independently associated with CCA-IMT cross-sectionally. The lack of clear associations with CCA-IMT progression may be explained by imprecision in its assessment within a limited time period. Our findings for 'inflammatory load' suggest important combined effects of the three inflammatory markers on early atherosclerosis.
- Published
- 2016
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