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1.
Pharmacoepidemiol Drug Saf ; 32(3): 279-286, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36527437

RESUMO

PURPOSE: Studies of rare side effects of new drugs with limited exposure may require pooling of multiple data sources. Federated Analyses (FA) allow real-time, interactive, centralized statistical processing of individual-level data from different data sets without transfer of sensitive personal data. METHODS: We review IT-architecture, legal considerations, and statistical methods in FA, based on a Swedish Medical Products Agency methodological development project. RESULTS: In a review of all post-authorisation safety studies assessed by the EMA during 2019, 74% (20/27 studies) reported issues with lack of precision in spite of mean study periods of 9.3 years. FA could potentially improve precision in such studies. Depending on the statistical model, the federated approach can generate identical results to a standard analysis. FA may be particularly attractive for repeated collaborative projects where data is regularly updated. There are also important limitations. Detailed agreements between involved parties are strongly recommended to anticipate potential issues and conflicts, document a shared understanding of the project, and fully comply with legal obligations regarding ethics and data protection. FA do not remove the data harmonisation step, which remains essential and often cumbersome. Reliable support for technical integration with the local server architecture and security solutions is required. Common statistical methods are available, but adaptations may be required. CONCLUSIONS: Federated Analyses require competent and active involvement of all collaborating parties but have the potential to facilitate collaboration across institutional and national borders and improve the precision of postmarketing drug safety studies.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Fonte de Informação , Humanos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/etiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/prevenção & controle
2.
Mult Scler ; 25(4): 565-573, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-29521573

RESUMO

BACKGROUND: Treatment of multiple sclerosis (MS) with interferon ß can lead to the development of antibodies directed against interferon ß that interfere with treatment efficacy. Several observational studies have proposed different HLA alleles and genetic variants associated with the development of antibodies against interferon ß. OBJECTIVE: To validate the proposed genetic markers and to identify new markers. METHODS: Associations of genetic candidate markers with antibody presence and development were examined in a post hoc analysis in 941 patients treated with interferon ß-1b in the Betaferon® Efficacy Yielding Outcomes of a New Dose (BEYOND) and BEtaseron®/BEtaferon® in Newly Emerging multiple sclerosis For Initial Treatment (BENEFIT) prospective phase III trials. All patients were treated with interferon ß-1b for at least 6 months. In addition, a genome-wide association study was conducted to identify new genetic variants. RESULTS: We confirmed an increased risk for carriers of HLA-DRB1*04:01 (odds ratio (OR) = 3.3, p = 6.9 × 10-4) and HLA-DRB1*07:01 (OR = 1.8, p = 3.5 × 10-3) for developing neutralizing antibodies (NAbs). Several additional, previously proposed HLA alleles and genetic variants showed nominally significant associations. In the exploratory analysis, variants in the HLA region were associated with NAb development at genome-wide significance (OR = 2.6, p = 2.30 × 10-15). CONCLUSION: The contribution of HLA alleles and HLA-associated single-nucleotide polymorphisms (SNPs) to the development and titer of antibodies against interferon ß was confirmed in the combined analysis of two multi-national, multi-center studies.


Assuntos
Anticorpos Neutralizantes/imunologia , Cadeias HLA-DRB1/genética , Fatores Imunológicos/imunologia , Interferon beta-1b/imunologia , Esclerose Múltipla , Adulto , Feminino , Estudo de Associação Genômica Ampla , Humanos , Fatores Imunológicos/administração & dosagem , Interferon beta-1b/administração & dosagem , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/tratamento farmacológico , Esclerose Múltipla/genética , Esclerose Múltipla/imunologia , Esclerose Múltipla Recidivante-Remitente/tratamento farmacológico , Esclerose Múltipla Recidivante-Remitente/genética , Esclerose Múltipla Recidivante-Remitente/imunologia , Polimorfismo de Nucleotídeo Único , Estudos Prospectivos
3.
Nat Genet ; 48(2): 134-43, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26691988

RESUMO

Advanced age-related macular degeneration (AMD) is the leading cause of blindness in the elderly, with limited therapeutic options. Here we report on a study of >12 million variants, including 163,714 directly genotyped, mostly rare, protein-altering variants. Analyzing 16,144 patients and 17,832 controls, we identify 52 independently associated common and rare variants (P < 5 × 10(-8)) distributed across 34 loci. Although wet and dry AMD subtypes exhibit predominantly shared genetics, we identify the first genetic association signal specific to wet AMD, near MMP9 (difference P value = 4.1 × 10(-10)). Very rare coding variants (frequency <0.1%) in CFH, CFI and TIMP3 suggest causal roles for these genes, as does a splice variant in SLC16A8. Our results support the hypothesis that rare coding variants can pinpoint causal genes within known genetic loci and illustrate that applying the approach systematically to detect new loci requires extremely large sample sizes.


Assuntos
Estudo de Associação Genômica Ampla , Degeneração Macular/genética , Predisposição Genética para Doença , Humanos , Mutação
5.
Hum Mol Genet ; 23(11): 3054-68, 2014 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-24430505

RESUMO

Quantitative ultrasound of the heel captures heel bone properties that independently predict fracture risk and, with bone mineral density (BMD) assessed by X-ray (DXA), may be convenient alternatives for evaluating osteoporosis and fracture risk. We performed a meta-analysis of genome-wide association (GWA) studies to assess the genetic determinants of heel broadband ultrasound attenuation (BUA; n = 14 260), velocity of sound (VOS; n = 15 514) and BMD (n = 4566) in 13 discovery cohorts. Independent replication involved seven cohorts with GWA data (in silico n = 11 452) and new genotyping in 15 cohorts (de novo n = 24 902). In combined random effects, meta-analysis of the discovery and replication cohorts, nine single nucleotide polymorphisms (SNPs) had genome-wide significant (P < 5 × 10(-8)) associations with heel bone properties. Alongside SNPs within or near previously identified osteoporosis susceptibility genes including ESR1 (6q25.1: rs4869739, rs3020331, rs2982552), SPTBN1 (2p16.2: rs11898505), RSPO3 (6q22.33: rs7741021), WNT16 (7q31.31: rs2908007), DKK1 (10q21.1: rs7902708) and GPATCH1 (19q13.11: rs10416265), we identified a new locus on chromosome 11q14.2 (rs597319 close to TMEM135, a gene recently linked to osteoblastogenesis and longevity) significantly associated with both BUA and VOS (P < 8.23 × 10(-14)). In meta-analyses involving 25 cohorts with up to 14 985 fracture cases, six of 10 SNPs associated with heel bone properties at P < 5 × 10(-6) also had the expected direction of association with any fracture (P < 0.05), including three SNPs with P < 0.005: 6q22.33 (rs7741021), 7q31.31 (rs2908007) and 10q21.1 (rs7902708). In conclusion, this GWA study reveals the effect of several genes common to central DXA-derived BMD and heel ultrasound/DXA measures and points to a new genetic locus with potential implications for better understanding of osteoporosis pathophysiology.


Assuntos
Calcâneo/diagnóstico por imagem , Fraturas Ósseas/genética , Estudo de Associação Genômica Ampla , Osteoporose/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Densidade Óssea , Calcâneo/fisiologia , Estudos de Coortes , Feminino , Fraturas Ósseas/diagnóstico por imagem , Fraturas Ósseas/metabolismo , Fraturas Ósseas/fisiopatologia , Predisposição Genética para Doença , Humanos , Masculino , Pessoa de Meia-Idade , Osteoporose/diagnóstico por imagem , Osteoporose/metabolismo , Osteoporose/fisiopatologia , Polimorfismo de Nucleotídeo Único , Ultrassonografia , Adulto Jovem
6.
Arch Gynecol Obstet ; 289(1): 123-9, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23860692

RESUMO

PURPOSE: Work-life balance is an upcoming issue for physicians. The working group "Family and Career" of the German Society for Gynecology and Obstetrics (DGGG) designed a survey to reflect the present work-life balance of female and male gynecologists in Germany. METHODS: The 74-item, web-based survey "Profession-Family-Career" was sent to all members of the DGGG (n = 4,564). In total, there were 1,036 replies (23%) from 75% female gynecologists (n = 775) aged 38 ± 7 (mean ± standard deviation [SD]) years and 25% male (n = 261) gynecologists aged 48 ± 11 years. Statistical analyses were performed using the mean and SD for descriptive analysis. Regression models were performed considering an effect of p ≤ 0.05 as statistically significant. RESULTS: 47% women and 46% men reported satisfaction with their current work-life balance independent of gender (p(gender) = 0.15). 70% women and 75 % men answered that work life and private life were equally important to them (p(gender) = 0.12). While 39% women versus 11% men worked part-time (p gender < 0.0001), men reported more overtime work than women (p(gender) < 0.0001). 75 % physicians were not satisfied with their salary independent of gender (p(gender) = 0.057). Work life affected private life of men and women in a similar way (all p(gender) > 0.05). At least 37% women and men neglected both their partner and their children very often due to their work. CONCLUSIONS: Female physicians often described their work situation similar to male physicians, although important differences regarding total work time, overtime work and appreciation by supervisors were reported. Work life affected private life of women and men in a similar way.


Assuntos
Ginecologia , Satisfação no Emprego , Obstetrícia , Satisfação Pessoal , Médicos/psicologia , Qualidade de Vida/psicologia , Adulto , Emprego/psicologia , Família/psicologia , Feminino , Alemanha , Humanos , Internet , Masculino , Pessoa de Meia-Idade
7.
Artigo em Inglês | MEDLINE | ID: mdl-23984293

RESUMO

BACKGROUND: The high intake of game meat in populations with a subsistence-based diet may affect their blood lipids and health status. OBJECTIVE: To examine the association between diet and circulating levels of blood lipid levels in a northern Swedish population. STUDY DESIGN: We compared a group with traditional lifestyle (TLS) based on reindeer herding (TLS group) with those from the same area with a non-traditional lifestyle (NTLS) typical of more industrialized regions of Sweden (NTLS group). The analysis was based on self-reported intake of animal source food (i.e. non-game meat, game meat, fish, dairy products and eggs) and the serum blood level of a number of lipids [total cholesterol (TC), low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), triglycerides (TG), glycerophospholipids and sphingolipids]. RESULTS: The TLS group had higher cholesterol, LDL and HDL levels than the reference group. Of the TLS group, 65% had cholesterol levels above the threshold for increased risk of coronary heart disease (≥ 240 mg/dl), as compared to 38% of the NTLS group. Self-reported consumption of game meat was positively associated with TC and LDL. CONCLUSIONS: The high game meat consumption of the TLS group is associated with increased cholesterol levels. High intake of animal protein and fat and low fibre is known to increase the risk of cardiovascular disease, but other studies of the TLS in northern Sweden have shown comparable incidences of cardiovascular disease to the reference (NTLS) group from the same geographical area. This indicates that factors other than TC influence disease risk. One such possible factor is dietary phospholipids, which are also found in high amounts specifically in game meat and have been shown to inhibit cholesterol absorption.


Assuntos
Colesterol/sangue , Dieta/estatística & dados numéricos , Glicerofosfolipídeos/sangue , Carne/efeitos adversos , Esfingolipídeos/sangue , Animais , Animais Selvagens , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Atividade Motora , Fatores de Risco , Suécia/epidemiologia , Triglicerídeos/sangue
8.
Nat Genet ; 45(6): 621-31, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23583979

RESUMO

Elevated resting heart rate is associated with greater risk of cardiovascular disease and mortality. In a 2-stage meta-analysis of genome-wide association studies in up to 181,171 individuals, we identified 14 new loci associated with heart rate and confirmed associations with all 7 previously established loci. Experimental downregulation of gene expression in Drosophila melanogaster and Danio rerio identified 20 genes at 11 loci that are relevant for heart rate regulation and highlight a role for genes involved in signal transmission, embryonic cardiac development and the pathophysiology of dilated cardiomyopathy, congenital heart failure and/or sudden cardiac death. In addition, genetic susceptibility to increased heart rate is associated with altered cardiac conduction and reduced risk of sick sinus syndrome, and both heart rate-increasing and heart rate-decreasing variants associate with risk of atrial fibrillation. Our findings provide fresh insights into the mechanisms regulating heart rate and identify new therapeutic targets.


Assuntos
Arritmias Cardíacas/genética , Frequência Cardíaca/genética , Animais , Arritmias Cardíacas/fisiopatologia , Frequência do Gene , Loci Gênicos , Estudo de Associação Genômica Ampla , Sistema de Condução Cardíaco/fisiopatologia , Humanos , Redes e Vias Metabólicas , Polimorfismo de Nucleotídeo Único , Locos de Características Quantitativas
9.
PLoS Genet ; 8(7): e1002655, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22829771

RESUMO

Stature is a classical and highly heritable complex trait, with 80%-90% of variation explained by genetic factors. In recent years, genome-wide association studies (GWAS) have successfully identified many common additive variants influencing human height; however, little attention has been given to the potential role of recessive genetic effects. Here, we investigated genome-wide recessive effects by an analysis of inbreeding depression on adult height in over 35,000 people from 21 different population samples. We found a highly significant inverse association between height and genome-wide homozygosity, equivalent to a height reduction of up to 3 cm in the offspring of first cousins compared with the offspring of unrelated individuals, an effect which remained after controlling for the effects of socio-economic status, an important confounder (χ(2) = 83.89, df = 1; p = 5.2 × 10(-20)). There was, however, a high degree of heterogeneity among populations: whereas the direction of the effect was consistent across most population samples, the effect size differed significantly among populations. It is likely that this reflects true biological heterogeneity: whether or not an effect can be observed will depend on both the variance in homozygosity in the population and the chance inheritance of individual recessive genotypes. These results predict that multiple, rare, recessive variants influence human height. Although this exploratory work focuses on height alone, the methodology developed is generally applicable to heritable quantitative traits (QT), paving the way for an investigation into inbreeding effects, and therefore genetic architecture, on a range of QT of biomedical importance.


Assuntos
Estatura/genética , Consanguinidade , Genes Recessivos , Heterogeneidade Genética , Característica Quantitativa Herdável , Adulto , Idoso , Bases de Dados Genéticas , Família , Feminino , Estudo de Associação Genômica Ampla , Homozigoto , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único
10.
Am J Hum Genet ; 90(5): 809-20, 2012 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-22503634

RESUMO

Omega-3 and omega-6 long-chain polyunsaturated fatty acids (LC-PUFAs) are essential for the development and function of the human brain. They can be obtained directly from food, e.g., fish, or synthesized from precursor molecules found in vegetable oils. To determine the importance of genetic variability to fatty-acid biosynthesis, we studied FADS1 and FADS2, which encode rate-limiting enzymes for fatty-acid conversion. We performed genome-wide genotyping (n = 5,652 individuals) and targeted resequencing (n = 960 individuals) of the FADS region in five European population cohorts. We also analyzed available genomic data from human populations, archaic hominins, and more distant primates. Our results show that present-day humans have two common FADS haplotypes-defined by 28 closely linked SNPs across 38.9 kb-that differ dramatically in their ability to generate LC-PUFAs. No independent effects on FADS activity were seen for rare SNPs detected by targeted resequencing. The more efficient, evolutionarily derived haplotype appeared after the lineage split leading to modern humans and Neanderthals and shows evidence of positive selection. This human-specific haplotype increases the efficiency of synthesizing essential long-chain fatty acids from precursors and thereby might have provided an advantage in environments with limited access to dietary LC-PUFAs. In the modern world, this haplotype has been associated with lifestyle-related diseases, such as coronary artery disease.


Assuntos
Ácidos Graxos Dessaturases/genética , Ácidos Graxos Ômega-3/metabolismo , Ácidos Graxos Ômega-6/metabolismo , Haplótipos , Adaptação Fisiológica , Sequência de Aminoácidos , Animais , Croácia , Estudos Transversais , Dessaturase de Ácido Graxo Delta-5 , Dieta , Ácidos Graxos Dessaturases/metabolismo , Humanos , Itália , Estilo de Vida , Dados de Sequência Molecular , Família Multigênica , Homem de Neandertal , Filogeografia , Polimorfismo de Nucleotídeo Único , Fatores de Risco , Escócia , Análise de Sequência de DNA , Suécia , População Branca/genética
11.
PLoS Genet ; 8(2): e1002490, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22359512

RESUMO

Phospho- and sphingolipids are crucial cellular and intracellular compounds. These lipids are required for active transport, a number of enzymatic processes, membrane formation, and cell signalling. Disruption of their metabolism leads to several diseases, with diverse neurological, psychiatric, and metabolic consequences. A large number of phospholipid and sphingolipid species can be detected and measured in human plasma. We conducted a meta-analysis of five European family-based genome-wide association studies (N = 4034) on plasma levels of 24 sphingomyelins (SPM), 9 ceramides (CER), 57 phosphatidylcholines (PC), 20 lysophosphatidylcholines (LPC), 27 phosphatidylethanolamines (PE), and 16 PE-based plasmalogens (PLPE), as well as their proportions in each major class. This effort yielded 25 genome-wide significant loci for phospholipids (smallest P-value = 9.88×10(-204)) and 10 loci for sphingolipids (smallest P-value = 3.10×10(-57)). After a correction for multiple comparisons (P-value<2.2×10(-9)), we observed four novel loci significantly associated with phospholipids (PAQR9, AGPAT1, PKD2L1, PDXDC1) and two with sphingolipids (PLD2 and APOE) explaining up to 3.1% of the variance. Further analysis of the top findings with respect to within class molar proportions uncovered three additional loci for phospholipids (PNLIPRP2, PCDH20, and ABDH3) suggesting their involvement in either fatty acid elongation/saturation processes or fatty acid specific turnover mechanisms. Among those, 14 loci (KCNH7, AGPAT1, PNLIPRP2, SYT9, FADS1-2-3, DLG2, APOA1, ELOVL2, CDK17, LIPC, PDXDC1, PLD2, LASS4, and APOE) mapped into the glycerophospholipid and 12 loci (ILKAP, ITGA9, AGPAT1, FADS1-2-3, APOA1, PCDH20, LIPC, PDXDC1, SGPP1, APOE, LASS4, and PLD2) to the sphingolipid pathways. In large meta-analyses, associations between FADS1-2-3 and carotid intima media thickness, AGPAT1 and type 2 diabetes, and APOA1 and coronary artery disease were observed. In conclusion, our study identified nine novel phospho- and sphingolipid loci, substantially increasing our knowledge of the genetic basis for these traits.


Assuntos
Genoma Humano , Estudo de Associação Genômica Ampla , Fosfolipídeos , Esfingolipídeos , População Branca/genética , Espessura Intima-Media Carotídea , Bases de Dados Genéticas , Dessaturase de Ácido Graxo Delta-5 , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/genética , Loci Gênicos , Humanos , Fosfolipídeos/sangue , Fosfolipídeos/genética , Polimorfismo de Nucleotídeo Único , Esfingolipídeos/sangue , Esfingolipídeos/genética
12.
J Atten Disord ; 16(1): 13-22, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20686099

RESUMO

OBJECTIVE: To explore the associations of subtypes of adult ADHD with other psychiatric problems, stressful life events, and sex differences. METHOD: Odds ratios were calculated using information from 17,899 participants from a population-based survey of adult twins born in Sweden between 1959 and 1985. RESULTS: Symptoms of attention deficit hyperactivity disorder (ADHD) were associated with an increased risk for symptoms of (odds ratio [95% confidence interval]): generalized anxiety disorder (5.6 [4.3; 6.5]), major depression (2.8 [2.4; 3.2]), bipolar disorder (8.0 [5.1; 12.6]), obsessive-compulsive disorder (3.9 [3.1; 4.9]), and alcohol dependence (2.6 [2.2; 3.1]). Symptoms of ADHD were found to be associated with an increased risk for stressful life events (1.8 [1.3; 2.4]). No significant difference in comorbidity was observed between the two sexes. CONCLUSION: Both women and men with ADHD are at increased risk for symptoms of other psychiatric disorders. They are also at increased risk for stressful life events.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Doenças em Gêmeos/diagnóstico , Acontecimentos que Mudam a Vida , Estresse Psicológico/diagnóstico , Gêmeos/psicologia , Adulto , Alcoolismo/diagnóstico , Alcoolismo/epidemiologia , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Comorbidade , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/epidemiologia , Doenças em Gêmeos/epidemiologia , Doenças em Gêmeos/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Escalas de Graduação Psiquiátrica , Sistema de Registros , Risco , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Suécia
13.
Eur J Hum Genet ; 20(1): 77-83, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21811304

RESUMO

We have used targeted genomic sequencing of high-complexity DNA pools based on long-range PCR and deep DNA sequencing by the SOLiD technology. The method was used for sequencing of 286 kb from four chromosomal regions with quantitative trait loci (QTL) influencing blood plasma lipid and uric acid levels in DNA pools of 500 individuals from each of five European populations. The method shows very good precision in estimating allele frequencies as compared with individual genotyping of SNPs (r(2) = 0.95, P < 10(-16)). Validation shows that the method is able to identify novel SNPs and estimate their frequency in high-complexity DNA pools. In our five populations, 17% of all SNPs and 61% of structural variants are not available in the public databases. A large fraction of the novel variants show a limited geographic distribution, with 62% of the novel SNPs and 59% of novel structural variants being detected in only one of the populations. The large number of population-specific novel SNPs underscores the need for comprehensive sequencing of local populations in order to identify the causal variants of human traits.


Assuntos
Variação Estrutural do Genoma , Mutação INDEL , Polimorfismo de Nucleotídeo Único , Locos de Características Quantitativas , Análise de Sequência de DNA/métodos , Cromossomos Humanos/genética , Estudos de Coortes , Biologia Computacional , Frequência do Gene , Testes Genéticos/métodos , Genoma Humano , Genótipo , Proteínas Facilitadoras de Transporte de Glucose/genética , Humanos , Lipase/genética , Sensibilidade e Especificidade , Alinhamento de Sequência
14.
Arch Phys Med Rehabil ; 92(12): 2012-7, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22133250

RESUMO

OBJECTIVE: To validate a novel assessment of inpatient physical activity. DESIGN: Prospective cohort study for the evaluation of a novel questionnaire for physical activity in geriatric inpatients. SETTING: German geriatric inpatient rehabilitation unit. PARTICIPANTS: Patients (N=96; 67 [72%] women; median age, 81y) with a variety of main underlying diagnoses, including musculoskeletal diseases, hip fracture, cardiovascular diseases, stroke, and others. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Ceiling and floor effects and administration time were measured. For criterion-related concurrent validity (convergent and discriminative), the Physical Activity in Inpatient Rehabilitation Assessment (PAIR) was administered in parallel to self-rated, proxy-rated, and performance-based measures of physical function at admission. Measurements were repeated at discharge and 4-month follow-up in the home environment, including a standard physical activity questionnaire to determine predictive validity. Spearman correlation coefficients were calculated to describe associations between parameters. Sensitivity to change was estimated using standardized response means (SRMs). RESULTS: Administration time of the PAIR ranged from less than 1 to 4 minutes. Ceiling effects occurred mainly at discharge (5%-14%), and floor effects (5%-11%), at admission. There were no missing values. Associations between convergent and predictive validity measures and functional measures (r=.43-.53, r=.49-.54, respectively) were clearly better when cognition was intact. Discriminative validity expressed as effect sizes ranged from .27 to 1.44. The SRM to describe sensitivity to change was .65 for the total score. CONCLUSIONS: The PAIR is the first validated questionnaire to assess physical activity in geriatric inpatients. It is practical and its validity and sensitivity to change are similar to existing physical activity questionnaires for community-dwelling older persons.


Assuntos
Atividade Motora , Reabilitação , Inquéritos e Questionários , Idoso , Idoso de 80 Anos ou mais , Feminino , Indicadores Básicos de Saúde , Humanos , Masculino , Psicometria
15.
PLoS Genet ; 7(10): e1002333, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22028671

RESUMO

Recent genome-wide association (GWA) studies described 95 loci controlling serum lipid levels. These common variants explain ∼25% of the heritability of the phenotypes. To date, no unbiased screen for gene-environment interactions for circulating lipids has been reported. We screened for variants that modify the relationship between known epidemiological risk factors and circulating lipid levels in a meta-analysis of genome-wide association (GWA) data from 18 population-based cohorts with European ancestry (maximum N = 32,225). We collected 8 further cohorts (N = 17,102) for replication, and rs6448771 on 4p15 demonstrated genome-wide significant interaction with waist-to-hip-ratio (WHR) on total cholesterol (TC) with a combined P-value of 4.79×10(-9). There were two potential candidate genes in the region, PCDH7 and CCKAR, with differential expression levels for rs6448771 genotypes in adipose tissue. The effect of WHR on TC was strongest for individuals carrying two copies of G allele, for whom a one standard deviation (sd) difference in WHR corresponds to 0.19 sd difference in TC concentration, while for A allele homozygous the difference was 0.12 sd. Our findings may open up possibilities for targeted intervention strategies for people characterized by specific genomic profiles. However, more refined measures of both body-fat distribution and metabolic measures are needed to understand how their joint dynamics are modified by the newly found locus.


Assuntos
Caderinas/genética , Colesterol/genética , Cromossomos Humanos Par 4/genética , Lipídeos/sangue , Lipídeos/genética , Relação Cintura-Quadril , Tecido Adiposo/metabolismo , Distribuição da Gordura Corporal , Colesterol/sangue , Mapeamento Cromossômico , Estudo de Associação Genômica Ampla , Genótipo , Humanos , Lipoproteínas/sangue , Lipoproteínas/genética , Fenótipo , Polimorfismo de Nucleotídeo Único , Protocaderinas , Locos de Características Quantitativas/genética , Fatores de Risco , Triglicerídeos/sangue , Triglicerídeos/genética , População Branca/genética
16.
Nat Genet ; 43(10): 1005-11, 2011 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-21909110

RESUMO

Numerous genetic loci have been associated with systolic blood pressure (SBP) and diastolic blood pressure (DBP) in Europeans. We now report genome-wide association studies of pulse pressure (PP) and mean arterial pressure (MAP). In discovery (N = 74,064) and follow-up studies (N = 48,607), we identified at genome-wide significance (P = 2.7 × 10(-8) to P = 2.3 × 10(-13)) four new PP loci (at 4q12 near CHIC2, 7q22.3 near PIK3CG, 8q24.12 in NOV and 11q24.3 near ADAMTS8), two new MAP loci (3p21.31 in MAP4 and 10q25.3 near ADRB1) and one locus associated with both of these traits (2q24.3 near FIGN) that has also recently been associated with SBP in east Asians. For three of the new PP loci, the estimated effect for SBP was opposite of that for DBP, in contrast to the majority of common SBP- and DBP-associated variants, which show concordant effects on both traits. These findings suggest new genetic pathways underlying blood pressure variation, some of which may differentially influence SBP and DBP.


Assuntos
Pressão Sanguínea/genética , Estudo de Associação Genômica Ampla , Artérias/metabolismo , Estudos de Casos e Controles , Seguimentos , Loci Gênicos , Humanos , Hipertensão/genética , Desequilíbrio de Ligação , Polimorfismo de Nucleotídeo Único
17.
Nature ; 478(7367): 103-9, 2011 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-21909115

RESUMO

Blood pressure is a heritable trait influenced by several biological pathways and responsive to environmental stimuli. Over one billion people worldwide have hypertension (≥140 mm Hg systolic blood pressure or ≥90 mm Hg diastolic blood pressure). Even small increments in blood pressure are associated with an increased risk of cardiovascular events. This genome-wide association study of systolic and diastolic blood pressure, which used a multi-stage design in 200,000 individuals of European descent, identified sixteen novel loci: six of these loci contain genes previously known or suspected to regulate blood pressure (GUCY1A3-GUCY1B3, NPR3-C5orf23, ADM, FURIN-FES, GOSR2, GNAS-EDN3); the other ten provide new clues to blood pressure physiology. A genetic risk score based on 29 genome-wide significant variants was associated with hypertension, left ventricular wall thickness, stroke and coronary artery disease, but not kidney disease or kidney function. We also observed associations with blood pressure in East Asian, South Asian and African ancestry individuals. Our findings provide new insights into the genetics and biology of blood pressure, and suggest potential novel therapeutic pathways for cardiovascular disease prevention.


Assuntos
Pressão Sanguínea/genética , Doenças Cardiovasculares/genética , Predisposição Genética para Doença/genética , Polimorfismo de Nucleotídeo Único/genética , África/etnologia , Ásia/etnologia , Pressão Sanguínea/fisiologia , Doença da Artéria Coronariana/genética , Europa (Continente)/etnologia , Estudo de Associação Genômica Ampla , Humanos , Hipertensão/genética , Nefropatias/genética , Acidente Vascular Cerebral/genética
18.
Hum Mol Genet ; 20(24): 5000-11, 2011 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-21908519

RESUMO

The majority of human proteins are post-translationally modified by covalent addition of one or more complex oligosaccharides (glycans). Alterations in glycosylation processing are associated with numerous diseases and glycans are attracting increasing attention both as disease biomarkers and as targets for novel therapeutic approaches. Using a recently developed high-throughput high-performance liquid chromatography (HPLC) analysis method, we have reported, in a pilot genome-wide association study of 13 glycan features in 2705 individuals from three European populations, that polymorphisms at three loci (FUT8, FUT6/FUT3 and HNF1A) affect plasma levels of N-glycans. Here, we extended the analysis to 33 directly measured and 13 derived glycosylation traits in 3533 individuals and identified three novel gene association (MGAT5, B3GAT1 and SLC9A9) as well as replicated the previous findings using an additional European cohort. MGAT5 (meta-analysis association P-value = 1.80 × 10(-10) for rs1257220) encodes a glycosyltransferase which is known to synthesize the associated glycans. In contrast, neither B3GAT1 (rs7928758, P = 1.66 × 10(-08)) nor SLC9A9 (rs4839604, P = 3.50 × 10(-13)) had previously been associated functionally with glycosylation of plasma proteins. Given the glucuronyl transferase activity of B3GAT1, we were able to show that glucuronic acid is present on antennae of plasma glycoproteins underlying the corresponding HPLC peak. SLC9A9 encodes a proton pump which affects pH in the endosomal compartment and it was recently reported that changes in Golgi pH can impair protein sialylation, giving a possible mechanism for the observed association.


Assuntos
Estudos de Associação Genética , Glucuronosiltransferase/genética , N-Acetilglucosaminiltransferases/genética , Proteínas do Tecido Nervoso/genética , Polimorfismo de Nucleotídeo Único/genética , Polissacarídeos/sangue , Trocadores de Sódio-Hidrogênio/genética , População Branca/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Cromatografia Líquida de Alta Pressão , Marcadores Genéticos , Glicosilação , Humanos , Redes e Vias Metabólicas/genética , Pessoa de Meia-Idade , Polissacarídeos/química , Polissacarídeos/isolamento & purificação , Adulto Jovem
19.
PLoS One ; 6(5): e19382, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21625484

RESUMO

RATIONALE: Lung function measures are heritable traits that predict population morbidity and mortality and are essential for the diagnosis of chronic obstructive pulmonary disease (COPD). Variations in many genes have been reported to affect these traits, but attempts at replication have provided conflicting results. Recently, we undertook a meta-analysis of Genome Wide Association Study (GWAS) results for lung function measures in 20,288 individuals from the general population (the SpiroMeta consortium). OBJECTIVES: To comprehensively analyse previously reported genetic associations with lung function measures, and to investigate whether single nucleotide polymorphisms (SNPs) in these genomic regions are associated with lung function in a large population sample. METHODS: We analysed association for SNPs tagging 130 genes and 48 intergenic regions (+/-10 kb), after conducting a systematic review of the literature in the PubMed database for genetic association studies reporting lung function associations. RESULTS: The analysis included 16,936 genotyped and imputed SNPs. No loci showed overall significant association for FEV(1) or FEV(1)/FVC traits using a carefully defined significance threshold of 1.3×10(-5). The most significant loci associated with FEV(1) include SNPs tagging MACROD2 (P = 6.81×10(-5)), CNTN5 (P = 4.37×10(-4)), and TRPV4 (P = 1.58×10(-3)). Among ever-smokers, SERPINA1 showed the most significant association with FEV(1) (P = 8.41×10(-5)), followed by PDE4D (P = 1.22×10(-4)). The strongest association with FEV(1)/FVC ratio was observed with ABCC1 (P = 4.38×10(-4)), and ESR1 (P = 5.42×10(-4)) among ever-smokers. CONCLUSIONS: Polymorphisms spanning previously associated lung function genes did not show strong evidence for association with lung function measures in the SpiroMeta consortium population. Common SERPINA1 polymorphisms may affect FEV(1) among smokers in the general population.


Assuntos
Biomarcadores/metabolismo , Genoma Humano , Estudo de Associação Genômica Ampla , Pulmão/fisiopatologia , Metanálise como Assunto , Doença Pulmonar Obstrutiva Crônica/genética , Volume Expiratório Forçado , Predisposição Genética para Doença , Humanos , Polimorfismo de Nucleotídeo Único/genética , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Testes de Função Respiratória , Reino Unido/epidemiologia , Capacidade Vital
20.
Mol Biosyst ; 7(6): 1852-62, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21445428

RESUMO

Recently, high-throughput technologies have been made available which allow the measurement of a broad spectrum of glycomics and lipidomics parameters in many samples. The aim of this study was to apply these methods and investigate associations between 46 glycan and 183 lipid traits measured in blood of 2041 Europeans from three different local populations (Croatia - VIS cohort; Sweden - NSPHS cohort; Great Britain - ORCADES cohort). N-glycans have been analyzed with High Performance Liquid Chromatography (HPLC) and lipids with Electrospray Ionization Tandem Mass Spectrometry (ESI-MS/MS) covering sterol lipids, glycerolipids, glycerophospholipids and sphingolipids in eight subclasses. Overall, 8418 associations were calculated using linear mixed effect models adjusted for pedigree, sex, age and multiple testing. We found 330 significant correlations in VIS. Pearson's correlation coefficient r ranged from -0.27 to 0.34 with corresponding p-values between 1.45 × 10(-19) and 4.83 × 10(-6), indicating statistical significance. A total of 71 correlations in VIS could be replicated in NSPHS (r = [-0.19; 0.35], p = [4.16 × 10(-18); 9.38 × 10(-5)]) and 31 correlations in VIS were also found in ORCADES (r = [-0.20; 0.24], p = [2.69 × 10(-10); 7.55 × 10(-5)]). However, in total only 10 correlations between a subset of triantennary glycans and unsaturated phosphatidylcholine, saturated ceramide, and sphingomyelin lipids in VIS (r = [0.18; 0.34], p = [2.98 × 10(-21); 1.69 × 10(-06)]) could be replicated in both NSPHS and ORCADES. In summary, the results show strong and consistent associations between certain glycans and lipids in all populations, but also population-specific correlations which may be caused by environmental and genetic differences. These associations point towards potential interactive metabolic pathways.


Assuntos
Lipídeos/química , Polissacarídeos/sangue , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Cromatografia Líquida de Alta Pressão/métodos , Cromatografia por Troca Iônica , Europa (Continente) , Feminino , Glicômica , Humanos , Interações Hidrofóbicas e Hidrofílicas , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Polissacarídeos/química , Polissacarídeos/isolamento & purificação , Espectrometria de Massas por Ionização por Electrospray , Espectrometria de Massas em Tandem , Adulto Jovem
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