| 1. |
- Li, Shu, et al.
(författare)
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Comparative efficacy and safety of urate-lowering therapy for the treatment of hyperuricemia : a systematic review and network meta-analysis
- 2016
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Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- The prevalence of hyperuricemia and gout has been increasing, but the comparative effectiveness and safety of different treatments remain uncertain. We aimed to compare the effectiveness and safety of different treatments for hyperuricemia using network meta-analysis methodology. We systematically reviewed fifteen randomized controlled trials (involving 7,246 patients through January 2016) that compared the effects of different urate-lowering drugs (allopurinol, benzbromarone, febuxostat, pegloticase and probenecid) on hyperuricemia. Drug efficacy and safety, as outcomes, were measured by whether the target level of serum urate acid was achieved and whether any adverse events occurred, respectively. We derived pooled effect sizes expressed as odds ratios (ORs) and 95% confidence intervals (CIs). The efficacy and safety of the drugs were ranked by cumulative ranking probabilities. Our findings show that febuxostat, benzbromarone, probenecid, pegloticase, and allopurinol were all highly effective at reducing the risk of hyperuricemia compared to placebo. Febuxostat had the best efficacy and safety compared to the other drugs. Furthermore, febuxostat 120 mg QD was more effective at achieving urate-lowering targets (OR: 0.17, 95% CI: 0.12-0.24) and safer (OR: 0.72, 95% CI: 0.56-0.91) than allopurinol.
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| 2. |
- Yang, Rongrong, et al.
(författare)
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A low-inflammatory diet is associated with a lower incidence of diabetes : role of diabetes-related genetic risk
- 2023
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Ingår i: BMC Medicine. - 1741-7015. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Whether a low-inflammatory diet relates to type 2 diabetes risk remains unclear. We examined the association between a low-inflammatory diet and risk of type 2 diabetes among normoglycemic and prediabetic participants. We also explored whether a low-inflammatory diet modifies genetic risk for type 2 diabetes.Methods: Among 142,271 diabetes-free UK Biobank participants (aged 39-72 years), 126,203 were normoglycemic and 16,068 were prediabetic at baseline. Participants were followed for up to 15 years to detect incident type 2 diabetes. At baseline, dietary intake was assessed with a 24-h dietary record. An inflammatory diet index (IDI) was generated based on high-sensitivity C-reactive protein levels and was a weighted sum of 34 food groups (16 anti-inflammatory and 18 pro-inflammatory). Participants were grouped into tertiles corresponding to inflammatory level (low, moderate, and high) based on IDI scores. Prediabetes at baseline was defined as HbA1c 5.7-6.4% in diabetes-free participants. Incident type 2 diabetes and age of onset were ascertained according to the earliest recorded date of type 2 diabetes in the Primary Care and Hospital inpatient data. A diabetes-related genetic risk score (GRS) was calculated using 424 single-nucleotide polymorphisms. Data were analyzed using Cox regression and Laplace regression.Results: During follow-up (median 8.40 years, interquartile range 6.89 to 11.02 years), 3348 (2.4%) participants in the normoglycemia group and 2496 (15.5%) in the prediabetes group developed type 2 diabetes. Type 2 diabetes risk was lower in normoglycemic (hazard ratio [HR] = 0.71, 95% confidence interval [CI] 0.65, 0.78) and prediabetic (HR = 0.81, 95% CI 0.73, 0.89) participants with low IDI scores compared to those with high IDI scores. A low-inflammatory diet may prolong type 2 diabetes onset by 2.20 (95% CI 1.67, 2.72) years among participants with normoglycemia and 1.11 (95% CI 0.59, 1.63) years among participants with prediabetes. In joint effect analyses, normoglycemic or prediabetes participants with low genetic predisposition to type 2 diabetes and low IDI scores had a significant 74% (HR = 0.26, 95% CI 0.21, 0.32) or 51% (HR = 0.49, 95% CI 0.40, 0.59) reduction in type 2 diabetes risk compared to those with high genetic risk plus high IDI scores. There were significant additive and multiplicative interactions between IDI and GRS in relation to type 2 diabetes risk in the normoglycemia group.ConclusionsA low-inflammatory diet is associated with a decreased risk of type 2 diabetes and may delay type 2 diabetes onset among participants with normal blood glucose or prediabetes. A low-inflammatory diet might significantly mitigate the risk of genetic factors on type 2 diabetes development.
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| 3. |
- Zhang, Yuan, et al.
(författare)
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Healthy lifestyle counteracts the risk effect of genetic factors on incident gout : a large population-based longitudinal study
- 2022
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Ingår i: BMC Medicine. - : Springer Science and Business Media LLC. - 1741-7015. ; 20:1
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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.
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| 4. |
- Cao, Zhi, et al.
(författare)
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Adherence to a healthy lifestyle counteracts the negative effects of risk factors on all-cause mortality in the oldest-old
- 2019
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Ingår i: Aging. - : Impact Journals, LLC. - 1945-4589. ; 11:18, s. 7605-7619
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Tidskriftsartikel (refereegranskat)abstract
- In the study, we examined the extent to which the harmful effects of risk factors on all-cause mortality can be counteracted by healthy lifestyle practices in the oldest-old (80 years of age and older). A total of 17,660 oldest-old from China were followed up for up to 10 years. The data were analyzed using the Cox proportional hazard model with adjustment for potential confounders. We found that having a rural residence, not being married, having lower economic status, physical disability, impaired cognitive function, or comorbidity were all associated with an elevated risk of mortality. Using these factors, we computed a weighted risk score. Because never smoking, never drinking, doing physical exercise, having an ideal diet, and a normal weight were independently associated with lower mortality, we also combined them to compute a weighted protection score. Both scores were divided into lowest, middle, and highest groups using their tertiles. In joint effect analyses, participants with the combined highest-risk score and lowest-protection score profile had a nearly threefold higher joint death risk. These analyses show that adherence to a healthy lifestyle counteracts the negative effect of risk factors on all-cause mortality in the oldest-old by more than 20%.
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| 5. |
- Cao, Zhi, et al.
(författare)
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Role of Cognitive Impairment, Physical Disability, and Chronic Conditions in the Association of Sleep Duration With All-Cause Mortality Among Very Old Adults
- 2020
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Ingår i: Journal of the American Medical Directors Association. - : Elsevier BV. - 1525-8610 .- 1538-9375. ; 21:10, s. 1458-1463
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This study aimed to examine the relationship between sleep duration and all-cause mortality, and to assess the role of cognitive impairment, physical disability, and chronic conditions on this association among very old adults.Design: A prospective cohort study.Setting and Participants: Within the Chinese Longitudinal Healthy Longevity Surveys, 17,637 oldest-old aged 80-105 years were followed up to 10 years (2005- 2014).Measures: Data on sleep duration at baseline were based on self-report and were categorized as short (<7 hour), moderate (7-9 hours), and long sleep (>9 hours). Information on cognitive function using the Mini-Mental State Examination (MMSE), physical disability using Activities of Daily Living (ADL), and chronic conditions including diabetes, heart disease, stroke, asthma, and cancer were collected at baseline based on a structured questionnaire. Information about vital status was ascertained and confirmed by a close family member or village doctor of the participant during the follow-up. Data were analyzed using Cox proportional hazards models, with adjustment for potential confounders.Results: During the follow-up of 10 years, 11,067 (62.7%) participants died. The multivariate-adjusted hazard ratios (HRs) with 95% confidence interval (CI) for mortality were 1.03 (0.98-1.09) for short sleep and 1.13 (1.08-1.18) for long sleep compared with moderate sleep duration. In stratified analysis by cognitive impairment, physical disability, and chronic conditions, the risk of morality was present only among people with MMSE scores <= 24 but did not differ much when stratified by physical disability and chronic conditions. There was a statistically significant interaction between long sleep and cognitive impairment on mortality (P for interaction = .002).Conclusions and Implications: Long sleep duration is associated with higher risk of mortality in very old adults independently of health conditions. Cognitive impairment may enhance this association. These findings suggest that health practitioners and families should be aware of the potential adverse prognosis associated with long sleep.
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| 6. |
- Guo, Jianqiu, et al.
(författare)
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Early life triclosan exposure and neurodevelopment of children at 3 years in a prospective birth cohort
- 2020
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Ingår i: International journal of hygiene and environmental health. - : Urban & Fischer. - 1438-4639 .- 1618-131X. ; 224
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Early life exposure to triclosan, an emerging endocrine disrupting chemical, may adversely impact childhood neurodevelopment, but limited epidemiologic studies have examined the associations.OBJECTIVE: We evaluated the associations between prenatal and postnatal triclosan exposure and child neurodevelopment at 3 years.METHODS: The study included 377 mother-child pairs who participated in Sheyang Mini Birth Cohort Study (SMBCS), a longitudinal birth cohort in China. Triclosan concentrations in maternal and 3-year-old child urine samples were quantified using gas chromatography-tandem mass spectrometry (GC-MS/MS). Gesell Developmental Schedules (GDS) were used to assess child neurodevelopment at 3 years of age. Multivariate linear regression models were applied to estimate associations of prenatal and postnatal urinary triclosan concentrations with children's developmental quotients (DQs).RESULTS: Detection frequencies of triclosan in maternal and childhood urine samples were 100% and 99.5%, respectively. The median values of prenatal and postnatal urinary triclosan levels were 0.65 and 0.44 μg/L, respectively. One ln-unit increase of maternal urinary triclosan concentration was associated with increase of DQ scores in motor area of children (regression coefficient, β = 0.28, 95% confidence interval, CI: 0.03, 0.54; p = 0.03). In sex-stratified analyses, maternal urinary triclosan levels were significantly related to increases in DQ scores in motor area among boys (β = 0.25, 95%CI: 0.01, 0.50; p = 0.04), while postnatal urinary triclosan concentrations were inversely associated with DQ scores in social area in boys (β = -0.37, 95%CI: -0.72, -0.03; p = 0.03).CONCLUSIONS: The findings suggested that prenatal triclosan exposure predicted increases in motor scores, while postnatal triclosan exposure was related to reductions in social scores of 3-year-old children. These associations were only observed in boys. The biological mechanisms linking triclosan exposure to neurodevelopment await further studies.
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| 7. |
- Li, Huiping, et al.
(författare)
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Association of comprehensive mental health with incident cardiovascular disease : A prospective cohort study
- 2022
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Ingår i: Journal of Affective Disorders. - : Elsevier BV. - 0165-0327. ; 298, s. 388-395
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Evidence is limited regarding the impact of comprehensive mental health on the risk of subsequent cardiovascular events.OBJECTIVES: To investigate the association of mental health status with cardiovascular disease (CVD) in the UK Biobank.METHODS: This prospective study included 339,616 participants aged 40 to 69 years who were enrolled between 2006 and 2010 and were followed up to 2020, without CVD at baseline. A mental health score was created using information about depressive symptoms, anxiety, loneliness, and neuroticism. Cardiovascular disease events ascertained through hospital inpatient. Cox models were used to estimate hazard ratios and 95% confidence intervals across mental health score.RESULTS: During a median follow-up of 11.3 years (3.7 million person-years), we documented 22,688 CVD cases including 18,460 CHD cases and 5,070 stroke cases (some individuals were diagnosed as having both CHD and stroke). A statistically significantly increased risk of incident CVD was observed for the four mental factors individually, with adjusted hazard ratios ranging from 1.03 to 1.44. The composite score of such four mental factors was also positively associated with CVD risk in a dose-response manner, with the highest scores associated with a 1.56-fold (95% confidence interval 1.47 to 1.65), 1.61-fold (1.51 to 1.72), and 1.44-fold (1.25 to 1.67) higher CVD, CHD, and stroke risk, respectively.CONCLUSIONS: In this large prospective study, poor mental health status was associated with an increased risk of CVD. Our results highlight the importance to jointly investigate the mental health factors in relation to the risk of CVD.
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| 8. |
- Li, Huiping, et al.
(författare)
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Association of Ultra-Processed Food Intake with Cardiovascular And Respiratory Disease Multimorbidity : A Prospective Cohort Study
- 2023
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Ingår i: Molecular Nutrition & Food Research. - : Wiley. - 1613-4133 .- 1613-4125. ; 67:11
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Tidskriftsartikel (refereegranskat)abstract
- SCOPE: Evidence suggests a positive association between ultra-processed food (UPF) consumption and the incidence of cardiovascular disease (CVD). We aimed to investigate associations between UPF intake and respiratory disease, CVD, and their multimorbidity in a large prospective cohort.METHODS AND RESULTS: Within the UK Biobank, participants who were free from respiratory disease or CVD at baseline and completed at least two times 24-h dietary records were included in this study. After adjusting for socioeconomic status and lifestyle factors, the hazard ratios (95% confidence interval) for each ten percent increase in UPF were 1.06 (1.04, 1.09) for CVD, 1.04 (1.02, 1.06) for respiratory disease, 1.15 (1.08, 1.22) for CVD mortality, and 1.06 (1.01, 1.12) for their multimorbidity, respectively. In addition, replacing 20% of UPF weight in diet with an equivalent proportion of unprocessed or minimally processed foods was estimated to be associated with 11% lower risk of CVD, 7% lower risk of respiratory disease, 25% lower risk of CVD mortality and 11% lower risk of CVD and respiratory disease multimorbidity.CONCLUSION: In this prospective cohort study, higher consumption of UPF was associated with higher risks of CVD and respiratory disease multimorbidity. Further longitudinal studies are needed to confirm our findings. This article is protected by copyright. All rights reserved.
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| 9. |
- Li, Huiping, et al.
(författare)
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Association of Ultraprocessed Food Consumption With Risk of Dementia : A Prospective Cohort
- 2022
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Ingår i: Neurology. - 1526-632X. ; 99:10, s. 1056-1066
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There has been a growing body of evidence associating consumption of ultra-processed foods (UPF) with adverse health outcomes including depression, cardiovascular disease, all-cause mortality. However, whether UPF are associated with dementia is unknown. The authors investigated the associations between UPF and dementia incidence in UK biobank.METHODS: We included 72,083 participants (55 years or older) who were free from dementia at baseline and provided at least two times 24-h dietary assessments from the UK Biobank study. Follow-up occurred through March 2021. UPF were defined according to the NOVA classification. Incident all-cause dementia comprising Alzheimer's disease and vascular dementia was ascertained through electronic linkages to hospital and mortality records. Cox proportional hazards were used to estimate the association between the proportion (%) of UPF in the diet and the subsequent risk of dementia. In addition, substitution analysis was used to estimate the risk of dementia when substituting UPF with an equivalent proportion of unprocessed or minimally processed foods.RESULTS: During a total of 717,333 person-years of follow-up (median 10.0 years), 518 participants developed dementia, of which 287 developed Alzheimer's disease and 119 developed vascular dementia. In the fully adjusted model, consumption of UPF was associated with higher risk of dementia (hazard ratio (HR) for 10% increase in UPF: 1.25; 95% confidence interval (CI): 1.14, 1.37), Alzheimer's disease (HR: 1.14; 95% CI: 1.00, 1.30) and vascular dementia (HR: 1.28; 95% CI: 1.06, 1.55), respectively. In addition, replacing 10% of UPF weight in diet with an equivalent proportion of unprocessed or minimally processed foods was estimated to be associated with a 19% lower risk of dementia (HR: 0.81; 95% CI: 0.74, 0.89).CONCLUSIONS: In this prospective cohort study, higher consumption of UPF was associated with higher risk of dementia, while substituting unpr2ocessed or minimally processed foods for UPF was associated lower risk of dementia.
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| 10. |
- Lin, Jing, et al.
(författare)
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Association of time spent in outdoor light and genetic susceptibility with the risk of type 2 diabetes
- 2023
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Ingår i: Science of the Total Environment. - 0048-9697 .- 1879-1026. ; 888
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Tidskriftsartikel (refereegranskat)abstract
- To explore the joint association of time spent in outdoor light and genetic susceptibility with the risk of type 2 diabetes (T2D). A total of 395,809 individuals of European ancestry with diabetes-free at baseline in the UK Biobank were in-cluded. Time spent in outdoor light on a typical day in summer or winter was obtained from the questionnaire. T2D genetic risk was quantified via the polygenic risk score (PRS) and divided into three levels based on tertiles (lower, in-termediate, and higher). T2D cases were ascertained according to the hospital records of diagnoses. After the median follow-up of 12.55 years, the association of outdoor light time and T2D risk demonstrated a nonlinear (J-shaped) trend. Compared to individuals with an average of 1.5-2.5 h/day of outdoor light, individuals who spent <1.5 h/ day or >2.5 h/day in outdoor light both had an elevated risk of T2D, and the risk of T2D related to <1.5 h/day outdoor light time was much higher (hazard ratio [HR] = 1.10, 95 % confidence interval [CI]: 1.06 to 1.15). After combining with PRS, in comparison with the lower PRS - average 1.5-2.5 h/day outdoor light group (reference), the higher PRS - <1.5 h/day outdoor light group had the highest T2D risk (HR = 2.74, 95 % CI: 2.55 to 2.94), the higher PRS - >2.5 h/ day outdoor light group also had a higher risk of T2D (HR = 2.58, 95 % CI: 2.43 to 2.74). The interaction between average outdoor light time and genetic susceptibility for T2D was statistically significant (Paverage for interaction <0.001). We found that optimal outdoor light time may modify the genetic risk for T2D. This suggests the T2D risk related to genetic factors could be prevented by spending optimal outdoor light time.
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