Folic acid supplement use and menstrual cycle characteristics: a cross-sectional study of Danish pregnancy planners.

PURPOSE: To examine the association between folic acid (FA) supplementation obtained through either single FA tablets or multivitamins (MVs) and menstrual cycle characteristics among 5386 women aged 18-40 years, enrolled in an Internet-based study of Danish women attempting pregnancy during 2007-2011. METHODS: In a cross-sectional study, we used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations of FA supplementation with menstrual cycle regularity; short (<27 days), long (30-33 days), and very long (≥34 days) cycle lengths; and duration and intensity of menstrual bleeding. RESULTS: Compared with nonuse, FA supplementation was associated with reduced odds of short cycle length (OR = 0.80, 95% CI: 0.68-0.94) and a trend toward increased odds of very long cycle length (OR = 1.21, 95% CI: 0.87-1.68) compared with cycle length of 27-29 days. The inverse association with short cycle length was stronger among 18- to 30-year-old women (OR = 0.68, 95% CI: 0.53-0.87), nulliparous women (OR = 0.66, 95% CI: 0.52-0.84), and women who used both FA and MVs (OR = 0.75, 95% CI: 0.60-0.95). We found no clear association between FA supplementation and cycle regularity and duration and intensity of menstrual bleeding. CONCLUSIONS: FA supplementation was inversely associated with short menstrual cycle length. This association was strongest among women aged 18-30 years, nulliparous women, and women who used both FA and MVs.

Long-term outcome of sirolimus-eluting and zotarolimus-eluting coronary stent implantation in patients with and without diabetes mellitus (a Danish organization for randomized trials on clinical outcome III substudy).

We compared 5-year clinical outcomes in diabetic and nondiabetic patients treated with Endeavor zotarolimus-eluting stents (ZESs; Endeavor Sprint, Medtronic, Santa Rosa, California) or Cypher sirolimus-eluting stents (SESs; Cordis, Johnson & Johnson, Warren, New Jersey) coronary implantation. We randomized 2,332 patients to either ZESs (n = 1,162, n = 169 diabetic patients) or SESs (n = 1,170, n = 168 diabetic patients) stratified according to presence or absence of diabetes mellitus. End points included major adverse cardiac event (MACE), a composite of cardiac death, myocardial infarction, target vessel revascularization (TVR), and definite stent thrombosis. Among diabetic patients, MACE occurred more frequently in patients treated with ZESs than SESs (48 [28.4%] vs 31 [18.5%]; odds ratio [OR] 1.75, 95% confidence interval [CI] 1.05 to 2.93, p = 0.032) because of a higher rate of TVR (32 [18.9%] vs 14 [8.3%]; OR 2.57, 95% CI 1.32 to 5.02, p = 0.006). Among nondiabetic patients, ZES and SES had similar MACE rates at 5-year follow-up but SES was associated with a significantly higher risk of definite stent thrombosis (10 [1.0%] vs 23 [2.3%]; OR 0.43, 95% CI 0.20 to 0.91, p = 0.028). Moreover, during the last 4 years, ZES had fewer MACE, TVR, and stent thrombosis events among nondiabetic patients. In conclusion, SES remains superior to ZES in patients with diabetes throughout the 5-year follow-up, however, among nondiabetic patients, SES demonstrated a highly dynamic performance with favorable initial results followed by a late catch-up that included an overall higher risk of stent thrombosis.

Manganese superoxide dismutase and breast cancer recurrence: a Danish clinical registry-based case-control study, and a meta-analysis.

BACKGROUND: Manganese superoxide dismutase (MnSOD) inhibits oxidative damage and cancer therapy effectiveness. A polymorphism in its encoding gene (SOD2: Val16Ala rs4880) may confer poorer breast cancer survival, but data are inconsistent. We examined the association of SOD2 genotype and breast cancer recurrence (BCR) among patients treated with cyclophosphamide-based chemotherapy (Cyclo). We compared our findings with published studies using meta-analyses. METHODS: We conducted a population-based case-control study of BCR among women in Jutland, Denmark. Subjects were diagnosed with non-metastatic breast cancer from 1990-2001, received adjuvant Cyclo, and were registered in the Danish Breast Cancer Cooperative Group. We identified 118 patients with BCR and 213 matched breast cancer controls. We genotyped SOD2 and used conditional logistic regression to compute the odds ratio (OR) and associated 95% confidence intervals (95% CI) of BCR. We used random-effects meta-analytic models to evaluate the association of SOD2 polymorphisms and BCR. RESULTS: The frequency of the SOD2-Ala allele was 70% in cases versus 71% in controls; 40% versus 44% were heterozygotes, and 30% versus 25% were homozygotes, respectively. Heterozygote and homozygote carriers of the Ala allele had no increased rate of BCR (OR = 1.1, 95%CI = 0.65, 2.0, and OR = 0.87, 95%CI = 0.47, 1.6, respectively). Five studies informed the meta-analytic models; summary estimates associating BCR for homozygote, or any inheritance of the variant Ala allele were 1.18 (95%CI = 0.74, 1.88), and 1.18, (95%CI = 0.91, 1.54), respectively. CONCLUSION: Our findings do not suggest that MnSOD enzymatic activity, as measured by SOD2 genotype, affects rates of BCR among patients treated with Cyclo.

Variation in proportion of frequent attenders between Danish general practices.

AIM: The authors examined the inter-practice variation in the proportion of adult frequent attenders and whether practice factors may explain some of this variation. METHODS: A population-based cross-sectional study was performed on the basis of registers including 262 active general practices and their 419,072 registered adults aged 20 and over in the County of Aarhus, Denmark (630,000 inhabitants) from November 1997 to October 1998. The number of face-to-face daytime contacts with general practitioners was counted for each individual on the basis of data drawn from the files of the National Health Service. Frequent attenders were defined as the 10% most frequent attenders in the county over 12 months for each sex, and four age groups. Both the crude and standardized proportions of frequent attenders in each practice were calculated. Associations between practice factors and the frequent attender proportions were assessed from the squared partial correlation coefficients. RESULTS: The proportion of frequent attenders ranged from 1.9 to 26.2% (factor 13.8) (standardized: 1.6 to 27.8% (factor 17.4)) with 10th to 90th percentiles of 4.4 to 12.9% (factor 2.9) (standardized: 4.3 to 13.2% (factor 3.1)). A low standardized proportion of frequent attenders was statistically significantly associated with a high degree of urbanization, a large number of registered individuals per GP and female GP (multiple R(2) > 0.16 for all practices and 0.22 for solo practices). CONCLUSIONS: Variation in the proportion of frequent attenders was considerable between practices and about one-fifth of this variation could be explained by practice factors.

Predictive value and completeness of the registration of congenital abnormalities in three Danish population-based registries.

AIMS: The predictive value and completeness of data on congenital abnormalities (CAs) collected in three administrative health registries in the County of North Jutland, Denmark were compared. METHODS: The study included all singleton liveborn infants in the county during the period 1991-94 (n = 24,147). All infants recorded as having a CA in either the Medical Birth Registry (MBR), the Hospital Discharge Registry (HDR), or the National Registry of Congenital Abnormalities (NRCA) were identified, and the recordings in each registry were compared. Infants recorded in at least two registries were considered correctly diagnosed with a CA for the sake of the analyses. The predictive value was defined as the number of infants correctly diagnosed with a CA in the registry divided by the total number of infants recorded with a CA in the registry. In all cases with recording in one registry only, the predictive value of the registration with CA diagnosis was assessed through a review of a sample of medical records. The completeness was defined as the number of correctly diagnosed CAs in the registry divided by the total number of identified CAs. RESULTS: The predictive value and completeness were calculated as 89.1% (85.3-92.8) and 32.3% (28.9-35.7) in the MBR; 88.2% (85.9-90.5) and 89.9% (87.7-92.1) in the HDR; and 99.6% (98.9-100.0) and 36.0% (32.5-39.5) in the NRCA. CONCLUSIONS: The HDR seems to have a predictive value and completeness that are acceptable for general surveillance and epidemiological research regarding CAs. The NRCA may be suitable for case-control studies owing to a high predictive value.