| 1. |
- Zhang, Yuan, et al.
(författare)
-
Healthy lifestyle counteracts the risk effect of genetic factors on incident gout : a large population-based longitudinal study
- 2022
-
Ingår i: BMC Medicine. - : Springer Science and Business Media LLC. - 1741-7015. ; 20:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Risk genes linked to the development of gout have been identified, and lifestyle factors are related to gout risk. It remains unclear whether healthy lifestyle factors can mitigate the genetic risk of gout. Therefore, we aimed to explore whether and to what extent a healthy lifestyle can mitigate the risk of gout related to genetic factors.Methods: Within the UK Biobank, 416,481 gout-free participants (aged 37–74) were identified at baseline. Polygenic risk for gout was assessed and categorized as low (lowest tertile), middle (tertile 2), and high (highest tertile). Healthy lifestyle factors included no/moderate alcohol consumption, no smoking, physical activity, and a healthy diet. Participants were categorized into three groups according to their number of healthy lifestyle factors: unfavorable (0 or 1), intermediate (any 2), and favorable (3 or 4). Data were analyzed using Cox proportional hazard models.Results: Over the follow-up (median: 12.1 years), 6206 participants developed gout. Compared to low genetic risk, the hazard ratios (HRs) and 95% confidence intervals (CIs) of gout was 1.44 (1.35–1.54) for middle and 1.77 (1.66–1.89) for high genetic risk. The HRs (95% CIs) of gout were 0.63 (0.59–0.67) for a favorable lifestyle and 0.79 (0.75–0.85) for an intermediate lifestyle, compared to an unfavorable lifestyle. In joint effect analysis, compared to participants with low genetic predisposition and a favorable lifestyle, the HRs (95% CIs) of gout were 2.39 (2.12–2.70)/3.12 (2.79–3.52) in those with middle and high genetic predisposition plus unfavorable lifestyle profiles, and 1.53 (1.35–1.74)/1.98 (1.75–2.24) for those with middle and high genetic predisposition plus favorable lifestyle profiles, respectively. Moreover, compared to an unfavorable lifestyle, the HRs of gout related to a favorable lifestyle was 0.64 (95% CI, 0.56–0.73) for low genetic risk, 0.65 (95% CI, 0.58–0.72) for middle genetic risk, and 0.62 (95% CI, 0.57–0.69) for high genetic risk. There was a significant additive interaction between unfavorable lifestyle and high genetic risk on gout.Conclusions: Healthy lifestyle was associated with a lower risk of gout and may attenuate the risk of gout related to genetic factors by almost a third.
|
|
| 2. |
- Guo, Jie, et al.
(författare)
-
Association of body mass index and its long-term changes with cardiometabolic diseases : A nationwide twin study
- 2021
-
Ingår i: Clinical Nutrition. - : Elsevier BV. - 0261-5614 .- 1532-1983. ; 40:11, s. 5467-5474
-
Tidskriftsartikel (refereegranskat)abstract
- Background & aims: The association between higher body mass index (BMI) and cardiometabolic diseases (CMDs, including type 2 diabetes and cardiovascular diseases) is not well understood. We aimed to examine the association of BMI and its long-term changes with cardiometabolic diseases (CMDs) and explore the role of familial background and healthy lifestyle in this association.Methods: Within the Swedish Twin Registry, 36 622 CMD-free individuals aged ≥40 were followed for up to 16 years. BMI data was collected at baseline and 25–35 years prior to baseline. Healthy lifestyle (non-smoking, no/mild alcohol consumption, and regular physical activity) was assessed as unfavourable (none or only one of these factors) vs. favourable (two or three). Incident CMDs were identified by linkage with the Swedish National Patient Registry. Two strategies were followed: 1) Cox models in all twin individuals; 2) stratified Cox models in CMD-discordant twin pairs.Results: At baseline, 16 195 (44.2%) study participants had overweight/obesity (BMI ≥ 25 kg/m2) and 11 202 (30.6%) developed CMDs over follow-up. Among all participants, the hazard ratio (HR) and 95% confidence interval (CI) of developing any CMD was 1.52 (1.45–1.58) for people with overweight/obesity compared to normal BMI (20–25 kg/m2). Compared to stable normal BMI, HRs (95% CIs) of CMDs were 1.28 (1.02–1.59) and 1.33 (1.24–1.43) for only earlier life or only later life overweight/obesity, respectively, and 1.69 (1.55–1.85) for overweight/obesity both in earlier and later life. In stratified Cox analyses conducted among all CMD-discordant twin pairs, overweight/obesity was associated with greater risk of CMDs (1.37, 95% CI 1.18–1.61). In joint effect analysis, the risk of CMDs related to overweight/obesity was diminished 32% among people with a favourable lifestyle (1.51, 95% CI 1.44–1.58) compared to those with overweight/obesity and an unfavourable lifestyle (2.20, 95% CI 2.03–2.38).Conclusions: Overweight/obesity is associated with an increased risk of CMDs, and shared genetic and early-life environmental factors might not account for this association. However, a favourable lifestyle could attenuate the risk of high BMI-related CMDs.
|
|
| 3. |
- Li, Xuerui, et al.
(författare)
-
Association of life-course reproductive duration with mortality : a population-based twin cohort study
- 2022
-
Ingår i: American Journal of Obstetrics and Gynecology. - : Elsevier BV. - 0002-9378 .- 1097-6868. ; 227:5, s. 748.e1-748.e13
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGOUND: Although age at menopause has been linked to mortality, the association between the entire reproductive lifespan and mortality remains unclear.OBJECTIVE: This study aimed to examine to what extent life-course reproductive duration is associated with all-cause mortality and explore the role of a healthy lifestyle and familial background in such an association.STUDY DESIGN: A total of 11,669 women (mean age, 63.54 years) from the Swedish Twin Registry were followed for up to 19 years. Information on reproductive duration (the interval between ages at menarche and menopause) and lifestyle factors (including smoking, alcohol consumption, and physical activity; divided into unfavorable/intermediate/favorable) was collected on the basis of a structured questionnaire. Survival status was obtained from the Sweden Cause of Death Register. The data were analyzed using generalized estimating equation models, Laplace regression, and conditional logistic regression.RESULTS: In the generalized estimating equation model, compared with those with ≤34 reproductive years, the odds ratio (95% confidence interval) of all-cause mortality was 0.79 (0.68–0.90) for those with ≥40 reproductive years, which prolonged survival time by 0.84 (0.24–1.43) years. Women with ≥40 reproductive years plus a favorable lifestyle (odds ratio, 0.28; 95% confidence interval, 0.23–0.35) were at a lower risk of all-cause mortality than those with <40 reproductive years plus an unfavorable lifestyle. An additive interaction between ≥40 reproductive years and a favorable lifestyle on all-cause mortality was observed (attributable proportion, 0.584; 95% confidence interval, 0.016–1.151). The odds ratios in conditional logistic regression and generalized estimating equation models did not differ significantly (P=.67).CONCLUSION: A longer reproductive lifespan is associated with reduced all-cause mortality and prolongs survival by 0.84 years. A favorable lifestyle may amplify the beneficial effect of longer reproductive lifespan on mortality. Familial background does not account for the observed association.
|
|
| 4. |
- Li, Xuerui, et al.
(författare)
-
Association of low birth weight with cardiometabolic diseases in Swedish twins : a population-based cohort study
- 2021
-
Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 11:6
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives To examine the association between low birth weight (LBW) and cardiometabolic diseases (CMDs, including heart disease, stroke and type 2 diabetes mellitus) in adulthood, and to explore whether genetic, early-life environmental and healthy lifestyle factors play a role in this association.Design A population-based twin study.Setting Twins from the Swedish Twin Registry who were born in 1958 or earlier participated in the Screening Across the Lifespan Twin (SALT) study for a full-scale screening during 1998-2002 and were followed up until 2014.Participants 19 779 twin individuals in Sweden with birthweight data available (mean age: 55.45 years). Primary and secondary outcome measures CMDs were assessed based on self-reported medical records, medication use and records from the National Patient Registry. A lifestyle index encompassing smoking status, alcohol consumption, exercise levels and Body Mass Index was derived from the SALT survey and categorised as unfavourable, intermediate or favourable. Data were analysed using generalised estimating equation (GEE) models and conditional logistic regression models.Results Of all participants, 3998 (20.2%) had LBW and 5335 (27.0%) had incident CMDs (mean age at onset: 63.64 +/- 13.26 years). In GEE models, the OR of any CMD was 1.39 (95% CI 1.27 to 1.52) for LBW. In conditional logistic regression models, the LBW-CMD association became non-significant (OR=1.21, 95% CI 0.94 to 1.56). The difference in ORs from the two models was statistically significant (p<0.001). In the joint effect analysis, the multiadjusted OR of CMDs was 3.47 (95% CI 2.72 to 4.43) for participants with LBW plus an unfavourable lifestyle and 1.25 (95% CI 0.96 to 1.62) for those with LBW plus a favourable lifestyle.Conclusion LBW is associated with an increased risk of adult CMDs, and genetic and early-life environmental factors may account for this association. However, a favourable lifestyle profile may modify this risk.
|
|
| 5. |
- Li, Xuerui, et al.
(författare)
-
High lifelong cognitive reserve prolongs disability-free survival : The role of cognitive function
- 2023
-
Ingår i: Alzheimer's & Dementia. - : Wiley. - 1552-5260 .- 1552-5279. ; 19:1, s. 208-216
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: The association between cognitive reserve (CR) and survival with independence is unknown. We examined whether lifelong CR accumulation is associated with disability-free survival and explored the extent to which cognitive function mediates this association.Methods: Within the Rush Memory and Aging Project, 1633 dementia- and disability-free participants were followed annually for up to 22 years. Lifelong CR including education, early-/mid-/late-life cognitive activities, and late-life social activity was assessed and tertiled.Results: CR score was dose-dependently associated with disability/death (hazard ratio [HR] 0.96, 95% confidence interval [CI] 0.93–0.99). Compared to low CR, the HR (95% CI) of disability/death was 0.82 (0.70–0.95) for high CR. The median disability-free survival time was prolonged by 0.99 (95% CI 0.28–1.71) years for participants with high CR. Cognitive function mediated 35.7% of the association between CR and disability-free survival.Discussion: High lifelong CR was associated with prolonged disability-free survival. Cognitive function mediates about one-third of this association. Our findings underscore the importance of CR for healthy aging.
|
|
| 6. |
- Sun, Zhuoyu, et al.
(författare)
-
Gestational diabetes mellitus and risks of gynecologic cancers : Results from a nationwide Swedish twin study
- 2021
-
Ingår i: Gynecologic Oncology. - : Elsevier BV. - 0090-8258 .- 1095-6859. ; 162:1, s. 142-147
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Type 2 diabetes has been associated with increased risk of gynecologic cancers, yet the effect of gestational diabetes mellitus (GDM) on gynecologic cancers is unclear.Objectives: To examine associations between GDM history and subsequent gynecologic cancers in parous women, and to explore whether gestational hypertension (GH) plays a role in the associations.Study design: The population-based cohort study included 15,941 individuals from the Swedish Twin Registry. The history of GDM and GH was ascertained based on self-reports. Incident cases of gynecologic cancers (including cancers of the cervix, uterus, ovaries and other female genitalia) were obtained from the National Patients Registry and the Swedish Cancer Registry. Generalized estimating equation models were applied to analyze associations between GDM and gynecologic cancers. Stratified analysis was used to explore whether associations between GDM and gynecologic cancers differed by GH. Additive and multiplicative interactions were calculated between GDM and GH.Results: Of all participants, 350 (2.2%) had GDM, and 1762 (11.1%) had incident gynecologic cancers. No statistically significant associations were found between GDM and risks of any gynecologic cancers. However, GDM was associated with an increased risk of ovarian cancer (OR = 5.29, 95% CI: 1.63–17.19) in women with GH. Interactions between GDM and GH were observed on the additive scale (Attributable proportion due to interaction: 0.86, 95% CI 0.42–1.30, P < 0.001).Conclusions: The associations between GDM and risks of gynecologic cancers were not evident, but the effect of GDM on the risk of ovarian cancer was modified by GH. Further validation in larger cohorts is warranted.
|
|
| 7. |
- Wang, Jingya, et al.
(författare)
-
Association of Pulmonary Function With Motor Function Trajectories and Disability Progression Among Older Adults : A Long-Term Community-Based Cohort Study
- 2022
-
Ingår i: The journals of gerontology. Series A, Biological sciences and medical sciences. - : Oxford University Press (OUP). - 1079-5006 .- 1758-535X. ; 77:12, s. 2524-2531
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The association of pulmonary function (PF) with motor function and disability remains unclear. We investigate the association of PF with motor function trajectories and disability progression, and explore the role of social activity, cognitive function, and cardiovascular diseases (CVDs) in this relationship.Methods: Within the Rush Memory and Aging Project, 1 403 disability-free participants (mean age: 79.28 years) were followed for up to 22 years. PF was measured with a composite score based on peak expiratory flow, forced expiratory volume in 1 second, and forced vital capacity at baseline. Global motor function including dexterity, gait, and hand strength was assessed annually using 10 motor tests. Disability was evaluated according to the basic activities of daily living. Social activity was defined as the frequency of common types of social interaction. Global cognitive function was assessed using a battery of 19 cognitive performance tests. CVDs (including stroke, congestive heart failure, and heart diseases) were ascertained at baseline. Linear mixed-effects models were used.Results: Compared to high PF, low PF was related to faster decline in global motor function (β = −0.005, 95% confidence interval [CI]: −0.008 to −0.001) and all 3 specific motor abilities (p < .05), as well as faster progression of disability (β = 0.012, 95% CI: 0.009 to 0.014). There was a statistically significant interaction between PF and social activity/cognitive function on disability progression (β = 0.005, 95% CI: 0.001 to 0.009, p = .010/β = 0.004, 95% CI: 0.001 to 0.009, p = .025).Conclusion: Poor PF accelerates motor function decline and the progression of disability. A high level of social activity and cognitive function appear to decelerate disability progression related to poor PF.
|
|
| 8. |
- Wang, Shuqi, et al.
(författare)
-
Association of lifespan reproductive duration with depression in Swedish twins : The role of hormone replacement therapy
- 2023
-
Ingår i: International Journal of Gynecology & Obstetrics. - : Wiley. - 0020-7292 .- 1879-3479. ; 162:1, s. 309-316
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To examine the association between reproductive duration and postmenopausal depression (taking the use of hormone replacement therapy [HRT] into account).Methods: In this population-based cohort study, 11 320 postmenopausal women (mean age 63.6 years) were followed for up to 18 years. Reproductive duration was categorized into three groups: short (≤34 years), average (35–39 years), and long (≥40 years). Depression was ascertained from the Sweden National Patient Registry.Results: During the follow up, 593 (5.24%) women developed depression. In the multi-adjusted generalized estimating equation model, the odds ratios (ORs) of depression were 1.28 (95% confidence interval [CI] 1.05–1.55) and 1.25 (95% CI 1.01–1.55) for women with short and long reproductive durations, respectively, compared with those women with average reproductive duration. Women with a non-typical reproductive duration (≤34 or ≥40 years) who received HRT were at a higher risk of depression (OR 1.82, 95% CI 1.42–2.33). There was a significant additive interaction between non-typical reproductive duration and the use of HRT on depression (attributable proportion 0.26, 95% CI 0.03–0.50).Conclusion: Women with a short or long reproductive duration, especially those with a history of HRT use, have a higher risk of depression after menopause compared with those with an average reproductive duration.
|
|
| 9. |
- Wang, Zhiyu, et al.
(författare)
-
Association of Sleep Duration, Napping, and Sleep Patterns With Risk of Cardiovascular Diseases : A Nationwide Twin Study
- 2022
-
Ingår i: Journal of the American Heart Association. - 2047-9980. ; 11:15
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Although sleep disorders have been linked to cardiovascular diseases (CVDs), the association between sleep characteristics and CVDs remains inconclusive. We aimed to examine the association of nighttime sleep duration, daytime napping, and sleep patterns with CVDs and explore whether genetic and early-life environmental factors account for this association.METHODS AND RESULTS: In the Swedish Twin Registry, 12 268 CVD-free twin individuals (mean age=70.3 years) at baseline were followed up to 18 years to detect incident CVDs. Sleep duration, napping, and sleep patterns (assessed by sleep duration, chronotype, insomnia, snoring, and daytime sleepiness) were self-reported at baseline. CVDs were ascertained through the Swedish National Patient Registry and the Cause of Death Register. Data were analyzed using a Cox model. In the multiadjusted Cox model, compared with 7 to 9 hours/night, the hazard ratios (HRs) of CVDs were 1.14 (95% CI, 1.01-1.28) for <7 hours/night and 1.10 (95% CI, 1.00-1.21) for >= 10 hours/night, respectively. Compared with no napping, napping 1 to 30 minutes (HR, 1.11 [95% CI, 1.03-1.18]) and >30 minutes (HR, 1.23 [95% CI, 1.14-1.33]) were related to CVDs. Furthermore, a poor sleep pattern was associated with CVDs (HR, 1.22 [95% CI, 1.05-1.41]). The co-twin matched control analyses showed similar results as the unmatched analyses, and there was no significant interaction between sleep characteristics and zygosity (P values >0.05).CONCLUSIONS: Short or long sleep (<7 or >= 10 hours/night), napping, and poor sleep patterns are associated with an increased CVD risk. Genetic and early-life environmental factors may not account for the sleep-CVD association.
|
|
| 10. |
- Wang, Zhangyu, et al.
(författare)
-
Influence of Cardiovascular Risk Burden on Motor Function Among Older Adults : Mediating Role of Cardiovascular Diseases Accumulation and Cognitive Decline
- 2022
-
Ingår i: Frontiers in Medicine. - : Frontiers Media SA. - 2296-858X. ; 9
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: This study aimed to investigate the association of the cardiovascular risk burden assessed by the Framingham General Cardiovascular Risk Score (FGCRS) with the trajectories of motor function over time and to assess the mediating effects of cardiovascular diseases (CVDs) accumulation and cognitive decline in such association.Methods: In Rush Memory and Aging Project, a total of 1,378 physical health participants (mean age: 79.3 ± 7.3 years) were followed up for up to 22 years. FGCRS at baseline was assessed and categorized into tertiles (lowest, middle, and highest). Global motor function (including dexterity, gait, and hand strength) was assessed annually with 10 motor tests. CVDs (including stroke, congestive heart failure, and other heart diseases) were ascertained at baseline and follow-ups, and the number of CVDs accumulation over time was assessed. Global cognitive function was tested annually by 19 tests. Data were analyzed using the linear mixed-effects models and mediation analysis.Results: At baseline, FGCRS ranged from 4 to 28 (mean score: 15.6 ± 3.7). Over the follow-up (median: 5.3 years; interquartile range: 2.9–9.0 years), in multi-adjusted mixed-effects models, the highest FGCRS was associated with faster decline in global motor function (β = −0.0038; 95% confidence interval [CI]: −0.0069 to −0.0008), dexterity (β = −0.0056; 95% CI: −0.0093 to −0.0020), gait (β = −0.0039; 95% CI: −0.0077 to −0.0001), and hand strength (β = −0.0053; 95% CI: −0.0098 to −0.0008) compared with the lowest tertile. In mediation analysis, CVDs accumulation and cognitive decline mediated 8.4% and 42.9% of the association between FGCRS and global motor function over time, respectively.Conclusion: Higher cardiovascular risk burden is associated with a faster decline in motor function including dexterity, gait, and hand strength. CVDs accumulation and cognitive decline may partially mediate the association between cardiovascular risk burden and global motor function decline.
|
|
