| 331. |
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| 332. |
- Persson, Asa, et al.
(författare)
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Long-term exposure to transportation noise and obesity: A pooled analysis of eleven Nordic cohorts
- 2024
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Ingår i: ENVIRONMENTAL EPIDEMIOLOGY. - 2474-7882. ; 8:4
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Tidskriftsartikel (refereegranskat)abstract
- Background:Available evidence suggests a link between exposure to transportation noise and an increased risk of obesity. We aimed to assess exposure-response functions for long-term residential exposure to road traffic, railway and aircraft noise, and markers of obesity. Methods:Our cross-sectional study is based on pooled data from 11 Nordic cohorts, including up to 162,639 individuals with either measured (69.2%) or self-reported obesity data. Residential exposure to transportation noise was estimated as a time-weighted average L-den 5 years before recruitment. Adjusted linear and logistic regression models were fitted to assess beta coefficients and odds ratios (OR) with 95% confidence intervals (CI) for body mass index, overweight, and obesity, as well as for waist circumference and central obesity. Furthermore, natural splines were fitted to assess the shape of the exposure-response functions. Results:For road traffic noise, the OR for obesity was 1.06 (95% CI = 1.03, 1.08) and for central obesity 1.03 (95% CI = 1.01, 1.05) per 10 dB L-den. Thresholds were observed at around 50-55 and 55-60 dB L-den, respectively, above which there was an approximate 10% risk increase per 10 dB L-den increment for both outcomes. However, linear associations only occurred in participants with measured obesity markers and were strongly influenced by the largest cohort. Similar risk estimates as for road traffic noise were found for railway noise, with no clear thresholds. For aircraft noise, results were uncertain due to the low number of exposed participants. Conclusion:Our results support an association between road traffic and railway noise and obesity.
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| 333. |
- Persson, Christina, 1985, et al.
(författare)
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Risk of Heart Failure in Obese Patients With and Without Bariatric Surgery in Sweden-A Registry-Based Study
- 2017
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Ingår i: Journal of Cardiac Failure. - : Elsevier BV. - 1071-9164 .- 1532-8414. ; 23:7, s. 530-537
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Tidskriftsartikel (refereegranskat)abstract
- Background: Obesity is a known risk factor for heart failure. The prevalence of both conditions has increased in Sweden during the past several decades. Obesity surgery has been shown to improve cardiac function. We therefore investigated whether the risk of heart failure was lower in obese patients after bariatric surgery compared with obese patients without surgical intervention. Methods and results: From the Swedish National Patient Registry. we created a cohort including 47,859 patients aged 18-74 years with a primary diagnosis of obesity from 2000 to 2011. Of these, 22,295 (46.6%) underwent bariatric surgery (mean age 40.7 (standard deviation [SD] 10.7) years, 75.9% female). There were 25,564 (53.4%) nonsurgical obese patients (mean age 44.3 (SD 13.2) years, 66.8% female). Patients who underwent bariatric surgery had a markedly reduced risk of heart failure compared with nonsurgical obese patients (age- and sex-adjusted hazard ratio [HR] 0.37, 95% confidence interval [CI] 0.29-0.46). The lower risk persisted after further adjustment for baseline differences in known risk factors for heart failure (HR 0.37, 95% CI 0.30-0.46). Conclusion: Patients who underwent bariatric surgery had a reduced risk of heart failure after surgery compared with nonsurgical obese patients.
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| 334. |
- Persson, Carina Ulla, 1970, et al.
(författare)
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Secular trends in cardiovascular risk factors among women aged 45-54years in Gothenburg, Sweden, from 1980 to 2014
- 2020
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundA declining trend in mean cholesterol levels and smoking has been observed in high-income western countries during the last few decades, whereas obesity rates have increased. Simultaneously, mortality from coronary heart disease has decreased. The aim of the present study was to determine whether the trends in cardiovascular risk factors have continued in successive cohorts of middle-aged women over a period of 34years.MethodsSix population-based, cross-sectional samples of women (n=2294) mean age: 49.8years (range: 45-54), living in Gothenburg, Sweden, were investigated between 1980 and 2014.ResultsBody mass index (BMI) increased over time, with a mean BMI of 24.7kg/m(2) in 1980 to 25.7kg/m(2) in 2013-2014, corresponding to a weight gain of 4.5kg, together with an increase in the proportion of obese individuals (BMI >= 30kg/m(2)) from 10.4 to 16.6% (p=0.0012). The proportion of smokers and women with hypertension decreased from 34.5 to 12.8% (p=0.0006) and from 37.7 to 24.5% (p<0.0001) respectively. Mean total serum cholesterol levels decreased from 6.23 (SD 1.09) mmol/L in 1980 to 5.43 (SD 0.98) mmol/L in 2013-2014 (p<0.0001). Self-reported leisure time regular exercise increased from 7.8% in 1980 to 35.6% in 2013-2014 (p<0.0001). For women born in 1963, the prevalence ratio of not having any of five major cardiovascular risk factors was 1.82 (95% confidence interval (CI) 1.38-2.41), compared with women born in 1925-1934.ConclusionThe trend towards increasing obesity, more leisure-time physical activity and less smoking remains, while the decrease in serum cholesterol appears to have abated.
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| 335. |
- Persson, Christina, 1985, et al.
(författare)
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Young women, body size and risk of atrial fibrillation.
- 2018
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Ingår i: European journal of preventive cardiology. - : Oxford University Press (OUP). - 2047-4881 .- 2047-4873. ; 25:2, s. 173-180
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Tidskriftsartikel (refereegranskat)abstract
- Background A large body size in early adult life has been associated with an increased risk of atrial fibrillation (AF) later in life in men; however, this has not yet been investigated in women.Prospective cohort study.We included all women in the Swedish Medical Birth Registry with known weight and height from 1982 to 2014. The main exposure body surface area (BSA) was calculated as the square root of (height [cm] × weight [kg]/3600). Information on hospital diagnoses of AF were obtained from the Patient Registry. The study population comprised 1,522,329 women (mean age 28.3 years).A total of 6993 women (0.5%) were diagnosed with AF during a maximum follow-up of 33.6 years (mean 16.6 years, confidence interval [CI] 16.6-16.6). Risk of AF rose linearly with increasing BSA, body mass index (BMI) and height, with up to a threefold increased risk in the biggest women. Hazard ratios associated with BSA were 1.21 (95% CI 1.12-1.30), 1.45 (95% CI 1.35-1.56) and 2.11 (95% CI 1.97-2.26) when comparing the second, third and fourth quartiles, respectively, with the first. The elevated risk persisted after stratifying for different levels of BMI, even among women with low-normal BMI. Conclusion A larger body size measured early in adulthood was, independent from BMI, associated with an increased risk of AF in women during follow-up of up to 33 years.
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| 336. |
- Prescott, E., et al.
(författare)
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Improving diagnosis and treatment of women with angina pectoris and microvascular disease: The iPOWER study design and rationale
- 2014
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Ingår i: American Heart Journal. - : Elsevier BV. - 0002-8703. ; 167:4, s. 452-458
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Tidskriftsartikel (refereegranskat)abstract
- Background The iPOWER study aims at determining whether routine assessment of coronary microvascular dysfunction (CMD) in women with angina and no obstructive coronary artery disease is feasible and identifies women at risk. Methods All women with angina referred to invasive angiographic assessment in Eastern Denmark are invited to join the study according to in- and exclusion criteria. Assessment includes demographic, clinical and psychosocial data, symptoms, electrocardiogram, blood- and urine samples and transthoracic echocardiography during rest and dipyridamol stress with measurement of coronary flow reserve (CFR) by Doppler of the left anterior descending artery. In substudies CMD will be assessed by positron emission tomography, peripheral endothelial function, magnetic resonance imaging-and computed tomography derived myocardial perfusion scans, angiographic corrected TIMI frame counts, advanced echocardiographic modalities at rest and during stress, and invasive measures of CFR and coronary vascular reactivity. The study will include 2000 women who will be followed for 5 years for cardiovascular outcomes. Results By May 2013, 1685 women have been screened, 759 eligible patients identified, 530 contacted, and 299 (56%) agreed to participate. Among the first 50 patients, Doppler CFR was successfully measured in 49 (98%). Conclusions Among women with suspected ischemic heart disease and no obstructive coronary artery disease, non-invasive Doppler CFR is feasible as a routine assessment. The study will provide information on methods to diagnose CMD and determine the prognostic value of routine non-invasive assessment ofmicrovascular function. Future study will provide women identified with CMD participation in interventional substudies designed to test treatment strategies.
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| 337. |
- Pyko, Andrei, et al.
(författare)
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Long-Term Exposure to Transportation Noise and Ischemic Heart Disease: A Pooled Analysis of Nine Scandinavian Cohorts.
- 2023
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Ingår i: Environmental health perspectives. - : Environmental Health Perspectives. - 1552-9924 .- 0091-6765. ; 131:1
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Tidskriftsartikel (refereegranskat)abstract
- Transportation noise may induce cardiovascular disease, but the public health implications are unclear.The study aimed to assess exposure-response relationships for different transportation noise sources and ischemic heart disease (IHD), including subtypes.Pooled analyses were performed of nine cohorts from Denmark and Sweden, together including 132,801 subjects. Time-weighted long-term exposure to road, railway, and aircraft noise, as well as air pollution, was estimated based on residential histories. Hazard ratios (HRs) were calculated using Cox proportional hazards models following adjustment for lifestyle and socioeconomic risk factors.A total of 22,459 incident cases of IHD were identified during follow-up from national patient and mortality registers, including 7,682 cases of myocardial infarction. The adjusted HR for IHD was 1.03 [95% confidence interval (CI) 1.00, 1.05] per 10 dB Lden for both road and railway noise exposure during 5 y prior to the event. Higher risks were indicated for IHD excluding angina pectoris cases, with HRs of 1.06 (95% CI: 1.03, 1.08) and 1.05 (95% CI: 1.01, 1.08) per 10 dB Lden for road and railway noise, respectively. Corresponding HRs for myocardial infarction were 1.02 (95% CI: 0.99, 1.05) and 1.04 (95% CI: 0.99, 1.08). Increased risks were observed for aircraft noise but without clear exposure-response relations. A threshold at around 55 dB Lden was suggested in the exposure-response relation for road traffic noise and IHD.Exposure to road, railway, and aircraft noise in the prior 5 y was associated with an increased risk of IHD, particularly after exclusion of angina pectoris cases, which are less well identified in the registries. https://doi.org/10.1289/EHP10745.
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| 338. |
- Raina, P., et al.
(författare)
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Assessing global risk factors for non-fatal injuries from road traffic accidents and falls in adults aged 35-70 years in 17 countries: a cross-sectional analysis of the Prospective Urban Rural Epidemiological (PURE) study
- 2016
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Ingår i: Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention. - : BMJ. - 1353-8047 .- 1475-5785. ; 22, s. 92-98
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To assess risk factors associated with non-fatal injuries (NFIs) from road traffic accidents (RTAs) or falls. METHODS: Our study included 151 609 participants from the Prospective Urban Rural Epidemiological study. Participants reported whether they experienced injuries within the past 12 months that limited normal activities. Additional questions elicited data on risk factors. We employed multivariable logistic regression to analyse data. RESULTS: Overall, 5979 participants (3.9% of 151 609) reported at least one NFI. Total number of NFIs was 6300: 1428 were caused by RTAs (22.7%), 1948 by falls (30.9%) and 2924 by other causes (46.4%). Married/common law status was associated with fewer falls, but not with RTA. Age 65-70 years was associated with fewer RTAs, but more falls; age 55-64 years was associated with more falls. Male versus female was associated with more RTAs and fewer falls. In lower-middle-income countries, rural residence was associated with more RTAs and falls; in low-income countries, rural residence was associated with fewer RTAs. Previous alcohol use was associated with more RTAs and falls; current alcohol use was associated with more falls. Education was not associated with either NFI type. CONCLUSIONS: This study of persons aged 35-70 years found that some risk factors for NFI differ according to whether the injury is related to RTA or falls. Policymakers may use these differences to guide the design of prevention policies for RTA-related or fall-related NFI.
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| 339. |
- Rajan, S., et al.
(författare)
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Association of Symptoms of Depression with Cardiovascular Disease and Mortality in Low-, Middle-, and High-Income Countries
- 2020
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Ingår i: JAMA Psychiatry. - : American Medical Association (AMA). - 2168-622X. ; 77:10, s. 1052-1063
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Tidskriftsartikel (refereegranskat)abstract
- Importance: Depression is associated with incidence of and premature death from cardiovascular disease (CVD) and cancer in high-income countries, but it is not known whether this is true in low- and middle-income countries and in urban areas, where most people with depression now live. Objective: To identify any associations between depressive symptoms and incident CVD and all-cause mortality in countries at different levels of economic development and in urban and rural areas. Design, Setting, and Participants: This multicenter, population-based cohort study was conducted between January 2005 and June 2019 (median follow-up, 9.3 years) and included 370 urban and 314 rural communities from 21 economically diverse countries on 5 continents. Eligible participants aged 35 to 70 years were enrolled. Analysis began February 2018 and ended September 2019. Exposures: Four or more self-reported depressive symptoms from the Short-Form Composite International Diagnostic Interview. Main Outcomes and Measures: Incident CVD, all-cause mortality, and a combined measure of either incident CVD or all-cause mortality. Results: Of 145862 participants, 61235 (58%) were male and the mean (SD) age was 50.05 (9.7) years. Of those, 15983 (11%) reported 4 or more depressive symptoms at baseline. Depression was associated with incident CVD (hazard ratio [HR], 1.14; 95% CI, 1.05-1.24), all-cause mortality (HR, 1.17; 95% CI, 1.11-1.25), the combined CVD/mortality outcome (HR, 1.18; 95% CI, 1.11-1.24), myocardial infarction (HR, 1.23; 95% CI, 1.10-1.37), and noncardiovascular death (HR, 1.21; 95% CI, 1.13-1.31) in multivariable models. The risk of the combined outcome increased progressively with number of symptoms, being highest in those with 7 symptoms (HR, 1.24; 95% CI, 1.12-1.37) and lowest with 1 symptom (HR, 1.05; 95% CI, 0.92 -1.19; P for trend <.001). The associations between having 4 or more depressive symptoms and the combined outcome were similar in 7 different geographical regions and in countries at all economic levels but were stronger in urban (HR, 1.23; 95% CI, 1.13-1.34) compared with rural (HR, 1.10; 95% CI, 1.02-1.19) communities (P for interaction =.001) and in men (HR, 1.27; 95% CI, 1.13-1.38) compared with women (HR, 1.14; 95% CI, 1.06-1.23; P for interaction <.001). Conclusions and Relevance: In this large, population-based cohort study, adults with depressive symptoms were associated with having increased risk of incident CVD and mortality in economically diverse settings, especially in urban areas. Improving understanding and awareness of these physical health risks should be prioritized as part of a comprehensive strategy to reduce the burden of noncommunicable diseases worldwide.. © 2020 American Medical Association. All rights reserved.
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| 340. |
- Rawshani, Aidin, 1991, et al.
(författare)
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Adipose tissue morphology, imaging and metabolomics predicting cardiometabolic risk and family history of type 2 diabetes in non-obese men
- 2020
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Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 10:1
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Tidskriftsartikel (refereegranskat)abstract
- We evaluated the importance of body composition, amount of subcutaneous and visceral fat, liver and heart ectopic fat, adipose tissue distribution and cell size as predictors of cardio-metabolic risk in 53 non-obese male individuals. Known family history of type 2 diabetes was identified in 25 individuals. The participants also underwent extensive phenotyping together with measuring different biomarkers and non-targeted serum metabolomics. We used ensemble learning and other machine learning approaches to identify predictors with considerable relative importance and their intricate interactions. Visceral fat and age were strong individual predictors of ectopic fat accumulation in liver and heart along with markers of lipid oxidation and reduced glucose tolerance. Subcutaneous adipose cell size was the strongest individual predictor of whole-body insulin sensitivity and also a marker of visceral and ectopic fat accumulation. The metabolite 3-MOB along with related branched-chain amino acids demonstrated strong predictability for family history of type 2 diabetes.
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