| 21. |
- Mehlig, Kirsten, 1964, et al.
(författare)
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Physical Activity, Weight Status, Diabetes and Dementia: A 34-Year Follow-Up of the Population Study of Women in Gothenburg
- 2014
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Ingår i: Neuroepidemiology. - : S. Karger AG. - 0251-5350 .- 1423-0208. ; 42:4, s. 252-259
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is evidence of a synergistic interaction between obesity and sedentary lifestyle with respect to diabetes. Although diabetes is a known risk factor for dementia, it is unclear if both diseases have common aetiologies. Methods: A community-based sample of 1,448 Swedish women, aged 38-60 years and free of diabetes and dementia in 1968, was followed by means of up to 5 examinations spread over 34 years. 9.6% of all women developed diabetes and 11.4% developed dementia (over 40,000 person-years of follow-up for each disease). Cox proportional hazard regression was used to assess the influence of selected risk factors on both diseases, and the relation between diabetes and dementia. Results: Comparing risk factors for incident diabetes and dementia, both diseases showed a synergistic association with obesity combined with a low level of leisure time physical activity [hazard ratio (HR) for interaction = 2.7, 95% confidence interval (Cl) = 1.2-6.3 for diabetes and HR = 3.3, 95% Cl = 1.1-9.9 for dementia]. Development of diabetes doubled the risk for subsequent dementia (HR = 2.2, 95% Cl = 1.1-4.4), which was slightly reduced upon adjustment for common risk factors. Conclusions: Shared risk factors suggest a similar aetiology for diabetes and dementia and partially explain the association between diseases. (C) 2014 S. Karger AG, Basel
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| 22. |
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| 23. |
- Miao Jonasson, Junmei
(författare)
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Epidemiological studies on complications in type 1 diabetes
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The main threat to the health of patients with type 1 diabetes (T1DM) is its complications. This thesis aimed to assess the risks of hip fracture, non-trauma lower extremity amputation (LEA) and myocardial infarction in patients with T1DM as well as the fertility in women with T1DM. In the Swedish Inpatient Register, we identified a population-based cohort of T1DM patients who were first hospitalized for diabetes before age 31. Follow-up for outcomes of interest was done through cross-linkage of the Inpatient Register or linkage to the Causes of Death, Multi-Generation or Medical Birth Register. Standardized Hospitalization / Incidence / Fertility Ratios (SHRs, SIRs and SFRs) with 95% Confidence Interval (CI), were used to estimate relative rates. Poisson Regression modeling was used to compare the relative effects of the SHRs/SIRs/SFRs and the risk of LEAs in different calendar periods. The Kaplan-Meier method was used to estimate the cumulative probability of the outcome of interest. Compared with the general population, more than 7-fold and 9-fold excess risks for hip fracture were observed in men and women, respectively. The cumulative probability of hip fracture was 6.58% until age 65. The risk of LEAs had decreased by 40% in the most recent calendar period (2000-2004) compared to the previous period. However, these patients still had an extremely high risk compared with the general population. By the age of 65, the cumulative probability of a LEA was 11.0% for women, and 20.7% for men. The SIRs for myocardial infarction among T1DM patients decreased from 32.3 for the period 1975-1984 to 15.3 for 1985-1994, and then decreased further to 9.7 for 1995-2004. The relative risk during the follow-up period 1995-2004 decreased by 50% compared to 1975-1984. Similar trends were observed for men and women, non-fatal and fatal myocardial infarction, although excess risks were notable for fatal myocardial infarction in women. No excess risk of myocardial infarction was observed for their non-DM brothers, while a modest excess risk was noted for their non-DM sisters. At age 65 the cumulative probability of a myocardial infarction was 28% for T1DM patients, while the corresponding figure for their non-T1DM siblings was 6%. The presence of diabetes complications conferred much higher risks for hip fracture, non-trauma LEAs and myocardial infarction. Reduced fertility was confined to women first hospitalized before 1985 and a normalization of fertility was observed in women who were first hospitalized after 1985. The presence of diabetes complications was associated with subfertility in all calendar-year strata. The proportions of newborns with congenital malformations decreased from 11.7% during 1973 1984 to 6.9% during 1995 2004, but were still higher compared to that of the women in the general Swedish population. In conclusion, although relative risks for myocardial infarction, non-trauma LEAs decreased markedly with time and also fertility normalized in recent period, T1DM patients are still at increased risk for these complications, especially among those with diabetes complications. Better treatment of hyper-glycemia and hyper-lipidemia as well as hypertension are most probably the cause of the reduced risks. Effective early preventive programs should be further designed and implemented.
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| 24. |
- Miao Jonasson, Junmei, 1972, et al.
(författare)
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Excess Body Weight and Cancer Risk in Patients with Type 2 Diabetes Who Were Registered in Swedish National Diabetes Register - Register-Based Cohort Study in Sweden
- 2014
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Ingår i: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 9:9
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To assess the association between excess body weight and cancer risk in patients with type 2 diabetes (T2D) who were registered in the Swedish National Diabetes Register (NDR). Methods: This is a cohort study based on 25,268 patients with T2D and baseline BMI >= 18.5 kg/m(2) from NDR 1997-1999. Subjects were grouped according to BMI into normal weight (18.5 to 24.9), overweight (25 to 29.9) or obesity (30 or more). All subjects were followed until the first occurrence of cancer, or death, or the end of follow-up (December 31, 2009). Adjusted hazard ratios (HRs) and 95% confidence interval (CI) for cancer risks were estimated by Cox regression. Results: In men with T2D, overweight was associated with increased risks of all cancer [1.13 (1.02-1.27)], gastrointestinal cancer [1.34 (1.07-1.72)] and colorectal cancer [1.59 (1.18-2.13)]; obesity was related to higher risks of all cancer [1.17 (1.04-1.33)], gastrointestinal cancer [1.40 (1.08-1.82)] and colorectal cancer [1.62 (1.17-2.24)]. In women with T2D, obesity was associated with increased risk of all cancer [1.30 (1.12-1.51)], gastrointestinal cancer [1.40 (1.03-1.91)] and postmenopausal breast cancer [1.39 (1.00-1.91)]. Conclusions: Excess body weight was associated with increased risks of all cancer, gastrointestinal cancer and colorectal cancer in men with T2D. Obesity was related with elevated risks of all cancer, gestational cancer and postmenopausal breast cancer in women with T2D.
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| 25. |
- Miao Jonasson, Junmei, 1972, et al.
(författare)
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HbA1C and Cancer Risk in Patients with Type 2 Diabetes - A Nationwide Population-Based Prospective Cohort Study in Sweden
- 2012
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Ingår i: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 7:6
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Tidskriftsartikel (refereegranskat)abstract
- Background: Diabetes is associated with increased cancer risk. The underlying mechanisms remain unclear. Hyperglycemia might be one risk factor. HbA1c is an indicator of the blood glucose level over the latest 1 to 3 months. This study aimed to investigate association between HbA1c level and cancer risks in patients with type 2 diabetes based on real life situations. Methods: This is a cohort study on 25,476 patients with type 2 diabetes registered in the Swedish National Diabetes Register from 1997-1999 and followed until 2009. Follow-up for cancer was accomplished through register linkage. We calculated incidences of and hazard ratios (HR) for cancer in groups categorized by HbA1c <= 58 mmol/mol (7.5%) versus >58 mmol/mol, by quartiles of HbA1c, and by HbA1c continuously at Cox regression, with covariance adjustment for age, sex, diabetes duration, smoking and insulin treatment, or adjusting with a propensity score. Results: Comparing HbA1c >58 mmol/mol with <= 58 mmol/mol, adjusted HR for all cancer was 1.02 [95% CI 0.95-1.10] using baseline HbA1c, and 1.04 [95% CI 0.97-1.12] using updated mean HbA1c, and HRs were all non-significant for specific cancers of gastrointestinal, kidney and urinary organs, respiratory organs, female genital organs, breast or prostate. Similarly, no increased risks of all cancer or the specific types of cancer were found with higher quartiles of baseline or updated mean HbA1c, compared to the lowest quartile. HR for all cancer was 1.01 [0.98-1.04] per 1%-unit increase in HbA1c used as a continuous variable, with non-significant HRs also for the specific types of cancer per unit increase in HbA1c. Conclusions: In this study there were no associations between HbA1c and risks for all cancers or specific types of cancer in patients with type 2 diabetes.
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| 26. |
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| 27. |
- Miao Jonasson, Junmei, 1972, et al.
(författare)
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Personality traits and the risk of coronary heart disease or stroke in women with diabetes - an epidemiological study based on the Women's Health Initiative.
- 2019
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Ingår i: Menopause. - 1530-0374. ; 26:10, s. 1117-24
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Tidskriftsartikel (refereegranskat)abstract
- We studied the associations between personality traits and the risk of coronary heart disease (CHD) or stroke in women with diabetes.From the Women's Health Initiative, 15,029 women aged 50 to 79 years at enrollment and with self-reported treated diabetes at baseline or follow-up, were followed for a mean of 10 years. Personality traits measured from validated scales included hostility, optimism, ambivalence over emotional expressiveness, and negative emotional expressiveness. Multivariable Cox proportional-hazards regression models were used to examine associations between personality traits and the risk of adjudicated CHD (nonfatal myocardial infarction and CHD death) or stroke outcomes. Progressively adjusted regression approach was used in the multivariable models to adjust for demographics, depression, anthropometric variables, and lifestyle factors.A total of 1,118 incident CHD and 710 incident stroke cases were observed. Women in the highest quartile of hostility had 22% (hazard ratio [HR] 1.22, 95% confidence interval [CI] 1.01-1.48) increased risk for CHD compared with women in the lowest quartile of hostility. P values for trend were greater than 0.05. Stratified analysis by prevalent or incident diabetes showed that the highest quartile of hostility had 34% increased risk for CHD (HR 1.34, 95% CI 1.03-1.74) among women with incident diabetes. Other personality traits were not significantly associated with stroke or CHD.Hostility was associated with incidence of CHD among postmenopausal women with diabetes, especially among incident diabetes. These results provide a basis for targeted prevention programs for women with a high level of hostility and diabetes.
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| 28. |
- Miao Jonasson, Junmei, 1972, et al.
(författare)
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Social Support, Social Network Size, Social Strain, Stressful Life Events, and Coronary Heart Disease in Women With Type 2 Diabetes: A Cohort Study Based on the Women's Health Initiative
- 2020
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Ingår i: Diabetes care. - : American Diabetes Association. - 0149-5992 .- 1935-5548. ; 43:8, s. 1759-1766
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE We studied associations between social support, social network size, social strain, or stressful life events and risk of coronary heart disease (CHD) in postmenopausal women with type 2 diabetes. RESEARCH DESIGN AND METHODS From the Women's Health Initiative, 5,262 postmenopausal women with type 2 diabetes at baseline were included. Cox proportional hazards regression models adjusted for demographics, depressive symptoms, anthropometric variables, and lifestyle factors were used to examine associations between social factors and CHD. RESULTS A total of 672 case subjects with CHD were observed during an average 12.79 (SD 6.29) years of follow-up. There was a significant linear trend toward higher risk of CHD as the number of stressful life events increased (Pfor trend = 0.01; hazard ratio [HR] [95% CI] for the third and fourth quartiles compared with first quartile: 1.27 [1.03-1.56] and 1.30 [1.04-1.64]). Being married or in an intimate relationship was related to decreased risk of CHD (HR 0.82 [95% CI 0.69-0.97]). CONCLUSIONS Among postmenopausal women with type 2 diabetes, higher levels of stressful life events were associated with higher risk of CHD. Experience of stressful life events might be considered as a risk factor for CHD among women with type 2 diabetes.
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| 29. |
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| 30. |
- Nemes, Szilard, 1977, et al.
(författare)
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A diagnostic algorithm to identify paired tumors with clonal origin.
- 2013
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Ingår i: Genes, chromosomes & cancer. - : Wiley. - 1098-2264 .- 1045-2257. ; 52:11, s. 1007-16
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Tidskriftsartikel (refereegranskat)abstract
- Despite practical implications we still lack standardized methods for clonality testing of tumor pairs. Each tumor is characterized by a set of chromosomal abnormalities, nonrandom changes preferentially involving specific chromosomes and chromosomal regions. Although tumors accumulate chromosomal abnormalities during their development, the majority of these alterations is specific and characteristic for each individual tumor is not exhibited at the population level. Assumingly, secondary tumors that develop from disseminated cells from the primary tumor inherit not only chromosomal changes specific for the cancerous process but also random chromosomal changes that accumulate during tumor development. Based on this assumption, we adopted an intuitive index for genomic similarities of paired tumors, which ranges between zero (completely different genomic profiles) and one (identical genomic profiles). To test the assumption that two tumors have clonal origins if they share a higher degree of genomic similarity than two randomly paired tumors, we built a permutation-based null-hypothesis procedure. The procedure is demonstrated using two publicly available data sets. The article highlights the complexities of clonality testing and aims to offer an easy to follow blueprint that will allow researchers to test genomic similarities of paired tumors, with the proposed index or any other index that fits their need. © 2013 Wiley Periodicals, Inc.
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