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  • Föregående 12[3]4567...8Nästa
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21.
  • de Marco, Roberto, et al. (författare)
  • Risk Factors for Chronic Obstructive Pulmonary Disease in a European Cohort of Young Adults
  • 2011
  • Ingår i: American Journal of Respiratory and Critical Care Medicine. - 1073-449X .- 1535-4970. ; 183:7, s. 891-897
  • Tidskriftsartikel (refereegranskat)abstract
    • Rationale: Few studies have investigated the factors associated with the early inception of chronic obstructive pulmonary disease (COPD). Objectives: We investigated COPD risk factors in an international cohort of young adults using different spirometric definitions of the disease. Methods. We studied 4,636 subjects without asthma who had prebronchodilator FEV1/FVC measured in the European Community Respiratory Health Survey both in 1991 to 1993 (when they were 20-44 yr old) and in 1999 to 2002. COPD was defined according to the Global Initiative for Chronic Obstructive Lung Disease fixed cut-off criterion (FEV1/FVC < 0.70), and two criteria based on the Quanjer and LuftiBus reference equations (FEV1/FVC less than lower limit of normal). COPD determinants were studied using two-level Poisson regression models. Measurements and Main Results: COPD incidence ranged from 1.85 (lower limit of normal [Quanjer]) to 2.88 (Global Initiative for Chronic Obstructive Lung Disease) cases/1,000/yr. Although about half of the cases had smoked less than 20 pack-years, smoking was the main risk factor for COPD, and it accounted for 29 to 39% of the new cases during the follow-up. Airway hyperresponsiveness was the second strongest risk factor (15-17% of new cases). Other determinants were respiratory infections in childhood and a family history of asthma, whereas the role of sex, age, and of being underweight largely depended on the definition of COPD used. Conclusions: COPD may start early in life. Smoking prevention should be given the highest priority to reduce COPD occurrence. Airway hyperresponsiveness, a family history of asthma, and respiratory infections in childhood are other important determinants of COPD. We suggest the need for a definition of COPD that is not exclusively based on spirometry.
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22.
  • Di Cesare, Mariachiara, et al. (författare)
  • Trends in adult body-mass index in 200 countries from 1975 to 2014 : a pooled analysis of 1698 population-based measurement studies with 19.2 million participants
  • 2016
  • Ingår i: The Lancet. - : Elsevier. - 0140-6736 .- 1474-547X. ; 387:10026, s. 1377-1396
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Underweight and severe and morbid obesity are associated with highly elevated risks of adverse health outcomes. We estimated trends in mean body-mass index (BMI), which characterises its population distribution, and in the prevalences of a complete set of BMI categories for adults in all countries.Methods We analysed, with use of a consistent protocol, population-based studies that had measured height and weight in adults aged 18 years and older. We applied a Bayesian hierarchical model to these data to estimate trends from 1975 to 2014 in mean BMI and in the prevalences of BMI categories (<18.5 kg/m(2) [underweight], 18.5 kg/m(2) to <20 kg/m(2), 20 kg/m(2) to <25 kg/m(2), 25 kg/m(2) to <30 kg/m(2), 30 kg/m(2) to <35 kg/m(2), 35 kg/m(2) to <40 kg/m(2), = 40 kg/m(2) [morbid obesity]), by sex in 200 countries and territories, organised in 21 regions. We calculated the posterior probability of meeting the target of halting by 2025 the rise in obesity at its 2010 levels, if post-2000 trends continue.Findings We used 1698 population-based data sources, with more than 19.2 million adult participants (9.9 million men and 9.3 million women) in 186 of 200 countries for which estimates were made. Global age-standardised mean BMI increased from 21.7 kg/m(2) (95% credible interval 21.3-22.1) in 1975 to 24.2 kg/m(2) (24.0-24.4) in 2014 in men, and from 22.1 kg/m(2) (21.7-22.5) in 1975 to 24.4 kg/m(2) (24.2-24.6) in 2014 in women. Regional mean BMIs in 2014 for men ranged from 21.4 kg/m(2) in central Africa and south Asia to 29.2 kg/m(2) (28.6-29.8) in Polynesia and Micronesia; for women the range was from 21.8 kg/m(2) (21.4-22.3) in south Asia to 32.2 kg/m(2) (31.5-32.8) in Polynesia and Micronesia. Over these four decades, age-standardised global prevalence of underweight decreased from 13.8% (10.5-17.4) to 8.8% (7.4-10.3) in men and from 14.6% (11.6-17.9) to 9.7% (8.3-11.1) in women. South Asia had the highest prevalence of underweight in 2014, 23.4% (17.8-29.2) in men and 24.0% (18.9-29.3) in women. Age-standardised prevalence of obesity increased from 3.2% (2.4-4.1) in 1975 to 10.8% (9.7-12.0) in 2014 in men, and from 6.4% (5.1-7.8) to 14.9% (13.6-16.1) in women. 2.3% (2.0-2.7) of the world's men and 5.0% (4.4-5.6) of women were severely obese (ie, have BMI = 35 kg/m(2)). Globally, prevalence of morbid obesity was 0.64% (0.46-0.86) in men and 1.6% (1.3-1.9) in women.Interpretation If post-2000 trends continue, the probability of meeting the global obesity target is virtually zero. Rather, if these trends continue, by 2025, global obesity prevalence will reach 18% in men and surpass 21% in women; severe obesity will surpass 6% in men and 9% in women. Nonetheless, underweight remains prevalent in the world's poorest regions, especially in south Asia.
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23.
  • Dratva, Julia, et al. (författare)
  • Early Life Origins of Lung Ageing : Early Life Exposures and Lung Function Decline in Adulthood in Two European Cohorts Aged 28-73 Years
  • 2016
  • Ingår i: PLOS ONE. - 1932-6203. ; 11:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives Early life environment is essential for lung growth and maximally attained lung function. Whether early life exposures impact on lung function decline in adulthood, an indicator of lung ageing, has scarcely been studied. Methods Spirometry data from two time points (follow-up time 9-11 years) and information on early life exposures, health and life-style were available from 12862 persons aged 28-73 years participating in the European population-based cohorts SAPALDIA (n = 5705) and ECRHS (n = 7157). The associations of early life exposures with lung function (FEV1) decline were analysed using mixed-effects linear regression. Results Early life exposures were significantly associated with FEV1 decline, with estimates almost as large as personal smoking. FEV1 declined more rapidly among subjects born during the winter season (adjusted difference in FEV1/year of follow-up [95% CI] -2.04ml [-3.29;-0.80]), of older mothers, (-1.82 ml [-3.14;-0.49]) of smoking mothers (-1.82ml [-3.30;-0.34] or with younger siblings (-2.61ml [-3.85;-1.38]). Less rapid FEV1-decline was found in subjects who had attended daycare (3.98ml [2.78; 5.18]), and indicated in subjects with pets in childhood (0.97ml [-0.16; 2.09]). High maternal age and maternal smoking appeared to potentiate effects of personal smoking. The effects were independent of asthma at any age. Conclusion Early life factors predicted lung function decline decades later, suggesting that some mechanisms related lung ageing may be established early in life. Early life programming of susceptibility to adult insults could be a possible pathway that should be explored further.
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24.
  • Felix, Janine F, et al. (författare)
  • Genome-wide association analysis identifies three new susceptibility loci for childhood body mass index.
  • 2016
  • Ingår i: Human molecular genetics. - 1460-2083. ; 25:2, s. 389-403
  • Tidskriftsartikel (refereegranskat)abstract
    • A large number of genetic loci are associated with adult body mass index. However, the genetics of childhood body mass index are largely unknown. We performed a meta-analysis of genome-wide association studies of childhood body mass index, using sex- and age-adjusted standard deviation scores. We included 35 668 children from 20 studies in the discovery phase and 11 873 children from 13 studies in the replication phase. In total, 15 loci reached genome-wide significance (P-value < 5 × 10(-8)) in the joint discovery and replication analysis, of which 12 are previously identified loci in or close to ADCY3, GNPDA2, TMEM18, SEC16B, FAIM2, FTO, TFAP2B, TNNI3K, MC4R, GPR61, LMX1B and OLFM4 associated with adult body mass index or childhood obesity. We identified three novel loci: rs13253111 near ELP3, rs8092503 near RAB27B and rs13387838 near ADAM23. Per additional risk allele, body mass index increased 0.04 Standard Deviation Score (SDS) [Standard Error (SE) 0.007], 0.05 SDS (SE 0.008) and 0.14 SDS (SE 0.025), for rs13253111, rs8092503 and rs13387838, respectively. A genetic risk score combining all 15 SNPs showed that each additional average risk allele was associated with a 0.073 SDS (SE 0.011, P-value = 3.12 × 10(-10)) increase in childhood body mass index in a population of 1955 children. This risk score explained 2% of the variance in childhood body mass index. This study highlights the shared genetic background between childhood and adult body mass index and adds three novel loci. These loci likely represent age-related differences in strength of the associations with body mass index.
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25.
  • Gari, Merce, et al. (författare)
  • Impacts of atmospheric chlor-alkali factory emissions in surrounding populations
  • 2014
  • Ingår i: Environment International. - 0160-4120 .- 1873-6750. ; 65, s. 1-8
  • Tidskriftsartikel (refereegranskat)abstract
    • Environmental exposures need to be assessed for the understanding of the health risks of general population. Organochlorine compounds (OCs) from chlor-alkali plants (CAPs) are significant for the exposomes of individuals living in locations receiving their emissions and have to be determined. The aims of the study are to identify the area of influence of past and present OC emissions from CAPs and to set quantitative body burden estimates. A CAP situated in a rural area was selected for study. The geographic distribution of the atmospheric emissions was monitored using olive tree leaves. Human biomonitoring was assessed by serum analysis from general population (n = 1340). DC concentrations followed exponential decay functions with maxima in the immediate vicinity of the factory. The individuals living within 1 km exhibited hexachlorobenzene (HCB), polychlorobiphenyls (PCBs) and DDT-DDE (dichlorodiphenyltrichloroethane-dichlorodiphenyldichloroethylene) concentrations that were 12, 1.3-1.9 and 3.9 times higher than in sites not influenced by the emissions from this factory. Individuals from municipalities situated 15-25 km away from the CAP showed 1.5, 12-1.4 and 1.3 times higher serum HCB. PCB and DDT concentrations than in distant sites. The high serum concentrations of DDT and PCBs were observed even 23-31 years and 9-17 years after manufacture completion of these compounds, respectively. Our methodology provides a way for assessment of the influence of past and present atmospheric OCs emissions from CAPs into the exposome of individuals living in nearby areas.
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26.
  • Gómez Real, Francisco, et al. (författare)
  • Menstrual irregularity and asthma and lung function
  • 2007
  • Ingår i: Journal of Allergy and Clinical Immunology. - 0091-6749 .- 1097-6825. ; 120:3, s. 557-564
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Oligomenorrhea was associated with more asthma (Respiratory Health in Northern Europe study), but a possible association with lung function has not been investigated previously. Objective: To investigate whether oligomenorrhea was related to lung function and asthma, and whether body mass index and physical activity modified associations. Methods: Women age 28 to 44 years (n = 1631) participating in the European Community Respiratory Health Survey were included. Women who were taking exogenous sex hormones, were pregnant, or had recently given birth were excluded. Results: Long or irregular menstrual cycles were reported by 313 women (19%). Oligomenorrhea was significantly associated with more asthma symptoms (odds ratio [OR], 1.76; 95% CI, 1.29-2.40), allergic asthma (OR, 2.46; 95% CI, 1.43-4.23), and lower forced vital capacity (FVC; adjusted difference, 63 mL; 95% CI, -124 to -1). When excluding women using asthma medication, very lean women, or women exercising daily, these associations remained significant. Effects of oligomenorrhea were additive to those of body mass index (BMI) on asthma and FVC. Asthma symptoms increased significantly with BMI. FVC and FEV1 increased with BMI until 25 kg/m2 and thereafter decreased with increasing BMI. Excluding women exercising daily, asthma symptoms increased significantly with decreasing physical activity (OR, 1.09; 95% CI, 1.001-1.19) per category of physical activity) independently of oligomenorrhea. Among women exercising daily, oligomenorrhea predicted very high risk for asthma symptoms (OR, 12.6; 95% CI, 3.7-43). Conclusion: Women with oligomenorrhea have reduced lung function and more asthma, particularly allergic asthma, independent of BMI and physical activity. Airways pathology may have not only a hormonal but also a metabolic component. Clinical implications: Women with oligomenorrhea should be investigated with regard to asthma and lung function. Underlying metabolic disturbance should be considered in asthma.
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27.
  • Guerra, Stefano, et al. (författare)
  • Health-related quality of life and risk factors associated with spirometric restriction
  • 2017
  • Ingår i: European Respiratory Journal. - : The European Respiratory Society. - 0903-1936 .- 1399-3003. ; 49:5
  • Tidskriftsartikel (refereegranskat)abstract
    • The restrictive spirometric pattern is associated with a substantial morbidity and mortality burden. We sought to determine to what extent spirometric restriction is associated with impaired quality of life.We used data from two large population-based European cohorts: 6698 European Community Respiratory Health Survey (ECRHS) and 6069 Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults (SAPALDIA) adult participants. The restrictive pattern was defined as forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ≥lower limit of normal (LLN) and FVC 1/FVC In both cohorts, the restrictive pattern was associated with heavy smoking, being underweight or obese and the coexistence of respiratory symptoms. In univariate analyses, compared with the normal group, both the restrictive and obstructive pattern had significant Physical Component Summary deficits (−2.77 and −2.08, respectively, in ECRHS; −3.25 and −2.14, respectively, in SAPALDIA; all p-values <0.001). However, in models adjusted for sex, age, education, body mass index, smoking, comorbidities and respiratory symptoms, only the restrictive pattern remained significantly associated with Physical Component Summary deficits (p=0.004 in ECRHS; p=0.001 in SAPALDIA).The restrictive spirometric pattern is associated with deficits in the physical component of quality of life that are partly independent of the presence of respiratory symptoms.
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28.
  • Götschi, Thomas, et al. (författare)
  • Air pollution and lung function in the European Community Respiratory Health Survey.
  • 2008
  • Ingår i: International journal of epidemiology. - 1464-3685. ; 37:6, s. 1349-58
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: The association of long-term air pollution and lung function has not been studied across adult European multi-national populations before. The aim of this study was to determine the association between long-term urban background air pollution and lung function levels, as well as change in lung function among European adults. METHODS: Forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and the ratio thereof (FEV1/FVC) were assessed at baseline and after 9 years of follow-up in adults from 21 European centres (followed-up sample 5610). Fine particles (PM(2.5)) were measured in 2000/2001 using central monitors. RESULTS: Despite sufficient statistical power no significant associations were found between city-specific annual mean PM(2.5) and average lung function levels. The findings also do not support an effect on change in lung function, albeit statistical power was insufficient to significantly detect such an association. CONCLUSIONS: The inability to refuse the null hypothesis may reflect (i) no effect of urban air pollution on lung function or (ii) inherent biases due to the study design. Examples of the latter are lack of individual-level air quality assignment, not quantified within-city contrasts in traffic-related pollution, or the heterogeneity of the studied populations and their urban environments. Future studies on long-term effects of air pollution on lung function could increase statistical power and reduce potential misclassification and confounding by characterizing exposure on the level of individuals, capturing contrasts due to local sources, in particular traffic.
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29.
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30.
  • Götschi, Thomas, et al. (författare)
  • Elemental composition and reflectance of ambient fine particles at 21 European locations
  • 2005
  • Ingår i: Atmospheric Environment. - Oxford : Pergamon Press. - 1352-2310 .- 1873-2844. ; 39:32, s. 5947-5958
  • Tidskriftsartikel (refereegranskat)abstract
    • We sampled fine particles (PM2.5) over a 1-year period at 21 central urban monitoring sites in 20 cities of the European Community Respiratory Health Survey (ECRHS). Particle filters were then analysed for elemental composition using energy dispersive X-ray fluorescence spectrometry and reflectance (light absorption). Elemental analyses yielded valid results for 15 elements (Al, As, Br, Ca, Cl, Cu, Fe, K, Mn, Pb, S, Si, Ti, V, Zn). Annual and seasonal means Of PM2.5, reflectance, and elements show a wide range across Europe with the lowest levels found in Iceland and up to 80 times higher concentrations in Northern Italy. This pattern holds for most of the air pollution indicators. The mass concentration of S did constitute the largest fraction of the analysed elements Of PM2.5 in all locations. The crustal component varies from less than 10% up to 25% across these cities. Temporal correlations of daily values vary considerably from city to city, depending on the indicators compared. Nevertheless, correlations between estimates of long-term exposure, such as annual means, are generally high among indicators Of PM2.5 from anthropogenic sources, such as S, metals, and reflectance. This highlights the difficulty to disentangle effects of specific sources or PM constituents in future health effect analyses using annual averages.
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