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1.
Artigo em Inglês | MEDLINE | ID: mdl-33619999

RESUMO

Background: Evidence has accumulated to support the involvement of gastrointestinal (GI) dysfunction, possibly via gut microbial dysbiosis and alterations in the enteric nervous system, in the pathophysiology of different neurodegenerative diseases. However, whether patients with GI dysfunction have altered risk of amyotrophic lateral sclerosis (ALS) remains unknown.Methods: Based on a historical nationwide cohort study-ESPRESSO-in Sweden, we compared the risk of ALS among individuals with a previous GI biopsy finding of normal mucosa or non-specific inflammation, as two conditions of GI dysfunction, to that of individuals without any GI biopsy. We identified all individuals with a GI biopsy result of either normal mucosa (n = 483,442) or non-specific inflammation (n = 566,663) during 1965-2016 in Sweden as the exposed groups. For each exposed individual, we randomly selected up to five controls from the general Swedish population after individual matching by age and sex. Both the exposed and unexposed individuals were followed from date of biopsy (exposed individuals) or date of selection (unexposed individuals) until ALS diagnosis, emigration out of Sweden, death, or 31 December 2016, whichever came first. Stratified Cox regression models were used to estimate hazard ratios (HRs) and their 95% confidence intervals (CIs).Results: Compared to individuals without GI biopsy, individuals with a GI biopsy result of normal mucosa had an increased risk of ALS (HR = 1.22; 95%CI: 1.04-1.42) after excluding the first 2 years of follow-up to alleviate concern of surveillance bias. This increased risk was noted among male (HR = 1.20; 95%CI: 0.94-1.51) and female (HR = 1.23; 95%CI: 1.01-1.50), as well as among younger (<60 years; HR = 1.17; 95%CI: 0.94-1.44) and older (≥60 years; HR = 1.24; 95%CI: 0.99-1.56) individuals. In contrast, no association was observed for a GI biopsy result of non-specific inflammation (HR = 1.00; 95%CI: 0.88-1.15). Neither of the GI biopsy results was related to the mortality risk after ALS diagnosis.Conclusions: Individuals with a GI biopsy result of normal mucosa-representing potentially a distinct type of GI dysfunction-had a higher future risk of ALS. No association was however noted for a GI biopsy result of non-specific inflammation. Further studies are needed to validate this finding and to understand the underlying reasons for the contrasting result pattern.

2.
Aging (Albany NY) ; 122020 Nov 26.
Artigo em Inglês | MEDLINE | ID: mdl-33260148

RESUMO

With age-related functional deterioration, sensory impairment including vision impairment (VI), hearing impairment (HI), and dual sensory impairment (DSI) usually occurred among the elderly population, causing a decrease in functional capacity and quality of life. The study aimed to explore how sensory impairment is associated with the risk of all-cause mortality among the elderly adults in China. We prospectively investigated the association among 37,076 participants enrolled from 1998 to 2019 in the Chinese Longitudinal Healthy Longevity Survey. We also, as a sensitivity analysis, explored the association among 11,365 newly incident sensory impairment participants. Cox regression model with sensory impairment as a time-varying exposure was performed to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs). Compared with participants without sensory impairment, those with VI (HR=1.20, 95% CI: 1.15-1.24), HI (HR=1.26, 95% CI: 1.21-1.31), and DSI (HR: 1.46, 95% CI=1.41-1.52) had significant higher risk of all-cause mortality after adjusting for potential confounders. These associations were robust among subgroup analyses stratified by sex and entry age, and sensitivity analyses performed among newly incident sensory impairment participants. In conclusion, sensory impairment was associated with higher mortality risk among the elderly adults in China.

3.
BMC Geriatr ; 20(1): 541, 2020 12 30.
Artigo em Inglês | MEDLINE | ID: mdl-33380318

RESUMO

BACKGROUND: Although a U-shaped association between sleep duration and all-cause mortality has been found in general population, its association in the elderly adults, especially in the oldest-old, is rarely explored. METHODS: In present cohort study, we prospectively explore the association between sleep duration and all-cause mortality among 15,092 participants enrolled in the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2005 to 2019. Sleep duration and death information was collected by using structured questionnaires. Cox regression model with sleep duration as a time-varying exposure was performed to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs). The dose-response association between them was explored via a restricted cubic spline function. RESULTS: During an average follow-up of 4.51 (standard deviation, SD: 3.62) years, 10,768 participants died during the follow-up period. The mean (SD) age of the participants was 89.26 (11.56) years old. Compared to individuals with moderate sleep duration (7-8 hours), individuals with long sleep duration (> 8 hours) had a significantly higher risk of all-cause mortality (HR: 1.13, 95%CI: 1.09-1.18), but not among individuals with short sleep duration (≤ 6 hours) (HR: 1.02, 95%CI: 0.96-1.09). Similar results were observed in subgroup analyses based on age and gender. In the dose-response analysis, a J-shaped association was observed. CONCLUSIONS: Sleep duration was associated with all-cause mortality in a J-shaped pattern in the elderly population in China.


Assuntos
Atividades Cotidianas , Sono , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Estudos de Coortes , Feminino , Humanos , Masculino , Mortalidade , Fatores de Risco
4.
Sci Rep ; 10(1): 13371, 2020 08 07.
Artigo em Inglês | MEDLINE | ID: mdl-32770128

RESUMO

The use of proton pump inhibitors (PPIs) has been proposed as a potential risk factor for neurodegenerative diseases, but little is known regarding its role in amyotrophic lateral sclerosis (ALS). We therefore aimed to assess the association of PPI use with the subsequent risk of ALS, and performed a register-based nationwide nested case-control study, including 2,484 ALS cases diagnosed during July 2006-December 2013 in Sweden and 10 population controls per case that were individually matched to the case by sex, age, and area of residence. Dispenses and cumulative defined daily doses (cDDDs) of PPIs were extracted from the Swedish Prescribed Drug Register. The association of PPI use with the risk of ALS was assessed using conditional logistic regression, after applying different lag windows to avoid reverse causation. ALS patients were more likely to be dispensed with PPIs before diagnosis than controls. However, previous PPI use was not associated with an increased risk of ALS (OR = 1.08, 95% CI 0.97-1.19), and there was no dose-response relationship between cDDDs of PPIs and ALS risk (p = 0.0874), after excluding dispenses during the year before ALS diagnosis. The results were similar after excluding dispenses during the 2 or 3 years before ALS diagnosis.

5.
Nutr Cancer ; 70(4): 671-677, 2018 04 18.
Artigo em Inglês | MEDLINE | ID: mdl-29668313

RESUMO

To investigate the potential influence of dietary glycemic index, glycemic load, or carbohydrate intake and lung cancer risk in Shanghai. We prospectively investigated the associations among 130,858 participants in the Shanghai Women's and Men's Health Studies. Diet was assessed using validated food-frequency questionnaires. Lung cancer cases were ascertained through annual record linkage and every 2-3 years in-home visits. Cox proportional hazard regression model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). After excluding the first 2 years of observation, 1312 participants (including 649 women and 663 men) developed lung cancer during an average follow-up of 14.8 (SD: 2.0) years for SWHS and 9.3 (SD: 1.6) years for SMHS. In multivariable analysis, no statistically significant associations were observed between glycemic index, glycemic load, and carbohydrate intake and lung cancer risk for either men or women. Similar results were observed among never smokers, and participants without history of lung disease, diabetes, or hypertension. Stratification by body mass index or menopause status also did not alter the findings. Our studies, conducted in populations who habitually have high-carbohydrate diets, provide no evidence that dietary glycemic index, glycemic load, or carbohydrate intake is associated with lung cancer risk.


Assuntos
Carboidratos da Dieta/administração & dosagem , Índice Glicêmico , Carga Glicêmica , Neoplasias Pulmonares/etiologia , Adulto , China , Dieta , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Estudos Prospectivos , Fatores de Risco
6.
Eur J Cancer Prev ; 27(2): 144-151, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-26258808

RESUMO

Epidemiological studies have yielded inconsistent findings on the relationship between breastfeeding and the risk of endometrial cancer. Pertinent studies were identified by searching PubMed, Embase, and Web of Knowledge through February 2015 and by reviewing the reference lists of retrieved articles. Study-specific estimates were pooled using a random-effects model. Dose-response analysis was carried out for every 6-month increase in the duration of breastfeeding in relation to the risk of endometrial cancer. Three prospective and 11 case-control studies were included in this meta-analysis. The pooled estimates for ever compared with never breastfeeding and the longest duration of breastfeeding compared with the shortest were 0.91 [95% confidence interval (CI): 0.75-1.09] and 0.76 (95% CI: 0.59-0.98). The risk of endometrial cancer decreased by 7% for every 6-month increase in the duration of breastfeeding (relative risk: 0.93; 95% CI: 0.88-0.97). This study provides evidence that ever breastfeeding, particularly a longer duration of breastfeeding, is associated with a lower risk of endometrial cancer.


Assuntos
Aleitamento Materno , Neoplasias do Endométrio/epidemiologia , Neoplasias do Endométrio/prevenção & controle , Feminino , Humanos , Incidência , Razão de Chances , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo
7.
J Epidemiol ; 27(3): 89-97, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28142039

RESUMO

BACKGROUND: Few studies have evaluated dietary antioxidant vitamins intake in relation to risk of mortality in Asia. METHODS: We examined the associations between total carotene, vitamin C, and vitamin E from diet and risk of mortality from all causes, cancer, and cardiovascular disease in 134,358 participants (59,739 men and 74,619 women) from the Shanghai Men's Health Study and Shanghai Women's Health Study, two prospective cohort studies of middle-aged and elderly Chinese adults in urban Shanghai. Participants were followed up for a median period of 8.3 and 14.2 years for men and women, respectively. Hazard ratios (HRs) and 95% confidence interval (CIs) were estimated using Cox proportional hazards regression models. RESULTS: During the 495,332 and 1,029,198 person-years of follow-up for men and women, respectively, there were 10,079 deaths (4170 men and 5909 women). For men, compared with the lowest quintiles, the multivariable-adjusted risk reductions in the highest categories were 17% (HR 0.83; 95% CI, 0.76-0.92) for dietary total carotene and 17% (HR 0.83; 95% CI, 0.75-0.91) for dietary vitamin C. Associations were weaker in women than in men, though they were still statistically significant (highest versus lowest quintiles of dietary total carotene, HR 0.87; 95% CI, 0.80-0.95; dietary vitamin C: HR 0.83; 95% CI, 0.77-0.91). Significant inverse associations were observed between dietary total carotene, vitamin C, and risk of cardiovascular disease mortality but not cancer mortality. CONCLUSION: This study suggests that total carotene and vitamin C intake from diet were inversely associated with deaths from all causes and cardiovascular disease in middle-aged or elderly people in China.


Assuntos
Antioxidantes/administração & dosagem , Ácido Ascórbico/administração & dosagem , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Doenças Cardiovasculares/mortalidade , Carotenoides/administração & dosagem , Dieta , Suplementos Nutricionais , Neoplasias/mortalidade , Vitamina E/administração & dosagem , Vitaminas/administração & dosagem , Adulto , Idoso , Doenças Cardiovasculares/etnologia , Causas de Morte , China/epidemiologia , Estudos de Coortes , Relação Dose-Resposta a Droga , Feminino , Humanos , Masculino , Neoplasias/etnologia , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Fatores Socioeconômicos , Inquéritos e Questionários
8.
J Epidemiol ; 27(1): 36-41, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28135196

RESUMO

BACKGROUND: Green tea is one of the most widely consumed beverages in Asia. While a possible protective role of green tea against various chronic diseases has been suggested in experimental studies, evidence from human studies remains controversial. METHODS: We conducted this study using data from Shanghai Men's Health Study (SMHS) and Shanghai Women's Health Study (SWHS), two population-based prospective cohorts of middle-aged and elderly Chinese adults in urban Shanghai, China. Hazard ratios (HR) and 95% confidence intervals (CI) for risk of all-cause and cause-specific mortality associated with green tea intake were estimated using Cox proportional hazards regression models. RESULTS: During a median follow-up of 8.3 and 14.2 years for men and women, respectively, 6517 (2741 men and 3776 women) deaths were documented. We found that green tea consumption was inversely associated with risk of all-cause mortality (HR 0.95; 95% CI, 0.90-1.01), particularly among never-smokers (HR 0.89; 95% CI, 0.82-0.96). The inverse association with cardiovascular disease (CVD) mortality (HR 0.86; 95% CI, 0.77-0.97) was slightly stronger than that with all-cause mortality. No significant association was observed between green tea intake and cancer mortality (HR 1.01; 95% CI, 0.93-1.10). CONCLUSIONS: Green tea consumption may be inversely associated with risk of all-cause and CVD mortality in middle-aged and elderly Chinese adults, especially among never smokers.


Assuntos
Causas de Morte , Chá , Adulto , Idoso , Doenças Cardiovasculares/mortalidade , China/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Fumar/epidemiologia , População Urbana/estatística & dados numéricos
9.
Public Health Nutr ; 19(16): 2991-2998, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-27197889

RESUMO

OBJECTIVE: To investigate the potential influence of dietary Se intake on mortality among Chinese populations. DESIGN: We prospectively evaluated all-cause, CVD and cancer mortality risks associated with dietary Se intake in participants of the Shanghai Women's Health Study (SWHS) and the Shanghai Men's Health study (SMHS). Dietary Se intake was assessed by validated FFQ during in-person interviews. Cox proportional hazards models were used to calculate hazard ratios (HR) and 95 % CI. SETTING: Urban city in China. SUBJECTS: Chinese adults (n 133 957). RESULTS: During an average follow-up of 13·90 years in the SWHS and 8·37 years in the SMHS, 5749 women and 4217 men died. The mean estimated dietary Se intake was 45·48 µg/d for women and 51·34 µg/d for men, respectively. Dietary Se intake was inversely associated with all-cause mortality and CVD mortality in both women and men, with respective HR for the highest compared with the lowest quintile being 0·79 (95 % CI 0·71, 0·88; P trend<0·0001) and 0·80 (95 % CI 0·66, 0·98; P trend=0·0268) for women, and 0·79 (95 % CI 0·70, 0·89; P trend=0·0001) and 0·66 (95 % CI 0·54, 0·82; P trend=0·0002) for men. No significant associations were observed for cancer mortality in both women and men. Results were similar in subgroup and sensitivity analyses. CONCLUSIONS: Dietary Se intake was inversely associated with all-cause and cardiovascular mortality in both sexes, but not cancer mortality.


Assuntos
Dieta , Mortalidade , Selênio/administração & dosagem , Adulto , Doenças Cardiovasculares/mortalidade , China , Feminino , Seguimentos , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Neoplasias/mortalidade , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco
10.
Am J Epidemiol ; 182(11): 908-16, 2015 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-26568572

RESUMO

Findings on the association between television (TV) viewing and all-cause mortality in epidemiologic studies have been inconsistent. Therefore, we conducted a meta-analysis of data from prospective cohort studies to quantify this association. Relevant articles were identified by searching MEDLINE (PubMed; National Library of Medicine, Bethesda, Maryland) and EMBASE (Elsevier B.V., Amsterdam, the Netherlands) from inception to March 1, 2015, and reviewing the reference lists of retrieved articles. Study-specific results were pooled using a random-effects model. Of 2,578 citations identified by the search strategy, 10 cohort studies (61,494 deaths among 647,475 individuals) met the inclusion criteria. The summary relative risk of all-cause mortality for the highest category of TV viewing time versus the lowest was 1.33 (95% confidence interval: 1.20, 1.47), with heterogeneity among studies (I(2) = 66.7%, P(heterogeneity) = 0.001). In dose-response meta-analysis, TV viewing time was statistically significantly associated with all-cause mortality risk in a J-shaped fashion (P(nonlinearity) = 0.001). These results indicate that prolonged TV viewing time might increase the risk of all-cause mortality. Given the high prevalence of excessive TV viewing, public health recommendations or interventions aimed at decreasing the amount of TV viewing time in modern societies are warranted.


Assuntos
Mortalidade , Televisão , Estudos de Coortes , Humanos , Risco , Televisão/estatística & dados numéricos , Fatores de Tempo
11.
Chin J Cancer Res ; 27(5): 497-508, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26543337

RESUMO

BACKGROUND: The temporal relationship between hepatitis B virus (HBV) mutations and hepatocellular carcinoma (HCC) remains unclear. METHODS: We conducted a meta-analysis including cohort and nested case-control studies to prospectively examine the HCC risk associated with common variants of HBV in the PreS, Enhancer II, basal core promoter (BCP) and precore regions. Pertinent studies were identified by searching PubMed, Web of Science and the Chinese Biological Medicine databases through to November 2014. Study-specific risk estimates were combined using fixed or random effects models depending on whether significant heterogeneity was detected. RESULTS: Twenty prospective studies were identified, which included 8 cohort and 12 nested case-control studies. There was an increased risk of HCC associated with any PreS mutations with a pooled relative risk (RR) of 3.82 [95% confidence interval (CI): 2.59-5.61]. The pooled-RR for PreS deletion was 3.98 (95% CI: 2.28-6.95), which was higher than that of PreS2 start codon mutation (pooled-RR=2.63, 95% CI: 1.30-5.34). C1653T in Enhancer II was significantly associated with HCC risk (pooled-RR=1.83; 95% CI: 1.21-2.76). For mutations in BCP, statistically significant pooled-RRs of HCC were obtained for T1753V (pooled-RR=2.09; 95% CI: 1.49-2.94) and A1762T/G1764A double mutations (pooled-RR=3.11; 95% CI: 2.08-4.64). No statistically significant association with HCC risk was observed for G1896A in the precore region (pooled-RR=0.77; 95% CI: 0.47-1.26). CONCLUSIONS: This study demonstrated that PreS mutations, C1653T, T1753V, and A1762T/G1764A, were associated with an increased risk of HCC. Clinical practices concerning the HCC risk prediction and diagnosis may wish to focus on patients with these mutations.

12.
PLoS One ; 10(3): e0119313, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25803438

RESUMO

BACKGROUND: Epidemiological studies have reported inconsistent association between obesity and risk of bladder cancer, and the dose-response relationship between them has not been clearly defined. METHODS: We carried out a meta-analysis to summarize available evidence from epidemiological studies on this point. Relevant articles were identified by searching the PubMed and Web of Science databases through September 30, 2014. We pooled the relative risks from individual studies using random-effect model, and the dose-response relationship was estimated by using restricted cubic spline model. RESULTS: Fifteen cohort studies with 38,072 bladder cancer cases among 14,201,500 participants were included. Compared to normal weight, the pooled relative risks and corresponding 95% confidence intervals of bladder cancer were 1.07(1.01-1.14) and 1.10(1.06-1.14) for preobese and obesity, with moderate (I² = 37.6%, P = 0.029) and low (I² = 15.5%, P = 0.241) heterogeneities between studies, respectively. In a dose-response meta-analysis, body mass index (BMI) was associated with bladder cancer risk in a linear fashion (P(non-linearity) = 0.467) and the risk increased by 4.2% for each 5 kg/m2 increase. No significant publication bias was found (P = 0.912 for Begg's test, P = 0.712 for Egger's test). CONCLUSIONS: Findings from this dose-response meta-analysis suggest obesity is associated with linear-increased risk of bladder cancer.


Assuntos
Obesidade/epidemiologia , Neoplasias da Bexiga Urinária/epidemiologia , Adulto , Índice de Massa Corporal , Estudos de Coortes , Feminino , Humanos , Masculino , Fatores de Risco
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