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61.
  • Fava, Cristiano, et al. (författare)
  • The functional variant of the CLC-Kb channel T481S is not associated with blood pressure or hypertension in Swedes.
  • 2007
  • Ingår i: Journal of Hypertension. - 1473-5598. ; 25:1, s. 111-116
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective A common threonine481serine polymorphism (T481S) has been shown in vitro to strongly activate the chloride channel Kb (CLC-Kb) expressed in the kidney, and the 481S allele has been associated with human hypertension. The study aim was to evaluate the association of the T481 S polymorphism with blood pressure (BP) levels and the BP progression rate in Swedes. Design and methods The cardiovascular cohort of the Malmo Diet and Cancer (MDC) study is a population surveyed in 1991-1996 (n = 6103, DNA available on n = 6055), 53% of whom had also been examined 11 +/- 4.4 years earlier in the Malmo preventive Project (MPP) Hypertension was defined as having BP above 140/90 mmHg or being on antihypertensive therapy (AHT). Carriers of one or two copies of the 481S allele were compared with T481T homozygotes (noncarriers). Results Among individuals without AHT in the MIX study (n = 4988) there was no difference between carriers (n = 1164, 23%) and noricarriers (n = 3824, 77%) in systolic BP (139.3 +/- 8.3 vs 139.2 +/- 8.3 mmHg, P=0.82) or diastolic BP (86.0 +/- 9.1 vs 86.0 +/- 9.2 mmHg, P = 0.95). In subjects free from AHT at the Ill and Ill studies (n = 2627) there was no difference between carriers (n = 607, 23%) and noricarriers (n = 2020, 77%) in progression of systolic BP (2.1 +/- 2.6 vs 2.0 +/- 2.8 mmHg/year, P = 0.72) or diastolic BP (0.57 +/- 1.4 vs 0.58 +/- 1.6 mmHg/year, P = 0.85) from Ill to Ill Multivariate analysis gave no support of interaction between the CLC-Kb 481S polymorphism, gender, age or body mass index regarding their effect on BP. Conclusion Our data do not support a role of the CLC-Kb T481S polymorphism in BP regulation in Swedes.
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62.
  • Fava, Cristiano, et al. (författare)
  • The V433M Variant of the CYP4F2 Is Associated With Ischemic Stroke in Male Swedes Beyond Its Effect on Blood Pressure.
  • 2008
  • Ingår i: Hypertension. - 1524-4563. ; 52, s. 373-380
  • Tidskriftsartikel (refereegranskat)abstract
    • Cytochrome (CYP) 4A11 and CYP4F2 are responsible for renal production of 20-hydroxyeicosatetraenoic acid, a vasoconstrictor and natriuretic substance. The CYP4A11 F434S and CYP4F2 V433M polymorphisms reduce 20-hydroxyeicosatetraenoic acid production in vitro. The aim of the present study was to evaluate the effect of these polymorphisms on blood pressure (BP) levels, hypertension prevalence, and risk of incident cardiovascular events in middle-aged Swedes. The polymorphisms were genotyped in the cardiovascular cohort of the Malmö Diet and Cancer Study. The incidence of cardiovascular events (coronary events, n=276; ischemic stroke, n=199) was monitored over 10 years of follow-up. The analysis of BP levels was performed twice: either excluding or including subjects under antihypertensive treatment. In the whole population, CYP4A11 S434S homozygotes had higher systolic BP, both crude and adjusted for the number of antihypertensive drugs, and higher prevalence of hypertension with respect to F434 carriers. Male, but not female, CYP4F2 M433 carriers had significantly higher crude and adjusted systolic and diastolic BPs and a trend toward higher hypertension prevalence (P=0.06) with respect to V433V homozygotes. After adjustment for major cardiovascular risk factors, the hazard ratio for incident ischemic stroke in male CYP4F2 M433 carriers was significantly higher with respect to V433V homozygotes (hazard ratio: 1.69; 95% CI: 1.10 to 2.60) even when baseline BP levels and hypertension prevalence were included in the Cox proportional hazard model. A common CYP4F2 V433M polymorphism might increase the risk of incident ischemic stroke in male subjects only partially through its elevating effect on BP. Additional studies are needed to confirm these data.
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63.
  • Fedorowski, Artur, et al. (författare)
  • Consequences of orthostatic blood pressure variability in middle-aged men (The Malmö Preventive Project).
  • 2010
  • Ingår i: Journal of Hypertension. - 1473-5598. ; 28:3, s. 551-559
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To investigate the determinants and consequences of orthostatic hypotension in the middle-aged segment of the general population. METHODS: A population of 5722 men aged 52.6 +/- 3.6 years, previously included in the Malmö Preventive Project (n = 22 444 men), was re-screened after 5.6 +/- 1.0 years and thereafter followed up over a period of 19.6 +/- 5.3 years. RESULTS: At re-screening, 566 (9.9%) participants were found to have orthostatic hypotension according to international consensus criteria, of these 365 (64.5%) demonstrated systolic impairment only. In a multivariate adjusted logistic regression model, age, low BMI, hypertension, increased heart rate, antihypertensive treatment, diabetes and current smoking independently determined orthostatic hypotension, but systolic impairment also showed association with higher pulse pressure and reduced glomerular filtration rate. In a multivariate adjusted Cox proportional hazard model, men with orthostatic hypotension demonstrated a higher risk of incident coronary event, stroke and all-cause mortality than men without orthostatic hypotension. Systolic impairment was a better predictor of all studied endpoints than were the combined criteria of orthostatic hypotension. Moreover, participants with orthostatic hypotension at both baseline and re-screening showed the highest risk of any adverse event (hazard risk 1.76, 95% confidence interval 1.28-2.43, P = 0.001), exceeding the risk predicted by orthostatic hypotension at re-screening only (hazard risk 1.22, 95% confidence interval 1.07-1.38, P = 0.003). CONCLUSION: Orthostatic hypotension may be found in up to 10% of middle-aged men and correlates with well known cardiovascular risk factors such as hypertension, smoking, diabetes and kidney failure. Orthostatic impairment seems to constitute an independent cardiovascular risk factor and may be practically estimated by systolic reaction only. As orthostatic reaction may vary over time, repeated measurements or more accurate diagnostic methods are recommended to identify high-risk patients with persistent orthostatic hypotension.
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64.
  • Fedorowski, Artur, et al. (författare)
  • Orthostatic hypotension predicts all-cause mortality and coronary events in middle-aged individuals (The Malmo Preventive Project).
  • 2010
  • Ingår i: European Heart Journal. - : Oxford University Press (OUP). - 1522-9645 .- 0195-668X. ; 31, s. 85-91
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims Orthostatic hypotension (OH) has been linked to increased mortality and incidence of cardiovascular disease in various risk groups, but determinants and consequences of OH in the general population are poorly studied. Methods and results Prospective data of the Swedish 'Malmö Preventive Project' (n = 33 346, 67.3% men, mean age 45.7 +/- 7.4 years, mean follow-up 22.7 +/- 6.0 years) were analysed. Orthostatic hypotension was found in 6.2% of study participants and was associated with age, female gender, hypertension, antihypertensive treatment, increased heart rate, diabetes, low BMI, and current smoking. In Cox regression analysis, individuals with OH had significantly increased all-cause mortality (in particular those aged less than 42 years) and coronary event (CE) risk. Mortality and CE risk were distinctly higher in those with systolic blood pressure (BP) fall >/=30 mmHg [hazard ratio (HR): 1.6, 95% CI 1.3-1.9, P < 0.0001 and 1.6, 95% CI 1.2-2.1, P = 0.001] and diastolic BP fall >/=15 mmHg (HR: 1.4, 95% CI 1.1-1.9, P = 0.024 and 1.7, 95% CI 1.1-2.5, P = 0.01). In addition, impaired diastolic BP response had relatively greater impact (per mmHg) on CE incidence than systolic reaction. Conclusion Orthostatic hypotension can be detected in approximately 6% of middle-aged individuals and is often associated with such comorbidities as hypertension or diabetes. Presence of OH increases mortality and CE risk, independently of traditional risk factors. Although both impaired systolic and diastolic responses predict adverse events, the diastolic impairment shows stronger association with coronary disease.
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65.
  • Feigelson, HS, et al. (författare)
  • Haplotype analysis of the HSD17B1 gene and risk of breast cancer: A comprehensive approach to multicenter analyses of prospective cohort studies
  • 2006
  • Ingår i: Cancer Research. - 1538-7445. ; 66:4, s. 2468-2475
  • Tidskriftsartikel (refereegranskat)abstract
    • The 17 beta-hydroxysteroid dehydrogenase 1 gene (HSD17B1) encodes 17HSD1, which catalyzes the final step of estradiol biosynthesis. Despite the important role of HSD17B1 in hormone metabolism, few epidemiologic studies of HSD17B1 and breast cancer have been conducted. This study includes 5,370 breast cancer cases and 7,480 matched controls from five large cohorts in the Breast and Prostate Cancer Cohort Consortium. We characterized variation in HSD17B1 by resequencing and dense genotyping a multiethnic sample and identified haplotype-tagging single nucleotide polymorphisms (htSNP) that capture common variation within a 33.3-kb region around HSD17B1. Four htSNPs, including the previously studied SNP rs605059 (S312G), were genotyped to tag five common haplotypes in all cases and controls. Conditional logistic regression was used to estimate odds ratios (OR) for disease. We found no evidence of association between common HSD17B1 haplotypes or htSNPs and overall risk of breast cancer. The OR for each haplotype relative to the most common haplotype ranged from 0.98 to 1.07 (omnibus test for association: X-2 = 3.77, P = 0.58, 5 degrees of freedom). When cases were subdivided by estrogen receptor (ER) status, two common haplotypes were associated with ER-negative tumors (test for trend, Ps = 0.0009 and 0.0076; n = 353 cases). HSD17B1 variants that are common in Caucasians are not associated with overall risk of breast cancer; however, there was an association among the subset of ER-negative tumors. Although the probability that these ER-negative findings are false-positive results is high, these findings were consistent across each cohort examined and warrant further study.
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66.
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67.
  • Florez, J. C., et al. (författare)
  • Association testing of common variants in the insulin receptor substrate-1 gene (IRS1) with type 2 diabetes
  • 2007
  • Ingår i: Diabetologia. - : Springer Science and Business Media LLC. - 1432-0428 .- 0012-186X. ; 50:6, s. 1209-1217
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims/hypothesis Activation of the insulin receptor substrate-1 (IRS1) is a key initial step in the insulin signalling pathway. Despite several reports of association of the G972R polymorphism in its gene IRS1 with type 2 diabetes, we and others have not observed this association in well-powered samples. However, other nearby variants might account for the putative association signal. Subjects and methods We characterised the haplotype map of IRS1 and selected 20 markers designed to capture common variations in the region. We genotyped this comprehensive set of markers in several family-based and case-control samples of European descent totalling 12,129 subjects. Results In an initial sample of 2,235 North American and Polish case-control pairs, the minor allele of the rs934167 polymorphism showed nominal evidence of association with type 2 diabetes (odds ratio [OR] 1.25, 95% CI 1.03-1.51, p=0.03). This association showed a trend in the same direction in 7,659 Scandinavian samples (OR 1.16, 95% CI 0.96-1.39, p=0.059). The combined OR was 1.20 (p=0.008), but statistical correction for the number of variants examined yielded a p value of 0.086. We detected no differences across rs934167 genotypes in insulin-related quantitative traits. Conclusion/interpretation Our data do not support an association of common variants in IRS1 with type 2 diabetes in populations of European descent.
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68.
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69.
  • Friedenreich, Christine, et al. (författare)
  • Anthropometric factors and risk of endometrial cancer: the European prospective investigation into cancer and nutrition
  • 2007
  • Ingår i: Cancer Causes and Control. - : Springer Science and Business Media LLC. - 1573-7225 .- 0957-5243. ; 18:4, s. 399-413
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective To examine the association between anthropometry and endometrial cancer, particularly by menopausal status and exogenous hormone use subgroups. Methods Among 223,008 women in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, there were 567 incident endometrial cancer cases during 6.4 years of follow-up. The analysis was performed with Cox proportional hazards modeling. Results Weight, body mass index (BMI), waist and hip circumferences and waist-hip ratio (WHR) were strongly associated with increased risk of endometrial cancer. The relative risk (RR) for obese (BMI 30- < 40 kg/m(2)) compared to normal weight (BMI < 25) women was 1.78, 95% CI = 1.41-2.26, and for morbidly obese women (BMI >= 40) was 3.02, 95% CI = 1.66-5.52. The RR for women with a waist circumference of >= 88 cm vs. < 80 cm was 1.76, 95% CI = 1.42-2.19. Adult weight gain of >= 20 kg compared with stable weight (+/- 3 kg) increased risk independent of body weight at age 20 (RR = 1.75, 95% CI = 1.11-2.77). These associations were generally stronger for postmenopausal than premenopausal women, and oral contraceptives never-users than ever-users, and much stronger among never-users of hormone replacement therapy compared to ever-users. Conclusion Obesity, abdominal adiposity, and adult weight gain were strongly associated with endometrial cancer risk. These associations were particularly evident among never-users of hormone replacement therapy.
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70.
  • Friedenreich, Christine, et al. (författare)
  • Physical activity and risk of colon and rectal cancers: The European Prospective Investigation into Cancer and Nutrition
  • 2006
  • Ingår i: Cancer Epidemiology Biomarkers & Prevention. - 1538-7755. ; 15:12, s. 2398-2407
  • Tidskriftsartikel (refereegranskat)abstract
    • We investigated several aspects of the role of physical activity in colon and rectal cancer etiology that remain unclear in the European Prospective Investigation into Nutrition and Cancer. This cohort of 413,044 men and women had 1,094 cases of colon and 599 cases of rectal cancer diagnosed during an average of 6.4 years of follow-up. We analyzed baseline data on occupational, household, and recreational activity to examine associations by type of activity, tumor subsite, body mass index (BMI), and energy intake. The multivariate hazard ratio for colon cancer was 0.78 [95% confidence interval (95% CI), 0.59-1.03] among the most active participants when compared with the inactive, with evidence of a dose-response effect (P-trend = 0.04). For right-sided colon tumors, the risk was 0.65 (95% CI, 0.43-1.00) in the highest quartile of activity with evidence of a linear trend (P-trend=0.004). Active participants with a BMI under 25 had a risk of 0.63 (95% CI, 0.39-1.01) for colon cancer compared with the inactive. Finally, an interaction between BMI and activity (P-interaction=0.03) was observed for right-sided colon cancers; among moderately active and active participants with a BMI under 25, a risk of 0.38 (95% CI, 0.21-0.68) was found as compared with inactive participants with BMI > 30. No comparable decreased risks were observed for rectal cancer for any type of physical activity for any subgroup analyses or interactions considered. We found that physical activity reduced colon cancer risk, specifically for right-sided tumors and for lean participants, but not rectal cancer.
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