43 results on '"Tomi-Pekka Tuomainen"'
Search Results
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. 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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13. Temporal longitudinal associations of carotid-femoral pulse wave velocity and carotid intima-media thickness with resting heart rate and inflammation in youth
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Andrew O. Agbaje, Samuel Barmi, Kate M. Sansum, Tracy Baynard, Alan R. Barker, and Tomi-Pekka Tuomainen
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Physiology ,Physiology (medical) - Abstract
Higher arterial stiffness but not carotid-intima media thickness in adolescence preceded higher resting heart rate in young adulthood, however, elevated high sensitivity C-reactive protein in adolescence preceded higher arterial stiffness and carotid intima-thickness in young adulthood in the temporal causal path. Low-grade inflammation during adolescence may be causally associated with the development of subclinical arteriosclerosis and atherosclerosis in young adulthood.
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- 2023
14. Cumulative insulin resistance and hyperglycemia with arterial stiffness and carotid IMT progression in 1,779 adolescents: a 9-yr longitudinal cohort study
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Andrew O. Agbaje, Justin P. Zachariah, Olutola Bamsa, Augustine N. Odili, and Tomi-Pekka Tuomainen
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Physiology ,Physiology (medical) ,Endocrinology, Diabetes and Metabolism - Abstract
Fasting plasma glucose, insulin, and insulin resistance had a J- or U-shaped increase from 15 to 24 yr with the base of the curve at age 17 yr. Cumulative high insulin and high insulin resistance from 15 to 24 yr were negatively associated with arterial stiffness progression from ages 17 to 24 yr. Age 17 yr may be an optimal timing for intervention targeted at sustaining the protective effect of the decline of insulin and insulin resistance on arterial stiffness progression.
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- 2023
15. Cumulative muscle mass and blood pressure but not fat mass drives arterial stiffness and carotid intima-media thickness progression in the young population and is unrelated to vascular organ damage
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Andrew O. Agbaje, Alan R. Barker, and Tomi-Pekka Tuomainen
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Physiology ,Internal Medicine ,Cardiology and Cardiovascular Medicine - Abstract
We examined the longitudinal associations of fat mass, lean mass, and blood pressure (BP) from childhood through young adulthood with changes in carotid-femoral pulse wave velocity (cfPWV), a measure of arterial stiffness, and carotid intima-media thickness (cIMT). We included 3863 participants from the Avon Longitudinal Study of Parents and Children birth cohort. Fat mass and lean mass, measured by dual-energy X-ray absorptiometry, and BP were measured at ages 9, 17 and 24 years and classified into low, moderate, and high tertiles. cfPWV and cIMT were measured at 17 and 24 years of age. Associations were examined via linear mixed effect models and adjusted for cardiometabolic and lifestyle factors. Among 1720 [44.5%] male and 2143 [55.5%] female participants, cumulative high exposures to lean mass (effect estimate 0.006 m/s [95% CI 0.001 to 0.010; p = 0.022]), systolic BP (0.013 m/s [0.009 to 0.017; p p p p = 0.001]), and systolic BP (0.010 mm; [0.006 to 0.014; p
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- 2022
16. Associations between total dairy, high-fat dairy and low-fat dairy intake, and depressive symptoms: findings from a population-based cross-sectional study
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Meghan Hockey, Mohammadreza Mohebbi, Tommi Tolmunen, Sari Hantunen, Tomi-Pekka Tuomainen, Helen Macpherson, Felice N. Jacka, Jyrki K. Virtanen, Tetyana Rocks, and Anu Ruusunen
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Nutrition and Dietetics ,Medicine (miscellaneous) - Abstract
Purpose Evidence on the association between dairy intake and depression is conflicting. Given numerous dietary guidelines recommend the consumption of low-fat dairy products, this study examined associations between total dairy, high-fat dairy, and low-fat dairy intake and the prevalence of elevated depressive symptoms. Associations between dairy products, which differed in both fat content and fermentation status, and depressive symptoms were also explored. Methods This cross-sectional study included 1600 Finnish adults (mean age 63 ± 6 years; 51% female) recruited as part of the Kuopio Ischaemic Heart Disease Risk Factor Study. Dairy intake was assessed using 4-day food records. Elevated depressive symptoms were defined as having a score ≥ 5 on the Diagnostic and Statistical Manual of Mental Disorders-III Depression Scale, and/or regularly using one or more prescription drugs for depressive symptoms. Results In total, 166 participants (10.4%) reported having elevated depressive symptoms. Using multivariate logistic regression models, intake in the highest tertile of high-fat dairy products (OR 0.64, 95% CI 0.41–0.998, p trend = 0.04) and high-fat non-fermented dairy products (OR 0.60, 95% CI 0.39–0.92, p trend = 0.02) were associated with reduced odds for having elevated depressive symptoms. Whereas no significant association was observed between intake of total dairy, low-fat dairy, or other dairy products, and depressive symptoms. Conclusion Higher intake of high-fat dairy and high-fat non-fermented dairy products were associated with reduced odds for having elevated depressive symptoms in middle-aged and older Finnish adults. Given the high global consumption of dairy products, and widespread burden of depression, longitudinal studies that seek to corroborate these findings are required.
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- 2022
17. Nonfermented Dairy Intake, but Not Fermented Dairy Intake, Associated with a Higher Risk of Depression in Middle-Age and Older Finnish Men
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Meghan Hockey, Erin Hoare, Mohammadreza Mohebbi, Tommi Tolmunen, Sari Hantunen, Tomi-Pekka Tuomainen, Helen Macpherson, Heidi Staudacher, Felice N Jacka, Jykri K Virtanen, Tetyana Rocks, and Anu Ruusunen
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Male ,Cross-Sectional Studies ,Nutrition and Dietetics ,Cultured Milk Products ,Depression ,Risk Factors ,Humans ,Medicine (miscellaneous) ,Dairy Products ,Prospective Studies ,Middle Aged ,Finland ,Diet - Abstract
Despite the putative health benefits of fermented dairy products, evidence on the association between fermented dairy and nonfermented dairy intake, and depression incidence is limited.This study examined cross-sectional and prospective associations between total dairy, fermented dairy, and nonfermented dairy intake with 1) the presence of elevated depressive symptoms and 2) the risk of a future hospital discharge or outpatient diagnosis of depression.Data from 2603 Finnish men (aged 42-60 y), recruited as part of the Kuopio Ischaemic Heart Disease Risk Factor Study, were included. Multivariable logistic regression models were used to examine ORs and 95% CIs for elevated depressive symptoms (Human Population Laboratory scale ≥5 points) at baseline. Cox proportional hazards regression models were used to estimate HRs and 95% CIs between dairy categories and risk of depression diagnoses.In cross-sectional analyses, fermented dairy intake in the highest (compared with lowest) tertile was associated with lower odds of having elevated depressive symptoms (adjusted OR: 0.70; 95% CI: 0.52, 0.96). Each 100-g increase in nonfermented dairy intake was associated with higher odds of having elevated depressive symptoms (adjusted OR: 1.06; 95% CI: 1.01, 1.10). During a mean follow-up time of 24 y, 113 males received a diagnosis of depression. After excluding cheese intake, higher fermented dairy intake was associated with a lower risk of depression diagnosis (adjusted HR: 0.62; 95% CI: 0.38, 1.03), which was strengthened after excluding those with elevated depressive symptoms at baseline (adjusted HR: 0.55; 95% CI: 0.31, 0.99), whereas nonfermented dairy intake in the highest tertile was associated with a 2-fold higher risk of depression (adjusted HR: 2.02; 95% CI: 1.20, 3.42).Fermented dairy and nonfermented dairy intake were differentially associated with depression outcomes when examined cross-sectionally and over a mean period of 24 y. These findings suggest that dairy fermentation status may influence the association between dairy intake and depression in Finnish men. The KIHD study was registered at clinicaltrials.gov as NCT03221127.
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- 2022
18. What is the most appropriate follow-up time for detecting the epidemiological relationship between coronary artery disease and its main risk factors: novel findings from a 35-year follow-up study
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Ari Voutilainen, Christina Brester, Mikko Kolehmainen, and Tomi-Pekka Tuomainen
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General Medicine ,Cardiology and Cardiovascular Medicine - Published
- 2023
19. Predicting risk of cardiovascular death in the high-dimensional cohort follow-up data in the presence of competing events: a guide for building a modeling pipeline
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Christina Brester, Tomi-Pekka Tuomainen, Ari Voutilainen, Jussi Kauhanen, and Mikko Kolehmainen
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Epidemiology ,Health Informatics - Published
- 2022
20. 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
21. The association between renal hyperfiltration and mortality is not mediated by diabetes mellitus
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Mounir Ould Setti, Ari Voutilainen, Leo Niskanen, and Tomi-Pekka Tuomainen
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Nephrology ,Urology - Abstract
Background Renal hyperfiltration (RHF), recently established as a risk factor for mortality, is linked to current and subsequent diabetes mellitus (DM). DM could be seen as a mediator in the pathway between RHF and mortality. However, the mediating role of DM in the relationship between RHF and mortality is unclear. Methods and results Based on a cohort of 2682 Finnish men from the Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD) followed-up for 35 years, we evaluated the association between RHF and mortality, with DM as a mediator, following two methods: a classic mediation analysis approach, using Cox regression, and a counterfactual framework for mediation analysis, using g-computation, Cox regression, and logistic regression. RHF is associated with an increased risk of mortality. This association was not mediated by DM. Under a counterfactual framework and on a hazard ratio scale, RHF association with mortality had a total effect of 1.54 (95% confidence interval, 1.26–1.98) and a controlled direct effect of 1.66 (1.34–2.16). Conclusion An association between RHF and mortality risk, independent of DM, was established. RHF should be considered, managed, and followed-up as a mortality-associated condition, regardless of the status of DM. We suggest clinicians to consider including RHF screening in routine clinical care, especially diabetic care.
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- 2023
22. Multiplicative, additive, and interactive associations of 25-hydroxyvitamin D with lung and prostate cancer
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Ari Voutilainen, Jyrki K. Virtanen, Sari Hantunen, Tarja Nurmi, Petra Kokko, and Tomi-Pekka Tuomainen
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Nutrition and Dietetics ,Endocrinology, Diabetes and Metabolism ,Medicine (miscellaneous) ,General Medicine - Abstract
Abstract. Results regarding the epidemiological association of vitamin D with lung (LCA) and prostate cancer (PCA) are controversial. This study tested whether serum 25-hydroxyvitamin D [25(OH)D] concentrations have interactive epidemiological associations with smoking, the number-one risk factor for LCA, and age, the number-one risk factor for PCA. Also, this study investigated whether the associations of 25(OH)D, smoking, age, alcohol consumption, body mass index, diet (the healthy Nordic diet score), and physical activity with incident LCA and PCA are multiplicative or additive. The study of association types makes it easier to select appropriate statistical methods. The Kuopio Ischaemic Heart Disease Risk Factor Study provided the data of 2578 men with 112 LCA and 300 PCA cases over 35 years by the end of 2019. Serum 25(OH)D did not associate with LCA and PCA or interact with smoking and age. The association of smoking with LCA was additive; 13 extra cases per 1000 men every 10 years. Age and alcohol consumption multiplicatively increased the hazard of LCA (hazard ratio, 95% confidence interval for age >50: 3.56, 1.82–6.17; drink per week: 1.01, 1.00–1.03), whereas adherence to healthy Nordic diet decreased it (per score point: 0.95, 0.89–1.00). The association of age >50 with PCA was additive; 2.5 extra cases per 1000 men every 10 years. To conclude, there was no epidemiological relationship of pre-diagnostic 25(OH)D concentrations with the incidence of LCA and PCA. The respective associations of smoking and age >50 with LCA and PCA were additive rather than multiplicative.
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- 2023
23. Associations of fermented and non-fermented dairy consumption with serum C-reactive protein concentrations – A cross-sectional analysis
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Elisa K. Voutilainen, Sari Hantunen, Anu Ruusunen, Tomi-Pekka Tuomainen, and Jyrki K. Virtanen
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Adult ,Male ,C-Reactive Protein ,Cross-Sectional Studies ,Milk ,Nutrition and Dietetics ,Risk Factors ,Endocrinology, Diabetes and Metabolism ,Animals ,Humans ,Middle Aged ,Diet - Abstract
The results of epidemiological studies on dairy products and low-grade inflammation are scarce and inconsistent. Some studies have suggested that the associations may vary depending on the type of dairy product consumed. The aim of this cross-sectional study was to investigate the associations between intake of fermented and non-fermented dairy products and separately butter and serum high-sensitivity C-reactive protein (hs-CRP), a common inflammation marker, among a population with high dairy intake.The study included 1338 generally healthy men aged 42-60 years and serum hs-CRP ≤10 mg/L from the Kuopio Ischaemic Heart Disease Risk Factory Study, examined in 1984-1989. Dietary intakes were assessed using 4-day food records. ANCOVA and linear and logistic regression were used for analyses.The reported mean intakes of fermented and non-fermented dairy products and butter were 189 (SD 217), 522 (SD 330) and 33 (SD 27) g/d, respectively. In the model adjusted for age, year of examination and energy intake (Model 1), higher intake of total dairy, total non-fermented dairy, total milk and butter were associated with higher concentration of serum hs-CRP, whereas fermented dairy intake was not associated with serum hs-CRP. After further adjustment for potential confounders, only higher butter intake remained statistically significantly associated with increased serum hs-CRP (P-trend = 0.049). The odds ratio for elevated hs-CRP (3 mg/L) in the highest vs. the lowest quartile was 2.50 (95% confidence interval 1.19-5.26, P-trend = 0.02).These results suggest that high intake of butter, but not other dairy products may be associated with increased low-grade inflammation.
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- 2022
24. Effect of Arterial Stiffness and Carotid Intima-Media Thickness Progression on the Risk of Dysglycemia, Insulin Resistance, and Dyslipidemia: a Temporal Causal Longitudinal Study
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Andrew O. Agbaje, Alan R. Barker, Gary F. Mitchell, and Tomi-Pekka Tuomainen
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Male ,Adolescent ,Blood Pressure ,Pulse Wave Analysis ,Carotid Intima-Media Thickness ,Young Adult ,Cross-Sectional Studies ,Vascular Stiffness ,Risk Factors ,Glucose Intolerance ,Internal Medicine ,Humans ,Female ,Longitudinal Studies ,Insulin Resistance ,Dyslipidemias - Abstract
Background: We investigated the temporal causal longitudinal associations of carotid-femoral pulse wave velocity (cfPWV), a measure of arterial stiffness, and carotid intima-media thickness (cIMT) progression with the risk of dysglycemia, insulin resistance, and dyslipidemia. Methods: We included 3862, 17.7-year-old, participants from the Avon Longitudinal Study of Parents and Children, followed up for 7 years. cfPWV, cIMT, and fasting plasma samples were repeatedly measured. We computed homeostatic model assessment (HOMA) of insulin resistance and percent pancreatic beta-cell function. Data were analyzed using logistic regression, linear mixed-effect, and cross-lagged structural equation models. Results: A higher cfPWV at 17.7 years was associated with higher insulin at age 24.5 years (odds ratio, 1.25 [CI, 1.08–1.44]; P =0.003), which slightly attenuated after covariates adjustment. Higher cIMT at 17.7 years was associated with lower insulin (odds ratio, 0.06 [0.01–0.95]; P =0.046) at 24.5 years, after covariate adjustments. In mixed-effect models, the 7-year progression in cfPWV (predictor) was directly associated with the increase in triglyceride (outcome). cIMT progression was associated with the 7-year increase in LDL (low-density lipoprotein), triglyceride, and glucose. In cross-lagged models, higher cfPWV at 17.7 years was associated with higher insulin ( β =0.06, SE, 0.12, P =0.014), HOMA of insulin resistance, and HOMA-percent pancreatic beta-cell function at 24.5 years. However, insulin, HOMA of insulin resistance, and HOMA-percent pancreatic beta-cell function at 17.7 years were not associated with cfPWV at 24.5 years. Higher cIMT at 17.7 years was associated with reduced insulin, HOMA of insulin resistance, and HOMA-percent pancreatic beta-cell function at 24.5 years, but not vice versa. Higher glucose at 17.7 years was associated with higher cfPWV and cIMT at 24.5 years only. Conclusions: Arterial stiffness in adolescence may be a causal risk factor for hyperinsulinemia and insulin resistance in young adulthood.
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- 2022
25. Lipid profile, lipid ratios, apolipoproteins, and risk of cardiometabolic multimorbidity in men: The Kuopio Ischaemic Heart Disease Risk Factor Study
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Behnam Tajik, Ari Voutilainen, Jussi Kauhanen, Moshen Mazidi, Gregory Y. H. Lip, Tomi‐Pekka Tuomainen, and Masoud Isanejad
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Male ,Cholesterol, HDL ,Organic Chemistry ,Multimorbidity ,Coronary Disease ,Cholesterol, LDL ,Cell Biology ,Biochemistry ,Apolipoproteins ,Diabetes Mellitus, Type 2 ,Heart Disease Risk Factors ,Risk Factors ,Humans ,Female ,Triglycerides ,Apolipoproteins B - Abstract
The blood level of lipids, apolipoproteins, and lipid ratios are important predictors of some chronic diseases. However, their association with cardiometabolic multimorbidity (CMM) is less known. We evaluated a wide range of lipid profiles and lipid ratios, including low-density lipoprotein-cholesterol (LDL-C), very-low-density lipoprotein-cholesterol (VLDL-C), high-density lipoprotein-cholesterol (HDL-C), and apoA1 and B, as well triglyceride and total cholesterol with risk of incident CMM. In 1728 men aged 52.5 ± 5.2 years from the Kuopio Ischaemic Heart Disease were included in this study. We defined CMM as coexisting of two or more of stroke, type 2 diabetes mellitus (T2D), coronary heart disease (CHD). A Cox proportional hazard regression method was applied to evaluate the risk of CMM against the exposures. During the mean follow-up of 22.4 years, 335 men suffered from CMM conditions. Higher serum triglyceride and VLDL concentrations were associated with a higher risk of coexisting T2D-CHD (HRs 1.99 (95% CI, 1.12-3.53) and HRs 1.79 (95% CI, 1.04-3.11), respectively. Whereas higher HDL was associated with lower incident [HRs 0.49 (95% CI, 0.40-1.00)]. The HRs for coexisting T2D-CHD was 2.02 (95% CI, 1.01-3.07) for total cholesterol/HDL-C, 1.85 (95% CI, 1.04-3.29) for triglyceride/HDL-C, 1.69 (95% CI, 1.01-2.31) for Non-HDL-C/HDL-C, and 1.89 (95% CI, 1.03-2.46) for apoB/apoA1. In contrast, serum LDL-C/apoB ratios were inversely associated with the risk of coexisting T2D-CHD [HRs 0.50 (95% CI, 0.28-0.90)]. No associations were observed between our exposures and other CMM conditions. In conclusion, elevated triglyceride, VLDL-C, total cholesterol/HDL-C, TG/HDL-C, apoB/apoA1 as well as lower LDL-C/apoB were independently associated with the higher risk of T2D-CHD coexistence.
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- 2022
26. Mild-to-Moderate Kidney Dysfunction and Cardiovascular Disease: Observational and Mendelian Randomization Analyses
- Author
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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
27. Cumulative dyslipidemia with arterial stiffness and carotid IMT progression in asymptomatic adolescents: A simulated intervention longitudinal study using temporal inverse allocation model
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Andrew O. Agbaje, Donald M. Lloyd-Jones, Costan G. Magnussen, and Tomi-Pekka Tuomainen
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Cardiology and Cardiovascular Medicine - Abstract
We aimed to examine the longitudinal associations of total cholesterol (TC), non-high-density lipoprotein cholesterol (non-HDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride, and low-density lipoprotein cholesterol (LDL-C) with carotid-femoral pulse wave velocity (cfPWV) and carotid intima-media thickness (cIMT) progression.We studied 1779, 15-year-old participants from the Avon Longitudinal Study of Parents and Children, UK birth cohort, followed up for 9 years. Fasting TC, non-HDL-C, HDL-C, triglyceride, and LDL-C were measured at 15, 17, and 24 years and age-categorized as normal, elevated, and dyslipidemia based on National Heart, Lung, and Blood Institute lipid guidelines. cfPWV and cIMT were measured at 17 and 24 years. Associations were examined using linear mixed-effect models. To simulate the treatment of dyslipidemia we conducted temporal inverse allocation model analyses.Among 1779 [49.9% female] participants, mean lipid levels and proportions at elevated or dyslipidemia categories increased from ages 15 through 24 years. Persistently elevated TC: effect estimate 0.026 mm; [95% CI 0.004 to 0.049; p = 0.024], elevated non-HDL-C, and elevated LDL-C were cumulatively associated with cIMT progression. Persistent borderline-low HDL-C: -0.027 mm; [-0.050 to -0.005; p = 0.019] and very-low HDL-C -0.035 mm; [-0.057 to -0.013; p = 0.002] levels were associated with cIMT progression. A temporal inverse allocation of elevated and dyslipidemic levels with normal lipid levels at age 17 years attenuated the associations of cumulative elevated TC, non-HDL-C, LDL-C, and low HDL-C with cIMT progression. Cumulative elevated lipids or dyslipidemia were not associated with cfPWV progression.Late adolescence is key to preventing, halting, and reversing dyslipidemic-related preclinical atherosclerosis progression, warranting universal lipid screening in the general pediatric population.
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- 2022
28. Associations of the serum
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Haleh, Esmaili, Behnam, Tajik, Tomi-Pekka, Tuomainen, Sudhir, Kurl, Jukka T, Salonen, and Jyrki K, Virtanen
- Abstract
Low intake or tissue concentrations of the
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- 2022
29. 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
- Subjects
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
30. Abstract EP70: Adolescent Arterial Stiffness Precedes Elevated Resting Heart Rate In Young Adulthood: A 7-year Temporal Longitudinal Analysis Using Cross-lagged Structural Equation Model
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Andrew O Agbaje, Alan R Barker, and Tomi-Pekka Tuomainen
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Abstract
Introduction: Elevated resting heart rate in adults is an established risk factor in the lifelong process of atherogenesis and its intermediate process such as arterial stiffness. Arterial stiffness is an independent predictor of cardiovascular events. However, it is unclear whether resting heart rate temporally and bi-directionally associates with arterial stiffness especially among healthy adolescents and young adults. Hence, plausible biologic pathways through which elevated resting heart rate associate with arterial stiffness in the young population remains unknown. Hypothesis: To examine the temporal longitudinal associations of carotid-femoral pulse wave velocity (cfPWV), a measure of arterial stiffness, with resting heart rate among adolescents aged 17.7 years. Methods: We studied 3862 (55.5% female) British adolescents followed up for 7 years until 24.5 years of age, using data from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort, England, UK. At baseline and follow-up, fat mass and lean mass were measured by dual-energy Xray absorptiometry, systolic blood pressure and heart rate by Omron BP/pulse monitor, and cfPWV by Vicorder ultrasound scan. We conducted logistic regression and cross-lagged autoregressive structural equation model analyses and adjusted for age at baseline, sex, moderate to vigorous physical activity, smoking status, family history of cardiometabolic diseases, time in years between measurement at 17.7 and 24.5 years, systolic blood pressure, fat mass, lean mass, and fasting plasma samples viz. low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglyceride, high-sensitivity C-reactive protein, glucose, and insulin. Results: Participants' mean (SD) age in years was 17.72 (0.33) and 24.54 (0.73) at baseline and follow-up, respectively. Among 3862 adolescents, 10% were at moderate to high risk of elevated resting heart rate at 24.5 years. Higher cfPWV at 17.7 years was associated with the risk of elevated resting heart rate at follow-up [ Odds ratio = 1.32 (95% confidence interval 1.06 - 1.65); p=0.014]. In the cross-lagged temporal analysis, higher cfPWV at 17.7 years was associated with higher resting heart rate [ Standardized regression coefficient (β) = 0.06 standard error (SE) = 3.85, p Conclusion: We observed, for the first time, in a large healthy cohort of adolescents that arterial stiffness temporally preceded elevated resting heart rate in young adulthood, after controlling for cardiometabolic and lifestyle factors. This evidence informs that public health and clinical effort may be targeted at early detection and prevention of arterial stiffness from adolescence.
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- 2022
31. Abstract 045: Adolescent Arterial Stiffness Precedes Elevated Resting Heart Rate In Young Adulthood: A 7-year Temporal Longitudinal Analysis Using Cross-lagged Structural Equation Model
- Author
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Andrew O Agbaje, Alan R Barker, and Tomi-Pekka Tuomainen
- Subjects
Physiology (medical) ,Cardiology and Cardiovascular Medicine - Abstract
Introduction: Elevated resting heart rate in adults is an established risk factor in the lifelong process of atherogenesis and its intermediate process such as arterial stiffness. Arterial stiffness is an independent predictor of cardiovascular events. However, it is unclear whether resting heart rate temporally and bi-directionally associates with arterial stiffness especially among healthy adolescents and young adults. Hence, plausible biologic pathways through which elevated resting heart rate associate with arterial stiffness in the young population remains unknown. Hypothesis: To examine the temporal longitudinal associations of carotid-femoral pulse wave velocity (cfPWV), a measure of arterial stiffness, with resting heart rate among adolescents aged 17.7 years. Methods: We studied 3862 (55.5% female) British adolescents followed up for 7 years until 24.5 years of age, using data from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort, England, UK. At baseline and follow-up, fat mass and lean mass were measured by dual-energy Xray absorptiometry, systolic blood pressure and heart rate by Omron BP/pulse monitor, and cfPWV by Vicorder ultrasound scan. We conducted logistic regression and cross-lagged autoregressive structural equation model analyses and adjusted for age at baseline, sex, moderate to vigorous physical activity, smoking status, family history of cardiometabolic diseases, time in years between measurement at 17.7 and 24.5 years, systolic blood pressure, fat mass, lean mass, and fasting plasma samples viz. low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglyceride, high-sensitivity C-reactive protein, glucose, and insulin. Results: Participants' mean (SD) age in years was 17.72 (0.33) and 24.54 (0.73) at baseline and follow-up, respectively. Among 3862 adolescents, 10% were at moderate to high risk of elevated resting heart rate at 24.5 years. Higher cfPWV at 17.7 years was associated with the risk of elevated resting heart rate at follow-up [ Odds ratio = 1.32 (95% confidence interval 1.06 - 1.65); p=0.014]. In the cross-lagged temporal analysis, higher cfPWV at 17.7 years was associated with higher resting heart rate [ Standardized regression coefficient (β) = 0.06 standard error (SE) = 3.85, p Conclusion: We observed, for the first time, in a large healthy cohort of adolescents that arterial stiffness temporally preceded elevated resting heart rate in young adulthood, after controlling for cardiometabolic and lifestyle factors. This evidence informs that public health and clinical effort may be targeted at early detection and prevention of arterial stiffness from adolescence.
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- 2022
32. How competing risks affect the epidemiological relationship between vitamin D and prostate cancer incidence? A population-based study
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Ari Voutilainen, Jyrki K. Virtanen, Sari Hantunen, Tarja Nurmi, Petra Kokko, and Tomi‐Pekka Tuomainen
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Male ,Endocrinology ,Risk Factors ,Urology ,Incidence ,Humans ,Prostatic Neoplasms ,General Medicine ,Prospective Studies ,Vitamins ,Middle Aged ,Vitamin D - Abstract
We hypothesized that controversial results regarding the epidemiological relationship between circulating 25-hydroxyvitamin D, 25(OH)D, and risk of prostate cancer (PCA) incidence are partly due to competing risks. To test the hypothesis, we studied associations across 25(OH)D, PCA and death in 2578 middle-aged men belonging to the Kuopio Ischaemic Heart Disease Risk Factor Study. The men were free of cancer at baseline, and the mean (SD) follow-up time was 23.3 (9.1) years. During this period, 296 men had a PCA diagnosis, and 1448 men died without the PCA diagnosis. The absolute risk of developing PCA was highest in the highest 25(OH)D tertile (15%), whereas that of death was highest in the lowest 25(OH)D tertile (67%). A competing risk analysis showed that belonging to the highest 25(OH)D tertile increased the risk of PCA incidence and improved survival with the respective hazard ratios (HR) of 1.35 (95% CI = 1.07-1.70) and 0.79 (95% CI = 0.71-0.89). Adjusting for 10 covariates together with 25(OH)D did not significantly change the results, but the respective adjusted HRs for PCA and death were 1.20 and 0.87. To conclude, the competing risk analysis did not eliminate the direct relationship between 25(OH)D and PCA but rather strengthened it.
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- 2022
33. 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
- Subjects
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
34. 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
- Subjects
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
35. 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
36. Associations of serum n-3 and n-6 polyunsaturated fatty acids with prevalence and incidence of nonalcoholic fatty liver disease
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Tiia NK Mäkelä, Tomi-Pekka Tuomainen, Sari Hantunen, and Jyrki K Virtanen
- Subjects
Adult ,Fatty Acid Desaturases ,Male ,Nutrition and Dietetics ,Incidence ,Fatty Acids ,Medicine (miscellaneous) ,Middle Aged ,Linoleic Acid ,Cross-Sectional Studies ,Non-alcoholic Fatty Liver Disease ,Fatty Acids, Omega-6 ,Fatty Acids, Omega-3 ,Fatty Acids, Unsaturated ,Prevalence ,Humans ,Female ,Prospective Studies ,Aged - Abstract
Nonalcoholic fatty liver disease (NAFLD) is a major cause of liver diseases worldwide, and lifestyle and diet are significant factors in its development. Recent studies have suggested that dietary fat quality is associated with the development of NAFLD.Our purpose was to investigate the cross-sectional and longitudinal associations of serum n-3 (ω-3) and n-6 (ω-6) PUFAs with NAFLD among middle-aged and older men and women from eastern Finland. We also investigated the associations of estimated Δ5-desaturase and Δ6-desaturase activities, enzymes involved in PUFA metabolism, with NAFLD.After exclusions, the cross-sectional analyses included 1533 men examined in 1984-1989 and 674 men and 870 women examined in 1998-2001 in the Kuopio Ischaemic Heart Disease Risk Factor Study. The longitudinal analyses included 520 men examined in 1991-1993 and 301 men and 466 women examined in 2005-2008. Fatty liver index (FLI) was used as a surrogate for NAFLD. Hepatic steatosis was defined as FLI 60. ANCOVA and logistic regression were used for analyses.In the longitudinal analyses, participants with higher serum concentrations of total n-6 PUFA and linoleic acid, the major n-6 PUFA, had markedly lower FLI and lower odds for hepatic steatosis (e.g., odds ratios for incident hepatic steatosis in the highest compared with lowest quartiles were ≤0.41), whereas serum γ-linolenic acid concentration was associated with a higher FLI and higher odds for hepatic steatosis. The associations with the other PUFAs were generally weaker and nonsignificant. In the cross-sectional analyses, also the long-chain n-3 PUFAs had inverse associations. In most analyses, high estimated Δ5-desaturase activity was associated with lower risk and high estimated Δ6-desaturase activity with higher risk for NAFLD.In middle-aged and older Finnish adults, higher serum concentrations of total n-6 PUFAs and linoleic acid were associated with lower odds for future NAFLD.
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- 2021
37. Effects of Arterial Stiffness and Carotid Intima-Media Thickness Progression on the Risk of Overweight/Obesity and Elevated Blood Pressure/Hypertension: a Cross-Lagged Cohort Study
- Author
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Tomi-Pekka Tuomainen, Andrew O. Agbaje, and Alan R. Barker
- Subjects
Male ,medicine.medical_specialty ,obesity ,Adolescent ,Diastole ,Blood Pressure ,body mass index ,Overweight ,Carotid Intima-Media Thickness ,Young Adult ,Vascular Stiffness ,Risk Factors ,Internal medicine ,Surveys and Questionnaires ,Internal Medicine ,medicine ,Humans ,carotid-femoral pulse wave velocity ,Child ,Pulse wave velocity ,Adiposity ,Ultrasonography ,business.industry ,Original Articles ,medicine.disease ,Blood pressure ,Intima-media thickness ,Hypertension ,Arterial stiffness ,Cardiology ,Lean body mass ,ComputingMethodologies_DOCUMENTANDTEXTPROCESSING ,Disease Progression ,Female ,medicine.symptom ,atherosclerosis ,business ,Body mass index - Abstract
Supplemental Digital Content is available in the text., We examined the temporal longitudinal associations of carotid-femoral pulse wave velocity (cfPWV), a measure of arterial stiffness, and carotid intima-media thickness (cIMT) with the risk of overweight/obesity and elevated blood pressure (BP)/hypertension. We studied 3862 adolescents aged 17.7 years from the Avon Longitudinal Study of Parents and Children, followed-up for 7 years. cfPWV and cIMT were measured by ultrasound. Total and trunk fat mass and lean mass were assessed by dual-energy X-ray absorptiometry. Body mass index and BP were measured. Data were analyzed using logistic regression, linear mixed-effect, and cross-lagged structural equation models, with covariate adjustments. Among 1719 male and 2143 female participants, higher cfPWV at 17.7 years was associated with the risk of elevated systolic BP/hypertension (odds ratio, 1.20 [1.02–1.41]; P=0.026), elevated diastolic BP/hypertension (1.77 [1.32–2.38]; P
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- 2021
38. Abstract 11483: A 7-Year Arterial Stiffness and Carotid Intima-Media Thickness Progression Predict Obesity, High Lean Mass, and Incident Hypertension from Age 17.7 to 24.5 Years: the ALSPAC Study
- Author
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Andrew O Agbaje, Alan R Barker, and Tomi-Pekka Tuomainen
- Subjects
Physiology (medical) ,Cardiology and Cardiovascular Medicine - Abstract
Introduction: An American Heart Association’s statement recommended investigating the natural history of arterial stiffness and blood pressure (BP) vis-à-vis the rate at which arterial stiffness and BP increase with age. Hypothesis: To test whether carotid-femoral pulse wave velocity (cfPWV), a measure of arterial stiffness, and carotid intima-media thickness (cIMT) progression independently predict increased fat mass and BP. Methods: We studied 3862 participants from the Avon Longitudinal Study of Parents and Children birth cohort. cfPWV and cIMT were measured by ultrasound scan, total and trunk fat mass, and lean mass by dual-energy Xray absorptiometry scan, body mass index (BMI), BP, heart rate, fasting insulin, glucose, high sensitivity C-reactive protein, and lipid profile were measured at ages 17.7 and 24.5 years. Participants at >75th percentile of total and trunk fat mass or having >24.9 kg/m 2 BMI were classified as overweight and obese, >75th percentile as high lean mass, and >120/80 mm Hg as elevated BP and hypertension. Data were analysed with logistic regression and linear mixed models, adjusting for cardiometabolic and lifestyle factors. Results: Among 1719 [44.5%] male and 2143 [55.5%] female participants, cfPWV at 17.7 years independently predicted systolic hypertension [Odds ratio (OR) 1.19 (1.01 - 1.40); p=0.043], diastolic hypertension [OR 1.77 (1.32 - 2.38); p2 (-0.06 - -0.01); p=0.039]. cIMT progression from age 17.7 - 24.5 years was directly associated with the 7-year increase in total fat mass, trunk fat mass, lean mass, BMI, and diastolic BP. Conclusions: Arterial stiffness and cIMT progression independently predicted obesity, high lean mass, and incident hypertension among young adults.
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- 2021
39. Abstract 13236: Differing Relations Of Arterial Stiffness And Carotid Intima-Media Thickness In Adolescence With Metabolic Risks In Young Adulthood: The ALSPAC Study
- Author
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Andrew O Agbaje, Alan R Barker, and Tomi-Pekka Tuomainen
- Subjects
Physiology (medical) ,Cardiology and Cardiovascular Medicine - Abstract
Introduction: Carotid-femoral pulse wave velocity (cfPWV), a measure of arterial stiffness, and carotid intima-media thickness (cIMT) are strong predictors of cardiovascular and all-cause mortality in adults. However, due to the unavailability of hard outcomes among adolescents and young adults, it remains unclear how cfPWV and cIMT predict metabolic outcomes in these age groups. Hypothesis: We tested whether cfPWV and cIMT during adolescence similarly or differently predict higher insulin, glucose, plasma lipid, and increased inflammation in young adulthood. Methods: Altogether 3862 British (56% females) participants from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort, England, UK were studied. cfPWV was measured by Vicorder device, cIMT by CardioHealth ultrasound scan, systolic blood pressure (BP) and heart rate by Omron BP/pulse monitor, total fat mass and lean mass by dual-energy Xray absorptiometry, moderate to vigorous physical activity by accelerometer, and smoking status by questionnaire. Insulin, plasma glucose, lipid profiles, and high sensitivity C-reactive protein were measured during a fasting state. Insulin resistance (HOMA-IR) was estimated from (insulin x glucose)/22.5. We conducted linear regression analyses and adjusted for cardiometabolic and lifestyle factors at 17.7 years. Results: Participants' mean (SD) age in years at different time points were [17.72 (0.33) and 24.54 (0.73)]. cfPWV at age 17.7 years was inversely associated with high-density lipoprotein cholesterol [β = -0.32 (CI: -0.60 to -0.04); p=0.028] and directly associated with insulin [0.28 (0.05 to 0.50); p=0.019] and HOMA-IR [0.28 (0.04 to 0.53); p=0.026] at 24.5 years. cIMT at age 17.7 years was inversely associated with insulin [-0.33 (-0.59 to -0.07); p=0.024] and HOMA-IR [-0.32 (-0.59 to -0.04); p=0.026] at 24.5 years. cfPWV and cIMT at 17.7 years were unrelated to other metabolic and inflammatory markers at 24.5 years. Conclusions: Arterial stiffness during adolescence may be a novel risk factor for predicting reduced high-density lipoprotein cholesterol and increased insulin resistance in young adults. However, carotid wall thickening in adolescence predicted higher insulin sensitivity 7 years later.
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- 2021
40. Arterial stiffness in adolescence predicts elevated blood pressure in young adulthood: the ALSPAC study
- Author
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Alan R. Barker, Tomi-Pekka Tuomainen, and Andrew O. Agbaje
- Subjects
medicine.medical_specialty ,business.industry ,Internal medicine ,Arterial stiffness ,medicine ,Cardiology ,Young adult ,Cardiology and Cardiovascular Medicine ,medicine.disease ,business ,Elevated blood - Abstract
Background The American Heart Association's scientific statement on the importance of arterial stiffness recommended that future studies investigate whether increasing arterial stiffness with advancing age results from the age-associated increase in systolic blood pressure (BP). The statement also recommended investigating the natural history of arterial stiffness and BP vis-à-vis the rate at which arterial stiffness and BP increase with age. These questions remain largely unanswered in a population sample of apparently healthy adolescence and young adults. Purpose To investigate whether carotid-femoral pulse wave velocity (cfPWV), a measure of arterial stiffness, during adolescence predicts increased systolic and diastolic blood pressure in young adulthood. Methods We studied 3862 British (56% females) participants from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort, Bristol, UK. cfPWV was measured by Vicorder device ultrasound scan, total fat mass and lean mass were measured by dual-energy Xray absorptiometry, and systolic and diastolic BP by Omron BP/pulse monitor. We conducted multivariable linear regression analyses and adjusted for baseline covariates such as age, sex, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglyceride, high sensitivity C-reactive protein, fasting blood glucose, fasting insulin concentration, heart rate, moderate to vigorous physical activity, smoking status, family history of cardiometabolic diseases, total fat mass, lean mass and systolic or diastolic BP depending on the outcome. All variables were measured both at age 17.7 and 24.5 years. Results Participants mean (SD) age in years at different time points were [17.72 (0.33) and 24.54 (0.73)]. Over a 7-year follow-up period, cfPWV was directly and independently associated with systolic BP [β = 10.762 (CI: 3.107 to 18.417); p=0.006] and diastolic BP [19.535 (12.879 to 26.191); p Conclusion Our findings showed that increasing arterial stiffness independently predicts higher systolic and diastolic BP with advancing age. Besides, a 0.1 m/s increase in arterial stiffness at age 17.7 years may result in a 1 mmHg increase in systolic BP and a 2 mmHg increase in diastolic BP seven years later. Therefore, public health effort should be targeted at preventing or reducing arterial stiffness during adolescence in order to decrease the risk of elevated BP in later life. Funding Acknowledgement Type of funding sources: Foundation. Main funding source(s): Jenny and Antti Wihuri Foundation and the Finnish Cultural Foundation
- Published
- 2021
41. Fat mass paradox and carotid intima-media thickness progression: A longitudinal study from childhood through young adulthood
- Author
-
Andrew O. Agbaje, Alan R. Barker, and Tomi-Pekka Tuomainen
- Subjects
Endocrinology ,Endocrinology, Diabetes and Metabolism - Published
- 2022
42. Adolescence arterial stiffness precedes insulin resistance in young adulthood: A 7-year temporal longitudinal findings using cross-lagged structural equation model
- Author
-
Andrew O. Agbaje, Alan R. Barker, and Tomi-Pekka Tuomainen
- Subjects
Endocrinology ,Endocrinology, Diabetes and Metabolism - Published
- 2022
43. Longitudinal and bi-directional associations of arterial stiffness with general and central fat mass from adolescence through young adulthood: The ALSPAC Study
- Author
-
Andrew O. Agbaje, Alan R. Barker, and Tomi-Pekka Tuomainen
- Subjects
Endocrinology ,Endocrinology, Diabetes and Metabolism - Published
- 2022
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