| 1. |
- Bengtsson, Caroline, et al.
(författare)
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Incident chronic rhinosinusitis is associated with impaired sleep quality: Results of the RhiNE study
- 2019
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Ingår i: Journal of Clinical Sleep Medicine. - : American Academy of Sleep Medicine (AASM). - 1550-9389 .- 1550-9397. ; 15:6, s. 899-905
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Tidskriftsartikel (refereegranskat)abstract
- Study Objectives: Chronic rhinosinusitis (CRS) is a common inflammatory disease of the nasal cavity and paranasal sinuses. Associations between CRS and poor sleep quality have been reported. This 10-year follow-up study investigates possible associations between incident CRS and sleep quality. Methods: A questionnaire was sent to 16,500 individuals in Sweden, Norway, Denmark, Iceland and Estonia in 2000. It included questions on airway diseases, age, sex, body mass index, smoking habits, comorbidities, education and sleep quality. In 2010, a second questionnaire was sent to the same individuals, with a response rate of 53%. A subgroup of 5,145 individuals without nasal symptoms in 2000 was studied. Multiple logistic regression was performed to examine associations between CRS (defined according to the European position paper on rhinosinusitis and nasal polyps epidemiological criteria) at follow-up and sleep quality, with adjustment for potential confounders. Individuals with the respective sleep problem at baseline were excluded. Results: Over 10 years, 141 (2.7%) of the individuals without nasal symptoms in 2000 had developed CRS. CRS was associated with difficulties inducing sleep (adjusted odds ratio 2.81 [95% CI 1.67–4.70]), difficulties maintaining sleep (2.07 [1.35–3.18]), early morning awakening (3.03 [1.91–4.81]), insomnia (2.21 [1.46–3.35]), excessive daytime sleepiness (2.85 [1.79–4.55]), and snoring (3.31 [2.07–5.31]). Three insomnia symptoms at baseline increased the risk of CRS at follow-up by 5.00 (1.93–12.99). Conclusions: Incident CRS is associated with impaired sleep quality and excessive daytime sleepiness. Insomnia symptoms may be a risk factor for the development of CRS. © 2019 American Academy of Sleep Medicine. All rights reserved.
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| 2. |
- Dratva, Julia, et al.
(författare)
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Validation of self-reported figural drawing scales against anthropometric measurements in adults
- 2016
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Ingår i: Public Health Nutrition. - : Cambridge University Press. - 1368-9800 .- 1475-2727. ; 19:11, s. 1944-1951
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of the present study was to validate figural drawing scales depicting extremely lean to extremely obese subjects to obtain proxies for BMI and waist circumference in postal surveys.Design: Reported figural scales and anthropometric data from a large population-based postal survey were validated with measured anthropometric data from the same individuals by means of receiver-operating characteristic curves and a BMI prediction model.Setting: Adult participants in a Scandinavian cohort study first recruited in 1990 and followed up twice since.Subjects: Individuals aged 38-66 years with complete data for BMI (n 1580) and waist circumference (n 1017).Results: Median BMI and waist circumference increased exponentially with increasing figural scales. Receiver-operating characteristic curve analyses showed a high predictive ability to identify individuals with BMI > 25.0 kg/m(2) in both sexes. The optimal figural scales for identifying overweight or obese individuals with a correct detection rate were 4 and 5 in women, and 5 and 6 in men, respectively. The prediction model explained 74% of the variance among women and 62% among men. Predicted BMI differed only marginally from objectively measured BMI.Conclusions: Figural drawing scales explained a large part of the anthropometric variance in this population and showed a high predictive ability for identifying overweight/obese subjects. These figural scales can be used with confidence as proxies of BMI and waist circumference in settings where objective measures are not feasible.
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| 3. |
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| 4. |
- Janson, Christer, et al.
(författare)
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Change in the prevalence asthma, rhinitis and respiratory symptom over a 20 year period : associations to year of birth, life style and sleep related symptoms
- 2018
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Ingår i: BMC Pulmonary Medicine. - : BioMed Central. - 1471-2466. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this investigation was to study change in adults over a 20 year period in the prevalence of respiratory symptoms and disorders and its association to year of birth, life style and sleep related variables.Method: Adults 20-44 years of age, 6085 women and 5184 men, were randomly selected from seven centres in Northern Europe and followed for 20 years. The number of participants in the first survey was 21,595 and 11,269 participated in all three surveys. The participants were divided into three birth cohorts: 1944-1955, 1956-1965 and 1966-1975.Results: During the 20 year period the prevalence of wheeze decreased (-2%) and the prevalence of asthma (+ 4%) and allergic rhinitis (+ 5%) increased, whereas the prevalence of nocturnal respiratory symptoms was relatively unchanged. The increase in allergic rhinitis was largest in those born 1966 to 1975 except in Estonia. There was large decrease in smoking (-20%), increase in obesity (+ 7%) and snoring (+ 6%) during the study period. Smoking, obesity, snoring and nocturnal gastroesophageal reflux (nGER) were related to a higher risk of all symptoms. Obesity, snoring and nGER were also independently related to asthma.Conclusion: We conclude that as our participants got older there was a decrease in wheeze, no change in nocturnal symptoms and an increase in reported asthma and allergic rhinitis. These changes in prevalence are probably related to a decrease in smoking being counteracted by an increase in allergy, obesity and sleep related disorders.
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| 5. |
- Janson, Emma, et al.
(författare)
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Insomnia associated with traffic noise and proximity to traffic : a cross-sectional study of the Respiratory Health in Northern Europe III population
- 2020
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Ingår i: Journal of Clinical Sleep Medicine (JCSM). - : American Academy of Sleep Medicine. - 1550-9389 .- 1550-9397. ; 16:4, s. 545-552
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Tidskriftsartikel (refereegranskat)abstract
- Study Objectives: Exposure to traffic noise increases the risk of sleeping disturbance, but little is known about the effect of traffic-related air pollution on insomnia symptoms. We aimed to investigate the separate associations of self-reported proximity to traffic and traffic noise with insomnia.Methods: This is a cross-sectional study of the population included in the Respiratory Health in Northern Europe study, consisting of randomly selected men and women born between 1945 and 1973, from 7 Northern European centers. Hearing traffic noise in the bedroom, bedroom window proximity to traffic, and insomnia symptoms were self-reported. Bedroom window proximity to traffic was used as a surrogate for exposure to traffic-related air pollution. The following insomnia symptoms were assessed: difficulty initiating sleep, difficulty maintaining sleep, and early morning awakening.Results: A total of 12,963 individuals was included. Traffic noise was positively associated with all three insomnia symptoms: difficulty initiating sleep (odds ratio [OR] = 3.54; 95% confidence interval [CI]: 1.85, 6.76), difficulty maintaining sleep (OR = 2.95; 95% CI: 1.62, 5.37), and early morning awakening (OR = 3.25; 95% CI: 1.97, 5.37). Proximity to traffic without disturbing noise was associated with difficulty initiating sleep (OR = 1.62; 95% CI: 1.45, 1.82).Conclusions: This study adds further support to the identification of traffic noise as a risk factor for insomnia. Proximity to traffic without being exposed to noise was associated with an increased risk of difficulty initiating sleep. Our findings indicate that insomnia may be associated with both traffic noise and traffic-related air pollution.
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| 6. |
- Johannessen, Ane, et al.
(författare)
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Longterm follow-up in European respiratory health studies : patterns and implications
- 2014
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Ingår i: BMC Pulmonary Medicine. - : BioMed Central. - 1471-2466. ; 14, s. 63-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Selection bias is a systematic error in epidemiologic studies that may seriously distort true measures of associations between exposure and disease. Observational studies are highly susceptible to selection bias, and researchers should therefore always examine to what extent selection bias may be present in their material and what characterizes the bias in their material. In the present study we examined long-term participation and consequences of loss to follow-up in the studies Respiratory Health in Northern Europe (RHINE), Italian centers of European Community Respiratory Health Survey (I-ECRHS), and the Italian Study on Asthma in Young Adults (ISAYA). METHODS: Logistic regression identified predictors for follow-up participation. Baseline prevalence of 9 respiratory symptoms (asthma attack, asthma medication, combined variable with asthma attack and/or asthma medication, wheeze, rhinitis, wheeze with dyspnea, wheeze without cold, waking with chest tightness, waking with dyspnea) and 9 exposure-outcome associations (predictors sex, age and smoking; outcomes wheeze, asthma and rhinitis) were compared between all baseline participants and long-term participants. Bias was measured as ratios of relative frequencies and ratios of odds ratios (ROR). RESULTS: Follow-up response rates after 10 years were 75% in RHINE, 64% in I-ECRHS and 53% in ISAYA. After 20 years of follow-up, response was 53% in RHINE and 49% in I-ECRHS. Female sex predicted long-term participation (in RHINE OR (95%CI) 1.30(1.22, 1.38); in I-ECRHS 1.29 (1.11, 1.50); and in ISAYA 1.42 (1.25, 1.61)), as did increasing age. Baseline prevalence of respiratory symptoms were lower among long-term participants (relative deviations compared to total baseline population 0-15% (RHINE), 0-48% (I-ECRHS), 3-20% (ISAYA)), except rhinitis which had a slightly higher prevalence. Most exposure-outcome associations did not differ between long-term participants and all baseline participants, except lower OR for rhinitis among ISAYA long-term participating smokers (relative deviation 17% (smokers) and 44% (10-20 pack years)). CONCLUSIONS: We found comparable patterns of long-term participation and loss to follow-up in RHINE, I-ECRHS and ISAYA. Baseline prevalence estimates for long-term participants were slightly lower than for the total baseline population, while exposure-outcome associations were mainly unchanged by loss to follow-up.
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| 7. |
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| 8. |
- Lønnebotn, Marianne, et al.
(författare)
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Polycystic ovary syndrome, body mass index and hypertensive disorders in pregnancy
- 2018
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Ingår i: Pregnancy Hypertension. - : Elsevier. - 2210-7789 .- 2210-7797. ; 11, s. 32-37
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Some studies of women with polycystic ovary syndrome (PCOS) report increased prevalence of hypertensive disorders in pregnancy, while others do not. Several of these studies do not control for obesity. We aimed to study whether PCOS is associated with hypertensive disorders in pregnancy and whether it is dependent on body mass index (BMI).Study design: We present a cross-sectional analysis of 3732 women from Denmark, Estonia, Iceland, Norway and Sweden, born in 1945-72, who participated in the Respiratory Health In Northern Europe (RHINE) study and answered an extensive women's health questionnaire on menstruation, PCOS, infertility, pregnancy history and childbirth. The main outcome measurement was hypertensive disorders of pregnancy. We adjusted for smoking, age, infertility treatment and study center. Effect modification by BMI was assessed.Results: PCOS was related to hypertensive disorders in pregnancy with a relative risk (RR) of 1.62 (95% CI 1.09-2.42). This relationship was found among underweight women with a BMI of <18.5 kg/m(2) [RR=5.2 (95% CI 1.66-16.5)] and obese women with a BMI of >= 30 kg/m(2) [RR=2.36 (95% CI 1.29-4.31)], but not among normal-weight women, BMI 18.5-25 kg/m(2) [1.08 (0.53-2.20)], or overweight women, BMI 25-30 kg/m(2) [1.24 (0.50-3.08)] (p-interaction=0.041).Conclusion: Polycystic ovary syndrome is associated with hypertensive disorders in pregnancy. This association only occurs among underweight and obese women and not among normal-weight and slightly overweight women.
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| 9. |
- Pesce, Giancarlo, et al.
(författare)
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Low dehydroepiandrosterone sulfate (DHEA-S) is associated with worse lung function in women
- 2018
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Ingår i: European Respiratory Journal. - : European Respiratory Society. - 0903-1936 .- 1399-3003. ; 52
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- DHEA-S is the most abundant circulating steroid hormone in humans. Low concentrations of DHEA-S have been linked to several chronic diseases, but it is unclear if DHEA-S affects respiratory health. As part of the ALEC project [EU H2020 grant #633212], the associations of DHEA-S concentrations with lung function levels and decline were evaluated in women from the general population.Serum DHEA-S concentrations were measured in 2,250 women (28-57 years) participating in the European Community Respiratory Health Survey in 1999-2002. Associations of DHEA-S concentrations (categorized by age-adjusted quintiles) with FEV1, FVC, and the FEV1/FVC ratio were investigated using linear regression models adjusted for age, height, active and passive smoking, BMI, physical activity, education, menopausal status, and with study centre included as a random effect. Associations of DHEA-S concentrations with yearly decline in lung function (ΔFEV1, ΔFVC, ΔFEV1/FVC) were assessed in 1,340 women with spirometry data at follow-up in 2010-2014.The median (25th-75th percentile) concentration of DHEA-S was 4.2 µmol/L (2.9-6.0). The concentration of DHEA-S was significantly higher in current smokers and steadily declined with age. In fully adjusted models, women with low DHEA-S concentrations (below the 1st quintile) at baseline had worse FEV1 (-80mL, p<0.001) and FVC (-79mL, p=0.001) compared to women with higher DHEA-S levels. Low DHEA-S concentrations at baseline were associated with ΔFEV1/FVC (-0.08%/year, p=0.006), but not with ΔFEV1 or ΔFVC.The results suggest that low DHEA-S concentrations are associated with worse lung function in women, but have limited effects on lung function decline.
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| 10. |
- Pesce, G., et al.
(författare)
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Low serum DHEA-S is associated with impaired lung function in women
- 2020
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Ingår i: EClinicalMedicine. - : Elsevier BV. - 2589-5370. ; 23
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Tidskriftsartikel (refereegranskat)abstract
- Background: Emerging evidence suggests that androgens and estrogens have a role in respiratory health, but it is largely unknown whether levels of these hormones can affect lung function in adults from the general population. This study investigated whether serum dehydroepiandrosterone sulfate (DHEA-S), a key precursor of both androgens and estrogens in peripheral tissues, was related to lung function in adult women participating in the European Community Respiratory Health Survey (ECRHS). Methods: Lung function and serum DHEA-S concentrations were measured in n = 2,045 and n = 1,725 women in 1999–2002 and in 2010–2013, respectively. Cross-sectional associations of DHEA-S levels (expressed as age-adjusted z-score) with spirometric outcomes were investigated, adjusting for smoking habits, body mass index, menopausal status, and use of corticosteroids. Longitudinal associations of DHEA-S levels in 1999–2002 with incidence of restrictive pattern and airflow limitation in 2010–2013 were also assessed. Findings: Women with low DHEA-S (z-score<-1) had lower FEV1 (% of predicted, adjusted difference: -2.2; 95%CI: -3.5 to -0.9) and FVC (-1.7; 95%CI: -2.9 to -0.5) and were at a greater risk of having airflow limitation and restrictive pattern on spirometry than women with higher DHEA-S levels. In longitudinal analyses, low DHEA-S at baseline was associated with a greater incidence of airflow limitation after an 11-years follow-up (incidence rate ratio, 3.43; 95%CI: 1.91 to 6.14). Interpretation: Low DHEA-S levels in women were associated with impaired lung function and a greater risk of developing airflow limitation later in adult life. Our findings provide new evidence supporting a role of DHEA-S in respiratory health. Funding: EU H2020, grant agreement no.633212 © 2020 The Authors
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